SPIRIT: Systematic Planning of Intelligent Reuse of Integrated Clinical Routine Data. A Conceptual Best-practice Framework and Procedure Model.

PubMed

Hackl, W O; Ammenwerth, E

2016-01-01

Secondary use of clinical routine data is receiving an increasing amount of attention in biomedicine and healthcare. However, building and analysing integrated clinical routine data repositories are nontrivial, challenging tasks. As in most evolving fields, recognized standards, well-proven methodological frameworks, or accurately described best-practice approaches for the systematic planning of solutions for secondary use of routine medical record data are missing. We propose a conceptual best-practice framework and procedure model for the systematic planning of intelligent reuse of integrated clinical routine data (SPIRIT). SPIRIT was developed based on a broad literature overview and further refined in two case studies with different kinds of clinical routine data, including process-oriented nursing data from a large hospital group and high-volume multimodal clinical data from a neurologic intensive care unit. SPIRIT aims at tailoring secondary use solutions to specific needs of single departments without losing sight of the institution as a whole. It provides a general conceptual best-practice framework consisting of three parts: First, a secondary use strategy for the whole organization is determined. Second, comprehensive analyses are conducted from two different viewpoints to define the requirements regarding a clinical routine data reuse solution at the system level from the data perspective (BOTTOM UP) and at the strategic level from the future users perspective (TOP DOWN). An obligatory clinical context analysis (IN BETWEEN) facilitates refinement, combination, and integration of the different requirements. The third part of SPIRIT is dedicated to implementation, which comprises design and realization of clinical data integration and management as well as data analysis solutions. The SPIRIT framework is intended to be used to systematically plan the intelligent reuse of clinical routine data for multiple purposes, which often was not intended when the primary clinical documentation systems were implemented. SPIRIT helps to overcome this gap. It can be applied in healthcare institutions of any size or specialization and allows a stepwise setup and evolution of holistic clinical routine data reuse solutions.

Technical Assistance From State Health Departments for Communities Engaged in Policy, Systems, and Environmental Change: The ACHIEVE Program

PubMed Central

Hefelfinger, Jenny; Patty, Alice; Ussery, Ann

2013-01-01

Introduction This study assessed the value of technical assistance provided by state health department expert advisors and by the staff of the National Association of Chronic Disease Directors (NACDD) to community groups that participated in the Action Communities for Health, Innovation, and Environmental Change (ACHIEVE) Program, a CDC-funded health promotion program. Methods We analyzed quantitative and qualitative data reported by community project coordinators to assess the nature and value of technical assistance provided by expert advisors and NACDD staff and the usefulness of ACHIEVE resources in the development and implementation of community action plans. A grounded theory approach was used to analyze and categorize phrases in text data provided by community coordinators. Open coding placed conceptual labels on text phrases. Frequency distributions of the quantitative data are described and discussed. Results The most valuable technical assistance and program support resources were those determined to be in the interpersonal domain (ie, interactions with state expert advisors, NACDD staff, and peer-to-peer support). The most valuable technical assistance events were action institutes, coaches’ meetings, webinars, and technical assistance conference calls. Conclusion This analysis suggests that ACHIEVE communities valued the management and training assistance provided by expert advisors and NACDD staff. State health department expert advisors provided technical guidance and support, including such skills or knowledge-based services as best-practice strategies, review and discussion of community assessment data, sustainability planning, and identification of possible funding opportunities. NACDD staff led development and implementation of technical assistance events. PMID:24157078

Best Practices for Reduction of Uncertainty in CFD Results

NASA Technical Reports Server (NTRS)

Mendenhall, Michael R.; Childs, Robert E.; Morrison, Joseph H.

2003-01-01

This paper describes a proposed best-practices system that will present expert knowledge in the use of CFD. The best-practices system will include specific guidelines to assist the user in problem definition, input preparation, grid generation, code selection, parameter specification, and results interpretation. The goal of the system is to assist all CFD users in obtaining high quality CFD solutions with reduced uncertainty and at lower cost for a wide range of flow problems. The best-practices system will be implemented as a software product which includes an expert system made up of knowledge databases of expert information with specific guidelines for individual codes and algorithms. The process of acquiring expert knowledge is discussed, and help from the CFD community is solicited. Benefits and challenges associated with this project are examined.

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

Price, L.K.; Phylipsen, G.J.M.; Worrell, E.

Iron and steel production consumes enormous quantities of energy, especially in developing countries where outdated, inefficient technologies are still used to produce iron and steel. Carbon dioxide emissions from steel production, which range between 5 and 15% of total country emissions in key developing countries (Brazil, China, India, Mexico, and South Africa), will continue to grow as these countries develop and as demand for steel products such as materials, automobiles, and appliances increases. In this report, we describe the key steel processes, discuss typical energy-intensity values for these processes, review historical trends in iron and steel production by process inmore » five key developing countries, describe the steel industry in each of the five key developing countries, present international comparisons of energy use and carbon dioxide emissions among these countries, and provide our assessment of the technical potential to reduce these emissions based on best-practice benchmarking. Using a best practice benchmark, we find that significant savings, in the range of 33% to 49% of total primary energy used to produce steel, are technically possible in these countries. Similarly, we find that the technical potential for reducing intensities of carbon dioxide emissions ranges between 26% and 49% of total carbon dioxide emissions from steel production in these countries.« less

How Well Does LCA Model Land Use Impacts on Biodiversity?--A Comparison with Approaches from Ecology and Conservation.

PubMed

Curran, Michael; de Souza, Danielle Maia; Antón, Assumpció; Teixeira, Ricardo F M; Michelsen, Ottar; Vidal-Legaz, Beatriz; Sala, Serenella; Milà i Canals, Llorenç

2016-03-15

The modeling of land use impacts on biodiversity is considered a priority in life cycle assessment (LCA). Many diverging approaches have been proposed in an expanding literature on the topic. The UNEP/SETAC Life Cycle Initiative is engaged in building consensus on a shared modeling framework to highlight best-practice and guide model application by practitioners. In this paper, we evaluated the performance of 31 models from both the LCA and the ecology/conservation literature (20 from LCA, 11 from non-LCA fields) according to a set of criteria reflecting (i) model completeness, (ii) biodiversity representation, (iii) impact pathway coverage, (iv) scientific quality, and (v) stakeholder acceptance. We show that LCA models tend to perform worse than those from ecology and conservation (although not significantly), implying room for improvement. We identify seven best-practice recommendations that can be implemented immediately to improve LCA models based on existing approaches in the literature. We further propose building a "consensus model" through weighted averaging of existing information, to complement future development. While our research focuses on conceptual model design, further quantitative comparison of promising models in shared case studies is an essential prerequisite for future informed model choice.

Creating a Culture of Safety Around Bar-Code Medication Administration: An Evidence-Based Evaluation Framework.

PubMed

Kelly, Kandace; Harrington, Linda; Matos, Pat; Turner, Barbara; Johnson, Constance

2016-01-01

Bar-code medication administration (BCMA) effectiveness is contingent upon compliance with best-practice protocols. We developed a 4-phased BCMA evaluation program to evaluate the degree of integration of current evidence into BCMA policies, procedures, and practices; identify barriers to best-practice BCMA use; and modify BCMA practice in concert with changes to the practice environment. This program provides an infrastructure for frontline nurses to partner with hospital leaders to continually evaluate and improve BCMA using a systematic process.

Partnerships for community mental health in the Asia-Pacific: principles and best-practice models across different sectors.

PubMed

Ng, Chee; Fraser, Julia; Goding, Margaret; Paroissien, David; Ryan, Brigid

2013-02-01

Stage Two of the Asia-Pacific Community Mental Health Development Project was established to document successful partnership models in community mental health care in the region. This paper summarizes the best-practice examples and principles of partnerships in community mental health across 17 Asia-Pacific countries. A series of consensus workshops between countries identified best-practice exemplars that promote or advance community mental health care in collaboration with a range of community stakeholders. These prototypes highlighted a broad range of partnerships across government, non-government and community agencies, as well as service users and family carers. From practice-based evidence, a set of 10 key principles was developed that can be applied in building partnerships for community mental health care consistent with the local cultures, communities and systems in the region. Such practical guidance can be useful to minimize fragmentation of community resources and promote effective partnerships to extend community mental health services in the region.

Best-Practice Physical Activity Programs for Older Adults: Findings From the National Impact Study

PubMed Central

Seymour, Rachel B.; Campbell, Richard T.; Whitelaw, Nancy; Bazzarre, Terry

2009-01-01

Objectives. We assessed the impact of existing best-practice physical activity programs for older adults on physical activity participation and health-related outcomes. Methods. We used a multisite, randomized trial with 544 older adults (mean age 66 years) and measures at baseline, 5, and 10 months to test the impact of a multiple-component physical activity program compared with results for a control group that did not participate in such a program. Results. For adults who participated in a multiple-component physical activity program, we found statistically significant benefits at 5 and 10 months with regard to self-efficacy for exercise adherence over time (P < .001), adherence in the face of barriers (P = .01), increased upper- and lower-body strength (P = .02, P = .01), and exercise participation (P = .01). Conclusions. Best-practice community-based physical activity programs can measurably improve aspects of functioning that are risk factors for disability among older adults. US public policy should encourage these inexpensive health promotion programs. PMID:19059858

Alcoa: Plant-Wide Energy Assessment Finds Potential Savings at Aluminum Extrusion Facility. Industrial Technologies Program, Aluminum BestPractices Plant-Wide Assessment Case Study.

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

Not Available

2003-09-01

Alcoa completed an energy assessment of its Engineered Products aluminum extrusion facility in Plant City, Florida, in 2001. The company identified energy conservation opportunities throughout the plant and prepared a report as an example for performing energy assessments at similar Alcoa facilities. If implemented, the cost of energy for the plant would be reduced by more than$800,000 per year by conserving 3 million kWh of electricity and 150,000 MMBtu of natural gas.

Aboriginal community controlled health services: leading the way in primary care.

PubMed

Panaretto, Kathryn S; Wenitong, Mark; Button, Selwyn; Ring, Ian T

2014-06-16

The national Closing the Gap framework commits to reducing persisting disadvantage in the health of Aboriginal and Torres Strait Islander people in Australia, with cross-government-sector initiatives and investment. Central to efforts to build healthier communities is the Aboriginal community controlled health service (ACCHS) sector; its focus on prevention, early intervention and comprehensive care has reduced barriers to access and unintentional racism, progressively improving individual health outcomes for Aboriginal people. There is now a broad range of primary health care data that provides a sound evidence base for comparing the health outcomes for Indigenous people in ACCHSs with the outcomes achieved through mainstream services, and these data show: models of comprehensive primary health care consistent with the patient-centred medical home model; coverage of the Aboriginal population higher than 60% outside major metropolitan centres; consistently improving performance in key performance on best-practice care indicators; and superior performance to mainstream general practice. ACCHSs play a significant role in training the medical workforce and employing Aboriginal people. ACCHSs have risen to the challenge of delivering best-practice care and there is a case for expanding ACCHSs into new areas. To achieve the best returns, the current mainstream Closing the Gap investment should be shifted to the community controlled health sector.

Eliminating Health Care Disparities With Mandatory Clinical Decision Support: The Venous Thromboembolism (VTE) Example.

PubMed

Lau, Brandyn D; Haider, Adil H; Streiff, Michael B; Lehmann, Christoph U; Kraus, Peggy S; Hobson, Deborah B; Kraenzlin, Franca S; Zeidan, Amer M; Pronovost, Peter J; Haut, Elliott R

2015-01-01

All hospitalized patients should be assessed for venous thromboembolism (VTE) risk factors and prescribed appropriate prophylaxis. To improve best-practice VTE prophylaxis prescription for all hospitalized patients, we implemented a mandatory computerized clinical decision support (CCDS) tool. The tool requires completion of checklists to evaluate VTE risk factors and contraindications to pharmacological prophylaxis, and then recommends the risk-appropriate VTE prophylaxis regimen. The objective of the study was to examine the effect of a quality improvement intervention on race-based and sex-based health care disparities across 2 distinct clinical services. This was a retrospective cohort study of a quality improvement intervention. The study included 1942 hospitalized medical patients and 1599 hospitalized adult trauma patients. In this study, the proportion of patients prescribed risk-appropriate, best-practice VTE prophylaxis was evaluated. Racial disparities existed in prescription of best-practice VTE prophylaxis in the preimplementation period between black and white patients on both the trauma (70.1% vs. 56.6%, P=0.025) and medicine (69.5% vs. 61.7%, P=0.015) services. After implementation of the CCDS tool, compliance improved for all patients, and disparities in best-practice prophylaxis prescription between black and white patients were eliminated on both services: trauma (84.5% vs. 85.5%, P=0.99) and medicine (91.8% vs. 88.0%, P=0.082). Similar findings were noted for sex disparities in the trauma cohort. Despite the fact that risk-appropriate prophylaxis should be prescribed equally to all hospitalized patients regardless of race and sex, practice varied widely before our quality improvement intervention. Our CCDS tool eliminated racial disparities in VTE prophylaxis prescription across 2 distinct clinical services. Health information technology approaches to care standardization are effective to eliminate health care disparities.

Factors influencing performance of health workers in the management of seriously sick children at a Kenyan tertiary hospital--participatory action research.

PubMed

Irimu, Grace W; Greene, Alexandra; Gathara, David; Kihara, Harrison; Maina, Christopher; Mbori-Ngacha, Dorothy; Zurovac, Dejan; Migiro, Santau; English, Mike

2014-02-07

Implementation of World Health Organization case management guidelines for serious childhood illnesses remains a challenge in hospitals in low-income countries. Facilitators of and barriers to implementation of locally adapted clinical practice guidelines (CPGs) have not been explored. This ethnographic study based on the theory of participatory action research (PAR) was conducted in Kenyatta National Hospital, Kenya's largest teaching hospital. The primary intervention consisted of dissemination of locally adapted CPGs. The PRECEDE-PROCEED health education model was used as the conceptual framework to guide and examine further reinforcement activities to improve the uptake of the CPGs. Activities focussed on introduction of routine clinical audits and tailored educational sessions. Data were collected by a participant observer who also facilitated the PAR over an eighteen-month period. Naturalistic inquiry was utilized to obtain information from all hospital staff encountered while theoretical sampling allowed in-depth exploration of emerging issues. Data were analysed using interpretive description. Relevance of the CPGs to routine work and emergence of a champion of change facilitated uptake of best-practices. Mobilization of basic resources was relatively easily undertaken while activities that required real intellectual and professional engagement of the senior staff were a challenge. Accomplishments of the PAR were largely with the passive rather than active involvement of the hospital management. Barriers to implementation of best-practices included i) mismatch between the hospital's vision and reality, ii) poor communication, iii) lack of objective mechanisms for monitoring and evaluating quality of clinical care, iv) limited capacity for planning strategic change, v) limited management skills to introduce and manage change, vi) hierarchical relationships, and vii) inadequate adaptation of the interventions to the local context. Educational interventions, often regarded as 'quick-fixes' to improve care in low-income countries, may be necessary but are unlikely to be sufficient to deliver improved services. We propose that an understanding of organizational issues that influence the behaviour of individual health professionals should guide and inform the implementation of best-practices.

Periscope: Looking into Learning in Best-Practices Physics Classrooms

NASA Astrophysics Data System (ADS)

Scherr, Rachel E.; Goertzen, Renee Michelle

2018-02-01

Periscope is a set of lessons to support learning assistants, teaching assistants, and faculty in learning to notice and interpret classroom events the way an accomplished teacher does. Periscope lessons are centered on video episodes from a variety of best-practices university physics classrooms. By observing, discussing, and reflecting on teaching situations similar to their own, instructors practice applying lessons learned about teaching to actual teaching situations and develop their pedagogical content knowledge. Instructors also get a view of other institutions' transformed courses, which can support and expand the vision of their own instructional improvement and support the transfer of course developments among faculty. Periscope is available for free to educators at http://physport.org/periscope.

Towards a Formal Basis for Modular Safety Cases

NASA Technical Reports Server (NTRS)

Denney, Ewen; Pai, Ganesh

2015-01-01

Safety assurance using argument-based safety cases is an accepted best-practice in many safety-critical sectors. Goal Structuring Notation (GSN), which is widely used for presenting safety arguments graphically, provides a notion of modular arguments to support the goal of incremental certification. Despite the efforts at standardization, GSN remains an informal notation whereas the GSN standard contains appreciable ambiguity especially concerning modular extensions. This, in turn, presents challenges when developing tools and methods to intelligently manipulate modular GSN arguments. This paper develops the elements of a theory of modular safety cases, leveraging our previous work on formalizing GSN arguments. Using example argument structures we highlight some ambiguities arising through the existing guidance, present the intuition underlying the theory, clarify syntax, and address modular arguments, contracts, well-formedness and well-scopedness of modules. Based on this theory, we have a preliminary implementation of modular arguments in our toolset, AdvoCATE.

An Evaluation of the Decision-Making Capacity Assessment Model.

PubMed

Brémault-Phillips, Suzette C; Parmar, Jasneet; Friesen, Steven; Rogers, Laura G; Pike, Ashley; Sluggett, Bryan

2016-09-01

The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. A mixed methods approach was used. Survey ( N = 126) and focus group ( N = 49) data were collected from practitioners utilizing the Model. Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes. Post-training, participants agreed that they followed the Model's guiding principles (90%), used problem-solving (92%), understood discipline-specific roles (87%), were confident in their knowledge of DMCAs (75%) and pertinent legislation (72%), accessed consultative services (88%), and received management support (64%). Model implementation is impeded when role clarity, physician engagement, inter-professional buy-in, accountability, dedicated resources, information sharing systems, and remuneration are lacking. Dedicated resources, job descriptions inclusive of DMCAs, ongoing education/mentoring supports, access to consultative services, and appropriate remuneration would support implementation. The DMCA Model offers practitioners, inter-professional teams, and organizations a best-practice and implementation approach to DMCAs. Addressing barriers and further contextualizing the Model would be warranted.

An Evaluation of the Decision-Making Capacity Assessment Model

PubMed Central

Brémault-Phillips, Suzette C.; Parmar, Jasneet; Friesen, Steven; Rogers, Laura G.; Pike, Ashley; Sluggett, Bryan

2016-01-01

Background The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. Methods A mixed methods approach was used. Survey (N = 126) and focus group (N = 49) data were collected from practitioners utilizing the Model. Results Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes. Post-training, participants agreed that they followed the Model’s guiding principles (90%), used problem-solving (92%), understood discipline-specific roles (87%), were confident in their knowledge of DMCAs (75%) and pertinent legislation (72%), accessed consultative services (88%), and received management support (64%). Model implementation is impeded when role clarity, physician engagement, inter-professional buy-in, accountability, dedicated resources, information sharing systems, and remuneration are lacking. Dedicated resources, job descriptions inclusive of DMCAs, ongoing education/mentoring supports, access to consultative services, and appropriate remuneration would support implementation. Conclusions The DMCA Model offers practitioners, inter-professional teams, and organizations a best-practice and implementation approach to DMCAs. Addressing barriers and further contextualizing the Model would be warranted. PMID:27729947

MIRD Pamphlet No. 23: Quantitative SPECT for Patient-Specific 3-Dimensional Dosimetry in Internal Radionuclide Therapy

PubMed Central

Dewaraja, Yuni K.; Frey, Eric C.; Sgouros, George; Brill, A. Bertrand; Roberson, Peter; Zanzonico, Pat B.; Ljungberg, Michael

2012-01-01

In internal radionuclide therapy, a growing interest in voxel-level estimates of tissue-absorbed dose has been driven by the desire to report radiobiologic quantities that account for the biologic consequences of both spatial and temporal nonuniformities in these dose estimates. This report presents an overview of 3-dimensional SPECT methods and requirements for internal dosimetry at both regional and voxel levels. Combined SPECT/CT image-based methods are emphasized, because the CT-derived anatomic information allows one to address multiple technical factors that affect SPECT quantification while facilitating the patient-specific voxel-level dosimetry calculation itself. SPECT imaging and reconstruction techniques for quantification in radionuclide therapy are not necessarily the same as those designed to optimize diagnostic imaging quality. The current overview is intended as an introduction to an upcoming series of MIRD pamphlets with detailed radionuclide-specific recommendations intended to provide best-practice SPECT quantification–based guidance for radionuclide dosimetry. PMID:22743252

Technical efficiency of women's health prevention programs in Bucaramanga, Colombia: a four-stage analysis.

PubMed

Ruiz-Rodriguez, Myriam; Rodriguez-Villamizar, Laura A; Heredia-Pi, Ileana

2016-10-13

Primary Health Care (PHC) is an efficient strategy to improve health outcomes in populations. Nevertheless, studies of technical efficiency in health care have focused on hospitals, with very little on primary health care centers. The objective of the present study was to use the Data Envelopment Analysis to estimate the technical efficiency of three women's health promotion and disease prevention programs offered by primary care centers in Bucaramanga, Colombia. Efficiency was measured using a four-stage data envelopment analysis with a series of Tobit regressions to account for the effect of quality outcomes and context variables. Input/output information was collected from the institutions' records, chart reviews and personal interviews. Information about contextual variables was obtained from databases from the primary health program in the municipality. A jackknife analysis was used to assess the robustness of the results. The analysis was based on data from 21 public primary health care centers. The average efficiency scores, after adjusting for quality and context, were 92.4 %, 97.5 % and 86.2 % for the antenatal care (ANC), early detection of cervical cancer (EDCC) and family planning (FP) programs, respectively. On each program, 12 of the 21 (57.1 %) health centers were found to be technically efficient; having had the best-practice frontiers. Adjusting for context variables changed the scores and reference rankings of the three programs offered by the health centers. The performance of the women's health prevention programs offered by the centers was found to be heterogeneous. Adjusting for context and health care quality variables had a significant effect on the technical efficiency scores and ranking. The results can serve as a guide to strengthen management and organizational and planning processes related to local primary care services operating within a market-based model such as the one in Colombia.

Interactions between pre-processing and classification methods for event-related-potential classification: best-practice guidelines for brain-computer interfacing.

PubMed

Farquhar, J; Hill, N J

2013-04-01

Detecting event related potentials (ERPs) from single trials is critical to the operation of many stimulus-driven brain computer interface (BCI) systems. The low strength of the ERP signal compared to the noise (due to artifacts and BCI irrelevant brain processes) makes this a challenging signal detection problem. Previous work has tended to focus on how best to detect a single ERP type (such as the visual oddball response). However, the underlying ERP detection problem is essentially the same regardless of stimulus modality (e.g., visual or tactile), ERP component (e.g., P300 oddball response, or the error-potential), measurement system or electrode layout. To investigate whether a single ERP detection method might work for a wider range of ERP BCIs we compare detection performance over a large corpus of more than 50 ERP BCI datasets whilst systematically varying the electrode montage, spectral filter, spatial filter and classifier training methods. We identify an interesting interaction between spatial whitening and regularised classification which made detection performance independent of the choice of spectral filter low-pass frequency. Our results show that pipeline consisting of spectral filtering, spatial whitening, and regularised classification gives near maximal performance in all cases. Importantly, this pipeline is simple to implement and completely automatic with no expert feature selection or parameter tuning required. Thus, we recommend this combination as a "best-practice" method for ERP detection problems.

ACR white paper on teleradiology practice: a report from the Task Force on Teleradiology Practice.

PubMed

Silva, Ezequiel; Breslau, Jonathan; Barr, Robert M; Liebscher, Lawrence A; Bohl, Michael; Hoffman, Thomas; Boland, Giles W L; Sherry, Cynthia; Kim, Woojin; Shah, Samir S; Tilkin, Mike

2013-08-01

Teleradiology services are now embedded into the workflow of many radiology practices in the United States, driven largely by an expanding corporate model of services. This has brought opportunities and challenges to both providers and recipients of teleradiology services and has heightened the need to create best-practice guidelines for teleradiology to ensure patient primacy. To this end, the ACR Task Force on Teleradiology Practice has created this white paper to update the prior ACR communication on teleradiology and discuss the current and possible future state of teleradiology in the United States. This white paper proposes comprehensive best-practice guidelines for the practice of teleradiology, with recommendations offered regarding future actions. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Best-Practice Criteria for Practical Security of Self-Differencing Avalanche Photodiode Detectors in Quantum Key Distribution

NASA Astrophysics Data System (ADS)

Koehler-Sidki, A.; Dynes, J. F.; Lucamarini, M.; Roberts, G. L.; Sharpe, A. W.; Yuan, Z. L.; Shields, A. J.

2018-04-01

Fast-gated avalanche photodiodes (APDs) are the most commonly used single photon detectors for high-bit-rate quantum key distribution (QKD). Their robustness against external attacks is crucial to the overall security of a QKD system, or even an entire QKD network. We investigate the behavior of a gigahertz-gated, self-differencing (In,Ga)As APD under strong illumination, a tactic Eve often uses to bring detectors under her control. Our experiment and modeling reveal that the negative feedback by the photocurrent safeguards the detector from being blinded through reducing its avalanche probability and/or strengthening the capacitive response. Based on this finding, we propose a set of best-practice criteria for designing and operating fast-gated APD detectors to ensure their practical security in QKD.

Student-selected component in the medical curriculum: investigations and psychiatric referral for paracetamol overdose in an accident and emergency department

PubMed Central

Cowman, James G; Bakheet, Manuel

2017-01-01

Background A student-selected component (SSC) of the medical curriculum requires the student to be self-directed in locating and undertaking a placement in a clinical specialty of their choosing and completing a project. The clinical area for experience was an accident and emergency department, and our topic was a focused audit on the investigations and referral for paracetamol overdose. The purpose of this paper is twofold: to reflect on the education value to medical students of an SSC in a medical curriculum, and to highlight learning and understanding through completion of an audit. Materials and methods An audit approach was applied. The aim of the project study was to investigate the level of compliance with best-practice guidelines for investigations and psychiatric referral in paracetamol overdose. Results A total of 40 cases meeting the inclusion criteria were randomly selected. The sample had a mean age of 27 years, of whom 70.5% were female, and the ingested dose of paracetamol ranged from 0.864 to 80 g. Paracetamol abuse may present as intentional and unintentional overdose. In our study, 85% of cases were identified as intentional overdose and 76% had a history of psychiatric illness. Generally, medical management was compliant with guidelines, with some minor irregularities. The international normalized ratio was the most underperformed test. Conclusion Our choice of topic, paracetamol overdose, contributed to our understanding of the breadth of factors to be considered in the emergency medical management of a patient. In this regard, we had the benefit of understanding how the diagnostic and therapeutic factors, when applied in accordance with best-practice guidelines, work very effectively. The SSC impacted positively on our cognitive, personal, and professional development. In facilitating the student with choice, the SSC encouraged self-direction and proactivity. We gained experience in the discipline of research and acquired some skills in independent thinking and analysis. PMID:28883749

Developing More Adaptive, Innovative, and Interactive Organizations.

ERIC Educational Resources Information Center

Doerfel, Marya L.; Ruben, Brent D.

2002-01-01

Presents a comprehensive view of benchmarking, including best-practice approaches to organizational assessment and improvement in higher education (the Malcolm Baldrige and "balanced scorecard" frameworks) and lessons that can be gleaned from the benchmarking process. (EV)

Supporting child witnesses during identification lineups: Exploring the effectiveness of registered intermediaries.

PubMed

Wilcock, Rachel; Crane, Laura; Hobson, Zoe; Nash, Gilly; Kirke-Smith, Mimi; Henry, Lucy A

2018-01-01

Performance at identification lineup was assessed in eighty-five 6- to 11-year-old typically developing children. Children viewed a live staged event involving 2 male actors, and were asked to identify the perpetrators from 2 separate lineups (one perpetrator-present lineup and one perpetrator-absent lineup). Half the children took part in lineups adapted by a registered intermediary (an impartial, trained professional who facilitates understanding and communication between vulnerable witnesses and members of the justice system), and half took part in "best-practice" lineups, according to the current guidance for eyewitness identification in England and Wales. Children receiving assistance from a registered intermediary (relative to children who received best-practice lineups) were more accurate in their identifications for perpetrator-present lineups, and there was some evidence that they were also more accurate for perpetrator-absent lineups. This provides the first empirical evidence for the effectiveness of registered intermediary support during identification lineups.

Improving low-wage, midsized employers' health promotion practices: a randomized controlled trial.

PubMed

Hannon, Peggy A; Harris, Jeffrey R; Sopher, Carrie J; Kuniyuki, Alan; Ghosh, Donetta L; Henderson, Shelly; Martin, Diane P; Weaver, Marcia R; Williams, Barbara; Albano, Denise L; Meischke, Hendrika; Diehr, Paula; Lichiello, Patricia; Hammerback, Kristen E; Parks, Malcolm R; Forehand, Mark

2012-08-01

The Guide to Community Preventive Services (Community Guide) offers evidence-based intervention strategies to prevent chronic disease. The American Cancer Society (ACS) and the University of Washington Health Promotion Research Center co-developed ACS Workplace Solutions (WPS) to improve workplaces' implementation of Community Guide strategies. To test the effectiveness of WPS for midsized employers in low-wage industries. Two-arm RCT; workplaces were randomized to receive WPS during the study (intervention group) or at the end of the study (delayed control group). Forty-eight midsized employers (100-999 workers) in King County WA. WPS provides employers one-on-one consulting with an ACS interventionist via three meetings at the workplace. The interventionist recommends best practices to adopt based on the workplace's current practices, provides implementation toolkits for the best practices the employer chooses to adopt, conducts a follow-up visit at 6 months, and provides technical assistance. Employers' implementation of 16 best practices (in the categories of insurance benefits, health-related policies, programs, tracking, and health communications) at baseline (June 2007-June 2008) and 15-month follow-up (October 2008-December 2009). Data were analyzed in 2010-2011. Intervention employers demonstrated greater improvement from baseline than control employers in two of the five best-practice categories; implementing policies (baseline scores: 39% program, 43% control; follow-up scores: 49% program, 45% control; p=0.013) and communications (baseline scores: 42% program, 44% control; follow-up scores: 76% program, 55% control; p=0.007). Total best-practice implementation improvement did not differ between study groups (baseline scores: 32% intervention, 37% control; follow-up scores: 39% intervention, 42% control; p=0.328). WPS improved employers' health-related policies and communications but did not improve insurance benefits design, programs, or tracking. Many employers were unable to modify insurance benefits and reported that the time and costs of implementing best practices were major barriers. This study is registered at clinicaltrials.gov NCT00452816. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Breast reconstruction with tissue expanders: implementation of a standardized best-practices protocol to reduce infection rates.

PubMed

Khansa, Ibrahim; Hendrick, Russell G; Shore, Alison; Meyerson, Joseph; Yang, Maelee; Boehmler, James H

2014-07-01

Periprosthetic infection remains a frustrating and costly complication of breast reconstruction with tissue expanders. Although some specific steps have been previously shown to reduce periprosthetic infections, no comprehensive protocol addressing all aspects of preoperative, intraoperative, and postoperative patient management has been evaluated in the literature. The authors' goal was to evaluate the effectiveness of their protocol at reducing periprosthetic infections. A comprehensive, best-practices protocol was introduced and implemented in November of 2010. All patients undergoing breast reconstruction using tissue expanders at the authors' institution in the 5 years before the protocol, and in the 2 years after, were analyzed. Three hundred five patients underwent 456 tissue expander reconstructions in the 5 years before the protocol, and 198 patients underwent 313 reconstructions in the 2 years after. Significantly fewer patients developed periprosthetic infection after protocol (11.6 percent versus 18.4 percent; p=0.042), and the number of infected tissue expanders trended toward a decrease (9.3 percent versus 13.2 percent; p=0.097). On multivariate analysis, the protocol significantly reduced the odds of periprosthetic infection (OR, 0.45; p=0.022). Predictors of infection included obesity (OR, 2.01; p=0.045) and preoperative breast size larger than C cup (OR, 2.83; p=0.006). The authors' comprehensive, best-practices protocol allowed them to reduce the odds of tissue expander infections by 55 percent (OR, 0.45; p=0.022). The authors were able to identify several potential areas of improvement that may help them lower the rate of infection further in the future. Therapeutic, III.

Implementation of a central line maintenance care bundle in hospitalized pediatric oncology patients.

PubMed

Rinke, Michael L; Chen, Allen R; Bundy, David G; Colantuoni, Elizabeth; Fratino, Lisa; Drucis, Kim M; Panton, Stephanie Y; Kokoszka, Michelle; Budd, Alicia P; Milstone, Aaron M; Miller, Marlene R

2012-10-01

To investigate whether a multidisciplinary, best-practice central line maintenance care bundle reduces central line-associated blood stream infection (CLABSI) rates in hospitalized pediatric oncology patients and to further delineate the epidemiology of CLABSIs in this population. We performed a prospective, interrupted time series study of a best-practice bundle addressing all areas of central line care: reduction of entries, aseptic entries, and aseptic procedures when changing components. Based on a continuous quality improvement model, targeted interventions were instituted to improve compliance with each of the bundle elements. CLABSI rates and epidemiological data were collected for 10 months before and 24 months after implementation of the bundle and compared in a Poisson regression model. CLABSI rates decreased from 2.25 CLABSIs per 1000 central line days at baseline to 1.79 CLABSIs per 1000 central line days during the intervention period (incidence rate ratio [IRR]: 0.80, P = .58). Secondary analyses indicated CLABSI rates were reduced to 0.81 CLABSIs per 1000 central line days in the second 12 months of the intervention (IRR: 0.36, P = .091). Fifty-nine percent of infections resulted from Gram-positive pathogens, 37% of patients with a CLABSI required central line removal, and patients with Hickman catheters were more likely to have a CLABSI than patients with Infusaports (IRR: 4.62, P = .02). A best-practice central line maintenance care bundle can be implemented in hospitalized pediatric oncology patients, although long ramp-up times may be necessary to reap maximal benefits. Further research is needed to determine if this CLABSI rate reduction can be sustained and spread.

The Effect of Monitoring: How Data Collection Type and Frequency Boosts Participation and the Adoption of Best Practices in a Coffee Agronomy Training Program in Rwanda.

PubMed

Gathani, Sachin; Gomez, Maria Paula; Sabates, Ricardo; Stoelinga, Dimitri

2015-12-01

The impact of surveying on individuals' behavior and decision making has been widely studied in academic literature on market research but not so much the impact of monitoring on economic development interventions. To estimate whether different monitoring strategies lead to improvement in participation levels and adoption of best practices for coffee production for farmer who participated in TechnoServe Agronomy Training Program in Rwanda. Farmers were identified randomly for monitoring purposes to belong to two different groups and then selected depending on the additional criterion of having productive coffee trees. We estimate treatment-on-the-treated and intention-to-treat effects on training attendance rates and farmers best-practice adoptions using difference-in-differences estimation techniques. Farmers were randomly identified to a high or low monitoring with different type and frequency of data collection and selected if they had productive coffee trees as part of the monitoring strategy. Attendance to training sessions by all farmers in the program and best-practice adoption data for improving coffee yield. We find that monitoring led to surprisingly large increases in farmer participation levels in the project and also improved best-practice adoption rates. We also find that higher frequency of data collection has long-lasting effects and are more pronounced for low-attendance farmers. Monitoring not only provides more data and a better understanding of project dynamics, which in turn can help improve design, but can also improve processes and outcomes, in particular for the least engaged. © The Author(s) 2016.

Best practices for world-class call centers.

PubMed

1998-11-01

Quality, not quantity, counts more in performance measures for best-practice call centers. Spend money on effective upfront training to save later through increased employee and customer loyalty. Give structured feedback and strong internal support to call-center representatives.

VOLTTRON™: Tech-to-Market Best-Practices Guide for Small- and Medium-Sized Commercial Buildings

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

Cort, Katherine A.; Haack, Jereme N.; Katipamula, Srinivas

VOLTTRON™ is an open-source distributed control and sensing platform developed by Pacific Northwest National Laboratory for the U.S. Department of Energy. It was developed to be used by the Office of Energy Efficiency and Renewable Energy to support transactive controls research and deployment activities. VOLTTRON is designed to be an overarching integration platform that could be used to bring together vendors, users, and developers and enable rapid application development and testing. The platform is designed to support modern control strategies, including the use of agent- and transaction-based controls. It also is designed to support the management of a wide rangemore » of applications, including heating, ventilation, and air-conditioning systems; electric vehicles; and distributed-energy and whole-building loads. This report was completed as part of the Building Technologies Office’s Technology-to-Market Initiative for VOLTTRON’s Market Validation and Business Case Development efforts. The report provides technology-to-market guidance and best practices related to VOLTTRON platform deployments and commercialization activities for use by entities serving small- and medium-sized commercial buildings. The report characterizes the platform ecosystem within the small- and medium-sized commercial building market and articulates the value proposition of VOLTTRON for three core participants in this ecosystem: 1) platform owners/adopters, 2) app developers, and 3) end-users. The report also identifies key market drivers and opportunities for open platform deployments in the small- and medium-sized commercial building market. Possible pathways to the market are described—laboratory testing to market adoption to commercialization. We also identify and address various technical and market barriers that could hinder deployment of VOLTTRON. Finally, we provide “best practice” tech-to-market guidance for building energy-related deployment efforts serving small- and medium-sized commercial buildings.« less

More than Just a Game? Combat-Themed Gaming Among Recent Veterans with Posttraumatic Stress Disorder.

