Science.gov

Sample records for advance planning documents

  1. 75 FR 66319 - State Systems Advance Planning Document (APD) Process

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-28

    ... HUMAN SERVICES 45 CFR Part 95 RIN 0970-AC33 State Systems Advance Planning Document (APD) Process AGENCY... Health and Human Services (HHS). ACTION: Final rule. SUMMARY: The Advance Planning Document (APD) process... support programs for children and families. The Advance Planning Document (APD) process governs...

  2. 45 CFR 1355.54 - Submittal of advance planning documents.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... accordance with procedures specified by 45 CFR part 95, subpart F. ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Submittal of advance planning documents. 1355.54... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES...

  3. 45 CFR 1355.54 - Submittal of advance planning documents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... procedures specified by 45 CFR part 95, subpart F. ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Submittal of advance planning documents. 1355.54... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES...

  4. 45 CFR 1355.54 - Submittal of advance planning documents.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... procedures specified by 45 CFR part 95, subpart F. ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Submittal of advance planning documents. 1355.54... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES...

  5. 45 CFR 1355.54 - Submittal of advance planning documents.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... accordance with procedures specified by 45 CFR part 95, subpart F. ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Submittal of advance planning documents. 1355.54... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES...

  6. 45 CFR 1355.54 - Submittal of advance planning documents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... procedures specified by 45 CFR part 95, subpart F. ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Submittal of advance planning documents. 1355.54... FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES...

  7. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document...

  8. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document...

  9. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document...

  10. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document...

  11. 42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document...

  12. Documentation of Advance Care Planning for Community-Dwelling Elders

    PubMed Central

    Yung, Victoria Y.; Walling, Anne M.; Min, Lillian; Wenger, Neil S.

    2010-01-01

    Abstract Background Advance planning for end-of-life care has gained acceptance, but actual end-of-life care is often incongruent with patients' previously stated goals. We assessed the flow of advance care planning information from patients to medical records in a community sample of older adults to better understand why advance care planning is not more successful. Methods Our study used structured interview and medical record data from community-dwelling older patients in two previous studies: Assessing Care of Vulnerable Elders (ACOVE)-1 (245 patients age ≥65 years and screened for high risk of death/functional decline in 1998–1999) and ACOVE-2 (566 patients age ≥75 who screened positive for falls/mobility disorders, incontinence, and/or dementia in 2002–2003). We compared interview data on patients' preferences, advance directives, and surrogate decision-makers with findings from the medical record. Results In ACOVE-1, 38% of surveyed patients had thought about limiting the aggressiveness of medical care; 24% of surveyed patients stated that they had spoken to their doctor about this. The vast majority of patients (88%–93%) preferred to die rather than remain permanently in a coma, on a ventilator, or tube fed. Regardless of patients' specific preferences, 15%–22% of patients had preference information in their medical record. Among patients who reported that they had completed an advance directive and had given it to their health-care provider, 15% (ACOVE-1) and 47% (ACOVE-2) had advance directive information in the medical record. Among patients who had not completed an advance directive but had given surrogate decision-maker information to their provider, 0% (ACOVE-1) and 16% (ACOVE-2) had documentation of a surrogate decision-maker in the medical record. Conclusions Community-dwelling elders' preferences for end-of-life care are not consistent with documentation in their medical records. Electronic health records and standardized data

  13. 45 CFR 95.610 - Submission of advance planning documents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... contained at §§ 1355.54 through 1355.57, § 307.15 and 42 CFR subchapter C, part 433. (c) Advance Planning... considerations including, where appropriate, the use of service-orientated architecture and a transfer of...

  14. 45 CFR 307.20 - Submittal of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... prescribed in 45 CFR part 95, subpart F. ... 45 Public Welfare 2 2011-10-01 2011-10-01 false Submittal of advance planning documents for... § 307.20 Submittal of advance planning documents for computerized support enforcement systems. The...

  15. 45 CFR 307.20 - Submittal of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... prescribed in 45 CFR part 95, subpart F. ... 45 Public Welfare 2 2014-10-01 2012-10-01 true Submittal of advance planning documents for... § 307.20 Submittal of advance planning documents for computerized support enforcement systems. The...

  16. 45 CFR 307.20 - Submittal of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... prescribed in 45 CFR part 95, subpart F. ... 45 Public Welfare 2 2012-10-01 2012-10-01 false Submittal of advance planning documents for... § 307.20 Submittal of advance planning documents for computerized support enforcement systems. The...

  17. 45 CFR 307.20 - Submittal of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... prescribed in 45 CFR part 95, subpart F. ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Submittal of advance planning documents for... § 307.20 Submittal of advance planning documents for computerized support enforcement systems. The...

  18. 45 CFR 307.20 - Submittal of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... prescribed in 45 CFR part 95, subpart F. ... 45 Public Welfare 2 2013-10-01 2012-10-01 true Submittal of advance planning documents for... § 307.20 Submittal of advance planning documents for computerized support enforcement systems. The...

  19. 45 CFR 95.610 - Submission of advance planning documents.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... generally applies to large statewide system developments and/or major hardware acquisitions. States with large, independent counties requesting funding at the regular match rate for county systems are strongly... administration and operations; (ii) A project management plan that addresses the planning project...

  20. 45 CFR 307.40 - Suspension of approval of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 2 2011-10-01 2011-10-01 false Suspension of approval of advance planning documents for computerized support enforcement systems. 307.40 Section 307.40 Public Welfare Regulations... ENFORCEMENT SYSTEMS § 307.40 Suspension of approval of advance planning documents for computerized...

  1. 45 CFR 307.40 - Suspension of approval of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Suspension of approval of advance planning documents for computerized support enforcement systems. 307.40 Section 307.40 Public Welfare Regulations Relating to Public Welfare OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD SUPPORT ENFORCEMENT...

  2. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning...

  3. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning...

  4. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning...

  5. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning...

  6. 42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning...

  7. Impact of a Care Directives Activity Tab in the Electronic Health Record on Documentation of Advance Care Planning

    PubMed Central

    Turley, Marianne; Wang, Susan; Meng, Di; Kanter, Michael; Garrido, Terhilda

    2016-01-01

    Context: To ensure patient-centered end-of-life care, advance care planning (ACP) must be documented in the medical record and readily retrieved across care settings. Objective: To describe use of the Care Directives Activity tab (CDA), a single-location feature in the electronic health record for collecting and viewing ACP documentation in inpatient and ambulatory care settings, and to assess its association with ACP documentation rates. Design: Retrospective pre- and postimplementation analysis in 2012 and 2013 at Kaiser Permanente Southern California among 113,309 patients aged 65 years and older with ACP opportunities during outpatient or inpatient encounters. Main Outcome Measures: Providers’ CDA use rates and documentation rates of advance directives and physician orders for life-sustaining treatments stratified by CDA use. Results: Documentation rates of advance directives and physician orders for life-sustaining treatments among patients with outpatient and inpatient encounters were 3.5 to 9.6 percentage points higher for patients with CDA use vs those without it. The greatest differences were for orders for life-sustaining treatments among patients with inpatient encounters and for advance directives among patients with outpatient encounters; both were 9.6 percentage points higher among those with CDA use than those without it. All differences were significant after controlling for yearly variation (p < 0.001). Conclusion: Statistically significant differences in documentation rates between patients with and without CDA use suggest the potential of a standardized location in the electronic health record to improve ACP documentation. Further research is required to understand effects of CDA use on retrieval of preferences and end-of-life care. PMID:27057820

  8. Advance care planning knowledge and documentation in a hospitalized cancer population

    PubMed Central

    Barakat, Ayman; Barnes, Sunni A.; Casanova, Mark A.; Stone, Marvin J.; Shuey, Kathleen M.

    2013-01-01

    To have a better understanding of our patients’ knowledge of advance directive planning and execution, as well as communication with their oncologists regarding their wishes, we conducted a survey on our inpatient hematology-oncology services. A total of 68 unique hospitalized patients with a diagnosis of cancer completed surveys. Surveys were given to all oncology patients regardless of their reason for admission. Overall, 29% of the patients reported having had a discussion with their oncologist regarding their wishes if they became seriously ill or near death. Of those who did have this conversation, the majority said that they, rather than their physician, initiated it. Although the vast majority of patients (97%) knew what a living will was, only 54% had one in place. Twenty patients had a discussion with their oncologist, and 14 of them (70%) had a living will. This percentage was higher than in the group that did not have a conversation with their physician (48%; 23 of 48 patients), but the difference was not statistically significant. Most cancer patients admitted to an inpatient oncology unit either did not have or did not recall having a discussion with their oncologist regarding end-of-life issues. This study gives us a baseline of information in evaluating future interventions directed to improve the quality of patient-physician communication regarding end-of-life planning. PMID:24082411

  9. 45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... capacity planning services. (F) Develop performance metrics which allow tracking project completion against... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT...

  10. 45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... capacity planning services. (F) Develop performance metrics which allow tracking project completion against... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT...

  11. Planning a Multimedia Documentation Project.

    ERIC Educational Resources Information Center

    Rockley, Ann

    1994-01-01

    Outlines the process of planning and developing a multimedia documentation project. Discusses audience, task, and information analysis; selection of the most appropriate media; effective design; establishment of the development team; hardware and software requirements; costs; and project planning. (SR)

  12. Strategic Planning Document.

    ERIC Educational Resources Information Center

    Illinois State Univ., Normal. Coll. of Education.

    An outline is presented of long-term planning for the improvement of the College of Education at Illinois State University. Focus will be on instruction, research, and service. While a large percentage of effort will be allocated to instruction, a significant portion of personnel resources will be devoted to applied research and direct service to…

  13. Advance Care Planning

    MedlinePlus

    ... Division of Geriatrics and Clinical Gerontology Division of Neuroscience FAQs Funding Opportunities Intramural Research Program Office of ... Is Advance Care Planning? Advance care planning involves learning about the types of decisions that might need ...

  14. 36 CFR 219.30 - Plan documentation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Plan documentation. 219.30... National Forest System Land and Resource Management Planning Planning Documentation § 219.30 Plan documentation. A plan is a repository of documents that integrates and displays the desired...

  15. 36 CFR 219.30 - Plan documentation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Plan documentation. 219.30... National Forest System Land and Resource Management Planning Planning Documentation § 219.30 Plan documentation. A plan is a repository of documents that integrates and displays the desired...

  16. Advance Care Planning.

    PubMed

    Stallworthy, Elizabeth J

    2013-04-16

    Advance care planning should be available to all patients with chronic kidney disease, including end-stage kidney disease on renal replacement therapy. Advance care planning is a process of patient-centred discussion, ideally involving family/significant others, to assist the patient to understand how their illness might affect them, identify their goals and establish how medical treatment might help them to achieve these. An Advance Care Plan is only one useful outcome from the Advance Care Planning process, the education of patient and family around prognosis and treatment options is likely to be beneficial whether or not a plan is written or the individual loses decision making capacity at the end of life. Facilitating Advance Care Planning discussions requires an understanding of their purpose and communication skills which need to be taught. Advance Care Planning needs to be supported by effective systems to enable the discussions and any resulting Plans to be used to aid subsequent decision making. PMID:23586906

  17. Advanced optical document security elements

    NASA Astrophysics Data System (ADS)

    Škereš, Marek; Svoboda, Jakub; Possolt, Martin; Květoš, Milan; Fiala, Pavel

    2012-01-01

    ABSTRACT Synthetic diffractive structures represent an important tool in the optical document security. Their macroscopic visual behavior is based on properties of a very fine micro-structure which cannot be copied using common copying techniques. The visual effects can be easily observed by a common observer without any special inspection tools. However, when a high level of security is needed, additional features are often included based on an optical encryption of information. In this paper, a novel encryption technique is presented, which is based on utilizing the plastic holographic foil as a waveguide and special diffractive structures as coupling elements. When an in-coupling area is illuminated with a defined light beam, the light is coupled into the waveguide and travels to an out-coupling part. The encrypted information is encoded either in the shape of the out-coupling area or it can be formed from an out-coupling hologram in free space above the element. Both laser and normal white light sources can be used for reading the information. The coupling areas can be mixed with diffractive micro-structures forming visual effects and can be invisible during a normal observation of the hologram. The couplers can be realized using the technology fully compatible with the standard process for mastering and replication of the security elements. Several extensions of the described idea of waveguide cryptograms are also included. Finally, a set of real samples of the security elements is presented, which were realized using an advanced matrix laser lithography technique.

  18. Advance Planning by Same-Sex Couples

    ERIC Educational Resources Information Center

    Riggle, Ellen D. B.; Rostosky, Sharon S.; Prather, Robert A.

    2006-01-01

    The lack of legal recognition of same-sex couples can leave partners vulnerable in a crisis or emergency. Advance planning is one strategy couples can use to establish legal rights. Analyses of data collected from both partners in 131 same-sex couples suggested that executing advance-planning documents (wills, powers of attorney for finance and…

  19. Melter Disposal Strategic Planning Document

    SciTech Connect

    BURBANK, D.A.

    2000-09-25

    This document describes the proposed strategy for disposal of spent and failed melters from the tank waste treatment plant to be built by the Office of River Protection at the Hanford site in Washington. It describes program management activities, disposal and transportation systems, leachate management, permitting, and safety authorization basis approvals needed to execute the strategy.

  20. Advancement Planning: An Objectives View.

    ERIC Educational Resources Information Center

    Druck, Kalman B.

    1986-01-01

    Planning must revolve around objectives related to students, faculty, money, and political support. When it is understood that all of the institution's advancement activity should help produce these four things, planning is easy. (MLW)

  1. Advanced Fuels Campaign Execution Plan

    SciTech Connect

    Kemal Pasamehmetoglu

    2010-10-01

    The purpose of the Advanced Fuels Campaign (AFC) Execution Plan is to communicate the structure and management of research, development, and demonstration (RD&D) activities within the Fuel Cycle Research and Development (FCRD) program. Included in this document is an overview of the FCRD program, a description of the difference between revolutionary and evolutionary approaches to nuclear fuel development, the meaning of science-based development of nuclear fuels, and the “Grand Challenge” for the AFC that would, if achieved, provide a transformational technology to the nuclear industry in the form of a high performance, high reliability nuclear fuel system. The activities that will be conducted by the AFC to achieve success towards this grand challenge are described and the goals and milestones over the next 20 to 40 year period of research and development are established.

  2. Advanced Fuels Campaign Execution Plan

    SciTech Connect

    Kemal Pasamehmetoglu

    2011-09-01

    The purpose of the Advanced Fuels Campaign (AFC) Execution Plan is to communicate the structure and management of research, development, and demonstration (RD&D) activities within the Fuel Cycle Research and Development (FCRD) program. Included in this document is an overview of the FCRD program, a description of the difference between revolutionary and evolutionary approaches to nuclear fuel development, the meaning of science-based development of nuclear fuels, and the 'Grand Challenge' for the AFC that would, if achieved, provide a transformational technology to the nuclear industry in the form of a high performance, high reliability nuclear fuel system. The activities that will be conducted by the AFC to achieve success towards this grand challenge are described and the goals and milestones over the next 20 to 40 year period of research and development are established.

  3. Advanced Production Planning Models

    SciTech Connect

    JONES,DEAN A.; LAWTON,CRAIG R.; KJELDGAARD,EDWIN A.; WRIGHT,STEPHEN TROY; TURNQUIST,MARK A.; NOZICK,LINDA K.; LIST,GEORGE F.

    2000-12-01

    >This report describes the innovative modeling approach developed as a result of a 3-year Laboratory Directed Research and Development project. The overall goal of this project was to provide an effective suite of solvers for advanced production planning at facilities in the nuclear weapons complex (NWC). We focused our development activities on problems related to operations at the DOE's Pantex Plant. These types of scheduling problems appear in many contexts other than Pantex--both within the NWC (e.g., Neutron Generators) and in other commercial manufacturing settings. We successfully developed an innovative and effective solution strategy for these types of problems. We have tested this approach on actual data from Pantex, and from Org. 14000 (Neutron Generator production). This report focuses on the mathematical representation of the modeling approach and presents three representative studies using Pantex data. Results associated with the Neutron Generator facility will be published in a subsequent SAND report. The approach to task-based scheduling described here represents a significant addition to the literature for large-scale, realistic scheduling problems in a variety of production settings.

  4. 32 CFR 813.6 - Planning and requesting combat documentation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Planning and requesting combat documentation... SALES AND SERVICES VISUAL INFORMATION DOCUMENTATION PROGRAM § 813.6 Planning and requesting combat documentation. (a) Planned combat documentation. Air components identify documentation needs as early...

  5. 32 CFR 813.6 - Planning and requesting combat documentation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Planning and requesting combat documentation... SALES AND SERVICES VISUAL INFORMATION DOCUMENTATION PROGRAM § 813.6 Planning and requesting combat documentation. (a) Planned combat documentation. Air components identify documentation needs as early...

  6. Advanced Materials Laboratory hazards assessment document

    SciTech Connect

    Barnett, B.; Banda, Z.

    1995-10-01

    The Department of Energy Order 55OO.3A requires facility-specific hazards assessments be prepared, maintained, and used for emergency planning purposes. This hazards assessment document describes the chemical and radiological hazards associated with the AML. The entire inventory was screened according to the potential airborne impact to onsite and offsite individuals. The air dispersion model, ALOHA, estimated pollutant concentrations downwind from the source of a release, taking into consideration the toxicological and physical characteristics of the release site, the atmospheric conditions, and the circumstances of the release. The greatest distance at which a postulated facility event will produce consequences exceeding the Early Severe Health Effects threshold is 23 meters. The highest emergency classification is a General Emergency. The Emergency Planning Zone is a nominal area that conforms to DOE boundaries and physical/jurisdictional boundaries such as fence lines and streets.

  7. Advance Care Planning

    Cancer.gov

    The thirteenth module of the EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study: Cultural Considerations When Caring for African Americans explores the attitudes and practices of African Americans related to completion of advance directives, and recommends effective strategies to improve decision-making in the setting of serious, life-threatening illness, in ways that augment patient autonomy and support patient-centered goal-setting and decision-making among African American patients and their families.

  8. Advance care planning for people with dementia.

    PubMed

    2016-05-27

    Advance care planning (ACP) provides a framework for discussing and documenting care preferences in preparation for situations in which a person loses the cognitive capacity to make decisions. It can be particularly valuable in assisting people in the early stages of living with a dementia, supported by their families, to document their preferences for care at the later stages of their illness. While the potential benefits of ACP are widely acknowledged, there remain gaps in the research evidence on ACP and challenges in implementing ACP in practice. The three recently-published studies described below address these issues. PMID:27231079

  9. Advance care planning in the elderly.

    PubMed

    Lum, Hillary D; Sudore, Rebecca L; Bekelman, David B

    2015-03-01

    Key components of advance care planning (ACP) for the elderly include choosing a surrogate decision maker, identifying personal values, communicating with surrogates and clinicians, documenting wishes in advance directives, and translating values and preferences for future medical care into medical orders. ACP often involves multiple brief discussions over time. This article outlines common benefits and barriers to ACP in primary care, and provides practical approaches to integrating key ACP components into primary care for older adults. Opportunities for multidisciplinary teams to incorporate ACP into brief clinic visits are highlighted. PMID:25700590

  10. ANS severe accident program overview & planning document

    SciTech Connect

    Taleyarkhan, R.P.

    1995-09-01

    The Advanced Neutron Source (ANS) severe accident document was developed to provide a concise and coherent mechanism for presenting the ANS SAP goals, a strategy satisfying these goals, a succinct summary of the work done to date, and what needs to be done in the future to ensure timely licensability. Guidance was received from various bodies [viz., panel members of the ANS severe accident workshop and safety review committee, Department of Energy (DOE) orders, Nuclear Regulatory Commission (NRC) requirements for ALWRs and advanced reactors, ACRS comments, world-wide trends] were utilized to set up the ANS-relevant SAS goals and strategy. An in-containment worker protection goal was also set up to account for the routine experimenters and other workers within containment. The strategy for achieving the goals is centered upon closing the severe accident issues that have the potential for becoming certification issues when assessed against realistic bounding events. Realistic bounding events are defined as events with an occurrency frequency greater than 10{sup {minus}6}/y. Currently, based upon the level-1 probabilistic risk assessment studies, the realistic bounding events for application for issue closure are flow blockage of fuel element coolant channels, and rapid depressurization-related accidents.

  11. Planning Ahead: Advanced Heart Failure

    MedlinePlus

    ... Pressure Tools & Resources Stroke More Planning Ahead: Advanced Heart Failure Updated:Aug 24,2016 An important part of ... content was last reviewed on 04/16/2015. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  12. 32 CFR 644.23 - Real Estate Planning Documents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Real Estate Planning Documents. 644.23 Section... PROPERTY REAL ESTATE HANDBOOK Project Planning Military (army and Air Force) and Other Federal Agencies § 644.23 Real Estate Planning Documents. (a) Real Estate Planning Reports. (1) A Real Estate...

  13. 32 CFR 644.23 - Real Estate Planning Documents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Real Estate Planning Documents. 644.23 Section... PROPERTY REAL ESTATE HANDBOOK Project Planning Military (army and Air Force) and Other Federal Agencies § 644.23 Real Estate Planning Documents. (a) Real Estate Planning Reports. (1) A Real Estate...

  14. 32 CFR 644.23 - Real Estate Planning Documents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Real Estate Planning Documents. 644.23 Section... PROPERTY REAL ESTATE HANDBOOK Project Planning Military (army and Air Force) and Other Federal Agencies § 644.23 Real Estate Planning Documents. (a) Real Estate Planning Reports. (1) A Real Estate...

  15. 32 CFR 644.23 - Real Estate Planning Documents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Real Estate Planning Documents. 644.23 Section... PROPERTY REAL ESTATE HANDBOOK Project Planning Military (army and Air Force) and Other Federal Agencies § 644.23 Real Estate Planning Documents. (a) Real Estate Planning Reports. (1) A Real Estate...

  16. How Workflow Documentation Facilitates Curation Planning

    NASA Astrophysics Data System (ADS)

    Wickett, K.; Thomer, A. K.; Baker, K. S.; DiLauro, T.; Asangba, A. E.

    2013-12-01

    The description of the specific processes and artifacts that led to the creation of a data product provide a detailed picture of data provenance in the form of a workflow. The Site-Based Data Curation project, hosted by the Center for Informatics Research in Science and Scholarship at the University of Illinois, has been investigating how workflows can be used in developing curation processes and policies that move curation "upstream" in the research process. The team has documented an individual workflow for geobiology data collected during a single field trip to Yellowstone National Park. This specific workflow suggests a generalized three-part process for field data collection that comprises three distinct elements: a Planning Stage, a Fieldwork Stage, and a Processing and Analysis Stage. Beyond supplying an account of data provenance, the workflow has allowed the team to identify 1) points of intervention for curation processes and 2) data products that are likely candidates for sharing or deposit. Although these objects may be viewed by individual researchers as 'intermediate' data products, discussions with geobiology researchers have suggested that with appropriate packaging and description they may serve as valuable observational data for other researchers. Curation interventions may include the introduction of regularized data formats during the planning process, data description procedures, the identification and use of established controlled vocabularies, and data quality and validation procedures. We propose a poster that shows the individual workflow and our generalization into a three-stage process. We plan to discuss with attendees how well the three-stage view applies to other types of field-based research, likely points of intervention, and what kinds of interventions are appropriate and feasible in the example workflow.

  17. Not that way: Advance Care Planning

    PubMed Central

    How, Choon How; Koh, Lip Hoe

    2015-01-01

    Advance Care Planning (ACP) is a process of discussion of healthcare decisions with regard to a patient’s future health and personal care, should they become unable to make or communicate their own decisions in the future. ACP can be as simple as a chat about the patient’s end-of-life wishes with their trusted loved ones, and may involve their doctors, organisations and trained facilitators. The process can be documented with available online resources, such as structured tools. Family physicians, with whom patients share unique therapeutic relationships, are in the best position to introduce and start the ACP conversation with their patients. PMID:25640095

  18. Advancing the Documentation of Buried Archaeological Landscapes

    NASA Astrophysics Data System (ADS)

    Neubauer, W.; Doneus, M.; Trinks, I.

    2012-07-01

    The future demands on professional archaeological prospection will be its ability to cover large areas in a time and cost efficient manner with very high spatial resolution and accuracy. The objective of the 2010 in Vienna established Ludwig Boltzmann Institute for Archaeological Prospection and Virtual Archaeology, in collaboration with its nine European partner organisations, is the advancement of the state-of-the-art. This goal will be achieved by focusing on the development of remote sensing, geophysical prospection and virtual reality applications. Main focus will be placed on novel integrated interpretation approaches combining cutting-edge near-surface prospection methods with advanced computer science.

  19. Planning, Conducting, and Documenting Data Analysis for Program Improvement

    ERIC Educational Resources Information Center

    Winer, Abby; Taylor, Cornelia; Derrington, Taletha; Lucas, Anne

    2015-01-01

    This 2015 document was developed to help technical assistance (TA) providers and state staff define and limit the scope of data analysis for program improvement efforts, including the State Systemic Improvement Plan (SSIP); develop a plan for data analysis; document alternative hypotheses and additional analyses as they are generated; and…

  20. 33 CFR 332.4 - Planning and documentation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Planning and documentation. 332.4 Section 332.4 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE COMPENSATORY MITIGATION FOR LOSSES OF AQUATIC RESOURCES § 332.4 Planning and documentation. (a) Pre-application consultations....

  1. 33 CFR 332.4 - Planning and documentation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Planning and documentation. 332.4 Section 332.4 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE COMPENSATORY MITIGATION FOR LOSSES OF AQUATIC RESOURCES § 332.4 Planning and documentation. (a) Pre-application consultations....

  2. 33 CFR 332.4 - Planning and documentation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Planning and documentation. 332.4 Section 332.4 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE COMPENSATORY MITIGATION FOR LOSSES OF AQUATIC RESOURCES § 332.4 Planning and documentation. (a) Pre-application consultations....

  3. Advanced Manufacturing Processes Laboratory Building 878 hazards assessment document

    SciTech Connect

    Wood, C.; Thornton, W.; Swihart, A.; Gilman, T.

    1994-07-01

    The introduction of the hazards assessment process is to document the impact of the release of hazards at the Advanced Manufacturing Processes Laboratory (AMPL) that are significant enough to warrant consideration in Sandia National Laboratories` operational emergency management program. This hazards assessment is prepared in accordance with the Department of Energy Order 5500.3A requirement that facility-specific hazards assessments be prepared, maintained, and used for emergency planning purposes. This hazards assessment provides an analysis of the potential airborne release of chemicals associated with the operations and processes at the AMPL. This research and development laboratory develops advanced manufacturing technologies, practices, and unique equipment and provides the fabrication of prototype hardware to meet the needs of Sandia National Laboratories, Albuquerque, New Mexico (SNL/NM). The focus of the hazards assessment is the airborne release of materials because this requires the most rapid, coordinated emergency response on the part of the AMPL, SNL/NM, collocated facilities, and surrounding jurisdiction to protect workers, the public, and the environment.

  4. Automated documentation generator for advanced protein crystal growth

    NASA Technical Reports Server (NTRS)

    Maddux, Gary A.; Provancha, Anna; Chattam, David

    1994-01-01

    To achieve an environment less dependent on the flow of paper, automated techniques of data storage and retrieval must be utilized. This software system, 'Automated Payload Experiment Tool,' seeks to provide a knowledge-based, hypertext environment for the development of NASA documentation. Once developed, the final system should be able to guide a Principal Investigator through the documentation process in a more timely and efficient manner, while supplying more accurate information to the NASA payload developer. The current system is designed for the development of the Science Requirements Document (SRD), the Experiment Requirements Document (ERD), the Project Plan, and the Safety Requirements Document.

  5. Advanced planetary analyses. [for planetary mission planning

    NASA Technical Reports Server (NTRS)

    1974-01-01

    The results are summarized of research accomplished during this period concerning planetary mission planning are summarized. The tasks reported include the cost estimations research, planetary missions handbook, and advanced planning activities.

  6. 36 CFR 219.14 - Decision document and planning records.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... amendment, or revision in a decision document prepared according to Forest Service NEPA procedures (36 CFR... the plan components meet the sustainability requirements of § 219.8, the diversity requirements...

  7. 36 CFR 219.14 - Decision document and planning records.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... amendment, or revision in a decision document prepared according to Forest Service NEPA procedures (36 CFR... the plan components meet the sustainability requirements of § 219.8, the diversity requirements...

  8. 36 CFR 219.14 - Decision document and planning records.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... amendment, or revision in a decision document prepared according to Forest Service NEPA procedures (36 CFR... the plan components meet the sustainability requirements of § 219.8, the diversity requirements...

  9. Advanced Life Support Project Plan

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Life support systems are an enabling technology and have become integral to the success of living and working in space. As NASA embarks on human exploration and development of space to open the space frontier by exploring, using and enabling the development of space and to expand the human experience into the far reaches of space, it becomes imperative, for considerations of safety, cost, and crew health, to minimize consumables and increase the autonomy of the life support system. Utilizing advanced life support technologies increases this autonomy by reducing mass, power, and volume necessary for human support, thus permitting larger payload allocations for science and exploration. Two basic classes of life support systems must be developed, those directed toward applications on transportation/habitation vehicles (e.g., Space Shuttle, International Space Station (ISS), next generation launch vehicles, crew-tended stations/observatories, planetary transit spacecraft, etc.) and those directed toward applications on the planetary surfaces (e.g., lunar or Martian landing spacecraft, planetary habitats and facilities, etc.). In general, it can be viewed as those systems compatible with microgravity and those compatible with hypogravity environments. Part B of the Appendix defines the technology development 'Roadmap' to be followed in providing the necessary systems for these missions. The purpose of this Project Plan is to define the Project objectives, Project-level requirements, the management organizations responsible for the Project throughout its life cycle, and Project-level resources, schedules and controls.

  10. Advanced Air Transportation Technologies Project, Final Document Collection

    NASA Technical Reports Server (NTRS)

    Mogford, Richard H.; Wold, Sheryl (Editor)

    2008-01-01

    This CD ROM contains a compilation of the final documents of the Advanced Air Transportation Technologies (AAIT) project, which was an eight-year (1996 to 2004), $400M project managed by the Airspace Systems Program office, which was part of the Aeronautics Research Mission Directorate at NASA Headquarters. AAIT focused on developing advanced automation tools and air traffic management concepts that would help improve the efficiency of the National Airspace System, while maintaining or enhancing safety. The documents contained in the CD are final reports on AAIT tasks that serve to document the project's accomplishments over its eight-year term. Documents include information on: Advanced Air Transportation Technologies, Autonomous Operations Planner, Collaborative Arrival Planner, Distributed Air/Ground Traffic Management Concept Elements 5, 6, & 11, Direct-To, Direct-To Technology Transfer, Expedite Departure Path, En Route Data Exchange, Final Approach Spacing Tool - (Active and Passive), Multi-Center Traffic Management Advisor, Multi Center Traffic Management Advisor Technology Transfer, Surface Movement Advisor, Surface Management System, Surface Management System Technology Transfer and Traffic Flow Management Research & Development.

  11. Guidance and Control Software Project Data - Volume 1: Planning Documents

    NASA Technical Reports Server (NTRS)

    Hayhurst, Kelly J. (Editor)

    2008-01-01

    The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes the planning documents from the GCS project. Volume 1 contains five appendices: A. Plan for Software Aspects of Certification for the Guidance and Control Software Project; B. Software Development Standards for the Guidance and Control Software Project; C. Software Verification Plan for the Guidance and Control Software Project; D. Software Configuration Management Plan for the Guidance and Control Software Project; and E. Software Quality Assurance Activities.

  12. Plans for Advanced LIGO Instruments

    NASA Astrophysics Data System (ADS)

    Wilkinson, Carol

    2005-04-01

    The proposed Advanced LIGO detector will have an increase in sensitivity over initial LIGO by a factor of ten, with an increased bandwidth in the region of highest sensitivity and the ability to tune for specific astrophysical sources. Advanced LIGO will achieve the equivalent of the one-year integrated observation time of initial LIGO in just several hours, allowing observation of astrophysical gravitational waves on a regular basis. The Advanced LIGO detector will replace the existing detector at the LIGO Observatories while retaining the existing building and vacuum system infrastructure. The new instruments build on the initial LIGO Fabry-Perot Michelson Interferometer layout and take advantage of significant advances in technology since the design of initial LIGO in the 1990's. Signal strength/sensitivity will be improved by increasing the laser power, lowering optical absorption, and adding signal recycling to the Fabry-Perot arm cavities. Stray forces on the test masses will be controlled by reducing thermal noise sources in the suspensions and optics and using a multi-staged seismic isolation system with inertial sensing and feedback control. The LIGO laboratory, the LIGO Science Collaboration, and international partners have undertaken a structured program of research and development, including testing of full-scale prototypes in context. Significant progress has been made on several of the detector subsystems. The Advanced LIGO project has been through National Science Foundation peer review and the National Science Board has recommended it for funding. Based on a proposed funding start in 2007, detector installation will begin in 2010, with observations at an advanced level of commissioning in 2013.

  13. 33 CFR 332.4 - Planning and documentation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... DEFENSE COMPENSATORY MITIGATION FOR LOSSES OF AQUATIC RESOURCES § 332.4 Planning and documentation. (a... self-sustaining aquatic resource restoration, establishment, enhancement, and/or preservation at the... project will provide the required compensation for unavoidable impacts to aquatic resources resulting...

  14. 33 CFR 332.4 - Planning and documentation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... DEFENSE COMPENSATORY MITIGATION FOR LOSSES OF AQUATIC RESOURCES § 332.4 Planning and documentation. (a... self-sustaining aquatic resource restoration, establishment, enhancement, and/or preservation at the... project will provide the required compensation for unavoidable impacts to aquatic resources resulting...

  15. Managing Strategic and Long-Range Planning via a Proactive, User-Friendly Planning Document.

    ERIC Educational Resources Information Center

    Dailey, Anne Louise; And Others

    1991-01-01

    A computerized method for managing institutional information to use in creating college planning documents is described. Development of the database, manipulation of the data for reporting, uses in strategic and long-range planning, and the model's implications for improvement of planning processes are discussed. (MSE)

  16. Plan for advanced microelectronics processing technology application

    SciTech Connect

    Goland, A.N.

    1990-10-01

    The ultimate objective of the tasks described in the research agreement was to identify resources primarily, but not exclusively, within New York State that are available for the development of a Center for Advanced Microelectronics Processing (CAMP). Identification of those resources would enable Brookhaven National Laboratory to prepare a program plan for the CAMP. In order to achieve the stated goal, the principal investigators undertook to meet the key personnel in relevant NYS industrial and academic organizations to discuss the potential for economic development that could accompany such a Center and to gauge the extent of participation that could be expected from each interested party. Integrated of these discussions was to be achieved through a workshop convened in the summer of 1990. The culmination of this workshop was to be a report (the final report) outlining a plan for implementing a Center in the state. As events unfolded, it became possible to identify the elements of a major center for x-ray lithography on Lone Island at Brookhaven National Laboratory. The principal investigators were than advised to substitute a working document based upon that concept in place of a report based upon the more general CAMP workshop originally envisioned. Following that suggestion from the New York State Science and Technology Foundation, the principals established a working group consisting of representatives of the Grumman Corporation, Columbia University, the State University of New York at Stony Brook, and Brookhaven National Laboratory. Regular meetings and additional communications between these collaborators have produced a preproposal that constitutes the main body of the final report required by the contract. Other components of this final report include the interim report and a brief description of the activities which followed the establishment of the X-ray Lithography Center working group.

  17. Strategy Guideline: Advanced Construction Documentation Recommendations for High Performance Homes

    SciTech Connect

    Lukachko, A.; Gates, C.; Straube, J.

    2011-12-01

    As whole house energy efficiency increases, new houses become less like conventional houses that were built in the past. New materials and new systems require greater coordination and communication between industry stakeholders. The Guideline for Construction Documents for High Performance Housing provides advice to address this need. The reader will be presented with four changes that are recommended to achieve improvements in energy efficiency, durability and health in Building America houses: create coordination drawings, improve specifications, improve detail drawings, and review drawings and prepare a Quality Control Plan.

  18. Advancing the Community College Strategic Plan.

    ERIC Educational Resources Information Center

    Herbkersman, Neil; Hibbert-Jones, Karla

    2002-01-01

    Discusses the importance of developing a comprehensive grants development process to advance community college strategic plans, especially in the current economic climate. Details the process as developed and implemented by Sinclair Community College (Ohio). States that colleges that employ methodical processes and effective operating systems to…

  19. Recommended documentation plan for the FLAG and CHEMFLUB computer codes

    SciTech Connect

    1983-09-02

    Reviews have been conducted on both FLAG and CHEMFLUB's documentation and computer codes. The documentation of both models is: (1) incomplete, (2) confusing, (3) not helpful to the reader, (4) filled with extraneous information and (5) lack claimed versatility in analyzing coal gasifier systems. The documentation is such that the computer coding itself must be used as a reference to complete the documentation. Once the codes are set up they are relatively easy to run. We have exercised both of them. Most of our efforts thus far have been concentrated on FLAG because of its importance and complexity. FLAG in its present form can not be expected to yield meaningful data applicable to coal gasifier systems. The reasons for this are twofold. First, the model is incorrect in describing some aspects of fluid particle behavior in coal gasifier systems. Second, the numerical formulation/solution methodology is incorrectly implemented and introduces spurious numerical effects, thereby obscuring the physics of the model. In brief, this means that resulting calculations are not correctly related to the physics. CHEMFLUB, while less extensively exercised, shows that it should be no surprise that CHEMFLUB is best utilized as a tool for generating first approximations. We have concluded from these reviews that we cannot perform meaningful comparisons as required under tasks 3.3, 3.4, and 3.5 without first reconstructing and correcting when necessary the physical/numerical models. A plan is presented for accomplishing this reconstruction/modification.

  20. Standard Review Plan Update and Development Program. Implementing Procedures Document

    SciTech Connect

    Not Available

    1992-05-01

    This implementing procedures document (IPD) was prepared for use in implementing tasks under the standard review plan update and development program (SRP-UDP). The IPD provides comprehensive guidance and detailed procedures for SRP-UDP tasks. The IPD is mandatory for contractors performing work for the SRP-UDP. It is guidance for the staff. At the completion of the SRP-UDP, the IPD will be revised (to remove the UDP aspects) and will replace NRR Office Letter No. 800 as long-term maintenance procedures.

  1. [Advanced directives document and neurologist-patient relationship].

    PubMed

    Boada Rovira, M

    2004-12-01

    Perception of health and disease, pain and suffering, quality of life, personal relationships, privacy and intimacy, culture and social values, can now be stated in a written document, by way of a living will, giving legal legitimacy to each patient's way of being and understanding life, to be used when the subject cannot express it by him/herself. In this way, the patients will participate in the therapeutic process and will incorporate their desires and decisions through the Informed Consent and the Advanced Directives Document (ADD). Both documents translate and indicate how to treat and care for a patient who will progressively lose his/her cognitive faculties and others will decided for him/her, in the case of dementias. The basis of ADD is respect and promotion of the patient's autonomy, prolonging his/her right to decide in the stages in which he/she cannot do it. It consists in some instructions or orientations for the patient to be cared for in a certain way, according to his/her will. To this effect, a representative will be named who will act in the subject's name and who will help to interpret and make decisions when the patient cannot. Specifically, in Alzheimer's disease, ADD allows the patient to decide, in full lucidity, freedom and autonomy, how to live a progressive and irreversible disease. Explicit mention can be made to the will of making his/her disease known publically or not, the care of its aspect, privacy, type of care, whether institutionalized or home care, limitation of visits, treatment intensity and prolongation, palliative cares, donation of biological samples, participation in drug clinical trials. PMID:15719290

  2. Development and evaluation of an aged care specific Advance Care Plan

    PubMed Central

    Silvester, William; Parslow, Ruth A; Lewis, Virginia J; Fullam, Rachael S; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Hudson, Rosalie

    2013-01-01

    Objectives To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. Design An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention. Participants and setting 19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria. Results Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents’ values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans. Conclusions Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector. PMID:23626906

  3. 14 CFR 151.113 - Advance planning proposals: Sponsor eligibility.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Engineering Proposals § 151.113 Advance planning proposals: Sponsor eligibility. The sponsor of an advance planning and engineering proposal must be a public agency, as defined in § 151.37(a), and must be...

  4. Earth Observing System (EOS) Advanced Microwave Sounding Unit-A (AMSU-A): Instrumentation interface control document

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This Interface Control Document (ICD) defines the specific details of the complete accomodation information between the Earth Observing System (EOS) PM Spacecraft and the Advanced Microwave Sounding Unit (AMSU-A)Instrument. This is the first submittal of the ICN: it will be updated periodically throughout the life of the program. The next update is planned prior to Critical Design Review (CDR).

  5. Knowledge Management Platform in Advanced Product Quality Planning

    NASA Astrophysics Data System (ADS)

    Chiliban, Bogdan; Baral, Lal Mohan; Kifor, Claudiu

    2014-12-01

    Knowledge is an essential part of organizational competitiveness. This vital resource must be managed correctly within organizations in order to achieve desired performance levels within all undertakings. The process of managing knowledge is a very difficult one due to the illusive nature of the resource itself. Knowledge is stored within every aspect of an organization starting from people and ending with documents and processes. The Knowledge Management Platform is designed as a facilitator for managers and employees in all endeavours knowledge related within the Advanced Product Quality Planning Procedure

  6. Advanced Directives and Advanced Care Planning for Healthcare Professionals.

    PubMed

    Booth, Adam T; Lehna, Carlee

    2016-01-01

    The purposes of this study were to assess healthcare professionals' need for information on advanced directives and to implement and evaluate an educational plan for change in knowledge and behaviors related to advanced directives. End-of-life (EOL) care is an important topic for patients to discuss with their families and healthcare professionals (HP). Needs assessment data were collected from healthcare providers at an urban trauma intensive care unit (ICU) in Louisville, Kentucky on concepts related to end-of-life. Next, healthcare professionals participated in an educational intervention focused on: knowledge about advanced directives; communication techniques for healthcare professionals to use with patients and their families; awareness of the patient's level of illness in advanced care planning; and specifics about living wills in Kentucky and how to complete one. Pre- and post-test data were collected to evaluate change in knowledge, capability an average of 8.7 years (SD = 9.1; range = 1.9-35 years) in healthcare and worked an average of 8.4 years (SD = 9.3; range = 4 months to 35 years) in their respective ICUs. Eighty-seven percent did not have an AD in place even though their perceived knowledge about AD remained moderate throughout pre- and post-test scores (3.3 to 3.8 on a 5 point scale, respectively). Total post-test scores revealed a 2% improvement in correct responses. These findings point to the need for education of healthcare providers in the ICU to increase early AD and ACP discussions with patients and their families. PMID:27183766

  7. Planning Document for an NBSR Conversion Safety Analysis Report

    SciTech Connect

    Diamond D. J.; Baek J.; Hanson, A.L.; Cheng, L-Y.; Brown, N.; Cuadra, A.

    2013-09-25

    The NIST Center for Neutron Research (NCNR) is a reactor-laboratory complex providing the National Institute of Standards and Technology (NIST) and the nation with a world-class facility for the performance of neutron-based research. The heart of this facility is the National Bureau of Standards Reactor (NBSR). The NBSR is a heavy water moderated and cooled reactor operating at 20 MW. It is fueled with high-enriched uranium (HEU) fuel elements. A Global Threat Reduction Initiative (GTRI) program is underway to convert the reactor to low-enriched uranium (LEU) fuel. This program includes the qualification of the proposed fuel, uranium and molybdenum alloy foil clad in an aluminum alloy, and the development of the fabrication techniques. This report is a planning document for the conversion Safety Analysis Report (SAR) that would be submitted to, and approved by, the Nuclear Regulatory Commission (NRC) before the reactor could be converted.This report follows the recommended format and content from the NRC codified in NUREG-1537, “Guidelines for Preparing and Reviewing Applications for the Licensing of Non-power Reactors,” Chapter 18, “Highly Enriched to Low-Enriched Uranium Conversions.” The emphasis herein is on the SAR chapters that require significant changes as a result of conversion, primarily Chapter 4, Reactor Description, and Chapter 13, Safety Analysis. The document provides information on the proposed design for the LEU fuel elements and identifies what information is still missing. This document is intended to assist ongoing fuel development efforts, and to provide a platform for the development of the final conversion SAR. This report contributes directly to the reactor conversion pillar of the GTRI program, but also acts as a boundary condition for the fuel development and fuel fabrication pillars.

  8. [Advance Care Planning in Cancer Care].

    PubMed

    Kizawa, Yoshiyuki; Yamaguchi, Takashi; Yotani, Nobuyuki

    2016-03-01

    Advance care planning (ACP) is one of the most important issues to consider in providing quality end of life care for cancer patients. ACP has been described as a process whereby a patient, in consultation with health care providers, family members, and important others, makes decisions about his or her future health care, in the event he or she becomes incapable of participating in medical treatment decisions. ACP improves rates of following end of life wishes, increases patient and family satisfaction, and reduces family stress, anxiety, and depression. This article clarifies the differences among ACP, advance directives, and living wills. Additionally, we describe, based on clinical experience, how to introduce ACP most effectively for all stages of cancer care. PMID:27067841

  9. Advanced Materials Laboratory User Test Planning Guide

    NASA Technical Reports Server (NTRS)

    Orndoff, Evelyne

    2012-01-01

    Test process, milestones and inputs are unknowns to first-time users of the Advanced Materials Laboratory. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

  10. Advanced Stirling Radioisotope Generator Life Certification Plan

    NASA Technical Reports Server (NTRS)

    Rusick, Jeffrey J.; Zampino, Edward J.

    2013-01-01

    An Advanced Stirling Radioisotope Generator (ASRG) power supply is being developed by the Department of Energy (DOE) in partnership with NASA for potential future deep space science missions. Unlike previous radioisotope power supplies for space exploration, such as the passive MMRTG used recently on the Mars Curiosity rover, the ASRG is an active dynamic power supply with moving Stirling engine mechanical components. Due to the long life requirement of 17 years and the dynamic nature of the Stirling engine, the ASRG project faced some unique challenges trying to establish full confidence that the power supply will function reliably over the mission life. These unique challenges resulted in the development of an overall life certification plan that emphasizes long-term Stirling engine test and inspection when analysis is not practical. The ASRG life certification plan developed is described.

  11. Advanced Life Support Equivalent System Mass Guidelines Document

    NASA Technical Reports Server (NTRS)

    Levri, Julie; Fisher, John W.; Jones, Harry W.; Drysdale, Alan E.; Ewert, Michael K.; Hanford, Anthony J.; Hogan, John A.; Joshi, Jitendri, A.; Vaccari, David A.

    2003-01-01

    This document is a viewgraph presentation which provides guidelines for performing an Equivalent System Mass (ESM) evaluation for trade study purposes. The document: 1) Defines ESM; 2) Explains how to calculate ESM; 3) Discusses interpretation of ESM results. The document is designed to provide detailed instructive material for researchers who are performing ESM evaluations for the first time.

  12. Advanced Simulation and Computing Business Plan

    SciTech Connect

    Rummel, E.

    2015-07-09

    To maintain a credible nuclear weapons program, the National Nuclear Security Administration’s (NNSA’s) Office of Defense Programs (DP) needs to make certain that the capabilities, tools, and expert staff are in place and are able to deliver validated assessments. This requires a complete and robust simulation environment backed by an experimental program to test ASC Program models. This ASC Business Plan document encapsulates a complex set of elements, each of which is essential to the success of the simulation component of the Nuclear Security Enterprise. The ASC Business Plan addresses the hiring, mentoring, and retaining of programmatic technical staff responsible for building the simulation tools of the nuclear security complex. The ASC Business Plan describes how the ASC Program engages with industry partners—partners upon whom the ASC Program relies on for today’s and tomorrow’s high performance architectures. Each piece in this chain is essential to assure policymakers, who must make decisions based on the results of simulations, that they are receiving all the actionable information they need.

  13. Idaho National Laboratory Ten-Year Site Plan Project Description Document

    SciTech Connect

    Not Listed

    2012-03-01

    This document describes the currently active and proposed infrastructure projects listed in Appendix B of the Idaho National Laboratory 2013-2022 Ten Year Site Plan (DOE/ID-11449). It was produced in accordance with Contract Data Requirements List I.06. The projects delineated in this document support infrastructure needs at INL's Research and Education Campus, Materials and Fuels Complex, Advanced Test Reactor Complex and the greater site-wide area. The projects provide critical infrastructure needed to meet current and future INL opereational and research needs. Execution of these projects will restore, rebuild, and revitalize INL's physical infrastructure; enhance program execution, and make a significant contribution toward reducing complex-wide deferred maintenance.

  14. Advanced Nuclear Technology: Advanced Light Water Reactors Utility Requirements Document Small Modular Reactors Inclusion Summary

    SciTech Connect

    Loflin, Leonard; McRimmon, Beth

    2014-12-18

    This report summarizes a project by EPRI to include requirements for small modular light water reactors (smLWR) into the EPRI Utility Requirements Document (URD) for Advanced Light Water Reactors. The project was jointly funded by EPRI and the U.S. Department of Energy (DOE). The report covers the scope and content of the URD, the process used to revise the URD to include smLWR requirements, a summary of the major changes to the URD to include smLWR, and how to use the URD as revised to achieve value on new plant projects.

  15. Submittal Requirements for Review of Planning, Bidding and Construction Documents for Georgia Public Schools.

    ERIC Educational Resources Information Center

    Georgia State Dept. of Education, Atlanta. Facilities Services Unit.

    This document presents the Georgia Department of Education's submittal requirements for documents addressing the planning and construction of educational facilities. Requirements cover such areas as project funding sources, copies and format, site plan, floor plans, elevations and sections, construction delivery method, and heating, air…

  16. Site Characterization Plan (SCP) conceptual design criteria document

    SciTech Connect

    Naiknimbalkar, N.M.

    1986-05-19

    This SCP Conceptual Design Criteria Document was developed to guide engineering effort for Engineering Study No. 10, the supporting document for Chapter 6 of the SCP. The document provides regulatory design guidance, design rationale derived from the Generic Requirements for a Mined Geological Disposal System document, site-specific criteria, and design assumptions. Appendices were added to provide additional information on geology and seals design. 24 figs., 15 tabs.

  17. SCP (Site Characterization Plan) conceptual design criteria document

    SciTech Connect

    Naiknimbalkar, N.M.

    1985-05-01

    This SCP Conceptual Design Criteria Document was developed to guide engineering efforts for Engineering Study No. 10, the supporting document for Chapter 6 of the SCP. The document provides regulatory design guidance, design rationale derived from the Generic Requirements for a Mined Geological Disposal System document, site-specific criteria, and design assumptions. Appendices were added to provide additional information on geology and seals design.

  18. Advanced Education and Technology Business Plan, 2008-11

    ERIC Educational Resources Information Center

    Alberta Advanced Education and Technology, 2008

    2008-01-01

    The Ministry of Advanced Education and Technology's 2008-11 business plan identifies how it plans to work over the next three years to enhance advanced learning opportunities and innovation for all Albertans. Alberta's advanced learning system is composed of public board-governed institutions, the apprenticeship and industry training system,…

  19. 14 CFR 151.111 - Advance planning proposals: General.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Engineering Proposals § 151.111 Advance planning proposals: General. (a) Each advance planning and engineering... application, under §§ 151.21(c) and 151.27, or both. (c) Each proposal must relate to planning and engineering... “Airport Activity Statistics of Certificated Route Air Carriers” (published jointly by FAA and the...

  20. 14 CFR 151.111 - Advance planning proposals: General.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Engineering Proposals § 151.111 Advance planning proposals: General. (a) Each advance planning and engineering... application, under §§ 151.21(c) and 151.27, or both. (c) Each proposal must relate to planning and engineering... “Airport Activity Statistics of Certificated Route Air Carriers” (published jointly by FAA and the...

  1. 14 CFR 151.111 - Advance planning proposals: General.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Engineering Proposals § 151.111 Advance planning proposals: General. (a) Each advance planning and engineering... application, under §§ 151.21(c) and 151.27, or both. (c) Each proposal must relate to planning and engineering... “Airport Activity Statistics of Certificated Route Air Carriers” (published jointly by FAA and the...

  2. 14 CFR 151.111 - Advance planning proposals: General.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Engineering Proposals § 151.111 Advance planning proposals: General. (a) Each advance planning and engineering... application, under §§ 151.21(c) and 151.27, or both. (c) Each proposal must relate to planning and engineering... “Airport Activity Statistics of Certificated Route Air Carriers” (published jointly by FAA and the...

  3. 14 CFR 151.111 - Advance planning proposals: General.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Engineering Proposals § 151.111 Advance planning proposals: General. (a) Each advance planning and engineering... application, under §§ 151.21(c) and 151.27, or both. (c) Each proposal must relate to planning and engineering... “Airport Activity Statistics of Certificated Route Air Carriers” (published jointly by FAA and the...

  4. Local School and Central Office Planning Spring, 1972. (Study Document).

    ERIC Educational Resources Information Center

    Milwaukee Public Schools, WI.

    A revision of an earlier rough draft entitled "Local School and System-Wide Planning," this report outlines the planning process. Flow charts and a narrative description of a Central Office and Local School Planning Cycle are provided. This cycle consists of the following steps: (1) superintendent's statement on the implementation of plan cycle,…

  5. Automated documentation generator for advanced protein crystal growth

    NASA Technical Reports Server (NTRS)

    Maddux, Gary A.; Provancha, Anna; Chattam, David; Ford, Ronald

    1993-01-01

    The System Management and Production Laboratory at the Research Institute, the University of Alabama in Huntsville (UAH), was tasked by the Microgravity Experiment Projects (MEP) Office of the Payload Projects Office (PPO) at Marshall Space Flight Center (MSFC) to conduct research in the current methods of written documentation control and retrieval. The goals of this research were to determine the logical interrelationships within selected NASA documentation, and to expand on a previously developed prototype system to deliver a distributable, electronic knowledge-based system. This computer application would then be used to provide a paperless interface between the appropriate parties for the required NASA document.

  6. Advanced Education and Technology Business Plan, 2010-13

    ERIC Educational Resources Information Center

    Alberta Advanced Education and Technology, 2010

    2010-01-01

    This paper presents the business plan of the Ministry of Advanced Education and Technology for 2010 to 2013. Advanced Education and Technology supports the advanced learning system by providing funding for advanced learning providers, coordinating and approving programs of study at public institutions, licensing and approving programs at private…

  7. 30 CFR 254.4 - May I reference other documents in my response plan?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... OFFSHORE OIL-SPILL RESPONSE REQUIREMENTS FOR FACILITIES LOCATED SEAWARD OF THE COAST LINE General § 254.4... National Contingency Plan (NCP), Area Contingency Plan (ACP), MMS environmental documents, and Oil...

  8. Advanced Reactor Technology -- Regulatory Technology Development Plan (RTDP)

    SciTech Connect

    Moe, Wayne Leland

    2015-05-01

    This DOE-NE Advanced Small Modular Reactor (AdvSMR) regulatory technology development plan (RTDP) will link critical DOE nuclear reactor technology development programs to important regulatory and policy-related issues likely to impact a “critical path” for establishing a viable commercial AdvSMR presence in the domestic energy market. Accordingly, the regulatory considerations that are set forth in the AdvSMR RTDP will not be limited to any one particular type or subset of advanced reactor technology(s) but rather broadly consider potential regulatory approaches and the licensing implications that accompany all DOE-sponsored research and technology development activity that deal with commercial non-light water reactors. However, it is also important to remember that certain “minimum” levels of design and safety approach knowledge concerning these technology(s) must be defined and available to an extent that supports appropriate pre-licensing regulatory analysis within the RTDP. Final resolution to advanced reactor licensing issues is most often predicated on the detailed design information and specific safety approach as documented in a facility license application and submitted for licensing review. Because the AdvSMR RTDP is focused on identifying and assessing the potential regulatory implications of DOE-sponsored reactor technology research very early in the pre-license application development phase, the information necessary to support a comprehensive regulatory analysis of a new reactor technology, and the resolution of resulting issues, will generally not be available. As such, the regulatory considerations documented in the RTDP should be considered an initial “first step” in the licensing process which will continue until a license is issued to build and operate the said nuclear facility. Because a facility license application relies heavily on the data and information generated by technology development studies, the anticipated regulatory

  9. Development of an interactive computer program for advance care planning

    PubMed Central

    Green, Michael J.; Levi, Benjamin H.

    2013-01-01

    Objective To describe the development of an innovative, multimedia decision aid for advance care planning. Background Advance care planning is an important way for people to articulate their wishes for medical care when they are not able to speak for themselves. Living wills and other types of advance directives are the most commonly used tools for advance care planning, but have been criticized for being vague, difficult to interpret, and inconsistent with individuals’ core beliefs and values. Results We developed a multimedia, computer-based decision aid for advance care planning (‘Making Your Wishes Known: Planning Your Medical Future’) to overcome many of the limitations of standard advance directive forms. This computer program guides individuals through the process of advance care planning, and unlike standard advance directives, provides tailored education, values clarification exercises, and a decision-making tool that translates an individual’s values and preferences into a specific medical plan that can be implemented by a health-care team. Pilot testing with 50 adult volunteers recruited from an outpatient primary care clinic showed high levels of satisfaction with the program. Further pilot testing with 34 cancer patients indicated that the program was perceived to be highly accurate at representing patients’ wishes. Conclusions This paper describes the development of an innovative decision aid for advance care planning that was designed to overcome common problems with standard advance directives. Preliminary testing suggests that it is acceptable to users and is accurate. PMID:18823445

  10. Advanced Planning for Tsunamis in California

    NASA Astrophysics Data System (ADS)

    Miller, K.; Wilson, R. I.; Larkin, D.; Reade, S.; Carnathan, D.; Davis, M.; Nicolini, T.; Johnson, L.; Boldt, E.; Tardy, A.

    2013-12-01

    The California Tsunami Program is comprised of the California Governor's Office of Emergency Services (CalOES) and the California Geological Survey (CGS) and funded through the National Tsunami Hazard Mitigation Program (NTHMP) and the Federal Emergency Management Agency (FEMA). The program works closely with the 20 coastal counties in California, as well as academic, and industry experts to improve tsunami preparedness and mitigation in shoreline communities. Inundation maps depicting 'worst case' inundation modeled from plausible sources around the Pacific were released in 2009 and have provided a foundation for public evacuation and emergency response planning in California. Experience during recent tsunamis impacting the state (Japan 2011, Chile 2010, Samoa 2009) has brought to light the desire by emergency managers and decision makers for even more detailed information ahead of future tsunamis. A solution to provide enhanced information has been development of 'playbooks' to plan for a variety of expected tsunami scenarios. Elevation 'playbook' lines can be useful for partial tsunami evacuations when enough information about forecast amplitude and arrival times is available to coastal communities and there is sufficient time to make more educated decisions about who to evacuate for a given scenario or actual event. NOAA-issued Tsunami Alert Bulletins received in advance of a distant event will contain an expected wave height (a number) for each given section of coast. Provision of four elevation lines for possible inundation enables planning for different evacuation scenarios based on the above number potentially alleviating the need for an 'all or nothing' decision with regard to evacuation. Additionally an analytical tool called FASTER is being developed to integrate storm, tides, modeling errors, and local tsunami run-up potential with the forecasted tsunami amplitudes in real-time when a tsunami Alert is sent out. Both of these products will help

  11. Advance crew procedures development techniques: Procedures generation program requirements document

    NASA Technical Reports Server (NTRS)

    Arbet, J. D.; Benbow, R. L.; Hawk, M. L.

    1974-01-01

    The Procedures Generation Program (PGP) is described as an automated crew procedures generation and performance monitoring system. Computer software requirements to be implemented in PGP for the Advanced Crew Procedures Development Techniques are outlined.

  12. A Pharmacotherapy Capstone Course to Advance Pharmacy Students’ Clinical Documentation Skills

    PubMed Central

    Ahmed, Ghada F.

    2012-01-01

    Objective. To implement and assess the effectiveness of a capstone pharmacotherapy course designed to integrate in-class curriculum using patient cases and drug-information questions. The course was intended to improve third-year doctor of pharmacy (PharmD) students' clinical documentation skills in preparation for beginning advanced pharmacy practice experiences (APPEs). Design. This 2-credit, semester-long course consisted of 6 patient cases and 12 drug-information questions posted electronically on an Internet-based medical chart, a public health presentation, a knowledge examination, and an objective standardized performance assessment. In class, students engaged in active-learning exercises and clinical problem-solving. Students worked outside of class in small groups to retrieve and discuss assigned articles and review medication information in preparation for in-class discussions. Assessment. A rubric was used to assess the patient cases and questions that students completed and submitted individually. Data for 4 consecutive course offerings (n=622) were then analyzed. A significant improvement was found in the “misplaced” but not the “missing” documentation ratings for both assessment and plan notes in the final assessment compared with baseline. In course evaluations, the majority of students agreed that the course integrated material across the curriculum (97%) and improved their clinical writing skills (80.5%). Conclusion. A capstone pharmacy course was successful in integrating and reviewing much of the material covered across the PharmD curriculum and in improving students’ clinical documentation skills. PMID:23049106

  13. Advance Care Planning among People Living with Dialysis

    PubMed Central

    Elliott, Barbara A.; Gessert, Charles E.

    2016-01-01

    Purpose: Recent nephrology literature focuses on the need for discussions regarding advance care planning (ACP) for people living with dialysis (PWD). PWD and their family members’ attitudes toward ACP and other aspects of late-life decision making were assessed in this qualitative study. Methodology: Thirty-one interviews were completed with 20 PWD over the age of 70 (mean dialysis 34 months) and 11 family members, related to life experiences, making medical decisions, and planning for the future. Interviews were recorded, transcribed and analyzed. Findings: Four themes regarding ACP emerged from this secondary analysis of the interviews: how completing ACP, advance directives (AD), and identifying an agent fit into PWD experiences; PWD understanding of their prognosis; what gives PWD lives meaning and worth; and PWD care preferences when their defined meaning and worth are not part of their experience. These PWD and family members revealed that ACP is ongoing and common among them. They did not seem to think their medical providers needed to be part of these discussions, since family members were well informed. Practical implications: These results suggest that if health care providers and institutions need AD forms completed, it will important to work with both PWD and their family members to assure personal wishes are documented and honored. PMID:27417605

  14. Reliability of an interactive computer program for advance care planning.

    PubMed

    Schubart, Jane R; Levi, Benjamin H; Camacho, Fabian; Whitehead, Megan; Farace, Elana; Green, Michael J

    2012-06-01

    Despite widespread efforts to promote advance directives (ADs), completion rates remain low. Making Your Wishes Known: Planning Your Medical Future (MYWK) is an interactive computer program that guides individuals through the process of advance care planning, explaining health conditions and interventions that commonly involve life or death decisions, helps them articulate their values/goals, and translates users' preferences into a detailed AD document. The purpose of this study was to demonstrate that (in the absence of major life changes) the AD generated by MYWK reliably reflects an individual's values/preferences. English speakers ≥30 years old completed MYWK twice, 4 to 6 weeks apart. Reliability indices were assessed for three AD components: General Wishes; Specific Wishes for treatment; and Quality-of-Life values (QoL). Twenty-four participants completed the study. Both the Specific Wishes and QoL scales had high internal consistency in both time periods (Knuder Richardson formula 20 [KR-20]=0.83-0.95, and 0.86-0.89). Test-retest reliability was perfect for General Wishes (κ=1), high for QoL (Pearson's correlation coefficient=0.83), but lower for Specific Wishes (Pearson's correlation coefficient=0.57). MYWK generates an AD where General Wishes and QoL (but not Specific Wishes) statements remain consistent over time. PMID:22512830

  15. Reliability of an Interactive Computer Program for Advance Care Planning

    PubMed Central

    Levi, Benjamin H.; Camacho, Fabian; Whitehead, Megan; Farace, Elana; Green, Michael J

    2012-01-01

    Abstract Despite widespread efforts to promote advance directives (ADs), completion rates remain low. Making Your Wishes Known: Planning Your Medical Future (MYWK) is an interactive computer program that guides individuals through the process of advance care planning, explaining health conditions and interventions that commonly involve life or death decisions, helps them articulate their values/goals, and translates users' preferences into a detailed AD document. The purpose of this study was to demonstrate that (in the absence of major life changes) the AD generated by MYWK reliably reflects an individual's values/preferences. English speakers ≥30 years old completed MYWK twice, 4 to 6 weeks apart. Reliability indices were assessed for three AD components: General Wishes; Specific Wishes for treatment; and Quality-of-Life values (QoL). Twenty-four participants completed the study. Both the Specific Wishes and QoL scales had high internal consistency in both time periods (Knuder Richardson formula 20 [KR-20]=0.83–0.95, and 0.86–0.89). Test-retest reliability was perfect for General Wishes (κ=1), high for QoL (Pearson's correlation coefficient=0.83), but lower for Specific Wishes (Pearson's correlation coefficient=0.57). MYWK generates an AD where General Wishes and QoL (but not Specific Wishes) statements remain consistent over time. PMID:22512830

  16. DOE planning workshop advanced biomedical technology initiative

    SciTech Connect

    Not Available

    1994-06-01

    The Department of Energy has mad major contributions in the biomedical sciences with programs in medical applications and instrumentation development, molecular biology, human genome, and computational sciences. In an effort to help determine DOE`s role in applying these capabilities to the nation`s health care needs, a planning workshop was held on January 11--12, 1994. The workshop was co-sponsored by the Department`s Office of Energy Research and Defense Programs organizations. Participants represented industry, medical research institutions, national laboratories, and several government agencies. They attempted to define the needs of the health care industry. identify DOE laboratory capabilities that address these needs, and determine how DOE, in cooperation with other team members, could begin an initiative with the goals of reducing health care costs while improving the quality of health care delivery through the proper application of technology and computational systems. This document is a report of that workshop. Seven major technology development thrust areas were considered. Each involves development of various aspects of imaging, optical, sensor and data processing and storage technologies. The thrust areas as prioritized for DOE are: (1) Minimally Invasive Procedures; (2) Technologies for Individual Self Care; (3) Outcomes Research; (4) Telemedicine; (5) Decision Support Systems; (6) Assistive Technology; (7) Prevention and Education.

  17. State Education Plan. Technical Reference Document. A State Functional Plan Technical Reference Document Prepared in Accordance with Chapter 226, Hawaii Revised Statutes.

    ERIC Educational Resources Information Center

    Hawaii State Dept. of Education, Honolulu.

    This document stands primarily as a support for the Hawaii State Education Functional Plan and serves the following general purposes: (1) to present implementing actions for education consonant with the Hawaii State Plan; (2) to provide directions for the Department of Education; and (3) to help improve the quality of public education in Hawaii.…

  18. Advance care planning in South Korea: Social work perspective.

    PubMed

    Kwon, Sung Ae; Kolomer, Stacey

    2016-08-01

    As ethical issues arise concerning the continuation of futile medical treatment for dying patients in Korean society, advance directive planning initiatives have been put into place to guide practice. This article describes the awareness and attitudes of social workers in Korea regarding advance care planning and related factors. A total of 246 gerontological/geriatric social workers completed a mailed or in-person survey regarding awareness and attitudes toward advance care planning. Seventy-three percent (n = 180) of the participants reported no knowledge of advance directives. Social workers who emphasized self-determination as a professional value, professed a preference for hospice care, and who were comfortable discussing death were more likely to have a positive attitudes toward advance care planning. This study reinforces the need for the infusion of advance care planning and end-of-life training in social work education in Korea. PMID:27428654

  19. Advanced High-Level Waste Glass Research and Development Plan

    SciTech Connect

    Peeler, David K.; Vienna, John D.; Schweiger, Michael J.; Fox, Kevin M.

    2015-07-01

    The U.S. Department of Energy Office of River Protection (ORP) has implemented an integrated program to increase the loading of Hanford tank wastes in glass while meeting melter lifetime expectancies and process, regulatory, and product quality requirements. The integrated ORP program is focused on providing a technical, science-based foundation from which key decisions can be made regarding the successful operation of the Hanford Tank Waste Treatment and Immobilization Plant (WTP) facilities. The fundamental data stemming from this program will support development of advanced glass formulations, key process control models, and tactical processing strategies to ensure safe and successful operations for both the low-activity waste (LAW) and high-level waste (HLW) vitrification facilities with an appreciation toward reducing overall mission life. The purpose of this advanced HLW glass research and development plan is to identify the near-, mid-, and longer-term research and development activities required to develop and validate advanced HLW glasses and their associated models to support facility operations at WTP, including both direct feed and full pretreatment flowsheets. This plan also integrates technical support of facility operations and waste qualification activities to show the interdependence of these activities with the advanced waste glass (AWG) program to support the full WTP mission. Figure ES-1 shows these key ORP programmatic activities and their interfaces with both WTP facility operations and qualification needs. The plan is a living document that will be updated to reflect key advancements and mission strategy changes. The research outlined here is motivated by the potential for substantial economic benefits (e.g., significant increases in waste throughput and reductions in glass volumes) that will be realized when advancements in glass formulation continue and models supporting facility operations are implemented. Developing and applying advanced

  20. The Documentation and Demonstration of the Planning Process: A Report on the Planning of the Teacher Corps Corpsmember Training Institute.

    ERIC Educational Resources Information Center

    Savage, John A.

    The Corpsmember Training Institute (CMTI) is a three-week living and learning experience for all new Teacher Corps Interns and Team Leaders. The first CMTI planning process is documented in this report. The first chapter serves as an overview of the planning process. It provides a brief description of the sequence of planning events, and discusses…

  1. 45 CFR 95.610 - Submission of advance planning documents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... generally applies to large statewide system developments and/or major hardware acquisitions. States with... Specification and/or a General Systems Design (GSD); (vi) A commitment to define the State's functional... of an existing system, including the transfer of another State's General System Design that the...

  2. 45 CFR 95.610 - Submission of advance planning documents.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... generally applies to large statewide system developments and/or major hardware acquisitions. States with... Specification and/or a General Systems Design (GSD); (vi) A commitment to define the State's functional... of an existing system, including the transfer of another State's General System Design that the...

  3. Advanced reactors transition FY 1997 multi-year work plan WBS 7.3

    SciTech Connect

    Hulvey, R.K.

    1996-09-27

    This document describes in detail the work to be accomplised in FY 1997 and the out-years for the Advanced Reactors Transition (WBS 7.3) under the management of the Babcock & Wilcox Hanford Company. This document also includes specific milestones and funding profiles. Based upon the Fiscal Year 1997 Multi-Year Work Plan, the Department of Energy will provide authorization to perform the work described.

  4. NASTRAN documentation for flutter analysis of advanced turbopropellers

    NASA Technical Reports Server (NTRS)

    Elchuri, V.; Gallo, A. M.; Skalski, S. C.

    1982-01-01

    An existing capability developed to conduct modal flutter analysis of tuned bladed-shrouded discs was modified to facilitate investigation of the subsonic unstalled flutter characteristics of advanced turbopropellers. The modifications pertain to the inclusion of oscillatory modal aerodynamic loads of blades with large (backward and forward) varying sweep.

  5. 40 CFR 230.94 - Planning and documentation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... mitigation statement required by 33 CFR 325.1(d)(7), the proposed avoidance and minimization and the amount... waters and uplands; methods for establishing the desired plant community; plans to control invasive plant species; the proposed grading plan, including elevations and slopes of the substrate; soil management;...

  6. 40 CFR 230.94 - Planning and documentation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... mitigation statement required by 33 CFR 325.1(d)(7), the proposed avoidance and minimization and the amount... waters and uplands; methods for establishing the desired plant community; plans to control invasive plant species; the proposed grading plan, including elevations and slopes of the substrate; soil management;...

  7. 40 CFR 230.94 - Planning and documentation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... mitigation statement required by 33 CFR 325.1(d)(7), the proposed avoidance and minimization and the amount... waters and uplands; methods for establishing the desired plant community; plans to control invasive plant species; the proposed grading plan, including elevations and slopes of the substrate; soil management;...

  8. 40 CFR 230.94 - Planning and documentation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... mitigation statement required by 33 CFR 325.1(d)(7), the proposed avoidance and minimization and the amount... waters and uplands; methods for establishing the desired plant community; plans to control invasive plant species; the proposed grading plan, including elevations and slopes of the substrate; soil management;...

  9. Strategy Guideline. Advanced Construction Documentation Recommendations for High Performance Homes

    SciTech Connect

    Lukachko, A.; Gates, C.; Straube, J.

    2011-12-01

    As whole house energy efficiency increases, new materials and new systems require greater coordination and communication between industry stakeholders. This report presents four changes that are recommended to achieve improvements in energy efficiency, durability and health in Building America houses: create coordination drawings, improve specifications, improve detail drawings, and review drawings and prepare a Quality Control Plan.

  10. Plan for a National Documentation, Information and Library System for Jamaica.

    ERIC Educational Resources Information Center

    National Council on Libraries, Archives and Documentation Services, Kingston (Jamaica).

    This document presents the proposals of ten working parties, each dealing with a particular type of library or a major topic of current concern, which were set up in 1977 to aid the Jamaica National Council on Libraries, Archives, and Documentation Services in the formulation of a plan for a national documentation, information, and library system.…

  11. 40 CFR 230.94 - Planning and documentation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... mitigation statement required by 33 CFR 325.1(d)(7), the proposed avoidance and minimization and the amount... species; the proposed grading plan, including elevations and slopes of the substrate; soil management;...

  12. 32 CFR 644.23 - Real Estate Planning Documents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... directives by the approprate Air Force Regional Civil Engineer (AFRCE). Such reports need not be submitted to.... (viii) Engineering Feasibility Study (if construction is planned). (ix) Draft Acquisition Report...

  13. Meeting of Experts on Planning Documentation and Library Networks in Africa (NATIS). Working Document.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Paris (France).

    Signicant developments in the documentation and library services of 32 African countries since the Kampala, Uganda meeting held in 1970 are enumerated. Particular reference is given to the countries' progress in meeting the following objectives set forth by the Intergovernment Conference: (1) legislation; (2) creation of coordinating bodies; (3)…

  14. Advanced Education and Technology Business Plan, 2007-10

    ERIC Educational Resources Information Center

    Alberta Enterprise and Advanced Education, 2007

    2007-01-01

    The Government of Alberta Strategic Business Plan addresses significant opportunities and challenges facing Alberta over the next three years and positions Alberta to make the most of its economic, social and natural advantages. It is a plan to strategically manage growth and plan for a sustainable and secure future. Advanced Education and…

  15. Advanced topics in character recongition and document analysis: research works in intelligent image and document research lab, Tsinghua University

    NASA Astrophysics Data System (ADS)

    Ding, Xiaoqing

    2009-01-01

    Character Recognition and Document Retrieval still are very interesting research area although great progress in performance has been made over the last decades. Advanced research topics in character recognition and Document analysis are introduced in this paper, which include the further research in Tsinghai University on handwritten Chinese character recognition, multilingual character recognition and writer identification. In handwritten Chinese character recognition a special cascade MQDF classifier is discussed for unconstrained cursive handwritten Chinese Character recognition and an optimum handwritten strip recognition algorithm is introduced. In writer identification content dependent and content independent algorithms are discussed. In multilingual character recognition a THOCR multilingual, including Japanese, Korean, Tibetan, Mongolian, Uyghur, Arabic document recognition system is introduced in this paper.

  16. Proposed Site Treatment Plan (PSTP). STP reference document

    SciTech Connect

    1995-02-22

    The Department of Energy (DOE) is required by Section 3021(b) of the Resource Conservation and Recovery Act (RCRA), as amended by the Federal Facility Compliance Act (FFCAct), to prepare a plan describing the development of treatment capacities and technologies for treating mixed waste (hazardous/radioactive waste). DOE decided to prepare its site treatment plan in a three phased approach. The first phase, called the Conceptual Site Treatment Plan (CSTP), was issued in October 1993. At the Savannah River Site (SRS) the CSTP described mixed waste streams generated at SRS and listed treatment scenarios for each waste stream utilizing an onsite, offsite DOE, and offsite or onsite commercial or vendor treatment option. The CSTP is followed by the Draft Site Treatment Plan (DSTP), due to be issued in August 1994. The DSTP, the current activity., will narrow the options discussed in the CSTP to a preferred treatment option, if possible, and will include waste streams proposed to be shipped to SRS from other DOE facilities as well as waste streams SRS may send offsite for treatment. The SRS DSTP process has been designed to address treatment options for each of the site`s mixed waste streams. The SRS Proposed Site Treatment Plan (PSTP) is due to be issued in February 1995. The compliance order would be derived from the PSTP.

  17. Planning National Infrastructures for Documentation, Libraries and Archives; Outline of a General Policy.

    ERIC Educational Resources Information Center

    D'Olier, J. H.; Delmas, B.

    Designed for governmental planners, documentalists, librarians, and archivists, these two United Nations studies examine integration of the planning of libraries and archives services with the planning of economic and social development. In Study 1, the planning of documentation centers and libraries is investigated. An appendix includes survey…

  18. Strategic targeting of advance care planning interventions: the Goldilocks phenomenon.

    PubMed

    Billings, J Andrew; Bernacki, Rachelle

    2014-04-01

    Strategically selecting patients for discussions and documentation about limiting life-sustaining treatments-choosing the right time along the end-of-life trajectory for such an intervention and identifying patients at high risk of facing end-of-life decisions-can have a profound impact on the value of advance care planning (ACP) efforts. Timing is important because the completion of an advance directive (AD) too far from or too close to the time of death can lead to end-of-life decisions that do not optimally reflect the patient's values, goals, and preferences: a poorly chosen target patient population that is unlikely to need an AD in the near future may lead to patients making unrealistic, hypothetical choices, while assessing preferences in the emergency department or hospital in the face of a calamity is notoriously inadequate. Because much of the currently studied ACP efforts have led to a disappointingly small proportion of patients eventually benefitting from an AD, careful targeting of the intervention should also improve the efficacy of such projects. A key to optimal timing and strategic selection of target patients for an ACP program is prognostication, and we briefly highlight prognostication tools and studies that may point us toward high-value AD interventions. PMID:24493203

  19. Search Hanford Accessible Reports Electronically system test plan and documentation: Revision 1

    SciTech Connect

    White, E.L.

    1994-12-07

    The purpose of this document is to describe the following items: the approach, resources, and sequence of the testing activities; identifies the components and features to be tested; the personnel responsible for testing; the risks associated with this plan; and test cases and procedures. This document contains all test documentation for the SHARE system. The Search Hanford Accessible Reports Electronically (SHARE) testing process is based upon WHC-CM-3-10, Software Practices, Section SP-3.3 REV 0, and Appendix J REV 0. These procedures and guidelines are based on IEEE Standard 829-1983. The planning in this document was further influenced through guidance in IEEE Standard 1012-1986. This document contains the System, Acceptance, Integration and Component Test Plans, Designs, Procedures, and Cases for SHARE. The Test Cases and procedures have been attached to the document.

  20. Sulfur Oxides Risk and Exposure Assessment Planning Document

    EPA Science Inventory

    In conducting risk/exposure assessments for the Sulfur Oxides NAAQS review, EPA will first develop a draft Scope and Methods Plan which will describe the proposed scope of the quantitative and qualitative analyses to be performed and the tools/methods that may be employed

  1. State Vocational Education Resource Document: Planning for the Intermediate Future.

    ERIC Educational Resources Information Center

    Broadbent, William

    This report, which presents various economic and demographic data about Hawaii, is intended to assist persons responsible for the short-term planning of vocational-technical education programs in the state. The report is organized in terms of a series of potentially relevant concerns that should be considered during the educational planning…

  2. Advanced reactors transition fiscal year 1995 multi-year program plan WBS 7.3

    SciTech Connect

    Loika, E.F.

    1994-09-22

    This document describes in detail the work to be accomplished in FY-1995 and the out years for the Advanced Reactors Transition (WBS 7.3). This document describes specific milestones and funding profiles. Based upon the Fiscal Year 1995 Multi-Year Program Plan, DOE will provide authorization to perform the work outlined in the FY 1995 MYPP. Following direction given by the US Department of Energy (DOE) on December 15, 1993, Advanced Reactors Transition (ART), previously known as Advanced Reactors, will provide the planning and perform the necessary activities for placing the Fast Flux Test Facility (FFTF) in a radiologically and industrially safe shutdown condition. The DOE goal is to accomplish the shutdown in approximately five years. The Advanced Reactors Transition Multi-Year Program Plan, and the supporting documents; i.e., the FFTF Shutdown Program Plan and the FFTF Shutdown Project Resource Loaded Schedule (RLS), are defined for the life of the Program. During the transition period to achieve the Shutdown end-state, the facilities and systems will continue to be maintained in a safe and environmentally sound condition. Additionally, facilities that were associated with the Office of Nuclear Energy (NE) Programs, and are no longer required to support the Liquid Metal Reactor Program will be deactivated and transferred to an alternate sponsor or the Decontamination and Decommissioning (D and D) Program for final disposition, as appropriate.

  3. Advanced Education Business Plan 2005-2008

    ERIC Educational Resources Information Center

    Alberta Advanced Education, 2005

    2005-01-01

    In collaboration with learning providers, the advanced education system, industry, communities, government agencies and non-governmental organizations, Advanced Education strives to create accessible, affordable and quality learning opportunities that are responsive to the ongoing learning needs of Albertans. The Ministry's 2005-08 Business Plan…

  4. Guideline for Performing Systematic Approach to Evaluate and Qualify Legacy Documents that Support Advanced Reactor Technology Activity

    SciTech Connect

    Honma, George

    2015-10-01

    The establishment of a systematic process for the evaluation of historic technology information for use in advanced reactor licensing is described. Efforts are underway to recover and preserve Experimental Breeder Reactor II and Fast Flux Test Facility historical data. These efforts have generally emphasized preserving information from data-acquisition systems and hard-copy reports and entering it into modern electronic formats suitable for data retrieval and examination. The guidance contained in this document has been developed to facilitate consistent and systematic evaluation processes relating to quality attributes of historic technical information (with focus on sodium-cooled fast reactor (SFR) technology) that will be used to eventually support licensing of advanced reactor designs. The historical information may include, but is not limited to, design documents for SFRs, research-and-development (R&D) data and associated documents, test plans and associated protocols, operations and test data, international research data, technical reports, and information associated with past U.S. Nuclear Regulatory Commission (NRC) reviews of SFR designs. The evaluation process is prescribed in terms of SFR technology, but the process can be used to evaluate historical information for any type of advanced reactor technology. An appendix provides a discussion of typical issues that should be considered when evaluating and qualifying historical information for advanced reactor technology fuel and source terms, based on current light water reactor (LWR) requirements and recent experience gained from Next Generation Nuclear Plant (NGNP).

  5. Advance Care Planning in Nursing Homes: Correlates of Capacity and Possession of Advance Directives

    ERIC Educational Resources Information Center

    Allen, Rebecca S.; DeLaine, Shermetra R.; Chaplin, William F.; Marson, Daniel C.; Bourgeois, Michelle S.; Dijkstra, Katinka; Burgio, Louis D.

    2003-01-01

    Purpose: The identification of nursing home residents who can continue to participate in advance care planning about end-of-life care is a critical clinical and bioethical issue. This study uses high quality observational research to identify correlates of advance care planning in nursing homes, including objective measurement of capacity. Design…

  6. Acquisition plan for Digital Document Storage (DDS) prototype system

    NASA Technical Reports Server (NTRS)

    1990-01-01

    NASA Headquarters maintains a continuing interest in and commitment to exploring the use of new technology to support productivity improvements in meeting service requirements tasked to the NASA Scientific and Technical Information (STI) Facility, and to support cost effective approaches to the development and delivery of enhanced levels of service provided by the STI Facility. The DDS project has been pursued with this interest and commitment in mind. It is believed that DDS will provide improved archival blowback quality and service for ad hoc requests for paper copies of documents archived and serviced centrally at the STI Facility. It will also develop an operating capability to scan, digitize, store, and reproduce paper copies of 5000 NASA technical reports archived annually at the STI Facility and serviced to the user community. Additionally, it will provide NASA Headquarters and field installations with on-demand, remote, electronic retrieval of digitized, bilevel, bit mapped report images along with branched, nonsequential retrieval of report subparts.

  7. Advance Care Planning for Serious Illness

    MedlinePlus

    ... conversations Caring Connections National Hospice and Palliative Care Organization Links to every state’s advance care directive forms http: / / www. caringinfo. org/ i4a/ pages/ index. cfm? ...

  8. Improving patient-centered care through advance care planning.

    PubMed

    Motley, Molly

    2013-06-01

    Advance care planning is crucial for patients confronting incurable, debilitating, or terminal disease. Discussing end-of-life issues can reduce overtreatment and undertreatment as defined by the patient, and improve satisfaction with care. PMID:23805592

  9. Voyager: Perils of advanced planning, 1960 - 1967

    NASA Technical Reports Server (NTRS)

    1984-01-01

    Contract proposals; phased project planning; budgetary problems; Saturn 1 B-Centaur versus Saturn V; mission guidelines and management assignments; and the origins of the Voyager project are discussed.

  10. Promoting perioperative advance care planning: a systematic review of advance care planning decision aids.

    PubMed

    Aslakson, Rebecca A; Schuster, Anne L R; Reardon, Jessica; Lynch, Thomas; Suarez-Cuervo, Catalina; Miller, Judith A; Moldovan, Rita; Johnston, Fabian; Anton, Blair; Weiss, Matthew; Bridges, John F P

    2015-11-01

    This systematic review identifies possible decision aids that promote perioperative advance care planning (ACP) and synthesizes the available evidence regarding their use. Using PubMed, EMBASE, Cochrane, SCOPUS, Web of Science, CINAHL, PsycINFO and Sociological Abstracts, researchers identified and screened articles for eligibility. Data were abstracted and risk of bias assessed for included articles. Thirty-nine of 5327 articles satisfied the eligibility criteria. Primarily completed in outpatient ambulatory populations, studies evaluated a variety of ACP decision aids. None were evaluated in a perioperative population. Fifty unique outcomes were reported with no head-to-head comparisons conducted. Findings are likely generalizable to a perioperative population and can inform development of a perioperative ACP decision aid. Future studies should compare the effectiveness of ACP decision aids. PMID:26346494

  11. Legal Briefing: Medicare Coverage of Advance Care Planning.

    PubMed

    Pope, Thaddeus Mason

    2015-01-01

    This issue's "Legal Briefing" column covers the recent decision by the Centers for Medicare and Medicaid Services (CMS) to expand Medicare coverage of advance care planning, beginning 1 January 2016. Since 2009, most "Legal Briefings" in this journal have covered a wide gamut of judicial, legislative, and regulatory developments concerning a particular topic in clinical ethics. In contrast, this "Legal Briefing" is more narrowly focused on one single legal development. This concentration on Medicare coverage of advance care planning seems warranted. Advance care planning is a frequent subject of articles in JCE. After all, it has long been seen as an important, albeit only partial, solution to a significant range of big problems in clinical ethics. These problems range from medical futility disputes to decision making for incapacitated patients who have no available legally authorized surrogate. Consequently, expanded Medicare coverage of advance care planning is a potentially seismic development. It may materially reduce both the frequency and severity of key problems in clinical ethics. Since the sociological, medical, and ethical literature on advance care planning is voluminous, I will not even summarize it here. Instead, I focus on Medicare coverage. I proceed, chronologically, in six stages: 1. Prior Medicare Coverage of Advance Care Planning 2. Proposed Expanded Medicare Coverage in 2015 3. Proposed Expanded Medicare Coverage in 2016 4. The Final Rule Expanding Medicare Coverage in 2016 5. Remaining Issues for CMS to Address in 2017 6. Pending Federal Legislation. PMID:26752396

  12. Preschool Teachers' Perspectives on Planning and Documentation in Preschool

    ERIC Educational Resources Information Center

    Alvestad, Torgeir; Sheridan, Sonja

    2015-01-01

    This article is based on a research project focusing on Norwegian teachers' planning and documentation of children's learning in preschool. Norwegian preschools follow a national curriculum and teachers are obliged to document both professional practice and learning outcomes. The aim of the article is to investigate teachers'…

  13. 30 CFR 254.4 - May I reference other documents in my response plan?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... plan? 254.4 Section 254.4 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION, AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL-SPILL RESPONSE REQUIREMENTS FOR FACILITIES LOCATED... environmental documents, and Oil Spill Removal Organization (OSRO) documents that are readily accessible to...

  14. Education-Planning-Programming-Budgeting System Documentation Manual for School Districts, Version II, Model 1.

    ERIC Educational Resources Information Center

    Pennsylvania Univ., Philadelphia. Government Studies Center.

    This document details a semiautomated PPB system developed in an ESEA Title III project, Intermediate Unit Planning Study, for use in Pennsylvania (see EA 002 750). Two semiautomated versions were developed, both dependent for calculation on the use of electronic data processing equipment. This is a documentation manual for the first of these…

  15. Comment and response document for the long-term surveillance plan for the Shiprock, New Mexico, disposal site

    SciTech Connect

    Not Available

    1994-09-01

    This document contains comments and responses regarding the long-term surveillance plan for the Shiprock, New Mexico uranium mine tailings disposal site. Discrepencies and errors within the plan document are noted and corrections are recorded.

  16. Summary of US Fusion Program Planning Documents Relating to Innovative Confinement Concepts (1992-2005)

    NASA Astrophysics Data System (ADS)

    Woodruff, S.

    2007-06-01

    During the 1990's approximately 15 planning documents were produced by community consensus and by panels of experts. These documents lead to the restructuring of the Office of Fusion Energy (OFE). The OFE adopted joint goals of science and performance and opened a solicitation for Innovative Confinement Concept (ICC) experiments. This paper summarizes the documents that appeared during this time that relate to the ICCs.

  17. Plan for an Advanced Turbine Systems Program

    SciTech Connect

    Bajura, R.A.; Webb, H.A.; Parks, W.P.

    1993-03-01

    A draft version of this paper was presented at the Clemson Clean, affordable, and reliable natural gas utilization technologies will play a growing role in meeting future power generation needs in the United States. The US Department of Energy`s (DOE) National Energy Strategy projected that total demand for natural gas will rise from 18.5 trillion cubic feet (tcf) in 1990 to 24.2 tcf by the year 2000. Much of this increase is attributed to the increased use of natural gas as a fuel for electric power generation. Candidate technologies for gas fired power generation include gas turbine and fuel cell systems. The first workshop on research needs for advanced gas turbine systems for power generation was held on April 8-10, 1991 in Greenville, South Carolina. The goals of the Clemson-I Workshop were to identify research needs which would accelerate the development of advanced gas turbines and to consider new approaches to implement this research. The Clemson-I Workshop focused on advanced gas turbine systems which would have a lower cost of electricity or better environmental performance than systems currently under development. The workshop was cosponsored by the DOE`s Morgantown Energy Technology Center (METC), Clemson University, and the South Carolina Energy Research and Development Center. The proceedings from the workshop have been published. The 75 participants in the Clemson-I Workshop represented a broad spectrum of the gas turbine Research & Development (R&D) community as well as potential users of advanced gas turbines. Gas turbine manufacturers, the electric utility industry, the university community, as well as government and private sector R&D sponsors were represented. Participants in the Clemson-I Workshop concluded that it is technically feasible to develop advanced turbine systems and that Government participation would accelerate the developmental effort. Advanced turbine systems could be operated on natural gas or adapted to coal or biomass firing.

  18. Plan for an Advanced Turbine Systems Program

    SciTech Connect

    Bajura, R.A.; Webb, H.A. ); Parks, W.P. )

    1993-01-01

    A draft version of this paper was presented at the Clemson Clean, affordable, and reliable natural gas utilization technologies will play a growing role in meeting future power generation needs in the United States. The US Department of Energy's (DOE) National Energy Strategy projected that total demand for natural gas will rise from 18.5 trillion cubic feet (tcf) in 1990 to 24.2 tcf by the year 2000. Much of this increase is attributed to the increased use of natural gas as a fuel for electric power generation. Candidate technologies for gas fired power generation include gas turbine and fuel cell systems. The first workshop on research needs for advanced gas turbine systems for power generation was held on April 8-10, 1991 in Greenville, South Carolina. The goals of the Clemson-I Workshop were to identify research needs which would accelerate the development of advanced gas turbines and to consider new approaches to implement this research. The Clemson-I Workshop focused on advanced gas turbine systems which would have a lower cost of electricity or better environmental performance than systems currently under development. The workshop was cosponsored by the DOE's Morgantown Energy Technology Center (METC), Clemson University, and the South Carolina Energy Research and Development Center. The proceedings from the workshop have been published. The 75 participants in the Clemson-I Workshop represented a broad spectrum of the gas turbine Research Development (R D) community as well as potential users of advanced gas turbines. Gas turbine manufacturers, the electric utility industry, the university community, as well as government and private sector R D sponsors were represented. Participants in the Clemson-I Workshop concluded that it is technically feasible to develop advanced turbine systems and that Government participation would accelerate the developmental effort. Advanced turbine systems could be operated on natural gas or adapted to coal or biomass firing.

  19. Revised Faculty Compensation, Evaluation, and Advancement Plan. March, 1998.

    ERIC Educational Resources Information Center

    May, Joe

    This report provides the revised faculty compensation, evaluation, and advancement plan for Pueblo Community College (PCC) in Colorado. Section 1 contains the PCC three-level salary plan and discusses guidelines for initial appointment and level placement of faculty, initial salary computations, and minimum initial employment requirements. Section…

  20. Model documentation: Electricity Market Module, Electricity Capacity Planning submodule

    SciTech Connect

    Not Available

    1994-04-07

    The National Energy Modeling System (NEMS) is a computer modeling system developed by the Energy Information Administration (EIA). The NEMS produces integrated forecasts for energy markets in the United States by achieving a general equilibrium solution for energy supply and demand. Currently, for each year during the period from 1990 through 2010, the NEMS describes energy supply, conversion, consumption, and pricing. The Electricity Market Module (EMM) is the electricity supply component of the National Energy Modeling System (NEMS). The supply of electricity is a conversion activity since electricity is produced from other energy sources (e.g., fossil, nuclear, and renewable). The EMM represents the generation, transmission, and pricing of electricity. The EMM consists of four main submodules: Electricity Capacity Planning (ECP), Electricity Fuel Dispatching (EFD), Electricity Finance and Pricing (EFP), and Load and Demand-Side Management (LDSM). The ECP evaluates changes in the mix of generating capacity that are necessary to meet future demands for electricity and comply with environmental regulations. The EFD represents dispatching (i.e., operating) decisions and determines how to allocate available capacity to meet the current demand for electricity. Using investment expenditures from the ECP and operating costs from the EFD, the EFP calculates the price of electricity, accounting for state-level regulations involving the allocation of costs. The LDSM translates annual demands for electricity into distributions that describe hourly, seasonal, and time-of-day variations. These distributions are used by the EFD and the ECP to determine the quantity and types of generating capacity that are required to insure reliable and economical supplies of electricity. The EMM also represents nonutility suppliers and interregional and international transmission and trade. These activities are included in the EFD and the ECP.

  1. 30 CFR 746.13 - Decision document and recommendation on mining plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Decision document and recommendation on mining plan. 746.13 Section 746.13 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR FEDERAL LANDS PROGRAM REVIEW AND APPROVAL OF MINING PLANS § 746.13...

  2. 30 CFR 746.13 - Decision document and recommendation on mining plan.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Decision document and recommendation on mining plan. 746.13 Section 746.13 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR FEDERAL LANDS PROGRAM REVIEW AND APPROVAL OF MINING PLANS § 746.13...

  3. Communicating Nursing Care Using the Health Level Seven Consolidated Clinical Document Architecture Release 2 Care Plan.

    PubMed

    Matney, Susan A; Dolin, Gay; Buhl, Lindy; Sheide, Amy

    2016-03-01

    A care plan provides a patient, family, or community picture and outlines the care to be provided. The Health Level Seven Consolidated Clinical Document Architecture (C-CDA) Release 2 Care Plan Document is used to structure care plan data when sharing the care plan between systems and/or settings. The American Nurses Association has recommended the use of two terminologies, Logical Observation Identifiers Names and Codes (LOINC) for assessments and outcomes and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) for problems, procedures (interventions), outcomes, and observation findings within the C-CDA. This article describes C-CDA, introduces LOINC and SNOMED CT, discusses how the C-CDA Care Plan aligns with the nursing process, and illustrates how nursing care data can be structured and encoded within a C-CDA Care Plan. PMID:26765657

  4. Advanced Coal Conversion Process Demonstration Project. Environmental Monitoring Plan

    SciTech Connect

    Not Available

    1992-04-01

    Western Energy Company (WECO) was selected by the Department of Energy (DOE) to demonstrate the Advanced Coal Conversion Process (ACCP) which upgrades low rank coals into high Btu, low sulfur, synthetic bituminous coal. As specified in the Corporate Agreement, RSCP is required to develop an Environmental Monitoring Plan (EMP) which describes in detail the environmental monitoring activities to be performed during the project execution. The purpose of the EMP is to: (1) identify monitoring activities that will be undertaken to show compliance to applicable regulations, (2) confirm the specific environmental impacts predicted in the National Environmental Policy Act documentation, and (3) establish an information base of the assessment of the environmental performance of the technology demonstrated by the project. The EMP specifies the streams to be monitored (e.g. gaseous, aqueous, and solid waste), the parameters to be measured (e.g. temperature, pressure, flow rate), and the species to be analyzed (e.g. sulfur compounds, nitrogen compounds, trace elements) as well as human health and safety exposure levels. The operation and frequency of the monitoring activities is specified, as well as the timing for the monitoring activities related to project phase (e.g. preconstruction, construction, commissioning, operational, post-operational). The EMP is designed to assess the environmental impacts and the environmental improvements resulting from construction and operation of the project.