PubMed

Elliott, Luther; Golub, Andrew; Price, Matthew; Bennett, Alexander

2015-08-01

This article examines recent combat veterans' experiences of "first-person shooter" (FPS) gaming and its relationship to posttraumatic stress disorder (PTSD). Current PTSD treatment approaches increasingly use virtual reality (VR) technologies, which have many similarities with FPS games. To explore these similarities, this article presents six case studies from recently separated veterans in New York City who reported both current PTSD symptoms and regular use of combat-themed FPS games. In open-ended interviews, participants discussed a range of benefits as well as the importance of regulating use and avoiding particular contextual dimensions of gaming to maintain healthy gaming habits. Findings demonstrate the need for more comprehensive study and dissemination of best-practices information about FPS gaming in the context of combat-related PTSD symptomatology.

Ceph-based storage services for Run2 and beyond

NASA Astrophysics Data System (ADS)

van der Ster, Daniel C.; Lamanna, Massimo; Mascetti, Luca; Peters, Andreas J.; Rousseau, Hervé

2015-12-01

In 2013, CERN IT evaluated then deployed a petabyte-scale Ceph cluster to support OpenStack use-cases in production. With now more than a year of smooth operations, we will present our experience and tuning best-practices. Beyond the cloud storage use-cases, we have been exploring Ceph-based services to satisfy the growing storage requirements during and after Run2. First, we have developed a Ceph back-end for CASTOR, allowing this service to deploy thin disk server nodes which act as gateways to Ceph; this feature marries the strong data archival and cataloging features of CASTOR with the resilient and high performance Ceph subsystem for disk. Second, we have developed RADOSFS, a lightweight storage API which builds a POSIX-like filesystem on top of the Ceph object layer. When combined with Xrootd, RADOSFS can offer a scalable object interface compatible with our HEP data processing applications. Lastly the same object layer is being used to build a scalable and inexpensive NFS service for several user communities.

A decade of adult intensive care unit design: a study of the physical design features of the best-practice examples.

PubMed

Rashid, Mahbub

2006-01-01

This article reports a study of the physical design characteristics of a set of adult intensive care units (ICUs), built between 1993 and 2003. These ICUs were recognized as the best-practice examples by the Society of Critical Care Medicine, the American Association of Critical Care Nurses, and the American Institute of Architects. This study is based on a systematic analysis of the materials found on these ICUs in the booklet and videos jointly published by the above organizations in 2005. The study finds that most of these examples of best-practice adult ICUs have the following negative characteristics: (1) they are built as renovation projects with more health and safety hazards during construction; (2) most of them are mixed-service units with more safety and staffing problems; (3) the overall layout and the layout of staff work areas in these ICUs do not have any common design solutions for improved patient and staff outcomes; and (4) in these ICUs, family space is often located outside the unit, and family access to the patient room is restricted, even though family presence at the bedside may be important for improved patient outcomes. Some of these negative characteristics are offset by the following positive characteristics in most ICUs: (1) they have only private patient rooms for improved patient care, safety, privacy, and comfort; (2) most patient beds are freestanding for easy access to patients from all sides; (3) they have handwashing sinks and waste disposal facilities in the patient room for improved safety; and (4) most patient rooms have natural light to help patients with circadian rhythms. The article discusses, in detail, the implications of its findings, and the role of the ICU design community in a very complicated design context.

Adherence to best practice consensus guidelines for implant-based breast reconstruction: Results from the iBRA national practice questionnaire survey.

PubMed

Mylvaganam, Senthurun; Conroy, Elizabeth J; Williamson, Paula R; Barnes, Nicola L P; Cutress, Ramsey I; Gardiner, Matthew D; Jain, Abhilash; Skillman, Joanna M; Thrush, Steven; Whisker, Lisa J; Blazeby, Jane M; Potter, Shelley; Holcombe, Christopher

2018-05-01

The 2008 National Mastectomy and Breast Reconstruction Audit demonstrated marked variation in the practice and outcomes of breast reconstruction in the UK. To standardise practice and improve outcomes for patients, the British professional associations developed best-practice guidelines with specific guidance for newer mesh-assisted implant-based techniques. We explored the degree of uptake of best-practice guidelines within units performing implant-based reconstruction (IBBR) as the first phase of the implant Breast Reconstruction Evaluation (iBRA) study. A questionnaire developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Simple summary statistics were calculated for each survey item to assess compliance with current best-practice guidelines. 81 units from 79 NHS Trusts completed the questionnaire. Marked variation was observed in adherence to guidelines, especially those relating to clinical governance and infection prevention strategies. Less than half (n = 28, 47%) of units obtained local clinical governance board approval prior to offering new mesh-based techniques and prospective audit of the clinical, cosmetic and patient-reported outcomes of surgery was infrequent. Most units screened for methicillin-resistant staphylococcus aureus prior to surgery but fewer than 1 in 3 screened for methicillin-sensitive strains. Laminar-flow theatres (recommended for IBBR) were not widely-available with less than 1 in 5 units having regular access. Peri-operative antibiotics were widely-used, but the type and duration were highly-variable. The iBRA national practice questionnaire has demonstrated variation in reported practice and adherence to IBBR guidelines. High-quality evidence is urgently required to inform best practice. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Therapists in Oncology Settings

ERIC Educational Resources Information Center

Hendrick, Susan S.

2013-01-01

This article describes the author's experiences of working with cancer patients/survivors both individually and in support groups for many years, across several settings. It also documents current best-practice guidelines for the psychosocial treatment of cancer patients/survivors and their families. The author's view of the important qualities…

Aligning Assessments for COSMA Accreditation

ERIC Educational Resources Information Center

Laird, Curt; Johnson, Dennis A.; Alderman, Heather

2015-01-01

Many higher education sport management programs are currently in the process of seeking accreditation from the Commission on Sport Management Accreditation (COSMA). This article provides a best-practice method for aligning student learning outcomes with a sport management program's mission and goals. Formative and summative assessment procedures…

Best practices : bus signage for persons with visual impairments : light-emitting diode (LED) signs

DOT National Transportation Integrated Search

2004-01-01

This best-practices report provides key information regarding the use of Light-Emitting Diode (LED) sign technologies to present destination and route information on transit vehicles. It will assist managers and engineers in the acquisition and use o...

Prevalence, characteristics and management of headache experienced by people with schizophrenia and schizoaffective disorder: a cross sectional cohort study.

PubMed

Connaughton, Joanne; Wand, Benedict

2017-08-01

Headache is the most common type of pain reported by people with schizophrenia. This study aimed to establish prevalence, characteristics and management of these headaches. One hundred participants with schizophrenia/schizoaffective disorder completed a reliable and valid headache questionnaire. Two clinicians independently classified each headache as migraine, tension-type, cervicogenic or other. The 12-month prevalence of headache (57%) was higher than the general population (46%) with no evidence of a relationship between psychiatric clinical characteristics and presence of headache. Prevalence of cervicogenic (5%) and migraine (18%) was comparable to the general population. Tension-type (16%) had a lower prevalence and 19% of participants experienced other headache. No one with migraine was prescribed migraine specific medication; no one with cervicogenic and tension-type received best-practice treatment. Headache is a common complaint in people with schizophrenia/schizoaffective disorder with most fitting recognised diagnostic criteria for which effective interventions are available. No one in this sample was receiving best-practice care for their headache.

Best practices for fungal germplasm repositories and perspectives on their implementation.

PubMed

Wiest, Aric; Schnittker, Robert; Plamann, Mike; McCluskey, Kevin

2012-02-01

In over 50 years, the Fungal Genetics Stock Center has grown to become a world-recognized biological resource center. Along with this growth comes the development and implementation of myriad practices for the management and curation of a diverse collection of filamentous fungi, yeast, and molecular genetic tools for working with the fungi. These practices include techniques for the testing, manipulation, and preservation of individual fungal isolates as well as for processing of thousands of isolates in parallel. In addition to providing accurate record keeping, an electronic managements system allows the observation of trends in strain distribution and in sample characteristics. Because many ex situ fungal germplasm repositories around the world share similar objectives, best-practice guidelines have been developed by a number of organizations such as the Organization for Economic Cooperation and Development or the International Society for Biological and Environmental Repositories. These best-practice guidelines provide a framework for the successful operation of collections and promote the development and interactions of biological resource centers around the world.

Social work practice in the digital age: therapeutic e-mail as a direct practice methodology.

PubMed

Mattison, Marian

2012-07-01

The author addresses the risks and benefits of incorporating therapeutic e-mail communication into clinical social work practice. Consumer demand for online clinical services is growing faster than the professional response. E-mail, when used as an adjunct to traditional meetings with clients, offers distinct advantages and risks. Benefits include the potential to reach clients in geographically remote and underserved communities, enhancing and extending the therapeutic relationship and improving treatment outcomes. Risks include threats to client confidentiality and privacy, liability coverage for practitioners, licensing jurisdiction, and the lack of competency standards for delivering e-mail interventions. Currently, the social work profession does not have adequate instructive guidelines and best-practice standards for using e-mail as a direct practice methodology. Practitioners need (formal) academic training in the techniques connected to e-mail exchanges with clients. The author describes the ethical and legal risks for practitioners using therapeutic e-mail with clients and identifies recommendations for establishing best-practice standards.

ADHD Diagnosis: As Simple As Administering a Questionnaire or a Complex Diagnostic Process?

PubMed

Parker, Ashton; Corkum, Penny

2016-06-01

The present study investigated the validity of using the Conners' Teacher and Parent Rating Scales (CTRS/CPRS) or semistructured diagnostic interviews (Parent Interview for Child Symptoms and Teacher Telephone Interview) to predict a best-practices clinical diagnosis of ADHD. A total of 279 children received a clinical diagnosis based on a best-practices comprehensive assessment (including diagnostic parent and teacher interviews, collection of historical information, rating scales, classroom observations, and a psychoeducational assessment) at a specialty ADHD Clinic in Truro, Nova Scotia, Canada. Sensitivity and specificity with clinical diagnosis were determined for the ratings scales and diagnostic interviews. Sensitivity and specificity values were high for the diagnostic interviews (91.8% and 70.7%, respectively). However, while sensitivity of the CTRS/CPRS was relatively high (83.5%), specificity was poor (35.7%). The low specificity of the CPRS/CTRS is not sufficient to be used alone to diagnose ADHD. (J. of Att. Dis. 2016; 20(6) 478-486). © The Author(s) 2013.

Natural orifice transendoluminal surgery and laparoendoscopic single-site surgery: the future of laparoscopic radical prostatectomy.

PubMed

Barret, Eric; Sanchez-Salas, Rafael; Ercolani, Matthew C; Rozet, Francois; Galiano, Marc; Cathelineau, Xavier

2011-03-01

Techniques for minimally invasive radical prostatectomy (RP) have been carefully reviewed by surgical teams worldwide in order to identify possible weaknesses and facilitate further improvement in their overall performance. The initial plan of action has been to carefully study the best-practice techniques for open RP in order to reproduce and standardize performance from the laparoscopic perspective. Similar to open surgery, the learning curve of minimally invasive RP has been well documented in terms of objective evaluation of outcomes for cancer control and functional results. Natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have recently gained momentum as feasible techniques for minimal access urological surgery. NOTES-LESS drastically limit the surgeon's ability to choose the site of entry for operative instruments; therefore, the advantages of NOTES-LESS are gained with the understanding that the surgical procedure is more technically challenging. There are several key elements in RP techniques (in particular, dorsal vein control, apex exposure and cavernosal nerve sparing) that can have significant implications on oncologic and functional results. These steps are hard to perform in a limited working field. LESS radical prostatectomy can clearly be facilitated by using robotic technology.

Best Practices in ELL Instruction

ERIC Educational Resources Information Center

Li, Guofang, Ed.; Edwards, Patricia A., Ed.

2010-01-01

In this work, prominent authorities review the latest research on all aspects of ELL instruction (K-12) and identify what works for today's students and schools. Provided are best-practice guidelines for targeting reading, writing, oral language, vocabulary, content-domain literacies, and other core skill areas; assessing culturally and…

Treating Cronbach's Alpha Reliability Coefficients as Data in Counseling Research

ERIC Educational Resources Information Center

Helms, Janet E.; Henze, Kevin T.; Sass, Terry L.; Mifsud, Venus A.

2006-01-01

Scientific associations and measurement experts in psychology and education have voiced various standards and best-practice recommendations concerning reliability data over the years. Yet in the counseling psychology literature, there is virtually no single-source compilation and articulation of good practices for reporting, analyzing, and…

Consensus Among International Ethical Guidelines for the Provision of Videoconferencing-Based Mental Health Treatments.

PubMed

Sansom-Daly, Ursula M; Wakefield, Claire E; McGill, Brittany C; Wilson, Helen L; Patterson, Pandora

2016-05-18

Online technologies may reduce barriers to evidence-based mental health care, yet they also create numerous ethical challenges. Recently, numerous professional organizations and expert groups have produced best-practice guidelines to assist mental health professionals in delivering online interventions in an ethically and clinically sound manner. However, there has been little critical examination of these international best-practice guidelines regarding appropriate electronic mental health (e-mental health) service delivery via technologies such as videoconferencing (including Skype), particularly for specific, vulnerable populations. Further, the extent to which concordance exists between these guidelines remains unclear. Synthesizing this literature to provide clear guidance to both mental health professionals and researchers is critical to ensure continued progress in the field of e-mental health. This study aims to review all currently available ethical and best-practice guidelines relating to videoconferencing-delivered mental health treatments in order to ascertain the recommendations for which international consensus could be found. Additionally, this review examines the extent to which each set of guidance addresses several key special populations, including children and young people, and populations living with illness. This systematic review examined guidelines using a two-armed search strategy, examining (1) professional organizations' published guidance; and (2) MEDLINE, PsycINFO, and EMBASE for the past ten years. In order to determine consensus for best-practice, a recommendation was considered "firm" if 50% or more of the reviewed guidelines endorsed it and "tentative" if recommended by fewer guidelines than these. The professional guidelines were also scored by two raters using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) criteria. In the study, 19 guidelines were included, yielding 11 specific "firm" and a further 123 "tentative-level" recommendations regarding the appropriateness of e-mental health, competence, legal and regulatory issues, confidentiality, consent, professional boundaries, and crisis management. International consensus yielded firm guidance across almost all areas except professional boundaries and some aspects of determining the appropriateness of e-mental health. Few guidelines specifically addressed special populations. Overall guideline quality varied; however, 42% (8/19) of the guidelines scored at least 5 out of 7. This synthesis of guidelines provides a foundation for clinicians and researchers utilizing e-mental health worldwide. The lack of specific guidance relating to special populations is an area warranting further attention in order to strengthen mental health professionals' and researchers' capacity to ethically and effectively tailor e-mental health interventions to these groups.

U.S. DOE Southeast Clean Energy Application Center

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

Panzarella, Isaac; Mago, Pedro; Kalland, Stephen

2013-12-31

Between 2010 and 2013, the U.S. Department of Energy (DOE) funded the Southeast Clean Energy Application Center (SE-CEAC), co-located at the North Carolina Solar Center at NC State University (NCSU) and at Mississippi State University. The SE-CEAC was one of eight regional CEACs established to promote and assist in transforming the market for combined heat and power (CHP), district energy (DE) and waste heat to power (WHP) throughout the U.S. CHP locates power generation at the point of demand and makes productive use of the residual thermal energy for process and space heating in factories and businesses, thus lowering themore » cost of meeting electricity and heat requirements and increasing energy efficiency. The overall goal of the SE-CEAC was to support end-user implementation and overall market transformation for CHP and related clean energy technologies. Five objectives were targeted to achieve the goal: 1. Market Analysis and Information Dissemination 2. Outreach and Education for Potential CHP End-users 3. Policy Support for State and Regional Stakeholders 4. Technical Assistance to Support CHP Deployment 5. Collaboration with DOE and other CEACs Throughout the project, the CEACs provided key services of education and outreach, technical assistance and market analysis in support of project objectives. These services were very effective at achieving key objectives of assisting prospective CHP end-users and informing policy makers, utilities and others about the benefits of CHP. There is a marked increase in the awareness of CHP technologies and applications as an energy resource among end-users, policymakers, utility regulators, electric utilities and natural gas utilities in the Southeast region as a result. At the end of 2013, a number of best-practice policies for CHP were applied or under consideration in various Southeast states. The SE-CEAC met its targets for providing technical assistance with over 50 analyses delivered for 412 MW of potential end-users CHP applications. Of these 50 MW of projects were under consideration at the end of 2013 based on SE-CEAC technical assistance findings.« less

More than Just a Game? Combat-Themed Gaming Among Recent Veterans with Posttraumatic Stress Disorder

PubMed Central

Golub, Andrew; Price, Matthew; Bennett, Alexander

2015-01-01

Abstract This article examines recent combat veterans' experiences of “first-person shooter” (FPS) gaming and its relationship to posttraumatic stress disorder (PTSD). Current PTSD treatment approaches increasingly use virtual reality (VR) technologies, which have many similarities with FPS games. To explore these similarities, this article presents six case studies from recently separated veterans in New York City who reported both current PTSD symptoms and regular use of combat-themed FPS games. In open-ended interviews, participants discussed a range of benefits as well as the importance of regulating use and avoiding particular contextual dimensions of gaming to maintain healthy gaming habits. Findings demonstrate the need for more comprehensive study and dissemination of best-practices information about FPS gaming in the context of combat-related PTSD symptomatology. PMID:26182214

Energy information systems (EIS): Technology costs, benefit, and best practice uses

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

Granderson, Jessica; Lin, Guanjing; Piette, Mary Ann

2013-11-26

Energy information systems are the web-based software, data acquisition hardware, and communication systems used to store, analyze, and display building energy data. They often include analysis methods such as baselining, benchmarking, load profiling, and energy anomaly detection. This report documents a large-scale assessment of energy information system (EIS) uses, costs, and energy benefits, based on a series of focused case study investigations that are synthesized into generalizable findings. The overall objective is to provide organizational decision makers with the information they need to make informed choices as to whether or not to invest in an EIS--a promising technology that canmore » enable up to 20 percent site energy savings, quick payback, and persistent low-energy performance when implemented as part of best-practice energy management programs.« less

Tolerance and Education in Multicultural Societies

ERIC Educational Resources Information Center

Wiater, Werner, Ed.; Manschke, Doris, Ed.

2011-01-01

This book examines the concepts of tolerance and education in multicultural societies. It focuses on different aspects of multiculturalism in these societies and considers possible conflicts and tensions as well as best-practice examples of co-existence among different cultural groups. Special emphasis is placed on educational issues and schools.…

What is Good University Financial Management?

ERIC Educational Resources Information Center

Taylor, Mark P.

2013-01-01

In the current and foreseeable harsh UK higher education environment, aspiring to best-practice financial management will be key to ensuring the prosperity--and indeed the survival--of any university. In this article I argue that good university financial management should provide stability to the institution, allow for investment as well as…

Resisting Best-Practice in Australian Practice-Based Jazz Doctorates

ERIC Educational Resources Information Center

Coady, Christopher; Webb, Michael

2017-01-01

Recent research on practice-based doctorates in Australia has revealed an institutional preference for "theorised" research approaches aimed at situating studies of practice within established academic paradigms. In this article we examine how the aim of communicating with artistic peers steers the research design and the production of…

Toward a Best-Practice Protocol for Assessment of Sensory Features in ASD

ERIC Educational Resources Information Center

Schaaf, Roseann C.; Lane, Alison E.

2015-01-01

Sensory difficulties are a commonly occurring feature of autism spectrum disorders and are now included as one manifestation of the "restricted, repetitive patterns of behavior, interests, or activities" diagnostic criteria of the DSM5 necessitating guidelines for comprehensive assessment of these features. To facilitate the development…

Curriculum for Environmental Education of the Disabled (C.E.E.D.).

ERIC Educational Resources Information Center

Abrams, William; And Others

The activities included in the Curriculum for Environmental Education of the Disabled (CEED) are based on current best-practices in the area of pollution prevention and address the following major areas: recycling, water and energy efficiency, transportation, citizenship, and outdoor appreciation. The activities emphasize the development of…

Principles and Practices Fostering Inclusive Excellence: Lessons from the Howard Hughes Medical Institute's Capstone Institutions

ERIC Educational Resources Information Center

DiBartolo, Patricia Marten; Gregg-Jolly, Leslie; Gross, Deborah; Manduca, Cathryn A.; Iverson, Ellen; Cooke, David B., III; Davis, Gregory K.; Davidson, Cameron; Hertz, Paul E.; Hibbard, Lisa; Ireland, Shubha K.; Mader, Catherine; Pai, Aditi; Raps, Shirley; Siwicki, Kathleen; Swartz, Jim E.

2016-01-01

Best-practices pedagogy in science, technology, engineering, and mathematics (STEM) aims for inclusive excellence that fosters student persistence. This paper describes principles of inclusivity across 11 primarily undergraduate institutions designated as Capstone Awardees in Howard Hughes Medical Institute's (HHMI) 2012 competition. The Capstones…

Technology Integration: A Research-Based Professional Development Program

ERIC Educational Resources Information Center

Faulder, Tori Rose

2011-01-01

This research-based thesis project explains the governmental acts and policies, investors, and other stakeholders who have worked to promote, question, and explore the use of information and communication technologies (ICT) in the classroom. Research suggests that best-practice ICT integration requires using ICT alongside constructivist pedagogy.…

Body Awareness and Movement for Students with Multiple Disabilities Including Visual Impairments

ERIC Educational Resources Information Center

DePountis, Vicki; Cady, Deborah; Hallak, Tracy

2013-01-01

This conference presentation examines concept development for congenitally blind students. It presents current research on best-practice for teaching this population. Examples of strategies to reinforce understanding of body concepts, spatial awareness, and positional language, while promoting mirroring, self regulation, and purposeful movement to…

Evaluating Computer-Related Incidents on Campus

ERIC Educational Resources Information Center

Rothschild, Daniel; Rezmierski, Virginia

2004-01-01

The Computer Incident Factor Analysis and Categorization (CIFAC) Project at the University of Michigan began in September 2003 with grants from EDUCAUSE and the National Science Foundation (NSF). The project's primary goal is to create a best-practices security framework for colleges and universities based on rigorous quantitative analysis of…

Undergraduate Single Mothers' Experiences in Postsecondary Education

ERIC Educational Resources Information Center

Beeler, Sydney

2016-01-01

Using Astin's (1993) College Impact Model, this chapter explores the current literature as it relates to single mothers in undergraduate postsecondary education. The chapter looks at the ways that undergraduates who are single mothers are counter to the "ideal-student" norms. Policy and best-practice recommendations conclude the chapter.

Real-world use of the risk-need-responsivity model and the level of service/case management inventory with community-supervised offenders.

PubMed

Dyck, Heather L; Campbell, Mary Ann; Wershler, Julie L

2018-06-01

The risk-need-responsivity model (RNR; Bonta & Andrews, 2017) has become a leading approach for effective offender case management, but field tests of this model are still required. The present study first assessed the predictive validity of the RNR-informed Level of Service/Case Management Inventory (LS/CMI; Andrews, Bonta, & Wormith, 2004) with a sample of Atlantic Canadian male and female community-supervised provincial offenders (N = 136). Next, the case management plans prepared from these LS/CMI results were analyzed for adherence to the principles of risk, need, and responsivity. As expected, the LS/CMI was a strong predictor of general recidivism for both males (area under the curve = .75, 95% confidence interval [.66, .85]), and especially females (area under the curve = .94, 95% confidence interval [.84, 1.00]), over an average 3.42-year follow-up period. The LS/CMI was predictive of time to recidivism, with lower risk cases taking longer to reoffend than higher risk cases. Despite the robust predictive validity of the LS/CMI, case management plans developed by probation officers generally reflected poor adherence to the RNR principles. These findings highlight the need for better training on how to transfer risk appraisal information from valid risk tools to case plans to better meet the best-practice principles of risk, need, and responsivity for criminal behavior risk reduction. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Governance of Organizational Learning: Empirical Evidence from Best-Practice Universities in Germany

ERIC Educational Resources Information Center

Lauer, Sabine; Wilkesmann, Uwe

2017-01-01

Purpose: The purpose of this paper is to link two modes of governance (transactional and transformational) to organizational learning by examining the example of academic teaching. Consequently, the "transformational" strategies of best practices that have been used by German universities to achieve teaching excellence are interpreted as…

Poverty, Performance, and Frog Ponds: What Best-Practice Research Tells Us about Their Connections

ERIC Educational Resources Information Center

Angelis, Janet I.; Wilcox, Kristen C.

2011-01-01

Having studied schools in the past eight years that have high concentrations of students living in poverty, but who consistently exceed the performance of similarly impoverished schools, the authors conclude that such higher-performing schools share common characteristics setting them apart. The three most essential are: Teachers, administrators,…

Leadership Educator Journeys: Expanding a Model of Leadership Educator Professional Identity Development

ERIC Educational Resources Information Center

Seemiller, Corey; Priest, Kerry L.

2017-01-01

There is a great deal of literature on leadership education best-practices (e.g., curricular considerations, teaching strategies, assessment of learning). Yet, to be a leadership educator is more than having knowledge or expertise of content and pedagogy. Perceptions, experiences, and values of leadership educators comprise a professional identity…

Comprehension Instruction: Research-Based Best Practices. Solving Problems in the Teaching of Literacy. Second Edition

ERIC Educational Resources Information Center

Block, Cathy Collins, Ed.; Parris, Sheri R., Ed.

2008-01-01

Now in a substantially revised and updated second edition, this comprehensive professional resource and text is based on cutting-edge research. In each chapter, leading scholars provide an overview of a particular aspect of comprehension, offer best-practice instructional guidelines and policy recommendations, present key research questions still…

A Best-Practice Model for Academic Advising of University Biology Majors

ERIC Educational Resources Information Center

Heekin, Jonathan Ralph Calvin

2013-01-01

Biology faculty at an East Coast university believed their undergraduate students were not being well served by the existing academic advising program. The purpose of this mixed methods project study was to evaluate the effectiveness of the academic advising model in a biology department. Guided by system-based organizational theory, a learning…

A Meta-Analysis of Approaches to Engage Social Work Students Online

ERIC Educational Resources Information Center

Farrel, Dorothy; Ray, Kateri; Rich, Telvis; Suarez, Zulema; Christenson, Brian; Jennigs, Lisa

2018-01-01

With an increase in social work courses being offered in online and hybrid formats, it is imperative that social work programs understand the new teaching tenets and engagement mediums employed to meet the new Council on Social Work Education's Educational Policy and Accreditation Standards. This meta-analysis explores best-practices pedagogy for…

Child and Adolescent Suicidal Behavior: School-Based Prevention, Assessment, and Intervention. Practical Intervention in the Schools Series

ERIC Educational Resources Information Center

Miller, David N.

2011-01-01

Meeting a crucial need, this book distills the best current knowledge on child and adolescent suicide prevention into comprehensive guidelines for school-based practitioners. The author draws on extensive research and clinical experience to provide best-practice recommendations for developing schoolwide prevention programs, conducting risk…

The Community Grant Writing Project: A Flexible Service-Learning Model for Writing-Intensive Courses

ERIC Educational Resources Information Center

Stevens, Courtney

2014-01-01

This article describes the Community Grant Writing Project (CGWP), a flexible service-learning framework designed for use in writing-intensive courses. The CGWP incorporates best-practice recommendations from the service-learning literature and addresses recent challenges identified for successful service-learning partnerships. In the CGWP,…

Internal Audit: Does it Enhance Governance in the Australian Public University Sector?

ERIC Educational Resources Information Center

Christopher, Joe

2015-01-01

This study seeks to confirm if internal audit, a corporate control process, is functioning effectively in Australian public universities. The study draws on agency theory, published literature and best-practice guidelines to develop an internal audit evaluation framework. A survey instrument is thereafter developed from the framework and used as a…

Why Peer Mentoring is an Effective Approach for Promoting College Student Success

ERIC Educational Resources Information Center

Collier, Peter J.

2017-01-01

Both hierarchical (e.g. student-faculty member or student-adviser) and peer (e.g. student-student) mentoring are recognized as best-practice strategies for promoting college student success. Formal mentoring programs utilizing both approaches can be found on many campuses. In the current institutional context of scarce or stagnant resources,…

The Project Method in Agricultural Education: Then and Now

ERIC Educational Resources Information Center

Roberts, T. Grady; Harlin, Julie F.

2007-01-01

The purpose of this philosophical paper was to synthesize theoretical and historical foundations of the project method and compare them to modern best-practices. A review of historical and contemporary literature related to the project method yielded six themes: 1) purpose of projects; 2) project classification; 3) the process; 4) the context; 5)…

Youth Arts: Creativity and Art as a Vehicle for Youth Development

ERIC Educational Resources Information Center

Houbolt, Sarah

2010-01-01

The Auckland City Council arts team has managed several successful youth arts projects across the city of Auckland. The council aims to establish a best-practice standard for community artists in line with international standards of community cultural development. This reflective paper explores the processes, impacts and outcomes of some of the…

Comprehension Instruction: Research-Based Best Practices. Solving Problems in the Teaching of Literacy.

ERIC Educational Resources Information Center

Block, Cathy Collins, Ed.; Pressley, Michael, Ed.

Noting that comprehension instruction is widely recognized as an essential component of developing students' pleasure and profit from reading, this book presents 25 essays on comprehension instruction that summarize current research and provide best-practice guidelines for teachers and teacher educators. Each chapter in the book presents key…

Diagnosis and Treatment of Borderline Personality Disorder in the College Mental Health Setting.

PubMed

Brickell, Claire M

2018-05-18

The impact of borderline personality disorder (BPD) on college students is not well studied, and there is currently little data about its phenomenology or treatment in this population. We review the available literature regarding evidence-based treatment for BPD on college campuses, as well as best-practice guidelines for the treatment of mental illness in the college setting. Diagnostic disclosure and psychoeducation are proposed as practical first steps in improving the treatment landscape. Preliminary studies of targeted treatment for BPD on college campuses are promising. They suggest that even pared-down interventions have the potential to help students feel better and function better. Experts in college mental health treatment emphasize the importance of gathering data, intervening early, communicating across treatment environments, appropriately marshaling resources, and providing psycho-education. To bring the on-campus treatment of BPD in line with best-practice guidelines, improved diagnostic practices are needed. Disclosing the diagnosis of BPD and educating students about this disorder are simple yet powerful interventions that can set the stage for further treatment and provide symptom relief.

Health and productivity management: establishing key performance measures, benchmarks, and best practices.

PubMed

Goetzel, R Z; Guindon, A M; Turshen, I J; Ozminkowski, R J

2001-01-01

Major areas considered under the rubric of health and productivity management (HPM) in American business include absenteeism, employee turnover, and the use of medical, disability, and workers' compensation programs. Until recently, few normative data existed for most HPM areas. To meet the need for normative information in HPM, a series of Consortium Benchmarking Studies were conducted. In the most recent application of the study, 1998 HPM costs, incidence, duration, and other program data were collected from 43 employers on almost one million workers. The median HPM costs for these organizations were $9992 per employee, which were distributed among group health (47%), turnover (37%), unscheduled absence (8%), nonoccupational disability (5%), and workers' compensation programs (3%). Achieving "best-practice" levels of performance (operationally defined as the 25th percentile for program expenditures in each HPM area) would realize savings of $2562 per employee (a 26% reduction). The results indicate substantial opportunities for improvement through effective coordination and management of HPM programs. Examples of best-practice activities collated from on-site visits to "benchmark" organizations are also reviewed.

Creating history: documents and patient participation in nurse-patient interviews.

PubMed

Jones, Aled

2009-09-01

Strongly worded directives regarding the need for increased patient participation during nursing interaction with patients have recently appeared in a range of 'best-practice' documents. This paper focuses on one area of nurse-patient communication, the hospital admission interview, which has been put forward as an ideal arena for increased patient participation. It uses data from a total of 27 admission interviews, extensive periods of participant observation and analysis of nursing records to examine how hospital admission interviews are performed by nurses and patients. Analysis shows that topics discussed during admission closely follow the layout of the admission document which nurses complete during the interview. Whilst it is tempting to describe the admission document as a 'super technological power' in influencing the interaction and restricting patient participation, this analysis attempts a more rounded reading of the data. Findings demonstrate that, whilst opportunities for patient participation were rare, admission interviews are complex interactional episodes that often belie simplistic or prescriptive guidance regarding interaction between nurses and patients. In particular, issue is taken with the lack of contextual and conceptual clarity with which best-practice guidelines are written.

The death of the Job plot, transparency, open science and online tools, uncertainty estimation methods and other developments in supramolecular chemistry data analysis.

PubMed

Brynn Hibbert, D; Thordarson, Pall

2016-10-25

Data analysis is central to understanding phenomena in host-guest chemistry. We describe here recent developments in this field starting with the revelation that the popular Job plot method is inappropriate for most problems in host-guest chemistry and that the focus should instead be on systematically fitting data and testing all reasonable binding models. We then discuss approaches for estimating uncertainties in binding studies using case studies and simulations to highlight key issues. Related to this is the need for ready access to data and transparency in the methodology or software used, and we demonstrate an example a webportal () that aims to address this issue. We conclude with a list of best-practice protocols for data analysis in supramolecular chemistry that could easily be translated to other related problems in chemistry including measuring rate constants or drug IC 50 values.

Prevention of healthcare associated infections: a descriptive study.

PubMed

Accardi, R; Castaldi, S; Marzullo, A; Ronchi, S; Laquintana, D; Lusignani, M

2017-01-01

This study aims to verify whether there are, and to which degree, knowledge and adherence to guidelines on the prevention and control of healthcare associated infections by nursing staff. Study design. A descriptive study was conducted on a sample of nurses in the areas of medicine, surgery, and its own specialties of the Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico in Milan from 1st December 2015 to 29th February 2016. The knowledge of the nursing staff have been investigated through the use of questionnaires with anonymous self-reporting method; inspections in the wards using observational grids were carried out in order to verify adherence to best-practice principles. The data collected concern, both for the knowledge and for the practice, the following macro-areas: a) Cleaning, disinfection and sterilization, b) Hand hygiene, c) Standard and isolation precautions, d) Prevention of catheter-related urinary tract infections, e) Prevention of catheter-related bacteremia, f) Prevention of surgical site infections, g) Prevention of respiratory tract infections. Statistical analyzes were performed using Microsoft Office Excel and STATA software. 245 nurses from 16 wards were involved. In each wards 4 inspections were conducted. 128 completed questionnaires were returned, all considered for the analysis of data; the adhesion was 52.2%. The participants achieved an overall score of 15.0 ± 4.1 (mean ± SD) on a maximum achievable score of 23 and >75% of them have reached a sufficient level. Among the most positive results, it must be underlined that nurses have demonstrated a higher level of knowledge for hand hygiene, with >81% correct answers; that the lumens of central venous catheters, when not in use, were kept covered with a protective cap in more than 99% of cases; that, for patients bearers of urinary catheter, the urinary drainage bag was maintained below the level of the bladder, as recommended, in more than 91% of the cases. On the contrary, as a very negative result, we found the greatest knowledge gap as regards cleaning, disinfection and sterilization, with a number of incorrect answers approaching 50%; furthermore, 64% of nurses wore jewels on their wrists, and / or hands when in action; finally, the alcohol-based handrub device could be easily reached from at least one of the beds of the room in less than 13% of the cases. Some knowledge gaps and differences with respect to adherence to best-practice principles for the prevention and control of healthcare associated infections was highlight by the present study.

Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. Treatment Improvement Protocol (TIP) Series 43

ERIC Educational Resources Information Center

Tinkler, Emily; Vallejos Bartlett, Catalina; Brooks, Margaret; Gilbert, Johnatnan Max; Henderson, Randi; Shuman, Deborah, J.

2005-01-01

TIP 43 provides best-practice guidelines for medication-assisted treatment of opioid addiction in opioid treatment programs (OTPs). The primary intended audience for this volume is substance abuse treatment providers and administrators who work in OTPs. Recommendations in the TIP are based on both an analysis of current research and determinations…

Substance Abuse Treatment: Group Therapy. Treatment Improvement Protocol (TIP) Series 41

ERIC Educational Resources Information Center

Gilbert, Jonathan Max; Hills, Susan; Rife, Mary Lou

2005-01-01

This Treatment Improvement Protocol (TIP) presents an overview of the role and efficacy of group therapy in substance abuse treatment. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel…

Super Searchers on Madison Avenue: Top Advertising and Marketing Professionals Share Their Online Research Strategies. Super Searchers, Volume XI.

ERIC Educational Resources Information Center

Villamora, Grace Avellana

This book presents interviews with 13 research professionals that contain favorite online search strategies and research tools, anecdotes, "how to" survival tips, and best-practice examples. The appendix lists referenced sites and sources in the following categories: (1) online resources; (2) books, annuals, newsletters, magazines, and…

Comparison and Evaluation of Learning Outcomes from an International Perspective: Development of a Best-Practice Process

ERIC Educational Resources Information Center

Elmgren, Maja; Ho, Felix; Åkesson, Eva; Schmid, Siegbert; Towns, Marcy

2015-01-01

Chemistry education focused on learning outcomes is increasingly practiced, providing new opportunities for international comparisons. The interest in intended learning outcomes and constructive alignment has grown in many parts of the world due to both research in higher education and political decisions. In an International Union of Pure and…

Substance Abuse Treatment for Persons With Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42

ERIC Educational Resources Information Center

Sacks, Stanley; Ries, Richard K.