  5. Advanced Photon Source experimental beamline Safety Assessment Document: Addendum to the Advanced Photon Source Accelerator Systems Safety Assessment Document (APS-3.2.2.1.0)

    SciTech Connect

    1995-01-01

    This Safety Assessment Document (SAD) addresses commissioning and operation of the experimental beamlines at the Advanced Photon Source (APS). Purpose of this document is to identify and describe the hazards associated with commissioning and operation of these beamlines and to document the measures taken to minimize these hazards and mitigate the hazard consequences. The potential hazards associated with the commissioning and operation of the APS facility have been identified and analyzed. Physical and administrative controls mitigate identified hazards. No hazard exists in this facility that has not been previously encountered and successfully mitigated in other accelerator and synchrotron radiation research facilities. This document is an updated version of the APS Preliminary Safety Analysis Report (PSAR). During the review of the PSAR in February 1990, the APS was determined to be a Low Hazard Facility. On June 14, 1993, the Acting Director of the Office of Energy Research endorsed the designation of the APS as a Low Hazard Facility, and this Safety Assessment Document supports that designation.

  6. The Evolution of Health Care Advance Planning Law and Policy

    PubMed Central

    Sabatino, Charles P

    2010-01-01

    Context: The legal tools of health care advance planning have substantially changed since their emergence in the mid-1970s. Thirty years of policy development, primarily at the state legislative level addressing surrogate decision making and advance directives, have resulted in a disjointed policy landscape, yet with important points of convergence evolving over time. An understanding of the evolution of advance care planning policy has important implications for policy at both the state and federal levels. Methods: This article is a longitudinal statutory and literature review of health care advance planning from its origins to the present. Findings: While considerable variability across the states still remains, changes in law and policy over time suggest a gradual paradigm shift from what is described as a “legal transactional approach” to a “communications approach,” the most recent extension of which is the emergence of Physician Orders for Life-Sustaining Treatment, or POLST. The communications approach helps translate patients’ goals into visible and portable medical orders. Conclusions: States are likely to continue gradually moving away from a legal transactional mode of advance planning toward a communications model, albeit with challenges to authentic and reliable communication that accurately translates patients’ wishes into the care they receive. In the meantime, the states and their health care institutions will continue to serve as the primary laboratory for advance care planning policy and practice. PMID:20579283

  7. Center for Advanced Energy Studies Program Plan

    SciTech Connect

    Kevin Kostelnik

    2005-09-01

    The world is facing critical energy-related challenges regarding world and national energy demands, advanced science and energy technology delivery, nuclear engineering educational shortfalls, and adequately trained technical staff. Resolution of these issues is important for the United States to ensure a secure and affordable energy supply, which is essential for maintaining U.S. national security, continued economic prosperity, and future sustainable development. One way that the U.S. Department of Energy (DOE) is addressing these challenges is by tasking the Battelle Energy Alliance, LLC (BEA) with developing the Center for Advanced Energy Studies (CAES) at the Idaho National Laboratory (INL). By 2015, CAES will be a self-sustaining, world-class, academic and research institution where the INL; DOE; Idaho, regional, and other national universities; and the international community will cooperate to conduct critical energy-related research, classroom instruction, technical training, policy conceptualization, public dialogue, and other events.

  8. Plan for advanced microelectronics processing technology application. Final report

    SciTech Connect

    Goland, A.N.

    1990-10-01

    The ultimate objective of the tasks described in the research agreement was to identify resources primarily, but not exclusively, within New York State that are available for the development of a Center for Advanced Microelectronics Processing (CAMP). Identification of those resources would enable Brookhaven National Laboratory to prepare a program plan for the CAMP. In order to achieve the stated goal, the principal investigators undertook to meet the key personnel in relevant NYS industrial and academic organizations to discuss the potential for economic development that could accompany such a Center and to gauge the extent of participation that could be expected from each interested party. Integrated of these discussions was to be achieved through a workshop convened in the summer of 1990. The culmination of this workshop was to be a report (the final report) outlining a plan for implementing a Center in the state. As events unfolded, it became possible to identify the elements of a major center for x-ray lithography on Lone Island at Brookhaven National Laboratory. The principal investigators were than advised to substitute a working document based upon that concept in place of a report based upon the more general CAMP workshop originally envisioned. Following that suggestion from the New York State Science and Technology Foundation, the principals established a working group consisting of representatives of the Grumman Corporation, Columbia University, the State University of New York at Stony Brook, and Brookhaven National Laboratory. Regular meetings and additional communications between these collaborators have produced a preproposal that constitutes the main body of the final report required by the contract. Other components of this final report include the interim report and a brief description of the activities which followed the establishment of the X-ray Lithography Center working group.

  9. Work Package 5: Contingency Management. Mission Planning Requirements Document: Preliminary Version. Revision A

    NASA Technical Reports Server (NTRS)

    2005-01-01

    The purpose of this document is to identify the general flight/mission planning requirements for same-day file-and-fly access to the NAS for both civil and military High-Altitude Long Endurance (HALE) Unmanned Aircraft System (UAS). Currently the scope of this document is limited to Step 1, operations above flight level 43,000 feet (FL430). This document describes the current applicable mission planning requirements and procedures for both manned and unmanned aircraft and addresses HALE UAS flight planning considerations in the future National Airspace System (NAS). It also discusses the unique performance and operational capabilities of HALE UAS associated with the Access 5 Project, presents some of the projected performance characteristics and conceptual missions for future systems, and provides detailed analysis of the recommended mission planning elements for operating HALE UAS in the NAS.

  10. [Depression screening and possible applications of advance care planning].

    PubMed

    Wada, Taizo

    2013-01-01

    Depression screening was conducted to determine the health status of community-dwelling elderly individuals, and the concept of advance care planning was introduced. While depression screening among the elderly often uses the Geriatric Depression Scale, a single question regarding depressive mood also provides a valid measure of depression in elderly persons. Depression is associated with lower activities of daily living, competence, and subjective quality of life among the elderly living in Vietnam and Indonesia, as well as in Japan. Advance care planning is a process of discussion between individuals and their care providers to make decisions about future care preferences and priorities, while they are still capable. If they wish, they may prepare an advance directive to inform others about their decisions and best interests, such as a written advance decision to refuse treatment and/or appointment of a person with lasting powers of attorney. The purpose of advance care planning is to enable elderly persons to receive better end-of-life care. To promote introduction of advance care planning in Japan, voluntary discussion among family members should be encouraged. PMID:23979330

  11. Advanced systems engineering and network planning support

    NASA Technical Reports Server (NTRS)

    Walters, David H.; Barrett, Larry K.; Boyd, Ronald; Bazaj, Suresh; Mitchell, Lionel; Brosi, Fred

    1990-01-01

    The objective of this task was to take a fresh look at the NASA Space Network Control (SNC) element for the Advanced Tracking and Data Relay Satellite System (ATDRSS) such that it can be made more efficient and responsive to the user by introducing new concepts and technologies appropriate for the 1997 timeframe. In particular, it was desired to investigate the technologies and concepts employed in similar systems that may be applicable to the SNC. The recommendations resulting from this study include resource partitioning, on-line access to subsets of the SN schedule, fluid scheduling, increased use of demand access on the MA service, automating Inter-System Control functions using monitor by exception, increase automation for distributed data management and distributed work management, viewing SN operational control in terms of the OSI Management framework, and the introduction of automated interface management.

  12. Beta Test Plan for Advanced Inverters Interconnecting Distributed Resources with Electric Power Systems

    SciTech Connect

    Hoke, A.; Chakraborty, S.; Basso, T.; Coddington, M.

    2014-01-01

    This document provides a preliminary (beta) test plan for grid interconnection systems of advanced inverter-based DERs. It follows the format and methodology/approach established by IEEE Std 1547.1, while incorporating: 1. Upgraded tests for responses to abnormal voltage and frequency, and also including ride-through. 2. A newly developed test for voltage regulation, including dynamic response testing. 3. Modified tests for unintentional islanding, open phase, and harmonics to include testing with the advanced voltage and frequency response functions enabled. Two advanced inverters, one single-phase and one three-phase, were tested under the beta test plan. These tests confirmed the importance of including tests for inverter dynamic response, which varies widely from one inverter to the next.

  13. Comparisons of ASTM standards cited in the NRC standard review plan, NUREG-0800 and related documents

    SciTech Connect

    Ankrum, A.R.; Bohlander, K.L.; Gilbert, E.R.; Pawlowski, R.A.; Spiesman, J.B.

    1995-10-01

    This report provides the results of comparisons of the cited and latest versions of ASTM standards cited in the NRC Standard Review Plan for the Review of Safety Analysis Reports for Nuclear Power Plants (NUREG 0800) and related documents. The comparisons were performed by Battelle Pacific Northwest Laboratories in support of the NRC`s Standard Review Plan Update and Development Program. Significant changes to the standards, from the cited version to the latest version, are described and discussed in a tabular format for each standard. Recommendations for updating each citation in the Standard Review Plan are presented. Technical considerations and suggested changes are included for related regulatory documents (i.e., Regulatory Guides and the Code of Federal Regulations) citing the standard. The results and recommendations presented in this document have not been subjected to NRC staff review.

  14. Advance end-of-life treatment planning. A research review.

    PubMed

    Miles, S H; Koepp, R; Weber, E P

    1996-05-27

    The year 1996 marks the fifth anniversary of the federal Patient Self-Determination Act. The Patient Self-Determination Act required hospitals, nursing homes, and health plans to ask whether patients have advance directives and to incorporate them into the medical record. A "living will" is an advance directive by which a person tells caregivers the circumstances in which life-sustaining treatment is to be provided or forgone if the patient is unable to communicate. A "durable power of attorney for health care" enables one to designate a person to speak on his or her behalf if the author loses decision-making capacity. "Advance planning" is the process of reflection, discussion, and communication of treatment preferences for end-of-life care that precedes and may lead to an advance directive. PMID:8638992

  15. Medicare and Advance Planning: The Importance of Context.

    PubMed

    Dresser, Rebecca

    2016-05-01

    In January 2016, a long-delayed Medicare change took effect. The Medicare program will now reimburse doctors for time they spend talking with patients about end-of-life care. This is the move that Sarah Palin and other Affordable Care Act critics said would authorize government "death panels" to decide whether older Americans should live or die. Today virtually no one buys into Palin's death panel rhetoric. But many people do think the Medicare change is a big deal. Representative Earl Blumenauer, a Democrat from Oregon who sponsored the original ACA reimbursement proposal, lauded the Medicare provision as "a turning point in end-of-life care." Others are not so sure about that. After all, laws promoting advance care planning have existed for decades. The federal Patient Self-Determination Act of 1990 and the many court decisions and state laws supporting advance care planning have had relatively little impact. Similarly, legal recognition of physician orders for life-sustaining treatment as advance planning instruments have not produced the improvements that were predicted. And from a broad perspective, advance care planning is a small piece of the puzzle. The effort to improve end-of-life care must take into account the limitations of advance decision-making, as well as the overriding importance of the general standard of care for terminally ill patients. PMID:27150411

  16. Advanced Hybrid Particulate Collector Project Management Plan

    SciTech Connect

    Miller, S.J.

    1995-11-01

    As the consumption of energy increases, its impact on ambient air quality has become a significant concern. Recent studies indicate that fine particles from coal combustion cause health problems as well as atmospheric visibility impairment. These problems are further compounded by the concentration of hazardous trace elements such as mercury, cadmium, selenium, and arsenic in fine particles. Therefore, a current need exists to develop superior, but economical, methods to control emissions of fine particles. Since most of the toxic metals present in coal will be in particulate form, a high level of fine- particle collection appears to be the best method of overall air toxics control. However, over 50% of mercury and a portion of selenium emissions are in vapor form and cannot be collected in particulate control devices. Therefore, this project will focus on developing technology not only to provide ultrahigh collection efficiency of particulate air toxic emissions, but also to capture vapor- phase trace metals such as mercury and selenium. Currently, the primary state-of-the-art technologies for particulate control are fabric filters (baghouses) and electrostatic precipitators (ESPs). However, they both have limitations that prevent them from achieving ultrahigh collection of fine particulate matter and vapor-phase trace metals. The objective of this project is to develop a highly reliable advanced hybrid particulate collector (AHPC) that can provide > 99.99 % particulate collection efficiency for all particle sizes between 0.01 and 50 14m, is applicable for use with all U.S. coals, and is cost-0443competitive with existing technologies. Phase I of the project is organized into three tasks: Task I - Project Management, Reporting, and Subcontract Consulting Task 2 - Modeling, Design, and Construction of 200-acfm AHPC Model Task 3 - Experimental Testing and Subcontract Consulting

  17. Decision aids for advance care planning: an overview of the state of the science.

    PubMed

    Butler, Mary; Ratner, Edward; McCreedy, Ellen; Shippee, Nathan; Kane, Robert L

    2014-09-16

    Advance care planning honors patients' goals and preferences for future care by creating a plan for when illness or injury impedes the ability to think or communicate about health decisions. Fewer than 50% of severely or terminally ill patients have an advance directive in their medical record, and physicians are accurate only about 65% of the time when predicting patient preferences for intensive care. Decision aids can support the advance care planning process by providing a structured approach to informing patients about care options and prompting them to document and communicate their preferences. This review, commissioned as a technical brief by the Agency for Healthcare Research and Quality Effective Health Care Program, provides a broad overview of current use of and research related to decision aids for adult advance care planning. Using interviews of key informants and a search of the gray and published literature from January 1990 to May 2014, the authors found that many decision aids are widely available but are not assessed in the empirical literature. The 16 published studies testing decision aids as interventions for adult advance care planning found that most are proprietary or not publicly available. Some are constructed for the general population, whereas others address disease-specific conditions that have more predictable end-of-life scenarios and, therefore, more discrete choices. New decision aids should be designed that are responsive to diverse philosophical perspectives and flexible enough to change as patients gain experience with their personal illness courses. Future efforts should include further research, training of advance care planning facilitators, dissemination and access, and tapping potential opportunities in social media or other technologies. PMID:25069709

  18. ICESat (GLAS) Science Processing Software Document Series. Volume 2; Science Data Management Plan; 4.0

    NASA Technical Reports Server (NTRS)

    Jester, Peggy L.; Hancock, David W., III

    1999-01-01

    This document provides the Data Management Plan for the GLAS Standard Data Software (SDS) supporting the GLAS instrument of the EOS ICESat Spacecraft. The SDS encompasses the ICESat Science Investigator-led Processing System (I-SIPS) Software and the Instrument Support Facility (ISF) Software. This Plan addresses the identification, authority, and description of the interface nodes associated with the GLAS Standard Data Products and the GLAS Ancillary Data.

  19. Advance Care Planning Beyond Advance Directives: Perspectives from Patients and Surrogates

    PubMed Central

    McMahan, Ryan; Knight, Sara J.; Fried, Terri R.; Sudore, Rebecca L.

    2014-01-01

    Context Advance care planning (ACP) has focused on documenting life-sustaining treatment preferences in advance directives (ADs). ADs alone may be insufficient to prepare diverse patients and surrogates for complex medical decisions. Objectives To understand what steps best prepare patients and surrogates for decision making. Methods We conducted 13 English/Spanish focus groups with participants from a Veterans Affairs and county hospital and the community. Seven groups included patients (n=38) aged ≥65 years, who reported making serious medical decisions. Six separate groups included surrogates (n=31), aged ≥18 years, who made decisions for others. Semi-structured focus groups asked what activities best prepared participants for decision making. Two investigators independently coded data and performed thematic content analysis. Disputes were resolved by consensus. Results Mean±SD patient age was 78±8 years and 61% were non-white. Mean±SD surrogate age was 57±10 years and 91% were non-white. Qualitative analysis identified four overarching themes about how to best prepare for decision making: 1) identify values based on past experiences and quality of life, 2) choose surrogates wisely and verify they understand their role, 3) decide whether to grant leeway in surrogate decision making, and 4) inform other family and friends of one's wishes to prevent conflict. Conclusion Beyond ADs, patients and surrogates recommend several additional steps to prepare for medical decision making including using past experiences to identify values, verifying the surrogate understands their role, deciding whether to grant surrogates leeway, and informing other family and friends of one's wishes. Future ACP interventions should consider incorporating these additional ACP activities. PMID:23200188

  20. HIV, Aging, and Advance Care Planning: Are We Successfully Planning for the Future?

    PubMed Central

    Allshouse, Amanda A.; Duong, Syki; MaWhinney, Samantha; Kohrt, Wendy M.; Campbell, Thomas B.

    2012-01-01

    Abstract Introduction Studies of advance care planning (ACP) completion rates in HIV-infected persons pre-date the “graying” of the HIV epidemic. We sought to examine current ACP completion rates and factors influencing completion among HIV-infected persons. Methods HIV-1-seropositive persons aged 45–65 years on effective antiretroviral therapy for a minimum of 6 months were enrolled in a cross-sectional survey. Likelihood of ACP was assessed by demographic and clinical characteristics, tested with odds ratios (OR) and 95% Wald confidence intervals (CI), and adjusted for gender. Results Of 238 participants, 112 (47%) completed ACP. Persons ≥55 years of age (OR 2.8; CI 1.6,5.0; p<0.001), males (OR 4.1; CI 1.8,9.3; p=0.004), and persons with higher education (OR 2.2; CI 1.3,4.0; p=0.007) were more likely to have completed ACP. Persons with a cardiac event were more likely to have completed ACP (OR 5.5; CI 1.6,25; p=0.03), although this effect was diminished after adjusting for gender (OR 4.5; CI 0.95,21.4; p=0.06). HIV infection diagnosed for greater than 5 years was not associated with ACP completion (OR 1.3; CI 0.7,2.7; p=0.4). Current CD4+ cell counts were similar between those completing and not completing documentation (588 cells/μL and 604 cells/μL, respectively; p=0.7). The likelihood of ACP did not significantly differ with other comorbidities. Discussion Less than 50% of middle-aged patients in HIV care had documented ACP. In particular, women and those with lower education were at greatest risk of non-completion and may need interventions to improve ACP. PMID:22694717

  1. Assessing Advance Care Planning: Examining Autonomous Selections in an Advance Directive.

    PubMed

    Klugman, Craig M; Tolwin, Nicole M

    2015-01-01

    We examined the management of completed advance directives including why participants completed a document, what procedures and values they chose, with whom they held end-of-life conversations, and where they stored their document. Participants elected to complete a SurveyMonkey survey that was made available to individuals who wrote an advance directive through TexasLivingWill.org; 491 individuals elected to fill out the survey, aged 19 to 94 years. The survey asked multiple questions about why participants completed an advance directive, where they would store it, and with whom they had conversations about their end-of-life wishes. A list of procedures and values allowed participants to indicate what they refused or requested in their advance directive. Advance directives are most often completed to allow patients to prepare and control the healthcare they wish to receive when dying. One-half to two-thirds of individuals refuse common end-of-life medical procedures, and the rest request the procedures. We found a correlation between the choice to refuse or request a procedure and the age of the participant. Participants reported that their end-of-life conversations most often occurred with their spouse. Respondents often reported that their advance directive was stored with their physician and power of attorney for healthcare, conversations with those individuals rarely happened. Advance directives document patients' requests for and refusals of end-of-life care. Physicians and surrogates need to be better educated so that the documents are part of a meaningful conversation with the patient. Because patients' choices change over their lifespan, these documents need to be revisited regularly and not completed as a onetime event. PMID:26399671

  2. Unit Planning Grids for Music: Grade 9-12 Advanced.

    ERIC Educational Resources Information Center

    Delaware State Dept. of Education, Dover.

    This unit planning grid outlines the expectations of Delaware high school students for advanced music studies. The grid identifies nine standards for music: (1) students will sing, independently and with others, a varied repertoire of music; (2) students will perform on instruments, independently and with others, a varied repertoire of music; (3)…

  3. Advanced Education and Technology Business Plan, 2009-12. Highlights

    ERIC Educational Resources Information Center

    Alberta Advanced Education and Technology, 2009

    2009-01-01

    Advanced Education and Technology provides strategic leadership for the development of the next generation economy in Alberta through the provision of accessible, affordable and quality learning opportunities for all Albertans and support for a dynamic and integrated innovation system. This paper provides the highlights of the business plan of the…

  4. 14 CFR 151.125 - Allowable advance planning costs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Allowable advance planning costs. 151.125 Section 151.125 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... as preliminary topographic and soil exploration; (2) Site evaluation; (3) Preliminary...

  5. 14 CFR 151.125 - Allowable advance planning costs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Allowable advance planning costs. 151.125 Section 151.125 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... as preliminary topographic and soil exploration; (2) Site evaluation; (3) Preliminary...

  6. 14 CFR 151.125 - Allowable advance planning costs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Allowable advance planning costs. 151.125 Section 151.125 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... as preliminary topographic and soil exploration; (2) Site evaluation; (3) Preliminary...

  7. 14 CFR 151.125 - Allowable advance planning costs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Allowable advance planning costs. 151.125 Section 151.125 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... as preliminary topographic and soil exploration; (2) Site evaluation; (3) Preliminary...

  8. 14 CFR 151.125 - Allowable advance planning costs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Allowable advance planning costs. 151.125 Section 151.125 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... as preliminary topographic and soil exploration; (2) Site evaluation; (3) Preliminary...

  9. An unequivocal good? Acknowledging the complexities of advance care planning.

    PubMed

    Robins-Browne, K; Palmer, V; Komesaroff, P

    2014-10-01

    Over the past few decades advance care planning (ACP) has become the subject of debate, research and legislation in many countries. Encouraging people to express their preference for treatment in advance, ideally in written form, seems a natural way to identify what someone might have wanted when they can no longer participate in decision-making. The notion of ACP as an unequivocal good permeates much of the research and policy work in this area. For example, ACP is now actively encouraged in Australian federal and state government policies and the Victorian Government has recently published a practical ACP strategy for Victorian health services (2014-2018). However, advance care plan is ethically complex and the introduction of the Victorian health services strategy provides an opportunity to reflect on this complexity, particularly on the benefits and risks of ACP. PMID:25302719

  10. 30 CFR 746.13 - Decision document and recommendation on mining plan.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) The findings and recommendations of the Bureau of Land Management with respect to the resource... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Decision document and recommendation on mining plan. 746.13 Section 746.13 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND...

  11. Comprehensive Planning Resource Document, 1990-91, for the Kern Community College District.

    ERIC Educational Resources Information Center

    Cook, Lauraine

    This compilation of resources for district planning in 1990-91 provides an overview of demographic, personnel, financial, facilities, and curriculum issues for the Kern Community College District (California) and its member institutions, Bakersfield, Cerro Coso, and Porterville colleges. The 10 sections of the document cover: (1) General…

  12. 30 CFR 254.4 - May I reference other documents in my response plan?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 2 2013-07-01 2013-07-01 false May I reference other documents in my response plan? 254.4 Section 254.4 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL-SPILL RESPONSE REQUIREMENTS FOR FACILITIES LOCATED SEAWARD OF THE COAST LINE General § 254.4 May I reference...

  13. Docket Search. Part of a Planning Document for the Establishment of a Nationwide Educational Telecommunications System.

    ERIC Educational Resources Information Center

    Synergetics, Inc., Washington, DC.

    A docket search reviews selected educational telecommunications issues brought to the attention of the Federal Communications Commission (FCC). The docket search was part of an effort to develop a planning document for the establishment of a nationwide educational telecommunications system. Key policy-making proceedings were identified which dealt…

  14. Essential Communication and Documentation Skills. Module: Final Assessment and Action Planning.

    ERIC Educational Resources Information Center

    Medina, Muriel; And Others

    This module is the 10th of 10 in the Essential Communication and Documentation Skills curriculum. It develops final assessment and action planning, workplace literacy skills identified as being directly related to the job of the direct care worker. The curriculum is designed to improve the competence of New York State Division for Youth direct…

  15. SERA - An Advanced Treatment Planning System for Neutron Therapy

    SciTech Connect

    C. A. Wemple; C. L. Albright; D. W. Nigg; D. W. Wessol; F. J. Wheeler; G. J. Harkin; M. B. Rossmeirer; M. T. Cohen; M. W. Frandsen

    1999-06-01

    The technology for computational dosimetry and treatment planning for Boron Neutron Capture Therapy (BNCT) has advanced significantly over the past few years. Because of the more complex nature of the problem, the computational methods that work well for treatment planning in photon radiotherapy are not applicable to BNCT. The necessary methods have, however, been developed and have been successfully employed both for research applications as well as human trials. Computational geometry for BNCT applications can be constructed directly from tomographic medical imagery and computed radiation dose distributions can be readily displayed in formats that are familiar to the radiotherapy community. The SERA system represents a significant advance in several areas for treatment planning. However further improvements in speed and results presentation are still needed for routine clinical applications, particularly when optimizations of dose pattern is required.

  16. Documentation of a Collaborative Transition Planning System: A Curriculum Planning Guide for Students with Mild Disabilities.

    ERIC Educational Resources Information Center

    Jackson, Jeanne

    This report describes and analyzes the transition process used at Savanna High School, Anaheim, California, and documents the unique contribution of the school's Independent Living Skills Transition Center. The report's seven sections focus on: (1) transition definitions and the need for a shared definition among agency personnel; (2) team…

  17. Comment and response document for the long-term surveillance plan for the Bodo Canyon Disposal Site, Durango. Colorado

    SciTech Connect

    1996-07-01

    This document contains comments made by the US Nuclear Regulatory Commission upon their review of the Long-Term Surveillance Plan for the Bodo Canyon Disposal Site, Durango, Colorado. Responses to the comments are also included in the document.

  18. AGU governance's decision-making process advances strategic plan

    NASA Astrophysics Data System (ADS)

    McPhaden, Michael; Finn, Carol; McEntee, Chris

    2012-10-01

    A lot has happened in a little more than 2 years, and we want give AGU members an update on how things are working under AGU's strategic plan and governance model. AGU is an organization committed to its strategic plan (http://www.agu.org/about/strategic_plan.shtml), and if you have not read the plan lately, we encourage you to do so. AGU's vision is to be an organization that "galvanizes a community of Earth and space scientists that collaboratively advances and communicates science and its power to ensure a sustainable future." We are excited about the progress we have made under this plan and the future course we have set for the Union. Everything the Board of Directors, Council, and committees put on their agendas is intended to advance AGU's strategic goals and objectives. Together with headquarters staff, these bodies are working in an integrated, effective manner to carry out this plan. The best way to demonstrate the progress made and each group's role is to walk through a recent example: the creation of a new Union-level award (see Figure 1).

  19. Design and analysis of advanced flight planning concepts

    NASA Technical Reports Server (NTRS)

    Sorensen, John A.

    1987-01-01

    The objectives of this continuing effort are to develop and evaluate new algorithms and advanced concepts for flight management and flight planning. This includes the minimization of fuel or direct operating costs, the integration of the airborne flight management and ground-based flight planning processes, and the enhancement of future traffic management systems design. Flight management (FMS) concepts are for on-board profile computation and steering of transport aircraft in the vertical plane between a city pair and along a given horizontal path. Flight planning (FPS) concepts are for the pre-flight ground based computation of the three-dimensional reference trajectory that connects the city pair and specifies the horizontal path, fuel load, and weather profiles for initializing the FMS. As part of these objectives, a new computer program called EFPLAN has been developed and utilized to study advanced flight planning concepts. EFPLAN represents an experimental version of an FPS. It has been developed to generate reference flight plans compatible as input to an FMS and to provide various options for flight planning research. This report describes EFPLAN and the associated research conducted in its development.

  20. Earth Observing System/Advanced Microwave SoundingUnit-A (EOS/AMSU-A): Acquisition activities plan

    NASA Technical Reports Server (NTRS)

    Schwantje, Robert

    1994-01-01

    This is the acquisition activities plan for the software to be used in the Earth Observing System (EOS) Advanced Microwave Sounding Unit-A (AMSU-A) system. This document is submitted in response to Contract NAS5-323 14 as CDRL 508. The procurement activities required to acquire software for the EOS/AMSU-A program are defined.

  1. Advance care planning and palliative medicine in advanced dementia: a literature review.

    PubMed

    Jethwa, Ketan Dipak; Onalaja, Oluwademilade

    2015-04-01

    Aims and method To assess the factors that affect the clinical use of advanced care planning and palliative care interventions in patients with dementia. A literature search of Medline, Embase and PsycINFO was performed to identify themes in advanced care planning and palliative care in dementia. Results In total, 64 articles were found, including 12 reviews, and three key areas emerged: barriers to advanced care planning, raising awareness and fostering communication between professionals and patients, and disease-specific interventions. Clinical implications Most of the studies analysed were carried out in the USA or Continental Europe. This narrative review aims to help guide future primary research, systematic reviews and service development in the UK. PMID:26191437

  2. Advance care planning and palliative medicine in advanced dementia: a literature review

    PubMed Central

    Jethwa, Ketan Dipak; Onalaja, Oluwademilade

    2015-01-01

    Aims and method To assess the factors that affect the clinical use of advanced care planning and palliative care interventions in patients with dementia. A literature search of Medline, Embase and PsycINFO was performed to identify themes in advanced care planning and palliative care in dementia. Results In total, 64 articles were found, including 12 reviews, and three key areas emerged: barriers to advanced care planning, raising awareness and fostering communication between professionals and patients, and disease-specific interventions. Clinical implications Most of the studies analysed were carried out in the USA or Continental Europe. This narrative review aims to help guide future primary research, systematic reviews and service development in the UK. PMID:26191437

  3. The potential for advanced computerized aids for comprehensible writing of technical documents

    NASA Astrophysics Data System (ADS)

    Kieras, D. E.

    1985-01-01

    It is widely agreed that technical documents for equipment are poorly written and hard to comprehend. This has been a long-standing problem because the information-processing demands of editing and revision are so high that many comprehensibility problems go undetected. However, many of these problems can be detected by computerized systems that scan a document and point out where the writing can be improved. Existing systems of this type are based on conventional writing customs, rather than on the research literature on comprehension, and give poor advice or miss important problems. They also do not process the input document to any depth. An approach to advanced writing aids is described; such a system would base its criticisms on what is known about the cognition psychology of comprehension, and would make use of techniques from artificial intelligence for processing the language. Some examples of the relevant research results are presented, and a demonstration system of this type is briefly described.

  4. Contribution of FDOPA PET to radiotherapy planning for advanced glioma

    NASA Astrophysics Data System (ADS)

    Dowson, Nicholas; Fay, Michael; Thomas, Paul; Jeffree, Rosalind; McDowall, Robert; Winter, Craig; Coulthard, Alan; Smith, Jye; Gal, Yaniv; Bourgeat, Pierrick; Salvado, Olivier; Crozier, Stuart; Rose, Stephen

    2014-03-01

    Despite radical treatment with surgery, radiotherapy and chemotherapy, advanced gliomas recur within months. Geographic misses in radiotherapy planning may play a role in this seemingly ineluctable recurrence. Planning is typically performed on post-contrast MRIs, which are known to underreport tumour volume relative to FDOPA PET scans. FDOPA PET fused with contrast enhanced MRI has demonstrated greater sensitivity and specificity than MRI alone. One sign of potential misses would be differences between gross target volumes (GTVs) defined using MRI alone and when fused with PET. This work examined whether such a discrepancy may occur. Materials and Methods: For six patients, a 75 minute PET scan using 3,4-dihydroxy-6-18F-fluoro-L-phynel-alanine (18F-FDOPA) was taken within 2 days of gadolinium enhanced MRI scans. In addition to standard radiotherapy planning by an experienced radiotherapy oncologist, a second gross target volume (GTV) was defined by an experienced nuclear medicine specialist for fused PET and MRI, while blinded to the radiotherapy plans. The volumes from standard radiotherapy planning were compared to the PET defined GTV. Results: The comparison indicated radiotherapy planning would change in several cases if FDOPA PET data was available. PET-defined contours were external to 95% prescribed dose for several patients. However, due to the radiotherapy margins, the discrepancies were relatively small in size and all received a dose of 50 Gray or more. Conclusions: Given the limited size of the discrepancies it is uncertain that geographic misses played a major role in patient outcome. Even so, the existence of discrepancies indicates that FDOPA PET could assist in better defining margins when planning radiotherapy for advanced glioma, which could be important for highly conformal radiotherapy plans.

  5. Care of Patients at the End of Life: Advance Care Planning.

    PubMed

    Ackermann, Richard J

    2016-08-01

    Advance directives are legal documents that give instructions about how to provide care when patients develop life-threatening illnesses and can no longer communicate their wishes. Two types of documents are widely used-a living will and a durable power of attorney for health care. Most states also authorize physician orders for life-sustaining treatment. Physicians should encourage patients, particularly those with severe chronic or terminal conditions, to prepare advance directives. Medicare now reimburses billing codes for advance care consultations. Directions regarding cardiopulmonary resuscitation and artificial ventilation often are included in advance care plans, and use of artificial nutrition and hydration (ANH) also should be addressed, particularly for patients with advanced dementia. Evidence shows that in such patients, ANH does not prolong survival, increase comfort, or improve quality of life. Given the lack of benefit, physicians should recommend against use of ANH for patients with dementia. Finally, physicians should encourage use of hospice services by patients whose life expectancy is 6 months or less. Although Medicare and most other health care insurers cover hospice care, and despite evidence that patient and family satisfaction increase when hospice services are used, many patients do not use these services. PMID:27490070

  6. Adapting and Testing Business Management Development Programs for Educational Administrators. Volume 4 of 6 Volumes. Appendix G-Planning Document: North Carolina SEA, Program Services. Appendix H-Planning Document: North Carolina LEA, Cabarrus County. Final Report.

    ERIC Educational Resources Information Center

    Klawuhn, Raymond E.; Basso, Alexander J.

    This document is comprised of two appendixes that provide a portion of the materials utilized in the project to test the feasibility of adapting business management practices to educational institutions. Included are the educational planning process documents for two of the eight participating management teams. Each planning process document…

  7. Adapting and Testing Business Management Development Programs for Educational Administrators. Volume 3 of 6 Volumes. Appendix E-Planning Document: Maryland LEA, Prince George's Co., Appendix F-Planning Document: North Carolina SEA, Executive Staff. Final Report.

    ERIC Educational Resources Information Center

    Klawuhn, Raymond E.; Basso, Alexander J.

    This document is comprised of two appendixes that provide a portion of the materials utilized in the project to test the feasibility of adapting business management practices to educational institutions. Included are the educational planning process documents for two of the eight participating management teams. Each planning process document…

  8. WHAT INFLUENCES INDIVIDUALS TO ENGAGE IN ADVANCE CARE PLANNING?

    PubMed Central

    Dellasega, Cheryl; Whitehead, Megan; Green, Michael J.

    2013-01-01

    Background Advance care planning (ACP) is an under-utilized process that involves thinking about what kind of life-prolonging medical care one would want should the need arise, identifying a spokesperson, and then communicating these wishes. Objective To better understand what influences individuals to engage in ACP. Design Three focus groups using semi-structured interactive interviews were conducted with 23 older individuals from three diverse populations in central Pennsylvania. Results Four categories of influences for engaging in ACP were identified: 1) Concern for Self; 2) Concern for Others; 3) Expectations About the Impact of Advance Care Planning; and 4) Anecdotes, Stories, & Experiences. Conclusions The motivations for undertaking ACP that we have identified offer healthcare providers insight into effective strategies for facilitating the process of ACP with their patients. PMID:20103783

  9. Implementation of a combined Cardiopulmonary Resuscitation and Treatment Escalation Plan document in a District General Hospital.

    PubMed

    Stockdale, Claire; Trivedi, Bhavi; Jerome, Ellen; Salih, Samir; Huntley, Christopher; Cooke, Eleanor; Massey, Yolanda; Mella, Sophie

    2014-01-01

    Documentation of appropriate escalation of treatment was identified as a problem for junior doctors and Critical Care Outreach Nurses at Musgrove Park Hospital. An audit of resuscitation and escalation documentation of all wards found that of the patients who were not for Cardiopulmonary resuscitation (and therefore not for full escalation of care), 78.4% had no documentation of the appropriate level of escalation of treatment should they deteriorate. The majority of junior doctors had experienced cases where they felt that inappropriate treatment had been given, where no escalation plan was documented. Using several Plan, Do, Study, Act (PDSA) cycles, drawing tools used in other trusts and departments, and the views of clinicians, we developed a treatment escalation plan (TEP) tool, to be included in the resuscitation form. This included consideration of referral to critical care, ward based non-invasive ventilation, and appropriate use of intravenous or oral antibiotics. This then prompted the responsible clinician to consider and document appropriate escalation of treatment. The CPR-TEP form was trialed using a quasi-experiment design allowing the aim to be tested using two groups - intervention and control. All patients in the intervention group were not for CPR and therefore had their TEP-CPR form filled in fully (n=68). The control group consisted of patients who were not for CPR but who did not have a TEP form filled in (n=36). The appropriateness of OOH (out of hours) treatment in those patients who experienced clinical deterioration was judged by questionnaire-based feedback from the in-hours team the following morning. Levels of inappropriate treatment between the two groups were compared to test the aim. At the end of the study period, questionnaire feedback indicated that 11.1% of patients in the group with the new CPR-TEP document had received inappropriate OOH care compared to 44.4% of patients in the group without the document. Using the TEP

  10. Documentation of a Model Action Plan to Deter Illicit Nuclear Trafficking

    SciTech Connect

    Smith, D; Kristo, M; Niemeyer, S; Dudder, G

    2006-07-28

    Theft, illegal possession, smuggling, or attempted unauthorized sale of nuclear and radiological materials remains a worldwide problem. The Nuclear Smuggling International Technical Working Group (ITWG) has adopted a model action plan to guide investigation of these cases through a systematic approach to nuclear forensics. The model action plan was recently documented and provides recommendations concerning incident response, collection of evidence in conformance with required legal standards, laboratory sampling and distribution of samples, radioactive materials analysis, including categorization and characterization of samples, forensics analysis of conventional evidence, and case development including interpretation of forensic signatures.

  11. Documentation of a model action plan to deter illicit nuclear trafficking

    SciTech Connect

    Smith, D. K.; Kristo, M. J.; Niemeyer, S.; Dudder, Gordon B.

    2008-05-04

    Theft, illegal possession, smuggling, or attempted unathorized sale of nuclear and radiological materials remains a worldwide problem. The Nuclear Smuggling International Technical Working Group (ITWG) has adopted a model action plan to guide investigation of these cases through a systematic approach to nuclear forensics. The model action plan was recently documented and provides recommendations concerning incident response, collection of evidence in conformance with required legal standards, laboratory sampling and distribution of samples, radioactive materials analysis, including categorization and characterization of samples, forensics analysis of conventional evidence, and case development including interpretation of forensic signatures.

  12. Building successful coalitions to promote advance care planning.

    PubMed

    Marchand, Lucille; Fowler, Kathryn J; Kokanovic, Obrad

    2005-01-01

    This qualitative study explored the challenges and successes of an advance care planning (ACP) coalition formed at the University of Wisconsin called Life Planning 2000. Data were obtained from key informant interviews (n = 24) and grounded theory. Major themes included commitment (the need for leadership, recruitment of key persons, and funding); cohesiveness (disparate groups collaborating toward a common purpose); and outcomes (including educational tool development). Coalitions need to define short-, intermediate-, and long-term goals that result in measurable outcomes and an evaluation process. Resources must be commensurate with goals. Results indicate that strong leadership, paid staff adequate funding, and the collaboration of diverse groups working toward a common goal are essential if a coalition promoting end-of-life (EOL) care planning is to be successful. PMID:16323714

  13. [Advance care planning for people with intellectual disability].

    PubMed

    Wagemans, Annemieke M A; van Wijmen, Frans C B

    2014-01-01

    Difficult medical decisions regularly need to be made for people with intellectual disability. They are often unable to play a meaningful role in this and the decisions fall to the family or guardians. A useful aid to proactive medical management is advance care planning. This is a long-term care plan which is centred on the well-being of patients and their quality of life. Ideally it should be a matter for patients and those closest to them, the responsible medical practitioner and those tasked with the day-to-day care of patients. It is important to draw up this plan carefully and to regularly review it in the light of current circumstances. PMID:25424633

  14. 25 CFR 290.17 - What documents must the Indian tribe include with the tribal revenue allocation plan?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false What documents must the Indian tribe include with the tribal revenue allocation plan? 290.17 Section 290.17 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ECONOMIC ENTERPRISES TRIBAL REVENUE ALLOCATION PLANS § 290.17 What documents must the Indian tribe include with the tribal...

  15. 42 CFR 137.361 - Does the Secretary have any other opportunities to approve planning or design documents prepared...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... approve planning or design documents prepared by the Self-Governance Tribe? 137.361 Section 137.361 Public... OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Roles of the Secretary in... opportunities to approve planning or design documents prepared by the Self-Governance Tribe? Yes, but only...

  16. A Conference on Planning for Documentation and the National Conference Follow-up Program (Myrtle Beach, South Carolina, February 1979).

    ERIC Educational Resources Information Center

    Dansker, Judith

    This document reports on the activities of the Southeastern Teacher Corps Network's 1979 conference on planning for the documentation and follow-up survey of educational conferences. Topics discussed at the meeting include developing the skills and operational procedures for documentation processes in Network organizations, and developing the…

  17. Technical Support Document: The Development of the Advanced Energy Design Guide for Highway Lodging Buildings

    SciTech Connect

    Jiang, Wei; Jarnagin, Ronald E.; Gowri, Krishnan; McBride, M.; Liu, Bing

    2008-09-30

    This Technical Support Document (TSD) describes the process and methodology for development of the Advanced Energy Design Guide for Highway Lodgings (AEDG-HL or the Guide), a design guidance document intended to provide recommendations for achieving 30% energy savings in highway lodging properties over levels contained in ANSI/ASHRAE/IESNA Standard 90.1-1999, Energy Standard for Buildings Except Low-Rise Residential Buildings. The AEDG-HL is the fifth in a series of guides being developed by a partnership of organizations, including the American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc. (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IESNA), the United States Green Buildings Council (USGBC), and the U.S. Department of Energy (DOE).

  18. NRC review of Electric Power Research Institute's Advanced Light Reactor Utility Requirements Document - Program summary, Project No. 669

    SciTech Connect

    Not Available

    1992-08-01

    The staff of the US Nuclear Regulatory Commission has prepared Volume 1 of a safety evaluation report (SER), NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document -- Program Summary,'' to document the results of its review of the Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document.'' This SER provides a discussion of the overall purpose and scope of the Requirements Document, the background of the staff's review, the review approach used by the staff, and a summary of the policy and technical issues raised by the staff during its review.

  19. 25 CFR 1000.52 - What criteria will the Director use to award advance planning grants?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false What criteria will the Director use to award advance... INDIAN SELF-DETERMINATION AND EDUCATION ACT Section 402(d) Planning and Negotiation Grants Advance Planning Grant Funding § 1000.52 What criteria will the Director use to award advance planning...

  20. 25 CFR 1001.9 - Selection criteria for tribes/consortia seeking advance planning grant funding.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... planning grant funding. 1001.9 Section 1001.9 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN AFFAIRS... advance planning grant funding. (a) Who is eligible to apply for a planning grant that will be awarded...-governance tribe and needs advance funding in order to complete the planning phase requirement may...

  1. Technical Support Document: The Development of the Advanced Energy Design Guide for Small Retail Buildings

    SciTech Connect

    Liu, Bing; Jarnagin, Ronald E.; Winiarski, David W.; Jiang, Wei; McBride, Merle F.; Crall, C.

    2006-09-30

    The Advanced Energy Design Guide for Small Retail Buildings (AEDG-SR) was developed by a partnership of organizations, including the American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IESNA), the United States Green Buildings Council (USGBC), and the Department of Energy (DOE). The guide is intended to offer recommendations to achieve 30% energy savings and thus to encourage steady progress towards net-zero energy buildings. The baseline level energy use was set at buildings built at the turn of the millennium, which are assumed to be based on ANSI/ASHRAE/IESNA Standard 90.1-1999, Energy Standard for Buildings Except Low-Rise Residential Buildings (refer to as the ?Standard? in this report). ASHRAE and its partners are engaged in the development of a series of guides for small commercial buildings, with the AEDG-SR being the second in the series. Previously the partnership developed the Advanced Energy Design Guide for Small Office Buildings: Achieving 30% Energy Savings Over ANSI/ASHRAE/IESNA Standard 90.1-1999, which was published in late 2004. The technical support document prepared by PNNL details how the energy analysis performed in support of the Guide and documents development of recommendation criteria.

  2. Dalton State College Strategic Plan, 2000-2003. Trends and Issues in Post-Secondary Education: An Environmental Analysis Report. A Strategic Planning Document.

    ERIC Educational Resources Information Center

    Dalton College, GA. Office of Institutional Research and Planning.

    This strategic planning document prepared by the Office of Institutional Research and Planning at Dalton State College (DSC) identifies significant demographic, economic, educational, political, social and technological trends, issues, and priorities impacting institutional planning for 2000-2003. The report describes institutional mission and…

  3. Summary Document: Restoration Plan for Major Airports after a Bioterrorist Attack

    SciTech Connect

    Raber, E

    2007-01-11

    This document provides general guidelines for developing a Restoration Plan for a major airport following release of a biological warfare agent. San Francisco International Airport was selected as the example airport during development of the Plan to illustrate specific details. The spore forming bacterium Bacillus anthracis was selected as the biological agent of primary concern because it is the most difficult of known bioterrorism agents to inactivate and is considered to be one of the agents most likely to be used as a biological weapon. The focus of the Plan is on activities associated with the Characterization, Remediation, and Clearance Phases that are defined herein. Activities associated with the Notification and First-Response Phases are briefly discussed in Appendixes A and B, respectively. In addition to the main text of this Plan and associated appendixes, a data supplement was developed specifically for San Francisco International Airport. Requests for the data supplement must be made directly to the Emergency Planning Operations Division of San Francisco International Airport.

  4. Experimental area plans for an advanced hadron facility

    SciTech Connect

    Hoffman, E.W.; Macek, R.J.; Tschalear, C.

    1986-01-01

    A brief overview is presented of the current plans for an experimental area for a new advanced hadron facility for the exploration of nuclear and particle physics. The facility, LAMPF II, is presently visualized as consisting of the LAMPF linac sending 800 MeV protons to a 6 GeV booster ring followed by a 45 GeV main ring. Two experimental areas area planned. The first is intended to provide neutrinos via a pair of pulsed focusing horns. The other is designed to accommodate secondary beams that span the range of useful energies up to GeV/c. Beam specification goals are discussed with respect to source brightness, beam purity, and beam-line acceptance and length. The various beam lines are briefly described. Production cross sections and rates are estimated for antiproton production. Problems of thermal energy deposition in both components and targets and of effectiveness of particle separators are discussed. 9 refs. (LEW)

  5. A Renewal Plan for the Advanced Photon Source

    SciTech Connect

    Fischetti, Robert F.; Fuoss, Paul H.; Gerig, Rodney E.; Maclean, John F.; Mills, Dennis M.; Srajer, George; Keane, Denis T.; Neumann, Dan A.

    2010-06-23

    With coordination from the APS Renewal Steering Committee (the members of which are the co-authors of this paper), staff and users of the U.S. Department of Energy's Advanced Photon Source (APS) at Argonne National Laboratory are in the process of developing a renewal plan for the facility. The renewal is a coordinated upgrade of the accelerator, beamlines, and associated technical structure that will enable users of the APS to address key scientific challenges in the coming decades. The cost of the renewal is estimated to be from $300M to $400M and to take approximately six years from start to finish.

  6. Advanced energy design and operation technologies research: Recommendations for a US Department of Energy multiyear program plan

    SciTech Connect

    Brambley, M.R.; Crawley, D.B.; Hostetler, D.D.; Stratton, R.C.; Addision, M.S.; Deringer, J.J.; Hall, J.D.; Selkowitz, S.E.

    1988-12-01

    This document describes recommendations for a multiyear plan developed for the US Department of Energy (DOE) as part of the Advanced Energy Design and Operation Technologies (AEDOT) project. The plan is an outgrowth of earlier planning activities conducted for DOE as part of design process research under the Building System Integration Program (BSIP). The proposed research will produce intelligent computer-based design and operation technologies for commercial buildings. In this document, the concept is explained, the need for these new computer-based environments is discussed, the benefits are described, and a plan for developing the AEDOT technologies is presented for the 9-year period beginning FY 1989. 45 refs., 37 figs., 9 tabs.

  7. Advance care planning for older people in Australia presenting to the emergency department from the community or residential aged care facilities.

    PubMed

    Street, Maryann; Ottmann, Goetz; Johnstone, Megan-Jane; Considine, Julie; Livingston, Patricia M

    2015-09-01

    The purpose of this retrospective, cross-sectional study was to determine the prevalence of advance care planning (ACP) among older people presenting to an Emergency Department (ED) from the community or a residential aged care facility. The study sample comprised 300 older people (aged 65+ years) presenting to three Victorian EDs in 2011. A total of 150 patients transferred from residential aged care to ED were randomly selected and then matched to 150 people who lived in the community and attended the ED by age, gender, reason for ED attendance and triage category on arrival. Overall prevalence of ACP was 13.3% (n = 40/300); over one-quarter (26.6%, n = 40/150) of those presenting to the ED from residential aged care had a documented Advance Care Plan, compared to none (0%, n = 0/150) of the people from the community. There were no significant differences in the median ED length of stay, number of investigations and interventions undertaken in ED, time seen by a doctor or rate of hospital admission for those with an Advance Care Plan compared to those without. Those with a comorbidity of cerebrovascular disease or dementia and those assessed with impaired brain function were more likely to have a documented Advance Care Plan on arrival at ED. Length of hospital stay was shorter for those with an Advance Care Plan [median (IQR) = 3 days (2-6) vs. 6 days (2-10), P = 0.027] and readmission lower (0% vs. 13.7%). In conclusion, older people from the community transferred to ED were unlikely to have a documented Advance Care Plan. Those from residential aged care who were cognitively impaired more frequently had an Advance Care Plan. In the ED, decisions of care did not appear to be influenced by the presence or absence of Advance Care Plans, but length of hospital admission was shorter for those with an Advance Care Plan. PMID:25443161

  8. Advanced Launch System advanced development oxidizer turbopump program: Technical implementation plan

    NASA Technical Reports Server (NTRS)

    Ferlita, F.

    1989-01-01

    The Advanced Launch Systems (ALS) Advanced Development Oxidizer Turbopump Program has designed, fabricated and demonstrated a low cost, highly reliable oxidizer turbopump for the Space Transportation Engine that minimizes the recurring cost for the ALS engines. Pratt and Whitney's (P and W's) plan for integrating the analyses, testing, fabrication, and other program efforts is addressed. This plan offers a comprehensive description of the total effort required to design, fabricate, and test the ALS oxidizer turbopump. The proposed ALS oxidizer turbopump reduces turbopump costs over current designs by taking advantage of design simplicity and state-of-the-art materials and producibility features without compromising system reliability. This is accomplished by selecting turbopump operating conditions that are within known successful operating regions and by using proven manufacturing techniques.

  9. Quality of advance care planning policy and practice in residential aged care facilities in Australia

    PubMed Central

    Silvester, William; Fullam, Rachael S; Parslow, Ruth A; Lewis, Virginia J; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Gilchrist, Jane

    2013-01-01

    Objectives To assess existing advance care planning (ACP) practices in residential aged care facilities (RACFs) in Victoria, Australia before a systematic intervention; to assess RACF staff experience, understanding of and attitudes towards ACP. Design Surveys of participating organisations concerning ACP-related policies and procedures, review of existing ACP-related documentation, and pre-intervention survey of RACF staff covering their role, experiences and attitudes towards ACP-related procedures. Setting 19 selected RACFs in Victoria. Participants 12 aged care organisations (representing 19 RACFs) who provided existing ACP-related documentation for review, 12 RACFs who completed an organisational survey and 45 staff (from 19 RACFs) who completed a pre-intervention survey of knowledge, attitudes and behaviour. Results Findings suggested that some ACP-related practices were already occurring in RACFs; however, these activities were inconsistent and variable in quality. Six of the 12 responding RACFs had written policies and procedures for ACP; however, none of the ACP-related documents submitted covered all information required to meet ACP best practice. Surveyed staff had limited experience of ACP, and discrepancies between self reported comfort, and levels of knowledge and confidence to undertake ACP-related activities, indicated a need for training and ongoing organisational support. Conclusions Surveyed organisations â policies and procedures related to ACP were limited and the quality of existing documentation was poor. RACF staff had relatively limited experience in developing advance care plans with facility residents, although attitudes were positive. A systematic approach to the implementation of ACP in residential aged care settings is required to ensure best practice is implemented and sustained. PMID:24644755

  10. ICESat (GLAS) Science Processing Software Document Series. Volume 1; Science Software Management Plan; 3.0

    NASA Technical Reports Server (NTRS)

    Hancock, David W., III

    1999-01-01

    This document provides the Software Management Plan for the GLAS Standard Data Software (SDS) supporting the GLAS instrument of the EOS ICESat Spacecraft. The SDS encompasses the ICESat Science Investigator-led Processing System (I-SIPS) Software and the Instrument Support Terminal (IST) Software. For the I-SIPS Software, the SDS will produce Level 0, Level 1, and Level 2 data products as well as the associated product quality assessments and descriptive information. For the IST Software, the SDS will accommodate the GLAS instrument support areas of engineering status, command, performance assessment, and instrument health status.

  11. A novel classification and online platform for planning and documentation of medical applications of additive manufacturing.

    PubMed

    Tuomi, Jukka; Paloheimo, Kaija-Stiina; Vehviläinen, Juho; Björkstrand, Roy; Salmi, Mika; Huotilainen, Eero; Kontio, Risto; Rouse, Stephen; Gibson, Ian; Mäkitie, Antti A

    2014-12-01

    Additive manufacturing technologies are widely used in industrial settings and now increasingly also in several areas of medicine. Various techniques and numerous types of materials are used for these applications. There is a clear need to unify and harmonize the patterns of their use worldwide. We present a 5-class system to aid planning of these applications and related scientific work as well as communication between various actors involved in this field. An online, matrix-based platform and a database were developed for planning and documentation of various solutions. This platform will help the medical community to structurally develop both research innovations and clinical applications of additive manufacturing. The online platform can be accessed through http://www.medicalam.info. PMID:24616012

  12. Center for Advanced Energy Studies (CAES) Strategic Plan

    SciTech Connect

    Kevin Kostelnik; Keith Perry

    2007-07-01

    Twenty-first century energy challenges include demand growth, national energy security, and global climate protection. The Center for Advanced Energy Studies (CAES) is a public/private partnership between the State of Idaho and its academic research institutions, the federal government through the U.S. Department of Energy (DOE) and the Idaho National Laboratory (INL) managed by the Battelle Energy Alliance (BEA). CAES serves to advance energy security for our nation by expanding the educational opportunities at the Idaho universities in energy-related areas, creating new capabilities within its member institutions, and delivering technological innovations leading to technology-based economic development for the intermountain region. CAES has developed this strategic plan based on the Balanced Scorecard approach. A Strategy Map (Section 7) summarizes the CAES vision, mission, customers, and strategic objectives. Identified strategic objectives encompass specific outcomes related to three main areas: Research, Education, and Policy. Technical capabilities and critical enablers needed to support these objectives are also identified. This CAES strategic plan aligns with and supports the strategic objectives of the four CAES institutions. Implementation actions are also presented which will be used to monitor progress towards fulfilling these objectives.

  13. Technical Support Document: Development of the Advanced Energy Design Guide for Small Office Buildings

    SciTech Connect

    Jarnagin, Ronald E.; Liu, Bing; Winiarski, David W.; McBride, Merle F.; Suharli, L.; Walden, D.

    2006-11-30

    This Technical Support Document (TSD) describes the process and methodology for the development of the Advanced Energy Design Guide for Small Office Buildings (AEDG-SO), a design guidance document intended to provide recommendations for achieving 30% energy savings in small office buildings over levels contained in ANSI/ASHRAE/IESNA Standard 90.1-1999, Energy Standard for Buildings Except Low-Rise Residential Buildings. The AEDG-SO is the first in a series of guides being developed by a partnership of organizations, including the American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc. (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IESNA), the New Buildings Institute (NBI), and the U.S. Department of Energy (DOE). Each of the guides in the AEDG series will provide recommendations and user-friendly design assistance to designers, developers and owners of small commercial buildings that will encourage steady progress towards net-zero energy buildings. The guides will provide prescriptive recommendation packages that are capable of reaching the energy savings target for each climate zone in order to ease the burden of the design and construction of energy-efficient small commercial buildings The AEDG-SO was developed by an ASHRAE Special Project committee (SP-102) made up of representatives of each of the partner organizations in eight months. This TSD describes the charge given to the committee in developing the office guide and outlines the schedule of the development effort. The project committee developed two prototype office buildings (5,000 ft2 frame building and 20,000 ft2 two-story mass building) to represent the class of small office buildings and performed an energy simulation scoping study to determine the preliminary levels of efficiency necessary to meet the energy savings target. The simulation approach used by the project committee is documented in this TSD along with

  14. Management plan documentation standard and Data Item Descriptions (DID). Volume of the information system life-cycle and documentation standards, volume 2

    NASA Technical Reports Server (NTRS)

    Callender, E. David; Steinbacher, Jody

    1989-01-01

    This is the second of five volumes of the Information System Life-Cycle and Documentation Standards. This volume provides a well-organized, easily used standard for management plans used in acquiring, assuring, and developing information systems and software, hardware, and operational procedures components, and related processes.

  15. Technical Support Document: Development of the Advanced Energy Design Guide for Large Hospitals - 50% Energy Savings

    SciTech Connect

    Bonnema, E.; Leach, M.; Pless, S.

    2013-06-01

    This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Large Hospitals: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-LH) ASHRAE et al. (2011b). The AEDG-LH is intended to provide recommendations for achieving 50% whole-building energy savings in large hospitals over levels achieved by following Standard 90.1-2004. The AEDG-LH was created for a 'standard' mid- to large-size hospital, typically at least 100,000 ft2, but the strategies apply to all sizes and classifications of new construction hospital buildings. Its primary focus is new construction, but recommendations may be applicable to facilities undergoing total renovation, and in part to many other hospital renovation, addition, remodeling, and modernization projects (including changes to one or more systems in existing buildings).

  16. 25 CFR 290.17 - What documents must the Indian tribe include with the tribal revenue allocation plan?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... INTERIOR ECONOMIC ENTERPRISES TRIBAL REVENUE ALLOCATION PLANS § 290.17 What documents must the Indian tribe... and place of adoption and the result of any vote taken, that certifies you have adopted the...

  17. 25 CFR 290.17 - What documents must the Indian tribe include with the tribal revenue allocation plan?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... INTERIOR ECONOMIC ENTERPRISES TRIBAL REVENUE ALLOCATION PLANS § 290.17 What documents must the Indian tribe... and place of adoption and the result of any vote taken, that certifies you have adopted the...

  18. 25 CFR 290.17 - What documents must the Indian tribe include with the tribal revenue allocation plan?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... INTERIOR ECONOMIC ENTERPRISES TRIBAL REVENUE ALLOCATION PLANS § 290.17 What documents must the Indian tribe... and place of adoption and the result of any vote taken, that certifies you have adopted the...

  19. 25 CFR 290.17 - What documents must the Indian tribe include with the tribal revenue allocation plan?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... INTERIOR ECONOMIC ENTERPRISES TRIBAL REVENUE ALLOCATION PLANS § 290.17 What documents must the Indian tribe... and place of adoption and the result of any vote taken, that certifies you have adopted the...

  20. Comment and response document for the long-term surveillance plan for the Collins Ranch Disposal Site Lakeview, Oregon

    SciTech Connect

    Not Available

    1993-11-01

    Twenty-nine comments from the US Nuclear Regulatory Commission and six from the Grand Junction Project Office for the long-term surveillance plan for the Collins Ranch Disposal Site, Lakeview, Oregon are documented along with their corresponding responses.

  1. Preliminary analysis of an integrated logistics system for OSSA payloads. Volume 3: OSSA integrated logistics support planning document

    NASA Technical Reports Server (NTRS)

    Palguta, T.; Bradley, W.; Stockton, T.

    1988-01-01

    Guidance in preparing and updating an integrated logistics support plan (ILSP) is given. Clear, concise, and detailed instructions are provided on the preparation and content of an ILSP in order to ensure a quality document that reflects total program requirements.

  2. Comment and response document for the long-term surveillance plan for the Falls City disposal site, Falls City, Texas

    SciTech Connect

    1996-11-01

    This is the Comment and Response Document dated November 1996 for the Long-Term Surveillance Plan for the Falls City Disposal Site in Falls City, Texas. The site is part of the U.S. DOE`s Uranium Mill Tailings Remedial Action Project (UMTRA). Several comments regarding the hydrology and surface erosion described in the Long-Term Surveillance Plan are addressed in this document.

  3. Site and facility waste transport planning documents (SPDs) status and findings

    SciTech Connect

    Schmid, S P; Danese, F L; Wankerl, M W

    1993-05-01

    Site and Facility Waste Transportation Services Planning Documents (SPDS) are detailed desk-top reference documents that initiate planning for shipping commercial spent nuclear fuel (SNF) from the sites where it is currently generated and/or stored to another location. Because of the unique design features and individual variations in the spent fuel handling and cask loading operation requirements for each facility, one SPD will be written for each of the commercial facilities currently expected to deliver SNF into the Civilian Radioactive Waste Management System (CRWMS) disposal system. One primary purpose of an SPD is to initiate the discussions that will lead to a determination of the type of spent fuel cask and transport mode that will be used to transport spent fuel from each facility. The initial assessment of which cask type and mode would best serve each facility is based on the principle that the largest possible capacity casks should be used at the greatest number of facilities to reduce the total number of spent fuel shipments. The final selection of cask and transportation mode will be arrived at following discussion with the facility licensed operator. Once agreed upon by OCRWM and the facility owner, the SPD wig be used as a primary input to the development of a Site Specific Servicing Plan (SSSP) that will detail chosen servicing options for the individual site. This paper will discuss the purpose and development of SPDs and the preliminary results of an evaluation of the ability of delivering facilities to handle and ship spent fuel casks within the confines of the local nation infrastructure.

  4. 76 FR 58509 - Release of Risk and Exposure Assessment Planning Document for the Review of the National Ambient...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... the NAAQS for Pb.\\1\\ The First Draft ISA was released in early May (76 FR 26284) and reviewed by CASAC at a public meeting announced in a separate notice (76 FR 36120). The document that is the subject of... this review was issued on February 26, 2010 (75 FR 8934). The REA Planning Document has been...

  5. Space Station Freedom advanced photovoltaics and battery technology development planning

    NASA Astrophysics Data System (ADS)

    Brender, Karen D.; Cox, Spruce M.; Gates, Mark T.; Verzwyvelt, Scott A.

    1993-05-01

    Space Station Freedom (SSF) usable electrical power is planned to be built up incrementally during assembly phase to a peak of 75 kW end-of-life (EOL) shortly after Permanently Manned Capability (PMC) is achieved in 1999. This power will be provided by planar silicon (Si) arrays and nickel-hydrogen (NiH2) batteries. The need for power is expected to grow from 75 kW to as much as 150 kW EOL during the evolutionary phase of SSF, with initial increases beginning as early as 2002. Providing this additional power with current technology may not be as cost effective as using advanced technology arrays and batteries expected to develop prior to this evolutionary phase. A six-month study sponsored by NASA Langley Research Center and conducted by Boeing Defense and Space Group was initiated in Aug. 1991. The purpose of the study was to prepare technology development plans for cost effective advanced photovoltaic (PV) and battery technologies with application to SSF growth, SSF upgrade after its arrays and batteries reach the end of their design lives, and other low Earth orbit (LEO) platforms. Study scope was limited to information available in the literature, informal industry contacts, and key representatives from NASA and Boeing involved in PV and battery research and development. Ten battery and 32 PV technologies were examined and their performance estimated for SSF application. Promising technologies were identified based on performance and development risk. Rough order of magnitude cost estimates were prepared for development, fabrication, launch, and operation. Roadmaps were generated describing key issues and development paths for maturing these technologies with focus on SSF application.

  6. Space Station Freedom advanced photovoltaics and battery technology development planning

    NASA Technical Reports Server (NTRS)

    Brender, Karen D.; Cox, Spruce M.; Gates, Mark T.; Verzwyvelt, Scott A.

    1993-01-01

    Space Station Freedom (SSF) usable electrical power is planned to be built up incrementally during assembly phase to a peak of 75 kW end-of-life (EOL) shortly after Permanently Manned Capability (PMC) is achieved in 1999. This power will be provided by planar silicon (Si) arrays and nickel-hydrogen (NiH2) batteries. The need for power is expected to grow from 75 kW to as much as 150 kW EOL during the evolutionary phase of SSF, with initial increases beginning as early as 2002. Providing this additional power with current technology may not be as cost effective as using advanced technology arrays and batteries expected to develop prior to this evolutionary phase. A six-month study sponsored by NASA Langley Research Center and conducted by Boeing Defense and Space Group was initiated in Aug. 1991. The purpose of the study was to prepare technology development plans for cost effective advanced photovoltaic (PV) and battery technologies with application to SSF growth, SSF upgrade after its arrays and batteries reach the end of their design lives, and other low Earth orbit (LEO) platforms. Study scope was limited to information available in the literature, informal industry contacts, and key representatives from NASA and Boeing involved in PV and battery research and development. Ten battery and 32 PV technologies were examined and their performance estimated for SSF application. Promising technologies were identified based on performance and development risk. Rough order of magnitude cost estimates were prepared for development, fabrication, launch, and operation. Roadmaps were generated describing key issues and development paths for maturing these technologies with focus on SSF application.

  7. Advanced Platform Systems Technology study. Volume 4: Technology advancement program plan

    NASA Technical Reports Server (NTRS)

    1983-01-01

    An overview study of the major technology definition tasks and subtasks along with their interfaces and interrelationships is presented. Although not specifically indicated in the diagram, iterations were required at many steps to finalize the results. The development of the integrated technology advancement plan was initiated by using the results of the previous two tasks, i.e., the trade studies and the preliminary cost and schedule estimates for the selected technologies. Descriptions for the development of each viable technology advancement was drawn from the trade studies. Additionally, a logic flow diagram depicting the steps in developing each technology element was developed along with descriptions for each of the major elements. Next, major elements of the logic flow diagrams were time phased, and that allowed the definition of a technology development schedule that was consistent with the space station program schedule when possible. Schedules show the major milestone including tests required as described in the logic flow diagrams.

  8. An overview of advance care planning for patients with advanced chronic kidney disease: The basics.

    PubMed

    Wasylynuk, Betty Ann; Davison, Sara N

    2016-01-01

    As the number of Canadians living with end-stage kidney disease (ESKD) continues to grow, even higher numbers are living with advanced chronic kidney disease (CKD). Many of these people will eventually require renal replacement therapy (RRT), either dialysis or transplantation. More than 50% of patients starting RRT today are aged 65 or older, with the fastest growing group being patients 75 years and older. Despite advances to dialysis technology and dialysis care, the mortality rates remain high and dialysis patients' end-of-life care may not align with their preferences or values. Advance care planning (ACP) is an essential component of quality comprehensive kidney care. Kidney care teams develop strong relationships with their patients and are well positioned to integrate ACP into routine kidney care. This article defines ACP, outlines the essential components of ACP, and discusses the benefits, challenges, and special considerations of ACP. By enhancing the kidney care team's understanding of ACP, this article aims to assist in integrating ACP into routine kidney care for patients with advanced CKD. PMID:27215058

  9. Development of Advanced Multi-Modality Radiation Treatment Planning Software

    SciTech Connect

    Nigg, D W; Hartmann Siantar, C

    2002-02-19

    The Idaho National Engineering and Environmental Laboratory (INEEL) has long been active in development of advanced Monte-Carlo based computational dosimetry and treatment planning methods and software for advanced radiotherapy, with a particular focus on Neutron Capture Therapy (NCT) and, to a somewhat lesser extent, Fast-Neutron Therapy. The most recent INEEL software product system of this type is known as SERA, Simulation Environment for Radiotherapy Applications. SERA is at a mature level in its life cycle, it has been licensed for research use worldwide, and it has become well established as a computational tool for research. However, along with its strengths, SERA also has some limitations in its structure and computational methodologies. More specifically, it is optimized only for neutron-based applications. Although photon transport can be computed with SERA, the simplified model that is used is designed primarily for photons produced in the neutron transport process. Thus SERA is not appropriate for applications to, for example, standard external-beam photon radiotherapy, which is by far more commonly used in the clinic than neutron based therapy.

  10. Plans for an Upgrade of the Advanced Photon Source

    NASA Astrophysics Data System (ADS)

    Mills, Dennis; APS-U Project Team

    2011-03-01

    We are presently developing plans for an upgrade of the Advanced Photon Source facility. Science has formally issued Critical Decision 0 and approved the Mission Need Statement in April of 2010, authorizing the APS to develop a conceptual design for the APS Upgrade (APS-U) project. The proposed upgrade will include enhancements to the accelerator, beamlines, and facility infrastructure. The high brilliance x-ray beams at high photon energy (e.g. > 25 keV) provided by the APS Upgrade will have strong impact on research in energy, the environment, new or improved materials, and biological studies. High-energy x-rays can penetrate into a wide range of realistic and/or extreme environments and allow imaging of structures and processes in unprecedented detail on picosecond time scales and nanometer length scales. The presentation will include some of the essential goals of the APS-U and proposed strategies to attain those goals. The Advanced Photon Source at Argonne National Laboratory is supported by the U. S. Department of Energy, Office of Science, Office of Basic Energy Sciences, under Contract No. DE-AC02-06CH11357.

  11. End-of-Life Care for Undocumented Immigrants With Advanced Cancer: Documenting the Undocumented.

    PubMed

    Jaramillo, Sylvia; Hui, David

    2016-04-01

    There are approximately 11.1 million undocumented immigrants in the United States, with a majority being Latino. Cancer is now the leading cause of death in Latinos. There is little research guiding providers on how to deliver optimal end-of-life care in this population. We describe a case of an undocumented Latino patient with advanced cancer, and provide a review of the literature on end-of-life care in undocumented immigrants. Our patient encountered many challenges as he navigated through the healthcare system in the last months of life. These included delayed diagnosis, limited social support, financial issues, fear of deportation, and language and cultural barriers, which resulted in significant physical and psychological distress. Within the undocumented patient population, there is often a lack of advance care planning, prognostic understanding, mistrust, religious practices, and cultural beliefs that may affect decision making. Given the growing number of undocumented immigrants in the United States, it is important for clinicians and policy makers to have a better understanding of the issues surrounding end-of-life care for undocumented immigrants, and work together to improve the quality of life and quality of end-of-life care for these disadvantaged individuals. PMID:26681362

  12. Fuel qualification plan for the Advanced Neutron Source Reactor

    SciTech Connect

    Copeland, G.L.

    1995-07-01

    This report describes the development and qualification plan for the fuel for the Advanced Neutron Source. The reference fuel is U{sub 3}Si{sub 2}, dispersed in aluminum and clad in 6061 aluminum. This report was prepared in May 1994, at which time the reference design was for a two-element core containing highly enriched uranium (93% {sup 235}U) . The reactor was in the process of being redesigned to accommodate lowered uranium enrichment and became a three-element core containing a higher volume fraction of uranium enriched to 50% {sup 235}U. Consequently, this report was not issued at that time and would have been revised to reflect the possibly different requirements of the lower-enrichment, higher-volume fraction fuel. Because the reactor is now being canceled, this unrevised report is being issued for archival purposes. The report describes the fabrication and inspection development plan, the irradiation tests and performance modeling to qualify performance, the transient testing that is part of the safety program, and the interactions and interfaces of the fuel development with other tasks.

  13. Advance Care Planning: practicalities, legalities, complexities and controversies.

    PubMed

    Horridge, Karen A

    2015-04-01

    Increasing numbers, complexities and technology dependencies of children and young people with life-limiting conditions require paediatricians to be well prepared to meet their changing needs. Paediatric Advance Care Planning provides a framework for paediatricians, families and their multidisciplinary teams to consider, reflect and record the outcome of their conversations about what might happen in the future in order to optimise quality of clinical care and inform decision-making. For some children and young people this will include discussions about the possibility of death in childhood. This may be unexpected and sudden, in the context of an otherwise active management plan or may be expected and necessitate discussions about the process of dying and attention to symptoms. Decision-making about appropriate levels of intervention must take place within a legal and ethical framework, recognising that the UK Equality Act (2010) protects the rights of disabled children and young people and infants and children of all ages to the same high quality healthcare as anyone else. PMID:25275088

  14. Advanced Stirling Convertor Durability Testing: Plans and Interim Results

    NASA Technical Reports Server (NTRS)

    Meer, David W.; Oriti, Salvatore M.

    2012-01-01

    The U.S. Department of Energy (DOE), Lockheed Martin Corporation (LM), and NASA Glenn Research Center (GRC) have been developing the Advanced Stirling Radioisotope Generator (ASRG) for use as a power system for space science missions. In support of this program, GRC has been involved in testing Stirling convertors, including the Advanced Stirling Convertor (ASC), for use in the ASRG. This testing includes electromagnetic interference/compatibility (EMI/EMC), structural dynamics, advanced materials, organics, and unattended extended operation. The purpose of the durability tests is to experimentally demonstrate the margins in the ASC design. Due to the high value of the hardware, previous ASC tests focused on establishing baseline performance of the convertors within the nominal operating conditions. The durability tests present the first planned extension of the operating conditions into regions beyond those intended to meet the product spec, where the possibility exists of lateral contact, overstroke, or over-temperature events. These tests are not intended to cause damage that would shorten the life of the convertors, so they can transition into extended operation at the conclusion of the tests. This paper describes the four tests included in the durability test sequence: 1) start/stop cycling, 2) exposure to constant acceleration in the lateral and axial directions, 3) random vibration at increased piston amplitude to induce contact events, and 4) overstroke testing to simulate potential failures during processing or during the mission life where contact events could occur. The paper also summarizes the analysis and simulation used to predict the results of each of these tests.

  15. Advanced Stirling Convertor Durability Testing: Plans and Interim Results

    NASA Technical Reports Server (NTRS)

    Meer, Dave; Oriti, Sal

    2012-01-01

    The U.S. Department of Energy (DOE), Lockheed Martin Corporation (LM), and NASA Glenn Research Center (GRC) have been developing the Advanced Stirling Radioisotope Generator (ASRG) for use as a power system for space science missions. In support of this program, NASA?s Glenn Research Center (GRC) has been involved in testing Stirling convertors, including the Advanced Stirling Convertor (ASC), for use in the ASRG. This testing includes electromagnetic interference/compatibility (EMI/EMC), structural dynamics, advanced materials, organics, and unattended extended operation. The purpose of the durability tests is to experimentally demonstrate the margins in the ASC design. Due to the high value of the hardware, previous ASC tests focused on establishing baseline performance of the convertors within the nominal operating conditions. The durability tests present the first planned extension of the operating conditions into regions beyond those intended to meet the product spec, where the possibility exists of lateral contact, overstroke, or over-temperature events. These tests are not intended to cause damage that would shorten the life of the convertors, so they can transition into extended operation at the conclusion of the tests. This paper describes the four tests included in the durability test sequence: 1) start/stop cycling, 2) exposure to constant acceleration in the lateral and axial directions, 3) random vibration at increased piston amplitude to induce contact events, and 4) overstroke testing to simulate potential failures during processing or during the mission life where contact events could occur. The paper also summarizes the analysis and simulation used to predict the results of each of these tests.

  16. The views of older Malaysians on advanced directive and advanced care planning: a qualitative study.

    PubMed

    Htut, Y; Shahrul, K; Poi, P J H

    2007-01-01

    The provision of optimum care for the ageing population is dependent on the understanding of their views and values on end of life issues. A qualitative descriptive study was conducted to describe views of elderly Malaysians on Advanced Care Planning (henceforth ACP) and Advanced Directives (henceforth AD), and explore factors influencing these views. Fifteen elderly subjects with ages ranging from 65 to 83 years, representing different ethnic and religious groups in Malaysia were selected for in-depth interviews guided by a questionnaire. Five core themes were extracted from the interviews: 1) Considering the future 2) Contingency plans for future illnesses 3) Attitudes towards life prolonging treatment procedures 4) Doctor-patient relationships and 5) Influence of religion on decisions related to future illness. Despite the lack of knowledge on ACP and AD, older respondents were very receptive to their concept. Although the majority agreed on the importance of planning for future medical management and having open discussion on end of life issues with their doctor, they felt it unnecessary to make a formal written AD. Most felt that the future was best left to fate or God, and none had made any contingency plan for severe future illnesses citing religion as reason for this view. Cardiopulmonary resuscitation, mechanical ventilation and dialysis were considered by most to be invasive life prolonging treatments. We suggest that doctors initiate discussions on end of life care with every older patient and their family so as to promote awareness and introduce the concept of ACP/AD to a Malaysian setting. PMID:18330404

  17. Exploring Advance Care Planning from the Nephrology Nurse Perspective: A Literature Review.

    PubMed

    Haras, Mary S; Astroth, Kim S; Woith, Wendy L; Kossman, Susan P

    2015-01-01

    Advance care planning is a process that engages healthcare providers and patients to articulate wishes of patients as their illness progresses. Persons with chronic kidney disease require earlier and more frequent advance care planning conversations because they are faced with increased co-morbidities and a shortened lifespan. This literature review explores the phenomenon of advance care planning and the potential factors affecting nephrology nurse engagement in these discussions. PMID:26290915

  18. Reactor Accident Analysis Methodology for the Advanced Test Reactor Critical Facility Documented Safety Analysis Upgrade

    SciTech Connect

    Gregg L. Sharp; R. T. McCracken

    2003-06-01

    The regulatory requirement to develop an upgraded safety basis for a DOE nuclear facility was realized in January 2001 by issuance of a revision to Title 10 of the Code of Federal Regulations Section 830 (10 CFR 830).1 Subpart B of 10 CFR 830, “Safety Basis Requirements,” requires a contractor responsible for a DOE Hazard Category 1, 2, or 3 nuclear facility to either submit by April 9, 2001 the existing safety basis which already meets the requirements of Subpart B, or to submit by April 10, 2003 an upgraded facility safety basis that meets the revised requirements.1 10 CFR 830 identifies Nuclear Regulatory Commission (NRC) Regulatory Guide 1.70, “Standard Format and Content of Safety Analysis Reports for Nuclear Power Plants”2 as a safe harbor methodology for preparation of a DOE reactor documented safety analysis (DSA). The regulation also allows for use of a graded approach. This report presents the methodology that was developed for preparing the reactor accident analysis portion of the Advanced Test Reactor Critical Facility (ATRC) upgraded DSA. The methodology was approved by DOE for developing the ATRC safety basis as an appropriate application of a graded approach to the requirements of 10 CFR 830.

  19. Reactor Accident Analysis Methodology for the Advanced Test Reactor Critical Facility Documented Safety Analysis Upgrade

    SciTech Connect

    Sharp, G.L.; McCracken, R.T.

    2003-05-13

    The regulatory requirement to develop an upgraded safety basis for a DOE Nuclear Facility was realized in January 2001 by issuance of a revision to Title 10 of the Code of Federal Regulations Section 830 (10 CFR 830). Subpart B of 10 CFR 830, ''Safety Basis Requirements,'' requires a contractor responsible for a DOE Hazard Category 1, 2, or 3 nuclear facility to either submit by April 9, 2001 the existing safety basis which already meets the requirements of Subpart B, or to submit by April 10, 2003 an upgraded facility safety basis that meets the revised requirements. 10 CFR 830 identifies Nuclear Regulatory Commission (NRC) Regulatory Guide 1.70, ''Standard Format and Content of Safety Analysis Reports for Nuclear Power Plants'' as a safe harbor methodology for preparation of a DOE reactor documented safety analysis (DSA). The regulation also allows for use of a graded approach. This report presents the methodology that was developed for preparing the reactor accident analysis portion of the Advanced Test Reactor Critical Facility (ATRC) upgraded DSA. The methodology was approved by DOE for developing the ATRC safety basis as an appropriate application of a graded approach to the requirements of 10 CFR 830.

  20. Advance Care Planning and the Quality of End-of-Life Care among Older Adults

    PubMed Central

    Bischoff, Kara E.; Sudore, Rebecca; Miao, Yinghui; Boscardin, W. John; Smith, Alexander K.

    2013-01-01

    Background Advance care planning is increasingly common, but whether it influences end-of-life quality of care remains controversial. Design Medicare data and survey data from the Health and Retirement Study were combined to determine whether advance care planning was associated with quality metrics. Setting The nationally representative Health and Retirement Study. Participants 4394 decedent subjects (mean age 82.6 years at death, 55% women). Measurements Advance care planning was defined as having an advance directive, durable power of attorney or having discussed preferences for end-of-life care with a next-of-kin. Outcomes included previously reported quality metrics observed during the last month of life (rates of hospital admission, in-hospital death, >14 days in the hospital, intensive care unit admission, >1 emergency department visit, hospice admission, and length of hospice ≤3 days). Results Seventy-six percent of subjects engaged in advance care planning. Ninety-two percent of advance directives stated a preference to prioritize comfort. After adjustment, subjects who engaged in advance care planning were less likely to die in a hospital (adjusted RR 0.87, 95% CI 0.80-0.94), more likely to be enrolled in hospice (aRR 1.68, 1.43-1.97), and less likely to receive hospice for ≤3 days before death (aRR 0.88, 0.85-0.91). Having an advance directive, a durable-power-of-attorney or an advance care planning discussion were each independently associated with a significant increase in hospice use (p<0.01 for all). Conclusion Advance care planning was associated with improved quality of care at the end of life, including less in-hospital death and increased use of hospice. Having an advance directive, assigning a durable power of attorney and conducting advance care planning discussions are all important elements of advance care planning. PMID:23350921

  1. Advancing Design-for-Assembly: The Next Generation in Assembly Planning

    SciTech Connect

    Calton, T.L.

    1998-12-09

    At the 1995 IEEE Symposium on Assembly and Task Planning, Sandia National Laboratories introduced the Archimedes 2 Software Tool [2]. The system was described as a second-generation assembly planning system that allowed preliminmy application of awembly planning for industry, while solidly supporting further research in planning techniques. Sandia has worked closely with indust~ and academia over the last four years. The results of these working relationships have bridged a gap for the next generation in assembly planning. Zke goal of this paper is to share Sandia 's technological advancements in assembly planning over the last four years and the impact these advancements have made on the manufacturing communip.

  2. Intervention thresholds: a conceptual frame for advance care planning choices

    PubMed Central

    2014-01-01

    Background Advance care planning (ACP) provides for decisions in the event of decisional incapacity. Determining ahead of time what a person may want is challenging and limits the utility of ACP. We present empirical evidence for a new approach to ACP: the individual’s “intervention threshold.” The intervention threshold is intuitively understood by clinicians and lay people, but has not been thoroughly described, measured, or analyzed. Methods Using a mixed-methods approach to address the concept of the intervention thresholds, we recruited 52 subjects from a population of chronically ill outpatients for structured telephone interviews assessing knowledge, attitudes, and prior ACP activities. Respondents were presented with 11 interventions for each of four medical scenarios. For each scenario, they were asked whether they would accept each intervention. Data was evaluated by descriptive statistics and chi-squared statistics. Results Complete data were obtained from 52 patients, mean age of 64.5, 34.6% of whom were male. Only 17.3% reported prior ACP discussion with a physician. Rates of accepting and refusing interventions varied by scenario (p < 0.0001) and intervention intensity (p < 0.0001). Conclusions These data provide evidence that people display transitions between wanting or not wanting interventions based on scenarios. Further research is needed to determine effective ways to identify, measure, and represent the components of an individual’s intervention threshold in order to facilitate informed decision making during future incapacity. PMID:24721698

  3. [Study of 4 patients implemented to Advance Care Planning].

    PubMed

    Kawabata, Megumi; Fujiwara, Yoko; Kawabata, Hidenobu

    2015-11-01

    This is a study of 4 patients implemented to Advance Care Planning (ACP) reflecting on the health care professionals' role and the outcomes. ACP has been defined as a process of formal decision making that aims to help patients establish their decision about future care that take effect when they lose capacity. For about two years, we tried to engage all patients who were referred to our palliative care team and their families to ACP since their first consultation. We informed their conditions at that time, how their health might change and how treatment might impact on their life goals. We also attempted to help patients' decision making and then fulfill their wishes in cooperation with patients' families and healthcare professionals. We learned three important elements: understanding patients' values and wishes, explaining prediction of the clinical course of the patients and establishing a collaborative healthcare team in order to fulfill the patients' hopes. ACP improved quality of life (QOL) not only for the patients involved, but also for the family members. ACP can play a crucial role in ensuring that patients receive the care they want throughout various stages of their lives. PMID:26742180

  4. Advanced Test Reactor Capabilities and Future Irradiation Plans

    SciTech Connect

    Frances M. Marshall

    2006-10-01

    The Advanced Test Reactor (ATR), located at the Idaho National Laboratory (INL), is one of the most versatile operating research reactors in the Untied States. The ATR has a long history of supporting reactor fuel and material research for the US government and other test sponsors. The INL is owned by the US Department of Energy (DOE) and currently operated by Battelle Energy Alliance (BEA). The ATR is the third generation of test reactors built at the Test Reactor Area, now named the Reactor Technology Complex (RTC), whose mission is to study the effects of intense neutron and gamma radiation on reactor materials and fuels. The current experiments in the ATR are for a variety of customers--US DOE, foreign governments and private researchers, and commercial companies that need neutrons. The ATR has several unique features that enable the reactor to perform diverse simultaneous tests for multiple test sponsors. The ATR has been operating since 1967, and is expected to continue operating for several more decades. The remainder of this paper discusses the ATR design features, testing options, previous experiment programs, future plans for the ATR capabilities and experiments, and some introduction to the INL and DOE's expectations for nuclear research in the future.

  5. Proceedings: Advanced motors and drives R D planning forum

    SciTech Connect

    McCleer, P.J. )

    1992-12-01

    With motors consuming nearly 70% of the total US electric power generation, there is a growing need for in-depth user information and comparison data on drive technology. Adjustable-speed drive technology offers opportunities for improving the productivity, energy conservation, and cost-effectiveness of motor operation. Recommendations from an EPRI R D motors and drives forum are organized into an assessment of research needs in areas of circuits, controls, power devices, motor design, and materials. EPRI's Advanced Motors and Drives R D Planning Forum was held June 21--22, 1990, in Monterey, California. More than 110 representatives from relevant economic sectors met in four sessions, each emphasizing a different aspect of motor technology and use. Session 1 reviewed the status of newer motor systems, such as permanent magnet (PM) and reluctance motors as well as associated power electronics. Session 2 reviewed motor and drive requirements in several key application areas such as heating, ventilating, and air conditioning (HVAC); refrigeration; petrochemicals; machine tools and appliances; motion control and robotics; and electric vehicle and automobile systems. Session 3 addressed issues involving motor materials, manufacturing, and marketing. Session 4's open discussions examined other motor and drive application needs and technology issues, while identifying and prioritizing R D areas.

  6. Comparisons of ANS, ASME, AWS, and NFPA standards cited in the NRC standard review plan, NUREG-0800, and related documents

    SciTech Connect

    Ankrum, A.R.; Bohlander, K.L.; Gilbert, E.R.; Spiesman, J.B.

    1995-11-01

    This report provides the results of comparisons of the cited and latest versions of ANS, ASME, AWS and NFPA standards cited in the NRC Standard Review Plan for the Review of Safety Analysis Reports for Nuclear Power Plants (NUREG 0800) and related documents. The comparisons were performed by Battelle Pacific Northwest Laboratories in support of the NRC`s Standard Review Plan Update and Development Program. Significant changes to the standards, from the cited version to the latest version, are described and discussed in a tabular format for each standard. Recommendations for updating each citation in the Standard Review Plan are presented. Technical considerations and suggested changes are included for related regulatory documents (i.e., Regulatory Guides and the Code of Federal Regulations) citing the standard. The results and recommendations presented in this document have not been subjected to NRC staff review.

  7. 41 CFR 302-7.106 - What documentation is required to receive an advance under the commuted rate method?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What documentation is required to receive an advance under the commuted rate method? 302-7.106 Section 302-7.106 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES TRANSPORTATION AND STORAGE OF PROPERTY 7-TRANSPORTATION...

  8. Earth Observing System (EOS) Advanced Microwave Sounding Unit: A (EOS/AMSU-A) Firmware Version Description Document

    NASA Technical Reports Server (NTRS)

    Cisneros, A.

    1998-01-01

    This is the final submittal of the Earth Observing System/Advanced Microwave Sounding Unit-A Firmware Version Description Document. Its purpose is to provide a precise description of the particular version of the firmware being released. This description also defines the version of the requirements and design applicable to this version.

  9. Education and Advance Care Planning in Nursing Homes: The Impact of Ownership Type.

    ERIC Educational Resources Information Center

    Walker, Leslie C.; Bradley, Elizabeth H.

    1998-01-01

    A study of 25 nonprofit and 87 for-profit nursing homes showed both types likely to offer education on advance care planning. However, nonprofits were more likely to have ongoing discussions that covered more than life support decisions and to have ethics committees to support advance care planning. (SK)

  10. 25 CFR 1001.9 - Selection criteria for tribes/consortia seeking advance planning grant funding.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... participate in self-governance. (e) Can tribes/consortia that receive advance planning grants also apply for a..., DEPARTMENT OF THE INTERIOR SELF-GOVERNANCE PROGRAM § 1001.9 Selection criteria for tribes/consortia seeking...-governance tribe and needs advance funding in order to complete the planning phase requirement may...

  11. 25 CFR 1001.9 - Selection criteria for tribes/consortia seeking advance planning grant funding.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... participate in self-governance. (e) Can tribes/consortia that receive advance planning grants also apply for a..., DEPARTMENT OF THE INTERIOR SELF-GOVERNANCE PROGRAM § 1001.9 Selection criteria for tribes/consortia seeking...-governance tribe and needs advance funding in order to complete the planning phase requirement may...

  12. 25 CFR 1001.9 - Selection criteria for tribes/consortia seeking advance planning grant funding.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... participate in self-governance. (e) Can tribes/consortia that receive advance planning grants also apply for a..., DEPARTMENT OF THE INTERIOR SELF-GOVERNANCE PROGRAM § 1001.9 Selection criteria for tribes/consortia seeking...-governance tribe and needs advance funding in order to complete the planning phase requirement may...

  13. 14 CFR 151.123 - Procedures: Offer; amendment; acceptance; advance planning agreement.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Procedures: Offer; amendment; acceptance; advance planning agreement. 151.123 Section 151.123 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... Planning and Engineering Proposals § 151.123 Procedures: Offer; amendment; acceptance; advance...

  14. 14 CFR 151.123 - Procedures: Offer; amendment; acceptance; advance planning agreement.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Procedures: Offer; amendment; acceptance; advance planning agreement. 151.123 Section 151.123 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... Planning and Engineering Proposals § 151.123 Procedures: Offer; amendment; acceptance; advance...

  15. That was then and this is now: A case study of document control for the Advanced Test Reactor

    SciTech Connect

    Collins, S.K.; Meltzer, F.L.

    1992-01-01

    Even as Department of Energy (DOE) budgets are being adjusted to reflect the changing international scene, DOE and its contractors are becoming more proactive in environment, safety, and health. This focus places stringent requirements on Configuration Management-Document Control. EG G Idaho, Inc. (EG G Idaho), a prime management and operations contractor for DOE at the Idaho National Engineering Laboratory (INEL), operates the Advanced Test Reactor (ATR) as a major continuing program. The ATR has been operating for 25 years, under successive contractors. The requirements and techniques originally developed and applied to configuration management-document control were, by today's standards, casual. To maximize the cost-effectiveness and accuracy of ATR Configuration Management-Document Control, a major effort was required. Documents, which previously existed in various electronic file formats, have been uniformly converted into a single word processing application. An Ethernet Local Area Network (LAN) has been installed and a competent network administrator hired. A document data base has been procured and installed on the file server. Further improvements are ongoing. The data base software enables rapid searches of existing documentation and retrieves documents with pinpoint accuracy. This capability means that an accurate, current operations baseline can be output for any system, component, or process. In many ways, the new focus on distributing current, correct, and complete information has yielded significant productivity and quality improvements and cost savings. This paper addresses the process of upgrading ATR Configuration Management-Document Control.

  16. That was then and this is now: A case study of document control for the Advanced Test Reactor

    SciTech Connect

    Collins, S.K.; Meltzer, F.L.

    1992-10-01

    Even as Department of Energy (DOE) budgets are being adjusted to reflect the changing international scene, DOE and its contractors are becoming more proactive in environment, safety, and health. This focus places stringent requirements on Configuration Management-Document Control. EG&G Idaho, Inc. (EG&G Idaho), a prime management and operations contractor for DOE at the Idaho National Engineering Laboratory (INEL), operates the Advanced Test Reactor (ATR) as a major continuing program. The ATR has been operating for 25 years, under successive contractors. The requirements and techniques originally developed and applied to configuration management-document control were, by today`s standards, casual. To maximize the cost-effectiveness and accuracy of ATR Configuration Management-Document Control, a major effort was required. Documents, which previously existed in various electronic file formats, have been uniformly converted into a single word processing application. An Ethernet Local Area Network (LAN) has been installed and a competent network administrator hired. A document data base has been procured and installed on the file server. Further improvements are ongoing. The data base software enables rapid searches of existing documentation and retrieves documents with pinpoint accuracy. This capability means that an accurate, current operations baseline can be output for any system, component, or process. In many ways, the new focus on distributing current, correct, and complete information has yielded significant productivity and quality improvements and cost savings. This paper addresses the process of upgrading ATR Configuration Management-Document Control.

  17. Policy Document on Earth Observation for Urban Planning and Management: State of the Art and Recommendations for Application of Earth Observation in Urban Planning

    NASA Technical Reports Server (NTRS)

    Nichol, Janet; King, Bruce; Xiaoli, Ding; Dowman, Ian; Quattrochi, Dale; Ehlers, Manfred

    2007-01-01

    A policy document on earth observation for urban planning and management resulting from a workshop held in Hong Kong in November 2006 is presented. The aim of the workshop was to provide a forum for researchers and scientists specializing in earth observation to interact with practitioners working in different aspects of city planning, in a complex and dynamic city, Hong Kong. A summary of the current state of the art, limitations, and recommendations for the use of earth observation in urban areas is presented here as a policy document.

  18. Life Sciences Space Station planning document: A reference payload for the Life Sciences Research Facility

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The Space Station, projected for construction in the early 1990s, will be an orbiting, low-gravity, permanently manned facility providing unprecedented opportunities for scientific research. Facilities for Life Sciences research will include a pressurized research laboratory, attached payloads, and platforms which will allow investigators to perform experiments in the crucial areas of Space Medicine, Space Biology, Exobiology, Biospherics and Controlled Ecological Life Support System (CELSS). These studies are designed to determine the consequences of long-term exposure to space conditions, with particular emphasis on assuring the permanent presence of humans in space. The applied and basic research to be performed, using humans, animals, and plants, will increase our understanding of the effects of the space environment on basic life processes. Facilities being planned for remote observations from platforms and attached payloads of biologically important elements and compounds in space and on other planets (Exobiology) will permit exploration of the relationship between the evolution of life and the universe. Space-based, global scale observations of terrestrial biology (Biospherics) will provide data critical for understanding and ultimately managing changes in the Earth's ecosystem. The life sciences community is encouraged to participate in the research potential the Space Station facilities will make possible. This document provides the range and scope of typical life sciences experiments which could be performed within a pressurized laboratory module on Space Station.

  19. Advanced Education and Technology Business Plan, 2010-13. Highlights

    ERIC Educational Resources Information Center

    Alberta Advanced Education and Technology, 2010

    2010-01-01

    The Ministry of Advanced Education and Technology envisions Alberta's prosperity through innovation and lifelong learning. Advanced Education and Technology's mission is to lead the development of a knowledge-driven future through a dynamic and integrated advanced learning and innovation system. This paper presents the highlights of the business…

  20. Advance planning in end-of-life care: legal and ethical considerations for neurologists.

    PubMed

    Kerrigan, Simon; Ormerod, Ian

    2010-06-01

    Neurological illnesses can leave patients unable to make legally valid decisions about their medical treatment. However, this loss of decision making capacity can often be predicted in advance. The law in the UK now enables patients to make legally binding arrangements to either refuse specific treatments in advance or to appoint others to make decisions on their behalf. This article discusses the mechanics of advance planning under UK law and the role of the neurologist in helping patients to plan ahead. PMID:20498185

  1. Advance care planning: identifying system-specific barriers and facilitators

    PubMed Central

    Hagen, N.A.; Howlett, J.; Sharma, N.C.; Biondo, P.; Holroyd-Leduc, J.; Fassbender, K.; Simon, J.