2005-01-01

This Treatment Improvement Protocol (TIP) provides guidelines for counselors and others working in the field of co-occurring substance use and mental disorders. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content…

Literature-Based Teaching in the Content Areas: 40 Strategies for K-8 Classrooms

ERIC Educational Resources Information Center

Cox, Carole

2011-01-01

Grounded in theory and best-practices research, this practical text provides teachers with 40 strategies for using fiction and non-fiction trade books to teach in five key content areas: language arts and reading, social studies, mathematics, science, and the arts. Each strategy provides everything a teacher needs to get started: a classroom…

Making a Difference: The Future of HPT in Sustaining Best-Practice International Capacity Development

ERIC Educational Resources Information Center

Kelly, Steven J.; Coughlin, Patrick C.; Novak, M. Mari

2012-01-01

Over the past decade, human performance technology (HPT) has become an important source of rigor and application in support of best practices in capacity development. HPT shares common principles with the Organisation for Economic Co-operation and Development best practices. This article explores HPT's critical role as the methodology of choice…

Towards Evidence-Based, Quality-Controlled Health Promotion: The Dutch Recognition System for Health Promotion Interventions

ERIC Educational Resources Information Center

Brug, Johannes; van Dale, Djoeke; Lanting, Loes; Kremers, Stef; Veenhof, Cindy; Leurs, Mariken; van Yperen, Tom; Kok, Gerjo

2010-01-01

Registration or recognition systems for best-practice health promotion interventions may contribute to better quality assurance and control in health promotion practice. In the Netherlands, such a system has been developed and is being implemented aiming to provide policy makers and professionals with more information on the quality and…

Substance Abuse Treatment for Persons with Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42

ERIC Educational Resources Information Center

Substance Abuse and Mental Health Services Administration, 2005

2005-01-01

Treatment Improvement Protocols (TIPs), developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (DHHS), are best-practice guidelines for the treatment of substance use disorders. CSAT draws on the experience…

Cutting Your Losses: Could Best-Practice Pedagogy Involve Acknowledging that Even Robust Hope May Be Vain?

ERIC Educational Resources Information Center

Schuurmans-Stekhoven, James

2009-01-01

A recent special issue of "Asia-Pacific Journal of Teacher Education" (Vol. 35, Issue 3, 2007) championed "robust hope" as fundamental to achieving educational utopias, and yet key features of hope were largely overlooked. Although hope feels good and has utility in some circumstances, in other situations different…

Supporting Best-Practice Literacy Instruction Utilizing National Standards: A Gradual-Release Model for Developing Site-Based Literacy Leaders

ERIC Educational Resources Information Center

Sableski, Mary-Kate; Arnold, Jackie Marshall

2017-01-01

Catholic elementary and secondary schools across the country recently adopted standards reflective of the Common Core State Standards to align instruction with state and national guidelines requiring the revision of curriculum and the adjustment of instruction to meet the new standards from an ideological model. This article describes a…

Substance Abuse Treatment For Adults in the Criminal Justice System. Treatment Improvement Protocol (TIP) Series 44

ERIC Educational Resources Information Center

Bartlett, Catalina; Dinsmore, Janet; Gilbert, J. Max; Kornblum, Annette; Latham, Joyce; Oliff, Helen; Paisner, Susan; Sutton, David

2005-01-01

This Treatment Improvement Protocol (TIP) provides guidelines for counselors and criminal justice personnel who treat offenders with substance use disorders. TIPs are best-practice guidelines that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel of experts in the…

Researching a Best-Practice End-of-Life Care Model for Canada

ERIC Educational Resources Information Center

Wilson, Donna M.; Birch, Stephen; Sheps, Sam; Thomas, Roger; Justice, Christopher; MacLeod, Rod

2008-01-01

The vast majority of the 220,000 Canadians who die each year, principally of old age and progressive ill health, do not have access to specialized hospice or palliative care. Hospice and palliative care programs are unevenly distributed across Canada, with existing programs limited in capacity and services varying considerably across programs.…

Substance Abuse Treatment And Family Therapy. A Treatment Improvement Protocol (TIP) Series 39

ERIC Educational Resources Information Center

Gilbert, Jonathan Max; Oliff, Helen; Sutton, David; Bartlett, Catalina; Henderson, Randi

2004-01-01

This Treatment Improvement Protocol (TIP) addresses substance abuse treatment in the context of family therapy. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel of experts in the…

Brokerage and SME Innovation: An Analysis of the Technology Transfer Service at Area Science Park, Italy

ERIC Educational Resources Information Center

Cattapan, Paolo; Passarelli, Mariacarmela; Petrone, Michele

2012-01-01

This paper contributes to the literature on innovation brokerage by analysing the effects of brokerage activities on the innovation and growth of small and medium-sized enterprises (SMEs). The authors provide a detailed description of the Technology Transfer Service (TTS), credited as a European best-practice innovation broker, at Area Science…

Place-Based Science Teaching and Learning: 40 Activities for K-8 Classrooms

ERIC Educational Resources Information Center

Buxton, Cory A.; Provenzo, Eugene F., Jr.

2011-01-01

Grounded in theory and best-practices research, this practical text provides elementary and middle school teachers with 40 place-based activities that will help them to make science learning relevant to their students. This text provides teachers with both a rationale and a set of strategies and activities for teaching science in a local context…

Addressing Viral Hepatitis in People with Substance Use Disorders. Treatment Improvement Protocol (TIP) Series 53

ERIC Educational Resources Information Center

Substance Abuse and Mental Health Services Administration, 2011

2011-01-01

Treatment Improvement Protocols (TIPs) are developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (HHS). Each TIP involves the development of topic-specific best-practice guidelines for the prevention and…

Implementing and Evaluating the Electronic Report on Adolescent Pregnancy (ERAP)

ERIC Educational Resources Information Center

Sheeder, Jeanelle L.

2010-01-01

It is well-known that there is a large gap between evidence-based best-practice guidelines and outcomes researchers use to define "optimal care" and the medical care patients actually receive. The gap between actual and desired birth outcomes is a particular concern that may be remediable. The purpose of this study is to implement a computerized…

Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series 40

ERIC Educational Resources Information Center

Boone, Margaret; Brown, Nancy J.; Moon, Mary A.; Schuman, Deborah J.; Thomas, Josephine; Wright, Denise L.

2004-01-01

This Treatment Improvement Protocol (TIP) addresses the clinical use of buprenorphine in the treatment of opioid addiction. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel of experts…

Reaching beyond an Online/Offline Divide: Invoking the Rhizome in Higher Education Course Design

ERIC Educational Resources Information Center

Jones, Angela; Bennett, Rebecca

2017-01-01

In the rush to digitise aspects of higher education to cater to an increasingly diverse and wide-ranging university market, there is a concern that best-practice teaching and learning based on sound pedagogy may be left behind. This article addresses this concern by offering a conceptual reimagining of the learning space that reaches beyond a…

The Devil Is in the Details: Examining the Evidence for "Proven" School-Based Drug Abuse Prevention Programs

ERIC Educational Resources Information Center

Gandhi, Allison Gruner; Murphy-Graham, Erin; Petrosino, Anthony; Chrismer, Sara Schwartz; Weiss, Carol H.

2007-01-01

In an effort to promote evidence-based practice, government officials, researchers, and program developers have developed lists of model programs in the prevention field. This article reviews the evidence used by seven best-practice lists to select five model prevention programs. The authors' examination of this research raises questions about the…

"That Doesn't Translate": The Role of Evidence-Based Practice in Disempowering Speech Pathologists in Acute Aphasia Management

ERIC Educational Resources Information Center

Foster, Abby; Worrall, Linda; Rose, Miranda; O'Halloran, Robyn

2015-01-01

Background: An evidence-practice gap has been identified in current acute aphasia management practice, with the provision of services to people with aphasia in the acute hospital widely considered in the literature to be inconsistent with best-practice recommendations. The reasons for this evidence-practice gap are unclear; however, speech…

Do Levels of Evidence Affect Breadth of Service? A Study on the Use of Clinical Guidance in a Learning Disability Service

ERIC Educational Resources Information Center

Pateraki, Eleni; Macmahon, Kenneth

2017-01-01

Abstract: For services across the UK, increasing emphasis is placed on the use of evidence-based psychological treatments. In this context, the Scottish Government published the MATRIX, a best-practice clinical governance document, with a brief section on therapies for people with learning disabilities. As with most clinical guidelines, randomised…

Staff Development of Direct Care Workers in Pennsylvania: The Relationship between Organizational Structure and Culture and Best-Practices in Training

ERIC Educational Resources Information Center

Kemeny, M. Elizabeth

2010-01-01

Using the conceptual model of social structure and personality framework (House, 1981) as a theoretical guide, this cross sectional mixed-method design examined how organizational structure and culture relate to practices for training direct care workers in 328 aging and disability network service provider organizations in Pennsylvania. To…

Educating for Justice: Creating a Mission-Driven Model of Bystander Intervention to Address Sexual Violence at U.S. Catholic Colleges and Universities

ERIC Educational Resources Information Center

Galarneau, Joy; O'Neill, Shannon

2015-01-01

This article presents bystander intervention education as a best-practice approach to sexual violence prevention in college settings. It draws out a connection between mission-specific resources that can be used to advance the prevention agenda, while examining how bystander intervention education can deepen community engagement in collegiate…

Implementation in action: how Australian Exercise Physiologists approach exercise prescription for people with mental illness.

PubMed

Stanton, Robert; Rosenbaum, Simon; Lederman, Oscar; Happell, Brenda

2018-04-01

Accredited Exercise Physiologists (AEPs) are trained to deliver exercise and physical activity interventions for people with chronic and complex health conditions including those with mental illness. However, their views on exercise for mental illness, their exercise prescription practices, and need for further training are unknown. To examine the way in which Australian AEPs prescribe exercise for people with mental illness. Eighty-one AEPs (33.3 ± 10.4 years) completed an online version of the Exercise in Mental Illness Questionnaire. Findings are reported using descriptive statistics. AEPs report a high level of knowledge and confidence in prescribing exercise for people with mental illness. AEPs rate exercise to be at least of equal value to many established treatments for mental illness, and frequently prescribe exercise based on current best-practice principles. A need for additional training was identified. The response rate was low (2.4%) making generalisations from the findings difficult. Exercise prescription practices utilised by AEPs are consistent with current best-practice guidelines and there is frequent consultation with consumers to individualise exercise based on their preferences and available resources. Further training is deemed important.

Clickers in the large classroom: current research and best-practice tips.

PubMed

Caldwell, Jane E

2007-01-01

Audience response systems (ARS) or clickers, as they are commonly called, offer a management tool for engaging students in the large classroom. Basic elements of the technology are discussed. These systems have been used in a variety of fields and at all levels of education. Typical goals of ARS questions are discussed, as well as methods of compensating for the reduction in lecture time that typically results from their use. Examples of ARS use occur throughout the literature and often detail positive attitudes from both students and instructors, although exceptions do exist. When used in classes, ARS clickers typically have either a benign or positive effect on student performance on exams, depending on the method and extent of their use, and create a more positive and active atmosphere in the large classroom. These systems are especially valuable as a means of introducing and monitoring peer learning methods in the large lecture classroom. So that the reader may use clickers effectively in his or her own classroom, a set of guidelines for writing good questions and a list of best-practice tips have been culled from the literature and experienced users.

Using "get with the guidelines" to improve cardiovascular secondary prevention.

PubMed

LaBresh, Kenneth A; Gliklich, Richard; Liljestrand, James; Peto, Randolph; Ellrodt, A Gray

2003-10-01

"Get With The Guidelines (GWTG)" was developed and piloted by the American Heart Association (AHA), New England Affiliate; MassPRO, Inc.; and other organizations to reduce the gap in the application of secondary prevention guidelines in hospitalized cardiovascular disease patients. Collaborative learning programs and technology solutions were created for the project. The interactive Web-based patient management tool (PMT) was developed using quality measures derived from the AHA/American College of Cardiology secondary prevention guidelines. It provided data entry, embedded reminders and guideline summaries, and online reports of quality measure performance, including comparisons with the aggregate performance of all hospitals. Multidisciplinary teams from 24 hospitals participated in the 2000-2001 pilot. Four collaborative learning sessions and monthly conference calls supported team interaction. Best-practices sharing and the use of an Internet tool enabled hospitals to change systems and collect data on 1,738 patients. The GWTG program, a template of learning sessions with didactic presentations, best-practices sharing, and collaborative multidisciplinary team meetings supported by the Internet-based data collection and reporting system, can be extended to multiple regions without requiring additional development. Following the completion of the pilot, the AHA adopted GWTG as a national program.

Clickers in the Large Classroom: Current Research and Best-Practice Tips

PubMed Central

2007-01-01

Audience response systems (ARS) or clickers, as they are commonly called, offer a management tool for engaging students in the large classroom. Basic elements of the technology are discussed. These systems have been used in a variety of fields and at all levels of education. Typical goals of ARS questions are discussed, as well as methods of compensating for the reduction in lecture time that typically results from their use. Examples of ARS use occur throughout the literature and often detail positive attitudes from both students and instructors, although exceptions do exist. When used in classes, ARS clickers typically have either a benign or positive effect on student performance on exams, depending on the method and extent of their use, and create a more positive and active atmosphere in the large classroom. These systems are especially valuable as a means of introducing and monitoring peer learning methods in the large lecture classroom. So that the reader may use clickers effectively in his or her own classroom, a set of guidelines for writing good questions and a list of best-practice tips have been culled from the literature and experienced users. PMID:17339389

omniClassifier: a Desktop Grid Computing System for Big Data Prediction Modeling

PubMed Central

Phan, John H.; Kothari, Sonal; Wang, May D.

2016-01-01

Robust prediction models are important for numerous science, engineering, and biomedical applications. However, best-practice procedures for optimizing prediction models can be computationally complex, especially when choosing models from among hundreds or thousands of parameter choices. Computational complexity has further increased with the growth of data in these fields, concurrent with the era of “Big Data”. Grid computing is a potential solution to the computational challenges of Big Data. Desktop grid computing, which uses idle CPU cycles of commodity desktop machines, coupled with commercial cloud computing resources can enable research labs to gain easier and more cost effective access to vast computing resources. We have developed omniClassifier, a multi-purpose prediction modeling application that provides researchers with a tool for conducting machine learning research within the guidelines of recommended best-practices. omniClassifier is implemented as a desktop grid computing system using the Berkeley Open Infrastructure for Network Computing (BOINC) middleware. In addition to describing implementation details, we use various gene expression datasets to demonstrate the potential scalability of omniClassifier for efficient and robust Big Data prediction modeling. A prototype of omniClassifier can be accessed at http://omniclassifier.bme.gatech.edu/. PMID:27532062

Participation in Peer-Led Academic Support Services: One Adaptation of a Natural Sciences Peer Learning Model to Enrichment in the Humanities

ERIC Educational Resources Information Center

Cheng, Stephen; Johnston, Susan

2014-01-01

Supplemental instruction (SI) has proven highly effective at improving success rates in high-risk first and second-year courses, in part because peerled SI sessions inculcate best-practice study skills in a specific learning context which provides opportunities for skill mastery. A successful SI program in the Faculty of Science at the University…

How to develop and write a case for technical writing

NASA Technical Reports Server (NTRS)

Couture, B.; Goldstein, J.

1981-01-01

Case of different sizes and shapes for teaching technical writing to engineers at Wayne State University have been developed. The case approach was adopted for some assignments because sophomores and juniors lacked technical expertise and professional knowledge of the engineering world. Cases were found to be good exercises, providing realistic practice in specific writing tasks or isolating particular skills in the composing process. A special kind of case which narrates the experiences of one technical person engaged in the problem-solving process in a professional rhetorical situation was developed. This type of long, realistic fiction is called a an "holistic" case. Rather than asking students to role-play a character, an holistic case realistically encompasses the whole of the technical writing process. It allows students to experience the total communication act in which the technical task and data are fully integrated into the rhetorical situation and gives an opportunity to perform in a realistic context, using skills and knowledge required in communication on the job. It is believed that the holistic case most fully exploits the advantages of the case method for students of professional communication.

SPARQL Assist language-neutral query composer

PubMed Central

2012-01-01

Background SPARQL query composition is difficult for the lay-person, and even the experienced bioinformatician in cases where the data model is unfamiliar. Moreover, established best-practices and internationalization concerns dictate that the identifiers for ontological terms should be opaque rather than human-readable, which further complicates the task of synthesizing queries manually. Results We present SPARQL Assist: a Web application that addresses these issues by providing context-sensitive type-ahead completion during SPARQL query construction. Ontological terms are suggested using their multi-lingual labels and descriptions, leveraging existing support for internationalization and language-neutrality. Moreover, the system utilizes the semantics embedded in ontologies, and within the query itself, to help prioritize the most likely suggestions. Conclusions To ensure success, the Semantic Web must be easily available to all users, regardless of locale, training, or preferred language. By enhancing support for internationalization, and moreover by simplifying the manual construction of SPARQL queries through the use of controlled-natural-language interfaces, we believe we have made some early steps towards simplifying access to Semantic Web resources. PMID:22373327

SPARQL assist language-neutral query composer.

PubMed

McCarthy, Luke; Vandervalk, Ben; Wilkinson, Mark

2012-01-25

SPARQL query composition is difficult for the lay-person, and even the experienced bioinformatician in cases where the data model is unfamiliar. Moreover, established best-practices and internationalization concerns dictate that the identifiers for ontological terms should be opaque rather than human-readable, which further complicates the task of synthesizing queries manually. We present SPARQL Assist: a Web application that addresses these issues by providing context-sensitive type-ahead completion during SPARQL query construction. Ontological terms are suggested using their multi-lingual labels and descriptions, leveraging existing support for internationalization and language-neutrality. Moreover, the system utilizes the semantics embedded in ontologies, and within the query itself, to help prioritize the most likely suggestions. To ensure success, the Semantic Web must be easily available to all users, regardless of locale, training, or preferred language. By enhancing support for internationalization, and moreover by simplifying the manual construction of SPARQL queries through the use of controlled-natural-language interfaces, we believe we have made some early steps towards simplifying access to Semantic Web resources.

Management of opioid painkiller dependence in primary care: ongoing recovery with buprenorphine/naloxone

PubMed Central

Hard, Bernadette

2014-01-01

Opioid painkiller dependence is a growing problem and best-practice management is not well defined. We report a case of a young woman exhibiting dependence on codeine, originally prescribed for myalgic encephalopathy, after escalating use over a 10-year period. In 2012, a consultation with a new general practitioner, who had extensive experience of patients with substance abuse, revealed the underlying dependence. After building trust for 6 months, she was able to admit to medication abuse, and was referred to the community drug and alcohol team. On presentation to the team, the patient had no pain issues and the dihydrocodeine use—600 tablets/week—solely reflected her dependence. The patient successfully underwent rapid induction with buprenorphine/naloxone as opioid substitution treatment over 2 days. She is currently stable, engaged with recovery support services and psychosocial counselling, and has just returned to work. She is maintained on a therapeutic dose of buprenorphine 10 mg/naloxone 2.5 mg. PMID:25432908

False confessions, expert testimony, and admissibility.

PubMed

Watson, Clarence; Weiss, Kenneth J; Pouncey, Claire

2010-01-01

The confession of a criminal defendant serves as a prosecutor's most compelling piece of evidence during trial. Courts must preserve a defendant's constitutional right to a fair trial while upholding the judicial interests of presenting competent and reliable evidence to the jury. When a defendant seeks to challenge the validity of that confession through expert testimony, the prosecution often contests the admissibility of the expert's opinion. Depending on the content and methodology of the expert's opinion, testimony addressing the phenomenon of false confessions may or may not be admissible. This article outlines the scientific and epistemological bases of expert testimony on false confession, notes the obstacles facing its admissibility, and provides guidance to the expert in formulating opinions that will reach the judge or jury. We review the 2006 New Jersey Superior Court decision in State of New Jersey v. George King to illustrate what is involved in the admissibility of false-confession testimony and use the case as a starting point in developing a best-practice approach to working in this area.

Management and Prevalence of Long-Term Conditions in Primary Health Care for Adults with Intellectual Disabilities Compared with the General Population: A Population-Based Cohort Study

ERIC Educational Resources Information Center

Cooper, Sally-Ann; Hughes-McCormack, Laura; Greenlaw, Nicola; McConnachie, Alex; Allan, Linda; Baltzer, Marion; McArthur, Laura; Henderson, Angela; Melville, Craig; McSkimming, Paula; Morrison, Jill

2018-01-01

Background: In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators. Method: Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term…

Current Capabilities, Issues, and Trends in LMSs and Authoring Tools

DTIC Science & Technology

2009-08-18

architecture  Embedded best-practice design principles  Support for immersive learning technologies  Support for social media 8 LMSs LMS Functionality is... Learning System Multimedia content Application demos VOIP Real-time Collaboration technologies from Adobe Connect Pro, WebEx, LiveMeeting, & Centra...ORGANIZATION NAME(S) AND ADDRESS(ES) Advanced Decision Learning (ADL),ADL Co-Lab,1901 N. Beauregard Street Suite 600,Alexandria,VA,22311 8

Tobacco retail regulation: the next frontier in tobacco control?

PubMed

Smyth, Colleen; Freeman, Becky; Maag, Audrey

2015-07-09

Australia has experienced significant reductions in smoking rates in recent decades, and public health scrutiny is turning to how further gains will be made. Regulatory controls, such as licensing to reduce retailer density or limit tobacco proximity to schools or licensed premises, have been suggested by some public health advocates as appropriate next steps. This paper summarises best-practice evidence in relation to tobacco retailer regulation, noting measures undertaken in New South Wales (NSW). Research on controlling the display of tobacco products and supply of tobacco to minors is well established. The evidence shows that a combination of licensing, enforcement, education, promotion restrictions at the point of sale and a well-funded compliance program to prevent sales to minors is a best-practice approach to tobacco retail regulation. The evidence for other measures - such as restricting the number of retail outlets, and restricting how and where tobacco is sold - is far less developed. There is insufficient evidence to determine if a positive licensing system and controls on the density and location of tobacco outlets would be effective in the Australian context. More evidence is required from jurisdictions that have implemented a positive licensing scheme to evaluate the effect of such schemes on smoking rates, the potential cost benefits and any unintended consequences.

Do failures in non-technical skills contribute to fatal medical accidents in Japan? A review of the 2010–2013 national accident reports

PubMed Central

Uramatsu, Masashi; Fujisawa, Yoshikazu; Mizuno, Shinya; Souma, Takahiro; Komatsubara, Akinori; Miki, Tamotsu

2017-01-01

Objectives We sought to clarify how large a proportion of fatal medical accidents can be considered to be caused by poor non-technical skills, and to support development of a policy to reduce number of such accidents by making recommendations about possible training requirements. Design Summaries of reports of fatal medical accidents, published by the Japan Medical Safety Research Organization, were reviewed individually. Three experienced clinicians and one patient safety expert conducted the reviews to determine the cause of death. Views of the patient safety expert were given additional weight in the overall determination. Setting A total of 73 summary reports of fatal medical accidents were reviewed. These reports had been submitted by healthcare organisations across Japan to the Japan Medical Safety Research Organization between April 2010 and March 2013. Primary and secondary outcome measures The cause of death in fatal medical accidents, categorised into technical skills, non-technical skills and inevitable progress of disease were evaluated. Non-technical skills were further subdivided into situation awareness, decision making, communication, team working, leadership, managing stress and coping with fatigue. Results Overall, the cause of death was identified as non-technical skills in 34 cases (46.6%), disease progression in 33 cases (45.2%) and technical skills in two cases (5.5%). In two cases, no consensual determination could be achieved. Further categorisation of cases of non-technical skills were identified as 14 cases (41.2%) of problems with situation awareness, eight (23.5%) with team working and three (8.8%) with decision making. These three subcategories, or combinations of them, were identified as the cause of death in 33 cases (97.1%). Conclusions Poor non-technical skills were considered to be a significant cause of adverse events in nearly half of the fatal medical accidents examined. Improving non-technical skills may be effective for reducing accidents, and training in particular subcategories of non-technical skills may be especially relevant. PMID:28209605

360 Degree Feedback Best Practices and the Army’s MSAF Program

DTIC Science & Technology

2011-04-04

assessments/360bestpractices.pdf (accessed March 22, 2011). 16 Walter W . Tornow , Manuel London, and CCL Associates, Maximizing the Value of 360- Degree...degree Appraisal Feedback Process,‖ Organizational Dynamics 25, (Autumn 1996): 3, in ProQuest (accessed February 3, 2011). 31 Tornow , London, and CCL...Associates, Maximizing the Value of 360-Degree Feedback, 152. 32 Wimer, ―The Dark Side of 360-Degree Feedback,‖ 42. 33 Ibid. 34 Tornow

A Case Study of Technical Assistance to Demonstration Programs for Young Handicapped Children. Part I.

ERIC Educational Resources Information Center

Behr, Shirley K.; And Others

The interim report presents an evaluation of TADS (Technical Assistance Development System) through case studies of TADS technical assistance to the staffs of two demonstration programs for preschool handicapped children and their families. Purposes of the study included obtaining indepth descriptions of the technical assistance process to…

A Case Study on the Status of Technical and Vocational Education in Thailand. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Shoolap, Charoon; Choomnoom, Siripan

This two-part report presents an overview of the vocational and technical education system in Thailand. The first part is a review of the current and likely future situations pertaining to vocational and technical education in that country. An analysis of economic conditions, human resource development, and the existing technical and vocational…

Urinary Tract Infections: Leading Initiatives in Selecting Empiric Outpatient Treatment (UTILISE)

PubMed Central

Landry, Eric; Sulz, Linda; Bell, Ali; Rathgeber, Lane; Balogh, Heather

2014-01-01

Background Overuse of fluoroquinolone antibiotics is associated with outbreaks of methicillin-resistant Staphylococcus aureus and of Clostridium difficile–associated diarrhea and increasing resistance in gram-negative organisms. Over the past decade, resistance of Escherichia coli to ciprofloxacin has increased in the Regina Qu’Appelle Health Region. In August 2011, an exploratory audit of the Regina General Hospital (RGH) emergency department showed that 20% of new antibiotic orders were for fluoroquinolones, and 60% of these new fluoroquinolone orders were for ciprofloxacin. It was postulated that ciprofloxacin was predominantly prescribed for outpatients with urinary tract infection. Objective: To develop, implement, and evaluate a best-practice algorithm for the empiric treatment of uncomplicated urinary tract infection in the RGH emergency department, as part of an educational initiative for emergency physicians. Methods: A literature review was conducted and local antibiogram data were analyzed to establish a best-practice algorithm for treatment of uncomplicated urinary tract infection in outpatients seen in the emergency department. A chart review was conducted from January to March 2011 to establish a baseline of empiric antibiotic use. An educational strategy targeting emergency physicians described changes in antibiotic resistance patterns in the health region, principles of antimicrobial stewardship, drivers of resistance, and the results of a literature review of best practice for urinary tract infection in outpatients. A post-intervention audit was conducted from January to March 2012 to determine changes in practice. Results: Comparison of results from the post-intervention audit with baseline data showed that adherence to best practice increased significantly, from 41% (39/96) before the intervention to 66% (50/76) after the intervention (odds ratio [OR] 2.81, 95% confidence interval [CI] 1.51–5.25; p < 0.001). There was also a significant change in overall antibiotic selection (OR 0.25, 95% CI 0.11–0.58; p < 0.001). Further analysis suggested that this significant change was driven by a decrease in use of ciprofloxacin, from 32% (31/96) to 11% (8/76). Conclusion: Creation of a best-practice algorithm and education focused on emergency physicians significantly increased adherence to best practice and optimized antibiotic prescribing for outpatients with uncomplicated urinary tract infection by limiting overuse of fluoroquinolones, primarily ciprofloxacin. PMID:24799721

Field Test of Advanced Duct-Sealing Technologies Within the Weatherization Assistance Program

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

Ternes, MP

A field test of an aerosol-spray duct-sealing technology and a conventional, best-practice approach was performed in 80 homes to determine the efficacy and programmatic needs of the duct-sealing technologies as applied in the U.S. Department of Energy Weatherization Assistance Program. The field test was performed in five states: Iowa, Virginia, Washington, West Virginia, and Wyoming. The study found that, compared with the best-practice approach, the aerosol-spray technology is 50% more effective at sealing duct leaks and can potentially reduce labor time and costs for duct sealing by 70%, or almost 4 crew-hours. Further study to encourage and promote use ofmore » the aerosol-spray technology within the Weatherization Assistance Program is recommended. A pilot test of full production weatherization programs using the aerosol-spray technology is recommended to develop approaches for integrating this technology with other energy conservation measures and minimizing impacts on weatherization agency logistics. In order to allow or improve adoption of the aerosol spray technology within the Weatherization Assistance Program, issues must be addressed concerning equipment costs, use of the technology under franchise arrangements with Aeroseal, Inc. (the holders of an exclusive license to use this technology), software used to control the equipment, safety, and training. Application testing of the aerosol-spray technology in mobile homes is also recommended.« less

Calibration of optimal use parameters for an ultraviolet light-emitting diode in eliminating bacterial contamination on needleless connectors.

PubMed

Hutchens, M P; Drennan, S L; Cambronne, E D

2015-06-01

Needleless connectors may develop bacterial contamination and cause central-line-associated bloodstream infections (CLABSI) despite rigorous application of best-practice. Ultraviolet (UV) light-emitting diodes (LED) are an emerging, increasingly affordable disinfection technology. We tested the hypothesis that a low-power UV LED could reliably eliminate bacteria on needleless central-line ports in a laboratory model of central-line contamination. Needleless central-line connectors were inoculated with Staphylococcus aureus. A 285 nm UV LED was used in calibrated fashion to expose contaminated connectors. Ports were directly applied to agar plates and flushed with sterile saline, allowing assessment of bacterial survival on the port surface and in simulated usage flow-through fluid. UV applied to needleless central-line connectors was highly lethal at 0·5 cm distance at all tested exposure times. At distances >1·5 cm both simulated flow-through and port surface cultures demonstrated significant bacterial growth following UV exposure. Logarithmic-phase S. aureus subcultures were highly susceptible to UV induction/maintenance dosing. Low-power UV LED doses at fixed time and distance from needleless central-line connector ports reduced cultivable S. aureus from >10(6) CFU to below detectable levels in this laboratory simulation of central-line port contamination. Low-power UV LEDs may represent a feasible alternative to current best-practice in connector decontamination. © 2015 The Society for Applied Microbiology.

Do failures in non-technical skills contribute to fatal medical accidents in Japan? A review of the 2010-2013 national accident reports.

PubMed

Uramatsu, Masashi; Fujisawa, Yoshikazu; Mizuno, Shinya; Souma, Takahiro; Komatsubara, Akinori; Miki, Tamotsu

2017-02-16

We sought to clarify how large a proportion of fatal medical accidents can be considered to be caused by poor non-technical skills, and to support development of a policy to reduce number of such accidents by making recommendations about possible training requirements. Summaries of reports of fatal medical accidents, published by the Japan Medical Safety Research Organization, were reviewed individually. Three experienced clinicians and one patient safety expert conducted the reviews to determine the cause of death. Views of the patient safety expert were given additional weight in the overall determination. A total of 73 summary reports of fatal medical accidents were reviewed. These reports had been submitted by healthcare organisations across Japan to the Japan Medical Safety Research Organization between April 2010 and March 2013. The cause of death in fatal medical accidents, categorised into technical skills, non-technical skills and inevitable progress of disease were evaluated. Non-technical skills were further subdivided into situation awareness, decision making, communication, team working, leadership, managing stress and coping with fatigue. Overall, the cause of death was identified as non-technical skills in 34 cases (46.6%), disease progression in 33 cases (45.2%) and technical skills in two cases (5.5%). In two cases, no consensual determination could be achieved. Further categorisation of cases of non-technical skills were identified as 14 cases (41.2%) of problems with situation awareness, eight (23.5%) with team working and three (8.8%) with decision making. These three subcategories, or combinations of them, were identified as the cause of death in 33 cases (97.1%). Poor non-technical skills were considered to be a significant cause of adverse events in nearly half of the fatal medical accidents examined. Improving non-technical skills may be effective for reducing accidents, and training in particular subcategories of non-technical skills may be especially relevant. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

26 CFR 601.106 - Appeals functions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... obtain Appeals consideration in (1) all office interview or correspondence examination cases or (2) a... technical advice on any technical or procedural question that develops during the processing and... on any technical or procedural question arising in connection with a case described in subdivision (i...

Full long-term design response analysis of a wave energy converter

DOE PAGES

Coe, Ryan G.; Michelen, Carlos; Eckert-Gallup, Aubrey; ...

2017-09-21

Efficient design of wave energy converters requires an accurate understanding of expected loads and responses during the deployment lifetime of a device. A study has been conducted to better understand best-practices for prediction of design responses in a wave energy converter. A case-study was performed in which a simplified wave energy converter was analyzed to predict several important device design responses. The application and performance of a full long-term analysis, in which numerical simulations were used to predict the device response for a large number of distinct sea states, was studied. Environmental characterization and selection of sea states for thismore » analysis at the intended deployment site were performed using principle-components analysis. The full long-term analysis applied here was shown to be stable when implemented with a relatively low number of sea states and convergent with an increasing number of sea states. As the number of sea states utilized in the analysis was increased, predicted response levels did not change appreciably. Furthermore, uncertainty in the response levels was reduced as more sea states were utilized.« less

Failure to identify or effectively manage prescription opioid dependence acted as a gateway to heroin use-buprenorphine/naloxone treatment and recovery in a surgical patient.

PubMed

Conroy, Stephen; Hill, Duncan

2014-12-17

The prescribing of opioid pain medication has increased markedly in recent years, with strong opioid dispensing increasing 18-fold in Tayside, Scotland since 1995. Despite this, little data is available to quantify the problem of opioid pain medication dependence (OPD) and until recently there was little guidance on best-practice treatment. We report the case of a young mother prescribed dihydrocodeine for postoperative pain relief who became opioid dependent. When her prescription was stopped without support, she briefly used heroin to overcome her withdrawal. After re-exposure to dihydrocodeine following surgery 9 years later and treatment with methadone for dependency, she was transferred to buprenorphine/naloxone. In our clinical experience and in agreement with Department of Health and Royal College of General Practitioner guidance, buprenorphine/naloxone is the preferred opioid substitution treatment for OPD. Our patient remains within her treatment programme and has returned to work on buprenorphine 16 mg/naloxone 4 mg in conjunction with social and psychological support. 2014 BMJ Publishing Group Ltd.

Principles and Practices Fostering Inclusive Excellence: Lessons from the Howard Hughes Medical Institute’s Capstone Institutions

PubMed Central

DiBartolo, Patricia Marten; Gregg-Jolly, Leslie; Gross, Deborah; Manduca, Cathryn A.; Iverson, Ellen; Cooke, David B.; Davis, Gregory K.; Davidson, Cameron; Hertz, Paul E.; Hibbard, Lisa; Ireland, Shubha K.; Mader, Catherine; Pai, Aditi; Raps, Shirley; Siwicki, Kathleen; Swartz, Jim E.

2016-01-01

Best-practices pedagogy in science, technology, engineering, and mathematics (STEM) aims for inclusive excellence that fosters student persistence. This paper describes principles of inclusivity across 11 primarily undergraduate institutions designated as Capstone Awardees in Howard Hughes Medical Institute’s (HHMI) 2012 competition. The Capstones represent a range of institutional missions, student profiles, and geographical locations. Each successfully directed activities toward persistence of STEM students, especially those from traditionally underrepresented groups, through a set of common elements: mentoring programs to build community; research experiences to strengthen scientific skill/identity; attention to quantitative skills; and outreach/bridge programs to broaden the student pool. This paper grounds these program elements in learning theory, emphasizing their essential principles with examples of how they were implemented within institutional contexts. We also describe common assessment approaches that in many cases informed programming and created traction for stakeholder buy-in. The lessons learned from our shared experiences in pursuit of inclusive excellence, including the resources housed on our companion website, can inform others’ efforts to increase access to and persistence in STEM in higher education. PMID:27562960

Full long-term design response analysis of a wave energy converter

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

Coe, Ryan G.; Michelen, Carlos; Eckert-Gallup, Aubrey

Efficient design of wave energy converters requires an accurate understanding of expected loads and responses during the deployment lifetime of a device. A study has been conducted to better understand best-practices for prediction of design responses in a wave energy converter. A case-study was performed in which a simplified wave energy converter was analyzed to predict several important device design responses. The application and performance of a full long-term analysis, in which numerical simulations were used to predict the device response for a large number of distinct sea states, was studied. Environmental characterization and selection of sea states for thismore » analysis at the intended deployment site were performed using principle-components analysis. The full long-term analysis applied here was shown to be stable when implemented with a relatively low number of sea states and convergent with an increasing number of sea states. As the number of sea states utilized in the analysis was increased, predicted response levels did not change appreciably. Furthermore, uncertainty in the response levels was reduced as more sea states were utilized.« less

Best-practices approach to determination of blood alcohol concentration (BAC) at specific time points: Combination of ante-mortem alcohol pharmacokinetic modeling and post-mortem alcohol generation and transport considerations.

PubMed

Cowan, Dallas M; Maskrey, Joshua R; Fung, Ernest S; Woods, Tyler A; Stabryla, Lisa M; Scott, Paul K; Finley, Brent L

2016-07-01

Alcohol concentrations in biological matrices offer information regarding an individual's intoxication level at a given time. In forensic cases, the alcohol concentration in the blood (BAC) at the time of death is sometimes used interchangeably with the BAC measured post-mortem, without consideration for alcohol concentration changes in the body after death. However, post-mortem factors must be taken into account for accurate forensic determination of BAC prior to death to avoid incorrect conclusions. The main objective of this work was to describe best practices for relating ante-mortem and post-mortem alcohol concentrations, using a combination of modeling, empirical data and other qualitative considerations. The Widmark modeling approach is a best practices method for superimposing multiple alcohol doses ingested at various times with alcohol elimination rate adjustments based on individual body factors. We combined the selected ante-mortem model with a suggestion for an approach used to roughly estimate changes in BAC post-mortem, and then analyzed the available data on post-mortem alcohol production in human bodies and potential markers for alcohol production through decomposition and putrefaction. Hypothetical cases provide best practice approaches as an example for determining alcohol concentration in biological matrices ante-mortem, as well as potential issues encountered with quantitative post-mortem approaches. This study provides information for standardizing BAC determination in forensic toxicology, while minimizing real world case uncertainties. Copyright © 2016 Elsevier Inc. All rights reserved.

Choosing a Cluster Sampling Design for Lot Quality Assurance Sampling Surveys

PubMed Central

Hund, Lauren; Bedrick, Edward J.; Pagano, Marcello

2015-01-01

Lot quality assurance sampling (LQAS) surveys are commonly used for monitoring and evaluation in resource-limited settings. Recently several methods have been proposed to combine LQAS with cluster sampling for more timely and cost-effective data collection. For some of these methods, the standard binomial model can be used for constructing decision rules as the clustering can be ignored. For other designs, considered here, clustering is accommodated in the design phase. In this paper, we compare these latter cluster LQAS methodologies and provide recommendations for choosing a cluster LQAS design. We compare technical differences in the three methods and determine situations in which the choice of method results in a substantively different design. We consider two different aspects of the methods: the distributional assumptions and the clustering parameterization. Further, we provide software tools for implementing each method and clarify misconceptions about these designs in the literature. We illustrate the differences in these methods using vaccination and nutrition cluster LQAS surveys as example designs. The cluster methods are not sensitive to the distributional assumptions but can result in substantially different designs (sample sizes) depending on the clustering parameterization. However, none of the clustering parameterizations used in the existing methods appears to be consistent with the observed data, and, consequently, choice between the cluster LQAS methods is not straightforward. Further research should attempt to characterize clustering patterns in specific applications and provide suggestions for best-practice cluster LQAS designs on a setting-specific basis. PMID:26125967

A practical guide to the application of the IUCN Red List of Ecosystems criteria.

PubMed

Rodríguez, Jon Paul; Keith, David A; Rodríguez-Clark, Kathryn M; Murray, Nicholas J; Nicholson, Emily; Regan, Tracey J; Miller, Rebecca M; Barrow, Edmund G; Bland, Lucie M; Boe, Kaia; Brooks, Thomas M; Oliveira-Miranda, María A; Spalding, Mark; Wit, Piet

2015-02-19

The newly developed IUCN Red List of Ecosystems is part of a growing toolbox for assessing risks to biodiversity, which addresses ecosystems and their functioning. The Red List of Ecosystems standard allows systematic assessment of all freshwater, marine, terrestrial and subterranean ecosystem types in terms of their global risk of collapse. In addition, the Red List of Ecosystems categories and criteria provide a technical base for assessments of ecosystem status at the regional, national, or subnational level. While the Red List of Ecosystems criteria were designed to be widely applicable by scientists and practitioners, guidelines are needed to ensure they are implemented in a standardized manner to reduce epistemic uncertainties and allow robust comparisons among ecosystems and over time. We review the intended application of the Red List of Ecosystems assessment process, summarize 'best-practice' methods for ecosystem assessments and outline approaches to ensure operational rigour of assessments. The Red List of Ecosystems will inform priority setting for ecosystem types worldwide, and strengthen capacity to report on progress towards the Aichi Targets of the Convention on Biological Diversity. When integrated with other IUCN knowledge products, such as the World Database of Protected Areas/Protected Planet, Key Biodiversity Areas and the IUCN Red List of Threatened Species, the Red List of Ecosystems will contribute to providing the most complete global measure of the status of biodiversity yet achieved. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Virtual seminars

NASA Astrophysics Data System (ADS)

Nelson, H. Roice

1997-06-01

A virtual seminar (SM) is an economic and effective instructional tool for teaching students who are at a distance from their instructor. Like conventional class room teaching, a virtual seminar requires an instructor, a student, and a method of communication. Teleconferencing, video conferencing, intranets and the Internet give learners in a Virtual Seminar the ability to interact immediately with their mentors and receive real and relevant answers. This paper shows how industry and academia can benefit from using methods developed and experience gained in presenting the first virtual seminars to academic and petroleum industry participants in mid-1996. The information explosion in industry means that business or technical information is worthless until it is assimilated into a corporate knowledge management system. A search for specific information often turns into a filtering exercise or an attempt to find patterns and classify retrieved material. In the setting of an interactive corporate information system, virtual seminars meet the need for a productive new relationship between creative people and the flux of corporate knowledge. Experience shows that it is more efficient to circulate timesensitive and confidential information electronically through a virtual seminar. Automating the classification of information and removing that task from the usual work load creates an electronic corporate memory and enhances the value of the knowledge to both users and a corporation. Catalogued benchmarks, best-practice standards, and Knowledge Maps (SM) of experience serve as key aids to communicating knowledge through virtual seminars and converting that knowledge into a profit-making asset.

Choosing a Cluster Sampling Design for Lot Quality Assurance Sampling Surveys.

PubMed

Hund, Lauren; Bedrick, Edward J; Pagano, Marcello

2015-01-01

Lot quality assurance sampling (LQAS) surveys are commonly used for monitoring and evaluation in resource-limited settings. Recently several methods have been proposed to combine LQAS with cluster sampling for more timely and cost-effective data collection. For some of these methods, the standard binomial model can be used for constructing decision rules as the clustering can be ignored. For other designs, considered here, clustering is accommodated in the design phase. In this paper, we compare these latter cluster LQAS methodologies and provide recommendations for choosing a cluster LQAS design. We compare technical differences in the three methods and determine situations in which the choice of method results in a substantively different design. We consider two different aspects of the methods: the distributional assumptions and the clustering parameterization. Further, we provide software tools for implementing each method and clarify misconceptions about these designs in the literature. We illustrate the differences in these methods using vaccination and nutrition cluster LQAS surveys as example designs. The cluster methods are not sensitive to the distributional assumptions but can result in substantially different designs (sample sizes) depending on the clustering parameterization. However, none of the clustering parameterizations used in the existing methods appears to be consistent with the observed data, and, consequently, choice between the cluster LQAS methods is not straightforward. Further research should attempt to characterize clustering patterns in specific applications and provide suggestions for best-practice cluster LQAS designs on a setting-specific basis.

Use of Research Interfaces for Psychophysical Studies With Cochlear-Implant Users

PubMed Central

Goupell, Matthew J.; Kan, Alan; Landsberger, David M.

2017-01-01

A growing number of laboratories are using research interfaces to conduct experiments with cochlear-implant (CI) users. Because these interfaces bypass a subject’s clinical sound processor, several concerns exist regarding safety and stimulation levels. Here we suggest best-practice approaches for how to safely and ethically perform this type of research and highlight areas of limited knowledge where further research is needed to help clarify safety limits. The article is designed to provide an introductory level of technical detail about the devices and the effects of electrical stimulation on perception and neurophysiology. From this, we summarize what should be the best practices in the field, based on the literature and our experience. Findings from the review of the literature suggest that there are three main safety concerns: (a) to prevent biological or neural damage, (b) to avoid presentation of uncomfortably loud sounds, and (c) to ensure that subjects have control over stimulus presentation. Researchers must pay close attention to the software–hardware interface to ensure that the three main safety concerns are closely monitored. An important area for future research will be the determination of the amount of biological damage that can occur from electrical stimulation from a CI placed in the cochlea, not in direct contact with neural tissue. As technology used in research with CIs evolve, some of these approaches may change. However, the three main safety principles outlined here are not anticipated to undergo change with technological advances. PMID:29113579

Physician assistants and the disclosure of medical error.

PubMed

Brock, Douglas M; Quella, Alicia; Lipira, Lauren; Lu, Dave W; Gallagher, Thomas H

2014-06-01

Evolving state law, professional societies, and national guidelines, including those of the American Medical Association and Joint Commission, recommend that patients receive transparent communication when a medical error occurs. Recommendations for error disclosure typically consist of an explanation that an error has occurred, delivery of an explicit apology, an explanation of the facts around the event, its medical ramifications and how care will be managed, and a description of how similar errors will be prevented in the future. Although error disclosure is widely endorsed in the medical and nursing literature, there is little discussion of the unique role that the physician assistant (PA) might play in these interactions. PAs are trained in the medical model and technically practice under the supervision of a physician. They are also commonly integrated into interprofessional health care teams in surgical and urgent care settings. PA practice is characterized by widely varying degrees of provider autonomy. How PAs should collaborate with physicians in sensitive error disclosure conversations with patients is unclear. With the number of practicing PAs growing rapidly in nearly all domains of medicine, their role in the error disclosure process warrants exploration. The authors call for educational societies and accrediting agencies to support policy to establish guidelines for PA disclosure of error. They encourage medical and PA researchers to explore and report best-practice disclosure roles for PAs. Finally, they recommend that PA educational programs implement trainings in disclosure skills, and hospitals and supervising physicians provide and support training for practicing PAs.

Transportation planning effectiveness: twenty case studies

DOT National Transportation Integrated Search

1977-12-31

This document consists of 20 site-specific case studies of urban area experience with the Technical Study Grant Program of the Urban Mass Transportation Administration (UMTA). The objective of the case studies is to determine how the Technical Study ...

Sustaining the US Air Force’s Force Support Career Field through Officer Workforce Planning

DTIC Science & Technology

2012-07-01

1983, cited in Barney, 1991, p. 101. 33 Afiouni, 2007, p. 125. 34 Barney, 1991; Collis & Montgomery, 1995, cited in Elliot ,p. 48. 35 Kaplan & Norton... Elliot , Hamish G.H., “SHRM Best-Practices & Sustainable Competitive Advantage: A Resource-Based View,” The Graduate Management Review, pp. 43-57...and Social Sciences, 2007. Hudson, W., Intellectual Capital: How to Build It, Enhance It, Use It, New York: John Wiley, 1993. Kaplan , R.S

Imaging of the small intestine in Crohn's disease: Joint position statement of the Indian Society of Gastroenterology and Indian Radiological and Imaging Association.

PubMed

Kedia, Saurabh; Sharma, Raju; Makharia, Govind K; Ahuja, Vineet; Desai, Devendra; Kandasamy, Devasenathipathy; Eapen, Anu; Ganesan, Karthik; Ghoshal, Uday C; Kalra, Naveen; Karthikeyan, D; Madhusudhan, Kumble Seetharama; Philip, Mathew; Puri, Amarender Singh; Puri, Sunil; Sinha, Saroj K; Banerjee, Rupa; Bhatia, Shobna; Bhat, Naresh; Dadhich, Sunil; Dhali, G K; Goswami, B D; Issar, S K; Jayanthi, V; Misra, S P; Nijhawan, Sandeep; Puri, Pankaj; Sarkar, Avik; Singh, S P; Srivastava, Anshu; Abraham, Philip; Ramakrishna, B S

2017-11-01

The Indian Society of Gastroenterology (ISG) Task Force on Inflammatory Bowel Disease and the Indian Radiological and Imaging Association (IRIA) developed combined ISG-IRIA evidence-based best-practice guidelines for imaging of the small intestine in patients with suspected or known Crohn's disease. These 29 position statements, developed through a modified Delphi process, are intended to serve as reference for teaching, clinical practice, and research.

Results from the first 4 years of pay for performance.

PubMed

DeVore, Susan D

2010-01-01

Some of the lessons hospitals that have participated in the Hospital Quality Incentive Demonstration project have learned include: the need to tie in quality-of-care initiatives to the organization's strategic plan and to incentive plans for all employees, from executives on down; the value in allowing hospital physicians to "own" quality improvement initiatives; the importance of making results of the initiative available to all staff; the benefit of creating best-practice teams to address improvements in specific clinical areas.

Technical Documentation and Legal Liability.

ERIC Educational Resources Information Center

Caher, John M.

1995-01-01

States that litigation over the interpretation and sufficiency of technical documentation is increasingly common as a number of suits have been filed in state and federal courts. Describes the case of "Martin versus Hacker," a recent case in which New York's highest court analyzed a technical writer's prose in the context of a lawsuit…

Argument-Based Airworthiness Assurance of Small UAS

NASA Technical Reports Server (NTRS)

Denney, Ewen; Pai, Ganesh

2015-01-01

Presently, there are three avenues by which Unmanned Aircraft System (UAS) operations are authorized in the U.S. National Airspace System (NAS): obtaining either (i) a certificate of authorization (COA), or (ii) a special airworthiness certificate (SAC) in either the experimental, or the restricted category, or (iii) an exemption from an airworthiness certificate together with a civil COA. The first is meant primarily for public entities, such as NASA; the remaining two are the only available means for civil UAS operations. Recently, the Federal Aviation Administration (FAA) has also proposed a regulatory framework targeted for certain small UAS, specifically those weighing 55 pounds or less, although final rulemaking remains pending. We have previously shown how an assurance case can aggregate heterogeneous reasoning and safety evidence, with application to UAS safety. In this paper, we describe how assurance cases can serve as a common framework to justify overall system safety, unifying both operational aspects and airworthiness, in particular system design assurance. We also show how this approach can coexist with, and augment, existing safety analysis processes and best-practices, by transforming the artifacts they produce into structured assurance arguments. To illustrate the applicability and utility of our approach, we have been applying it for the design assurance of an unmanned rotorcraft system, intended for precision agriculture operations, as part of the NASA Unmanned Aircraft System (UAS) Integration in the National Airspace System (NAS) project.

Why Did You Stay?: A Case Study of Male Student Persistence in Technical College

ERIC Educational Resources Information Center

Froehlich-Mueller, Kerry

2017-01-01

The purpose of this qualitative case study was to explore male student persistence at Central Technical College (CTC), a small public, two-year technical college in Wisconsin. Across the United States, there had been a surge in college enrollments during the recent recession. Interestingly, college enrollment and persistence of females has grown…

Advanced Risk Reduction Tool (ARRT) Special Case Study Report: Science and Engineering Technical Assessments (SETA) Program

NASA Technical Reports Server (NTRS)

Kirsch, Paul J.; Hayes, Jane; Zelinski, Lillian

2000-01-01

This special case study report presents the Science and Engineering Technical Assessments (SETA) team's findings for exploring the correlation between the underlying models of Advanced Risk Reduction Tool (ARRT) relative to how it identifies, estimates, and integrates Independent Verification & Validation (IV&V) activities. The special case study was conducted under the provisions of SETA Contract Task Order (CTO) 15 and the approved technical approach documented in the CTO-15 Modification #1 Task Project Plan.

Evaluating the effectiveness of case method instruction in technical communication

NASA Technical Reports Server (NTRS)

Feinberg, S. G.

1981-01-01

The effectiveness of the case method as an instructional technique in improving technical writing was evaluated. The development of a self-report instrument that attempts to measure changes in attitude toward technical communication and the presentation results change are the purpose of this paper. Standards for developing a case set forth by Goldstein and Couture, were used to design an evaluation instrument to measure the effect instruction on student attitude toward technical communication. This self-report instrument is based on model developed and tested by Daly and Miller who studied writer attitude and apprehension toward writing. It was the most important objective of any evaluation is to provide information for improving the program.

Screening and prevention of venous thromboembolism in critically ill patients: a decision analysis and economic evaluation.

PubMed

Sud, Sachin; Mittmann, Nicole; Cook, Deborah J; Geerts, William; Chan, Brian; Dodek, Peter; Gould, Michael K; Guyatt, Gordon; Arabi, Yaseen; Fowler, Robert A

2011-12-01

Venous thromboembolism is difficult to diagnose in critically ill patients and may increase morbidity and mortality. To evaluate the cost-effectiveness of strategies to reduce morbidity from venous thromboembolism in critically ill patients. A Markov decision analytic model to compare weekly compression ultrasound screening (screening) plus investigation for clinically suspected deep vein thrombosis (DVT) (case finding) versus case finding alone; and a hypothetical program to increase adherence to DVT prevention. Probabilities were derived from a systematic review of venous thromboembolism in medical-surgical intensive care unit patients. Costs (in 2010 $US) were obtained from hospitals in Canada, Australia, and the United States, and the medical literature. Analyses were conducted from a societal perspective over a lifetime horizon. Outcomes included costs, quality-adjusted life-years (QALY), and incremental cost-effectiveness ratios. In the base case, the rate of proximal DVT was 85 per 1,000 patients. Screening resulted in three fewer pulmonary emboli than case-finding alone but also two additional bleeding episodes, and cost $223,801 per QALY gained. In sensitivity analyses, screening cost less than $50,000 per QALY only if the probability of proximal DVT increased from a baseline of 8.5-16%. By comparison, increasing adherence to appropriate pharmacologic thromboprophylaxis by 10% resulted in 16 fewer DVTs, one fewer pulmonary emboli, and one additional heparin-induced thrombocytopenia and bleeding event, and cost $27,953 per QALY gained. Programs achieving increased adherence to best-practice venous thromboembolism prevention were cost-effective over a wide range of program costs and were robust in probabilistic sensitivity analyses. Appropriate prophylaxis provides better value in terms of costs and health gains than routine screening for DVT. Resources should be targeted at optimizing thromboprophylaxis.

Case Study on Technical and Vocational Education in Japan. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Iwamoto, Muneharu

In the course of Japan's economic progress, remarkable changes have occurred in the structure of industry and employment. Workers are in extremely short supply in such occupations as mining, manufacturing and construction, services, transportation and communication, sales, and professional and technical. On the basis of recommendations of the…

A Case Study of Technical Assistance to Demonstration Programs for Young Handicapped Children. Part III.

ERIC Educational Resources Information Center

Behr, Shirley K.; And Others

The report describes the third and final year of a 3-year case study of the technical assistance process as implemented by the Technical Assistance Development System (TADS) for the staffs of two demonstration programs for preschool handicapped children and their families. Following a review of TADS and the two demonstration programs, the…

Supply Chain Sustainability Analysis of Whole Algae Hydrothermal Liquefaction and Upgrading

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

Pegallapati, Ambica Koushik; Dunn, Jennifer B.; Frank, Edward D.

2015-04-01

The Department of Energy's Bioenergy Technology Office (BETO) collaborates with a wide range of institutions towards the development and deployment of biofuels and bioproducts. To facilitate this effort, BETO and its partner national laboratories develop detailed techno-economic assessments (TEA) of biofuel production technologies as part of the development of design cases and state of technology (SOT) analyses. A design case is a TEA that outlines a target case for a particular biofuel pathway. It enables preliminary identification of data gaps and research and development needs and provides goals and targets against which technology progress is assessed. On the other hand,more » an SOT analysis assesses progress within and across relevant technology areas based on actual experimental results relative to technical targets and cost goals from design cases and includes technical, economic, and environmental criteria as available. (SOT) analyses. A design case is a TEA that outlines a target case for a particular biofuel pathway. It enables preliminary identification of data gaps and research and development needs and provides goals and targets against which technology progress is assessed. On the other hand, an SOT analysis assesses progress within and across relevant technology areas based on actual experimental results relative to technical targets and cost goals from design cases and includes technical, economic, and environmental criteria as available. (SOT) analyses. A design case is a TEA that outlines a target case for a particular biofuel pathway. It enables preliminary identification of data gaps and research and development needs and provides goals and targets against which technology progress is assessed. On the other hand, an SOT analysis assesses progress within and across relevant technology areas based on actual experimental results relative to technical targets and cost goals from design cases and includes technical, economic, and environmental criteria as available.« less

Funding technology: evaluating and exercising the leasing option.

PubMed

McIntire, Mark; Waldron, David J

2006-11-01

Tax-exempt capital leases, when structured through the appropriate conduit authority, are an excellent option for financing equipment that the hospital wants to own. Operating leases offer the benefits of immediate cash flow savings when compared with buying equipment, fewer complications and lower upfront costs when compared with bond issues, and the ability to match short-term assets with short-term liabilities. A best-practice leasing process involves nine steps progressing from assessing needs and soliciting bids from equipment manufacturers to implementing the lease and providing continuing disclosure.

Fast-mode duplex qPCR for BCR-ABL1 molecular monitoring: innovation, automation, and harmonization.

PubMed

Gerrard, Gareth; Mudge, Katherine; Foskett, Pierre; Stevens, David; Alikian, Mary; White, Helen E; Cross, Nicholas C P; Apperley, Jane; Foroni, Letizia

2012-07-01

Reverse transcription quantitative polymerase chain reaction (RTqPCR)is currently the most sensitive tool available for the routine monitoring of disease level in patients undergoing treatment for BCRABL1 associated malignancies. Considerable effort has been invested at both the local and international levels to standardise the methodology and reporting criteria used to assess this critical metric. In an effort to accommodate the demands of increasing sample throughput and greater standardization, we adapted the current best-practice guidelines to encompass automation platforms and improved multiplex RT-qPCR technology.

Resident perspectives on communication training that utilizes immersive virtual reality.

PubMed

Real, Francis J; DeBlasio, Dominick; Ollberding, Nicholas J; Davis, David; Cruse, Bradley; Mclinden, Daniel; Klein, Melissa D

2017-01-01

Communication skills can be difficult to teach and assess in busy outpatient settings. These skills are important for effective counseling such as in cases of influenza vaccine hesitancy. It is critical to consider novel educational methods to supplement current strategies aimed at teaching relational skills. An immersive virtual reality (VR) curriculum on addressing influenza vaccine hesitancy was developed using Kern's six-step approach to curriculum design. The curriculum was meant to teach best-practice communication skills in cases of influenza vaccine hesitancy. Eligible participants included postgraduate level (PL) 2 and PL-3 pediatric residents (n = 24). Immediately following the curriculum, a survey was administered to assess residents' attitudes toward the VR curriculum and perceptions regarding the effectiveness of VR in comparison to other educational modalities. A survey was administered 1 month following the VR curriculum to assess trainee-perceived impact of the curriculum on clinical practice. All eligible residents (n = 24) completed the curriculum. Ninety-two percent (n = 22) agreed or strongly agreed that VR simulations were like real-life patient encounters. Seventy-five percent (n = 18) felt that VR was equally effective to standardized patient (SP) encounters and less effective than bedside teaching (P < 0.001). At 1-month follow-up, 67% of residents (n = 16) agreed or strongly agreed that the VR experience improved how they counseled families in cases of influenza vaccine hesitancy. An immersive VR curriculum at our institution was well-received by learners, and residents rated VR as equally effective as SP encounters. As such, immersive VR may be a promising modality for communication training.

Policy and stakeholder analysis of infant and young child feeding programmes in Sri Lanka.

PubMed

Godakandage, Sanjeeva S P; Senarath, Upul; Jayawickrama, Hiranya S; Siriwardena, Indika; Wickramasinghe, S W A D A; Arumapperuma, Prasantha; Ihalagama, Sathyajith; Nimalan, Srisothinathan; Archchuna, Ramanathan; Umesh, Claudio; Uddin, Shahadat; Thow, Anne Marie

2017-06-13

Infant and young child feeding practices (IYCF) play a critical role in growth and development of children. A favourable environment supported by appropriate policies and positive contributions from all stakeholders are prerequisites for achieving optimal IYCF practices. This study aimed to assess the IYCF-related policy environment and role of stakeholders in policy making in Sri Lanka, in order to identify opportunities to strengthen the policy environment to better support appropriate IYCF and reduce childhood malnutrition. We mapped national level policy-related documents on IYCF, and conducted a stakeholder analysis of IYCF policy making. A matrix was designed to capture data from IYCF policy-related documents using a thematic approach. A narrative synthesis of data from different documents was conducted to achieve the first objective. We then conducted an analysis of technical and funding links of stakeholders who shape IYCF policies and programmes in Sri Lanka using the Net-Map technique, to achieve the second objective. A total of 35 respondents were purposively selected based on their knowledge on the topic, and individual interviews were conducted. Twenty four policies were identified that contained provisions in line with global recommendations for best-practice IYCF, marketing of breast milk substitutes, strengthening health and non-health systems, maternity benefits, inter-sectoral collaboration, capacity building, health education and supplementation. However, there is no separate, written policy on IYCF in Sri Lanka. Participants identified 56 actors involved in shaping IYCF policies and programmes through technical support, and 36 through funding support. The Government Health Sector was the most connected as well as influential, followed by development partners. Almost all actors in the networks were supportive for IYCF policies and programmes. All evidence-based recommendations are covered in related policies. However, advocacy should be targeted towards strategic support for IYCF in high-level policy documents. The stakeholder analysis confirmed a network led by the government health sector. Enhancing the multi-sectoral commitments stressed in policy documents is an opportunity to strengthen IYCF policy process in Sri Lanka.

47 CFR 90.763 - EA, Regional and nationwide system operations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... on a case-by-case basis upon submission by the EA or Regional licensee of: (A) A technical analysis... by a licensee or the Commission, an EA or regional licensee shall furnish the technical parameters...

Development of the Exam of GeoloGy Standards, EGGS, to Measure Students' Conceptual Understanding of Geology Concepts

NASA Astrophysics Data System (ADS)

Guffey, S. K.; Slater, T. F.; Slater, S. J.

2017-12-01

Discipline-based geoscience education researchers have considerable need for criterion-referenced, easy-to-administer and easy-to-score, conceptual diagnostic surveys for undergraduates taking introductory science survey courses in order for faculty to better be able to monitor the learning impacts of various interactive teaching approaches. To support ongoing discipline-based science education research to improve teaching and learning across the geosciences, this study establishes the reliability and validity of a 28-item, multiple-choice, pre- and post- Exam of GeoloGy Standards, hereafter simply called EGGS. The content knowledge EGGS addresses is based on 11 consensus concepts derived from a systematic, thematic analysis of the overlapping ideas presented in national science education reform documents including the Next Generation Science Standards, the AAAS Benchmarks for Science Literacy, the Earth Science Literacy Principles, and the NRC National Science Education Standards. Using community agreed upon best-practices for creating, field-testing, and iteratively revising modern multiple-choice test items using classical item analysis techniques, EGGS emphasizes natural student language over technical scientific vocabulary, leverages illustrations over students' reading ability, specifically targets students' misconceptions identified in the scholarly literature, and covers the range of topics most geology educators expect general education students to know at the end of their formal science learning experiences. The current version of EGGS is judged to be valid and reliable with college-level, introductory science survey students based on both standard quantitative and qualitative measures, including extensive clinical interviews with targeted students and systematic expert review.

Characteristics of HIV Care and Treatment in PEPFAR-Supported Sites

PubMed Central

Filler, Scott; Berruti, Andres A.; Menzies, Nick; Berzon, Rick; Ellerbrock, Tedd V.; Ferris, Robert; Blandford, John M.

2011-01-01

Background The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has supported the extension of HIV care and treatment to 2.4 million individuals by September 2009. With increasing resources targeted toward scale-up, it is important to understand the characteristics of current PEPFAR-supported HIV care and treatment sites. Methods Forty-five sites in Botswana, Ethiopia, Nigeria, Uganda, and Vietnam were sampled. Data were collected retrospectively from successive 6-month periods of site operations, through reviews of facility records and interviews with site personnel between April 2006 and March 2007. Facility size and scale-up rate, patient characteristics, staffing models, clinical and laboratory monitoring, and intervention mix were compared. Results Sites added a median of 293 patients per quarter. By the evaluation’s end, sites supported a median of 1,649 HIV patients, 922 of them receiving antiretroviral therapy (ART). Patients were predominantly adult (97.4%) and the majority (96.5%) were receiving regimens based on nonnucleoside reverse transcriptase inhibitors (NNRTIs). The ratios of physicians to patients dropped substantially as sites matured. ART patients were commonly seen monthly or quarterly for clinical and laboratory monitoring, with CD4 counts being taken at 6-month intervals. One-third of sites provided viral load testing. Cotrimoxazole prophylaxis was the most prevalent supportive service. Conclusions HIV treatment sites scaled up rapidly with the influx of resources and technical support through PEPFAR, providing complex health services to progressively expanding patient cohorts. Human resources are stretched thin, and delivery models and intervention mix differ widely between sites. Ongoing research is needed to identify best-practice service delivery models. PMID:21346585

Using case studies to teach an engineering technology technical writing class

NASA Technical Reports Server (NTRS)

Green, M. M.

1981-01-01

The use of the case method in teaching various technical communication skills is described. Features of the method considered include: solving communication problems, identifying an audience, planning written communications, presenting written communications, and using visual aids.

The Development of Technical and Vocational Education in Malaysia--A Case Study in Quality Improvement. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Hee, Tieng Fok

The economic profile of Malaysia has changed from an economy mainly based on agriculture and the production of tin ore to a more balanced economy with continuing growth in the manufacturing and industrial sectors. Educational programs need to be upgraded and improved, particularly the direction and development of technical and vocational education…

The Development of Technical and Vocational Education in India--A Case Study in Quality Improvement. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Mishra, Arun K.

Education has a place of high priority on India's development agenda. The technical/vocational education (TVE) system is multisectoral with each ministry responsible for labor force development in that sector. The TVE programs in the formal education system are either state delivered or financed. The higher secondary vocational education program…

The Development of Technical and Vocational Education in Indonesia--A Case Study in Quality Improvement. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Bakri, Mohamad

After its independence in 1969, Indonesia studied and analyzed its previous colonial system of technical and vocational education (TVE) and took steps to overcome the shortcomings. TVE was required to provide expansion of work opportunities and industrial development to promote national development. Until 1989, attention was given to further…

What do consistently high-performing in vitro fertilization programs in the U.S. do?

PubMed

Van Voorhis, Bradley J; Thomas, Mika; Surrey, Eric S; Sparks, Amy

2010-09-01

To identify common clinical and laboratory practices among consistently high-performing IVF programs. Questionnaire study of selected IVF programs. Academic and private practice IVF programs. Ten of 12 programs identified as having consistently high singleton delivery rates per cycle. None. Common clinical practices. Common clinical practices identified among these programs included testing all patients for ovarian reserve, endometrial defects, and hydrosalpinges; use of a mixed LH and FSH stimulation protocol with step-down dosing; and use of ultrasound guidance for ET. Common laboratory practices included selective use of intracytoplasmic sperm injection, group culture of embryos in microdrops, and use of blastocyst ET in selected cases. Common laboratory features included good air quality using filtration and heated stages for oocyte and embryo work. Although a number of factors were identified in this best-practices questionnaire, programs often differed in many aspects of care. However, high-performing programs cited experience of physicians, embryologists, and staff members as well as consistency of approach, attention to detail, and good communication as being vital to excellent outcomes. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

NASA Perspective and Modeling of Thermal Runaway Propagation Mitigation in Aerospace Batteries

NASA Technical Reports Server (NTRS)

Shack, P.; Iannello, C.; Rickman, S.; Button, R.

2014-01-01

NASA has traditionally sought to reduce the likelihood of a single cell thermal runaway (TR) in their aerospace batteries to an absolute minimum by employing rigorous screening program of the cells. There was generally a belief that TR propagation resulting in catastrophic failure of the battery was a forgone conclusion for densely packed aerospace lithium-ion batteries. As it turns out, this may not be the case. An increasing number of purportedly TR propagation-resistant batteries are appearing among NASA partners in the commercial sector and the Department of Defense. In the recent update of the battery safety standard (JSC 20793) to address this paradigm shift, the NASA community included requirements for assessing TR severity and identifying simple, low-cost severity reduction measures. Unfortunately, there are no best-practice guidelines for this work in the Agency, so the first project team attempting to meet these requirements would have an undue burden placed upon them. A NASA engineering Safety Center (NESC) team set out to perform pathfinding activities for meeting those requirements. This presentation will provide contextual background to this effort, as well as initial results in attempting to model and simulate TR heat transfer and propagation within battery designs.

Bilingual teaching for multilingual students? Innovative dual-medium models in Slovene-German schools in Austria

NASA Astrophysics Data System (ADS)

Purkarthofer, Judith; Mossakowski, Jan

2011-12-01

Traditional bilingual education programmes in regional linguistic minority contexts face major challenges within the recent paradigm of linguistic diversity against a background of increasing migration, mobility and trans-locality. Based on three case studies, the authors of this paper focus on how particular dual-medium models are applied in Slovene-German schools in Carinthia, Austria. They examine not only how these schools provide for a balanced bilingual teaching and learning environment, but also how they deal with their students' multilingual realities and support their identification with bi- and multilingualism. The authors regard schools as institutional sites where linguistic dispositions are subject to discursive power relations and where language policies and educational goals are negotiated by teachers, parents and students alike. Drawing on speaker-centred and ethnographic approaches in sociolinguistic research, the authors seek to document experiences of all actors involved as well as spatial and discursive practices. Through this the authors show how these dual-medium schools achieve particular profiles in multilingual education which are potentially regarded as innovative examples of best-practice and as being of interest for students and families with heterogeneous linguistic backgrounds.

Composite Socio-Technical Systems: A Method for Social Energy Systems

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

Zhang, Yingchen; He, Fulin; Hao, Jun

In order to model and study the interactions between social on technical systems, a systemic method, namely the composite socio-technical systems (CSTS), is proposed to incorporate social systems, technical systems and the interaction mechanism between them. A case study on University of Denver (DU) campus grid is presented in paper to demonstrate the application of the proposed method. In the case study, the social system, technical system, and the interaction mechanism are defined and modelled within the framework of CSTS. Distributed and centralized control and management schemes are investigated, respectively, and numerical results verifies the feasibility and performance of themore » proposed composite system method.« less

Office of Exploration: Exploration studies technical report. Volume 2: Studies approach and results

NASA Technical Reports Server (NTRS)

Roberts, Barney B.; Bland, Dan

1988-01-01

The NASA Office of Exploration has been tasked with defining and recommending alternatives for an early 1990's national decision on a focused program of human exploration of the solar system. The Mission Analysis and System Engineering (MASE) group, which is managed by the Exploration Studies Office at the Johnson Space Center, is responsible for coordinating the technical studies necessary for accomplishing such a task. This technical report describes the process that has been developed in a case study approach. The four case studies that were developed in FY88 include: (1) human expedition to Phobos; (2) human expeditions to Mars; (3) lunar observatory; and (4) lunar outpost to early Mars evolution. The final outcome of this effort is a set of programmatic and technical conclusions and recommendations for the following year's work. Volume 2 describes the case study process, the technical results of each of the case studies, and opportunities for additional study. Included in the discussion of each case study is a description of the mission key features and profile. Mission definition and manifesting are detailed, followed by a description of the mission architecture and infrastructure. Systems concepts for the required orbital nodes, transportation systems, and planetary surface systems are discussed. Prerequisite implementation plans resulting from the synthesized case studies are described and in-depth assessments are presented.

Dead in the water--are we killing the hospital autopsy with poor consent practices?

PubMed

Henry, Jaimie; Nicholas, Nick

2012-07-01

It is now a recognized fact that the practice of conducting a consent (or hospital) post-mortem examination is in decline. There have been many reasons put forth to explain this demise, but the quality of the consenting process is frequently cited as having a high impact. This article focuses on consent practices for post-mortem examinations in England and Wales, and considers if our consent techniques are adversely affecting post-mortem examination uptake. We examine the regulatory compliance of trusts with their statutory obligations by analyzing the Human Tissue Authority's compliance and inspection reports. We further analyze 21 publicly available NHS Trust policies on post-mortem examination consent procedures, and consider whether these are fit for the purpose of meeting the dual needs of clinicians and the bereaved. Despite more Human Tissue Authority inspections, there is a disproportionate rise in enforcement actions, with up to 48% of sampled Trusts exhibiting shortcomings in their legal duties. Additionally, only 52.4% of sampled trusts follow the Human Tissue Authority best-practice model, with 23.8% having no documented procedures. Despite the well founded evidence base for best-practice models, consent practices for post-mortem examinations remains poor and is likely to have a gross adverse effect on the rate of post-mortem examinations. We recommend that NHS Trusts rigorously review their protocols and introduce a team-approach between clinicians and trained bereavement staff in core-consent teams, as the Human Tissue Authority suggests, whilst at the same time placing a strong emphasis on education for junior and senior colleagues alike.

Taking action against malnutrition in Asian healthcare settings: an initiative of a Northeast Asia Study Group.