    2015-01-01

    Background Advance care planning (acp) is an important process in health care today. How to prospectively identify potential local barriers and facilitators to uptake of acp across a complex, multi-sector, publicly funded health care system and how to develop specific mitigating strategies have not been well characterized. Methods We surveyed a convenience sample of clinical and administrative health care opinion leaders across the province of Alberta to characterize system-specific barriers and facilitators to uptake of acp. The survey was based on published literature about the barriers to and facilitators of acp and on the Michie Theoretical Domains Framework. Results Of 88 surveys, 51 (58%) were returned. The survey identified system-specific barriers that could challenge uptake of acp. The factors were categorized into four main domains. Three examples of individual system-specific barriers were “insufficient public engagement and misunderstanding,” “conflict among different provincial health service initiatives,” and “lack of infrastructure.” Local system-specific barriers and facilitators were subsequently explored through a semi-structured informal discussion group involving key informants. The group identified approaches to mitigate specific barriers. Conclusions Uptake of acp is a priority for many health care systems, but bringing about change in multi-sector health care systems is complex. Identifying system-specific barriers and facilitators to the uptake of innovation are important elements of successful knowledge translation. We developed and successfully used a simple and inexpensive process to identify local system-specific barriers and enablers to uptake of acp, and to identify specific mitigating strategies. PMID:26300673

  2. The Era of “E”: The Use of New Technologies in Advance Care Planning

    PubMed Central

    Green, Michael J.; Levi, Benjamin H.

    2012-01-01

    In this paper, we review developments in technology that can help patients, their loved ones, and healthcare providers engage in more effective advance care planning (ACP). We begin with a brief description of ACP and its purpose; then proceed to discuss various electronically available resources for ACP in the U.S.; and finally provide a critical assessment of the achievements, challenges, and future prospects for electronic advance care planning, or “e-planning.” PMID:23141197

  3. 30 CFR 254.4 - May I reference other documents in my response plan?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... OF THE INTERIOR OFFSHORE OIL-SPILL RESPONSE REQUIREMENTS FOR FACILITIES LOCATED SEAWARD OF THE COAST... documents, and Oil Spill Removal Organization (OSRO) documents that are readily accessible to the...

  4. 30 CFR 254.4 - May I reference other documents in my response plan?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... OF THE INTERIOR OFFSHORE OIL-SPILL RESPONSE REQUIREMENTS FOR FACILITIES LOCATED SEAWARD OF THE COAST... documents, and Oil Spill Removal Organization (OSRO) documents that are readily accessible to the...

  5. Expert Meeting on National Planning of Documentation and Library Services in Africa (Kampala, Uganda, 7-15 December 1970). Final Report.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Paris (France).

    The three objectives of this meeting are: (1) to evolve principles for the national planning of documentation and library services in African countries in relation to social, economic and educational plans; (2) to assess the documentation and library needs of African States and correlate a plan of development of these services for the region with…

  6. Comment and response document for the long-term surveillance plan for the Falls City Disposal Site, Falls City, Texas

    SciTech Connect

    1996-10-01

    This document contains the comments made by the US Nuclear Regulatory Commission on the Department of Energy`s (DOE) Long-Term Surveillance Plan for the Falls City Disposal Site, Falls City, Texas. DOE`s responses to the comments are also included.

  7. 20 CFR 669.660 - What planning documents and information are required in the application for MSFW youth grants and...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... required in the application for MSFW youth grants and when must they be filed? 669.660 Section 669.660... FARMWORKER JOBS PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The MSFW Youth Program § 669.660 What planning documents and information are required in the application for MSFW youth grants and when must...

  8. 20 CFR 669.660 - What planning documents and information are required in the application for MSFW youth grants and...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... required in the application for MSFW youth grants and when must they be filed? 669.660 Section 669.660... FARMWORKER JOBS PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The MSFW Youth Program § 669.660 What planning documents and information are required in the application for MSFW youth grants and when must...

  9. 20 CFR 669.660 - What planning documents and information are required in the application for MSFW youth grants and...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... required in the application for MSFW youth grants and when must they be filed? 669.660 Section 669.660... FARMWORKER JOBS PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The MSFW Youth Program § 669.660 What planning documents and information are required in the application for MSFW youth grants and when must...

  10. 20 CFR 669.660 - What planning documents and information are required in the application for MSFW youth grants and...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... required in the application for MSFW youth grants and when must they be filed? 669.660 Section 669.660... PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The MSFW Youth Program § 669.660 What planning documents and information are required in the application for MSFW youth grants and when must they be...

  11. 20 CFR 669.660 - What planning documents and information are required in the application for MSFW youth grants and...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... required in the application for MSFW youth grants and when must they be filed? 669.660 Section 669.660... PROGRAM UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT The MSFW Youth Program § 669.660 What planning documents and information are required in the application for MSFW youth grants and when must they be...

  12. Comment and response document for the long-term surveillance plan for the Collins Ranch Disposal Site, Lakeview, Oregon

    SciTech Connect

    Not Available

    1994-08-01

    This document contains comments made by the U.S. Nuclear Regulatory Commission addressing their concerns over the long-term monitoring program for the Collins Ranch Disposal Site, UMTRA project. Responses are included as well as plans for implementation of changes, if any are deemed necessary.

  13. Comment and response document for the final long-term surveillance plan for the Green River, Utah, disposal site

    SciTech Connect

    Not Available

    1994-08-01

    This document contains comments made by the U.S. Nuclear Regulatory Commission addressing their concerns over the long-term monitoring program for the Green River Disposal Site, UMTRA project. Responses are included as well as plans for implementation of changes, if any are deemed necessary.

  14. Technical Support Document: Development of the Advanced Energy Design Guide for K-12 Schools--30% Energy Savings

    SciTech Connect

    Pless, S.; Torcellini, P.; Long, N.

    2007-09-01

    This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for K-12 School Buildings (K-12 AEDG), a design guidance document intended to provide recommendations for achieving 30% energy savings in K-12 Schools over levels contained in ANSI/ASHRAE/IESNA Standard 90.1-1999, Energy Standard for Buildings Except Low-Rise Residential Buildings. The 30% energy savings target is the first step toward achieving net-zero energy schools; schools that, on an annual basis, draw from outside sources less or equal energy than they generate on site from renewable energy sources.

  15. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan part 2 mappings for the ASC software quality engineering practices, version 2.0.

    SciTech Connect

    Heaphy, Robert; Sturtevant, Judith E.; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR001.3.2 and CPR001.3.6 and to a Department of Energy document, ''ASCI Software Quality Engineering: Goals, Principles, and Guidelines''. This document also identifies ASC management and software project teams' responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  16. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1: ASC software quality engineering practices, Version 2.0.

    SciTech Connect

    Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  17. Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan. Part 2, Mappings for the ASC software quality engineering practices. Version 1.0.

    SciTech Connect

    Ellis, Molly A.; Heaphy, Robert; Sturtevant, Judith E.; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2005-01-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, 'ASCI Software Quality Engineering: Goals, Principles, and Guidelines'. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  18. Creating an advance-care-planning decision aid for high-risk surgery: a qualitative study

    PubMed Central

    2014-01-01

    Background High-risk surgery patients may lose decision-making capacity as a result of surgical complications. Advance care planning prior to surgery may be beneficial, but remains controversial and is hindered by a lack of appropriate decision aids. This study sought to examine stakeholders’ views on the appropriateness of using decision aids, in general, to support advance care planning among high-risk surgery populations and the design of such a decision aid. Methods Key informants were recruited through purposive and snowball sampling. Semi-structured interviews were conducted by phone until data collected reached theoretical saturation. Key informants were asked to discuss their thoughts about advance care planning and interventions to support advance care planning, particularly for this population. Researchers took de-identified notes that were analyzed for emerging concordant, discordant, and recurrent themes using interpretative phenomenological analysis. Results Key informants described the importance of initiating advance care planning preoperatively, despite potential challenges present in surgical settings. In general, decision aids were viewed as an appropriate approach to support advance care planning for this population. A recipe emerged from the data that outlines tools, ingredients, and tips for success that are needed to design an advance care planning decision aid for high-risk surgical settings. Conclusions Stakeholders supported incorporating advance care planning in high-risk surgical settings and endorsed the appropriateness of using decision aids to do so. Findings will inform the next stages of developing the first advance care planning decision aid for high-risk surgery patients. PMID:25067908

  19. The Timmons Savings Plan: A Working Document on a Plan to Encourage Families to Save for College.

    ERIC Educational Resources Information Center

    Tierney, Michael L.

    The Timmons Savings Plan, which encourages families to save toward college costs, is analyzed. This plan allows for periodic (non-tax deductible) contributions to an account administered by the U.S. Department of the Treasury. The amount deposited would be matched by the federal government in exchange for the government's earning the interest on…

  20. Advanced Education and Technology Business Plan, 2011-14

    ERIC Educational Resources Information Center

    Alberta Advanced Education and Technology, 2011

    2011-01-01

    Advanced Education and Technology's mission is to lead the development of a knowledge-driven future through a dynamic and integrated advanced learning and innovation system. Its core businesses are to: (1) provide strategic leadership for Campus Alberta and Alberta Innovates; and (2) engage learners, industry and the community in learning…

  1. Advanced Education and Technology Business Plan, 2009-12

    ERIC Educational Resources Information Center

    Alberta Advanced Education and Technology, 2009

    2009-01-01

    The Ministry of Advanced Education and Technology consists of the following entities for budget purposes: Department of Advanced Education and Technology, the Access to the Future Fund, Alberta Enterprise Corporation, Alberta Research Council Inc., and iCORE Inc. Achieving the Ministry's goals involves the work and coordination of many…

  2. Developing a Markup Language for Encoding Graphic Content in Plan Documents

    ERIC Educational Resources Information Center

    Li, Jinghuan

    2009-01-01

    While deliberating and making decisions, participants in urban development processes need easy access to the pertinent content scattered among different plans. A Planning Markup Language (PML) has been proposed to represent the underlying structure of plans in an XML-compliant way. However, PML currently covers only textual information and lacks…

  3. Time Pressure and Phonological Advance Planning in Spoken Production

    ERIC Educational Resources Information Center

    Damian, Markus F.; Dumay, Nicolas

    2007-01-01

    Current accounts of spoken production debate the extent to which speakers plan ahead. Here, we investigated whether the scope of phonological planning is influenced by changes in time pressure constraints. The first experiment used a picture-word interference task and showed that picture naming latencies were shorter when word distractors shared…

  4. Benefits of advanced software techniques for mission planning systems

    NASA Technical Reports Server (NTRS)

    Gasquet, A.; Parrod, Y.; Desaintvincent, A.

    1994-01-01

    The increasing complexity of modern spacecraft, and the stringent requirement for maximizing their mission return, call for a new generation of Mission Planning Systems (MPS). In this paper, we discuss the requirements for the Space Mission Planning and the benefits which can be expected from Artificial Intelligence techniques through examples of applications developed by Matra Marconi Space.

  5. Comparison of advance medical directive inquiry and documentation for hospital inpatients in three medical services: implications for policy changes.

    PubMed

    Anunobi, Echezona; Detweiler, Mark B; Sethi, Roopa; Thomas, Reena; Lutgens, Brian; Detweiler, Jonna G

    2015-01-01

    Following the introduction of the Patient Self-Determination Act of 1990, the Veterans Health Administration developed its own advance medical directive (AMD) policy, which most recently states that documentation is mandatory for all hospital patients in all settings. The object of this study was to assess the effectiveness of AMD documentation at a local Veterans Affairs Medical Center. AMD documentation was compared among three inpatient services: surgery, medicine, and psychiatry. Retrospective in nature, 594 inpatient cases were compared. Results revealed that, overall, the rate of AMD documentation was 37.7%. AMD documentation on surgery was statistically more frequent (45.6%) than for either medicine (33.2%) or psychiatry (34.5%). The difference between the numbers of days to AMD documentation for all three services was not statistically significant. While there was no statistically significant difference across gender, Caucasians had AMDs documented more frequently than African Americans (p < .001). Logistic regression reveals that social worker and physician intervention, not patient-specific variables, are the primary predictors of AMD incidence. Policy makers may need to consider the realities of hospital care, especially in emergency settings, and be more specific in the steps of implementation of the policy in the evenings, weekends, and holidays. True adherence to policy implementation may require hospital administrators to increase staff and educational efforts so that the concept of AMD communication and documentation is completely explained to all staff and patients. Policy should include an electronic record reminder that is renewed every 3 years and provisions for accommodating patients who arrive on weekends and holidays, with special awareness of the particular communication needs of minority groups. The study conclusions are that further inquiry is needed to understand these policy nuances to enable the Veterans Affairs Administration to

  6. Pediatric advance care planning from the perspective of health care professionals: A qualitative interview study

    PubMed Central

    Jox, Ralf J; Borasio, Gian Domenico; Führer, Monika

    2015-01-01

    Background: Pediatric advance care planning differs from the adult setting in several aspects, including patients’ diagnoses, minor age, and questionable capacity to consent. So far, research has largely neglected the professionals’ perspective. Aim: We aimed to investigate the attitudes and needs of health care professionals with regard to pediatric advance care planning. Design: This is a qualitative interview study with experts in pediatric end-of-life care. A qualitative content analysis was performed. Setting/participants: We conducted 17 semi-structured interviews with health care professionals caring for severely ill children/adolescents, from different professions, care settings, and institutions. Results: Perceived problems with pediatric advance care planning relate to professionals’ discomfort and uncertainty regarding end-of-life decisions and advance directives. Conflicts may arise between physicians and non-medical care providers because both avoid taking responsibility for treatment limitations according to a minor’s advance directive. Nevertheless, pediatric advance care planning is perceived as helpful by providing an action plan for everyone and ensuring that patient/parent wishes are respected. Important requirements for pediatric advance care planning were identified as follows: repeated discussions and shared decision-making with the family, a qualified facilitator who ensures continuity throughout the whole process, multi-professional conferences, as well as professional education on advance care planning. Conclusion: Despite a perceived need for pediatric advance care planning, several barriers to its implementation were identified. The results remain to be verified in a larger cohort of health care professionals. Future research should focus on developing and testing strategies for overcoming the existing barriers. PMID:25389347

  7. Foreword: planning for the future through advance directive instruments.

    PubMed

    Winick, B J

    1998-09-01

    The Foreword traces the development of advance directive instruments and discusses their legal enforceability and many benefits. Despite their advantages, advance directives remain underused and are frequently ignored by service providers. The contributors to this special issue discuss why this is so and offer and debate a variety of remedial proposals. They analyze the various legal, clinical, ethical, and practical issues presented by the use of advance directives for health and mental health care and examine new directions in their application. The Foreword describes the organization of this special issue, summarizes the articles it contains, and comments on their significance. PMID:12803208

  8. Project Plan: The MEDARP Documentation Unit to the School Improvement and Local School Development Projects.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Office of Educational Evaluation.

    The Metropolitan Educational Development and Research Project (MEDARP) Documentation Unit, located in the Office of Educational Evaluation (OEE) at the New York City Board of Education, is funded by the Ford Foundation to document, evaluate and provide technical assistance to the School Improvement and Local School Development Projects; these are…

  9. Individual Educational Plans in Swedish Schools -- Forming Identity and Governing Functions in Pupils' Documentation

    ERIC Educational Resources Information Center

    Andreasson, Ingela; Carlsson, Maj Asplund

    2013-01-01

    The documentation of pupils in Swedish schools is extensive and a documentation culture has come to characterize the schools in recent years. In the context of decentralization and changing governance, focus has increasingly been directed towards assessment, follow-up and evaluation of pupils' learning and social development. This article…

  10. Family Relationships and Advance Care Planning: Do Supportive and Critical Relations Encourage or Hinder Planning?

    PubMed Central

    2013-01-01

    Objectives. The effectiveness of advance care planning (ACP) may depend on family members’ understanding of patient preferences. However, we know of no studies that explore the association between family relationship dynamics and ACP. ACP includes a living will, durable power of attorney for health care (DPAHC) appointment, and discussions. We evaluated the effects of three aspects of family relations—general family functioning, support and criticism from spouse, and support and criticism from children—on both overall ACP and specific DPAHC designations. Method. Using multinomial logistic regression models and data from a sample of 293 older adults, we estimated the effects of family relationship quality on the likelihood of completing ACP and appointing a spouse or adult child as DPAHC. Analyses controlled for demographic and health characteristics. Results. Better overall family functioning increased the odds of ACP. Higher levels of spousal support increased the odds of holding informal discussions, whereas spousal criticism reduced the odds of naming one’s spouse as DPAHC. Both criticism and emotional support from children increased the odds that a child was named as DPAHC. Discussion. Family dynamics affect ACP in complex ways and should be considered when patients and their families discuss end-of-life care and make DPAHC designations. PMID:23286929

  11. Review of Planning for uncertainty: living wills and other advance directives for you and your family, 2nd edition by David John Doukas, M.D., and William Reichel, M.D

    PubMed Central

    Bernal, Ellen W

    2008-01-01

    Advance directives are useful ways to express one's wishes about end of life care, but even now most people have not completed one of the documents. David Doukas and William Reichel strongly encourage planning for end of life care. Although Planning for Uncertainty is at times fairly abstract for the general reader, it does provide useful background and practical steps.

  12. 38 CFR 17.32 - Informed consent and advance care planning.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... in 38 CFR Part 16, Protection of Human Subjects. (h) Advance health care planning. Subject to the... damage or sterilization, except as provided in this paragraph (g). Before treatment is initiated,...

  13. 38 CFR 17.32 - Informed consent and advance care planning.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... in 38 CFR Part 16, Protection of Human Subjects. (h) Advance health care planning. Subject to the... unusual or extremely hazardous treatment or procedure, e.g., that which might result in irreversible...

  14. 38 CFR 17.32 - Informed consent and advance care planning.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... in 38 CFR Part 16, Protection of Human Subjects. (h) Advance health care planning. Subject to the... unusual or extremely hazardous treatment or procedure, e.g., that which might result in irreversible...

  15. 38 CFR 17.32 - Informed consent and advance care planning.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... in 38 CFR Part 16, Protection of Human Subjects. (h) Advance health care planning. Subject to the... unusual or extremely hazardous treatment or procedure, e.g., that which might result in irreversible...

  16. 38 CFR 17.32 - Informed consent and advance care planning.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... in 38 CFR Part 16, Protection of Human Subjects. (h) Advance health care planning. Subject to the... unusual or extremely hazardous treatment or procedure, e.g., that which might result in irreversible...

  17. Ready or not: planning for health declines in couples with advanced multiple sclerosis.

    PubMed

    Chen, Hannah; Habermann, Barbara

    2013-02-01

    This study explored how couples living with advanced multiple sclerosis approach planning for health changes together. A qualitative descriptive approach was used, with multiple in-depth interviews. Ten couples were interviewed, consisting of 10 participants with advanced multiple sclerosis and their 10 respective spouses. Interviews were transcribed verbatim and analyzed for themes related to dyad decision making. Particular focus was paid to how or if couples planned for worsening health, including advance care planning. Characteristics of couples who had made plans for worsening health included a desire to make decisions ahead of time, work in a healthcare field, and a life-threatening health event for the care-giving partner. Characteristics of couples who had not discussed plans for worsening health included diminished quality of communication between partners and hoping for a cure. Findings suggest that providers may need to assess quality of communication between partners, because strained communication may negatively affect the process of informed healthcare decision making. PMID:23291870

  18. A review of advance care planning programs in long-term care homes: are they dementia friendly?

    PubMed

    Wickson-Griffiths, Abigail; Kaasalainen, Sharon; Ploeg, Jenny; McAiney, Carrie

    2014-01-01

    Background. Persons living with dementia in the long-term care home (LTCH) setting have a number of unique needs, including those related to planning for their futures. It is therefore important to understand the advance care planning (ACP) programs that have been developed and their impact in order for LTCH settings to select a program that best suits residents' needs. Methods. Four electronic databases were searched from 1990 to 2013, for studies that evaluated the impact of advance care planning programs implemented in the LTCH setting. Studies were critically reviewed according to rigour, impact, and the consideration of the values of residents with dementia and their family members according to the Dementia Policy Lens Toolkit. Results and Conclusion. Six ACP programs were included in the review, five of which could be considered more "dementia friendly." The programs indicated a variety of positive impacts in the planning and provision of end-of-life care for residents and their family members, most notably, increased ACP discussion and documentation. In moving forward, it will be important to evaluate the incorporation of residents with dementia's values when designing or implementing ACP interventions in the LTCH settings. PMID:24757563

  19. A Review of Advance Care Planning Programs in Long-Term Care Homes: Are They Dementia Friendly?

    PubMed Central

    Wickson-Griffiths, Abigail; Kaasalainen, Sharon; McAiney, Carrie

    2014-01-01

    Background. Persons living with dementia in the long-term care home (LTCH) setting have a number of unique needs, including those related to planning for their futures. It is therefore important to understand the advance care planning (ACP) programs that have been developed and their impact in order for LTCH settings to select a program that best suits residents' needs. Methods. Four electronic databases were searched from 1990 to 2013, for studies that evaluated the impact of advance care planning programs implemented in the LTCH setting. Studies were critically reviewed according to rigour, impact, and the consideration of the values of residents with dementia and their family members according to the Dementia Policy Lens Toolkit. Results and Conclusion. Six ACP programs were included in the review, five of which could be considered more “dementia friendly.” The programs indicated a variety of positive impacts in the planning and provision of end-of-life care for residents and their family members, most notably, increased ACP discussion and documentation. In moving forward, it will be important to evaluate the incorporation of residents with dementia's values when designing or implementing ACP interventions in the LTCH settings. PMID:24757563

  20. An Assessment of Social Diffusion in the Respecting Choices Advance Care Planning Program

    ERIC Educational Resources Information Center

    Moorman, Sara M.; Carr, Deborah; Kirchhoff, Karin T.; Hammes, Bernard J.

    2012-01-01

    This study examines the potential social diffusion effects of the Respecting Choices advance care planning program administered in La Crosse, Wisconsin, since 1991. The program produces educational materials for patients, trains facilitators to help patients prepare for end of life, and ensures that advance directives are connected to patients'…

  1. Academic Self-Perceptions of Ability and Course Planning among Academically Advanced Students

    ERIC Educational Resources Information Center

    Rudasill, Kathleen Moritz; Callahan, Carolyn M.

    2010-01-01

    The purpose of this study is to examine the contribution of gender to the academic self-perceptions of ability and related coursework plans for high school and college across academically advanced students. Participants were academically advanced students (N = 447) from grades 5 to 12. Findings revealed that (a) girls' self-perceptions of ability…

  2. Strategic Planning: How "Bifocal Vision" and a Living Document Create Success.

    ERIC Educational Resources Information Center

    Kryder, Leeanne G.

    1997-01-01

    States that "bifocal vision" allows workers to commit to a plan yet adapt to changes in business environment. Finds that written and oral communication are essential to the success of any strategic plan and that communication skills make technical communicators valuable corporate assets. Advocates introducing technical communication students to…

  3. 20 CFR 668.720 - What information must these planning documents contain?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... available to Native Americans in the community, including planned participation in the One-Stop system. (b..., DEPARTMENT OF LABOR INDIAN AND NATIVE AMERICAN PROGRAMS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Section... at 20 CFR 667.220. (d) INA grantees' plans must contain a projection of participant services...

  4. Identifying the Factors That Facilitate or Hinder Advance Planning by Persons With Dementia

    PubMed Central

    Hirschman, Karen B.; Kapo, Jennifer M.; Karlawish, Jason H. T.

    2009-01-01

    We performed semistructured interviews with 30 family members of patients with advanced dementia to identify the factors that facilitate or hinder advance planning by persons with dementia. All interviews were analyzed using qualitative data analysis techniques. The majority (77%) of family members reported that their relative had some form of written advance directive, and at least half reported previous discussions about health care preferences (57%), living situation or placement issues (50%), and finances or estate planning (60%) with the patient. Family members reported some themes that prompted planning and others that were barriers to planning. Events that most often triggered planning were medical, living situation, or financial issues associated with a friend or family member of the patient (57%). Barriers to planning included both passive and active avoidance. The most common form of passive avoidance was not realizing the importance of planning until it was too late to have the discussion (63%). The most common form of active avoidance was avoiding the discussion (53%). These data suggest potentially remediable strategies to address barriers to advance planning discussions. PMID:18580595

  5. A Strategic Action Plan for Advancing Math and Science Education in New Mexico 2007-2010

    ERIC Educational Resources Information Center

    New Mexico Public Education Department, 2007

    2007-01-01

    This Strategic Action Plan for Advancing Math and Science Education is an initial outline of strategies, actions, measures of progress, resources needed, timelines, and responsible parties. The Plan focuses on these three main goals: (1) increasing student interest, participation, and achievement in math and science; (2) raising public support and…

  6. Contabilidad Avanzada. Prontuario. Documento de Trabajo (Advanced Accounting. Handbook. Working Document).

    ERIC Educational Resources Information Center

    Puerto Rico State Dept. of Education, Hato Rey. Area for Vocational and Technical Education.

    This advanced accounting handbook is intended for a 2-semester course for 11th-grade students preparing to be accounting clerks. The guide begins with a course description, a list of competencies to be developed, and terminal and enabling objectives. Two outlines based on recommended texts cover the following topics: review of the accounting…

  7. Documenting Student Engagement Using an Intention/Reflection Exercise during an Advanced Pharmacy Practice Experience

    ERIC Educational Resources Information Center

    Fierke, Kerry K.; Lepp, Gardner A.

    2015-01-01

    The article shares the outcomes of a practice called Intention/Reflection (I/R) when applied to a group of ten students in a five-week course involving an international advanced pharmacy practice experience. Developed by the authors and founded on a combination of theoretical principles, this practice is unique because of the blend of formative…

  8. Impact of a Disease-Specific Advance Care Planning Intervention on End-of-life Care

    PubMed Central

    Kirchhoff, Karin T.; Hammes, Bernard J.; Kehl, Karen A.; Briggs, Linda A.; Brown, Roger L.

    2012-01-01

    Background/Objectives Advance Care Planning (ACP) allows patients to state preferences for their end of life care but these preferences are frequently ignored. Following a Patient-Centered ACP interview (PC-ACP), patients’ preferences were compared to care received at end of life. Design A randomized controlled trial was conducted with patients with Congestive Heart Failure or End-stage Renal Disease and their surrogates who were randomized to receive either PC-ACP or usual care. Setting Two centers in Wisconsin with associated clinics/dialysis units provided patients. Participants Of the 313 patients and their surrogates who completed entry data, 110 died. Intervention During PC-ACP the trained facilitator assessed the patient and surrogate understanding of and experiences with the illness, provided information about disease-specific treatment options and their benefits and burden, assisted in documentation of patient treatment preferences, and assisted the surrogates in understanding the patient’s preferences and their role. Measurements Preferences were documented and then compared to the care received at end of life determined by surrogate interviews or medical charts. Results Patients (74%) frequently continued to make their own decisions about care to the end. The experimental group had fewer (1/62) but not significantly so cases where the patients could not get their wishes met about CPR than control (6/48). Significantly more experimental patients withdrew from dialysis than control. Conclusions Patients and their surrogates were generally willing to discuss preferences with a trained facilitator. Most patients received the care they desired at end of life or altered their preferences to be in accord with the care they could receive. A larger sample with surrogate decision makers is needed to detect significance. PMID:22458336

  9. Role of standard documents in advancing the standardization of microfluidics connectors

    NASA Astrophysics Data System (ADS)

    Tantra, Ratna; van Heeren, Henne; Jarman, John

    2016-04-01

    An emerging trend within the microfluidic community is to standardize common parts in order to facilitate design and production activities. The goal is clear: to enhance interoperability and promote plug-and-play. A recent launch of a pan-European project, Microfluidic (MF) Manufacturing, has identified an item that is in immediate need of standardization: having in place geometrical specifications for MF connectors. In order to accelerate the adoption of such standards, there is a need to consider the pivotal role of standard documents. The purpose of this paper is to provide background information on document standards development. In addition, the future implications related to the MF manufacturing project will be discussed. A strengths, weaknesses, opportunities, and threats analysis has been carried out to identify points of action. The findings show that although there is a need to publish under International Organization for Standardization (ISO), the actual realization of a full ISO standard document is not feasible. The recommendation is to initially publish via an ISO Workshop Agreement. Parallel to such activity, there is a need to encourage stakeholders help kick start a currently dormant working group that supports microfluidics under ISO to help pave the way for future standardization activities in the microfluidics community.

  10. Chemical release and radiation effects experiment advanced planning and coordination

    NASA Technical Reports Server (NTRS)

    Vaughan, William W.; Alzmann, Melanie

    1991-01-01

    The efforts conducted to provide assessments and planning support for the Chemical Release and Radiation Effects Satellite (CRRES) Experiments are summarized. Included are activities regarding scientific working group and workshop development including the preparation of descriptive information on the CRRES Project.

  11. Plan of advanced satellite communication experiments using ETS-6

    NASA Technical Reports Server (NTRS)

    Ikegami, Tetsushi

    1989-01-01

    In 1992, an Engineering Test Satellite 6 is scheduled to be launched by an H-2 rocket. The missions of ETS-6 are to establish basic technologies of inter-satellite communications using S-band, millimeter waves and optical beams and of fixed and mobile satellite communications using multibeam antenna on board the satellite. A plan of the experiments is introduced.

  12. Advanced Simulation in Undergraduate Pilot Training (ASUPT) Facility Utilization Plan.

    ERIC Educational Resources Information Center

    Hagin, William V.; Smith, James F.

    The capabilities of a flight simulation research facility located at Williams AFB, Arizona are described. Research philosophy to be applied is discussed. Long range and short range objectives are identified. A time phased plan for long range research accomplishment is described. In addition, some examples of near term research efforts which will…

  13. Chemical release and radiation effects experiment advanced planned

    NASA Technical Reports Server (NTRS)

    Vaughan, William W.; Alzmann, Melanie

    1990-01-01

    A summary of the efforts conducted to provide assessments and planning support for the Chemical Release and Radiation Experiment Satellite (CRRES) is reported. Included are activities regarding scientific working group and workshop development including the preparation of descriptive information on the CRRES project.

  14. Technical Support Document: The Development of the Advanced Energy Design Guide for Small Warehouse and Self-Storage Buildings

    SciTech Connect

    Liu, Bing; Jarnagin, Ronald E.; Jiang, Wei; Gowri, Krishnan

    2007-12-01

    This Technical Support Document (TSD) describes the process and methodology for development of the Advanced Energy Design Guide for Small Warehouse and Self-storage Buildings (AEDG-WH or the Guide), a design guidance document intended to provide recommendations for achieving 30% energy savings in small warehouses over levels contained in ANSI/ASHRAE/IESNA Standard 90.1-1999, Energy Standard for Buildings Except Low-Rise Residential Buildings. The AEDG-WH is the fourth in a series of guides being developed by a partnership of organizations, including the American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc. (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IESNA), the United States Green Buildings Council (USGBC), and the U.S. Department of Energy (DOE).

  15. Teaching Advance Care Planning to Medical Students with a Computer-Based Decision Aid

    PubMed Central

    Levi, Benjamin H.

    2013-01-01

    Discussing end-of-life decisions with cancer patients is a crucial skill for physicians. This article reports findings from a pilot study evaluating the effectiveness of a computer-based decision aid for teaching medical students about advance care planning. Second-year medical students at a single medical school were randomized to use a standard advance directive or a computer-based decision aid to help patients with advance care planning. Students' knowledge, skills, and satisfaction were measured by self-report; their performance was rated by patients. 121/133 (91%) of students participated. The Decision-Aid Group (n=60) outperformed the Standard Group (n=61) in terms of students´ knowledge (p<0.01), confidence in helping patients with advance care planning (p<0.01), knowledge of what matters to patients (p=0.05), and satisfaction with their learning experience (p<0.01). Likewise, patients in the Decision Aid Group were more satisfied with the advance care planning method (p<0.01) and with several aspects of student performance. Use of a computer-based decision aid may be an effective way to teach medical students how to discuss advance care planning with cancer patients. PMID:20632222

  16. Analysis the Nursing Documentation of the Observation Plans and Practices of Breast Cancer Using Nursing NAVI.

    PubMed

    Inoue, Manami; Tsuru, Satoko; Omori, Miho; Sudo, Kumiko; Wako, Fumiko

    2016-01-01

    We analyzed in nursing observation planning and practices circumstances of a breast cancer patient using the Nursing NAVI® Contents. The result of this analyzed were clearly that the master plan item was satisfying a vital signature, so it could be practiced 100%. But even if the observation item of in-out balance were not records so the implementation rate of the 50%, comparison with the Nursing NAVI® Contents. About the item esteemed as required item, like, the thing with the low observation implementation rate became clear. We found that problem about estrangement of the difference between the planning the observation drafting and the implementation. The implementation item can see a little tendency much, and later, the plan item will be also a problem about the current state to which the necessary item is inferior. PMID:27332490

  17. Development of Advanced Multi-Modality Radiation Treatment Planning Software for Neutron Radiotherapy and Beyond

    SciTech Connect

    Nigg, D; Wessol, D; Wemple, C; Harkin, G; Hartmann-Siantar, C

    2002-08-20

    The Idaho National Engineering and Environmental Laboratory (INEEL) has long been active in development of advanced Monte-Carlo based computational dosimetry and treatment planning methods and software for advanced radiotherapy, with a particular focus on Neutron Capture Therapy (NCT) and, to a somewhat lesser extent, Fast-Neutron Therapy. The most recent INEEL software system of this type is known as SERA, Simulation Environment for Radiotherapy Applications. As a logical next step in the development of modern radiotherapy planning tools to support the most advanced research, INEEL and Lawrence Livermore National Laboratory (LLNL), the developers of the PEREGRTNE computational engine for radiotherapy treatment planning applications, have recently launched a new project to collaborate in the development of a ''next-generation'' multi-modality treatment planning software system that will be useful for all modern forms of radiotherapy.

  18. Advancement of remote technology: past perspectives and future plans

    SciTech Connect

    Feldman, M J; Hamel, W R

    1984-01-01

    In the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory, a comprehensive remote systems development program has existed for the past five years. The new remote technology under development is expected to significantly improve remote operations by extending the range of admissible remote tasks and increasing remote work efficiency. The motivation and justification for the program are discussed by surveying the 40 years of remote operating experience which exists and considering the essential features of various old and new philosophies which have been, or are being, used in remote engineering. A future direction based upon the Remotex concept is explained, and recent progress in the development of an advanced servomanipulator-based maintenance concept is summarized to show that a new generation of remote systems capability is feasible through advanced technology. 20 references, 10 figures, 1 table.

  19. Advancement of remote systems technology: past perspectives and future plans

    SciTech Connect

    Feldman, M.J.; Hamel, W.R.

    1984-01-01

    In the Fuel Recycle Division, Consolidated Fuel Reprocessing Program, at the Oak Ridge National Laboratory, a comprehensive remote systems development program has existed for the past five years. The new remote technology under development is expected to significantly improve remote operations by extending the range of admissible remote tasks and increasing remote work efficiency. The motivation and justification for the program are discussed by surveying the 40 years of remote operating experience which exists and considering the essential features of various old and new philosophies which have been, or are being, used in remote engineering. A future direction based upon the Teletec concept is explained, and recent progress in the development of an advanced servomanipulator-based maintenance concept is summarized to show that a new generation of remote systems capability is feasible through advanced technology. 20 references, 9 figures, 1 table.

  20. Advancement of remote technology: past perspectives and future plans

    SciTech Connect

    Feldman, M.J.; Hamel, W.R.

    1984-01-01

    In the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory, a comprehensive remote systems development program has existed for the past five years. The new remote technology under development is expected to significantly improve remote operations by extending the range of admissible remote tasks and increasing remote work efficiency. The motivation and justification for the program are discussed by surveying the 40 years of remote operating experience which exists and considering the essential features of various old and new philosophies which have been, or are being, used in remote engineering. A future direction based upon the Remotex concept is explained, and recent progress in the development of an advanced servomanipulator-based maintenance concept is summarized to show that a new generation of remote systems capability is feasible through advanced technology. 20 references, 9 figures, 1 table.

  1. Advancement of remote systems technology: past perspectives and future plans

    SciTech Connect

    Feldman, M.J.; Hamel, W.R.

    1984-01-01

    In the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory, a comprehensive remote systems development program has existed for the past five years. The new remote technology under development is expected to significantly improve remote operations by extending the range of admissible remote tasks and increasing remote work efficiency. The motivation and justification for the program are discussed by surveying the 40 years of remote operating experience which exists and considering the essential features of various old and new philosophies which have been, or are being, used in remote engineering. A future direction based upon the Remotex concept is explained, and recent progress in the development of an advanced servomanipulator-based maintenance concept is summarized to show that a new generation of remote systems capability is feasible through advanced technology. 9 references, 5 figures.

  2. Waste Management Planned for the Advanced Fuel Cycle Facility

    SciTech Connect

    Soelberg

    2007-09-01

    The U.S. Department of Energy (DOE) Global Nuclear Energy Partnership (GNEP) program has been proposed to develop and employ advanced technologies to increase the proliferation resistance of spent nuclear fuels, recover and reuse nuclear fuel resources, and reduce the amount of wastes requiring permanent geological disposal. In the initial GNEP fuel cycle concept, spent nuclear fuel is to be reprocessed to separate re-useable transuranic elements and uranium from waste fission products, for fabricating new fuel for fast reactors. The separated wastes would be converted to robust waste forms for disposal. The Advanced Fuel Cycle Facility (AFCF) is proposed by DOE for developing and demonstrating spent nuclear fuel recycling technologies and systems. The AFCF will include capabilities for receiving and reprocessing spent fuel and fabricating new nuclear fuel from the reprocessed spent fuel. Reprocessing and fuel fabrication activities will generate a variety of radioactive and mixed waste streams. Some of these waste streams are unique and unprecedented. The GNEP vision challenges traditional U.S. radioactive waste policies and regulations. Product and waste streams have been identified during conceptual design. Waste treatment technologies have been proposed based on the characteristics of the waste streams and the expected requirements for the final waste forms. Results of AFCF operations will advance new technologies that will contribute to safe and economical commercial spent fuel reprocessing facilities needed to meet the GNEP vision. As conceptual design work and research and design continues, the waste management strategies for the AFCF are expected to also evolve.

  3. Advanced type placement and geonames database: comprehensive coordination plan

    SciTech Connect

    Barnes, A.E.; Gough, E.C.; Brown, R.M.; Zied, A.

    1983-01-01

    This paper presents a preliminary comprehensive coordination plan for the technical development and integration of an automated names database capture and management of an overall automated cartographic system, for the Defense Mapping Agency. It broadly covers the technical issues associated with system and associated subsystems functional requirements, inter-subsystem interaction common technologies in hardware, software, database, and artificial intelligence. The 3-phase RandD cycles for each and all subsystems are also outlined.

  4. Engaging Chinese American Adults in Advance Care Planning: A Community-Based, Culturally Sensitive Seminar.

    PubMed

    Lee, Mei Ching; Hinderer, Katherine A; Friedmann, Erika

    2015-08-01

    Ethnic minority groups are less engaged than Caucasian American adults in advance care planning (ACP). Knowledge deficits, language, and culture are barriers to ACP. Limited research exists on ACP and advance directives in the Chinese American adult population. Using a pre-posttest, repeated measures design, the current study explored the effectiveness of a nurseled, culturally sensitive ACP seminar for Chinese American adults on (a) knowledge, completion, and discussion of advance directives; and (b) the relationship between demographic variables, advance directive completion, and ACP discussions. A convenience sample of 72 urban, community-dwelling Chinese American adults (mean age=61 years) was included. Knowledge, advance directive completion, and ACP discussions increased significantly after attending the nurse-led seminar (p<0.01). Increased age correlated with advance directive completion and ACP discussions; female gender correlated with ACP discussions. Nursing education in a community setting increased advance directive knowledge and ACP engagement in Chinese American adults. PMID:25912237

  5. Quality Standards for Early Childhood Care and Education Services: A Planning Document.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Education, Denver.

    This document is intended to be a self-evaluation tool to assist Colorado early childhood programs in working toward quality services. Eleven sections provide rating criteria on: (1) interaction among staff and children; (2) curriculum; (3) family-staff partnership; (4) staff qualifications and development; (5) administration; (6) staffing…

  6. 45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... feasibility of the proposed effort and provide for the conduct of a requirements analysis study which address... indicate how the results of the requirements analysis study will be incorporated into the proposed...

  7. 45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... feasibility of the proposed effort and provide for the conduct of a requirements analysis study which address... indicate how the results of the requirements analysis study will be incorporated into the proposed...

  8. 45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... feasibility of the proposed effort and provide for the conduct of a requirements analysis study which address... indicate how the results of the requirements analysis study will be incorporated into the proposed...

  9. The advancement of public awareness, concerning TRU waste characterization, using a virtual document.

    SciTech Connect

    West, T. B.; Burns, T. P.; Estill, W. G.; Riggs, M. J.; Taggart, Daniel P.; Punjak, W. A.

    2002-01-01

    Building public trust and confidence through openness is a goal of the DOE Carlsbad Field Office for the Waste Isolation Pilot Plant (WIPP). The objective of the virtual document described in this paper is to give the public an overview of the waste characterization steps, an understanding of how waste characterization instrumentation works, and the type and amount of data generated from a batch of drums. The document is intended to be published on a web page andlor distributed at public meetings on CDs. Users may gain as much information as they desire regarding the transuranic (TRU) waste characterization program, starting at the highest level requirements (drivers) and progressing to more and more detail regarding how the requirements are met. Included are links to: (1) drivers (which include laws, permits and DOE Orders) (2) various characterization steps required for transportation and disposal under WIPP's Hazardous Waste Facility Permit (3) physical/chemical basis for each characterization method (4) types of data produced (5) quality assurance process that accompanies each measurement

  10. Recent advances in surgical planning & navigation for tumor biopsy and resection.

    PubMed

    Wang, Defeng; Ma, Diya; Wong, Matthew Lun; Wáng, Yì Xiáng J

    2015-10-01

    This paper highlights recent advancements in imaging technologies for surgical planning and navigation in tumor biopsy and resection which need high-precision in detection and characterization of lesion margin in preoperative planning and intraoperative navigation. Multimodality image-guided surgery platforms brought great benefits in surgical planning and operation accuracy via registration of various data sets with information on morphology [X-ray, magnetic resonance (MR), computed tomography (CT)], function connectivity [functional magnetic resonance imaging (fMRI), diffusion tensor imaging (DTI), rest-status fMRI], or molecular activity [positron emission tomography (PET)]. These image-guided platforms provide a correspondence between the pre-operative surgical planning and intra-operative procedure. We envisage that the combination of advanced multimodal imaging, three-dimensional (3D) printing, and cloud computing will play increasingly important roles in planning and navigation of surgery for tumor biopsy and resection in the coming years. PMID:26682133

  11. Recent advances in surgical planning & navigation for tumor biopsy and resection

    PubMed Central

    Ma, Diya; Wong, Matthew Lun; Wáng, Yì Xiáng J.

    2015-01-01

    This paper highlights recent advancements in imaging technologies for surgical planning and navigation in tumor biopsy and resection which need high-precision in detection and characterization of lesion margin in preoperative planning and intraoperative navigation. Multimodality image-guided surgery platforms brought great benefits in surgical planning and operation accuracy via registration of various data sets with information on morphology [X-ray, magnetic resonance (MR), computed tomography (CT)], function connectivity [functional magnetic resonance imaging (fMRI), diffusion tensor imaging (DTI), rest-status fMRI], or molecular activity [positron emission tomography (PET)]. These image-guided platforms provide a correspondence between the pre-operative surgical planning and intra-operative procedure. We envisage that the combination of advanced multimodal imaging, three-dimensional (3D) printing, and cloud computing will play increasingly important roles in planning and navigation of surgery for tumor biopsy and resection in the coming years. PMID:26682133

  12. Attitudes on end-of-life care and advance care planning in the lesbian and gay community.

    PubMed

    Stein, G L; Bonuck, K A

    2001-01-01

    Gay men and lesbians have special interests in documenting their preferences regarding advance care planning and end-of-life care. A 64-item survey instrument was developed to ascertain the preferences of this community regarding approaches to end-of-life care, viewpoints on physician-assisted suicide (PAS) and euthanasia, and practices regarding advance care planning. The survey was completed by 575 participants recruited through community-based health care and social service organizations serving the lesbian and gay community, primarily in the New York metropolitan area. Respondents represent a diverse group of women (36%) and men (63%) from various age, racial/ethnic, and religious/spiritual backgrounds; 10% were human immunodeficiency virus (HIV)-positive. Respondents' perspectives on end-of-life care are generally consistent with findings from other attitudinal studies of U.S. adults: a majority supported legalization of PAS and preferred a palliative approach to end-of-life care. However, the gay community sample revealed even stronger support for assisted suicide and palliative care. Although respondents completed advance directives at a higher rate than adults generally, the legal importance for gay men and lesbians to execute directives should encourage health care providers and community organizations to assume a larger educational role on advance care planning. Results confirm other reports on the need to address provider communication skills. It is speculated that the HIV epidemic was a major influence behind these results because of the overwhelming personal impact of the epidemic on most gay men and lesbians during the past two decades. PMID:11441626

  13. Strategic environmental assessment in tourism planning - Extent of application and quality of documentation

    SciTech Connect

    Carvalho Lemos, Clara; Fischer, Thomas B.; Pereira Souza, Marcelo

    2012-07-15

    Strategic environmental assessment (SEA) has been applied throughout the world in different sectors and in various ways. This paper reports on results of a PhD research on SEA applied to tourism development planning, reflecting the situation in mid-2010. First, the extent of tourism specific SEA application world-wide is established. Then, based on a review of the quality of 10 selected SEA reports, good practice, as well as challenges, trends and opportunities for tourism specific SEA are identified. Shortcomings of SEA in tourism planning are established and implications for future research are outlined. - Highlights: Black-Right-Pointing-Pointer The extent of tourism specific SEA practice is identified. Black-Right-Pointing-Pointer Selected SEA/Tourism reports are evaluated. Black-Right-Pointing-Pointer SEA application to tourism planning is still limited. Black-Right-Pointing-Pointer A number of shortcomings can be pointed out.

  14. It's just too hard! Australian health care practitioner perspectives on barriers to advance care planning.

    PubMed

    Boddy, Jennifer; Chenoweth, Lesley; McLennan, Vanette; Daly, Michelle

    2013-01-01

    This article presents findings from six focus groups with health care practitioners in an Australian hospital during 2010, which sought to elicit their perspectives on the barriers for people to plan their future health care should they become unwell. Such knowledge is invaluable in overcoming the barriers associated with advance care planning and enhancing the uptake of advance directives and the appointment of an enduring power of attorney for people of all ages. A person's rights to self-determination in health care, including decision making about their wishes for future care in the event they lose cognitive capacity, should not be overlooked against the backdrop of increasing pressure on health care systems. Findings suggest that multiple barriers exist, from practitioners' perspectives, which can be divided into three major categories, namely: patient-centred, practitioner-centred and system-centred barriers. Specifically, patient-centred barriers include lack of knowledge, accessibility concerns, the small 'window of opportunity' to discuss advance care planning, emotional reactions and avoidance when considering one's mortality, and demographic influences. At the practitioner level, barriers relate to a lack of knowledge and uncertainty around advance care planning processes. Systemically, legislative barriers (including a lack of a central registry and conflicting state legislation), procedural issues (particularly in relation to assessing cognitive capacity and making decisions ad hoc) and questions about delegation, roles and responsibilities further compound the barriers to advance care planning. PMID:22951247

  15. Promoting advance planning for health care and research among older adults: A randomized controlled trial

    PubMed Central

    2012-01-01

    Background Family members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research studies. Discussion and documentation of preferences could improve proxies' abilities to decide for their loved ones. This trial assesses the efficacy of an advance planning intervention in improving the accuracy of substitute decision-making and increasing the frequency of documented preferences for health care and research. It also investigates the financial impact on the healthcare system of improving substitute decision-making. Methods/Design Dyads (n = 240) comprising an older adult and his/her self-selected proxy are randomly allocated to the experimental or control group, after stratification for type of designated proxy and self-report of prior documentation of healthcare preferences. At baseline, clinical and research vignettes are used to elicit older adult preferences and assess the ability of their proxy to predict those preferences. Responses are elicited under four health states, ranging from the subject's current health state to severe dementia. For each state, we estimated the public costs of the healthcare services that would typically be provided to a patient under these scenarios. Experimental dyads are visited at home, twice, by a specially trained facilitator who communicates the dyad-specific results of the concordance assessment, helps older adults convey their wishes to their proxies, and offers assistance in completing a guide entitled My Preferences that we designed specifically for that purpose. In between these meetings, experimental dyads attend a group information session about My Preferences. Control dyads attend three monthly workshops aimed at promoting healthy behaviors. Concordance assessments are repeated at the

  16. Electronic document management system analysis report and system plan for the Environmental Restoration Program

    SciTech Connect

    Frappaolo, C.