PubMed

Higashiguchi, Takashi; Arai, Hidenori; Claytor, Ling Hui; Kuzuya, Masafumi; Kotani, Joji; Lee, Shyh-Dye; Michel, Jean-Pierre; Nogami, Tetsushi; Peng, Nanhai

2017-03-01

Malnutrition is common in Asia, especially among people who are critically ill and/or older. Study results from China, Japan, and Taiwan show that malnutrition or risk of malnutrition is found in up to 30% of communitydwelling people and as much as 50% of patients admitted to hospitals-with prevalence even higher among those older than 70 years. In Asia, malnutrition takes substantial tolls on health, physical function, and wellbeing of people affected, and it adds huge financial burdens to healthcare systems. Attention to nutrition, including protein intake, can help prevent or delay disease- and age-related disabilities and can speed recovery from illness or surgery. Despite compelling evidence and professional guidelines on appropriate nutrition care in hospital and community settings, patients' malnutrition is often overlooked and under-treated in Asian healthcare, as it is worldwide. Since the problem of malnutrition continues to grow as many Asian populations become increasingly "gray", it is important to take action now. A medical education (feedM.E.) Global Study Group developed a strategy to facilitate best-practice hospital nutrition care: screen-intervene-supervene. As members of a newly formed feedM.E. Northeast Asia Study Group, we endorse this care strategy, guiding clinicians to screen each patient's nutritional status upon hospital admission or at initiation of care, intervene promptly when nutrition care is needed, and supervene or follow-up routinely with adjustment and reinforcement of nutrition care plans, including post-discharge. To encourage best-practice nutrition in Asian patient care settings, our paper includes a simple, stepwise Nutrition Care Pathway (NCP) in multiple languages.

Cost of best-practice primary care management of chronic disease in a remote Aboriginal community.

PubMed

Gador-Whyte, Andrew P; Wakerman, John; Campbell, David; Lenthall, Sue; Struber, Janet; Hope, Alex; Watson, Colin

2014-06-16

To estimate the cost of completing all chronic care tasks recommended by the Central Australian Rural Practitioners Association Standard Treatment Manual (CARPA STM) for patients with type 2 diabetes and chronic kidney disease (CKD). The study was conducted at a health service in a remote Central Australian Aboriginal community between July 2010 and May 2011. The chronic care tasks required were ascertained from the CARPA STM. The clinic database was reviewed for data on disease prevalence and adherence to CARPA STM guidelines. Recommended tasks were observed in a time-and-motion study of clinicians' work. Clinicians were interviewed about systematic management and its barriers. Expenditure records were analysed for salary and administrative costs. Diabetes and CKD prevalence; time spent on chronic disease care tasks; completion of tasks recommended by the CARPA STM; barriers to systematic care identified by clinicians; and estimated costs of optimal primary care management of all residents with diabetes or CKD. Projected annual costs of best-practice care for diabetes and CKD for this community of 542 people were $900 792, of which $645 313 would be met directly by the local primary care service. Estimated actual expenditure for these conditions in 2009-10 was $446 585, giving a projected funding gap of $198 728 per annum, or $1733 per patient. High staff turnover, acute care workload and low health literacy also hindered optimal chronic disease care. Barriers to optimal care included inadequate funding and workforce issues. Reduction of avoidable hospital admissions and overall costs necessitates adequate funding of primary care of chronic disease in remote communities.

Improving the Quality of Care for Patients Diagnosed With Glioma During the Perioperative Period

PubMed Central

Riblet, Natalie B.V.; Schlosser, Evelyn M.; Homa, Karen; Snide, Jennifer A.; Jarvis, Lesley A.; Simmons, Nathan E.; Sargent, David H.; Mason, Linda P.; Cooney, Tobi J.; Kennedy, Nancy L.; Fadul, Camilo E.

2014-01-01

Purpose: Although there is agreement on the oncologic management of patients with glioma, few guidelines exist to standardize other aspects of care, including supportive care. Methods: A quality improvement (QI) project was chartered to improve the care provided to patients with glioma. A multidisciplinary team was convened and identified 10 best-practice measures. Using a plan-do-study-act framework, the team brainstormed and implemented various improvement interventions between June 2011 and October 2012. Statistical process control charts were used to evaluate progress. A dashboard of quality measures was generated to allow for ongoing measurement and reporting. Results: The retrospective assessment phase consisted of 43 patients with diagnosis of glioma. A manual medical record review for these patients showed that compliance with 10 best-practice measures ranged from 23% to 100%. Several factors contributed to less-than-ideal process performance, including poor communication among disciplines and lack of familiarity with the larger system of care. After implementing improvement interventions, performance was measured in 96 consecutive patients with glioma. The proportion of patients who met criteria for 10 practice measures significantly improved (pre-QI work, 63%; post-QI work, 85%; P = .003). The largest improvement was observed in the measure assessing for preoperative notification of the neuro-oncology program (pre-QI work, 39%; post-QI work, 97%; P < .001). Conclusion: QI principles were used by a multidisciplinary team to improve the quality of care for patients with glioma during the perioperative period. Leadership involvement, ongoing dialogue across departments, and reporting of system performance were important for sustaining process improvements. PMID:25294392

Mild traumatic brain injury in children: management practices in the acute care setting.

PubMed

Kool, Bridget; King, Vivienne; Chelimo, Carol; Dalziel, Stuart; Shepherd, Michael; Neutze, Jocelyn; Chambers, Nikki; Wells, Susan

2014-08-01

Accurate diagnosis, treatment and follow up of children suffering mild traumatic brain injury (MTBI) is important as post-concussive symptoms and long-term disability might occur. This research explored the decisions clinicians make in their assessment and management of children with MTBI in acute care settings, and identified barriers and enablers to the delivery of best-practice care. A purposeful sample of 29 clinicians employed in two metropolitan paediatric EDs and one Urgent Care clinic was surveyed using a vignette-based questionnaire that also included domains of guideline awareness, attitudes to MTBI care, use of clinical decision support systems, and knowledge and skills for practising evidence-based healthcare. Overall, the evaluation and management of children presenting acutely with MTBI generally followed best-practice guidelines, particularly in relation to identifying intracranial injuries that might require surgical intervention, observation for potential deterioration, adequate pain management and the provision of written head injury advice on discharge. Larger variation emerged in regard to follow-up care and referral pathways. Potential barriers to best- practice were lack of guideline awareness, attitudes to MTBI, and lack of time or other priorities. Opportunities exist to improve care for children who present in acute care settings following mild traumatic brain injury. These include having up-to-date guidelines that are consistent across acute care settings; providing clearer pathways for referral and follow up; targeting continuing medical education towards potential complications; and providing computerised decision support so that assessment and management are conducted systematically. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Exploring the Benefits of Teacher-Modeling Strategies Integrated into Career and Technical Education

ERIC Educational Resources Information Center

Cathers, Thomas J., Sr.

2013-01-01

This case study examined how career and technical education classes function using multiple instructional modeling strategies integrated into vocational and technical training environments. Seven New Jersey public school technical teachers received an introductory overview of the investigation and participated by responding to 10 open-end…

25 CFR 41.10 - Technical assistance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Community College's request in writing. In any case, where the type and source of technical assistance is... for technical assistance under this section shall be made in writing and sent to the applicant within... 25 Indians 1 2010-04-01 2010-04-01 false Technical assistance. 41.10 Section 41.10 Indians BUREAU...

Proceedings of the CASE Adoption Workshop Held in Pittsburgh, Pennsylvania on 13-14 November 1990

DTIC Science & Technology

1992-05-01

position. It Is published in the interest of scientific and technical information exchange. Review and Approval This report has been reviewed and is...available through the Defense Technical Information Center. DTIC provides access so and transr of scientific and technical information for DoD... Metthods and Tools $1,850 P-Cube Corporation 572 East Lamibert Rd CASEbase (a PC-based CASE database) $495 Brea, CA 92621 (714) 990-3169 Foresite

Analysis of professional malpractice claims in implant dentistry in Italy from insurance company technical reports, 2006 to 2010.

PubMed

Pinchi, Vilma; Varvara, Giuseppe; Pradella, Francesco; Focardi, Martina; Donati, Michele D; Norelli, Gianaristide

2014-01-01

The aim of the study was to analyze the characteristics of implant dentistry claims in Italy based on insurance company technical reports for malpractice claims. One hundred twenty-one technical reports of cases of professional malpractice in implant dentistry between 2006 and 2010 were included in the study. Data included the sex and age of the patient and dentist, the kind of negligence claimed, and the damages awarded as a consequence of the alleged misconduct. Of the cases examined in this study, 9.9% went to court. The patients were female in 73.6% of the cases. Most of the technical errors were committed during implant insertion (82.6%). In 50.4% of cases, the technical error involved the surrounding structures, such as damage to the inferior alveolar nerve (32.2%) or the lingual nerve (2.5%), invasion of the maxillary sinus (9.1%), or pulpal dental necrosis in adjacent teeth (6.6%). Incomplete clinical documentation was apparent in 54.5% of cases. In 9.9% of cases, a civil suit had already been filed before a visit, and medicolegal advice from the insurance expert had been procured. The discrepancy between the total number of cases examined and those that went to court indicates that implant malpractice claims in Italy are most often settled out of court. The large number of intraoperative errors seen and the high proportion of injuries to surrounding structures suggest that implant dentists would benefit from further specific training. Also, clinical documentation vital to a defense against any claims relating to professional misconduct was incomplete or absent in more than half of the cases.

National Athletic Trainers' Association Position Statement: Management of Sport Concussion

PubMed Central

Broglio, Steven P.; Cantu, Robert C.; Gioia, Gerard A.; Guskiewicz, Kevin M.; Kutcher, Jeffrey; Palm, Michael; McLeod, Tamara C. Valovich

2014-01-01

Objective: To provide athletic trainers, physicians, and other health care professionals with best-practice guidelines for the management of sport-related concussions. Background: An estimated 3.8 million concussions occur each year in the United States as a result of sport and physical activity. Athletic trainers are commonly the first medical providers available onsite to identify and evaluate these injuries. Recommendations: The recommendations for concussion management provided here are based on the most current research and divided into sections on education and prevention, documentation and legal aspects, evaluation and return to play, and other considerations. PMID:24601910

The Assay Guidance Manual: Quantitative Biology and Pharmacology in Preclinical Drug Discovery.

PubMed

Coussens, Nathan P; Sittampalam, G Sitta; Guha, Rajarshi; Brimacombe, Kyle; Grossman, Abigail; Chung, Thomas D Y; Weidner, Jeffrey R; Riss, Terry; Trask, O Joseph; Auld, Douglas; Dahlin, Jayme L; Devanaryan, Viswanath; Foley, Timothy L; McGee, James; Kahl, Steven D; Kales, Stephen C; Arkin, Michelle; Baell, Jonathan; Bejcek, Bruce; Gal-Edd, Neely; Glicksman, Marcie; Haas, Joseph V; Iversen, Philip W; Hoeppner, Marilu; Lathrop, Stacy; Sayers, Eric; Liu, Hanguan; Trawick, Bart; McVey, Julie; Lemmon, Vance P; Li, Zhuyin; McManus, Owen; Minor, Lisa; Napper, Andrew; Wildey, Mary Jo; Pacifici, Robert; Chin, William W; Xia, Menghang; Xu, Xin; Lal-Nag, Madhu; Hall, Matthew D; Michael, Sam; Inglese, James; Simeonov, Anton; Austin, Christopher P

2018-06-07

The Assay Guidance Manual (AGM) is an eBook of best-practices for the design, development, and implementation of robust assays for early drug discovery. Initiated by pharmaceutical company scientists, the manual provides guidance for designing a "testing funnel" of assays to identify genuine hits using high-throughput screening (HTS) and advancing them through pre-clinical development. Combined with a workshop/tutorial component, the overall goal of the AGM is to provide a valuable resource for training translational scientists. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Cultural competent patient-centered nursing care.

PubMed

Darnell, Linda K; Hickson, Shondell V

2015-03-01

This article provides a theoretic framework for culturally diverse practice, provides a model for developing cultural competency, and provides best-practice guidelines for conducting a cultural assessment on patients to identify their diverse needs to integrate into a patient-centered plan of care. The role of ethics is discussed to empower mutual respect, equality, and trust building in patients to promote positive health care outcomes. Cultural diversity tool kits from the National League for Nursing and the American Association of Colleges of Nursing are reviewed to provide educational resources to the front line nurse. Copyright © 2015 Elsevier Inc. All rights reserved.

Workplace Wellness Programs: How Regulatory Flexibility Might Undermine Success

PubMed Central

2014-01-01

The Patient Protection and Affordable Care Act revised the law related to workplace wellness programs, which have become part of the nation’s broader health strategy. Health-contingent programs are required to be reasonably designed. However, the regulatory requirements are lax and might undermine program efficacy in terms of both health gains and financial return. I propose a method for the government to support a best-practices approach by considering an accreditation or certification process. Additionally I discuss the need for program evaluation and the potential for employers to be subject to litigation if programs are not carefully implemented. PMID:25211713

Practical Issues of Conducting a Q Methodology Study: Lessons Learned From a Cross-cultural Study.

PubMed

Stone, Teresa Elizabeth; Maguire, Jane; Kang, Sook Jung; Cha, Chiyoung

This article advances nursing research by presenting the methodological challenges experienced in conducting a multination Q-methodology study. This article critically analyzes the relevance of the methodology for cross-cultural and nursing research and the challenges that led to specific responses by the investigators. The use of focus groups with key stakeholders supplemented the Q-analysis results. The authors discuss practical issues and shared innovative approaches and provide best-practice suggestions on the use of this flexible methodology. Q methodology has the versatility to explore complexities of contemporary nursing practice and cross-cultural health research.

Mobile Apps for Bipolar Disorder: A Systematic Review of Features and Content Quality.

PubMed

Nicholas, Jennifer; Larsen, Mark Erik; Proudfoot, Judith; Christensen, Helen

2015-08-17

With continued increases in smartphone ownership, researchers and clinicians are investigating the use of this technology to enhance the management of chronic illnesses such as bipolar disorder (BD). Smartphones can be used to deliver interventions and psychoeducation, supplement treatment, and enhance therapeutic reach in BD, as apps are cost-effective, accessible, anonymous, and convenient. While the evidence-based development of BD apps is in its infancy, there has been an explosion of publicly available apps. However, the opportunity for mHealth to assist in the self-management of BD is only feasible if apps are of appropriate quality. Our aim was to identify the types of apps currently available for BD in the Google Play and iOS stores and to assess their features and the quality of their content. A systematic review framework was applied to the search, screening, and assessment of apps. We searched the Australian Google Play and iOS stores for English-language apps developed for people with BD. The comprehensiveness and quality of information was assessed against core psychoeducation principles and current BD treatment guidelines. Management tools were evaluated with reference to the best-practice resources for the specific area. General app features, and privacy and security were also assessed. Of the 571 apps identified, 82 were included in the review. Of these, 32 apps provided information and the remaining 50 were management tools including screening and assessment (n=10), symptom monitoring (n=35), community support (n=4), and treatment (n=1). Not even a quarter of apps (18/82, 22%) addressed privacy and security by providing a privacy policy. Overall, apps providing information covered a third (4/11, 36%) of the core psychoeducation principles and even fewer (2/13, 15%) best-practice guidelines. Only a third (10/32, 31%) cited their information source. Neither comprehensiveness of psychoeducation information (r=-.11, P=.80) nor adherence to best-practice guidelines (r=-.02, P=.96) were significantly correlated with average user ratings. Symptom monitoring apps generally failed to monitor critical information such as medication (20/35, 57%) and sleep (18/35, 51%), and the majority of self-assessment apps did not use validated screening measures (6/10, 60%). In general, the content of currently available apps for BD is not in line with practice guidelines or established self-management principles. Apps also fail to provide important information to help users assess their quality, with most lacking source citation and a privacy policy. Therefore, both consumers and clinicians should exercise caution with app selection. While mHealth offers great opportunities for the development of quality evidence-based mobile interventions, new frameworks for mobile mental health research are needed to ensure the timely availability of evidence-based apps to the public.

A Case Study of Technical Assistance to Demonstration Programs for Young Handicapped Children. Part II.

ERIC Educational Resources Information Center

Behr, Shirley K.; And Others

A project to provide technical assistance to staffs of two demonstration programs for preschool handicapped children and their families is described. The focus was technical assistance developed and exercised by the Technical Assistance Development System (TADS), which assisted in the development of the Handicapped Children's Early Education…

Development of a Technical Practice for Roll Stabilization System Selection. Phase I

DTIC Science & Technology

1974-10-01

the roll motions, velocity, acceleration and in some cases the lift on the fin. The fin is actuated by a hydraulic system which in most cases can...Technical Report 7401.06-1 I. 00VT ACCESSION NO 4. TITLI fantf S«M<(I*> ■ PHASE I REPORT ON THE (DEVELOPMENT OF A TECHNICAL PRACTICE FOR ROLL...ship rolling, for a given application, is considered. The Influence of human effectiveness and subsystem performance on this determination is

Reform of China's Technical and Vocational Education in the Transition from a Planned Economy System to a Socialist Market Economy System--A Case Study. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Yu, Zuguang; Zeng, Zida

Since the early 1990s, China's government has followed a socialist market economy system. Accordingly, the technical and vocational education (TVE) should be restructured to meet its needs. Reform of the TVE system has four aspects. First, reform of the planning system includes a move from a central plan of enrollment to planning according to…

[A case of the fatal injury by technical electricity from a mobile device (cell phone) connected to the circuit].

PubMed

Rudenko, I A; Kil'dyushov, E M; Koludarova, E M; Morozov, V Yu; Fetisov, V A

2015-01-01

The authors report a case of the fatal injury by technical electricity from a mobile device (cell phone) attached to the circuit in a moist environment as a result of the unsafe handling of the gadget (when taking the bath).

To core, or not to core: the impact of coring on tree health and a best-practice framework for collecting dendrochronological information from living trees.

PubMed

Tsen, Edward W J; Sitzia, Tommaso; Webber, Bruce L

2016-11-01

Trees are natural repositories of valuable environmental information that is preserved in the growth and structure of their stems, branches and roots. Dendrochronological analyses, based on the counting, crossdating and characterisation of incrementally formed wood rings, offer powerful insights for diverse fields including ecology, climatology and archaeology. The application of this toolset is likely to increase in popularity over coming decades due to advances in the field and a reduction in the cost of analyses. In research settings where the continued value of living trees subject to dendrochronological investigation is important, the use of an increment bore corer to extract trunk tissue is considered the best option to minimise negative impacts on tree health (e.g. stress and fitness). A small and fragmented body of literature, however, reports significant after-effects, and in some cases fatal outcomes, from this sampling technique. As it stands, the literature documenting increment bore coring (IBC) impacts lacks experimental consistency and is poorly replicated, making it difficult for prospective users of the method to assess likely tree responses to coring. This paucity of information has the potential to lead to destructive misuse of the method and also limits its safe implementation in circumstances where the risk of impacts may be appropriate. If IBC is to fulfil its potential as a method of choice across research fields, then we must first address our limited understanding of IBC impacts and provide a framework for its appropriate future use. Firstly, we review the historical context of studies examining the impacts of IBC on trees to identify known patterns, focal issues and biases in existing knowledge. IBC wound responses, particularly those that impact on lumber quality, have been the primary focus of prior studies. No universal treatment was identified that conclusively improved wound healing and few studies have linked wound responses to tree health impacts. Secondly, we build on literature insights using a theoretical approach to identify the most important factors to guide future research involving implementation of IBC, including innate tree characteristics and environmental factors. Thirdly, we synthesise and interrogate the quantitative data available through meta-analysis to identify risk factors for wound reactions. Although poor reporting standards, restricted scopes and a bias towards temperate ecosystems limited quantitative insight, we found that complete cambial wound closure could still harbour high rates of internal trunk decay, and that conditions favouring faster growth generally correlated with reduced indices of internal and external damage in broadleaved taxa. Finally, we propose a framework for guiding best-practice application of IBC to address knowledge gaps and maximise the utility of this method, including standardised reporting indices for identifying and minimising negative impacts on tree health. While IBC is an underutilised tool of ecological enquiry with broad applicability, the method will always incur some risk of negative impacts on the cored tree. We caution that the decision to core, or not to core, must be given careful consideration on a case-by-case basis. In time, we are confident that this choice will be better informed by evidence-based insight. © 2015 Cambridge Philosophical Society.

Smartphone and tablet apps for concussion road warriors (team clinicians): a systematic review for practical users.

PubMed

Lee, Hopin; Sullivan, S John; Schneiders, Anthony G; Ahmed, Osman Hassan; Balasundaram, Arun Prasad; Williams, David; Meeuwisse, Willem H; McCrory, Paul

2015-04-01

Mobile technologies are steadily replacing traditional assessment approaches for the recognition and assessment of a sports concussion. Their ease of access, while facilitating the early identification of a concussion, also raises issues regarding the content of the applications (apps) and their suitability for different user groups. To locate and review apps that assist in the recognition and assessment of a sports concussion and to assess their content with respect to that of internationally accepted best-practice instruments. A search of international app stores and of the web using key terms such as 'concussion', 'sports concussion' and variants was conducted. For those apps meeting the inclusion criteria, data were extracted on the platform, intended users and price. The content of each app was benchmarked to the Sport Concussion Assessment Tool 2 (SCAT2) and Pocket SCAT2 using a custom scoring scheme to generate a percentage compliance statistic. 18 of the 155 apps identified met the inclusion criteria. Almost all (16/18) were available on an iOS platform and only five required a payment to purchase. The apps were marketed for a wide range of intended users from medical professionals to the general public. The content of the apps varied from 0% to 100% compliance with the selected standard, and 'symptom evaluation' components demonstrated the highest level of compliance. The surge in availability of apps in an unregulated market raises concerns as to the appropriateness of their content for different groups of end users. The consolidation of best-practice concussion instruments now provides a framework to inform the development of future apps. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Information needs of generalists and specialists using online best-practice algorithms to answer clinical questions.

PubMed

Cook, David A; Sorensen, Kristi J; Linderbaum, Jane A; Pencille, Laurie J; Rhodes, Deborah J

2017-07-01

To better understand clinician information needs and learning opportunities by exploring the use of best-practice algorithms across different training levels and specialties. We developed interactive online algorithms (care process models [CPMs]) that integrate current guidelines, recent evidence, and local expertise to represent cross-disciplinary best practices for managing clinical problems. We reviewed CPM usage logs from January 2014 to June 2015 and compared usage across specialty and provider type. During the study period, 4009 clinicians (2014 physicians in practice, 1117 resident physicians, and 878 nurse practitioners/physician assistants [NP/PAs]) viewed 140 CPMs a total of 81 764 times. Usage varied from 1 to 809 views per person, and from 9 to 4615 views per CPM. Residents and NP/PAs viewed CPMs more often than practicing physicians. Among 2742 users with known specialties, generalists ( N  = 1397) used CPMs more often (mean 31.8, median 7 views) than specialists ( N  = 1345; mean 6.8, median 2; P  < .0001). The topics used by specialists largely aligned with topics within their specialties. The top 20% of available CPMs (28/140) collectively accounted for 61% of uses. In all, 2106 clinicians (52%) returned to the same CPM more than once (average 7.8 views per topic; median 4, maximum 195). Generalists revisited topics more often than specialists (mean 8.8 vs 5.1 views per topic; P  < .0001). CPM usage varied widely across topics, specialties, and individual clinicians. Frequently viewed and recurrently viewed topics might warrant special attention. Specialists usually view topics within their specialty and may have unique information needs. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Access to timely formal dementia care in Europe: protocol of the Actifcare (ACcess to Timely Formal Care) study.

PubMed

Kerpershoek, Liselot; de Vugt, Marjolein; Wolfs, Claire; Jelley, Hannah; Orrell, Martin; Woods, Bob; Stephan, Astrid; Bieber, Anja; Meyer, Gabriele; Engedal, Knut; Selbaek, Geir; Handels, Ron; Wimo, Anders; Hopper, Louise; Irving, Kate; Marques, Maria; Gonçalves-Pereira, Manuel; Portolani, Elisa; Zanetti, Orazio; Verhey, Frans

2016-08-23

Previous findings indicate that people with dementia and their informal carers experience difficulties accessing and using formal care services due to a mismatch between needs and service use. This mismatch causes overall dissatisfaction and is a waste of the scarce financial care resources. This article presents the background and methods of the Actifcare (ACcess to Timely Formal Care) project. This is a European study aiming at best-practice development in finding timely access to formal care for community-dwelling people with dementia and their informal carers. There are five main objectives: 1) Explore predisposing and enabling factors associated with the use of formal care, 2) Explore the association between the use of formal care, needs and quality of life and 3) Compare these across European countries, 4) Understand the costs and consequences of formal care services utilization in people with unmet needs, 5) Determine the major costs and quality of life drivers and their relationship with formal care services across European countries. In a longitudinal cohort study conducted in eight European countries approximately 450 people with dementia and informal carers will be assessed three times in 1 year (baseline, 6 and 12 months). In this year we will closely monitor the process of finding access to formal care. Data on service use, quality of life and needs will be collected. The results of Actifcare are expected to reveal best-practices in organizing formal care. Knowledge about enabling and predisposing factors regarding access to care services, as well as its costs and consequences, can advance the state of the art in health systems research into pathways to dementia care, in order to benefit people with dementia and their informal carers.

Does Provider Self-Reporting of Etiquette Behaviors Improve Patient Experience? A Randomized Controlled Trial.

PubMed

Siddiqui, Zishan; Qayyum, Rehan; Bertram, Amanda; Durkin, Nowella; Kebede, Sosena; Ponor, Lucia; Oduyebo, Ibironke; Allen, Lisa; Brotman, Daniel J

2017-06-01

There is a glaring lack of published evidence-based strategies to improve the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience scores on the physician domain. Strategies that have been used are resource intensive and difficult to sustain. We hypothesized that prompting providers to assess their own etiquette-based practices every 2 weeks over the course of 1 year would improve patient experience on the physician domain. Randomized controlled trial. 4 acute care hospitals. Hospitalists. Hospitalists were randomized to the study or the control arm. The study arm was prompted every 2 weeks for 12 months to report how frequently they engaged in 7 best-practice bedside etiquette behaviors. Control arm participants received similarly worded questions on quality improvement behaviors. Provider experience scores were calculated from the physician HCAHPS and Press Ganey survey provider items. Physicians reported high rates of etiquette-based behavior at baseline, and this changed modestly over the study period. Self-reported etiquette behaviors were not associated with experience scores. The difference in difference analysis of the baseline and postintervention physician experience scores between the intervention arm and the control arm was not statistically significant (P = 0.71). In this 12-month study, biweekly reflection and reporting of best-practice bedside etiquette behaviors did not result in significant improvement on physician domain experience scores. It is likely that hospitalists' self-assessment of their bedside etiquette may not reflect patient perception of these behaviors. Furthermore, hospitalists may be resistant to improvement in this area since they rate themselves highly at baseline. Journal of Hospital Medicine 2017;12:402-406. © 2017 Society of Hospital Medicine

Policy-into-practice for rheumatoid arthritis: randomized controlled trial and cohort study of e-learning targeting improved physiotherapy management.

PubMed

Fary, Robyn E; Slater, Helen; Chua, Jason; Ranelli, Sonia; Chan, Madelynn; Briggs, Andrew M

2015-07-01

To examine the effectiveness of a physiotherapy-specific, web-based e-learning platform, "RAP-el," in best-practice management of rheumatoid arthritis (RA) using a single-blind, randomized controlled trial (RCT) and prospective cohort study. Australian-registered physiotherapists were electronically randomized into intervention and control groups. The intervention group accessed RAP-eL over 4 weeks. Change in self-reported confidence in knowledge and skills was compared between groups at the end of the RCT using linear regression conditioned for baseline scores by a blinded assessor, using intent-to-treat analysis. Secondary outcomes included physiotherapists' satisfaction with RA management and responses to RA-relevant clinical statements and practice-relevant vignettes. Retention was evaluated in a cohort study 8 weeks after the RCT. Eighty physiotherapists were randomized into the intervention and 79 into the control groups. Fifty-six and 48, respectively, provided baseline data. Significant between-group differences were observed for change in confidence in knowledge (mean difference 8.51; 95% confidence interval [95% CI] 6.29, 10.73; effect size 1.62) and skills (mean difference 7.26; 95% CI 5.1, 9.4; effect size 1.54), with the intervention group performing better. Satisfaction in ability to manage RA, 4 of the 6 clinical statements, and responses to vignettes demonstrated significant improvement in the intervention group. Although 8-week scores showed declines in most outcomes, their clinical significance remains uncertain. RAP-eL can improve self-reported confidence, likely practice behaviors and satisfaction in physiotherapists' ability to manage people with RA, and improve their clinical knowledge in several areas of best-practice RA management in the short term. © 2015, American College of Rheumatology.

Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS).

PubMed

Einstein, Andrew J; Pascual, Thomas N B; Mercuri, Mathew; Karthikeyan, Ganesan; Vitola, João V; Mahmarian, John J; Better, Nathan; Bouyoucef, Salah E; Hee-Seung Bom, Henry; Lele, Vikram; Magboo, V Peter C; Alexánderson, Erick; Allam, Adel H; Al-Mallah, Mouaz H; Flotats, Albert; Jerome, Scott; Kaufmann, Philipp A; Luxenburg, Osnat; Shaw, Leslee J; Underwood, S Richard; Rehani, Madan M; Kashyap, Ravi; Paez, Diana; Dondi, Maurizio

2015-07-07

To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing 'best practices' worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose. We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March-April 2013. Eight 'best practices' relating to radiation exposure were identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory. Patient radiation effective dose (ED) ranged between 0.8 and 35.6 mSv (median 10.0 mSv). Average laboratory ED ranged from 2.2 to 24.4 mSv (median 10.4 mSv); only 91 (30%) laboratories achieved the median ED ≤ 9 mSv recommended by guidelines. Laboratory QIs ranged from 2 to 8 (median 5). Both ED and QI differed significantly between laboratories, countries, and world regions. The lowest median ED (8.0 mSv), in Europe, coincided with high best-practice adherence (mean laboratory QI 6.2). The highest doses (median 12.1 mSv) and low QI (4.9) occurred in Latin America. In hierarchical regression modelling, patients undergoing MPI at laboratories following more 'best practices' had lower EDs. Marked worldwide variation exists in radiation safety practices pertaining to MPI, with targeted EDs currently achieved in a minority of laboratories. The significant relationship between best-practice implementation and lower doses indicates numerous opportunities to reduce radiation exposure from MPI globally. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS)

PubMed Central

Einstein, Andrew J.; Pascual, Thomas N. B.; Mercuri, Mathew; Karthikeyan, Ganesan; Vitola, João V.; Mahmarian, John J.; Better, Nathan; Bouyoucef, Salah E.; Hee-Seung Bom, Henry; Lele, Vikram; Magboo, V. Peter C.; Alexánderson, Erick; Allam, Adel H.; Al-Mallah, Mouaz H.; Flotats, Albert; Jerome, Scott; Kaufmann, Philipp A.; Luxenburg, Osnat; Shaw, Leslee J.; Underwood, S. Richard; Rehani, Madan M.; Kashyap, Ravi; Paez, Diana; Dondi, Maurizio

2015-01-01

Aims To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing ‘best practices’ worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose. Methods and results We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March–April 2013. Eight ‘best practices’ relating to radiation exposure were identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory. Patient radiation effective dose (ED) ranged between 0.8 and 35.6 mSv (median 10.0 mSv). Average laboratory ED ranged from 2.2 to 24.4 mSv (median 10.4 mSv); only 91 (30%) laboratories achieved the median ED ≤ 9 mSv recommended by guidelines. Laboratory QIs ranged from 2 to 8 (median 5). Both ED and QI differed significantly between laboratories, countries, and world regions. The lowest median ED (8.0 mSv), in Europe, coincided with high best-practice adherence (mean laboratory QI 6.2). The highest doses (median 12.1 mSv) and low QI (4.9) occurred in Latin America. In hierarchical regression modelling, patients undergoing MPI at laboratories following more ‘best practices’ had lower EDs. Conclusion Marked worldwide variation exists in radiation safety practices pertaining to MPI, with targeted EDs currently achieved in a minority of laboratories. The significant relationship between best-practice implementation and lower doses indicates numerous opportunities to reduce radiation exposure from MPI globally. PMID:25898845

Getting it right the second time.

PubMed

Szulanski, Gabriel; Winter, Sidney

2002-01-01

Once a business performs a complex activity well, the parent organization often wants to replicate that success. But doing that is surprisingly difficult, and businesses nearly always fail when they try to reproduce a best practice. The reason? People approaching best-practice replication are overly optimistic and overconfident. They try to perfect an operation that's running nearly flawlessly, or they try to piece together different practices to create the perfect hybrid. Getting it right the second time (and all the times after that) involves adjusting for overconfidence in your own abilities and imposing strict discipline on the process and the organization. The authors studied numerous business settings to find out how organizational routines were successfully reproduced, and they identified five steps for successful replication. First, make sure you've got something that can be copied and that's worth copying. Some processes don't lend themselves to duplication; others can be copied but maybe shouldn't be. Second, work from a single template. It provides proof success, performance measurements, a tactical approach, and a reference for when problems arise. Third, copy the example exactly, and fourth, make changes only after you achieve acceptable results. The people who developed the template have probably already encountered many of the problems you want to "fix," so it's best to create a working system before you introduce changes. Fifth, don't throw away the template. If your copy doesn't work, you can use the template to identify and solve problems. Best-practice replication, while less glamorous than pure innovation, contributes enormously to the bottom line of most companies. The article's examples--Banc One, Rank Xerox, Intel, Starbucks, and Re/Max Israel--prove that exact copying is a non-trivial, challenging accomplishment.

Preventing mental illness: closing the evidence-practice gap through workforce and services planning.

PubMed

Furber, Gareth; Segal, Leonie; Leach, Matthew; Turnbull, Catherine; Procter, Nicholas; Diamond, Mark; Miller, Stephanie; McGorry, Patrick

2015-07-24

Mental illness is prevalent across the globe and affects multiple aspects of life. Despite advances in treatment, there is little evidence that prevalence rates of mental illness are falling. While the prevention of cardiovascular disease and cancers are common in the policy dialogue and in service delivery, the prevention of mental illness remains a neglected area. There is accumulating evidence that mental illness is at least partially preventable, with increasing recognition that its antecedents are often found in infancy, childhood, adolescence and youth, creating multiple opportunities into young adulthood for prevention. Developing valid and reproducible methods for translating the evidence base in mental illness prevention into actionable policy recommendations is a crucial step in taking the prevention agenda forward. Building on an aetiological model of adult mental illness that emphasizes the importance of intervening during infancy, childhood, adolescence and youth, we adapted a workforce and service planning framework, originally applied to diabetes care, to the analysis of the workforce and service structures required for best-practice prevention of mental illness. The resulting framework consists of 6 steps that include identifying priority risk factors, profiling the population in terms of these risk factors to identify at-risk groups, matching these at-risk groups to best-practice interventions, translation of these interventions to competencies, translation of competencies to workforce and service estimates, and finally, exploring the policy implications of these workforce and services estimates. The framework outlines the specific tasks involved in translating the evidence-base in prevention, to clearly actionable workforce, service delivery and funding recommendations. The framework describes the means to deliver mental illness prevention that the literature indicates is achievable, and is the basis of an ongoing project to model the workforce and service structures required for mental illness prevention.

Randomized trial of guiding hypertension management using central aortic blood pressure compared with best-practice care: principal findings of the BP GUIDE study.

PubMed

Sharman, James E; Marwick, Thomas H; Gilroy, Deborah; Otahal, Petr; Abhayaratna, Walter P; Stowasser, Michael

2013-12-01

Arm cuff blood pressure (BP) may overestimate cardiovascular risk. Central aortic BP predicts mortality and could be a better method for patient management. We sought to determine the usefulness of central BP to guide hypertension management. This was a prospective, open-label, blinded-end point study in 286 patients with hypertension randomized to treatment decisions guided by best-practice usual care (n=142; using office, home, and 24-hour ambulatory BP) or, in addition, by central BP intervention (n=144; using SphygmoCor). Therapy was reviewed every 3 months for 12 months, and recommendations were provided to each patient and his/her doctor on antihypertensive medication titration. Outcome measures were as follows: medication quantity (daily defined dose), quality of life, and left ventricular mass (3-dimensional echocardiography). There was 92% compliance with recommendations on medication titration, and quality of life improved in both groups (post hoc P<0.05). For usual care, there was no change in daily defined dose (all P>0.10), but with intervention there was a significant stepwise decrease in daily defined dose from baseline to 3 months (P=0.008) and each subsequent visit (all P<0.001). Intervention was associated with cessation of medication in 23 (16%) patients versus 3 (2%) in usual care (P<0.001). Despite this, there were no differences between groups in left ventricular mass index, 24-hour ambulatory BP, home systolic BP, or aortic stiffness (all P>0.05). We conclude that guidance of hypertension management with central BP results in a significantly different therapeutic pathway than conventional cuff BP, with less use of medication to achieve BP control and no adverse effects on left ventricular mass, aortic stiffness, or quality of life.

Evaluating the Sensitivity of a Media-Fill Challenge Test Under Various Situations as a Reliable Method for Recommended Aseptic Technique Competency Assessment

PubMed Central

Moody, Colleen A.; Eckel, Stephen F.; Amerine, Lindsey B.

2015-01-01

Background: Microbial contamination of compounded medications is a serious concern within hospital pharmacies as it can lead to severe patient injury. The United States Pharmacopeia <797> mandates that pharmacy personnel responsible for preparing compounded sterile preparations must annually demonstrate competency in aseptic technique by performing a media-fill challenge test. Objective: The purpose of this study is to evaluate the sensitivity of a commonly used media-fill test through proper and improper compounding techniques. Methods: Two aseptically trained pharmacy technicians performed media-fill challenge testing by carrying out 5 separate manipulations 5 times each for a total of 25 trials. Sterile vials, syringes, and intravenous bags were prepared. The first manipulation followed best-practice aseptic technique and sterile compounding procedures. Each of the following 4 manipulations removed one aspect of best-practice aseptic technique. The prepared products were incubated at 20°C to 25°C. A positive result for microbial contamination is indicated by visible turbidity within the vials, syringes, and intravenous bags at the following check points: 24 hours, 72 hours, 7 days, 14 days, 21 days, and >30 days. Results: Twenty-five trials, each containing 10 distinct admixtures, resulted in a total of 250 compounded preparations. No single preparation showed signs of turbidity, sedimentation, or visible microbial growth at any of the 6 checkpoints yielding a 0% contamination rate. However, the positive controls inoculated with bacteria did have positive microbial growth results. Conclusion: A more sensitive test needs to be developed to provide assurances that all poor aseptic practices are detected in compounding personnel.

Brain-CODE: A Secure Neuroinformatics Platform for Management, Federation, Sharing and Analysis of Multi-Dimensional Neuroscience Data.

PubMed

Vaccarino, Anthony L; Dharsee, Moyez; Strother, Stephen; Aldridge, Don; Arnott, Stephen R; Behan, Brendan; Dafnas, Costas; Dong, Fan; Edgecombe, Kenneth; El-Badrawi, Rachad; El-Emam, Khaled; Gee, Tom; Evans, Susan G; Javadi, Mojib; Jeanson, Francis; Lefaivre, Shannon; Lutz, Kristen; MacPhee, F Chris; Mikkelsen, Jordan; Mikkelsen, Tom; Mirotchnick, Nicholas; Schmah, Tanya; Studzinski, Christa M; Stuss, Donald T; Theriault, Elizabeth; Evans, Kenneth R

2018-01-01

Historically, research databases have existed in isolation with no practical avenue for sharing or pooling medical data into high dimensional datasets that can be efficiently compared across databases. To address this challenge, the Ontario Brain Institute's "Brain-CODE" is a large-scale neuroinformatics platform designed to support the collection, storage, federation, sharing and analysis of different data types across several brain disorders, as a means to understand common underlying causes of brain dysfunction and develop novel approaches to treatment. By providing researchers access to aggregated datasets that they otherwise could not obtain independently, Brain-CODE incentivizes data sharing and collaboration and facilitates analyses both within and across disorders and across a wide array of data types, including clinical, neuroimaging and molecular. The Brain-CODE system architecture provides the technical capabilities to support (1) consolidated data management to securely capture, monitor and curate data, (2) privacy and security best-practices, and (3) interoperable and extensible systems that support harmonization, integration, and query across diverse data modalities and linkages to external data sources. Brain-CODE currently supports collaborative research networks focused on various brain conditions, including neurodevelopmental disorders, cerebral palsy, neurodegenerative diseases, epilepsy and mood disorders. These programs are generating large volumes of data that are integrated within Brain-CODE to support scientific inquiry and analytics across multiple brain disorders and modalities. By providing access to very large datasets on patients with different brain disorders and enabling linkages to provincial, national and international databases, Brain-CODE will help to generate new hypotheses about the biological bases of brain disorders, and ultimately promote new discoveries to improve patient care.

Brain-CODE: A Secure Neuroinformatics Platform for Management, Federation, Sharing and Analysis of Multi-Dimensional Neuroscience Data

PubMed Central

Vaccarino, Anthony L.; Dharsee, Moyez; Strother, Stephen; Aldridge, Don; Arnott, Stephen R.; Behan, Brendan; Dafnas, Costas; Dong, Fan; Edgecombe, Kenneth; El-Badrawi, Rachad; El-Emam, Khaled; Gee, Tom; Evans, Susan G.; Javadi, Mojib; Jeanson, Francis; Lefaivre, Shannon; Lutz, Kristen; MacPhee, F. Chris; Mikkelsen, Jordan; Mikkelsen, Tom; Mirotchnick, Nicholas; Schmah, Tanya; Studzinski, Christa M.; Stuss, Donald T.; Theriault, Elizabeth; Evans, Kenneth R.

2018-01-01

Historically, research databases have existed in isolation with no practical avenue for sharing or pooling medical data into high dimensional datasets that can be efficiently compared across databases. To address this challenge, the Ontario Brain Institute’s “Brain-CODE” is a large-scale neuroinformatics platform designed to support the collection, storage, federation, sharing and analysis of different data types across several brain disorders, as a means to understand common underlying causes of brain dysfunction and develop novel approaches to treatment. By providing researchers access to aggregated datasets that they otherwise could not obtain independently, Brain-CODE incentivizes data sharing and collaboration and facilitates analyses both within and across disorders and across a wide array of data types, including clinical, neuroimaging and molecular. The Brain-CODE system architecture provides the technical capabilities to support (1) consolidated data management to securely capture, monitor and curate data, (2) privacy and security best-practices, and (3) interoperable and extensible systems that support harmonization, integration, and query across diverse data modalities and linkages to external data sources. Brain-CODE currently supports collaborative research networks focused on various brain conditions, including neurodevelopmental disorders, cerebral palsy, neurodegenerative diseases, epilepsy and mood disorders. These programs are generating large volumes of data that are integrated within Brain-CODE to support scientific inquiry and analytics across multiple brain disorders and modalities. By providing access to very large datasets on patients with different brain disorders and enabling linkages to provincial, national and international databases, Brain-CODE will help to generate new hypotheses about the biological bases of brain disorders, and ultimately promote new discoveries to improve patient care. PMID:29875648

Use of a business excellence model to improve conservation programs.

PubMed

Black, Simon; Groombridge, Jim

2010-12-01

The current shortfall in effectiveness within conservation biology is illustrated by increasing interest in "evidence-based conservation," whose proponents have identified the need to benchmark conservation initiatives against actions that lead to proven positive effects. The effectiveness of conservation policies, approaches, and evaluation is under increasing scrutiny, and in these areas models of excellence used in business could prove valuable. Typically, conservation programs require years of effort and involve rigorous long-term implementation processes. Successful balance of long-term efforts alongside the achievement of short-term goals is often compromised by management or budgetary constraints, a situation also common in commercial businesses. "Business excellence" is an approach many companies have used over the past 20 years to ensure continued success. Various business excellence evaluations have been promoted that include concepts that could be adapted and applied in conservation programs. We describe a conservation excellence model that shows how scientific processes and results can be aligned with financial and organizational measures of success. We applied the model to two well-documented species conservation programs. In the first, the Po'ouli program, several aspects of improvement were identified, such as more authority for decision making in the field and better integration of habitat management and population recovery processes. The second example, the black-footed ferret program, could have benefited from leadership effort to reduce bureaucracy and to encourage use of best-practice species recovery approaches. The conservation excellence model enables greater clarity in goal setting, more-effective identification of job roles within programs, better links between technical approaches and measures of biological success, and more-effective use of resources. The model could improve evaluation of a conservation program's effectiveness and may be used to compare different programs, for example during reviews of project performance by sponsoring organizations. © 2010 Society for Conservation Biology.

Stating the Case for CTE in Arizona

ERIC Educational Resources Information Center

Reese, Susan

2006-01-01

This article discusses the academic success of CTE students in Arizona which is making a solid case for the role of career and technical education in America's high schools. When the Association for Career and Technical Education (ACTE) issued its position paper, "Reinventing the American High School for the 21st Century," it contained…

Case Studies on Technical and Vocational Education in Asia and the Pacific. Report of Regional Meeting (Kuala Lumpur, Malaysia, December 12-15, 1994). Exemplar Curriculum Project Working Group Report.

ERIC Educational Resources Information Center

Haas, Adrian, Ed.

This conference report provides summaries of presentations of country case studies from a project to investigate factors that impinged upon the status of technical and vocational education (TVE) in Asian and Pacific countries. The report includes the case study project terms of reference, a list of delegates, and agenda. Summaries follow of the…

A Review of Legal Decisions Relevant to Technical Standards Used in Pharmacy School Admissions

PubMed Central

2017-01-01

The implementation of an effective and legally sound technical standards procedure for pharmacy schools requires a proactive approach by admissions officers. Applicants with disabilities are accorded significant rights that must not be infringed during the admissions process in order to ensure compliance with applicable law. This article provides a review of applicable state cases, federal cases, and OCR decisions and guidance to help pharmacy schools identify procedures and implement technical standards into their admissions processes as required by ACPE Standards 2016. PMID:28381897

The Effect of Technical Assistance on Involvement and Use: The Case of a Research, Evaluation, and Technical Assistance Project

ERIC Educational Resources Information Center

Roseland, Denise; Volkov, Boris B.; Callow-Heusser, Catherine

2011-01-01

In contrast to typical National Science Foundation program evaluations, the Utah State Math Science Partnership-Research, Evaluation and Technical Assistance Project (MSP-RETA) provided technical assistance (TA) in two forms: direct TA for up to 10 projects a year, and professional development sessions for a larger number of project staff. Not…

Biological Water Quality Criteria

EPA Pesticide Factsheets

Page contains links to Technical Documents pertaining to Biological Water Quality Criteria, including, technical assistance documents for states, tribes and territories, program overviews, and case studies.

Collaboration Strategies to Reduce Technical Debt

ERIC Educational Resources Information Center

Miko, Jeffrey Allen

2017-01-01

Inadequate software development collaboration processes can allow technical debt to accumulate increasing future maintenance costs and the chance of system failures. The purpose of this qualitative case study was to explore collaboration strategies software development leaders use to reduce the amount of technical debt created by software…

48 CFR 715.303-70 - Responsibilities of USAID evaluation committees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... evaluation committees. A technical evaluation committee shall be established for each proposed procurement. In each case, the committee shall be composed of a chair representing the cognizant technical office... representatives from other concerned offices as appropriate. (b) Technical evaluation procedures. (1) The...

The importance of defining technical issues in interagency environmental negotiations

USGS Publications Warehouse

Lamb, B.L.; Burkardt, N.; Taylor, J.G.

2001-01-01

The role of technical clarity in successful multiparty negotiations was studied. Investigations involved in-depth interviews with the principal participants in six consultations conducted under the U.S. Federal Energy Regulatory Commission’s hydroelectric power project licensing procedures. Technical clarity was especially important in these cases because they concerned science-based questions. The principal issues in the six cases were fish passage, instream flow for fish habitat, and entrainment of fish in hydropower turbines. It was concluded that technical clarity was one of the most critical elements in resolving these conflicts. In the least successful negotiations, parties failed to address the basic values of the dispute before plunging into technical studies. The results of those studies usually highlighted the potential for negative outcomes and increased polarization between the participants. In the most successful negotiations, the various parties shared an understanding of each of their basic values. These shared understandings led to technical studies that cast the negotiation in a positive light and illuminated possible solutions.

Technical knowledge and skills development in the informal sector in Kenya: The case of custom tailors

NASA Astrophysics Data System (ADS)

Apunda, Edwinah Amondi; de Klerk, Helena M.; Ogina, Teresa

2017-06-01

Custom tailors working in the informal sector in Nairobi, Kenya, mainly acquire technical skills through undertaking traditional apprenticeships (TAs). However, most of these tailors are semi-skilled, produce low-quality products and are often poorer than their formally trained counterparts. This qualitative case study explores the aspects of technical skills and knowledge which tailoring apprentices develop, and the factors which influence these outcomes. The findings show that apprentices do acquire basic technical skills for immediate application to ongoing tailoring activities (such as how to take body measurements, draft patterns, and cut, sew and finish constructed garments). However, apprentices do not acquire the technical knowledge that underpins the trade. Most master tailors who have completed TAs lack technical knowledge and have no access to technical skills upgrading. This perpetuates the cycle of basic and limited technical skills transfer to apprentices, poor performance and poverty among tailors. Both apprentices and master tailors expressed concern over knowledge limitations in TAs and a need to access further training to improve skills and acquire knowledge of the trade. The authors of this article argue that, technically and pedagogically, skilled master tailors are critical to improving training quality. Complementary training in theoretical knowledge is also important in improving apprentices' technical skills and understanding of the trade. Inclusion of TAs in government policy may help ensure sustainable improvement of skills.

Organising, Providing and Evaluating Technical Training for Early Career Researchers: A Case Study

ERIC Educational Resources Information Center

van Besouw, Rachel M.; Rogers, Katrine S.; Powles, Christopher J.; Papadopoulos, Timos; Ku, Emery M.

2013-01-01

This paper considers the importance of providing technical training opportunities for Early Career Researchers (ECRs) worldwide through the case study of a MATLAB training programme, which was proposed, organised, managed and evaluated by a team of five ECRs at the University of Southampton. The effectiveness of the programme in terms of the…

Technical Knowledge and Skills Development in the Informal Sector in Kenya: The Case of Custom Tailors

ERIC Educational Resources Information Center

Apunda, Edwinah Amondi; de Klerk, Helena M.; Ogina, Teresa

2017-01-01

Custom tailors working in the informal sector in Nairobi, Kenya, mainly acquire technical skills through undertaking traditional apprenticeships (TAs). However, most of these tailors are semi-skilled, produce low-quality products and are often poorer than their formally trained counterparts. This qualitative case study explores the aspects of…

BluePyOpt: Leveraging Open Source Software and Cloud Infrastructure to Optimise Model Parameters in Neuroscience.

PubMed

Van Geit, Werner; Gevaert, Michael; Chindemi, Giuseppe; Rössert, Christian; Courcol, Jean-Denis; Muller, Eilif B; Schürmann, Felix; Segev, Idan; Markram, Henry

2016-01-01

At many scales in neuroscience, appropriate mathematical models take the form of complex dynamical systems. Parameterizing such models to conform to the multitude of available experimental constraints is a global non-linear optimisation problem with a complex fitness landscape, requiring numerical techniques to find suitable approximate solutions. Stochastic optimisation approaches, such as evolutionary algorithms, have been shown to be effective, but often the setting up of such optimisations and the choice of a specific search algorithm and its parameters is non-trivial, requiring domain-specific expertise. Here we describe BluePyOpt, a Python package targeted at the broad neuroscience community to simplify this task. BluePyOpt is an extensible framework for data-driven model parameter optimisation that wraps and standardizes several existing open-source tools. It simplifies the task of creating and sharing these optimisations, and the associated techniques and knowledge. This is achieved by abstracting the optimisation and evaluation tasks into various reusable and flexible discrete elements according to established best-practices. Further, BluePyOpt provides methods for setting up both small- and large-scale optimisations on a variety of platforms, ranging from laptops to Linux clusters and cloud-based compute infrastructures. The versatility of the BluePyOpt framework is demonstrated by working through three representative neuroscience specific use cases.

24 CFR 570.402 - Technical assistance awards.

Code of Federal Regulations, 2014 CFR

2014-04-01

... CFR part 571); and the Special Purpose Grants for Insular Areas, Community Development Work Study and... attended by more than one unit of government. (d) Eligible activities. Activities eligible for technical.... Activities for which costs are ineligible under this section include: (1) In the case of technical assistance...

24 CFR 570.402 - Technical assistance awards.

Code of Federal Regulations, 2011 CFR

2011-04-01

... CFR part 571); and the Special Purpose Grants for Insular Areas, Community Development Work Study and... attended by more than one unit of government. (d) Eligible activities. Activities eligible for technical.... Activities for which costs are ineligible under this section include: (1) In the case of technical assistance...

Systems Engineering Technical Leadership Development Program

DTIC Science & Technology

2012-02-01

leading others in creative problem solving, complexity, and why projects fail . These topics were additionally supported by case studies designed to...Your Core Values Dominick Wed 12:30-1:30 Lunch Wed 1:30-2:45 Case Study: Why Projects Fail Pennotti Wed 2:45-3:00 Break Wed 3:00-4:30 Project...Case Study: When Good Wasn’t Good Enough 11. Technical Value-5: Group Project: AR2D2 RFP 12. Customer Expectation-1: Lecture: Why Systems Fail

[Survival analysis of 487 patients with kidney transplantation].

PubMed

Ianhez, L E; de Paula, F J; Campagnari, J C; Nahas, W C; Saldanha, L B; Arap, S; Sabbaga, E

1992-01-01

The causes of graft loss were analysed in a group of 487 kidney transplants, of which 252 (51.46%) concerned related donors, 139 (28.5%) cadaver donors and 96 (19.7%) non-related donors. A total of 74 kidneys were lost in the first 3 months after transplantation (15.19%). In 34 cases the loss was due to immunological factors (45.9%) in 21 cases (28.3%) to the death of the patients and in 19 cases (25.7%) to the technical causes. From 34 losses by immunological problems, 32 were rejections with humoral character (acute vascular rejection in 11 cases, late humoral rejection in 11 cases, immediate humoral rejection in 9 cases, ABO incompatibility in one case) and recurrence of original disease in one case. Acute cellular rejection was observed in only one patient. None of the patients died from immunological loss of the graft. The most frequent cause of death were sepsis (13 out of 21 patients) and the most common focus of infection was pulmonary (5 patients). It occurred most frequently with cadaveric donor, (10.07%). Death related to cardiovascular causes occurred in four patients, digestive in two and in consequence of arterial bleeding in two. Among the 23 losses by technical factors renal artery thrombosis was the most frequent (11 cases); renal rupture occurred in three cases, renal vein thrombosis in two rupture of arterial anastomosis in one and inviable kidney in another one. The technical loss was most frequent with cadaver donors (8.63%), followed by non-related donors (4.16%) and related donors (2.77%). Four patients died from causes directly related to technical factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Trials and tribulations: cross-learning from the practices of epidemiologists and economists in the evaluation of public health interventions.

PubMed

Powell-Jackson, Timothy; Davey, Calum; Masset, Edoardo; Krishnaratne, Shari; Hayes, Richard; Hanson, Kara; Hargreaves, James R

2018-06-01

The randomized controlled trial is commonly used by both epidemiologists and economists to test the effectiveness of public health interventions. Yet we have noticed differences in practice between the two disciplines. In this article, we propose that there are some underlying differences between the disciplines in the way trials are used, how they are conducted and how results from trials are reported and disseminated. We hypothesize that evidence-based public health could be strengthened by understanding these differences, harvesting best-practice across the disciplines and breaking down communication barriers between economists and epidemiologists who conduct trials of public health interventions.

[The German program for disease management guidelines--implementation with pathways and quality management].

PubMed

Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina

2007-07-15

In Germany, physicians enrolled in disease management programs are legally obliged to follow evidence-based clinical practice guidelines. That is why a Program for National Disease Management Guidelines (German DM-CPG Program) was established in 2002 aiming at implementation of best-practice evidence-based recommendations for nationwide as well as regional disease management programs. Against this background the article reviews programs, methods and tools for implementing DM-CPGs via clinical pathways as well as regional guidelines for outpatient care. Special reference is given to the institutionalized program of adapting DM-CPGs for regional use by primary-care physicians in the State of Hesse.

Emergency management of renal and genitourinary trauma: best practices update [digest].

PubMed

Bryant, Whitney K; Shewakramani, Sanjay; Zaurova, Milana

2017-08-22

In up to 10% of patients who experience abdominal trauma, renal and urogenital systems will be involved. In polytrauma patients with other potentially life-threatening injuries, renal and genitourinary trauma may be overlooked initially, but a delayed or missed diagnosis of these injuries may result in preventable complications. This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy. [Points & Pearls is a digest of Emergency Medicine Practice.].

Communicating the Future: Best Practices for Communication of Science and Technology to the Public

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

Porter, Gail

To advance the state of the art in science and technology communication to the public a conference was held March 6-8, 2002 at the National Institute of Standards and Technology in Gaithersburg, MD. This report of the conference proceedings includes a summary statement by the conference steering committee, transcripts or other text summarizing the remarks of conference speakers, and abstracts for 48 "best practice" communications programs selected by the steering committee through an open competition and a formal peer review process. Additional information about the 48 best practice programs is available on the archival conference Web site at www.nist.gov/bestpractices.

Emergency Department Medical Clearance of Patients with Psychiatric or Behavioral Emergencies, Part 1.

PubMed

Tucci, Veronica Theresa; Moukaddam, Nidal; Alam, Al; Rachal, James

2017-09-01

Patients presenting to the emergency department with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, interdisciplinary consensus on medical clearance is lacking, leading to wide variations in quality of care and, quite often, poor medical care. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach. This article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical or physical examination, and common pitfalls in the medical clearance process. Copyright © 2017 Elsevier Inc. All rights reserved.

Social marketing: application to medical education.

PubMed

David, S P; Greer, D S

2001-01-16

Medical education is often a frustrating endeavor, particularly when it attempts to change practice behavior. Traditional lecture-based educational methods are limited in their ability to sustain concentration and interest and to promote learner adherence to best-practice guidelines. Marketing techniques have been very effective in changing consumer behavior and physician behavior. However, the techniques of social marketing-goal identification, audience segmentation, and market research-have not been harnessed and applied to medical education. Social marketing can be applied to medical education in the effort to go beyond inoculation of learners with information and actually change behaviors. The tremendous potential of social marketing for medical education should be pilot-tested and systematically evaluated.

Exploration studies technical report, FY1988 status. Volume 1: Technical summary

NASA Technical Reports Server (NTRS)

1988-01-01

The Office of Exploration (OEXP) at NASA Headquarters has been tasked with defining and recommending alternatives for an early 1990's nationaL decision on a focused program of human exploration of the solar system. The Mission Analysis and System Engineering (MASE) group, which is managed by the Exploration Studies Office at the Lyndon B. Johnson Space Center, is responsible for coordinating the technical studies necessary for accomplishing such a task. This technical report, produced by the MASE, describes the process that has been developed in a case study approach. The four case studies developed in FY88 include: (1) Human Expedition to Phobos; (2) Human Expedition to Mars; (3) Lunar Observatory; and (4) Lunar Outpost to Early Mars Evolution. The final outcome of this effort is a set of programmatic and technical conclusions and recommendations for the following year's work.

The Marketability of Technical Graduates from Higher Educational Institutions (HEIs) Offering Technical and Vocational Education and Training (TVET): A Case from Malaysia

ERIC Educational Resources Information Center

Rajadurai, Jegatheesan; Sapuan, Noraina Mazuin; Daud, Salina; Abidin, Nurazariah

2018-01-01

Technical, Vocational Education and Training has been viewed as a means of developing a nation. The marketability of technical graduates is reliant on whether these graduates possess the attributes demanded by their respective industries. Hence, this study aims to investigate the gap between the key attributes of Higher Education Institutions'…

The Evaluation of the Effectiveness of ESP Courses in Enhancing Technical Translation Proficiency: A Case Study of ESP Course for Mechanical Engineering Students

ERIC Educational Resources Information Center

Hatam, Amir Hussein; Shafiei, Shilan

2012-01-01

The purpose of the present study was twofold. Firstly, it tried to investigate the relationship between the technical English proficiency of the students of Mechanical Engineering in the universities of Iran and their technical translation proficiency in translating technical texts of Mechanics. Secondly, it attempted to evaluate the effectiveness…

78 FR 51210 - Agency Information Collection Activities; Proposed Collection; Comments Requested: Office for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-20

... Technical Assistance Center (OVC TTAC) Online Trainings Package ACTION: 30-day notice. The Department of...: The Office for Victims of Crime Training and Technical Assistance Center (OVC TTAC) Online Trainings... online training and technical assistance and, in some cases, to online instructors or participants...

78 FR 36578 - Agency Information Collection Activities; Proposed Collection; Comments Requested: Office for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-18

... Collection; Comments Requested: Office for Victims of Crime Training and Technical Assistance Center (OVC...; Businesses or other for-profit. Abstract: The Office for Victims of Crime Training and Technical Assistance... will deliver these forms to recipients of online training and technical assistance and, in some cases...

22 CFR 126.1 - Prohibited exports and sales to certain countries.

Code of Federal Regulations, 2010 CFR

2010-04-01

...-case basis, for supplies of arms and related materials or technical training and assistance intended... Haiti, supplies of arms and related materials for technical training and assistance intended solely for..., defense services or technical data subject to this subchapter may be made to any country referred to in...

Crossing the Chasm--Introducing Flexible Learning into the Botswana Technical Education Programme: From Policy to Action

ERIC Educational Resources Information Center

Richardson, Alison Mead

2009-01-01

This paper reports on a longitudinal, ethnomethodological case study of the development towards flexible delivery of the Botswana Technical Education Programme (BTEP), offered by Francistown College of Technical & Vocational Education (FCTVE). Data collection methods included documentary analysis, naturalistic participant observation, and…

A Sharper Focus on Technical Workers: How to Educate and Train for the Global Economy

ERIC Educational Resources Information Center

Lamos, Erin; Simon, Martin; Waits, Mary Jo

2010-01-01

This report presents a case study of the Automotive Manufacturing Technical Education Collaborative (AMTEC), which brings together auto manufacturers and community colleges across 12 states to identify and implement wide-ranging improvements in technical education for automotive manufacturing workers. A "Big Collaboration"--AMTEC…

Building energy information systems: Synthesis of costs, savings, and best-practice uses

DOE PAGES

Granderson, Jessica; Lin, Guanjing

2016-02-19

Building energy information systems (EIS) are a powerful customer-facing monitoring and analytical technology that can enable up to 20% site energy savings for buildings. Few technologies are as heavily marketed, but in spite of their potential, EIS remain an under-adopted emerging technology. One reason is the lack of information on purchase costs and associated energy savings. While insightful, the growing body of individual case studies has not provided industry the information needed to establish the business case for investment. Vastly different energy and economic metrics prevent generalizable conclusions. This paper addresses three common questions concerning EIS use: what are themore » costs, what have users saved, and which best practices drive deeper savings? We present a large-scale assessment of the value proposition for EIS use based on data from over two-dozen organizations. Participants achieved year-over-year median site and portfolio savings of 17% and 8%, respectively; they reported that this performance would not have been possible without the EIS. The median five-year cost of EIS software ownership (up-front and ongoing costs) was calculated to be $1,800 per monitoring point (kilowatt meter points were most common), with a median portfolio-wide implementation size of approximately 200 points. In this paper, we present an analysis of the relationship between key implementation factors and achieved energy reductions. Extent of efficiency projects, building energy performance prior to EIS installation, depth of metering, and duration of EIS were strongly correlated with greater savings. As a result, we also identify the best practices use of EIS associated with greater energy savings.« less

Building energy information systems: Synthesis of costs, savings, and best-practice uses

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

Granderson, Jessica; Lin, Guanjing

Building energy information systems (EIS) are a powerful customer-facing monitoring and analytical technology that can enable up to 20% site energy savings for buildings. Few technologies are as heavily marketed, but in spite of their potential, EIS remain an under-adopted emerging technology. One reason is the lack of information on purchase costs and associated energy savings. While insightful, the growing body of individual case studies has not provided industry the information needed to establish the business case for investment. Vastly different energy and economic metrics prevent generalizable conclusions. This paper addresses three common questions concerning EIS use: what are themore » costs, what have users saved, and which best practices drive deeper savings? We present a large-scale assessment of the value proposition for EIS use based on data from over two-dozen organizations. Participants achieved year-over-year median site and portfolio savings of 17% and 8%, respectively; they reported that this performance would not have been possible without the EIS. The median five-year cost of EIS software ownership (up-front and ongoing costs) was calculated to be $1,800 per monitoring point (kilowatt meter points were most common), with a median portfolio-wide implementation size of approximately 200 points. In this paper, we present an analysis of the relationship between key implementation factors and achieved energy reductions. Extent of efficiency projects, building energy performance prior to EIS installation, depth of metering, and duration of EIS were strongly correlated with greater savings. As a result, we also identify the best practices use of EIS associated with greater energy savings.« less

Influences of Gender and Computer Gaming Experience in Occupational Desktop Virtual Environments: A Cross-Case Analysis Study

ERIC Educational Resources Information Center

Ausburn, Lynna J.; Ausburn, Floyd B.; Kroutter, Paul J.

2013-01-01

This study used a cross-case analysis methodology to compare four line-of-inquiry studies of desktop virtual environments (DVEs) to examine the relationships of gender and computer gaming experience to learning performance and perceptions. Comparison was made of learning patterns in a general non-technical DVE with patterns in technically complex,…

Communication and Collaboration in Library Technical Services: A Case Study of New York University in Abu Dhabi

ERIC Educational Resources Information Center

Parrott, Justin

2016-01-01

New York University Abu Dhabi Library has developed new strategies to increase efficiency in technical services processing between units based in New York and Abu Dhabi. This case study discusses the challenges specific to the international context and the methods used to overcome them, increase speed processing, and ultimately improve patron…

Summary of technical testimony in the Colorado Water Division 1 Trial

Treesearch

Nancy (Tech. Coord.) Gordon

1995-01-01

The Colorado Water Division 1 Water Rights Trial was one of the most significant federal reserved instream flow water rights cases to occur since the Supreme Court of the United States ruled in the case of United States v. New Mexico in 1978. This document summarize the large amount of technical data and information pertaining to the disciplines of geomorphology,...

The use of physician-patient email: a follow-up examination of adoption and best-practice adherence 2005-2008.

PubMed

Menachemi, Nir; Prickett, Charles T; Brooks, Robert G

2011-02-25

Improved communication from physician- patient emailing is an important element of patient centeredness. Physician-patient email use has been low; and previous data from Florida suggest that physicians who email with patients rarely implement best-practice guidelines designed to protect physicians and patients. Our objective was to examine whether email use with patients has changed over time (2005-2008) by using two surveys of Florida physicians, and to determine whether physicians have more readily embraced the best-practice guidelines in 2008 versus 2005. Lastly, we explored the 2008 factors associated with email use with patients and determined whether these factors changed relative to 2005. Our pooled time-series design used results from a 2005 survey (targeting 14,921 physicians) and a separate 2008 survey (targeting 7003 different physicians). In both years, physicians practicing in the outpatient setting were targeted with proportionally identical sampling strategies. Combined data from questions focusing on email use were analyzed using chi-square analysis, Fisher exact test, and logistic regression. A combined 6260 responses were available for analyses, representing a participation rate of 28.2% (4203/14,921) in 2005 and 29.4% (2057/7003) in 2008. Relative to 2005, respondents in 2008 were more likely to indicate that they personally used email with patients (690/4148, 16.6% vs 408/2001, 20.4%, c(2) (1) = 13.0, P < .001). However, physicians who reported frequently using email with patients did not change from 2005 to 2008 (2.9% vs 59/2001, 2.9%). Interest among physicians in future email use with patients was lower in 2008 (58.4% vs 52.8%, c(2) (2) = 16.6, P < .001). Adherence to email best practices remained low in 2008. When comparing 2005 and 2008 adherences with each of the individual guidelines, rates decreased over time in each category and were significantly lower for 4 of the 13 guidelines. Physician characteristics in 2008 that predicted email use with patients were different from 2005. Specifically, in multivariate analysis female physicians (OR 1.48, 95% CI 1.12-1.95), specialist physicians (OR 1.43, 95% CI 1.12-1.84), and those in a multispecialty practice (OR 1.76, 95% CI 1.30-2.37) were more likely than their counterparts to email with patients. Additionally, self-reported computer competency levels (on a 5-point Likert scale) among physicians predicted email use at every level of response. Email use between physicians and patients has changed little between 2005 and 2008. However, future physician interest in using email with patients has decreased. More troubling is the decrease in adherence to best practices designed to protect physicians and patients when using email. Policy makers wanting to harness the potential benefits of physician-patient email should devise plans to encourage adherence to best practices. These plans should also educate physicians on the existence of best practices and methods to incorporate these guidelines into routine workflows.

Mobile Apps for Bipolar Disorder: A Systematic Review of Features and Content Quality

PubMed Central

Larsen, Mark Erik; Proudfoot, Judith; Christensen, Helen

2015-01-01

Background With continued increases in smartphone ownership, researchers and clinicians are investigating the use of this technology to enhance the management of chronic illnesses such as bipolar disorder (BD). Smartphones can be used to deliver interventions and psychoeducation, supplement treatment, and enhance therapeutic reach in BD, as apps are cost-effective, accessible, anonymous, and convenient. While the evidence-based development of BD apps is in its infancy, there has been an explosion of publicly available apps. However, the opportunity for mHealth to assist in the self-management of BD is only feasible if apps are of appropriate quality. Objective Our aim was to identify the types of apps currently available for BD in the Google Play and iOS stores and to assess their features and the quality of their content. Methods A systematic review framework was applied to the search, screening, and assessment of apps. We searched the Australian Google Play and iOS stores for English-language apps developed for people with BD. The comprehensiveness and quality of information was assessed against core psychoeducation principles and current BD treatment guidelines. Management tools were evaluated with reference to the best-practice resources for the specific area. General app features, and privacy and security were also assessed. Results Of the 571 apps identified, 82 were included in the review. Of these, 32 apps provided information and the remaining 50 were management tools including screening and assessment (n=10), symptom monitoring (n=35), community support (n=4), and treatment (n=1). Not even a quarter of apps (18/82, 22%) addressed privacy and security by providing a privacy policy. Overall, apps providing information covered a third (4/11, 36%) of the core psychoeducation principles and even fewer (2/13, 15%) best-practice guidelines. Only a third (10/32, 31%) cited their information source. Neither comprehensiveness of psychoeducation information (r=-.11, P=.80) nor adherence to best-practice guidelines (r=-.02, P=.96) were significantly correlated with average user ratings. Symptom monitoring apps generally failed to monitor critical information such as medication (20/35, 57%) and sleep (18/35, 51%), and the majority of self-assessment apps did not use validated screening measures (6/10, 60%). Conclusions In general, the content of currently available apps for BD is not in line with practice guidelines or established self-management principles. Apps also fail to provide important information to help users assess their quality, with most lacking source citation and a privacy policy. Therefore, both consumers and clinicians should exercise caution with app selection. While mHealth offers great opportunities for the development of quality evidence-based mobile interventions, new frameworks for mobile mental health research are needed to ensure the timely availability of evidence-based apps to the public. PMID:26283290

Education, Technical Progress, and Economic Growth: The Case of Taiwan.

ERIC Educational Resources Information Center

Lin, T.-C.

2003-01-01

Investigates the effect of education and the role of technical progress on economic growth in Taiwan from 1965-2000. Finds that education has a positive and significant effect on growth, but the role of technical progress does not appear to be extraordinarily important. Furthermore, no markedly significant relationships exist between capital and…

A Basic Unit on Ethics for Technical Communicators.

ERIC Educational Resources Information Center

Markel, Mike

1991-01-01

Describes a basic unit on ethics for technical communicators and offers suggestions on how to go about teaching the unit. Includes a brief definition of ethics, an explanation of the employee's three basic obligations, ways to analyze common dilemmas in technical communication, the role of the code of conduct, and a case study. (SR)

International Students in an Indian Technical University: Faculty Counselors' Preparedness and Perspectives

ERIC Educational Resources Information Center

Karky, Nandini

2013-01-01

A qualitative inquiry into the presence of international students in an Indian Technical University, through the voices of the faculty, who are appointed as international students' counselors. A case study methodology was employed with document analysis and interviews to perceive how technical faculty managed students from varying cultural…

Transferring Codified Knowledge: Socio-Technical versus Top-Down Approaches

ERIC Educational Resources Information Center

Guzman, Gustavo; Trivelato, Luiz F.

2008-01-01

Purpose: This paper aims to analyse and evaluate the transfer process of codified knowledge (CK) performed under two different approaches: the "socio-technical" and the "top-down". It is argued that the socio-technical approach supports the transfer of CK better than the top-down approach. Design/methodology/approach: Case study methodology was…

NASA Engineering Excellence: A Case Study on Strengthening an Engineering Organization

NASA Technical Reports Server (NTRS)

Shivers, C. Herbert; Wessel, Vernon W.

2006-01-01

NASA implemented a system of technical authority following the Columbia Accident Investigation Board (CAE) report calling for independent technical authority to be exercised on the Space Shuttle Program activities via a virtual organization of personnel exercising specific technical authority responsibilities. After the current NASA Administrator reported for duty, and following the first of two planned "Shuttle Return to Flight" missions, the NASA Chief Engineer and the Administrator redirected the Independent Technical Authority to a program of Technical Excellence and Technical Authority exercised within the existing engineering organizations. This paper discusses the original implementation of technical authority and the transition to the new implementation of technical excellence, including specific measures aimed at improving safety of future Shuttle and space exploration flights.

JPRS Report, Science & Technology, USSR: Science & Technology Policy

DTIC Science & Technology

1990-02-28

Biliary, Post-Operative, and Chronic Pancreatites ." 12. Doctor of Technical Sciences Oleg Nikolayevich Kukushkin and Candidate of Technical...Motorygin: What is amazing here: established production in case of the absence of a market and in case of a chronic shortage does not like innovations...tremendous losses due to chronic shortages of serviceable equipment. Dozens of original technological processes are aimed at solving this problem

The Significance of Social Relationships in Learning to Become a Vocational and Technical Education Teacher: A Case Study of Three Individuals

ERIC Educational Resources Information Center

Goh, Adeline Yuen Sze

2013-01-01

This article about workplace learning examines the learning of individuals in becoming a Vocational and Technical Education (VTE) teacher in Brunei. Drawing on research findings from a group of student teachers, it presents case study accounts of three individuals to illustrate the importance of social relationships in learning to become a VTE…

15 CFR 1180.4 - Preparing a product for transfer.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SCIENTIFIC, TECHNICAL AND ENGINEERING INFORMATION TO THE NATIONAL TECHNICAL INFORMATION SERVICE § 1180.4... medium; (3) In the case of software, be accompanied by relevant documentation, such as operating manuals...