    1995-09-01

    Lockheed Martin Energy Systems, Inc. (LMES) has established and maintains Document Management Centers (DMCs) to support Environmental Restoration Program (ER) activities undertaken at three Oak Ridge facilities: Oak Ridge National Laboratory, Oak Ridge K-25 Site, Oak Ridge Y-12 Plant; and two sister sites: Portsmouth Gaseous Diffusion Plant in Portsmouth, Ohio, and Paducah Gaseous Diffusion Plant in Paducah, Kentucky. The role of the DMCs is to receive, store, retrieve, and properly dispose of records. In an effort to make the DMCs run more efficiently and to more proactively manage the records` life cycles from cradle to grave, ER has decided to investigate ways in which Electronic Document Management System (EDMS) technologies can be used to redefine the DMCs and their related processes. Specific goals of this study are tightening control over the ER documents, establishing and enforcing record creation and retention procedures, speeding up access to information, and increasing the accessibility of information. A working pilot of the solution is desired within the next six months. Based on a series of interviews conducted with personnel from each of the DMCs, key management, and individuals representing related projects, it is recommended that ER utilize document management, full-text retrieval, and workflow technologies to improve and automate records management for the ER program. A phased approach to solution implementation is suggested starting with the deployment of an automated storage and retrieval system at Portsmouth. This should be followed with a roll out of the system to the other DMCs, the deployment of a workflow-enabled authoring system at Portsmouth, and a subsequent roll out of this authoring system to the other sites.

  17. Advanced Environmental Monitoring and Control Program: Strategic Plan

    NASA Technical Reports Server (NTRS)

    Schmidt, Gregory

    1996-01-01

    Human missions in space, from short-duration shuttle missions lasting no more than several days to the medium-to-long-duration missions planned for the International Space Station, face a number of hazards that must be understood and mitigated for the mission to be carried out safely. Among these hazards are those posed by the internal environment of the spacecraft itself; through outgassing of toxic vapors from plastics and other items, failures or off-nominal operations of spacecraft environmental control systems, accidental exposure to hazardous compounds used in experiments: all present potential hazards that while small, may accumulate and pose a danger to crew health. The first step toward mitigating the dangers of these hazards is understanding the internal environment of the spacecraft and the compounds contained within it. Future spacecraft will have integrated networks of redundant sensors which will not only inform the crew of hazards, but will pinpoint the problem location and, through analysis by intelligent systems, recommend and even implement a course of action to stop the problem. This strategic plan details strategies to determine NASA's requirements for environmental monitoring and control systems for future spacecraft, and goals and objectives for a program to answer these needs.

  18. Interface Control Document Between the Double Shell Tanks (DST) System and the Plutonium Finishing Plan (PFP)

    SciTech Connect

    MAY, T.H.

    1999-11-03

    This document identifies the requirements and responsibilities for all parties to support waste transfer from the Plutonium Finishing Plant (PFP) facility to the Double-Shell Tank (DST) System of the River Protection Project (RPP). This Interface Control Document (ICD) will not attempt to control the physical portion of this interface because the physical equipment making up this interface, and any associated interface requirements, are already in place, operational and governed by existing operating specifications and other documentation. The PFP and DST Systems have a direct physical interface (the waste transfer pipeline) that travels between the 241-2 Building (TK-D5) and DST SY-102 via 244-TX double-contained receiver tank (DCRT). The purpose of the ICD process is to formalize working agreements between the RPP DST System and organization/companies internal and external to RPP. This ICD has been developed as part of the requirements basis for design of the DST System to support the Phase I Privatization effort.

  19. The Tennis Ball Bomb Incident or the Safety Plan as "Shelf Document"

    ERIC Educational Resources Information Center

    Fast, Jonathan; Fanelli, Rossella

    2003-01-01

    This article presents a case study of a single incident involving a high school student who brought a "tennis ball" bomb to school. Although the district had recently created a safety plan, with a specific protocol for the discovery of a bomb in the building, the principal and the crises team ignored it. The principal did not refer to the safety…

  20. Wills, Trusts, and Charitable Estate Planning: An Analysis of Document Effectiveness Using Panel Data

    ERIC Educational Resources Information Center

    James, Russell N., III

    2009-01-01

    This paper compares pre-death charitable testamentary expectations with post-death distributions for deceased panel members in the 1995-2006 Health and Retirement Study. Most respondents who reported having a charitable estate plan in the survey wave immediately prior to their death ultimately generated no charitable estate gift after death.…

  1. Proposed Site Treatment Plan (PSTP). Volumes 1 and 2 and Reference Document

    SciTech Connect

    Helmich, E.; Noller, D.K.; Wierzbicki, K.S.; Bailey, L.L.

    1994-12-22

    The Compliance Plan Volume provides overall schedules with target dates for achieving compliance with the land disposal restrictions (LDR) and contains procedures to establish milestones to be enforced under the Order. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume and is provided for informational purposes only.

  2. Restart Plan for the Prototype Vertical Denitration Calciner [SD Coversheet has Incorrect Document Number

    SciTech Connect

    SUTTER, C.S.

    1999-07-26

    Testing activities on the Prototype Vertical Denitration Calciner at PFP were suspended in January 1997 due to the hold on fissile material handling in the facility. The Restart Plan will govern the transition of the test program from the completion of the activity based startup review; through equipment checkout and surrogate material runs; to resumption of the testing program and transition to unrestricted testing.

  3. Plan of advanced satellite communications experiment using ETS-VI

    NASA Technical Reports Server (NTRS)

    Shiomi, Tadashi

    1988-01-01

    Communications Research Laboratory (CRL, Ministry of Posts and Telecommunications, Japan) has been engaged in development of three advanced satellite communication payloads aiming at experiments by Japan's 2-ton class Engineering Test Satellite VI (ETS-VI) which is to be launched in H-II rocket by NASDA in August 1992. CRL's three experimental systems are: (1) S-band inter-satellite communications; (2) millimeter-wave inter-satellite and personal-satellite communications; and (3) optical inter-satellite communications. CRL develops experimental optical communication system with telescope of 75 mm diameter which has gimbal mirror beam pointing/tracking mechanism. The onboard system has fundamental optical communication functions with laser diode transmitter of wavelength 0.83 micron, laser beam point-ahead mechanism, receiver of wavelength 0.51 micron, modulation/demodulation subsystem, and so on.

  4. From plans to actions in patient and public involvement: qualitative study of documented plans and the accounts of researchers and patients sampled from a cohort of clinical trials

    PubMed Central

    Buck, Deborah; Gamble, Carrol; Dudley, Louise; Preston, Jennifer; Hanley, Bec; Williamson, Paula R; Young, Bridget

    2014-01-01

    Patient and public involvement (PPI) in research is increasingly required, although evidence to inform its implementation is limited. Objective Inform the evidence base by describing how plans for PPI were implemented within clinical trials and identifying the challenges and lessons learnt by research teams. Methods We compared PPI plans extracted from clinical trial grant applications (funded by the National Institute for Health Research Health Technology Assessment Programme between 2006 and 2010) with researchers’ and PPI contributors’ interview accounts of PPI implementation. Analysis of PPI plans and transcribed qualitative interviews drew on the Framework technique. Results Of 28 trials, 25 documented plans for PPI in funding applications and half described implementing PPI before applying for funding. Plans varied from minimal to extensive, although almost all anticipated multiple modes of PPI. Interview accounts indicated that PPI plans had been fully implemented in 20/25 trials and even expanded in some. Nevertheless, some researchers described PPI within their trials as tokenistic. Researchers and contributors noted that late or minimal PPI engagement diminished its value. Both groups perceived uncertainty about roles in relation to PPI, and noted contributors’ lack of confidence and difficulties attending meetings. PPI contributors experienced problems in interacting with researchers and understanding technical language. Researchers reported difficulties finding ‘the right’ PPI contributors, and advised caution when involving investigators’ current patients. Conclusions Engaging PPI contributors early and ensuring ongoing clarity about their activities, roles and goals, is crucial to PPI's success. Funders, reviewers and regulators should recognise the value of preapplication PPI and allocate further resources to it. They should also consider whether PPI plans in grant applications match a trial's distinct needs. Monitoring and reporting PPI

  5. The advanced neutron source research and development plan

    SciTech Connect

    Selby, D.L.

    1995-08-01

    The Advanced Neutron Source (ANS) is being designed as a user-oriented neutron research laboratory centered around the most intense continuous beams of thermal and subthermal neutrons in the world (an order of magnitude more intense than beams available from the most advanced existing reactors). The ANS will be built around a new research reactor of 330-MW fission power, producing an unprecedented peak thermal flux of >7 {center_dot} 10{sup 19} {center_dot} m{sup -2} {center_dot} s{sup -1}. Primarily a research facility, the ANS will accommodate more than 1000 academic, industrial, and government researchers each year. They will conduct basic research in all branches of science as well as applied research leading to better understanding of new materials, including high temperature super conductors, plastics, and thin films. Some 48 neutron beam stations will be set up in the ANS beam rooms and the neutron guide hall for neutron scattering and for fundamental and nuclear physics research. There also will be extensive facilities for materials irradiation, isotope production, and analytical chemistry. The top level work breakdown structure (WBS) for the project. As noted in this figure, one component of the project is a research and development (R&D) program (WBS 1.1). This program interfaces with all of the other project level two WBS activities. Because one of the project guidelines is to meet minimum performance goals without relying on new inventions, this R&D activity is not intended to produce new concepts to allow the project to meet minimum performance goals. Instead, the R&D program will focus on the four objectives described.

  6. Advanced Seismic Probabilistic Risk Assessment Demonstration Project Plan

    SciTech Connect

    Justin Coleman

    2014-09-01

    Idaho National Laboratories (INL) has an ongoing research and development (R&D) project to remove excess conservatism from seismic probabilistic risk assessments (SPRA) calculations. These risk calculations should focus on providing best estimate results, and associated insights, for evaluation and decision-making. This report presents a plan for improving our current traditional SPRA process using a seismic event recorded at a nuclear power plant site, with known outcomes, to improve the decision making process. SPRAs are intended to provide best estimates of the various combinations of structural and equipment failures that can lead to a seismic induced core damage event. However, in general this approach has been conservative, and potentially masks other important events (for instance, it was not the seismic motions that caused the Fukushima core melt events, but the tsunami ingress into the facility).

  7. Earth Observing System/Meteorological Satellite (EOS/METSAT). Advanced Microwave Sounding Unit-A (AMSU-A) Contamination Control Plan

    NASA Technical Reports Server (NTRS)

    Fay, M.

    1998-01-01

    This Contamination Control Plan is submitted in response the Contract Document requirements List (CDRL) 007 under contract NAS5-32314 for the Earth Observing System (EOS) Advanced Microwave Sounding Unit A (AMSU-A). In response to the CDRL instructions, this document defines the level of cleanliness and methods/procedures to be followed to achieve adequate cleanliness/contamination control, and defines the required approach to maintain cleanliness/contamination control through shipping, observatory integration, test, and flight. This plan is also applicable to the Meteorological Satellite (METSAT) except where requirements are identified as EOS-specific. This plan is based on two key factors: a. The EOS/METSAT AMSU-A Instruments are not highly contamination sensitive. b. Potential contamination of other EOS Instruments is a key concern as addressed in Section 9/0 of the Performance Assurance Requirements for EOS/METSAT Integrated Programs AMSU-A Instrument (MR) (NASA Specification S-480-79).

  8. Advances in imaging technologies for planning breast reconstruction

    PubMed Central

    Mohan, Anita T.

    2016-01-01

    The role and choice of preoperative imaging for planning in breast reconstruction is still a disputed topic in the reconstructive community, with varying opinion on the necessity, the ideal imaging modality, costs and impact on patient outcomes. Since the advent of perforator flaps their use in microsurgical breast reconstruction has grown. Perforator based flaps afford lower donor morbidity by sparing the underlying muscle provide durable results, superior cosmesis to create a natural looking new breast, and are preferred in the context of radiation therapy. However these surgeries are complex; more technically challenging that implant based reconstruction, and leaves little room for error. The role of imaging in breast reconstruction can assist the surgeon in exploring or confirming flap choices based on donor site characteristics and presence of suitable perforators. Vascular anatomical studies in the lab have provided the surgeon a foundation of knowledge on location and vascular territories of individual perforators to improve our understanding for flap design and safe flap harvest. The creation of a presurgical map in patients can highlight any abnormal or individual anatomical variance to optimize flap design, intraoperative decision-making and execution of flap harvest with greater predictability and efficiency. This article highlights the role and techniques for preoperative planning using the newer technologies that have been adopted in reconstructive clinical practice: computed tomographic angiography (CTA), magnetic resonance angiography (MRA), laser-assisted indocyanine green fluorescence angiography (LA-ICGFA) and dynamic infrared thermography (DIRT). The primary focus of this paper is on the application of CTA and MRA imaging modalities. PMID:27047790

  9. Advances in imaging technologies for planning breast reconstruction.

    PubMed

    Mohan, Anita T; Saint-Cyr, Michel

    2016-04-01

    The role and choice of preoperative imaging for planning in breast reconstruction is still a disputed topic in the reconstructive community, with varying opinion on the necessity, the ideal imaging modality, costs and impact on patient outcomes. Since the advent of perforator flaps their use in microsurgical breast reconstruction has grown. Perforator based flaps afford lower donor morbidity by sparing the underlying muscle provide durable results, superior cosmesis to create a natural looking new breast, and are preferred in the context of radiation therapy. However these surgeries are complex; more technically challenging that implant based reconstruction, and leaves little room for error. The role of imaging in breast reconstruction can assist the surgeon in exploring or confirming flap choices based on donor site characteristics and presence of suitable perforators. Vascular anatomical studies in the lab have provided the surgeon a foundation of knowledge on location and vascular territories of individual perforators to improve our understanding for flap design and safe flap harvest. The creation of a presurgical map in patients can highlight any abnormal or individual anatomical variance to optimize flap design, intraoperative decision-making and execution of flap harvest with greater predictability and efficiency. This article highlights the role and techniques for preoperative planning using the newer technologies that have been adopted in reconstructive clinical practice: computed tomographic angiography (CTA), magnetic resonance angiography (MRA), laser-assisted indocyanine green fluorescence angiography (LA-ICGFA) and dynamic infrared thermography (DIRT). The primary focus of this paper is on the application of CTA and MRA imaging modalities. PMID:27047790

  10. Expert Meeting on National Planning of Documentation and Library Services in Africa (Kampala, Uganda, 7-15 December 1970). Main Working Document.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Paris (France).

    The main working document encompasses the following seven main topics: (1) the role of documentation and library services in the educational, social and economical development in Africa; (2) the present state of documentation and library services in Africa; (3) library development in relation to the African Book Development Programme; (4) planning…

  11. Advanced crew procedures development techniques: Procedures and performance program training plan

    NASA Technical Reports Server (NTRS)

    Arbet, J. D.; Benbow, R. L.

    1975-01-01

    A plan developed to support the training of PPP users in the operations associated with PPP usage is described. This document contains an overview of the contents of each training session and a detailed outline to be used as the guideline for each session.

  12. The Advanced Neutron Source research and development plan

    SciTech Connect

    Selby, D.L.

    1992-11-30

    The Advanced Neutron Source (ANS) is being designed as a user-oriented neutron research laboratory centered around the most intense continuous beams of thermal and subthermal neutrons in the world. The ANS will be built around a new research reactor of [approximately] 330 MW fission power, producing an unprecedented peak thermal flux of > 7 [times] 10[sup 19] M[sup [minus]2] [center dot] S[sup [minus]1]. Primarily a research facility, the ANS will accommodate more than 1000 academic, industrial, and government researchers each year. They will conduct basic research in all branches of science-as well as applied research-leading to better understanding of new materials, including high temperature super conductors, plastics, and thin films. Some 48 neutron beam stations will be set up in the ANS beam rooms and the neutron guide hall for neutron scattering and for fundamental and nuclear physics research. There also will be extensive facilities for materials irradiation, isotope production, and analytical chemistry. The R D program will focus on the four objectives: Address feasibility issues; provide analysis support; evaluate options for improvement in performance beyond minimum requirements; and provide prototype demonstrations for unique facilities. The remainder of this report presents (1) the process by which the R D activities are controlled and (2) a discussion of the individual tasks that have been identified for the R D program, including their justification, schedule and costs. The activities discussed in this report will be performed by Martin Marietta Energy Systems, Inc. (MMES) through the Oak Ridge National Laboratory (ORNL) and through subcontracts with industry, universities, and other national laboratories. It should be noted that in general a success path has been assumed for all tasks.

  13. The Advanced Neutron Source research and development plan

    SciTech Connect

    Selby, D.L.

    1992-11-30

    The Advanced Neutron Source (ANS) is being designed as a user-oriented neutron research laboratory centered around the most intense continuous beams of thermal and subthermal neutrons in the world. The ANS will be built around a new research reactor of {approximately} 330 MW fission power, producing an unprecedented peak thermal flux of > 7 {times} 10{sup 19} M{sup {minus}2} {center_dot} S{sup {minus}1}. Primarily a research facility, the ANS will accommodate more than 1000 academic, industrial, and government researchers each year. They will conduct basic research in all branches of science-as well as applied research-leading to better understanding of new materials, including high temperature super conductors, plastics, and thin films. Some 48 neutron beam stations will be set up in the ANS beam rooms and the neutron guide hall for neutron scattering and for fundamental and nuclear physics research. There also will be extensive facilities for materials irradiation, isotope production, and analytical chemistry. The R&D program will focus on the four objectives: Address feasibility issues; provide analysis support; evaluate options for improvement in performance beyond minimum requirements; and provide prototype demonstrations for unique facilities. The remainder of this report presents (1) the process by which the R&D activities are controlled and (2) a discussion of the individual tasks that have been identified for the R&D program, including their justification, schedule and costs. The activities discussed in this report will be performed by Martin Marietta Energy Systems, Inc. (MMES) through the Oak Ridge National Laboratory (ORNL) and through subcontracts with industry, universities, and other national laboratories. It should be noted that in general a success path has been assumed for all tasks.

  14. Advanced Materials Development Program: Ceramic Technology for Advanced Heat Engines program plan, 1983--1993

    SciTech Connect

    Not Available

    1990-07-01

    The purpose of the Ceramic Technology for Advanced Heat Engines (CTAHE) Project is the development of an industrial technology base capable of providing reliable and cost-effective high temperature ceramic components for application in advanced heat engines. There is a deliberate emphasis on industrial'' in the purpose statement. The project is intended to support the US ceramic and engine industries by providing the needed ceramic materials technology. The heat engine programs have goals of component development and proof-of-concept. The CTAHE Project is aimed at developing generic basic ceramic technology and does not involve specific engine designs and components. The materials research and development efforts in the CTAHE Project are focused on the needs and general requirements of the advanced gas turbine and low heat rejection diesel engines. The CTAHE Project supports the DOE Office of Transportation Systems' heat engine programs, Advanced Turbine Technology Applications (ATTAP) and Heavy Duty Transport (HDT) by providing the basic technology required for development of reliable and cost-effective ceramic components. The heat engine programs provide the iterative component design, fabrication, and test development logic. 103 refs., 18 figs., 11 tabs.

  15. Texas geothermal R D and D program planning support document. Final report

    SciTech Connect

    Davis, R.J.; Conover, M.F.; Keeney, R.C.; Personett, M.L.; Richmann, D.L.

    1981-08-28

    Program planning support was provided by; developing a geothermal RD and D program structure, characterizing the status of geothermal RD and D through review of literature and interaction with the geothermal research community, developing a candidate list of future Texas geothermal projects, and prioritizing the candidate projects based on appropriate evaluation criteria. The method used to perform this study and the results thereof are presented. Summary reviews of selected completed and ongoing projects and summary descriptions and evaluations of the candidate RD and D projects ar provided. A brief discussion emerging federal RD and D policies is presented. References and independent project rankings by three of the GRP members are included. (MHR)

  16. End-of-life communication in Korean older adults: With focus on advance care planning and advance directives.

    PubMed

    Shin, Dong Wook; Lee, Ji Eun; Cho, BeLong; Yoo, Sang Ho; Kim, SangYun; Yoo, Jun-Hyun

    2016-04-01

    The present article aimed to provide a comprehensive review of current status of end-of-life (EOL) care and sociocultural considerations in Korea, with focus on the EOL communication and use of advance directives (AD) in elderly Koreans. Through literature review, we discuss the current status of EOL care and sociocultural considerations in Korea, and provide a look-ahead. In Korea, patients often receive life-sustaining treatment until the very end of life. Advance care planning is rare, and most do-not-resuscitate decisions are made between the family and physician at the very end of patient's life. Koreans, influenced mainly by Confucian tradition, prefer a natural death and discontinuation of life-sustaining treatment. Although Koreans generally believe that death is natural and unavoidable, they tend not to think about or discuss death, and regard preparation for death as unnecessary. As a result, AD are completed by just 4.7% of the general adult population. This situation can be explained by several sociocultural characteristics including opting for natural death, wish not to burden others, preference for family involvement and trust in doctor, avoidance of talking about death, and filial piety. Patients often receive life-sustaining treatment until the very EOL, advance care planning and the use of AD is not common in Korea. This was related to unique sociocultural characteristics of Korea. A more active role of physicians, development of a more deliberate EOL discussion process, development of culturally appropriate AD and promotion of advance care planning might be required to provide good EOL care in Korea. PMID:26459613

  17. Implementing advance care planning: a qualitative study of community nurses' views and experiences

    PubMed Central

    2010-01-01

    Background Advance care planning (ACP) is a process of discussion about goals of care and a means of setting on record preferences for care of patients who may lose capacity or communication ability in the future. Implementation of ACP is widely promoted by policy makers. This study examined how community palliative care nurses in England understand ACP and their roles within ACP. It sought to identify factors surrounding community nurses' implementation of ACP and nurses' educational needs. Methods An action research strategy was employed. 23 community nurses from two cancer networks in England were recruited to 6 focus group discussions and three follow up workshops. Data were analysed using a constant comparison approach. Findings Nurses understood ACP to be an important part of practice and to have the potential to be a celebration of good nursing care. Nurses saw their roles in ACP as engaging with patients to elicit care preferences, facilitate family communication and enable a shift of care focus towards palliative care. They perceived challenges to ACP including: timing, how to effect team working in ACP, the policy focus on instructional directives which related poorly to patients' concerns; managing differences in patients' and families' views. Perceived barriers included: lack of resources; lack of public awareness about ACP; difficulties in talking about death. Nurses recommended the following to be included in education programmes: design of realistic scenarios; design of a flow chart; practical advice about communication and documentation; insights into the need for clinical supervision for ACP practice. Conclusions Nurses working in the community are centrally involved with patients with palliative care needs who may wish to set on record their views about future care and treatment. This study reveals some important areas for practice and educational development to enhance nurses' use and understanding of ACP. PMID:20377876

  18. Development and Validation of a Questionnaire to Detect Behavior Change in Multiple Advance Care Planning Behaviors

    PubMed Central

    Sudore, Rebecca L.; Stewart, Anita L.; Knight, Sara J.; McMahan, Ryan D.; Feuz, Mariko; Miao, Yinghui; Barnes, Deborah E.

    2013-01-01

    Introduction Advance directives have traditionally been considered the gold standard for advance care planning. However, recent evidence suggests that advance care planning involves a series of multiple discrete behaviors for which people are in varying stages of behavior change. The goal of our study was to develop and validate a survey to measure the full advance care planning process. Methods The Advance Care Planning Engagement Survey assesses “Process Measures” of factors known from Behavior Change Theory to affect behavior (knowledge, contemplation, self-efficacy, and readiness, using 5-point Likert scales) and “Action Measures” (yes/no) of multiple behaviors related to surrogate decision makers, values and quality of life, flexibility for surrogate decision making, and informed decision making. We administered surveys at baseline and 1 week later to 50 diverse, older adults from San Francisco hospitals. Internal consistency reliability of Process Measures was assessed using Cronbach's alpha (only continuous variables) and test-retest reliability of Process and Action Measures was examined using intraclass correlations. For discriminant validity, we compared Process and Action Measure scores between this cohort and 20 healthy college students (mean age 23.2 years, SD 2.7). Results Mean age was 69.3 (SD 10.5) and 42% were non-White. The survey took a mean of 21.4 minutes (±6.2) to administer. The survey had good internal consistency (Process Measures Cronbach's alpha, 0.94) and test-retest reliability (Process Measures intraclass correlation, 0.70; Action Measures, 0.87). Both Process and Action Measure scores were higher in the older than younger group, p<.001. Conclusion A new Advance Care Planning Engagement Survey that measures behavior change (knowledge, contemplation, self-efficacy, and readiness) and multiple advance care planning actions demonstrates good reliability and validity. Further research is needed to assess whether survey scores

  19. Technical Support Document: Development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings - 50% Energy Savings

    SciTech Connect

    Bonnema, Eric; Leach, Matt; Pless, Shanti

    2013-06-05

    This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-MBBR) ASHRAE et al. (2011b). The AEDG-MBBR is intended to provide recommendations for achieving 50% whole-building energy savings in retail stores over levels achieved by following ANSI/ASHRAE/IESNA Standard 90.1-2004, Energy Standard for Buildings Except Low-Rise Residential Buildings (Standard 90.1-2004) (ASHRAE 2004b). The AEDG-MBBR was developed in collaboration with the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IES), the U.S. Green Building Council (USGBC), and the U.S. Department of Energy.

  20. Technical Support Document: Development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings - 50% Energy Savings

    SciTech Connect

    Bonnema, E.; Leach, M.; Pless, S.

    2013-06-01

    This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Medium to Big Box Retail Buildings: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-MBBR) ASHRAE et al. (2011b). The AEDG-MBBR is intended to provide recommendations for achieving 50% whole-building energy savings in retail stores over levels achieved by following ANSI/ASHRAE/IESNA Standard 90.1-2004, Energy Standard for Buildings Except Low-Rise Residential Buildings (Standard 90.1-2004) (ASHRAE 2004b). The AEDG-MBBR was developed in collaboration with the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), the American Institute of Architects (AIA), the Illuminating Engineering Society of North America (IES), the U.S. Green Building Council (USGBC), and the U.S. Department of Energy.

  1. An Incentive Pay Plan for Advanced Practice Registered Nurses: Impact On Provider and Organizational Outcomes.

    PubMed

    Rhodes, Catherine A; Bechtle, Mavis; McNett, Molly

    2015-01-01

    Advanced practice registered nurses (APRNs) are integral to the provision of quality, cost-effective health care throughout the continuum of care. To promote job satisfaction and ultimately decrease turnover, an APRN incentive plan based on productivity and quality was formulated. Clinical productivity in the incentive plan was measured by national benchmarks for work relative value units for nonphysician providers. After the first year of implementation, APRNs were paid more for additional productivity and quality and the institution had an increase in patient visits and charges. The incentive plan is a win-win for hospitals that employ APRNs. PMID:26259336

  2. Profile: the National Documentation Centre for Family Planning of India's National Institute of Health and Family Welfare.

    PubMed

    1991-12-01

    In 1974, the National Documentation Centre for Family Planning was founded at India's National Institute of Health and Family Welfare with funds from the government and the UN Population Fund (UNFPA) to provide reliable population information to policy makers, planners, administrators for program development as well as to academics, researchers, students, and social workers engaged in population issues. Data collected from states and districts by the Ministry of Health and Family Welfare are disseminated through publications. The Centre receives documents from other Indian research entities and from foreign bodies. The existing collection consists of 40,000 books and monographs, 10,000 periodicals and journals, 450 current journals, 2000 institutional publications, 1000 annual reports, and 5000 fugitive material items. A data base containing this collected material has the purpose of generating various publications, and full copies of originals are provided at request. WHO designated the Centre a resource center for primary health care information. It is a linchpin of the Asia-Pacific POPIN network. Requests are frequent for information on family welfare program management. Dissemination includes information packages, annotated bibliographies, synthesized information, case studies, and field experience reports. The staff includes subject specialists, communication experts, and software and management specialists. 54 health and family welfare training centers have been involved in information activities since 1985. Exchange of information with population research centers has started by means of computer networking. Local area networks are developed with science libraries of major cities. DELNET (Delhi Library Network) launched a resource-sharing effort of health and family planning libraries. The creation of a National Population Information Database is also planned by the establishment of POPIN-India. PMID:12286547

  3. Trend Analysis of Administrative Documents Pertinent to the Community Alternatives and Institutional Reform Planning Grant Program. A Report to the U. S. Department of Health, Education and Welfare.

    ERIC Educational Resources Information Center

    Braddock, David L.; Sosowsky, Larry

    To identify trends in institutional reform and deinstitutionalization of the developmentally disabled, 34 administrative documents emanating from a federally funded planning grant program were examined. Documents were gathered in response to a survey letter to state Developmental Disabilities Councils, and fact sheets summarizing the documents…

  4. Ministry of Advanced Education and Labour Market Development 2008/09 Annual Service Plan Report

    ERIC Educational Resources Information Center

    Ministry of Advanced Education and Labour Market Development, 2009

    2009-01-01

    This Service Plan Report reflects the Ministry of Advanced Education and Labour Market Development's success in achieving the overall priorities of the Government of British Columbia, in the current economic conditions and other relevant external factors related to the strategic direction and operations of this Ministry. This paper also highlights…

  5. 15 CFR 714.3 - Advance declaration requirements for additionally planned production of Schedule 3 chemicals.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 3 CHEMICALS § 714.3 Advance... a Schedule 3 chemical above the declaration threshold; (ii) You plan to produce at a plant declared under § 714.1(a)(1)(ii) of the CWCR an additional Schedule 3 chemical above the declaration...

  6. 15 CFR 714.3 - Advance declaration requirements for additionally planned production of Schedule 3 chemicals.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 2 2011-01-01 2011-01-01 false Advance declaration requirements for additionally planned production of Schedule 3 chemicals. 714.3 Section 714.3 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS...

  7. 15 CFR 714.3 - Advance declaration requirements for additionally planned production of Schedule 3 chemicals.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 3 CHEMICALS § 714.3 Advance... a Schedule 3 chemical above the declaration threshold; (ii) You plan to produce at a plant declared under § 714.1(a)(1)(ii) of the CWCR an additional Schedule 3 chemical above the declaration...

  8. 15 CFR 714.3 - Advance declaration requirements for additionally planned production of Schedule 3 chemicals.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 3 CHEMICALS § 714.3 Advance... a Schedule 3 chemical above the declaration threshold; (ii) You plan to produce at a plant declared under § 714.1(a)(1)(ii) of the CWCR an additional Schedule 3 chemical above the declaration...

  9. 15 CFR 713.4 - Advance declaration requirements for additionally planned production, processing, or consumption...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 2 2011-01-01 2011-01-01 false Advance declaration requirements for additionally planned production, processing, or consumption of Schedule 2 chemicals. 713.4 Section 713.4 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF...

  10. 15 CFR 714.3 - Advance declaration requirements for additionally planned production of Schedule 3 chemicals.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ACTIVITIES INVOLVING SCHEDULE 3 CHEMICALS § 714.3 Advance... a Schedule 3 chemical above the declaration threshold; (ii) You plan to produce at a plant declared under § 714.1(a)(1)(ii) of the CWCR an additional Schedule 3 chemical above the declaration...

  11. Learning to Facilitate Advance Care Planning: The Novice Social Worker's Experience

    ERIC Educational Resources Information Center

    Washington, Karla; Bowland, Sharon; Mueggenburg, Kay; Pederson, Margaret; Otten, Sheila; Renn, Tanya

    2014-01-01

    Professional leaders have identified clear roles for social workers involved in advance care planning (ACP), a facilitated process whereby individuals identify their preferences for future medical care; yet information about effective teaching practices in this area is scant. This study reports on the experiences of 14 social workers who…

  12. Advance Planning of Form Properties in the Written Production of Single and Multiple Words

    ERIC Educational Resources Information Center

    Damian, Markus F.; Stadthagen-Gonzalez, Hans

    2009-01-01

    Three experiments investigated the scope of advance planning in written production. Experiment 1 manipulated phonological factors in single word written production, and Experiments 2 and 3 did the same in the production of adjective-noun utterances. In all three experiments, effects on latencies were found which mirrored those previously…

  13. Planning and Managing Learning Tasks and Activities. Advances in Research on Teaching. Volume 3.

    ERIC Educational Resources Information Center

    Brophy, Jere, Ed.

    This publication is the third volume in the "Advanced in Research on Teaching" series, which has been established to provide state-of-the-art conceptualization and analysis of the processes involved in functioning as a classroom teacher. This volume focuses on the planning and managing of learning tasks and activities, in particular, what is…

  14. Ministry of Advanced Education and Labour Market Development 2009/10-2011/12 Service Plan Update

    ERIC Educational Resources Information Center

    Ministry of Advanced Education and Labour Market Development, 2009

    2009-01-01

    The Ministry of Advanced Education and Labour Market Development's overarching purpose is to position British Columbia to meet the competitive challenges of the twenty-first century through better aligning labour market supply and demand. In the six months since the Ministry issued its February 2009 service plan and the subsequent re-election of…

  15. Future care planning: a first step to palliative care for all patients with advanced heart disease.

    PubMed

    Denvir, M A; Murray, S A; Boyd, K J

    2015-07-01

    Palliative care is recommended for patients with end-stage heart failure with several recent, randomised trials showing improvements in symptoms and quality of life and more studies underway. Future care planning provides a framework for discussing a range of palliative care problems with patients and their families. This approach can be introduced at any time during the patient's journey of care and ideally well in advance of end-of-life care. Future care planning is applicable to a wide range of patients with advanced heart disease and could be delivered systematically by cardiology teams at the time of an unplanned hospital admission, akin to cardiac rehabilitation for myocardial infarction. Integrating cardiology care and palliative care can benefit many patients with advanced heart disease at increased risk of death or hospitalisation. Larger, randomised trials are needed to assess the impact on patient outcomes and experiences. PMID:25900977

  16. Advance Care Planning Norms May Contribute to Hospital Variation in End-of-life ICU Use: A Simulation Study

    PubMed Central

    Barnato, Amber E.; Mohan, Deepika; Lane, Rondall K.; Huang, Yue Ming; Angus, Derek C.; Farris, Coreen; Arnold, Robert M.

    2014-01-01

    Background There is wide variation in end-of-life (EOL) intensive care unit (ICU) use among academic medical centers (AMCs). Objective To develop hypotheses regarding medical decision-making factors underlying this variation. Design High-fidelity simulation experiment involving a critically and terminally ill elder, followed by a survey and debriefing cognitive interview and evaluated using triangulated quantitative-qualitative comparative analysis. Setting 2 AMCs in the same state and health care system with disparate EOL ICU use. Subjects Hospital-based physicians responsible for ICU admission decisions. Measurements Treatment plan, prognosis, diagnosis, qualitative case perceptions and clinical reasoning. Main Results Sixty-seven of 111 (60%) eligible physicians agreed to participate; 48 (72%) could be scheduled. There were no significant between-AMC differences in 3-month prognosis or treatment plan, but there were systematic differences in perceptions of the case. Case perceptions at the low-intensity AMC seemed to be influenced by the absence of a DNR order in the context of norms of universal code status discussion and documentation upon admission, whereas case perceptions at the high-intensity AMC seemed to be influenced by the patient’s known metastatic gastric cancer in the context of norms of oncologists’ avoiding code status discussions. Conclusions In this simulation study of 2 AMCs, hospital-based physicians had different perceptions of an identical case. We hypothesize that different advance care planning norms may have influenced their decision-making heuristics. PMID:24615275

  17. Comment and response document for the final remedial action plan and site design for stabilization of the inactive uranium mill tailings sites at Slick Rock, Colorado. Revision 2

    SciTech Connect

    1996-05-01

    This document for the final remedial action plan and site design has been prepared for US Department of Energy Environmental Restoration Division as part of the Uranium Mill Tailings Remedial Action plan. Comments and responses are included for the site design for stabilization of the inactive uranium mill tailings sites at Slick Rock, Colorado.

  18. Advancements in integrating DSM and distributed generation and storage into T&D planning: Proceedings from the Third Annual Workshop

    SciTech Connect

    Not Available

    1994-09-01

    This third in a series of annual EPRI workshops focused on integrating demand-side management and distributed generation an into transmission and distribution planning. The workshop included utility case studies on integrated planning, results from utility pilot projects, analytical developments, and cross-departmental planning and implementation. In addition, the workshop featured information on advancements in area-specific planning and costing methods along with EPRI products that support utility integrated planning efforts.

  19. An Assessment of Social Diffusion in the Respecting Choices Advance Care Planning Program

    PubMed Central

    Moorman, Sara M.; Carr, Deborah; Kirchhoff, Karin T.; Hammes, Bernard J.

    2012-01-01

    This study examines the potential social diffusion effects of the Respecting Choices® advance care planning program, administered in La Crosse, Wisconsin since 1991. The program produces educational materials for patients, trains facilitators to help patients prepare for end-of-life, and ensures that advance directives are connected to patients' medical records. Using data from a survey of more than 5,000 white Wisconsin high school graduates in their mid-60s, we found that participants who were living in the La Crosse area were significantly less likely than their peers living elsewhere to have executed a living will or appointed a health care power of attorney. This pattern may reflect psychological reactance, where individuals reject a message or lesson when they perceive compliance as a threat to their autonomy. There was no evidence of social diffusion effects; participants who lived in the La Crosse region themselves or who had social network members residing in the area were no more likely than those with no known ties to the region to have engaged in advance care planning. Future studies should explore the processes through which individuals learn and share with others their knowledge of advance care planning. PMID:24567988

  20. Equipment concept design and development plans for microgravity science and applications research on space station: Combustion tunnel, laser diagnostic system, advanced modular furnace, integrated electronics laboratory

    NASA Technical Reports Server (NTRS)

    Uhran, M. L.; Youngblood, W. W.; Georgekutty, T.; Fiske, M. R.; Wear, W. O.

    1986-01-01

    Taking advantage of the microgravity environment of space NASA has initiated the preliminary design of a permanently manned space station that will support technological advances in process science and stimulate the development of new and improved materials having applications across the commercial spectrum. Previous studies have been performed to define from the researcher's perspective, the requirements for laboratory equipment to accommodate microgravity experiments on the space station. Functional requirements for the identified experimental apparatus and support equipment were determined. From these hardware requirements, several items were selected for concept designs and subsequent formulation of development plans. This report documents the concept designs and development plans for two items of experiment apparatus - the Combustion Tunnel and the Advanced Modular Furnace, and two items of support equipment the Laser Diagnostic System and the Integrated Electronics Laboratory. For each concept design, key technology developments were identified that are required to enable or enhance the development of the respective hardware.

  1. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1 : ASC software quality engineering practices version 1.0.

    SciTech Connect

    Minana, Molly A.; Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2005-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in DOE/AL Quality Criteria (QC-1) as conformance to customer requirements and expectations. This quality plan defines the ASC program software quality practices and provides mappings of these practices to the SNL Corporate Process Requirements (CPR 1.3.2 and CPR 1.3.6) and the Department of Energy (DOE) document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines (GP&G). This quality plan identifies ASC management and software project teams' responsibilities for cost-effective software engineering quality practices. The SNL ASC Software Quality Plan establishes the signatories commitment to improving software products by applying cost-effective software engineering quality practices. This document explains the project teams opportunities for tailoring and implementing the practices; enumerates the practices that compose the development of SNL ASC's software products; and includes a sample assessment checklist that was developed based upon the practices in this document.

  2. Mixed and Low-Level Waste Treatment Facility project. Appendix A, Environmental and regulatory planning and documentation: Draft

    SciTech Connect

    Not Available

    1992-04-01

    Mixed and low-level wastes generated at the Idaho National Engineering Laboratory (INEL) are required to be managed according to applicable State and Federal regulations, and Department of Energy Orders that provide for the protection of human health and the environment. The Mixed and Low-Level Waste Treatment Facility Project was chartered in 1991, by the Department of Energy to provide treatment capability for these mixed and low-level waste streams. The first project task consisted of conducting engineering studies to identify the waste streams, their potential treatment strategies, and the requirements that would be imposed on the waste streams and the facilities used to process them. This report, Appendix A, Environmental & Regulatory Planning & Documentation, identifies the regulatory requirements that would be imposed on the operation or construction of a facility designed to process the INEL`s waste streams. These requirements are contained in five reports that discuss the following topics: (1) an environmental compliance plan and schedule, (2) National Environmental Policy Act requirements, (3) preliminary siting requirements, (4) regulatory justification for the project, and (5) health and safety criteria.

  3. Advance care planning for cancer patients in primary care: a feasibility study

    PubMed Central

    Boyd, Kirsty; Mason, Bruce; Kendall, Marilyn; Barclay, Stephen; Chinn, David; Thomas, Keri; Sheikh, Aziz; Murray, Scott A

    2010-01-01

    Background Advance care planning is being promoted as a central component of end-of-life policies in many developed countries, but there is concern that professionals find its implementation challenging. Aim To assess the feasibility of implementing advance care planning in UK primary care. Design of study Mixed methods evaluation of a pilot educational intervention. Setting Four general practices in south-east Scotland. Method Interviews with 20 GPs and eight community nurses before and after a practice-based workshop; this was followed by telephone interviews with nine other GPs with a special interest in palliative care from across the UK. Results End-of-life care planning for patients typically starts as an urgent response to clear evidence of a short prognosis, and aims to achieve a ‘good death’. Findings suggest that there were multiple barriers to earlier planning: prognostic uncertainty; limited collaboration with secondary care; a desire to maintain hope; and resistance to any kind of ‘tick-box’ approach. Following the workshop, participants' knowledge and skills were enhanced but there was little evidence of more proactive planning. GPs from other parts of the UK described confusion over terminology and were concerned about the difficulties of implementing inflexible, policy-driven care. Conclusion A clear divide was found between UK policy directives and delivery of end-of-life care in the community that educational interventions targeting primary care professionals are unlikely to address. Advance care planning has the potential to promote autonomy and shared decision making about end-of-life care, but this will require a significant shift in attitudes. PMID:21144189

  4. Advanced Metering Plan for Monitoring Energy and Potable Water Use in PNNL EMS4 Buildings

    SciTech Connect

    Pope, Jason E.; Olson, Norman J.; Berman, Marc J.; Schielke, Dale R.

    2011-08-17

    This updated Advanced Metering Plan for monitoring whole building energy use in Pacific Northwest National Laboratory (PNNL) EMS4 buildings on the PNNL campus has been prepared in accordance with the requirements of the Energy Policy Act of 2005 (EPAct 2005), Section 103, U.S. Department of Energy (DOE) Order 430.2B, and Metering Best Practices, A Guide to Achieving Utility Resource Efficiency, Federal Energy Management Program, October 2007 (Sullivan et al. 2007). The initial PNNL plan was developed in July 2007 (Olson 2007), updated in September 2008 (Olson et al. 2008), updated in September 2009 (Olson et al. 2009), and updated again in August 2010 (Olson et al. 2010).

  5. A systematic review of the effectiveness of advance care planning interventions for people with cognitive impairment and dementia

    PubMed Central

    Robinson, Louise; Dickinson, Claire; Rousseau, Nicolette; Beyer, Fiona; Clark, Alexa; Hughes, Julian; Howel, Denise; Exley, Catherine

    2012-01-01

    Background: advance care planning (ACP) allows a patient to state their preferences for care, so that if in future they cannot make decisions their wishes are known. Our aim was to review systematically the effectiveness of ACP interventions in people with cognitive impairment and dementia. Methods: systematic searches of key electronic databases, supplemented by hand searches of reference lists and consultation with experts. Two independent reviewers undertook screening, data extraction and quality assessment. Results: four studies were included; three allocated providers randomly to intervention or control arm. All took place in nursing homes. Three studies reported formal processes of capacity assessment, only up to 36% of participants were judged to have capacity. Three studies reported positive findings in terms of documentation of patient preferences for care. Two studies reported significant reductions in hospitalisation rates; a third found increased use of hospice services in the intervention group. A meta-analysis could not be carried out due to heterogeneity of outcome measures. Conclusions: there is limited evidence for the effectiveness of ACP in people with cognitive impairment/dementia in terms of ACP documentation and health-care use. In terms of capacity to discuss ACP, nursing home settings may be too late for people with dementia. PMID:22156555

  6. ADVANCED HEAT TRANSFER TEST FACILITY, TRA666A. ELEVATIONS. ROOF FRAMING PLAN. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    ADVANCED HEAT TRANSFER TEST FACILITY, TRA-666A. ELEVATIONS. ROOF FRAMING PLAN. CONCRETE BLOCK SIDING. SLOPED ROOF. ROLL-UP DOOR. AIR INTAKE ENCLOSURE ON NORTH SIDE. F.C. TORKELSON 842-MTR-666-A5, 8/1966. INL INDEX NO. 531-0666-00-851-152258, REV. 2. - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID

  7. Incidence and Predictors of Advance Care Planning Among Persons with Cognitive Impairment

    PubMed Central

    Garand, Linda; Dew, Mary Amanda; Lingler, Jennifer H.; DeKosky, Steven T.

    2010-01-01

    Objective Persons with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) are at heightened risk for future decisional incapacity. We sought to characterize advance care planning (ACP) rates over time in individuals who had no advance directives (living will or durable power of attorney) in place when they initially presented for a cognitive evaluation. Design Retrospective analysis of data that had been prospectively collected. Setting Alzheimer’s Disease Research Center memory disorders clinic. Participants Persons (N=127) with a diagnosis of MCI or early AD (n = 72) or moderate to severe AD (n = 55) and no advance directives upon initial presentation for a cognitive evaluation. Measurements Extraction of responses to items pertaining to advance care planning assessed during annual semi-structured interviews. Results By 5 years of follow-up, 39% of the sample had initiated ACP, with little difference by baseline diagnosis. Younger subjects (under 65 years old) were significantly more likely to initiate advance directives (43%) than were older subjects (37%). This age effect was more pronounced in men than women as well as in married subjects, those with a family history of dementia, no depressive disorder, and subjects with moderate to severe AD (versus those with MCI or early AD) at baseline. Conclusion Only a minority of subjects initiated ACPs. The findings suggest the need for interventions aimed at enhancing ACP completion rates, particularly among older adults with cognitive impairment since these individuals may have a timed-limited opportunity to plan for future medical, financial, and other major life decisions. PMID:21785291

  8. Annual ADP planning document

    NASA Technical Reports Server (NTRS)

    Mogilevsky, M.

    1973-01-01

    The Category A computer systems at KSC (Al and A2) which perform scientific and business/administrative operations are described. This data division is responsible for scientific requirements supporting Saturn, Atlas/Centaur, Titan/Centaur, Titan III, and Delta vehicles, and includes realtime functions, Apollo-Soyuz Test Project (ASTP), and the Space Shuttle. The work is performed chiefly on the GEL-635 (Al) system located in the Central Instrumentation Facility (CIF). The Al system can perform computations and process data in three modes: (1) real-time critical mode; (2) real-time batch mode; and (3) batch mode. The Division's IBM-360/50 (A2) system, also at the CIF, performs business/administrative data processing such as personnel, procurement, reliability, financial management and payroll, real-time inventory management, GSE accounting, preventive maintenance, and integrated launch vehicle modification status.

  9. Accuracy of a Decision Aid for Advance Care Planning: Simulated End-of-Life Decision Making

    PubMed Central

    Levi, Benjamin H.; Heverley, Steven R.; Green, Michael J.

    2013-01-01

    Purpose Advance directives have been criticized for failing to help physicians make decisions consistent with patients’ wishes. This pilot study sought to determine if an interactive, computer-based decision aid that generates an advance directive can help physicians accurately translate patients’ wishes into treatment decisions. Methods We recruited 19 patient-participants who had each previously created an advance directive using a computer-based decision aid, and 14 physicians who had no prior knowledge of the patient-participants. For each advance directive, three physicians were randomly assigned to review the advance directive and make five to six treatment decisions for each of six (potentially) end-of-life clinical scenarios. From the three individual physicians’ responses, a “consensus physician response” was generated for each treatment decision (total decisions = 32). This consensus response was shared with the patient whose advance directive had been reviewed, and she/he was then asked to indicate how well the physician translated his/her wishes into clinical decisions. Results Patient-participants agreed with the consensus physician responses 84 percent (508/608) of the time, including 82 percent agreement on whether to provide mechanical ventilation, and 75 percent on decisions about cardiopulmonary resuscitation (CPR). Across the six vignettes, patient-participants’ rating of how well physicians translated their advance directive into medical decisions was 8.4 (range = 6.5–10, where 1 = extremely poorly, and 10 = extremely well). Physicians’ overall rating of their confidence at accurately translating patients’ wishes into clinical decisions was 7.8 (range = 6.1–9.3, 1 = not at all confident, 10 = extremely confident). Conclusion For simulated cases, a computer-based decision aid for advance care planning can help physicians more confidently make end-of-life decisions that patients will endorse. PMID:22167985

  10. Using Micro-Synchrophasor Data for Advanced Distribution Grid Planning and Operations Analysis

    SciTech Connect

    Stewart, Emma; Kiliccote, Sila; McParland, Charles; Roberts, Ciaran

    2014-07-01

    This report reviews the potential for distribution-grid phase-angle data that will be available from new micro-synchrophasors (µPMUs) to be utilized in existing distribution-grid planning and operations analysis. This data could augment the current diagnostic capabilities of grid analysis software, used in both planning and operations for applications such as fault location, and provide data for more accurate modeling of the distribution system. µPMUs are new distribution-grid sensors that will advance measurement and diagnostic capabilities and provide improved visibility of the distribution grid, enabling analysis of the grid’s increasingly complex loads that include features such as large volumes of distributed generation. Large volumes of DG leads to concerns on continued reliable operation of the grid, due to changing power flow characteristics and active generation, with its own protection and control capabilities. Using µPMU data on change in voltage phase angle between two points in conjunction with new and existing distribution-grid planning and operational tools is expected to enable model validation, state estimation, fault location, and renewable resource/load characterization. Our findings include: data measurement is outstripping the processing capabilities of planning and operational tools; not every tool can visualize a voltage phase-angle measurement to the degree of accuracy measured by advanced sensors, and the degree of accuracy in measurement required for the distribution grid is not defined; solving methods cannot handle the high volumes of data generated by modern sensors, so new models and solving methods (such as graph trace analysis) are needed; standardization of sensor-data communications platforms in planning and applications tools would allow integration of different vendors’ sensors and advanced measurement devices. In addition, data from advanced sources such as µPMUs could be used to validate models to improve

  11. Advanced Test Reactor -- Testing Capabilities and Plans AND Advanced Test Reactor National Scientific User Facility -- Partnerships and Networks

    SciTech Connect

    Frances M. Marshall

    2008-07-01

    The Advanced Test Reactor (ATR), at the Idaho National Laboratory (INL), is one of the world’s premier test reactors for providing the capability for studying the effects of intense neutron and gamma radiation on reactor materials and fuels. The physical configuration of the ATR, a 4-leaf clover shape, allows the reactor to be operated at different power levels in the corner “lobes” to allow for different testing conditions for multiple simultaneous experiments. The combination of high flux (maximum thermal neutron fluxes of 1E15 neutrons per square centimeter per second and maximum fast [E>1.0 MeV] neutron fluxes of 5E14 neutrons per square centimeter per second) and large test volumes (up to 122 cm long and 12.7 cm diameter) provide unique testing opportunities. For future research, some ATR modifications and enhancements are currently planned. In 2007 the US Department of Energy designated the ATR as a National Scientific User Facility (NSUF) to facilitate greater access to the ATR for material testing research by a broader user community. This paper provides more details on some of the ATR capabilities, key design features, experiments, and plans for the NSUF.

  12. NRC review of Electric Power Research Institute`s advanced light water reactor utility requirements document. Passive plant designs, chapter 1, project number 669

    SciTech Connect

    Not Available

    1994-08-01

    The Electric Power Research Institute (EPRI) is preparing a compendium of technical requirements, referred to as the {open_quotes}Advanced Light Water Reactor [ALWR] Utility Requirements Document{close_quotes}, that is acceptable to the design of an ALWR power plant. When completed, this document is intended to be a comprehensive statement of utility requirements for the design, construction, and performance of an ALWR power plant for the 1990s and beyond. The Requirements Document consists of three volumes. Volume 1, {open_quotes}ALWR Policy and Summary of Top-Tier Requirements{close_quotes}, is a management-level synopsis of the Requirements Document, including the design objectives and philosophy, the overall physical configuration and features of a future nuclear plant design, and the steps necessary to take the proposed ALWR design criteria beyond the conceptual design state to a completed, functioning power plant. Volume II consists of 13 chapters and contains utility design requirements for an evolutionary nuclear power plant [approximately 1350 megawatts-electric (MWe)]. Volume III contains utility design requirements for nuclear plants for which passive features will be used in their designs (approximately 600 MWe). In April 1992, the staff of the Office of Nuclear Reactor Regulation, U.S. Nuclear Regulatory Commission, issued Volume 1 and Volume 2 (Parts 1 and 2) of its safety evaluation report (SER) to document the results of its review of Volumes 1 and 2 of the Requirements Document. Volume 1, {open_quotes}NRC Review of Electric Power Research Institute`s Advanced Light Water Reactor Utility Requirements Document - Program Summary{close_quotes}, provided a discussion of the overall purpose and scope of the Requirements Document, the background of the staff`s review, the review approach used by the staff, and a summary of the policy and technical issues raised by the staff during its review.

  13. NRC review of Electric Power Research Institute`s advanced light water reactor utility requirements document. Passive plant designs, chapters 2-13, project number 669

    SciTech Connect

    Not Available

    1994-08-01

    The Electric Power Research Institute (EPRI) is preparing a compendium of technical requirements, referred to as the {open_quotes}Advanced Light Water Reactor [ALWR] Utility Requirements Document{close_quotes}, that is acceptable to the design of an ALWR power plant. When completed, this document is intended to be a comprehensive statement of utility requirements for the design, construction, and performance of an ALWR power plant for the 1990s and beyond. The Requirements Document consists of three volumes. Volume I, {open_quotes}ALWR Policy and Summary of Top-Tier Requirements{close_quotes}, is a management-level synopsis of the Requirements Document, including the design objectives and philosophy, the overall physical configuration and features of a future nuclear plant design, and the steps necessary to take the proposed ALWR design criteria beyond the conceptual design state to a completed, functioning power plant. Volume II consists of 13 chapters and contains utility design requirements for an evolutionary nuclear power plant [approximately 1350 megawatts-electric (MWe)]. Volume III contains utility design requirements for nuclear plants for which passive features will be used in their designs (approximately 600 MWe). In April 1992, the staff of the Office of Nuclear Reactor Regulation, U.S. Nuclear Regulatory Commission, issued Volume 1 and Volume 2 (Parts 1 and 2) of its safety evaluation report (SER) to document the results of its review of Volumes 1 and 2 of the Requirements Document. Volume 1, {open_quotes}NRC Review of Electric Power Research Institute`s Advanced Light Water Reactor Utility Requirements Document - Program Summary{close_quotes}, provided a discussion of the overall purpose and scope of the Requirements Document, the background of the staff`s review, the review approach used by the staff, and a summary of the policy and technical issues raised by the staff during its review.

  14. Palliative Care, Hospice, and Advance Care Planning: Views of People Living with HIV and Other Chronic Conditions.

    PubMed

    Slomka, Jacquelyn; Prince-Paul, Maryjo; Webel, Allison; Daly, Barbara J

    2016-01-01

    People living with HIV (PLWH) who survive to older adulthood risk developing multiple chronic medical conditions. Health policymakers recognize the role of early palliative care and advance care planning in improving health quality for at-risk populations, but misperceptions about palliative care, hospice, and advance care planning are common. Before testing a program of early palliative care for PLWH and other chronic conditions, we conducted focus groups to elicit perceptions of palliative care, hospice, and advance care planning in our target population. Overall, participants were unfamiliar with the term palliative care, confused concepts of palliative care and hospice, and/or associated hospice care with dying. Participants misunderstood advance care planning, but valued communication about health care preferences. Accepting palliative care was contingent on distinguishing it from hospice and historical memories of HIV and dying. Provision of high-quality, comprehensive care will require changing public perceptions and individuals' views in this high-risk population. PMID:27053406

  15. Corrective Action Decision Document/Corrective Action Plan for Corrective Action Unit 98: Frenchman Flat, Nevada National Security Site, Nevada, Revision 1

    SciTech Connect

    Irene Farnham and Sam Marutzky

    2011-07-01

    Water Act radiological standards at any time within 1,000 years. An external peer review of the groundwater flow and contaminant transport model was completed, and the model was accepted by NDEP to allow advancement to the CADD/CAP stage. The CADD/CAP stage focuses on model evaluation to ensure that existing models provide adequate guidance for the regulatory decisions regarding monitoring and institutional controls. Data-collection activities are identified and implemented to address key uncertainties in the flow and contaminant transport models. During the CR stage, final use restriction boundaries and CAU regulatory boundaries are negotiated and established; a long-term closure monitoring program is developed and implemented; and the approaches and policies for institutional controls are initiated. The model evaluation process described in this plan consists of an iterative series of five steps designed to build confidence in the site conceptual model and model forecasts. These steps are designed to identify data-collection activities (Step 1), document the data-collection activities in the 0CADD/CAP (Step 2), and perform the activities (Step 3). The new data are then assessed; the model is refined, if necessary; the modeling results are evaluated; and a model evaluation report is prepared (Step 4). The assessments are made by the modeling team and presented to the pre-emptive review committee. The decision is made by the modeling team with the assistance of the pre-emptive review committee and concurrence of NNSA/NSO to continue data and model assessment/refinement, recommend additional data collection, or recommend advancing to the CR stage. A recommendation to advance to the CR stage is based on whether the model is considered to be sufficiently reliable for designing a monitoring system and developing effective institutional controls. The decision to advance to the CR stage or to return to step 1 of the process is then made by NDEP (Step 5).

  16. 76 FR 56466 - Notice of Intent to Prepare an Environmental Document and Proposed Plan Amendment for the West...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-13

    ... Amendment for the West Mojave (WEMO) Plan, Motorized Vehicle Access Element, Inyo, Kern and Los Angeles and...-million acres of land in southern California. The 1980 CDCA Plan included 12 plan elements, including a Motorized Vehicle Element. The Motorized Vehicle Access Element of the CDCA Plan addressed both access...

  17. Benefits planning for advanced clinical information systems implementation at Allina hospitals and clinics.

    PubMed

    Thompson, Douglas Ivan; Henry, Sharon; Lockwood, Linda; Anderson, Brian; Atkinson, Susan

    2005-01-01

    Allina Hospitals and Clinics is implementing an enterprise-wide information system with inpatient and ambulatory clinical documentation and orders, clinical decision support, and revenue cycle applications. Allina has adopted a rigorous approach to planning for and realizing the expected clinical and financial benefits from this investment. Allina's strategies include: Forming a benefits realization team with formal responsibility for analysis, education, facilitation, and measurement; Studying system design to consider requirements for benefits realization; Integrating cultural, organizational and process change plans with system implementation plans; Measuring benefits using a measurement framework that matches organizational reporting, enables multi-level sequential analysis and adjusts for bias in quantifying benefits; Assigning accountability for achieving benefits by matching every benefit with an individual and an operational group; system executives, hospital executives, and department managers are held accountable for benefits within their scope of responsibility, and expected financial benefits are part of their yearly budgets. This article describes Allina's approach for benefits planning, contrasting it with the typical provider's approach to benefits realization. It argues that this approach may greatly increase the likelihood of realizing the value of investments in integrated clinical and business IT PMID:15682677

  18. Does facilitated Advance Care Planning reduce the costs of care near the end of life? Systematic review and ethical considerations

    PubMed Central

    Klingler, Corinna; in der Schmitten, Jürgen; Marckmann, Georg

    2015-01-01

    Background: While there is increasing evidence that Advance Care Planning has the potential to strengthen patient autonomy and improve quality of care near the end of life, it remains unclear whether it could also reduce net costs of care. Aim: This study aims to describe the cost implications of Advance Care Planning programmes and discusses ethical conflicts arising in this context. Design: We conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data sources: We systematically searched the databases PubMed, NHS EED, EURONHEED, Cochrane Library and EconLit. We included empirical studies (no limitation to study type) that investigated the cost implications of Advance Care Planning programmes involving professionally facilitated end-of-life discussions. Results and discussion: Seven studies met our inclusion criteria. Four of them used a randomised controlled design, one used a before-after design and two were observational studies. Six studies found reductions in costs of care ranging from USD1041 to USD64,827 per patient, depending on the study period and the cost measurement. One study detected no differences in costs. Studies varied considerably regarding the Advance Care Planning intervention, patient selection and costs measured which may explain some of the variations in findings. Normative appraisal: Looking at the impact of Advance Care Planning on costs raises delicate ethical issues. Given the increasing pressure to reduce expenditures, there may be concerns that cost considerations could unduly influence the sensitive communication process, thus jeopardising patient autonomy. Safeguards are proposed to reduce these risks. Conclusion: The limited data indicate net cost savings may be realised with Advance Care Planning. Methodologically robust trials with clearly defined Advance Care Planning interventions are needed to make the costs and returns of Advance Care Planning transparent. PMID

  19. Overview of recent advances in treatment planning for ion beam radiotherapy

    NASA Astrophysics Data System (ADS)

    Krämer, Michael; Scifoni, Emanuele; Schmitz, Frederike; Sokol, Olga; Durante, Marco

    2014-10-01

    To achieve practical calculations of dose delivery in ion beam radiotherapy, the physical models of beam propagation need to be properly implemented and supplemented by models describing the complex mechanisms of radiation damage in the biological tissues. TRiP98 is the first and most advanced treatment planning system for particles, in which physical and biological models have been incorporated to develop a clinically applicable tool for dose optimization and delivery. We report our recent advances in TRiP98 code development, in particular towards hypoxia-driven and multi-modal dose optimization. We also discuss the present needs and possible extensions of our models for which input from nanoscale physics is required. Contribution to the Topical Issue "Nano-scale Insights into Ion-beam Cancer Therapy", edited by Andrey V. Solov'yov, Nigel Mason, Paulo Limão-Vieira and Malgorzata Smialek-Telega.

  20. Planning and scheduling the Hubble Space Telescope: Practical application of advanced techniques

    NASA Technical Reports Server (NTRS)

    Miller, Glenn E.

    1994-01-01

    NASA's Hubble Space Telescope (HST) is a major astronomical facility that was launched in April, 1990. In late 1993, the first of several planned servicing missions refurbished the telescope, including corrections for a manufacturing flaw in the primary mirror. Orbiting above the distorting effects of the Earth's atmosphere, the HST provides an unrivaled combination of sensitivity, spectral coverage and angular resolution. The HST is arguably the most complex scientific observatory ever constructed and effective use of this valuable resource required novel approaches to astronomical observation and the development of advanced software systems including techniques to represent scheduling preferences and constraints, a constraint satisfaction problem (CSP) based scheduler and a rule based planning system. This paper presents a discussion of these systems and the lessons learned from operational experience.

  1. Planning and scheduling the Hubble Space Telescope: Practical application of advanced techniques

    NASA Astrophysics Data System (ADS)

    Miller, Glenn E.

    1994-10-01

    NASA's Hubble Space Telescope (HST) is a major astronomical facility that was launched in April, 1990. In late 1993, the first of several planned servicing missions refurbished the telescope, including corrections for a manufacturing flaw in the primary mirror. Orbiting above the distorting effects of the Earth's atmosphere, the HST provides an unrivaled combination of sensitivity, spectral coverage and angular resolution. The HST is arguably the most complex scientific observatory ever constructed and effective use of this valuable resource required novel approaches to astronomical observation and the development of advanced software systems including techniques to represent scheduling preferences and constraints, a constraint satisfaction problem (CSP) based scheduler and a rule based planning system. This paper presents a discussion of these systems and the lessons learned from operational experience.

  2. A Two Stage Solution Procedure for Production Planning System with Advance Demand Information

    NASA Astrophysics Data System (ADS)

    Ueno, Nobuyuki; Kadomoto, Kiyotaka; Hasuike, Takashi; Okuhara, Koji

    We model for ‘Naiji System’ which is a unique corporation technique between a manufacturer and suppliers in Japan. We propose a two stage solution procedure for a production planning problem with advance demand information, which is called ‘Naiji’. Under demand uncertainty, this model is formulated as a nonlinear stochastic programming problem which minimizes the sum of production cost and inventory holding cost subject to a probabilistic constraint and some linear production constraints. By the convexity and the special structure of correlation matrix in the problem where inventory for different periods is not independent, we propose a solution procedure with two stages which are named Mass Customization Production Planning & Management System (MCPS) and Variable Mesh Neighborhood Search (VMNS) based on meta-heuristics. It is shown that the proposed solution procedure is available to get a near optimal solution efficiently and practical for making a good master production schedule in the suppliers.

  3. Development plan for an advanced drilling system with real-time diagnostics (Diagnostics-While-Drilling)

    SciTech Connect

    FINGER,JOHN T.; MANSURE,ARTHUR J.; PRAIRIE,MICHAEL R.; GLOWKA,D.A.

    2000-02-01

    This proposal provides the rationale for an advanced system called Diagnostics-while-drilling (DWD) and describes its benefits, preliminary configuration, and essential characteristics. The central concept is a closed data circuit in which downhole sensors collect information and send it to the surface via a high-speed data link, where it is combined with surface measurements and processed through drilling advisory software. The driller then uses this information to adjust the drilling process, sending control signals back downhole with real-time knowledge of their effects on performance. The report presents background of related previous work, and defines a Program Plan for US Department of Energy (DOE), university, and industry cooperation.

  4. Wild Orangutan Males Plan and Communicate Their Travel Direction One Day in Advance

    PubMed Central

    van Schaik, Carel P.; Damerius, Laura; Isler, Karin

    2013-01-01

    The ability to plan for the future beyond immediate needs would be adaptive to many animal species, but is widely thought to be uniquely human. Although studies in captivity have shown that great apes are capable of planning for future needs, it is unknown whether and how they use this ability in the wild. Flanged male Sumatran orangutans (Pongo abelii) emit long calls, which females use to maintain earshot associations with them. We tested whether long calls serve to communicate a male's ever-changing predominant travel direction to facilitate maintaining these associations. We found that the direction in which a flanged male emits his long calls predicts his subsequent travel direction for many hours, and that a new call indicates a change in his main travel direction. Long calls given at or near the night nest indicate travel direction better than random until late afternoon on the next day. These results show that male orangutans make their travel plans well in advance and announce them to conspecifics. We suggest that such a planning ability is likely to be adaptive for great apes, as well as in other taxa. PMID:24040357

  5. Inter-subject variability modulates phonological advance planning in the production of adjective-noun phrases.

    PubMed

    Michel Lange, Violaine; Laganaro, Marina

    2014-01-01

    The literature on advance phonological planning in adjective-noun phrases (NPs) presents diverging results: while many experimental studies suggest that the entire NP is encoded before articulation, other results favor a span of encoding limited to the first word. Although cross-linguistic differences in the structure of adjective-NPs may account for some of these contrasting results, divergences have been reported even among similar languages and syntactic structures. Here we examined whether inter-individual differences account for variability in the span of phonological planning in the production of French NPs, where previous results indicated encoding limited to the first word. The span of phonological encoding is tested with the picture-word interference (PWI) paradigm using phonological distractors related to the noun or to the adjective of the NPs. In Experiment 1, phonological priming effects were limited to the first word in adjective NPs whichever the position of the adjective (pre-nominal or post-nominal). Crucially, phonological priming effects on the second word interacted with speakers' production speed suggesting different encoding strategies for participants. In Experiment 2, we tested this hypothesis further with a larger group of participants. Results clearly showed that slow and fast initializing participants presented different phonological priming patterns on the last element of adjective-NPs: while the first word was primed by a distractor for all speakers, only the slow speaker group presented a priming effect on the second element of the NP. These results show that the span of phonological encoding is modulated by inter-individual strategies: in experimental paradigms some speakers plan word by word whereas others encode beyond the initial word. We suggest that the diverging results reported in the literature on advance phonological planning may partly be reconciled in light of the present results. PMID:24550866

  6. Inter-subject variability modulates phonological advance planning in the production of adjective-noun phrases

    PubMed Central

    Michel Lange, Violaine; Laganaro, Marina

    2014-01-01

    The literature on advance phonological planning in adjective-noun phrases (NPs) presents diverging results: while many experimental studies suggest that the entire NP is encoded before articulation, other results favor a span of encoding limited to the first word. Although cross-linguistic differences in the structure of adjective-NPs may account for some of these contrasting results, divergences have been reported even among similar languages and syntactic structures. Here we examined whether inter-individual differences account for variability in the span of phonological planning in the production of French NPs, where previous results indicated encoding limited to the first word. The span of phonological encoding is tested with the picture-word interference (PWI) paradigm using phonological distractors related to the noun or to the adjective of the NPs. In Experiment 1, phonological priming effects were limited to the first word in adjective NPs whichever the position of the adjective (pre-nominal or post-nominal). Crucially, phonological priming effects on the second word interacted with speakers' production speed suggesting different encoding strategies for participants. In Experiment 2, we tested this hypothesis further with a larger group of participants. Results clearly showed that slow and fast initializing participants presented different phonological priming patterns on the last element of adjective-NPs: while the first word was primed by a distractor for all speakers, only the slow speaker group presented a priming effect on the second element of the NP. These results show that the span of phonological encoding is modulated by inter-individual strategies: in experimental paradigms some speakers plan word by word whereas others encode beyond the initial word. We suggest that the diverging results reported in the literature on advance phonological planning may partly be reconciled in light of the present results. PMID:24550866

  7. "I Don't Want to Die like that...": The Impact of Significant Others' Death Quality on Advance Care Planning

    ERIC Educational Resources Information Center

    Carr, Deborah

    2012-01-01

    Purpose of the Study: I examine whether 5 aspects of a significant other's death quality (pain, decision-making capacity, location, problems with end-of life care, and preparation) affect whether one does advance care planning (ACP). I also identify specific aspects of others' deaths that respondents say triggered their own planning. Design and…

  8. Ontario Basic Skills. Career Planning. A Thematic Unit for Integrated Curriculum: Advanced Level. [Student Workbook and] Teacher's Manual.

    ERIC Educational Resources Information Center

    Anderson, Marcia; And Others

    This set of publications, consisting of a student workbook and teacher's manual, is designed for use by adult learners registered in the advanced level of the career planning course of the Ontario (Canada) Basic Skills program. The student workbook contains units on the following topics: introduction to career planning, self-assessment for…

  9. NASA/ESA CV-990 Spacelab simulation. Appendixes: C, data-handling: Planning and implementation; D, communications; E, mission documentation

    NASA Technical Reports Server (NTRS)

    Reller, J. O., Jr.

    1976-01-01

    Data handling, communications, and documentation aspects of the ASSESS mission are described. Most experiments provided their own data handling equipment, although some used the airborne computer for backup, and one experiment required real-time computations. Communications facilities were set up to simulate those to be provided between Spacelab and the ground, including a downlink TV system. Mission documentation was kept to a minimum and proved sufficient. Examples are given of the basic documents of the mission.

  10. Advance Care Planning and HIV Infection in the Era of Antiretroviral Therapy: A Review.

    PubMed

    Sangarlangkarn, Aroonsiri; Merlin, Jessica S; Tucker, Rodney O; Kelley, Amy S

    In the era of antiretroviral therapy, HIV infection has become a chronic illness with associated multimorbidity, and practitioners are faced with an emerging population of HIV-infected patients with evolving needs for advance care planning (ACP), defined as communication between individuals and their proxies to plan for future health care decisions. This article provides a review of original research studies on ACP in HIV-infected adults in the era of antiretroviral therapy (1996-present) from PubMed, EMBASE, and PsycINFO. Eleven studies conducted between 1996 and 2015 met the selection criteria, with study sizes ranging from 9 to 2864 participants. Most studies consisted of white men in outpatient settings and had poorly defined definitions of ACP. Prevalence of ACP was variable (36%-54% had end-of-life communication, 8%-47% had advance directives). Lack of ACP was most commonly associated with low income, followed by lower severity of illness, low education level, black or Hispanic race, female sex, younger age, injection drug use, and social isolation. Practitioners reported limited time or energy and inadequate preparation or training as barriers to ACP. Existing literature on ACP in the era of antiretroviral therapy is limited, but shows that ACP prevalence in HIV-infected individuals is variable depending on socioeconomic factors, severity of illness, and practitioner resources and training. More research is needed to increase ACP among HIV-infected individuals. PMID:27398771

  11. 42 CFR 137.360 - Does the Secretary approve project planning and design documents prepared by the Self-Governance...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... design documents prepared by the Self-Governance Tribe? 137.360 Section 137.360 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Roles of the Secretary in Establishing and... documents prepared by the Self-Governance Tribe? The Secretary shall have at least one opportunity...

  12. 42 CFR 137.360 - Does the Secretary approve project planning and design documents prepared by the Self-Governance...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... design documents prepared by the Self-Governance Tribe? 137.360 Section 137.360 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Roles of the Secretary in Establishing and... documents prepared by the Self-Governance Tribe? The Secretary shall have at least one opportunity...

  13. 42 CFR 137.360 - Does the Secretary approve project planning and design documents prepared by the Self-Governance...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... design documents prepared by the Self-Governance Tribe? 137.360 Section 137.360 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Roles of the Secretary in Establishing and... documents prepared by the Self-Governance Tribe? The Secretary shall have at least one opportunity...

  14. 42 CFR 137.360 - Does the Secretary approve project planning and design documents prepared by the Self-Governance...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... design documents prepared by the Self-Governance Tribe? 137.360 Section 137.360 Public Health PUBLIC... HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Roles of the Secretary in Establishing and... documents prepared by the Self-Governance Tribe? The Secretary shall have at least one opportunity...

  15. Office of River Protection Advanced Low-Activity Waste Glass Research and Development Plan

    SciTech Connect

    Peeler, David K.; Kim, Dong-Sang; Vienna, John D.; Schweiger, Michael J.; Piepel, Gregory F.

    2015-11-01

    The U.S. Department of Energy Office of River Protection (ORP) has initiated and leads an integrated Advanced Waste Glass (AWG) program to increase the loading of Hanford tank wastes in glass while meeting melter lifetime expectancies and process, regulatory, and product performance requirements. The integrated ORP program is focused on providing a technical, science-based foundation for making key decisions regarding the successful operation of the Hanford Tank Waste Treatment and Immobilization Plant (WTP) facilities in the context of an optimized River Protection Project (RPP) flowsheet. The fundamental data stemming from this program will support development of advanced glass formulations, key product performance and process control models, and tactical processing strategies to ensure safe and successful operations for both the low-activity waste (LAW) and high-level waste vitrification facilities. These activities will be conducted with the objective of improving the overall RPP mission by enhancing flexibility and reducing cost and schedule. The purpose of this advanced LAW glass research and development plan is to identify the near-term, mid-term, and longer-term research and development activities required to develop and validate advanced LAW glasses, property-composition models and their uncertainties, and an advanced glass algorithm to support WTP facility operations, including both Direct Feed LAW and full pretreatment flowsheets. Data are needed to develop, validate, and implement 1) new glass property-composition models and 2) a new glass formulation algorithm. Hence, this plan integrates specific studies associated with increasing the Na2O and SO3/halide concentrations in glass, because these components will ultimately dictate waste loadings for LAW vitrification. Of equal importance is the development of an efficient and economic strategy for 99Tc management. Specific and detailed studies are being implemented to understand the fate of Tc throughout

  16. Advance care planning: A systematic review of randomised controlled trials conducted with older adults.

    PubMed

    Weathers, Elizabeth; O'Caoimh, Rónán; Cornally, Nicola; Fitzgerald, Carol; Kearns, Tara; Coffey, Alice; Daly, Edel; O'Sullivan, Ronan; McGlade, Ciara; Molloy, D William

    2016-09-01

    Advance care planning (ACP), involving discussions between patients, families and healthcare professionals on future healthcare decisions, in advance of anticipated impairment in decision-making capacity, improves satisfaction and end-of-life care while respecting patient autonomy. It usually results in the creation of a written advanced care directive (ACD). This systematic review examines the impact of ACP on several outcomes (including symptom management, quality of care and healthcare utilisation) in older adults (>65years) across all healthcare settings. Nine randomised controlled trials (RCTs) were identified by searches of the CINAHL, PubMed and Cochrane databases. A total of 3646 older adults were included (range 72-88 years). Seven studies were conducted with community dwellers and the other two RCTs were conducted in nursing homes. Most studies did not implement a standardised ACD, or measure the impact on quality of end-of-life care or on the death and dying experience. All studies had some risk of bias, with most scoring poorly on the Oxford Quality Scale. While ACP interventions are well received by older adults and generally have positive effects on outcomes, this review highlights the need for well-designed RCTs that examine the economic impact of ACP and its effect on quality of care in nursing homes and other sectors. PMID:27451328

  17. Frequency and Correlates of Advance Planning Among Cognitively Impaired Older Adults

    PubMed Central

    Lingler, Jennifer Hagerty; Hirschman, Karen B.; Garand, Linda; Dew, Mary Amanda; Becker, James T.; Schulz, Richard; DeKosky, Steven T.

    2009-01-01

    Objective To examine the prevalence and sociodemographic correlates of written advance planning among patients with or at risk for dementia-imposed decisional incapacity. Design Retrospective, cross-sectional. Setting University-based memory disorders clinic. Participants Persons with a consensus-based diagnosis of mild cognitive impairment (N = 112), probable or possible Alzheimer disease (AD; N = 549), and nondemented comparison subjects (N = 84). Intervention N/A. Measurements Semistructured interviews to assess durable power of attorney (DPOA) and living will (LW) status upon initial presentation for a dementia evaluation. Results Sixty-five percent of participants had a DPOA and 56% had a LW. Planning rates did not vary by diagnosis. European Americans (adjusted odds ratio = 4.75; 95% CI, 2.40-9.38), older adults (adjusted odds ratio = 1.05; 95% CI, 1.03-1.07) and college graduates (adjusted odds ratio = 2.06; 95% CI, 1.33-3.20) were most likely to have a DPOA. Findings were similar for LW rates. Conclusions Although a majority of persons with and at risk for the sustained and progressive decisional incapacity of AD are formally planning for the future, a substantial minority are not. PMID:18669942

  18. Advance care planning in stroke: influence of time on engagement in the process

    PubMed Central

    Green, Theresa; Gandhi, Shreyas; Kleissen, Tessa; Simon, Jessica; Raffin-Bouchal, Shelley; Ryckborst, Karla

    2014-01-01

    Purpose Individuals who experience stroke have a higher likelihood of subsequent stroke events, making it imperative to plan for future medical care. In the event of a further serious health event, engaging in the process of advanced care planning (ACP) can help family members and health care professionals (HCPs) make medical decisions for individuals who have lost the capacity to do so. Few studies have explored the views and experiences of patients with stroke about discussing their wishes and preferences for future medical events, and the extent to which stroke HCPs engage in conversations around planning for such events. In this study, we sought to understand how the process of ACP unfolded between HCPs and patients post-stroke. Patients and methods Using grounded theory (GT) methodology, we engaged in direct observation of HCP and patient interactions on an acute stroke unit and two stroke rehabilitation units. Using semi-structured interviews, 14 patients and four HCPs were interviewed directly about the ACP process. Results We found that open and continual ACP conversations were not taking place, patients experienced an apparent lack of urgency to engage in ACP, and HCPs were uncomfortable initiating ACP conversations due to the sensitive nature of the topic. Conclusion In this study, we identified lack of engagement in ACP post-stroke, attributable to patient and HCP factors. This encourages us to look further into the process of ACP in order to develop open communication between the patient with stroke, their families, and stroke HCPs. PMID:24493922

  19. Preparing GMAT for Operational Maneuver Planning of the Advanced Composition Explorer (ACE)

    NASA Technical Reports Server (NTRS)

    Qureshi, Rizwan Hamid; Hughes, Steven P.

    2014-01-01

    The General Mission Analysis Tool (GMAT) is an open-source space mission design, analysis and trajectory optimization tool. GMAT is developed by a team of NASA, private industry, public and private contributors. GMAT is designed to model, optimize and estimate spacecraft trajectories in flight regimes ranging from low Earth orbit to lunar applications, interplanetary trajectories and other deep space missions. GMAT has also been flight qualified to support operational maneuver planning for the Advanced Composition Explorer (ACE) mission. ACE was launched in August, 1997 and is orbiting the Sun-Earth L1 libration point. The primary science objective of ACE is to study the composition of both the solar wind and the galactic cosmic rays. Operational orbit determination, maneuver operations and product generation for ACE are conducted by NASA Goddard Space Flight Center (GSFC) Flight Dynamics Facility (FDF). This paper discusses the entire engineering lifecycle and major operational certification milestones that GMAT successfully completed to obtain operational certification for the ACE mission. Operational certification milestones such as gathering of the requirements for ACE operational maneuver planning, gap analysis, test plans and procedures development, system design, pre-shadow operations, training to FDF ACE maneuver planners, shadow operations, Test Readiness Review (TRR) and finally Operational Readiness Review (ORR) are discussed. These efforts have demonstrated that GMAT is flight quality software ready to support ACE mission operations in the FDF.

  20. Framework Programmable Platform for the Advanced Software Development Workstation (FPP/ASDW). Demonstration framework document. Volume 2: Framework process description

    NASA Technical Reports Server (NTRS)

    Mayer, Richard J.; Blinn, Thomas M.; Dewitte, Paula S.; Crump, John W.; Ackley, Keith A.

    1992-01-01

    In the second volume of the Demonstration Framework Document, the graphical representation of the demonstration framework is given. This second document was created to facilitate the reading and comprehension of the demonstration framework. It is designed to be viewed in parallel with Section 4.2 of the first volume to help give a picture of the relationships between the UOB's (Unit of Behavior) of the model. The model is quite large and the design team felt that this form of presentation would make it easier for the reader to get a feel for the processes described in this document. The IDEF3 (Process Description Capture Method) diagrams of the processes of an Information System Development are presented. Volume 1 describes the processes and the agents involved with each process, while this volume graphically shows the precedence relationships among the processes.

  1. Technology Alignment and Portfolio Prioritization (TAPP): Advanced Methods in Strategic Analysis, Technology Forecasting and Long Term Planning for Human Exploration and Operations, Advanced Exploration Systems and Advanced Concepts

    NASA Technical Reports Server (NTRS)

    Funaro, Gregory V.; Alexander, Reginald A.

    2015-01-01

    The Advanced Concepts Office (ACO) at NASA, Marshall Space Flight Center is expanding its current technology assessment methodologies. ACO is developing a framework called TAPP that uses a variety of methods, such as association mining and rule learning from data mining, structure development using a Technological Innovation System (TIS), and social network modeling to measure structural relationships. The role of ACO is to 1) produce a broad spectrum of ideas and alternatives for a variety of NASA's missions, 2) determine mission architecture feasibility and appropriateness to NASA's strategic plans, and 3) define a project in enough detail to establish an initial baseline capable of meeting mission objectives ACO's role supports the decision­-making process associated with the maturation of concepts for traveling through, living in, and understanding space. ACO performs concept studies and technology assessments to determine the degree of alignment between mission objectives and new technologies. The first step in technology assessment is to identify the current technology maturity in terms of a technology readiness level (TRL). The second step is to determine the difficulty associated with advancing a technology from one state to the next state. NASA has used TRLs since 1970 and ACO formalized them in 1995. The DoD, ESA, Oil & Gas, and DoE have adopted TRLs as a means to assess technology maturity. However, "with the emergence of more complex systems and system of systems, it has been increasingly recognized that TRL assessments have limitations, especially when considering [the] integration of complex systems." When performing the second step in a technology assessment, NASA requires that an Advancement Degree of Difficulty (AD2) method be utilized. NASA has used and developed or used a variety of methods to perform this step: Expert Opinion or Delphi Approach, Value Engineering or Value Stream, Analytical Hierarchy Process (AHP), Technique for the Order of

  2. Anticipatory Water Management in Phoenix using Advanced Scenario Planning and Analyses: WaterSim 5

    NASA Astrophysics Data System (ADS)

    Sampson, D. A.; Quay, R.; White, D. D.; Gober, P.; Kirkwood, C.

    2013-12-01

    Complexity, uncertainty, and variability are inherent properties of linked social and natural processes; sustainable resource management must somehow consider all three. Typically, a decision support tool (using scenario analyses) is used to examine management alternatives under suspected trajectories in driver variables (i.e., climate forcing's, growth or economic projections, etc.). This traditional planning focuses on a small set of envisioned scenarios whose outputs are compared against one-another in order to evaluate their differing impacts on desired metrics. Human cognition typically limits this to three to five scenarios. However, complex and highly uncertain issues may require more, often much more, than five scenarios. In this case advanced scenario analysis provides quantitative or qualitative methods that can reveal patterns and associations among scenario metrics for a large ensemble of scenarios. From this analysis, then, a smaller set of heuristics that describe the complexity and uncertainty revealed provides a basis to guide planning in an anticipatory fashion. Our water policy and management model, termed WaterSim, permits advanced scenario planning and analysis for the Phoenix Metropolitan Area. In this contribution we examine the concepts of advanced scenario analysis on a large scale ensemble of scenarios using our work with WaterSim as a case study. For this case study we created a range of possible water futures by creating scenarios that encompasses differences in water supplies (our surrogates for climate change, drought, and inherent variability in riverine flows), population growth, and per capital water consumption. We used IPCC estimates of plausible, future, alterations in riverine runoff, locally produced and vetted estimates of population growth projections, and empirical trends in per capita water consumption for metropolitan cities. This ensemble consisted of ~ 30, 700 scenarios (~575 k observations). We compared and contrasted

  3. Facilitated Psychiatric Advance Directives: A Randomized Trial of an Intervention to Foster Advance Treatment Planning Among Persons with Severe Mental Illness

    PubMed Central

    Swanson, Jeffrey W.; Swartz, Marvin S.; Elbogen, Eric B.; Van Dorn, Richard A.; Ferron, Joelle; Wagner, H. Ryan; McCauley, Barbara J.; Kim, Mimi

    2013-01-01

    Objective Studies show a high potential demand for psychiatric advance directives but low completion rates. The authors conducted a randomized study of a structured, manualized intervention to facilitate completion of psychiatric advance directives. Method A total of 469 patients with severe mental illness were randomly assigned to a facilitated psychiatric advance directive session or a control group that received written information about psychiatric advance directives and referral to resources in the public mental health system. Completion of an advance directive, its structure and content, and its short-term effects on working alliance and treatment satisfaction were recorded. Results Sixty-one percent of participants in the facilitated session completed an advance directive or authorized a proxy decision maker, compared with only 3% of control group participants. Psychiatrists rated the advance directives as highly consistent with standards of community practice. Most participants used the advance directive to refuse some medications and to express preferences for admission to specific hospitals and not others, although none used an advance directive to refuse all treatment. At 1-month follow-up, participants in the facilitated session had a greater working alliance with their clinicians and were more likely than those in the control group to report receiving the mental health services they believed they needed. Conclusions The facilitation session is an effective method of helping patients complete psychiatric advance directives and ensuring that the documents contain useful information about patients’ treatment preferences. Achieving the promise of psychiatric advance directives may require system-level policies to embed facilitation of these instruments in usual-care care settings. PMID:17074946

  4. Flight design system-1 system design. Volume 5: Data management and data base documentation support system. [for shuttle flight planning

    NASA Technical Reports Server (NTRS)

    1979-01-01

    Application software intended to reduce the man-hours required per flight design cycle by producing major flight design documents with little or no manual typing is described. The documentation support software is divided into two separately executable processors. However, since both processors support the same overall functions, and most of the software contained in one is also contained in the other, both are collectively presented.

  5. 41 CFR 302-7.106 - What documentation is required to receive an advance under the commuted rate method?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 4 2012-07-01 2012-07-01 false What documentation is... and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES TRANSPORTATION AND... weight (or other evidence of actual weight) or a reasonable estimate acceptable to your agency; and...

  6. 42 CFR 137.360 - Does the Secretary approve project planning and design documents prepared by the Self-Governance...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Implementing Construction Project Agreements § 137.360 Does the Secretary approve project planning and design... scope of work under a construction project agreement. ... 42 Public Health 1 2010-10-01 2010-10-01 false Does the Secretary approve project planning...

  7. Advanced Simulation and Computing Fiscal Year 2016 Implementation Plan, Version 0

    SciTech Connect

    McCoy, M.; Archer, B.; Hendrickson, B.

    2015-08-27

    The Stockpile Stewardship Program (SSP) is an integrated technical program for maintaining the safety, surety, and reliability of the U.S. nuclear stockpile. The SSP uses nuclear test data, computational modeling and simulation, and experimental facilities to advance understanding of nuclear weapons. It includes stockpile surveillance, experimental research, development and engineering programs, and an appropriately scaled production capability to support stockpile requirements. This integrated national program requires the continued use of experimental facilities and programs, and the computational capabilities to support these programs. The purpose of this IP is to outline key work requirements to be performed and to control individual work activities within the scope of work. Contractors may not deviate from this plan without a revised WA or subsequent IP.

  8. Exploring the district nurse role in facilitating individualised advance care planning.

    PubMed

    Boot, Michelle

    2016-03-01

    Health-care policy recognises the importance of engaging people in making decisions related to the management of their health. Advance care planning (ACP) offers a framework for decision making on end-of-life care. There are positive indicators that ACP enables health professionals to meet people's preferences. However, there are reports of insensitive attempts to engage people in end-of-life care decision making. District nurses are in the ideal position to facilitate ACP, as they have the opportunity to build relationships with the people they are caring for--an antecedent to sensitive ACP--and in recognising and fulfilling this role, they could ameliorate the risk of insensitive ACP. Distric nurse leaders also have a role to play in ensuring that organisational and environmental factors support appropriate ACP facilitation including: training, fostering a team culture that empowers district nurses to recognise and meet their ACP role, and advocating for appropriate ACP evaluation outcome measures. PMID:26940617

  9. Trends in Engagement in Advance Care Planning Behaviors and the Role of Socioeconomic Status.

    PubMed

    Khosla, Nidhi; Curl, Angela L; Washington, Karla T

    2016-08-01

    We investigated the trends in advance care planning (ACP) between 2002 and 2010 and whether socioeconomic status explained such trends. We conducted a pooled regression analysis of Health and Retirement Study data from 6052 proxies of deceased individuals. We studied 3 ACP behaviors, discussing end-of-life (EOL) care preferences, providing written EOL care instructions, and appointing a durable power of attorney for health care (DPAHC). ACP increased by 12% to 23% every 2 years from 2002 to 2010. Higher household income increased the odds of having a DPAHC. Education was not associated with ACP. Socioeconomic status alone appears to play a very limited role in predicting ACP. Engagement in ACP likely depends on a constellation of many social and contextual factors. PMID:25900854

  10. Coping Styles, Health Status and Advance Care Planning in Patients with Hematologic Malignancies

    PubMed Central

    Loberiza, Fausto R; Swore-Flecther, Barbara A.; Block, Susan D.; Back, Anthony L.; Goldman, Roberta E.; Tulsky, James A.; Lee, Stephanie J.

    2014-01-01

    This study evaluated if measures of psychological well-being, including coping style are associated with advance care planning (ACP). Data were from the HEMA-COMM study, a prospective observational study of physician-patient communication in patients with hematologic malignancies. ACP was defined as having a living will, having a health care proxy, discussing life support with family or friends, and discussing life support with a doctor or nurse. 293 patients participated: only 45 (15%) had all the elements of ACP, 215 (73%) had at least 1 element of ACP, while 33 (11%) did not engage in ACP. In multivariate analysis, specific coping styles but not other measures of psychosocial well being were associated with having written ACP. Verbal ACP was associated with patient-reported health and physician estimate of life expectancy. Our study suggests that tailoring ACP discussions to a patient’s coping style may increase engagement in ACP. PMID:21851220

  11. Mass Customization Production Planning System by Advance Demand Information Based on Unfulfilled-order-rate

    NASA Astrophysics Data System (ADS)

    Ueno, Nobuyuki; Kawasaki, Masaya; Okuhara, Koji

    In this paper, we try to model for ‘Naiji System’ which is a unique corporation between a maker and suppliers in Japan. We propose Mass Customization Production Planning & Management System (MCPS) based on unfulfilled-order-rate by using Advance Demand Information, which is called ‘Naiji’. This model is formulated as a nonlinear stochastic programming problem which minimizes the sum of production cost and inventory holding cost subject to the set of probabilistic constraint and some linear production constraints. We propose the new upper bound SOn (ρmin) to estimate the unfulfilled-order-rate more strictly. The procedure to find a good solution is developed by solving the linear programming problem repeatedly on the basic solution strategy that is ‘relaxation’. A computational load to obtain a solution by the proposed indicator is shown to be very small. Finally, an availability of the procedure is shown.

  12. Lessons learned from New York's community approach to advance care planning and MOLAT.

    PubMed

    Bomba, Patricia A; Orem, Katie

    2015-01-01

    This article reviews the lessons learned from the development and implementation of New York's community approach to advance care planning (ACP) as a wellness initiative and the key components of the complementary programs: Community Conversations on Compassionate Care (CCCC) and Medical Orders for Life-Sustaining Treatment (MOLST). Shared, informed medical decision-making is a patient-centered process that is critical to ensuring patient preferences for care are honored at the end of life. Providers must be trained, qualified, and comfortable with the discussions needed for effective shared, informed medical decision-making. Development, implementation, outcomes, lessons learned and sustainability of the CCCC and MOLST programs highlight the success of a healthcare and community collaborative initiative focused on improving care at the end of life. Community data support the value of implementing the CCCC and New York's MOLST throughout the country. PMID:25813415

  13. [Timing of Advance Care Planning in frail elderly patients: when to start?].

    PubMed

    Ott, Brenda; van Thiel, Ghislaine J M W; de Ruiter, Corinne M; van Delden, Hans J J M

    2015-01-01

    Advance Care Planning (ACP) is the process of discussing and recording patient preferences concerning goals for end-of-life care and to facilitate decision-making. ACP is an essential element of care for frail elderly patients because frailty increases the risks of negative health outcomes and loss of function. In this article, we present three patient cases to illustrate how general practitioners (GPs) can perform ACP and to demonstrate the importance of early and iterative end-of-life discussions with frail elderly patients. Good timing is decisive for the success of the intervention. GPs are in a key position to identify and discuss ACP matters at an early stage, supported by the geriatrician if necessary. Posing the 'surprise question' has proved helpful to determine timing. Complex ACP interventions contribute to care which is better adapted to the needs of frail elderly patients. PMID:25650032

  14. ADVANCED MR IMAGING METHODS FOR PLANNING AND MONITORING RADIATION THERAPY IN PATIENTS WITH HIGH GRADE GLIOMA

    PubMed Central

    Lupo, Janine M.; Nelson, Sarah J.

    2016-01-01

    This review explores how the integration of advanced imaging methods with high quality anatomic images significantly improves the characterization, target definition, assessment of response to therapy, and overall management of patients with high-grade glioma. Metrics derived from diffusion, perfusion, and susceptibility weighted MR imaging in conjunction with MR spectroscopic imaging, allows us to characterize regions of edema, hypoxia, increased cellularity, and necrosis within heterogeneous tumor and surrounding brain tissue. Quantification of such measures may provide a more reliable initial representation of tumor delineation and response to therapy than changes in the contrast enhancing or T2 lesion alone and have a significant impact on targeting resection, planning radiation, and assessing treatment effectiveness. In the long-term, implementation of these imaging methodologies can also aid in the identification of recurrent tumor and its differentiation from treatment-related confounds and facilitate the detection of radiation-induced vascular injury in otherwise normal appearing brain tissue. PMID:25219809

  15. Advanced transportation system study: Manned launch vehicle concepts for two way transportation system payloads to LEO. Program cost estimates document

    NASA Technical Reports Server (NTRS)

    Duffy, James B.

    1993-01-01

    This report describes Rockwell International's cost analysis results of manned launch vehicle concepts for two way transportation system payloads to low earth orbit during the basic and option 1 period of performance for contract NAS8-39207, advanced transportation system studies. Vehicles analyzed include the space shuttle, personnel launch system (PLS) with advanced launch system (ALS) and national launch system (NLS) boosters, foreign launch vehicles, NLS-2 derived launch vehicles, liquid rocket booster (LRB) derived launch vehicle, and cargo transfer and return vehicle (CTRV).