The Preclose Technique in Percutaneous Endovascular Aortic Repair: A Systematic Literature Review and Meta-analysis

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

Jaffan, Abdel Aziz A., E-mail: aajaffan@gmail.com; Prince, Ethan A., E-mail: eprince@lifespan.org; Hampson, Christopher O., E-mail: christopherohampson@gmail.com

2013-06-15

Purpose. To establish the efficacy and safety of the preclose technique in total percutaneous endovascular aortic repair (PEVAR).MethodsA systematic literature search of Medline database was conducted for series on PEVAR published between January 1999 and January 2012.ResultsThirty-six articles comprising 2,257 patients and 3,606 arterial accesses were included. Anatomical criteria used to exclude patients from undergoing PEVAR were not uniform across all series. The technical success rate was 94 % per arterial access. Failure was unilateral in the majority (93 %) of the 133 failed PEVAR cases. The groin complication rate in PEVAR was 3.6 %; a minority (1.6 %) ofmore » these groin complications required open surgery. The groin complication rate in failed PEVAR cases converted to groin cutdown was 6.1 %. A significantly higher technical success rate was achieved when arterial access was performed via ultrasound guidance. Technical failure rate was significantly higher with larger sheath size ({>=}20F). Conclusion. The preclose technique in PEVAR has a high technical success rate and a low groin complication rate. Technical success tends to increase with ultrasound-guided arterial access and decrease with larger access. When failure occurs, it is unilateral in the majority of cases, and conversion to surgical cutdown does not appear to increase the operative risk.« less

Agency, Socio-Cultural Context, and the Role of the Technical Communicator during IT Adoption: A Case Study in Innovation Diffusion across Cultures

ERIC Educational Resources Information Center

Coggio, Grace Leinbach

2010-01-01

This dissertation examines the diffusion of an innovative information technology system across multiple cultures between 2000 and 2006. Developed and implemented by technical communicators in the technical communication department of a global medical device company, the Advanced Single-Source Authoring and Publication System (ASAPS) brought…

Strategic Management for Competitive Advantage: A Case Study of Higher Technical and Vocational Education in Taiwan

ERIC Educational Resources Information Center

Huang, Hsun-I; Lee, Cheng-Fei

2012-01-01

Higher technical and vocational education institutions in Taiwan face the pressure of an oversupply of student places and fierce competition from domestic and international institutions. To cope with these challenges, higher technical and vocational education institutions that are better equipped to respond to market requirements are expected to…

Methodology for Planning Technical Education: With a Case Study of Polytechnics in Bangladesh.

ERIC Educational Resources Information Center

Ritzen, Jozef M.; Balderston, Judith B.

A product of research first begun by one of the authors in Bangladesh, this book develops a comprehensive set of methods for planning technical education. Wherever possible, the authors draw on existing tools, fitting them to the specific context of technical education. When faced with planning problems for which existing methods are ill suited…

[Esophagojejunal anastomoses with the EEA stapler after total gastrectomy. Technic and immediate results apropos of a recent series of 32 cases].

PubMed

Le Treut, Y P; Delpero, J R; Sabiani, P; Berthet, B; Bozon-Verduraz, E; Pol, B; Bricot, R

1987-12-01

32 consecutive total gastrectomies for cancer (20 extended total gastrectomies) were carried out through an abdominal approach. Reconstruction using a Rouxen-Y loop (28 cases) or an interposed jejunal loop (four cases) was done with an EEA stapled oesophago jejunostomy: 25 end to side and 5 end to end anastomosis were performed and two technical failures led to complete manual anastomosis. All patients have had post-operative X-ray examination: there was no anastomotic leakage in this series, even in the 3 patients (10%) who have died during the post-operative course. A critical study of this series and eight others one from elsewhere is presented: it is concluded that the stapling device allows an easier and safer oesophagojejunostomy than manual procedure, when great care is taken of technical details.

Canadian Civil-Military Relations, 1939-1941: A Case Study in Strategic Dialogue

DTIC Science & Technology

2011-07-01

second case study, and the subject of a companion Technical Memorandum, will examine the debates about military power in 1940 in the context of the...their influence in national strategic discussions. The second case study, and the subject of a companion Technical Memorandum, examines the...comprendre ce qui arrive ou devrait arriver. Un examen du rôle joué par le Général H.D.G. Crerar, le chef d’état-major général en 1940-1941, dans les

15 CFR 1180.4 - Preparing a product for transfer.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., TECHNICAL AND ENGINEERING INFORMATION TO THE NATIONAL TECHNICAL INFORMATION SERVICE § 1180.4 Preparing a...) In the case of software, be accompanied by relevant documentation, such as operating manuals, but not...

15 CFR 1180.4 - Preparing a product for transfer.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., TECHNICAL AND ENGINEERING INFORMATION TO THE NATIONAL TECHNICAL INFORMATION SERVICE § 1180.4 Preparing a...) In the case of software, be accompanied by relevant documentation, such as operating manuals, but not...

15 CFR 1180.4 - Preparing a product for transfer.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., TECHNICAL AND ENGINEERING INFORMATION TO THE NATIONAL TECHNICAL INFORMATION SERVICE § 1180.4 Preparing a...) In the case of software, be accompanied by relevant documentation, such as operating manuals, but not...

15 CFR 1180.4 - Preparing a product for transfer.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., TECHNICAL AND ENGINEERING INFORMATION TO THE NATIONAL TECHNICAL INFORMATION SERVICE § 1180.4 Preparing a...) In the case of software, be accompanied by relevant documentation, such as operating manuals, but not...

A technical case report on use of tubular retractors for anterior cervical spine surgery.

PubMed

Kulkarni, Arvind G; Patel, Ankit; Ankith, N V

2017-12-19

The authors put-forth this technical report to establish the feasibility of performing an anterior cervical corpectomy and fusion (ACCF) and a two-level anterior cervical discectomy and fusion (ACDF) using a minimally invasive approach with tubular retractors. First case: cervical spondylotic myelopathy secondary to a large postero-inferiorly migrated disc treated with corpectomy and reconstruction with a mesh cage and locking plate. Second case: cervical disc herniation with radiculopathy treated with a two-level ACDF. Both cases were operated with minimally invasive approach with tubular retractor using a single incision. Technical aspects and clinical outcomes have been reported. No intra or post-operative complications were encountered. Intra-operative blood loss was negligible. The patients had a cosmetic scar on healing. Standard procedure of placement of tubular retractors is sufficient for adequate surgical exposure with minimal invasiveness. Minimally invasive approach to anterior cervical spine with tubular retractors is feasible. This is the first report on use of minimally invasive approach for ACCF and two-level ACDF.

Severe forms of concealed penis without hypospadias: Surgical strategies

PubMed Central

de Jesus, Lisieux Eyer; Dekermacher, Samuel; Anderson, Kleber M.

2015-01-01

Introduction: Concealed penis (CP) may vary in severity and includes megaprepuce (MP) as a variant. Many different surgical strategies have been described in order to maximize penile exposure and to deal with skin deficiency. We describe the strategies that we use to overcome technical problems in severe cases of CP. Materials and Methods: Six consecutive cases of severe CP (including 3 with MP) were treated in a 2-year period between January 2011 and April 2013. These patients were treated using extensive degloving, removal of dysplastic dartos, Alexander's preputial flap, scrotal flaps and skin grafts. Three patients had been previously circumcised. Cases associated with hypospadias, obesity, disorders of sexual differentiation and micropenises were excluded. Results: All six patients attained good results, with good exposure of the penis, ability to void standing with a well-directed flow and reasonable esthetic results. A technical algorithm for the treatment of primary or recurring cases of CP is proposed. Conclusion: Alexander’ s distally based ventral preputial flap is a useful technical resource to treat MP cases. Free skin grafts and/or laterally based scrotal flaps may be used to cover the penis after release in severe cases of CP. PMID:26604447

Technical Communication: Perspectives for the Eighties, Part 1. Proceedings of the Technical Communications Sessions at the 32Nd Annual Meeting of the Conference on College Composition and Communication

NASA Technical Reports Server (NTRS)

Mathes, J. C. (Compiler); Pinelli, T. E. (Compiler)

1981-01-01

Proceeding of the technical communication sessions at the 32nd annual meeting of the Conference on College Composition and Communication held in Dallas, Texas, March 26-28, 1981 are summarized. The proceeding suggest that technical communication has become an important subfield and is becoming an intrinsic part of many undergraduate curricula. Technical communication as a separate discipline, however, is relatively new. For that reason, proceedings that can make current research available as quickly as possible are suggested for preparation. The following topics were addressed: (1) a history and definition of technical writing, (2) the case method is technical communication (3) teaching technical writing (4) oral communication and rhetorical theory, and (5) new approaches in and practical applications of technical writing.

Methods for engaging stakeholders in comparative effectiveness research: a patient-centered approach to improving diabetes care.

PubMed

Schmittdiel, Julie A; Desai, Jay; Schroeder, Emily B; Paolino, Andrea R; Nichols, Gregory A; Lawrence, Jean M; O'Connor, Patrick J; Ohnsorg, Kris A; Newton, Katherine M; Steiner, John F

2015-06-01

Engaging stakeholders in the research process has the potential to improve quality of care and the patient care experience. Online patient community surveys can elicit important topic areas for comparative effectiveness research. Stakeholder meetings with substantial patient representation, as well as representation from health care delivery systems and research funding agencies, are a valuable tool for selecting and refining pilot research and quality improvement projects. Giving patient stakeholders a deciding vote in selecting pilot research topics helps ensure their 'voice' is heard. Researchers and health care leaders should continue to develop best-practices and strategies for increasing patient involvement in comparative effectiveness and delivery science research.

Decentralizing the Team Station: Simulation before Reality as a Best-Practice Approach.

PubMed

Charko, Jackie; Geertsen, Alice; O'Brien, Patrick; Rouse, Wendy; Shahid, Ammarah; Hardenne, Denise

2016-01-01

The purpose of this article is to share the logistical planning requirements and simulation experience of one Canadian hospital as it prepared its staff for the change from a centralized inpatient unit model to the decentralized design planned for its new community hospital. With the commitment and support of senior leadership, project management resources and clinical leads worked collaboratively to design a decentralized prototype in the form of a pod-style environment in the hospital's current setting. Critical success factors included engaging the right stakeholders, providing an opportunity to test new workflows and technology, creating a strong communication plan and building on lessons learned as subsequent pod prototypes are launched.

Children's sleep needs: is there sufficient evidence to recommend optimal sleep for children?

PubMed

Matricciani, Lisa; Blunden, Sarah; Rigney, Gabrielle; Williams, Marie T; Olds, Tim S

2013-04-01

It is widely recognized that sleep is important for children's health and well-being and that short sleep duration is associated with a wide range of negative health outcomes. Recently, there has been much interest in whether or not there are sufficient data to support the specific recommendations made for how much sleep children need. In this article we explore concepts related to children's sleep need, discuss the theory, rationale, and empirical evidence for contemporary sleep recommendations, and outline future research directions for sleep recommendations. If sleep is to be treated as a therapeutic intervention, then consensus guidelines, statements, and evidence-based best-practice documents are needed to underpin sleep recommendations for children.

Emergency Department Medical Clearance of Patients with Psychiatric or Behavioral Emergencies, Part 2: Special Psychiatric Populations and Considerations.

PubMed

Alam, Al; Rachal, James; Tucci, Veronica Theresa; Moukaddam, Nidal

2017-09-01

Patients who present to the emergency department (ED) with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, there are wide variations in quality of care for these individuals. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach to patients. Our group has long advocated a dynamic comanagement approach for medical clearance in the ED, and this article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical/physical examination, and common pitfalls in the medical clearance process. Copyright © 2017 Elsevier Inc. All rights reserved.

Imaging normal pressure hydrocephalus: theories, techniques, and challenges.

PubMed

Keong, Nicole C H; Pena, Alonso; Price, Stephen J; Czosnyka, Marek; Czosnyka, Zofia; Pickard, John D

2016-09-01

The pathophysiology of NPH continues to provoke debate. Although guidelines and best-practice recommendations are well established, there remains a lack of consensus about the role of individual imaging modalities in characterizing specific features of the condition and predicting the success of CSF shunting. Variability of clinical presentation and imperfect responsiveness to shunting are obstacles to the application of novel imaging techniques. Few studies have sought to interpret imaging findings in the context of theories of NPH pathogenesis. In this paper, the authors discuss the major streams of thought for the evolution of NPH and the relevance of key imaging studies contributing to the understanding of the pathophysiology of this complex condition.

Technical Objects between Categorisation and Learning: An Exploratory Case Study in French Middle School

ERIC Educational Resources Information Center

Impedovo, M. A.; Andreucci, C.; Delserieys-Pedregosa, A.; Coiffard, C.; Ginestié, J.

2015-01-01

In this article we present exploratory research carried out in order to understand how students (from 12 to 14 years old) relate to technical objects. It uses technical objects that are part of everyday life and mediated reality. A questionnaire was administered to 57 students in French classes. The questionnaire was composed of three parts: 1)…

Repositioning the Facilities in Technical College Workshops for Efficiency: A Case Study of North Central Nigeria

ERIC Educational Resources Information Center

Umar, Ibrahim Y.; Ma'aji, Abdullahi S.

2010-01-01

This article focuses on assessing the facilities in Government Technical College workshops in the context of a developing country. A descriptive survey design was adopted. Two research questions and a hypothesis were formulated to guide the study. A 35-item questionnaire was developed based on the National Board for Technical Education (NBTE)…

The Technology of Technology Transfer. The Case of the Japan-Singapore Technical Institute. Discussion Paper No. 93.

ERIC Educational Resources Information Center

Araujo e Oliveira, Joao Batista; Pillay, Gerald F.

The new economic and industrial policies of the 1980s called for a major restructuring of the industrial profile of Singapore. The government decided to set up three new technical institutes to prepare and supply skilled workers to new investors: French-, German-, and Japan-Singapore Technical Institutes with the collaboration of the government…

Soft Skills in Health Careers Programs: A Case Study of A Regional Vocational Technical High School

ERIC Educational Resources Information Center

Park, Chong Myung

2017-01-01

The purpose of this study is to develop an understanding of the ways in which educational experiences might differ between a regional vocational technical high school (RVTH) and short-term career-training programs. A particular regional vocational technical high school was selected for its outstanding academic records and placement rates, and a…

The U.S. government technical report and the transfer of federally funded aerospace R & D

NASA Technical Reports Server (NTRS)

Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

1993-01-01

This article discusses the U.S. government technical report and the transfer of federally funded aerospace research and development in a conceptual framework of the federal government as a producer of scientific and technical information. The article summarizes current literature and research and discusses U.S. government technical report use and the importance of using data obtained from the NASA/DoD Aerospace Knowledge Diffusion Research Project. The authors make a case for changing existing U.S. technology policy and present a research agenda for the U.S. government technical report.

Is perception of quality more important than technical quality in patient video cases?

PubMed

Roland, Damian; Matheson, David; Taub, Nick; Coats, Tim; Lakhanpaul, Monica

2015-08-13

The use of video cases to demonstrate key signs and symptoms in patients (patient video cases or PVCs) is a rapidly expanding field. The aims of this study were to evaluate whether the technical quality, or judgement of quality, of a video clip influences a paediatrician's judgment on acuity of the case and assess the relationship between perception of quality and the technical quality of a selection of video clips. Participants (12 senior consultant paediatricians attending an examination workshop) individually categorised 28 PVCs into one of 3 possible acuities and then described the quality of the image seen. The PVCs had been converted into four different technical qualities (differing bit rates ranging from excellent to low quality). Participants' assessment of quality and the actual industry standard of the PVC were independent (333 distinct observations, spearmans rho = 0.0410, p = 0.4564). Agreement between actual acuity and participants' judgement was generally good at higher acuities but moderate at medium/low acuities of illness (overall correlation 0.664). Perception of the quality of the clip was related to correct assignment of acuity regardless of the technical quality of the clip (number of obs = 330, z = 2.07, p = 0.038). It is important to benchmark PVCs prior to use in learning resources as experts may not agree on the information within, or quality of, the clip. It appears, although PVCs may be beneficial in a pedagogical context, the perception of quality of clip may be an important determinant of an expert's decision making.

OEXP exploration studies technical report. Volume 3: Special reports, studies, and indepth systems assessments

NASA Technical Reports Server (NTRS)

Roberts, Barney B.; Bland, Dan

1988-01-01

The Office of Exploration (OEXP) at NASA has been tasked with defining and recommending alternatives for an early 1990's national decision on a focused program of manned exploration of the Solar System. The Mission analysis and System Engineering (MASE) group, which is managed by the Exploration Studies Office at the Johnson Space Center, is responsible for coordinating the technical studies necessary for accomplishing such a task. This technical report, produced by the MASE, describes the process used to conduct exploration studies and discusses the mission developed in a case study approach. The four case studies developed in FY88 include: (1) a manned expedition to PHOBOS; (2) a manned expedition to MARS; (3) a lunar surface observatory; and a lunar outpost to early Mars evolution. The final outcome of this effort is a set of programmatic and technical conclusions and recommendations for the following year's work.

Eradicating Barriers to Mental Health Care Through Integrated Service Models: Contemporary Perspectives for Psychiatric-Mental Health Nurses.

PubMed

Ellis, Horace; Alexander, Vinette

2016-06-01

There has been renewed, global interest in developing new and transformative models of facilitating access to high-quality, cost-effective, and individually-centered health care for severe mentally-ill (SMI) persons of diverse racial/ethnic, cultural and socioeconomic backgrounds. However, in our present-day health-service delivery systems, scholars have identified layers of barriers to widespread dispersal of well-needed mental health care both nationally and internationally. It is crucial that contemporary models directed at eradicating barriers to mental health services are interdisciplinary in context, design, scope, sequence, and best-practice standards. Contextually, nurses are well-positioned to influence the incorporation and integration of new concepts into operationally interdisciplinary, evidence-based care models with measurable outcomes. The aim of this concept paper is to use the available evidence to contextually explicate how the blended roles of psychiatric mental health (PMH) nursing can be influential in eradicating barriers to care and services for SMI persons through the integrated principles of collaboration, integration and service expansion across health, socioeconomic, and community systems. A large body of literature proposes that any best-practice standards aimed at eliminating barriers to the health care needs of SMI persons require systematic, well-coordinated interdisciplinary partnerships through evidence-based, high-quality, person-centered, and outcome-driven processes. Transforming the conceptual models of collaboration, integration and service expansion could be revolutionary in how care and services are coordinated and dispersed to populations across disadvantaged communities. Building on their longstanding commitment to individual and community care approaches, and their pivotal roles in research, education, leadership, practice, and legislative processes; PMH nurses are well-positioned to be both influential and instrumental in the development of innovative, revolutionary, and transformative paradigmatic models aimed at eradicating treatment barriers, promoting well-being, and reducing preventable mortalities and morbidities among SMI persons. Copyright © 2016 Elsevier Inc. All rights reserved.

Explaining the uptake of paediatric guidelines in a Kenyan tertiary hospital--mixed methods research.

PubMed

Irimu, Grace W; Greene, Alexandra; Gathara, David; Kihara, Harrison; Maina, Christopher; Mbori-Ngacha, Dorothy; Zurovac, Dejan; Santau, Migiro; Todd, Jim; English, Mike

2014-03-10

Evidence-based standards for management of the seriously sick child have existed for decades, yet their translation in clinical practice is a challenge. The context and organization of institutions are known determinants of successful translation, however, research using adequate methodologies to explain the dynamic nature of these determinants in the quality-of-care improvement process is rarely performed. We conducted mixed methods research in a tertiary hospital in a low-income country to explore the uptake of locally adapted paediatric guidelines. The quantitative component was an uncontrolled before and after intervention study that included an exploration of the intervention dose-effect relationship. The qualitative component was an ethnographic research based on the theoretical perspective of participatory action research. Interpretive integration was employed to derive meta-inferences that provided a more complete picture of the overall study results that reflect the complexity and the multifaceted ontology of the phenomenon studied. The improvement in health workers' performance in relation to the intensity of the intervention was not linear and was characterized by improved and occasionally declining performance. Possible root causes of this performance variability included challenges in keeping knowledge and clinical skills updated, inadequate commitment of the staff to continued improvement, limited exposure to positive professional role models, poor teamwork, failure to maintain professional integrity and mal-adaptation to institutional pressures. Implementation of best-practices is a complex process that is largely unpredictable, attributed to the complexity of contextual factors operating predominantly at professional and organizational levels. There is no simple solution to implementation of best-practices. Tackling root causes of inadequate knowledge translation in this tertiary care setting will require long-term planning, with emphasis on promotion of professional ethics and values and establishing an organizational framework that enhances positive aspects of professionalism. This study has significant implications for the quality of training in medical institutions and the development of hospital leadership.

Explaining the uptake of paediatric guidelines in a Kenyan tertiary hospital – mixed methods research

PubMed Central

2014-01-01

Background Evidence-based standards for management of the seriously sick child have existed for decades, yet their translation in clinical practice is a challenge. The context and organization of institutions are known determinants of successful translation, however, research using adequate methodologies to explain the dynamic nature of these determinants in the quality-of-care improvement process is rarely performed. Methods We conducted mixed methods research in a tertiary hospital in a low-income country to explore the uptake of locally adapted paediatric guidelines. The quantitative component was an uncontrolled before and after intervention study that included an exploration of the intervention dose-effect relationship. The qualitative component was an ethnographic research based on the theoretical perspective of participatory action research. Interpretive integration was employed to derive meta-inferences that provided a more complete picture of the overall study results that reflect the complexity and the multifaceted ontology of the phenomenon studied. Results The improvement in health workers’ performance in relation to the intensity of the intervention was not linear and was characterized by improved and occasionally declining performance. Possible root causes of this performance variability included challenges in keeping knowledge and clinical skills updated, inadequate commitment of the staff to continued improvement, limited exposure to positive professional role models, poor teamwork, failure to maintain professional integrity and mal-adaptation to institutional pressures. Conclusion Implementation of best-practices is a complex process that is largely unpredictable, attributed to the complexity of contextual factors operating predominantly at professional and organizational levels. There is no simple solution to implementation of best-practices. Tackling root causes of inadequate knowledge translation in this tertiary care setting will require long-term planning, with emphasis on promotion of professional ethics and values and establishing an organizational framework that enhances positive aspects of professionalism. This study has significant implications for the quality of training in medical institutions and the development of hospital leadership. PMID:24613001

Bringing central line-associated bloodstream infection prevention home: catheter maintenance practices and beliefs of pediatric oncology patients and families.

PubMed

Rinke, Michael L; Chen, Allen R; Milstone, Aaron M; Hebert, Lindsay C; Bundy, David G; Colantuoni, Elizabeth; Fratino, Lisa; Herpst, Cynthia; Kokoszka, Michelle; Miller, Marlene R

2015-04-01

A study was conducted to investigate (1) the extent to which best-practice central line maintenance practices were employed in the homes of pediatric oncology patients and by whom, (2) caregiver beliefs about central line care and central line-associated blood stream infection (CLABSI) risk, (3) barriers to optimal central line care by families, and (4) educational experiences and preferences regarding central line care. Researchers administered a survey to patients and families in a tertiary care pediatric oncology clinic that engaged in rigorous ambulatory and inpatient CLABSI prevention efforts. Of 110 invited patients and caregivers, 105 participated (95% response rate) in the survey (March-May 2012). Of the 50 respondents reporting that they or another caregiver change central line dressings, 48% changed a dressing whenever it was soiled as per protocol (many who did not change dressings per protocol also never personally changed dressings); 67% reported the oncology clinic primarily cares for their child's central line, while 29% reported that an adult caregiver or the patient primarily cares for the central line. Eight patients performed their own line care "always" or "most of the time." Some 13% of respondents believed that it was "slightly likely" or "not at all likely" that their child will get an infection if caregivers do not perform line care practices perfectly every time. Dressing change practices were the most difficult to comply with at home. Some 18% of respondents wished they learned more about line care, and 12% received contradictory training. Respondents cited a variety of preferences regarding line care teaching, although the majority looked to clinic nurses for modeling line care. Interventions aimed at reducing ambulatory CLABSIs should target appropriate educational experiences for adult caregivers and patients and identify ways to improve compliance with best-practice care.

The Semantic Automated Discovery and Integration (SADI) Web service Design-Pattern, API and Reference Implementation

PubMed Central

2011-01-01

Background The complexity and inter-related nature of biological data poses a difficult challenge for data and tool integration. There has been a proliferation of interoperability standards and projects over the past decade, none of which has been widely adopted by the bioinformatics community. Recent attempts have focused on the use of semantics to assist integration, and Semantic Web technologies are being welcomed by this community. Description SADI - Semantic Automated Discovery and Integration - is a lightweight set of fully standards-compliant Semantic Web service design patterns that simplify the publication of services of the type commonly found in bioinformatics and other scientific domains. Using Semantic Web technologies at every level of the Web services "stack", SADI services consume and produce instances of OWL Classes following a small number of very straightforward best-practices. In addition, we provide codebases that support these best-practices, and plug-in tools to popular developer and client software that dramatically simplify deployment of services by providers, and the discovery and utilization of those services by their consumers. Conclusions SADI Services are fully compliant with, and utilize only foundational Web standards; are simple to create and maintain for service providers; and can be discovered and utilized in a very intuitive way by biologist end-users. In addition, the SADI design patterns significantly improve the ability of software to automatically discover appropriate services based on user-needs, and automatically chain these into complex analytical workflows. We show that, when resources are exposed through SADI, data compliant with a given ontological model can be automatically gathered, or generated, from these distributed, non-coordinating resources - a behaviour we have not observed in any other Semantic system. Finally, we show that, using SADI, data dynamically generated from Web services can be explored in a manner very similar to data housed in static triple-stores, thus facilitating the intersection of Web services and Semantic Web technologies. PMID:22024447

The Semantic Automated Discovery and Integration (SADI) Web service Design-Pattern, API and Reference Implementation.

PubMed

Wilkinson, Mark D; Vandervalk, Benjamin; McCarthy, Luke

2011-10-24

The complexity and inter-related nature of biological data poses a difficult challenge for data and tool integration. There has been a proliferation of interoperability standards and projects over the past decade, none of which has been widely adopted by the bioinformatics community. Recent attempts have focused on the use of semantics to assist integration, and Semantic Web technologies are being welcomed by this community. SADI - Semantic Automated Discovery and Integration - is a lightweight set of fully standards-compliant Semantic Web service design patterns that simplify the publication of services of the type commonly found in bioinformatics and other scientific domains. Using Semantic Web technologies at every level of the Web services "stack", SADI services consume and produce instances of OWL Classes following a small number of very straightforward best-practices. In addition, we provide codebases that support these best-practices, and plug-in tools to popular developer and client software that dramatically simplify deployment of services by providers, and the discovery and utilization of those services by their consumers. SADI Services are fully compliant with, and utilize only foundational Web standards; are simple to create and maintain for service providers; and can be discovered and utilized in a very intuitive way by biologist end-users. In addition, the SADI design patterns significantly improve the ability of software to automatically discover appropriate services based on user-needs, and automatically chain these into complex analytical workflows. We show that, when resources are exposed through SADI, data compliant with a given ontological model can be automatically gathered, or generated, from these distributed, non-coordinating resources - a behaviour we have not observed in any other Semantic system. Finally, we show that, using SADI, data dynamically generated from Web services can be explored in a manner very similar to data housed in static triple-stores, thus facilitating the intersection of Web services and Semantic Web technologies.

Data-Driven Benchmarking of Building Energy Efficiency Utilizing Statistical Frontier Models

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

Kavousian, A; Rajagopal, R

2014-01-01

Frontier methods quantify the energy efficiency of buildings by forming an efficient frontier (best-practice technology) and by comparing all buildings against that frontier. Because energy consumption fluctuates over time, the efficiency scores are stochastic random variables. Existing applications of frontier methods in energy efficiency either treat efficiency scores as deterministic values or estimate their uncertainty by resampling from one set of measurements. Availability of smart meter data (repeated measurements of energy consumption of buildings) enables using actual data to estimate the uncertainty in efficiency scores. Additionally, existing applications assume a linear form for an efficient frontier; i.e.,they assume that themore » best-practice technology scales up and down proportionally with building characteristics. However, previous research shows that buildings are nonlinear systems. This paper proposes a statistical method called stochastic energy efficiency frontier (SEEF) to estimate a bias-corrected efficiency score and its confidence intervals from measured data. The paper proposes an algorithm to specify the functional form of the frontier, identify the probability distribution of the efficiency score of each building using measured data, and rank buildings based on their energy efficiency. To illustrate the power of SEEF, this paper presents the results from applying SEEF on a smart meter data set of 307 residential buildings in the United States. SEEF efficiency scores are used to rank individual buildings based on energy efficiency, to compare subpopulations of buildings, and to identify irregular behavior of buildings across different time-of-use periods. SEEF is an improvement to the energy-intensity method (comparing kWh/sq.ft.): whereas SEEF identifies efficient buildings across the entire spectrum of building sizes, the energy-intensity method showed bias toward smaller buildings. The results of this research are expected to assist researchers and practitioners compare and rank (i.e.,benchmark) buildings more robustly and over a wider range of building types and sizes. Eventually, doing so is expected to result in improved resource allocation in energy-efficiency programs.« less

Cost and technical efficiency of physician practices: a stochastic frontier approach using panel data.

PubMed

Heimeshoff, Mareike; Schreyögg, Jonas; Kwietniewski, Lukas

2014-06-01

This is the first study to use stochastic frontier analysis to estimate both the technical and cost efficiency of physician practices. The analysis is based on panel data from 3,126 physician practices for the years 2006 through 2008. We specified the technical and cost frontiers as translog function, using the one-step approach of Battese and Coelli to detect factors that influence the efficiency of general practitioners and specialists. Variables that were not analyzed previously in this context (e.g., the degree of practice specialization) and a range of control variables such as a patients' case-mix were included in the estimation. Our results suggest that it is important to investigate both technical and cost efficiency, as results may depend on the type of efficiency analyzed. For example, the technical efficiency of group practices was significantly higher than that of solo practices, whereas the results for cost efficiency differed. This may be due to indivisibilities in expensive technical equipment, which can lead to different types of health care services being provided by different practice types (i.e., with group practices using more expensive inputs, leading to higher costs per case despite these practices being technically more efficient). Other practice characteristics such as participation in disease management programs show the same impact throughout both cost and technical efficiency: participation in disease management programs led to an increase in both, technical and cost efficiency, and may also have had positive effects on the quality of care. Future studies should take quality-related issues into account.

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients.

PubMed

Velickovski, Filip; Ceccaroni, Luigi; Roca, Josep; Burgos, Felip; Galdiz, Juan B; Marina, Nuria; Lluch-Ariet, Magí

2014-11-28

The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway. The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow. The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team. A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms. Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems.

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients

PubMed Central

2014-01-01

Background The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway. Objectives The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow. Methods The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team. Results A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms. Conclusions Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems. PMID:25471545

Intramuscular Tranexamic Acid in Tactical and Combat Settings.

PubMed

Vu, Erik N; Wan, Wilson C Y; Yeung, Titus C; Callaway, David W

Uncontrolled hemorrhage remains a leading cause of preventable death in tactical and combat settings. Alternate routes of delivery of tranexamic acid (TXA), an adjunct in the management of hemorrhagic shock, are being studied. A working group for the Committee for Tactical Emergency Casualty Care reviewed the available evidence on the potential role for intramuscular (IM) administration of TXA in nonhospital settings as soon as possible from the point of injury. EMBASE and MEDLINE/PubMed databases were sequentially searched by medical librarians for evidence of TXA use in the following contexts and/or using the following keywords: prehospital, trauma, hemorrhagic shock, optimal timing, optimal dose, safe volume, incidence of venous thromboembolism (VTE), IM bioavailability. A total of 183 studies were reviewed. The strength of the available data was variable, generally weak in quality, and included laboratory research, case reports, retrospective observational reviews, and few prospective studies. Current volume and concentrations of available formulations of TXA make it, in theory, amenable to IM injection. Current bestpractice guidelines for large-volume injection (i.e., 5mL) support IM administration in four locations in the adult human body. One case series suggests complete bioavailability of IM TXA in healthy patients. Data are lacking on the efficacy and safety of IM TXA in hemorrhagic shock. There is currently insufficient evidence to support a strong recommendation for or against IM administration of TXA in the combat setting; however, there is an abundance of literature demonstrating efficacy and safety of TXA use in a broad range of patient populations. Balancing the available data and risk- benefit ratio, IM TXA should be considered a viable treatment option for tactical and combat applications. Additional studies should focus on the optimal dose and bioavailability of IM dosing of patients in hemorrhagic shock, with assessment of potential downstream sequelae. 2018.

Best Practices in Physics Program Assessment: Should APS Provide Accreditation Standards for Physics?

NASA Astrophysics Data System (ADS)

Hodapp, Theodore

The Phys21 report, ``Preparing Physics Students for 21st Century Careers,'' provides guidance for physics programs to improve their degree programs to make them more relevant for student career choices. Undertaking such changes and assessing impact varies widely by institution, with many departments inventing assessments with each periodic departmental or programmatic review. American Physical Society has embarked on a process to integrate information from Phys21, the results of other national studies, and educational research outcomes to generate a best-practices guide to help physics departments conduct program review, assessment, and improvement. It is anticipated that departments will be able to use this document to help with their role in university-level accreditation, and in making the case for improvements to departmental programs. Accreditation of physics programs could stem from such a document, and I will discuss some of the thinking of the APS Committee on Education in creating this guide, and how they are advising APS to move forward in the higher education landscape that is increasingly subject to standards-based evaluations. I will describe plans for the design, review, and dissemination of this guide, and how faculty can provide input into its development. This material is based upon work supported by the National Science Foundation under Grant No. 1540570. Opinions expressed do not necessarily reflect those of the NSF.

BluePyOpt: Leveraging Open Source Software and Cloud Infrastructure to Optimise Model Parameters in Neuroscience

PubMed Central

Van Geit, Werner; Gevaert, Michael; Chindemi, Giuseppe; Rössert, Christian; Courcol, Jean-Denis; Muller, Eilif B.; Schürmann, Felix; Segev, Idan; Markram, Henry

2016-01-01

At many scales in neuroscience, appropriate mathematical models take the form of complex dynamical systems. Parameterizing such models to conform to the multitude of available experimental constraints is a global non-linear optimisation problem with a complex fitness landscape, requiring numerical techniques to find suitable approximate solutions. Stochastic optimisation approaches, such as evolutionary algorithms, have been shown to be effective, but often the setting up of such optimisations and the choice of a specific search algorithm and its parameters is non-trivial, requiring domain-specific expertise. Here we describe BluePyOpt, a Python package targeted at the broad neuroscience community to simplify this task. BluePyOpt is an extensible framework for data-driven model parameter optimisation that wraps and standardizes several existing open-source tools. It simplifies the task of creating and sharing these optimisations, and the associated techniques and knowledge. This is achieved by abstracting the optimisation and evaluation tasks into various reusable and flexible discrete elements according to established best-practices. Further, BluePyOpt provides methods for setting up both small- and large-scale optimisations on a variety of platforms, ranging from laptops to Linux clusters and cloud-based compute infrastructures. The versatility of the BluePyOpt framework is demonstrated by working through three representative neuroscience specific use cases. PMID:27375471

Vocational Guidance for Equal Access and Opportunity for Girls and Women in Technical and Vocational Education. UNEVOC Studies in Technical and Vocational Education 6.