  16. How Do General Practitioners Conceptualise Advance Care Planning in Their Practice? A Qualitative Study

    PubMed Central

    De Vleminck, Aline; Pardon, Koen; Beernaert, Kim; Houttekier, Dirk; Vander Stichele, Robert; Deliens, Luc

    2016-01-01

    Objectives To explore how GPs conceptualise advance care planning (ACP), based on their experiences with ACP in their practice. Methods Five focus groups were held with 36 GPs. Discussions were analysed using a constant comparative method. Results Four overarching themes in the conceptualisations of ACP were discerned: (1) the organisation of professional care required to meet patients’ needs, (2) the process of preparing for death and discussing palliative care options, (3) the discussion of care goals and treatment decisions, (4) the completion of advance directives. Within these themes, ACP was both conceptualised in terms of content of ACP and/or in terms of tasks for the GP. A specific task that was mentioned throughout the discussion of the four different themes was (5) the task of actively initiating ACP by the GP versus passively waiting for patients’ initiation. Conclusions This study illustrates that GPs have varying conceptualisations of ACP, of which some are more limited to specific aspects of ACP. A shared conceptualisation and agreement on the purpose and goals of ACP is needed to ensure successful implementation, as well as a systematic integration of ACP in routine practice that could lead to a better uptake of all the important elements of ACP. PMID:27096846

  17. Honoring Choices Minnesota: Preliminary Data from a Community-Wide Advance Care Planning Model

    PubMed Central

    Wilson, Kent S; Kottke, Thomas E; Schettle, Sue

    2014-01-01

    Advance care planning (ACP) increases the likelihood that individuals who are dying receive the care that they prefer. It also reduces depression and anxiety in family members and increases family satisfaction with the process of care. Honoring Choices Minnesota is an ACP program based on the Respecting Choices model of La Crosse, Wisconsin. The objective of this report is to describe the process, which began in 2008, of implementing Honoring Choices Minnesota in a large, diverse metropolitan area. All eight large healthcare systems in the metropolitan area agreed to participate in the project, and as of April 30, 2013, the proportion of hospitalized individuals 65 and older with advance care directives in the electronic medical record was 12.1% to 65.6%. The proportion of outpatients aged 65 and older was 11.6% to 31.7%. Organizations that had sponsored recruitment initiatives had the highest proportions of records containing healthcare directives. It was concluded that it is possible to reduce redundancy by recruiting all healthcare systems in a metropolitan area to endorse the same ACP model, although significantly increasing the proportion of individuals with a healthcare directive in their medical record requires a campaign with recruitment of organizations and individuals. PMID:25516036

  18. Redefining the “Planning” in Advance Care Planning: Preparing for End-of-Life Decision Making

    PubMed Central

    Sudore, Rebecca L.; Fried, Terri R.

    2010-01-01

    The traditional objective of advance care planning has been to have patients make treatment decisions in advance in an attempt to provide care consistent with their goals. We argue that the objective for advance care planning ought to be the preparation of patients and surrogates to participate with clinicians in making the best possible in-the-moment medical decisions. We provide practical steps for clinicians to help patients and surrogate decision makers achieve this objective in the outpatient setting. Preparation for in-the-moment decision making shifts the focus from having patients make premature decisions based on incomplete information to preparing patients and their surrogates for the types of decisions and conflicts they may encounter when they do have to engage in in-the-moment decision making. This approach does not preclude the completion of advance directives, but acknowledges that they are but one piece of information to be used at the time of decision making. PMID:20713793

  19. Ares First Stage "Systemology" - Combining Advanced Systems Engineering and Planning Tools to Assure Mission Success

    NASA Technical Reports Server (NTRS)

    Seiler, James; Brasfield, Fred; Cannon, Scott

    2008-01-01

    Ares is an integral part of NASA s Constellation architecture that will provide crew and cargo access to the International Space Station as well as low earth orbit support for lunar missions. Ares replaces the Space Shuttle in the post 2010 time frame. Ares I is an in-line, two-stage rocket topped by the Orion Crew Exploration Vehicle, its service module, and a launch abort system. The Ares I first stage is a single, five-segment reusable solid rocket booster derived from the Space Shuttle Program's reusable solid rocket motor. The Ares second or upper stage is propelled by a J-2X main engine fueled with liquid oxygen and liquid hydrogen. This paper describes the advanced systems engineering and planning tools being utilized for the design, test, and qualification of the Ares I first stage element. Included are descriptions of the current first stage design, the milestone schedule requirements, and the marriage of systems engineering, detailed planning efforts, and roadmapping employed to achieve these goals.

  20. Mass Customization Production Planning System by Advance Demand Information Based on Unfulfilled-order-rate II

    NASA Astrophysics Data System (ADS)

    Ueno, Nobuyuki; Kadomoto, Kiyotaka; Okuhara, Koji

    In the previous paper, we proposed Mass Customization Production Planning & Management System (MCPS) based on unfulfilled-order-rate by using Advance Demand Information which is called ‘Naiji System’ as an unique corporation between a maker and suppliers in Japan, and 3 indicators to estimate the unfulfilled-order-rate. Applying these indicators to the model, we investigated the behavior of unfulfilled-order-rate at the final period in the planning horizon. In this paper, we propose a new model for purchasing, and investigate the unfulfilled-order-rate at each period and the impact to the total inventory. We find that the total inventories become 5.9%-20.0% decreases by using SOn rather than by using SOn(0). And we enhance a base-stock policy to a new one with multi-period. We prove that the MCPS model for purchasing by using SOn(0) is equivalent to the base-stock policy with multi-period under the specified condition. Under this condition, the proposed model by using SOn decreases inventories more than the base-stock policy with multi-period.

  1. Mission planning and scheduling concept for the Advanced X-ray Astrophysics Facility (AXAF)

    NASA Technical Reports Server (NTRS)

    Newhouse, M.; Guffin, O. T.

    1994-01-01

    Projected for launch in the latter part of 1998, the Advanced X-ray Astrophysics Facility (AXAF), the third satellite in the Great Observatory series, promises to dramatically open the x-ray sky as the Hubble and Compton observatories have done in their respective realms. Unlike its companions, however, AXAF will be placed in a high altitude, highly elliptical orbit (10,000 x 100,000 km), and will therefore be subject to its own unique environment, spacecraft and science instrument constraints and communication network interactions. In support of this mission, ground operations personnel have embarked on the development of the AXAF Offline System (OFLS), a body of software divided into four basic functional elements: (1) Mission Planning and Scheduling, (2) Command Management, (3) Altitude Determination and Sensor Calibration and (4) Spacecraft Support and Engineering Analysis. This paper presents an overview concept for one of these major elements, the Mission Planning and Scheduling subsystem (MPS). The derivation of this concept is described in terms of requirements driven by spacecraft and science instrument characteristics, orbital environment and ground system capabilities. The flowdown of these requirements through the systems analysis process and the definition of MPS interfaces has resulted in the modular grouping of functional subelements depicted in the design implementation approach. The rationale for this design solution is explained and capabilities for the initial prototype system are proposed from the user perspective.

  2. Advances in 4D Treatment Planning for Scanned Particle Beam Therapy — Report of Dedicated Workshops

    PubMed Central

    Bert, Christoph; Graeff, Christian; Riboldi, Marco; Nill, Simeon; Baroni, Guido; Knopf, Antje-Christin

    2014-01-01

    We report on recent progress in the field of mobile tumor treatment with scanned particle beams, as discussed in the latest editions of the 4D treatment planning workshop. The workshop series started in 2009, with about 20 people from 4 research institutes involved, all actively working on particle therapy delivery and development. The first workshop resulted in a summary of recommendations for the treatment of mobile targets, along with a list of requirements to apply these guidelines clinically. The increased interest in the treatment of mobile tumors led to a continuously growing number of attendees: the 2012 edition counted more than 60 participants from 20 institutions and commercial vendors. The focus of research discussions among workshop participants progressively moved from 4D treatment planning to complete 4D treatments, aiming at effective and safe treatment delivery. Current research perspectives on 4D treatments include all critical aspects of time resolved delivery, such as in-room imaging, motion detection, beam application, and quality assurance techniques. This was motivated by the start of first clinical treatments of hepato cellular tumors with a scanned particle beam, relying on gating or abdominal compression for motion mitigation. Up to date research activities emphasize significant efforts in investigating advanced motion mitigation techniques, with a specific interest in the development of dedicated tools for experimental validation. Potential improvements will be made possible in the near future through 4D optimized treatment plans that require upgrades of the currently established therapy control systems for time resolved delivery. But since also these novel optimization techniques rely on the validity of the 4DCT, research focusing on alternative 4D imaging technique, such as MRI based 4DCT generation will continue. PMID:24354749

  3. 23 CFR 420.111 - What are the documentation requirements for use of FHWA planning and research funds?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... metropolitan planning area work programs is contained in 23 CFR part 450. Additional information on RD&T work..., and technology transfer related activities funded with other Federal or State and/or local...

  4. 23 CFR 420.111 - What are the documentation requirements for use of FHWA planning and research funds?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... metropolitan planning area work programs is contained in 23 CFR part 450. Additional information on RD&T work... various combinations, or brought together as a single work program. The expenditure of PL funds...

  5. 23 CFR 420.111 - What are the documentation requirements for use of FHWA planning and research funds?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... metropolitan planning area work programs is contained in 23 CFR part 450. Additional information on RD&T work... various combinations, or brought together as a single work program. The expenditure of PL funds...

  6. Economic Impact of an Advanced Illness Consultation Program within a Medicare Advantage Plan Population

    PubMed Central

    Colaberdino, Vincent; Marshall, Colleen; DuBose, Paul; Daitz, Mitchell

    2016-01-01

    Abstract Background: In the United States the quality and cost associated with medical treatment for individuals experiencing an advanced illness is highly variable and is often misaligned with the patient's and family's quality of life values and priorities. Many of the obstacles that stand in the way of aligning the care that an individual receives with their priorities are well understood in the context of behavioral science. Through employing behavioral based approaches to improve the quality of communication and shared decision making processes among patients, providers and families it is possible to enhance the efficiency of delivering care which is also more highly aligned with the individual's preferences. Objectives: The study objectives were to measure the economic impact of a proprietary advanced illness behavioral consultation program, the Vital Decisions Living Well Consultation Program (LWCP), on the cost of care delivered during the last six and three months of life for enrolled members in a Medicare Advantage plan. Study design: Retrospective matched case control analysis examined medical, pharmaceutical, and capitation expenses after an offset by premium revenue. Methods: The treatment population consisted of participating members of the LWCP who died between October 1, 2011 and March 31, 2013 (N = 1755). The control population consisted of plan members who died between July 1, 2008 and June 1, 2011, prior to the introduction of the LWCP (N = 5560). Criteria used to match treatment subjects with one or more control subjects were diagnosis, age at death, and health care costs incurred prior to the time under examination. A paired t-test evaluated the significance of differences between the matched treatment and control members. Results: The mean cost reduction during the last six months of life for treatment members compared to matched control group members was $13,956 (p < 0.001) during the last six months of life and $9,285 (p < 0

  7. Inverse Planned High-Dose-Rate Brachytherapy for Locoregionally Advanced Cervical Cancer: 4-Year Outcomes

    SciTech Connect

    Tinkle, Christopher L.; Weinberg, Vivian; Chen, Lee-May; Littell, Ramey; Cunha, J. Adam M.; Sethi, Rajni A.; Chan, John K.; Hsu, I-Chow

    2015-08-01

    Purpose: Evaluate the efficacy and toxicity of image guided brachytherapy using inverse planning simulated annealing (IPSA) high-dose-rate brachytherapy (HDRB) boost for locoregionally advanced cervical cancer. Methods and Materials: From December 2003 through September 2009, 111 patients with primary cervical cancer were treated definitively with IPSA-planned HDRB boost (28 Gy in 4 fractions) after external radiation at our institution. We performed a retrospective review of our experience using image guided brachytherapy. Of the patients, 70% had a tumor size >4 cm, 38% had regional nodal disease, and 15% had clinically evident distant metastasis, including nonregional nodal disease, at the time of diagnosis. Surgical staging involving pelvic lymph node dissection was performed in 15% of patients, and 93% received concurrent cisplatin-based chemotherapy. Toxicities are reported according to the Common Terminology Criteria for Adverse Events version 4.0 guidelines. Results: With a median follow-up time of 42 months (range, 3-84 months), no acute or late toxicities of grade 4 or higher were observed, and grade 3 toxicities (both acute and late) developed in 8 patients (1 constitutional, 1 hematologic, 2 genitourinary, 4 gastrointestinal). The 4-year Kaplan-Meier estimate of late grade 3 toxicity was 8%. Local recurrence developed in 5 patients (4 to 9 months after HDRB), regional recurrence in 3 (6, 16, and 72 months after HDRB), and locoregional recurrence in 1 (4 months after HDR boost). The 4-year estimates of local, locoregional, and distant control of disease were 94.0%, 91.9%, and 69.1%, respectively. The overall and disease-free survival rates at 4 years were 64.3% (95% confidence interval [CI] of 54%-73%) and 61.0% (95% CI, 51%-70%), respectively. Conclusions: Definitive radiation by use of inverse planned HDRB boost for locoregionally advanced cervical cancer is well tolerated and achieves excellent local control of disease. However, overall

  8. 24 CFR 266.310 - Insurance of advances or insurance upon completion; applicability of requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., work write-ups, and other contract documents. (2) Approval of advances. At all times, the loan must be... inspection, as well as in accord with plans, specifications, work write-ups and other contract documents....

  9. 24 CFR 266.310 - Insurance of advances or insurance upon completion; applicability of requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., work write-ups, and other contract documents. (2) Approval of advances. At all times, the loan must be... inspection, as well as in accord with plans, specifications, work write-ups and other contract documents....

  10. 24 CFR 266.310 - Insurance of advances or insurance upon completion; applicability of requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., work write-ups, and other contract documents. (2) Approval of advances. At all times, the loan must be... inspection, as well as in accord with plans, specifications, work write-ups and other contract documents....

  11. Multicriteria Optimization in Intensity-Modulated Radiation Therapy Treatment Planning for Locally Advanced Cancer of the Pancreatic Head

    SciTech Connect

    Hong, Theodore S. Craft, David L.; Carlsson, Fredrik; Bortfeld, Thomas R.

    2008-11-15

    Purpose: Intensity-modulated radiation therapy (IMRT) affords the potential to decrease radiation therapy-associated toxicity by creating highly conformal dose distributions. However, the inverse planning process can create a suboptimal plan despite meeting all constraints. Multicriteria optimization (MCO) may reduce the time-consuming iteration loop necessary to develop a satisfactory plan while providing information regarding trade-offs between different treatment planning goals. In this exploratory study, we examine the feasibility and utility of MCO in physician plan selection in patients with locally advanced pancreatic cancer (LAPC). Methods and Materials: The first 10 consecutive patients with LAPC treated with IMRT were evaluated. A database of plans (Pareto surface) was created that met the inverse planning goals. The physician then navigated to an 'optimal' plan from the point on the Pareto surface at which kidney dose was minimized. Results: Pareto surfaces were created for all 10 patients. A physician was able to select a plan from the Pareto surface within 10 minutes for all cases. Compared with the original (treated) IMRT plans, the plan selected from the Pareto surface had a lower stomach mean dose in 9 of 10 patients, although often at the expense of higher kidney dose than with the treated plan. Conclusion: The MCO is feasible in patients with LAPC and allows the physician to choose a satisfactory plan quickly. Generally, when given the opportunity, the physician will choose a plan with a lower stomach dose. The MCO enables a physician to provide greater active clinical input into the IMRT planning process.

  12. Earth Observing System (EOS)/Advanced Microwave Sounding Unit-A (AMSU-A): Calibration management plan

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This is the Calibration Management Plan for the Earth Observing System/Advanced Microwave Sounding Unit-A (AMSU-A). The plan defines calibration requirements, calibration equipment, and calibration methods for the AMSU-A, a 15 channel passive microwave radiometer that will be used for measuring global atmospheric temperature profiles from the EOS polar orbiting observatory. The AMSU-A system will also provide data to verify and augment that of the Atmospheric Infrared Sounder.

  13. "I Like to Plan Events": A Document Analysis of Essays Written by Applicants to a Public Relations Program

    ERIC Educational Resources Information Center

    Taylor, Ronald E.

    2016-01-01

    A document analysis of 249 essays written during a 5-year period by applicants to a public relations program at a major state university in the southeast suggests that there are enduring reasons why students choose to major in public relations. Public relations is described as a major that allows for and encourages creative expression and that…

  14. Savannah River Site mixed waste Proposed Site Treatment Plan (PSTP). Volumes 1 and 2 and reference document: Revision 2

    SciTech Connect

    Helmich, E.; Noller, D.K.; Wierzbicki, K.S.; Bailey, L.L.

    1995-07-13

    The DOE is required by the Resource Conservation and Recovery Act to prepare site treatment plans describing the development of treatment capacities and technologies for treating mixed waste. This proposed plan contains Savannah River Site`s preferred options and schedules for constructing new facilities, and otherwise obtaining treatment for mixed wastes. The proposed plan consists of 2 volumes. Volume 1, Compliance Plan, identifies the capacity to be developed and the schedules as required. Volume 2, Background, provides a detailed discussion of the preferred options with technical basis, plus a description of the specific waste streams. Chapters are: Introduction; Methodology; Mixed low level waste streams; Mixed transuranic waste; High level waste; Future generation of mixed waste streams; Storage; Process for evaluation of disposal issues in support of the site treatment plans discussions; Treatment facilities and treatment technologies; Offsite waste streams for which SRS treatment is the Preferred Option (Naval reactor wastes); Summary information; and Acronyms and glossary. This revision does not contain the complete revised report, but only those pages that have been revised.

  15. Advanced satellite workstation: An integrated workstation environment for operational support of satellite system planning and analysis

    NASA Technical Reports Server (NTRS)

    Sutton, Stewart A.

    1992-01-01

    A prototype integrated environment, the Advanced Satellite Workstation (ASW), is described that has been developed and delivered for evaluation and operator feedback in an operational satellite control center. The current ASW hardware consists of a Sun Workstation and Macintosh II Workstation connected via an ethernet Network Hardware and Software, Laser Disk System, Optical Storage System, and Telemetry Data File Interface. The central mission of ASW is to provide an intelligent decision support and training environment for operator/analysts of complex systems such as satellites. There have been many workstation implementations recently which incorporate graphical telemetry displays and expert systems. ASW is a considerably broader look at intelligent, integrated environments for decision support, based upon the premise that the central features of such an environment are intelligent data access and integrated toolsets. A variety of tools have been constructed in support of this prototype environment including: an automated pass planner for scheduling vehicle support activities, architectural modeler for hierarchical simulation and analysis of satellite vehicle subsystems, multimedia-based information systems that provide an intuitive and easily accessible interface to Orbit Operations Handbook and other relevant support documentation, and a data analysis architecture that integrates user modifiable telemetry display systems, expert systems for background data analysis, and interfaces to the multimedia system via inter-process communication.

  16. 77 FR 33232 - Notice of Intent To Prepare Environmental Documents and Proposed Plan Amendments for Off-Highway...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

    ...In compliance with the National Environmental Policy Act of 1969 (NEPA), as amended, and the Federal Land Policy and Management Act of 1976 (FLPMA), as amended, the Bureau of Land Management (BLM) Boise District Office, Four Rivers Field Office, Boise, Idaho, intends to prepare environmental assessments (EA) that will evaluate the effects of amending the 1983 Kuna Management Framework Plan......

  17. On the Flexibility of Grammatical Advance Planning during Sentence Production: Effects of Cognitive Load on Multiple Lexical Access

    ERIC Educational Resources Information Center

    Wagner, Valentin; Jescheniak, Jorg D.; Schriefers, Herbert

    2010-01-01

    Three picture-word interference experiments addressed the question of whether the scope of grammatical advance planning in sentence production corresponds to some fixed unit or rather is flexible. Subjects produced sentences of different formats under varying amounts of cognitive load. When speakers described 2-object displays with simple…

  18. The Power of Advance Care Planning in Promoting Hospice and Out-of-Hospital Death in a Dialysis Unit

    PubMed Central

    Weaner, Barbara B.; Long, Dustin

    2015-01-01

    Abstract Background: Despite mortality rates that exceed those of most cancers, hospice remains underutilized in patients with end-stage renal disease (ESRD) on dialysis and nearly half of all dialysis patients die in the hospital. Objective: To review the impact of advance care planning on withdrawal from dialysis, use of hospice, and location of death. Design: Retrospective review. Setting: A rural outpatient dialysis unit. Participants: Former dialysis patients who died over a 5-year period. Exposure: Advance care planning, the use of physician orders for life-sustaining therapy program (POLST). Main Outcome and Measure: Use of hospice among patients withdrawing from dialysis, location of death. Results: Advance care planning was associated with a low incidence of in-hospital death and among those who withdrew, a high use of hospice. Conclusions and Relevance: Comprehensive and systematic advance care planning among patients with ESRD on dialysis promotes greater hospice utilization and may facilitate the chance that death will occur out of hospital. PMID:25006866

  19. A Status of the Advanced Space Transportation Program from Planning to Action

    NASA Technical Reports Server (NTRS)

    Lyles, Garry; Griner, Carolyn

    1998-01-01

    A Technology Plan for Enabling Commercial Space Business was presented at the 48th International Astronautical Congress in Turin, Italy. This paper presents a status of the program's accomplishments. Technology demonstrations have progressed in each of the four elements of the program; (1) Low Cost Technology, (2) Advanced Reusable Technology, (3) Space Transfer Technology and (4) Space Transportation Research. The Low Cost Technology program element is primarily focused at reducing development and acquisition costs of aerospace hardware using a "design to cost" philosophy with robust margins, adapting commercial manufacturing processes and commercial off-the-shelf hardware. The attributes of this philosophy for small payload launch are being demonstrated at the component, sub-system, and system level. The X-34 "Fastrac" engine has progressed through major component and subsystem demonstrations. A propulsion system test bed has been implemented for system-level demonstration of component and subsystem technologies; including propellant tankage and feedlines, controls, pressurization, and engine systems. Low cost turbopump designs, commercial valves and a controller are demonstrating the potential for a ten-fold reduction in engine and propulsion system costs. The Advanced Reusable Technology program element is focused on increasing life through high strength-to-weight structures and propulsion components, highly integrated propellant tanks, automated checkout and health management and increased propulsion system performance. The validation of rocket based combined cycle (RBCC) propulsion is pro,-,ressing through component and subsystem testing. RBCC propulsion has the potential to provide performance margin over an all rocket system that could result in lower gross liftoff weight, a lower propellant mass fraction or a higher payload mass fraction. The Space Transfer Technology element of the program is pursuing technology that can improve performance and

  20. Planned preoperative radiation therapy for advanced laryngeal carcinoma. [/sup 60/Co

    SciTech Connect

    Kazem, I.; van den Broek, P.; Huygen, P.L.M.

    1982-09-01

    One hundred ten patients with predominantly advanced laryngeal carcinoma were treated in the period 1969-1978 with planned preoperative radiation therapy followed by surgery. Site distribution was: 63 supraglottic, 26 glottic, 15 transglottic and 6 subglottic. There were 4 Stage II patients, 66 Stage III and 40 Stage IV. Preoperative radiation therapy consisted of Telecobalt irradiation to a total dose of 25 Gy given to a target volume encompassing the larynx and regional neck nodes, given in 5 equal daily fractions of 5 Gy in 5 consecutive days. Surgery was performed 2 days later. Total laryngectomy was performed on 48 patients, total laryngectomy with neck dissection on 55 patients, supraglottic laryngectomy on 5 and supraglottic laryngectomy with neck dissection on 2 patients. Crude actuarial 5 and 10 year survival probability for the whole group is 71 and 61%, respectively. The corrected 5 and 10 year survival is 75%. For patients with T/sub 3/-T/sub 4/-N/sub 0/ tumors 5 and 10 year survival probability is: crude 65 and 58%, and corrected 70% respectively. For T/sub 3/-T/sub 4/-N/sub +/ crude: 75 and 60% and corrected: 78%. Of 110 patients, one died postoperative, three died of intercurrent disease, five died as a result of second malignancy, and 23 died of their larynx carcinoma: 12/23 because of locoregional failure, and 11/23 because of distant metastasis. We concluded that short intensive preoperative radiation therapy and surgery offer a high cure rate in the treatment of advanced resectable laryngeal carcinoma. The merits of this technique are outlined in the text.

  1. RISMC advanced safety analysis working plan: FY2015 - FY2019. Light Water Reactor Sustainability Program

    SciTech Connect

    Szilard, Ronaldo H; Smith, Curtis L

    2014-09-01

    In this report, the Advanced Safety Analysis Program (ASAP) objectives and value proposition is described. ASAP focuses on modernization of nuclear power safety analysis (tools, methods and data); implementing state-of-the-art modeling techniques (which include, for example, enabling incorporation of more detailed physics as they become available); taking advantage of modern computing hardware; and combining probabilistic and mechanistic analyses to enable a risk informed safety analysis process. The modernized tools will maintain the current high level of safety in our nuclear power plant fleet, while providing an improved understanding of safety margins and the critical parameters that affect them. Thus, the set of tools will provide information to inform decisions on plant modifications, refurbishments, and surveillance programs, while improving economics. The set of tools will also benefit the design of new reactors, enhancing safety per unit cost of a nuclear plant. As part of the discussion, we have identified three sets of stakeholders, the nuclear industry, the Department of Energy (DOE), and associated oversight organizations. These three groups would benefit from ASAP in different ways. For example, within the DOE complex, the possible applications that are seen include the safety of experimental reactors, facility life extension, safety-by-design in future generation advanced reactors, and managing security for the storage of nuclear material. This report provides information in five areas: (1) A value proposition (“why is this important?”) that will make the case for stakeholder’s use of the ASAP research and development (R&D) products; (2) An identification of likely end users and pathway to adoption of enhanced tools by the end-users; (3) A proposed set of practical and achievable “use case” demonstrations; (4) A proposed plan to address ASAP verification and validation (V&V) needs; and (5) A proposed schedule for the multi-year ASAP.

  2. Measuring engagement in advance care planning: a cross-sectional multicentre feasibility study

    PubMed Central

    Howard, Michelle; Bonham, Aaron J; Heyland, Daren K; Sudore, Rebecca; Fassbender, Konrad; Robinson, Carole A; McKenzie, Michael; Elston, Dawn; You, John J

    2016-01-01

    Objectives To assess the feasibility, acceptability and clinical sensibility of a novel survey, the advance care planning (ACP) Engagement Survey, in various healthcare settings. Setting A target sample of 50 patients from each of primary care, hospital, cancer care and dialysis care settings. Participants A convenience sample of patients without cognitive impairment who could speak and read English was recruited. Patients 50 and older were eligible in primary care; patients 80 and older or 55 and older with clinical markers of advanced chronic disease were recruited in hospital; patients aged 19 and older were recruited in cancer and renal dialysis centres. Outcomes We assessed feasibility, acceptability and clinical sensibility of the ACP Engagement Survey using a 6-point scale. The ACP Engagement Survey measures ACP processes (knowledge, contemplation, self-efficacy and readiness) on 5-point Likert scales and actions (yes/no). Results 196 patients (38–96 years old, 50.5% women) participated. Mean (±SD) time to administer was 48.8±19.6 min. Mean acceptability scores ranged from 3.2±1.3 in hospital to 4.7±0.9 in primary care, and mean relevance ranged from 3.5±1.0 in hospital to 4.9±0.9 in dialysis centres (p<0.001 for both). The mean process score was 3.1±0.6 and the mean action score was 11.2±5.6 (of a possible 25). Conclusions The ACP Engagement Survey demonstrated feasibility and acceptability in outpatient settings but was less feasible and acceptable among hospitalised patients due to length. A shorter version may improve feasibility. Engagement in ACP was low to moderate. PMID:27338877

  3. Early experience with digital advance care planning and directives, a novel consumer-driven program

    PubMed Central

    Yang, Zhiyong; Spivey, Christy; Boardman, Bonnie; Courtney, Maureen

    2016-01-01

    Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Our objectives were to determine the results of a digital ACP/AD through which consumers create, store, locate, and retrieve their ACP/AD at no charge and with minimal physician involvement, and the ACP/AD can be integrated into the electronic health record. The authors chose 900 users of MyDirectives, a digital ACP/AD tool, to achieve proportional representation of all 50 states by population size and then reviewed their responses. The 900 participants had an average age of 50.8 years (SD = 16.6); 84% of the men and 91% of the women were in self-reported good health when signing their ADs. Among the respondents, 94% wanted their physicians to consult a supportive and palliative care team if they were seriously ill; nearly 85% preferred cessation of life-sustaining treatments during their final days; 76% preferred to spend their final days at home or in a hospice; and 70% would accept attempted cardiopulmonary resuscitation in limited circumstances. Most respondents wanted an autopsy under certain conditions, and 62% wished to donate their organs. In conclusion, analysis of early experience with this ACP/AD platform demonstrates that individuals of different ages and conditions can engage in an interrogatory process about values, develop ADs that are more nuanced than traditional paper-based ADs in reflecting those values, and easily make changes to their ADs. Online ADs have the potential to remove barriers to ACP/AD and thus further improve patient-centered end-of-life care. PMID:27365867

  4. Early experience with digital advance care planning and directives, a novel consumer-driven program.

    PubMed

    Fine, Robert L; Yang, Zhiyong; Spivey, Christy; Boardman, Bonnie; Courtney, Maureen

    2016-07-01

    Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Our objectives were to determine the results of a digital ACP/AD through which consumers create, store, locate, and retrieve their ACP/AD at no charge and with minimal physician involvement, and the ACP/AD can be integrated into the electronic health record. The authors chose 900 users of MyDirectives, a digital ACP/AD tool, to achieve proportional representation of all 50 states by population size and then reviewed their responses. The 900 participants had an average age of 50.8 years (SD = 16.6); 84% of the men and 91% of the women were in self-reported good health when signing their ADs. Among the respondents, 94% wanted their physicians to consult a supportive and palliative care team if they were seriously ill; nearly 85% preferred cessation of life-sustaining treatments during their final days; 76% preferred to spend their final days at home or in a hospice; and 70% would accept attempted cardiopulmonary resuscitation in limited circumstances. Most respondents wanted an autopsy under certain conditions, and 62% wished to donate their organs. In conclusion, analysis of early experience with this ACP/AD platform demonstrates that individuals of different ages and conditions can engage in an interrogatory process about values, develop ADs that are more nuanced than traditional paper-based ADs in reflecting those values, and easily make changes to their ADs. Online ADs have the potential to remove barriers to ACP/AD and thus further improve patient-centered end-of-life care. PMID:27365867

  5. Earth Observing System/Advanced Microwave Sounding Unit-A (EOS/AMSU-A): Software concept document

    NASA Technical Reports Server (NTRS)

    Schwantje, Robert

    1994-01-01

    This document presents the concept for two separate but closely related software systems. The first is the special test equipment (STE) software used at Aerojet for AMSU-A instrument testing, and the second is the workstation software used at the spacecraft integration facility to monitor the AMSU-A instrument when installed on the spacecraft. The primary use of the STE software is to monitor the data output from the AMSU-A instruments, to command the instruments, and to perform automated thermal-vacuum calibration testing. The primary use of the workstation software is to monitor the AMSU-A instrument's performance through an Ethernet link during the instrument/spacecraft integration process.

  6. An Examination of Transition Planning Documents Using Kohler's Model for Successful Transition Planning with Classified Special Education Students

    ERIC Educational Resources Information Center

    Aiello, Angela

    2011-01-01

    This researcher addresses whether transition planning with classified special education students is being implemented in accordance with the Kohler model for successful transition programming. Using archival data obtained from two high schools, one with a specialized on campus program (School A) and the latter as an excluded site specializing in…

  7. Design, Implementation and Evaluation of an Architecture based on the CDA R2 Document Repository to Provide Support to the Contingency Plan.

    PubMed

    Campos, Fernando; Luna, Daniel; Sittig, Dean F; Bernaldo de Quirós, Fernán González

    2015-01-01

    The pervasive use of electronic records in healthcare increases the dependency on technology due to the lack of physical backup for the records. Downtime in the Electronic Health Record system is unavoidable, due to software, infrastructure and power failures as well as natural disasters, so there is a need to develop a contingency plan ensuring patient care continuity and minimizing risks for health care delivery. To mitigate these risks, two applications were developed allowing healthcare delivery providers to retrieve clinical information using the Clinical Document Architecture Release 2 (CDA R2) document repository as the information source. In this paper we describe the strategy, implementation and results; and provide an evaluation of effectiveness. PMID:26262033

  8. Estimating the Effect of Palliative Care Interventions and Advance Care Planning on ICU Utilization: A Systematic Review

    PubMed Central

    Khandelwal, Nita; Kross, Erin K.; Engelberg, Ruth A.; Coe, Norma B.; Long, Ann C.; Curtis, J. Randall

    2015-01-01

    Objective We conducted a systematic review to answer three questions: 1) Do advance care planning and palliative care interventions lead to a reduction in ICU admissions for adult patients with life-limiting illnesses? 2) Do these interventions reduce ICU length of stay? and 3) Is it possible to provide estimates of the magnitude of these effects? Data Sources We searched MEDLINE, EMBASE, Cochrane Controlled Clinical Trials, and Cumulative Index to Nursing and Allied Health Literature databases from 1995 through March 2014. Study Selection We included studies that reported controlled trials (randomized and nonrandomized) assessing the impact of advance care planning and both primary and specialty palliative care interventions on ICU admissions and ICU length of stay for critically ill adult patients. Data Extraction Nine randomized controlled trials and 13 nonrandomized controlled trials were selected from 216 references. Data Synthesis Nineteen of these studies were used to provide estimates of the magnitude of effect of palliative care interventions and advance care planning on ICU admission and length of stay. Three studies reporting on ICU admissions suggest that advance care planning interventions reduce the relative risk of ICU admission for patients at high risk of death by 37% (sd, 23%). For trials evaluating palliative care interventions in the ICU setting, we found a 26% (sd, 23%) relative risk reduction in length of stay with these interventions. Conclusions Despite wide variation in study type and quality, patients who received advance care planning or palliative care interventions consistently showed a pattern toward decreased ICU admissions and reduced ICU length of stay. Although sds are wide and study quality varied, the magnitude of the effect is possible to estimate and provides a basis for modeling impact on healthcare costs. PMID:25574794

  9. Feasibility and acceptability of advance care planning in elderly Italian and Greek speaking patients as compared to English-speaking patients: an Australian cross-sectional study

    PubMed Central

    Detering, Karen; Sutton, Elizabeth; Fraser, Scott; Wallis, Kasey; Silvester, William; Mawren, Daveena; Whiteside, Kathryn

    2015-01-01

    Objectives To assess the feasibility and acceptability of facilitated advance care planning (ACP) discussions in elderly Italian and Greek-speaking inpatients compared to English-speaking inpatients. Design, setting and participants This cross-sectional study with convenience sampling was conducted in Melbourne, Australia, and recruited hospital inpatients with medical decision-making capacity, aged 65 years or above, who spoke Greek (25 patients), Italian (24 patients) or English (63 patients). Intervention Facilitated ACP was offered, aiming to assists patients to consider and discuss their goals, values, beliefs and future treatment wishes with their family and doctor; to help them consider how they would like healthcare decisions made in the future if they become unable to do this for themselves; and to complete advance care directives. Main outcome measures The completion of ACP discussions, their duration, advance care directive completion and utilisation of interpreters. Results Of 112 patients, 109 (97%) had at least one discussion, 63 (54%) completed advance care directives, either nominating a substitute decision-maker, documenting their wishes or both, and 76 (68%) included family in discussions. The median duration of discussions for all patients was slightly more than 1 h, over two visits. There were no differences between the Greek-speaking and the Italian-speaking patients, or between the Non-English speaking and the English-speaking patients in any of these measures. Only 14 non-English speaking patients, (30%) utilised interpreters, but when utilised, patients were much more likely (p<0.005) to complete advance care directives. Conclusions Facilitated ACP in elderly Italian and Greek-speaking patients is feasible, acceptable and is similar to that for English-speaking patients. PMID:26319775

  10. Space transfer concepts and analysis for exploration missions. Implementation plan and element description document (draft final). Volume 3: Nuclear thermal rocket vehicle

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This document presents the nuclear thermal rocket (NTR) concept design developed in support of the Space Transfer Concepts and Analysis for Exploration Missions (STCAEM) study. The evolution of the NTR concept is described along with the requirements, guidelines and assumptions for the design. Operating modes and options are defined and a systems description of the vehicle is presented. Artificial gravity configuration options and space and ground support systems are discussed. Finally, an implementation plan is presented which addresses technology needs, schedules, facilities and costs.

  11. Space transfer concepts and analysis for exploration missions. Implementation plan and element description document (draft final). Volume 4: Solar electric propulsion vehicle

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This document presents the solar electric propulsion (SEP) concept design developed as part of the Space Transfer Concepts and Analysis for Exploration Missions (STCAEM) study. The evolution of the SEP concept is described along with the requirements, guidelines and assumptions for the design. Operating modes and options are defined and a systems description of the vehicle is presented. Artificial gravity configuration options and space and ground support systems are discussed. Finally, an implementation plan is presented which addresses technology needs, schedules, facilities, and costs.

  12. Photovoltaic system criteria documents. Volume 1: Guidelines for evaluating the management and operations planning of photovoltaic applications

    NASA Technical Reports Server (NTRS)

    Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

    1979-01-01

    Guidelines are provided to the Field Centers for organization, scheduling, project and cost control, and performance in the areas of project management and operations planning for Photovoltaics Test and Applications. These guidelines may be used in organizing a T and A Project Team for system design/test, site construction and operation, and as the basis for evaluating T and A proposals. The attributes are described for project management and operations planning to be used by the Field Centers. Specifically, all project management and operational issues affecting costs, schedules and performance of photovoltaic systems are addressed. Photovoltaic tests and applications include residential, intermediate load center, central station, and stand-alone systems. The sub-categories of system maturity considered are: Initial System Evaluation Experiments (ISEE); System Readiness Experiments (SRE); and Commercial Readiness Demonstration Projects (CRDP).

  13. Advanced treatment planning methods for efficient radiation therapy with laser accelerated proton and ion beams

    SciTech Connect

    Schell, Stefan; Wilkens, Jan J.

    2010-10-15

    lateral clustering and reduce the number of particles that have to be blocked in the beam delivery system. Furthermore, the optimization routine can be adjusted to reduce the number of dose spots and laser shots. The authors implemented these methods into a research treatment planning system for laser accelerated particles. Results: The authors' proposed methods can decrease the amount of secondary radiation produced when blocking particles with wrong energies or when reducing the total number of particles from one laser shot. Additionally, caused by the efficient use of the beam, the treatment time is reduced considerably. Both improvements can be achieved without extensively changing the quality of the treatment plan since conventional intensity modulated particle therapy usually includes a certain amount of unused degrees of freedom which can be used to adapt to laser specific properties. Conclusions: The advanced beam delivery and treatment planning methods reduce the need to have a perfect laser-based accelerator reproducing the properties of conventional accelerators that might not be possible without increasing treatment time and secondary radiation to the patient. The authors show how some of the differences to conventional beams can be overcome and efficiently used for radiation treatment.

  14. Diagnostic Systems Plan for the Advanced Light Source Top-OffUpgrade

    SciTech Connect

    Barry, Walter; Chin, Mike; Robin, David; Sannibale, Fernando; Scarvie, Tom; Steier, Christoph

    2005-05-10

    The Advanced Light Source (ALS) will soon be upgraded to enable top-off operations [1], in which electrons are quasi-continuously injected to produce constant stored beam current. The upgrade is structured in two phases. First, we will upgrade our injector from 1.5 GeV to 1.9 GeV to allow full energy injection and will start top-off operations. In the second phase, we will upgrade the Booster Ring (BR) with a bunch cleaning system to allow high bunch purity top-off injection. A diagnostics upgrade will be crucial for success in both phases of the top-off project, and our plan for it is described in this paper. New booster ring diagnostics will include updated beam position monitor (BPM) electronics, a tune monitoring system, and a new scraper. Two new synchrotron light monitors and a beam stop will be added to the booster-to-storage ring transfer line (BTS), and all the existing beam current monitors along the accelerator chain will be integrated into a single injection efficiency monitoring application. A dedicated bunch purity monitor will be installed in the storage ring (SR). Together, these diagnostic upgrades will enable smooth commissioning of the full energy injector and a quick transition to high quality top-off operation at the ALS.

  15. Advance Care Planning in Norwegian nursing homes-Who is it for?

    PubMed

    Thoresen, Lisbeth; Ahlzén, Rolf; Solbrække, Kari Nyheim

    2016-08-01

    Advance care planning (ACP) is an international concept for improving patient autonomy and communication in the context of anticipated deterioration and end-of-life care. In a preparatory conversation, health care professionals facilitate one or more conversations where nursing home residents are invited to reflect on, and articulate wishes and preferences concerning future medical treatment and end-of-life care. Our aim with this study was to increase knowledge of existing ACP practices in Norwegian nursing homes. We wanted to know how nursing home residents, relatives and nursing home staff take part in the conversations, and to what extent these conversations can be regarded as promoting autonomy, legal rights and individual needs for the residents. We conducted participant observation of seven preparatory conversations, followed by interviews with health care staff (together) and resident and relative (together). In the result section, we present an informative case example of an ACP conversation where common and important characteristics running through our data are present. These are further elaborated under the following headings: Life critical questions, Residents' quiet participation in the conversations, the Dying phase - a clinical issue, Nurses and physicians; different domains and Timing. We find that nursing home staff in our study wants to contribute to open awareness, autonomy and a good death, but there are little reflections about the purpose and content of the conversations, how they should be carried out and when, and what frail nursing home residents are able to understand and express in ACP conversations. PMID:27531449

  16. Agreement between Older Persons and their Surrogate Decision Makers Regarding Participation in Advance Care Planning

    PubMed Central

    Fried, Terri R.; Redding, Colleen A.; Robbins, Mark L.; O'Leary, John R.; Iannone, Lynne

    2014-01-01

    Objectives To examine agreement between older persons and their surrogates regarding participation in advance care planning (ACP). Design Observational cohort study. Setting Community Participants Persons age ≥ 65 and the individual they identified as most likely to make treatment decisions on their behalf. Measurements Older persons were asked about participation in four activities: 1. Completion of living will; 2. Completion of health care proxy; 3. Communication regarding views about life-sustaining treatment; 4. Communication regarding views about quality versus quantity of life. Surrogates were asked whether they believed the older person had completed these activities. Results Of 216 pairs, 81% agreed about whether a living will had been completed [k = .61, 95% confidence interval (CI) .51, .72]. Only 68% of pairs agreed about whether a health care proxy had been completed (k = .39, 95% CI .29, .50), 64% agreed about whether they had communicated regarding life-sustaining treatment (k = .22, 95% CI .09, .35), and 62% agreed about whether they had communicated regarding quality versus quantity of life (k = .23, 95% CI .11, .35). Conclusions While agreement between older persons and their surrogates regarding living will completion was good, agreement about participation in other aspects of ACP was fair to poor. Additional study is necessary to determine who is providing the most accurate report of objective ACP components and whether agreement regarding participation in ACP is associated with greater shared understanding of patients’ preferences. PMID:21649619

  17. Advance Care Planning Among Hematopoietic Cell Transplant Patients and Bereaved Caregivers

    PubMed Central

    Loggers, Elizabeth Trice; Lee, Stephanie; Chilson, Kate; Back, Anthony L.; Block, Susan; Loberiza, Fausto R.

    2014-01-01

    Younger, healthier patients contemplating high-risk (but potentially curative) hematopoietic cell transplants (HCT) may not consider advance care planning (ACP). We investigated the effect of pre-transplant ACP in surviving HCT patients and bereaved caregivers using retrospective, audiotaped telephone surveys. Subjects were identified between 2001–2003 via databases at two high-volume HCT centers. Transcripts were coded by 2 investigators, with differences resolved by consensus. HCT survivors (n=18) were interviewed a median of 13 months after HCT for acute leukemia (7), lymphoma (5), or other (6); 50% had living wills, 72% had a formal proxy. Twelve (67%) had discussed mortality risk pre-HCT with the medical team. Of those, 92% felt their hope and perception of the medical team's truthfulness was increased or unchanged (I/U) by the conversation, while all felt clinician commitment to transplant was I/U. Bereaved caregivers (n=11) were interviewed a median of 10 months post-death (median 31 days post-HCT, range 13–152). Nine (82%) had discussed mortality risk pre-HCT with the medical team; 7 (78%) felt hope was I/U, all felt clinician commitment to transplant and truthfulness was I/U, and most felt ACP reduced burden (67%). ACP discussions with patients and caregivers pre-HCT did not affect hope and supported confidence in medical teams. PMID:25068417

  18. Consensus views on advance care planning for dementia: a Delphi study.

    PubMed

    Sinclair, James B; Oyebode, Jan R; Owens, R Glynn

    2016-03-01

    The uptake of advance care planning (ACP) is particularly low among people with dementia. This may reflect barriers to communication between professionals, patients and families in the face of lack of consensus about the process. This study aimed to methodically investigate consensus views of how ACP should be explained and carried out with people with dementia. A three-round Delphi study explored views of how and when ACP should be addressed, what should be covered, who should be involved and why rates of ACP are low. Seventeen participants took part comprising family members, old age psychiatrists and policy makers. Thirty-two items reached consensus. The panel agreed on 11 different areas for discussion. They concurred that ACP was best addressed after the person has come to terms with the diagnosis when the individual feels ready to do so. There was a consensus view that the process should be couched in terms of 'certain possibilities'. Consensus items emphasised personal choice and autonomy, while also prioritising the need to discuss financial aspects and to include spouses. There was no consensus that professionals should be involved, although the panel viewed them as carrying some responsibility for low uptake. It is suggested that ACP should include general discussion of values as well as coverage of specific points. Professionals need to offer discussion and information on ACP, but also make clear that the patient has the right to choose whether to pursue ACP or not. PMID:25684278

  19. Sweet potato in a vegetarian menu plan for NASA's Advanced Life Support Program.

    PubMed

    Wilson, C D; Pace, R D; Bromfield, E; Jones, G; Lu, J Y

    1998-01-01

    Sweet potato has been selected as one of the crops for NASA's Advanced Life Support Program. Sweet potato primarily provides carbohydrate--an important energy source, beta-carotene, and ascorbic acid to a space diet. This study focuses on menus incorporating two sets of sweet potato recipes developed at Tuskegee University. One set includes recipes for 10 vegetarian products containing fom 6% to 20% sweet potato on a dry weight basis (pancakes, waffles, tortillas, bread, pie, pound cake, pasta, vegetable patties, doughnuts, and pretzels) that have been formulated, subjected to sensory evaluation, and determined to be acceptable. These recipes and the other set of recipes, not tested organoleptically, were substituted in a 10-day vegetarian menu plan developed by the American Institute of Biological Sciences (AIBS) Kennedy Space Center Biomass Processing Technical Panel. At least one recipe containing sweet potato was included in each meal. An analysis of the nutritional quality of this menu compared to the original AIBS menu found improved beta-carotene content (p<0.05). All other nutrients, except vitamin B6, and calories were equal and in some instances greater than those listed for NASA's Controlled Ecological Life Support Systems RDA. These results suggest that sweet potato products can be used successfully in menus developed for space with the added benefit of increased nutrient value and dietary variety. PMID:11876202

  20. Barriers and facilitators for general practitioners to engage in advance care planning: A systematic review

    PubMed Central

    2013-01-01

    Abstract Objective The aim of this systematic review is to identify the perceived factors hindering or facilitating GPs in engaging in advance care planning (ACP) with their patients about care at the end of life. Design Studies from 1990 to 2011 were found in four electronic databases (PubMed, CINAHL, EMBASE, PsycINFO); by contacting first authors of included studies and key experts; and searching through relevant journals and reference lists. Studies were screened, graded for quality, and analysed independently by two authors; those reporting the perception by GPs of barriers and facilitators to engagement in ACP were included. Results Eight qualitative studies and seven cross-sectional studies were included for data extraction. All barriers and facilitators identified were categorized as GP characteristics, perceived patient factors, or health care system characteristics. Stronger evidence was found for the following barriers: lack of skills to deal with patients’ vague requests, difficulties with defining the right moment, the attitude that it is the patient who should initiate ACP, and fear of depriving patients of hope. Stronger evidence was found for the following facilitators: accumulated skills, the ability to foresee health problems in the future, skills to respond to a patient's initiation of ACP, personal convictions about who to involve in ACP, and a longstanding patient–GP relationship and the home setting. Conclusion Initiation of ACP in general practice may be improved by targeting the GPs’ skills, attitudes, and beliefs but changes in health care organization and financing could also contribute. PMID:24299046