ERIC Educational Resources Information Center

Miller, Juliet V.; Vetter, Louise

A study examined the relevance of vocational information and guidance for the equal access of girls and women to technical/vocational education in the following countries: Argentina; India; Mexico; Republic of Korea; South Africa; Spain; Sweden; Turkey; United Arab Emirates; and Zambia. Case studies were conducted by using a multiple-strategy…

The Use of Physician-Patient Email: A Follow-up Examination of Adoption and Best-Practice Adherence 2005-2008

PubMed Central

Prickett, Charles T; Brooks, Robert G

2011-01-01

Background Improved communication from physician- patient emailing is an important element of patient centeredness. Physician-patient email use has been low; and previous data from Florida suggest that physicians who email with patients rarely implement best-practice guidelines designed to protect physicians and patients. Objective Our objective was to examine whether email use with patients has changed over time (2005-2008) by using two surveys of Florida physicians, and to determine whether physicians have more readily embraced the best-practice guidelines in 2008 versus 2005. Lastly, we explored the 2008 factors associated with email use with patients and determined whether these factors changed relative to 2005. Methods Our pooled time-series design used results from a 2005 survey (targeting 14,921 physicians) and a separate 2008 survey (targeting 7003 different physicians). In both years, physicians practicing in the outpatient setting were targeted with proportionally identical sampling strategies. Combined data from questions focusing on email use were analyzed using chi-square analysis, Fisher exact test, and logistic regression. Results A combined 6260 responses were available for analyses, representing a participation rate of 28.2% (4203/14,921) in 2005 and 29.4% (2057/7003) in 2008. Relative to 2005, respondents in 2008 were more likely to indicate that they personally used email with patients (690/4148, 16.6% vs 408/2001, 20.4%, c2 1 = 13.0, P < .001). However, physicians who reported frequently using email with patients did not change from 2005 to 2008 (2.9% vs 59/2001, 2.9%). Interest among physicians in future email use with patients was lower in 2008 (58.4% vs 52.8%, c2 2 = 16.6, P < .001). Adherence to email best practices remained low in 2008. When comparing 2005 and 2008 adherences with each of the individual guidelines, rates decreased over time in each category and were significantly lower for 4 of the 13 guidelines. Physician characteristics in 2008 that predicted email use with patients were different from 2005. Specifically, in multivariate analysis female physicians (OR 1.48, 95% CI 1.12-1.95), specialist physicians (OR 1.43, 95% CI 1.12-1.84), and those in a multispecialty practice (OR 1.76, 95% CI 1.30-2.37) were more likely than their counterparts to email with patients. Additionally, self-reported computer competency levels (on a 5-point Likert scale) among physicians predicted email use at every level of response. Conclusions Email use between physicians and patients has changed little between 2005 and 2008. However, future physician interest in using email with patients has decreased. More troubling is the decrease in adherence to best practices designed to protect physicians and patients when using email. Policy makers wanting to harness the potential benefits of physician-patient email should devise plans to encourage adherence to best practices. These plans should also educate physicians on the existence of best practices and methods to incorporate these guidelines into routine workflows. PMID:21447468

NASA/DoD Aerospace Knowledge Diffusion Research Project. Paper 29: The US government technical report and the transfer of federally funded aerospace R and D

NASA Technical Reports Server (NTRS)

Pinelli, Thomas E.; Barclay, Rebecca O.; Kennedy, John M.

1993-01-01

This article discusses the U.S. government technical report and the transfer of federally funded aerospace research and development in a conceptual framework of the federal government as a producer of scientific and technical information. The article summarizes current literature and research and discusses U.S. government technical report use and the importance of using data obtained from the NASA/DoD Aerospace Knowledge Diffusion Research Project. The authors make a case for changing existing U.S. technology policy and present a research agenda for the U.S. government technical report.

Properties of some statistics for AR-ARCH model with application to technical analysis

NASA Astrophysics Data System (ADS)

Huang, Xudong; Liu, Wei

2009-03-01

In this paper, we investigate some popular technical analysis indexes for AR-ARCH model as real stock market. Under the given conditions, we show that the corresponding statistics are asymptotically stationary and the law of large numbers hold for frequencies of the stock prices falling out normal scope of these technical analysis indexes under AR-ARCH, and give the rate of convergence in the case of nonstationary initial values, which give a mathematical rationale for these methods of technical analysis in supervising the security trends.

IVHS institutional issues and case studies : ADVANCE case study

DOT National Transportation Integrated Search

1994-04-01

This operational test case study is one of six performed in response to a Volpe National Transportation Systems Center technical task directive (TTD) to Science Applications International Corporation (SAIC) entitled, IVHS Institutional Issues and ...

National Strategies for Developing Human Resources through Technical and Vocational Education and Training. The 2001 KRIVET International Conference on Technical and Vocational Education and Training [Proceedings] (Seoul, South Korea, November 21-23, 2001).

ERIC Educational Resources Information Center

Korea Research Inst. for Vocational Education and Training, Seoul.

This document contains 19 papers and case studies, in English and Korean, from a conference on national strategies for developing human resources through technical and vocational education and training. The following are representative: "The Need to Innovate and Optimize Resources [Keynote]" (Wataru Iwamoto); "School to Work…

Design Development Test and Evaluation (DDT and E) Considerations for Safe and Reliable Human Rated Spacecraft Systems

NASA Technical Reports Server (NTRS)

Miller, James; Leggett, Jay; Kramer-White, Julie

2008-01-01

A team directed by the NASA Engineering and Safety Center (NESC) collected methodologies for how best to develop safe and reliable human rated systems and how to identify the drivers that provide the basis for assessing safety and reliability. The team also identified techniques, methodologies, and best practices to assure that NASA can develop safe and reliable human rated systems. The results are drawn from a wide variety of resources, from experts involved with the space program since its inception to the best-practices espoused in contemporary engineering doctrine. This report focuses on safety and reliability considerations and does not duplicate or update any existing references. Neither does it intend to replace existing standards and policy.

Medical talent management: a model for physician deployment.

PubMed

Brightman, Baird

2007-01-01

This article aims to provide a focused cost-effective method for triaging physicians into appropriate non-clinical roles to benefit both doctors and healthcare organizations. Reviews a validated career-planning process and customize it for medical talent management. A structured career assessment can differentiate between different physician work styles and direct medical talent into best-fit positions. This allows healthcare organizations to create a more finely tuned career ladder than the familiar "in or out" binary choice. PRACTICAL IMPLICATIONS--Healthcare organizations can invest in cost-effective processes for the optimal utilization of their medical talent. Provides a new use for a well-validated career assessment and planning system. The actual value of this approach should be studied using best-practices in ROI research.

Implanon NXT: Expert tips for best-practice insertion and removal.

PubMed

Pearson, Suzanne; Stewart, Mary; Bateson, Deborah

2017-03-01

The single rod etonogestrel contraceptive implant is available in Australia as Implanon NXT. It is a highly effective, long-acting reversible contraceptive method, which is suitable for most women across the reproductive lifespan. This article provides practical advice for clinicians who already insert and remove the contraceptive implant, as well as advice for those who have not yet acquired this procedural skill. Contraceptive implant procedures are usually performed in the general practice setting. Clinicians can support women in making an informed choice to have an implant by providing information about their benefits, side effects and risks, and timely access to insertion. Training in the procedures and compliance with procedural instructions are essential to minimise risks, including deep insertion and damage to neurovascular structures.

Peak-locking error reduction by birefringent optical diffusers

NASA Astrophysics Data System (ADS)

Kislaya, Ankur; Sciacchitano, Andrea

2018-02-01

The use of optical diffusers for the reduction of peak-locking errors in particle image velocimetry is investigated. The working principle of the optical diffusers is based on the concept of birefringence, where the incoming rays are subject to different deflections depending on the light direction and polarization. The performances of the diffusers are assessed via wind tunnel measurements in uniform flow and wall-bounded turbulence. Comparison with best-practice image defocusing is also conducted. It is found that the optical diffusers yield an increase of the particle image diameter up to 10 µm in the sensor plane. Comparison with reference measurements showed a reduction of both random and systematic errors by a factor of 3, even at low imaging signal-to-noise ratio.

Methods for Engaging Stakeholders in Comparative Effectiveness Research: A Patient-Centered Approach to Improving Diabetes Care

PubMed Central

Schmittdiel, Julie A.; Desai, Jay; Schroeder, Emily B.; Paolino, Andrea R.; Nichols, Gregory A.; Lawrence, Jean M.; O’Connor, Patrick J.; Ohnsorg, Kris A.; Newton, Katherine M.; Steiner, John F.

2016-01-01

ABSTRACT/Implementation Lessons Engaging stakeholders in the research process has the potential to improve quality of care and the patient care experience.Online patient community surveys can elicit important topic areas for comparative effectiveness research.Stakeholder meetings with substantial patient representation, as well as representation from health care delivery systems and research funding agencies, are a valuable tool for selecting and refining pilot research and quality improvement projects.Giving patient stakeholders a deciding vote in selecting pilot research topics helps ensure their ‘voice’ is heard.Researchers and health care leaders should continue to develop best-practices and strategies for increasing patient involvement in comparative effectiveness and delivery science research. PMID:26179728

76 FR 69132 - Trademark Technical and Conforming Amendments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

... Madrid Agreement Concerning the International Registration of Marks (``Madrid Rules'') to implement the... Cases and the Madrid Rules to implement the Trademark Technical and Conforming Amendment Act of 2010... Madrid Protocol (``Madrid Protocol registrants'') to file Affidavits or Declarations of Use or Excusable...

[Chemoembolization of symptomatic bone metastases: technical considerations and therapeutic effectiveness].

PubMed

Clarençon, F; Cormier, E; Di Maria, F; Sourour, N-A; Szatmary, Z; Rose, M; Chiras, J

2011-09-01

Chemoembolization of bone metastases is defined by the intraarterial perfusion of a chemotherapy agent followed by microparticles embolization to improve tissue impregnation. This technique increases the local concentration of the chemotherapy agent. Tumor response (stable or reduced tumor size) is achieved in 30-80% of cases with symptomatic relief in over 80% of cases. The indications, technical considerations, and effectiveness of this procedure will be reviewed. Copyright © 2011 Elsevier Masson SAS and Éditions françaises de radiologie. All rights reserved.

Catalog of Navy Training Courses (CANTRAC). Volume 1. Introductory, General Information and Quota Control Notes

DTIC Science & Technology

1990-01-01

Personnel E-6 and below are allowed BAQ on a case by case basis. NAVAL TECHNICAL TRAINING CENTER DETACHMENT FORT DEVENS , MA 1. SHORT TITLE...NAVTECHTRACENDET FT DEVENS , MA 2. ADDRESS: Officer in Charge, Naval Technical Training Center Detachment, Box 91, Fort Devens , MA 01433-5910 74 3. T9I.EPIONE: Monday...Into the Fort Devens area may place them in extrome financial hardship. 5. AVAILABILITY OF ThANSPORTATION: Both Logan (Boston) and Worcester airports

Catalog of Navy Training Courses (CANTRAC) Introductory, General Information and Quota Control Notes. Volume 1. Revision.

DTIC Science & Technology

1988-01-01

allowed BAQ on a case by case basis. S3 NAVAL TECHNICAL TRAINING CENTER DETACHMENT FORT DEVENS , MA.5 1. SHORT TITLE: NAVTECHTRACENDET FT DEVENS , MA 2...ADDRESS: Chief Petty Officer in Charge, Naval Technical Training Center Detachment, MacArthur Ave., Building 688, Fort Devens , MA 01433-6301 3. TELEPHONE...units are scarce with a high cost of living. 5. AVAILABILITY OF TRANSPORTATION: Worcester is only 25 to 30 miles from Fort Devens with limited air

Concrescence of permanent maxillary second and third molars: case report of non-surgical root canal treatment.

PubMed

Foran, Denise; Komabayashi, Takashi; Lin, Louis M

2012-03-01

Concrescence is a rare developmental anomaly with an overall incidence of 0.8% in the permanent dentition. While many case reports describe the treatment of concrescence with extraction, there are few reports of non-surgical root canal treatment (NSRCT), due to the atypical root form, canal morphology, and technical difficulties involved in concrescence. This unique case report describes a technical modification of NSRCT that can retain joined posterior maxillary teeth to maintain natural posterior occlusion without surgical intervention or dental implants, thereby avoiding the risk of damage to a large portion of the alveolar bone near the maxillary sinus.

Transcatheter Embolisation of Proximal Type 1 Endoleaks Following Endovascular Aneurysm Sealing (EVAS) Using the Nellix Device: Technique and Outcomes

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

Ameli-Renani, S., E-mail: seyedameli@doctors.org.uk; Morgan, R. A., E-mail: Robert.morgan@stgeorges.nhs.uk

2015-10-15

AimTo evaluate the technical success and mid-term outcomes following transcatheter embolisation of type 1a endoleak after Nellix endovascular aneurysm sealing (EVAS).Materials and MethodsSeven patients (5 men; mean age 83; range 79–90) underwent transcatheter embolisation between July 2013 and August 2014. The average time from EVAS to embolisation was 136 days (range 6–301) and from endoleak diagnosis to embolisation was 20 days (range 2–50). Embolisation was performed with coils and Onyx in six cases and Onyx only in one case. Technical success, imaging and clinical outcomes of embolisation were reviewed. Technical success was defined as elimination of the endoleak on completion angiography and first imaging follow-up.more » Clinical success was defined as unchanged or decreased aneurysm sac size on subsequent follow-up (average 8 months; range 103–471 days).ResultsAll cases were technically successful. One patient required a second endovascular procedure following Onyx reflux into the Nellix endograft and another patient required surgical closure of a brachial puncture site. All patients are endoleak free with stable sac size on the latest available follow-up imaging.ConclusionIf a type 1 endoleak occurs after EVAS, embolisation using Onyx with or without coils is feasible and effective with high technical success and freedom from endoleak recurrence at mid-term follow-up.« less

Ultrasound-Guided Percutaneous Tenotomy of Biceps Tendon: Technical Feasibility on Cadavers.

PubMed

Sconfienza, Luca Maria; Mauri, Giovanni; Messina, Carmelo; Aliprandi, Alberto; Secchi, Francesco; Sardanelli, Francesco; Randelli, Pietro Simone

2016-10-01

We tested the technical feasibility of ultrasound-guided percutaneous tenotomy of the long head of the biceps tendon (LHBT) in cadavers. Both shoulders of two fresh cadavers were scanned anteriorly to evaluate the extra-articular portion of the LHBT. Under ultrasound monitoring, a scalpel was advanced obliquely up to touch the superficial medial side of the LHBT, cutting it until the tendon was not visible anymore. Ultrasound evaluation was repeated after the procedure, and anatomic dissection was performed. The procedure was 100% feasible: four cuts were made to completely sever the tendon; the duration was less than 1 min. Skin incision measured 5 mm in two cases and 6 mm in two cases. Anatomic dissection confirmed complete tendon cut in all cases with proximal and distal tendon stumps very close to each other. Ultrasound-guided percutaneous LHBT tenotomy was 100% technically feasible in cadavers with a quick procedure and minimal cutaneous incision. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Genomics Virtual Laboratory: A Practical Bioinformatics Workbench for the Cloud

PubMed Central

Afgan, Enis; Sloggett, Clare; Goonasekera, Nuwan; Makunin, Igor; Benson, Derek; Crowe, Mark; Gladman, Simon; Kowsar, Yousef; Pheasant, Michael; Horst, Ron; Lonie, Andrew

2015-01-01

Background Analyzing high throughput genomics data is a complex and compute intensive task, generally requiring numerous software tools and large reference data sets, tied together in successive stages of data transformation and visualisation. A computational platform enabling best practice genomics analysis ideally meets a number of requirements, including: a wide range of analysis and visualisation tools, closely linked to large user and reference data sets; workflow platform(s) enabling accessible, reproducible, portable analyses, through a flexible set of interfaces; highly available, scalable computational resources; and flexibility and versatility in the use of these resources to meet demands and expertise of a variety of users. Access to an appropriate computational platform can be a significant barrier to researchers, as establishing such a platform requires a large upfront investment in hardware, experience, and expertise. Results We designed and implemented the Genomics Virtual Laboratory (GVL) as a middleware layer of machine images, cloud management tools, and online services that enable researchers to build arbitrarily sized compute clusters on demand, pre-populated with fully configured bioinformatics tools, reference datasets and workflow and visualisation options. The platform is flexible in that users can conduct analyses through web-based (Galaxy, RStudio, IPython Notebook) or command-line interfaces, and add/remove compute nodes and data resources as required. Best-practice tutorials and protocols provide a path from introductory training to practice. The GVL is available on the OpenStack-based Australian Research Cloud (http://nectar.org.au) and the Amazon Web Services cloud. The principles, implementation and build process are designed to be cloud-agnostic. Conclusions This paper provides a blueprint for the design and implementation of a cloud-based Genomics Virtual Laboratory. We discuss scope, design considerations and technical and logistical constraints, and explore the value added to the research community through the suite of services and resources provided by our implementation. PMID:26501966

Pathophysiology, treatment, and animal and cellular models of human ischemic stroke

PubMed Central

2011-01-01

Stroke is the world's second leading cause of mortality, with a high incidence of severe morbidity in surviving victims. There are currently relatively few treatment options available to minimize tissue death following a stroke. As such, there is a pressing need to explore, at a molecular, cellular, tissue, and whole body level, the mechanisms leading to damage and death of CNS tissue following an ischemic brain event. This review explores the etiology and pathogenesis of ischemic stroke, and provides a general model of such. The pathophysiology of cerebral ischemic injury is explained, and experimental animal models of global and focal ischemic stroke, and in vitro cellular stroke models, are described in detail along with experimental strategies to analyze the injuries. In particular, the technical aspects of these stroke models are assessed and critically evaluated, along with detailed descriptions of the current best-practice murine models of ischemic stroke. Finally, we review preclinical studies using different strategies in experimental models, followed by an evaluation of results of recent, and failed attempts of neuroprotection in human clinical trials. We also explore new and emerging approaches for the prevention and treatment of stroke. In this regard, we note that single-target drug therapies for stroke therapy, have thus far universally failed in clinical trials. The need to investigate new targets for stroke treatments, which have pleiotropic therapeutic effects in the brain, is explored as an alternate strategy, and some such possible targets are elaborated. Developing therapeutic treatments for ischemic stroke is an intrinsically difficult endeavour. The heterogeneity of the causes, the anatomical complexity of the brain, and the practicalities of the victim receiving both timely and effective treatment, conspire against developing effective drug therapies. This should in no way be a disincentive to research, but instead, a clarion call to intensify efforts to ameliorate suffering and death from this common health catastrophe. This review aims to summarize both the present experimental and clinical state-of-the art, and to guide future research directions. PMID:21266064

International Space Station Medical Projects - Full Services to Mars

NASA Technical Reports Server (NTRS)

Pietrzyk, R. A.; Primeaux, L. L.; Wood, S. J.; Vessay, W. B.; Platts, S. H.

2018-01-01

The International Space Station Medical Projects (ISSMP) Element provides planning, integration, and implementation services for HRP research studies for both spaceflight and flight analog research. Through the implementation of these two efforts, ISSMP offers an innovative way of guiding research decisions to meet the unique challenges of understanding the human risks to space exploration. Flight services provided by ISSMP include leading informed consent briefings, developing and validating in-flight crew procedures, providing ISS crew and ground-controller training, real-time experiment monitoring, on-orbit experiment and hardware operations and facilitating data transfer to investigators. For analog studies at the NASA Human Exploration Research Analog (HERA), the ISSMP team provides subject recruitment and screening, science requirements integration, data collection schedules, data sharing agreements, mission scenarios and facilities to support investigators. The ISSMP also serves as the HRP interface to external analog providers including the :envihab bed rest facility (Cologne, Germany), NEK isolation chamber (Moscow, Russia) and the Antarctica research stations. Investigators working in either spaceflight or analog environments requires a coordinated effort between NASA and the investigators. The interdisciplinary nature of both flight and analog research requires investigators to be aware of concurrent research studies and take into account potential confounding factors that may impact their research objectives. Investigators must define clear research requirements, participate in Investigator Working Group meetings, obtain human use approvals, and provide study-specific training, sample and data collection and procedures all while adhering to schedule deadlines. These science requirements define the technical, functional and performance operations to meet the research objectives. The ISSMP maintains an expert team of professionals with the knowledge and experience to guide investigators science through all aspects of mission planning, crew operations, and research integration. During this session, the ISSMP team will discuss best-practices approaches for successfully preparing and conducting studies in both the flight and analog environments. Critical tips and tricks will be shown to greatly improve your chances of successfully completing your research aboard the International Space Station and in Spaceflight Analogs.

Genomics Virtual Laboratory: A Practical Bioinformatics Workbench for the Cloud.

PubMed

Afgan, Enis; Sloggett, Clare; Goonasekera, Nuwan; Makunin, Igor; Benson, Derek; Crowe, Mark; Gladman, Simon; Kowsar, Yousef; Pheasant, Michael; Horst, Ron; Lonie, Andrew

2015-01-01

Analyzing high throughput genomics data is a complex and compute intensive task, generally requiring numerous software tools and large reference data sets, tied together in successive stages of data transformation and visualisation. A computational platform enabling best practice genomics analysis ideally meets a number of requirements, including: a wide range of analysis and visualisation tools, closely linked to large user and reference data sets; workflow platform(s) enabling accessible, reproducible, portable analyses, through a flexible set of interfaces; highly available, scalable computational resources; and flexibility and versatility in the use of these resources to meet demands and expertise of a variety of users. Access to an appropriate computational platform can be a significant barrier to researchers, as establishing such a platform requires a large upfront investment in hardware, experience, and expertise. We designed and implemented the Genomics Virtual Laboratory (GVL) as a middleware layer of machine images, cloud management tools, and online services that enable researchers to build arbitrarily sized compute clusters on demand, pre-populated with fully configured bioinformatics tools, reference datasets and workflow and visualisation options. The platform is flexible in that users can conduct analyses through web-based (Galaxy, RStudio, IPython Notebook) or command-line interfaces, and add/remove compute nodes and data resources as required. Best-practice tutorials and protocols provide a path from introductory training to practice. The GVL is available on the OpenStack-based Australian Research Cloud (http://nectar.org.au) and the Amazon Web Services cloud. The principles, implementation and build process are designed to be cloud-agnostic. This paper provides a blueprint for the design and implementation of a cloud-based Genomics Virtual Laboratory. We discuss scope, design considerations and technical and logistical constraints, and explore the value added to the research community through the suite of services and resources provided by our implementation.

Percutaneous CT and Fluoroscopy-Guided Screw Fixation of Pathological Fractures in the Shoulder Girdle: Technical Report of 3 Cases.

PubMed

Garnon, Julien; Koch, Guillaume; Ramamurthy, Nitin; Caudrelier, Jean; Rao, Pramod; Tsoumakidou, Georgia; Cazzato, Roberto Luigi; Gangi, Afshin

2016-09-01

To review our initial experience with percutaneous CT and fluoroscopy-guided screw fixation of pathological shoulder-girdle fractures. Between May 2014 and June 2015, three consecutive oncologic patients (mean age 65 years; range 57-75 years) with symptomatic pathological shoulder-girdle fractures unsuitable for surgery and radiotherapy underwent percutaneous image-guided screw fixation. Fractures occurred through metastases (n = 2) or a post-ablation cavity (n = 1). Mechanical properties of osteosynthesis were adjudged superior to stand-alone cementoplasty in each case. Cannulated screws were placed under combined CT and fluoroscopic guidance with complementary radiofrequency ablation or cementoplasty to optimise local palliation and secure screw fixation, respectively, in two cases. Follow-up was undertaken every few weeks until mortality or most recent appointment. Four pathological fractures were treated in three patients (2 acromion, 1 clavicular, 1 coracoid). Mean size of associated lesion was 2.6 cm (range 1-4.5 cm). Technical success was achieved in all cases (100 %), without complications. Good palliation and restoration of mobility were observed in two cases at 2-3 months; one case could not be followed due to early post-procedural oncologic mortality. Percutaneous image-guided shoulder-girdle osteosynthesis appears technically feasible with good short-term efficacy in this complex patient subset. Further studies are warranted to confirm these promising initial results.

Fostering Entrepreneurship through Business Incubation: The Role and Prospects of Postsecondary Vocational-Technical Education. Report 2: Case Studies.

ERIC Educational Resources Information Center

Hernandez-Gantes, Victor M.; And Others

This report presents nine case studies featuring efforts to foster community development through business incubation and entrepreneurial programs at two-year colleges. A background section discusses case description, and organization and format of case studies. The second section describes the case study design. Each case study is introduced with…

48 CFR 245.7002 - Duties and responsibilities of plant clearance officers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... clearance cases and disposal documents; (e) Initiate screening and provide technical support to screeners in...) Technical and quantitative allocability of property; (g) Ensure the timely shipment or release by the... are minimized and, when necessary, work with the contractor and property administrator to implement...

Linking Ethics and Language in the Technical Communication Classroom.

ERIC Educational Resources Information Center

Sims, Brenda R.

1993-01-01

Discusses research on ethics and technical communication and examines specific methods that writers may use to manipulate language and to present information unethically. Suggests questions designed to teach students how to analyze situations that may involve such manipulation and misrepresentation. Concludes with two case studies illustrating…

Push and pull models to manage patient consent and licensing of multimedia resources in digital repositories for case-based reasoning.

PubMed

Kononowicz, Andrzej A; Zary, Nabil; Davies, David; Heid, Jörn; Woodham, Luke; Hege, Inga

2011-01-01

Patient consents for distribution of multimedia constitute a significant element of medical case-based repositories in medicine. A technical challenge is posed by the right of patients to withdraw permission to disseminate their images or videos. A technical mechanism for spreading information about changes in multimedia usage licenses is sought. The authors gained their experience by developing and managing a large (>340 cases) repository of virtual patients within the European project eViP. The solution for dissemination of license status should reuse and extend existing metadata standards in medical education. Two methods: PUSH and PULL are described differing in the moment of update and the division of responsibilities between parties in the learning object exchange process. The authors recommend usage of the PUSH scenario because it is better adapted to legal requirements in many countries. It needs to be stressed that the solution is based on mutual trust of the exchange partners and therefore is most appropriate for use in educational alliances and consortia. It is hoped that the proposed models for exchanging consents and licensing information will become a crucial part of the technical frameworks for building case-based repositories.

Endoscopic management of bile leakage after liver transplantation.

PubMed

Oh, Dong-Wook; Lee, Sung Koo; Song, Tae Jun; Park, Do Hyun; Lee, Sang Soo; Seo, Dong-Wan; Kim, Myung-Hwan

2015-05-23

Endoscopic retrograde cholangiopancreatography (ERCP) can be an effective treatment for bile leakage after liver transplantation. We evaluated the efficacy of endoscopic treatment in liver transplantation in patients who developed bile leaks. Forty-two patients who developed bile leaks after liver transplantation were included in the study. If a bile leak was observed on ERCP, a sphincterotomy was performed, and a nasobiliary catheter was then inserted. If a bile leak was accompanied by a bile duct stricture, either the stricture was dilated with balloons, followed by nasobiliary catheter insertion across the bile duct stricture, or endoscopic retrograde biliary drainage was performed. In the bile leakage alone group (22 patients), endoscopic treatment was technically successful in 19 (86.4%) and clinically successful in 17 (77.3%) cases. Among the 20 patients with bile leaks with bile duct strictures, endoscopic treatment was technically successful in 13 (65.0%) and clinically successful in 10 (50.0%) cases. Among the 42 patients who underwent ERCP, technical success was achieved in 32 (76.2%) cases and clinical success was achieved in 27 (64.3%) cases. ERCP is an effective and safe therapeutic modality for bile leaks after liver transplantation. ERCP should be considered as an initial therapeutic modality in post-liver transplantation patients.

Inequity-aversion and relative kindness intention jointly determine the expenditure of effort in project teams.

PubMed

Han, Jiaojie; Rapoport, Amnon; Zhao, Rui

2017-01-01

The literature on team cooperation has neglected the effects of relative kindness intention on cooperation, which we measure by comparing the kindness intentions of an agent to her group members to the kindness shown by other members to this same agent. We argue that the agent's emotional reaction to material payoff inequity is not constant, but rather affected by her relative kindness intention. Then, we apply the model to team projects with multiple partners and investigate how inequity-aversion and relative kindness intention jointly influence team cooperation. We first consider the case of homogeneous agents, where their marginal productivity levels and technical capacities are the same, and then consider the case of heterogeneous agents, where their marginal productivity levels and technical capacities are not the same. Our results show that inequity-aversion has no effect on effort expenditure in the former case, but does affect it in the latter case. The consideration of relative kindness intention may impact the agents' optimal cooperative effort expenditure when their technical capacities are different. In addition, it is beneficial for team cooperation, and might not only reduce the negative impact but also enhance the positive impact of inequity-aversion on the agents' effort expenditures.

Ultrasound-Guided Intermediate Site Greater Occipital Nerve Infiltration: A Technical Feasibility Study.

PubMed

Zipfel, Jonathan; Kastler, Adrian; Tatu, Laurent; Behr, Julien; Kechidi, Rachid; Kastler, Bruno

2016-01-01

Two studies recently reported that computed tomography (CT) guided infiltration of the greater occipital nerve at its intermediate site allows a high efficacy rate with long-lasting pain relief following procedure in occipital neuralgia and in various craniofacial pain syndromes. The purpose of our study was to evaluate the technical feasibility and safety of ultrasound-guided intermediate site greater occipital nerve infiltration. Retrospective study. This study was conducted at the imaging department of a 1,409 bed university hospital. Local institutional review board approval was obtained and written consent was waived. In this retrospective study, 12 patients suffering from refractory occipital neuralgia or craniofacial pain syndromes were included between April and October 2014. They underwent a total of 21 ultrasound-guided infiltrations. Infiltration of the greater occipital nerve was performed at the intermediate site of the greater occipital nerve, at its first bend between obliqus capitis inferior and semispinalis capitis muscles with local anestetics and cortivazol. Technical success was defined as satisfactory diffusion of added iodinated contrast media in the fatty space between these muscles depicted on control CT scan. We also reported first data of immediate block test efficacy and initial clinical efficacy at 7 days, one month, and 3 months, defined by a decrease of at least 50% of visual analog scale (VAS) scores. Technical success rate was 95.24%. Patients suffered from right unilateral occipital neuralgia in 3 cases, left unilateral occipital neuralgia in 2 cases, bilateral occipital neuralgia in 2 cases, migraine in one case, cervicogenic headache in one case, tension-type headache in 2 cases, and cluster headache in one case. Block test efficacy was found in 93.3% (14/15) cases. Clinical efficacy was found in 80% of cases at 7 days, in 66.7% of cases at one month and in 60% of cases at 3 months. No major complications were noted. Some of the limitations of our study include that it represents a single institution. The low number of infiltrations included in this study, for this guidance procedure, is another bias. This ultrasound-guided infiltration technique appears to be feasible, safe, non-ionizing, and fast when targeting the greater occipital nerve in its intermediate portion. This imaging guidance modality should be used in routine clinical practice. Greater occipital nerve, infiltration, ultrasound guidance, corticosteroids, occipital neuralgia, craniofacial pain syndrome.

Case Study of 'Engineering Peer Meetings' in JPL's ST-6 Project

NASA Technical Reports Server (NTRS)

Chao, Lawrence P.; Tumer, Irem

2004-01-01

This design process error-proofing case study describes a design review practice implemented by a project manager at NASA Jet Propulsion Laboratory. There are many types of reviews at NASA: required and not, formalized and informal, programmatic and technical. Standing project formal reviews such as the Preliminary Design Review (PDR) and Critical Design Review (CDR) are a required part of every project and mission development. However, the engineering peer reviews that support teams technical work on such projects are often informal, ad hoc, and inconsistent across the organization. This case study discusses issues and innovations identified by a project manager at JPL and implemented in 'engineering peer meetings' for his group.

Case Study of "Engineering Peer Meetings" in JPL's ST-6 Project

NASA Technical Reports Server (NTRS)

Tumer, Irem Y.; Chao, Lawrence P.

2003-01-01

This design process error-proofing case study describes a design review practice implemented by a project manager at NASA Jet Propulsion Laboratory. There are many types of reviews at NASA: required and not, formalized and informal, programmatic and technical. Standing project formal reviews such as the Preliminary Design Review (PDR) and Critical Design Review (CDR) are a required part of every project and mission development. However, the engineering peer reviews that support teams technical work on such projects are often informal, ad hoc, and inconsistent across the organization. This case study discusses issues and innovations identified by a project manager at JPL and implemented in "engineering peer meetings" for his group.

An Integrated Delivery and Assessment Process to Address the Graduate Attribute Spectrum

ERIC Educational Resources Information Center

Symes, Mark; Ranmuthugala, Dev; Chin, Christopher; Carew, Anna

2011-01-01

In the past, engineering programmes were developed with separate technical learning outcomes supplemented by generic attributes. The latter were in most cases a standalone set of attributes developed by academic institutions or professional societies overseeing engineering accreditation processes. Although the technical learning outcomes were well…

Technical Writing in Hydrogeology.

ERIC Educational Resources Information Center

Tinker, John R., Jr.

1986-01-01

A project for Writing Across the Curriculum at the University of Wisconsin-Eau Claire is described as a method to relate the process of writing to the process of learning hydrology. The project focuses on an actual groundwater contamination case and is designed to improve the technical writing skills of students. (JN)

A Vowel-Based Method for Vocal Tract Control in Clarinet Pedagogy

ERIC Educational Resources Information Center

González, Darleny; Payri, Blas

2017-01-01

Our review of scientific literature shows that the activity inside the clarinetist's vocal tract (VT) affects pitch and timbre, while also facilitating technical exercises. Clarinetists adapt their VT intuitively and, in some cases, may compensate an inadequate VT configuration through unnecessary pressure, resulting in technical blockage,…

76 FR 11414 - Defense Federal Acquisition Regulation Supplement; Independent Research and Development Technical...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-02

... Acquisition Regulation Supplement; Independent Research and Development Technical Descriptions (DFARS Case... (DFARS) to require contractors to report independent research and development (IR&D) projects generating... the address shown below on or before May 2, 2011, to be considered in the formation of the final rule...

Multiple Intelligence Distribution of Prospective Teachers: The Case at Yildiz Technical University

ERIC Educational Resources Information Center

Çeliköz, Mine

2017-01-01

The aim of this study is to find out whether intelligence distributions differ or not according to gender and departmental variables by determining the dominant intelligence (Multiple Intelligence) distributions of prospective teachers studying at Yildiz Technical University Education Faculty. The population of the research constitutes the…

24 CFR 570.402 - Technical assistance awards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (24 CFR part 571); and the Special Purpose Grants for Insular Areas, Community Development Work Study... the assistance is limited to conferences/workshops attended by more than one unit of government. (d... section include: (1) In the case of technical assistance for States, the cost of carrying out the...

24 CFR 570.402 - Technical assistance awards.

Code of Federal Regulations, 2013 CFR

2013-04-01

... (24 CFR part 571); and the Special Purpose Grants for Insular Areas, Community Development Work Study... the assistance is limited to conferences/workshops attended by more than one unit of government. (d... section include: (1) In the case of technical assistance for States, the cost of carrying out the...

10 CFR 455.20 - Contents of State Plan.

Code of Federal Regulations, 2013 CFR

2013-01-01

... one approach may be used for all technical assistance programs in the State. If the State elects to... apportioning the funds that are available for schools and hospitals in a case of severe hardship. Such policies...'s policy regarding reasonable selection of energy conservation measures for study in a technical...

10 CFR 455.20 - Contents of State Plan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... one approach may be used for all technical assistance programs in the State. If the State elects to... apportioning the funds that are available for schools and hospitals in a case of severe hardship. Such policies...'s policy regarding reasonable selection of energy conservation measures for study in a technical...

24 CFR 570.402 - Technical assistance awards.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (24 CFR part 571); and the Special Purpose Grants for Insular Areas, Community Development Work Study... the assistance is limited to conferences/workshops attended by more than one unit of government. (d... section include: (1) In the case of technical assistance for States, the cost of carrying out the...

10 CFR 455.20 - Contents of State Plan.

Code of Federal Regulations, 2014 CFR

2014-01-01

... one approach may be used for all technical assistance programs in the State. If the State elects to... apportioning the funds that are available for schools and hospitals in a case of severe hardship. Such policies...'s policy regarding reasonable selection of energy conservation measures for study in a technical...

10 CFR 455.20 - Contents of State Plan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... one approach may be used for all technical assistance programs in the State. If the State elects to... apportioning the funds that are available for schools and hospitals in a case of severe hardship. Such policies...'s policy regarding reasonable selection of energy conservation measures for study in a technical...

10 CFR 455.20 - Contents of State Plan.

Code of Federal Regulations, 2012 CFR

2012-01-01

... one approach may be used for all technical assistance programs in the State. If the State elects to... apportioning the funds that are available for schools and hospitals in a case of severe hardship. Such policies...'s policy regarding reasonable selection of energy conservation measures for study in a technical...

Seeding the Edge of Career and Technical Education

ERIC Educational Resources Information Center

Mojkowski, Charles; Washor, Elliot

2007-01-01

There is a resurging interest in career and technical education (CTE) from business leaders, policymakers and educators who have discovered, and in some cases rediscovered, the benefits of authentic applied learning embedded in career pathways that combine a robust mixture of relationships, relevance and rigor. Despite the growing interest, many…

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

ERIC Educational Resources Information Center

Cripps, Michael J.

2011-01-01

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

Case Studies in Industry/TAFE Liaison: Success Factors.

ERIC Educational Resources Information Center

Anderson, Tony

This study examines what makes cooperative arrangements between industry and Technical and Further Education (TAFE) in Australia successful. A literature review highlighted the importance of the provision of high quality technical education that meets the needs of the client. A range of innovative or entrepreneurial examples of industry/TAFE…

76 FR 58144 - Defense Federal Acquisition Regulation Supplement; Presumption of Development Exclusively at...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-20

... technical data package, in cases where the Government may have funded only a small portion of the... subcontractor's asserted restrictions on technical data and computer software. DATES: Effective date: September... data and computer software. More specifically, the final rule affects these validation procedures in...

Workplace Skills in Practice. Case Studies of Technical Work.

ERIC Educational Resources Information Center

Stasz, Cathleen; And Others

A study was conducted to explore skills and work-related dispositions in technical work. It used a sociocultural approach to examine skills in seven target jobs in worksites representing diverse industries--health care, traffic management, transportation, and semiconductor manufacturing. It explored employers' strategies for obtaining the skills…

NASA's university program: Active grants and research contracts, fiscal year 1974

NASA Technical Reports Server (NTRS)

1974-01-01

Each entry includes institution and location, brief description of project, period of performance, principal investigator at institution, NASA technical officer (monitor), sponsoring NASA installation, interagency field of science or engineering classification C.A.S.E. category, grant or contract number, FY 74 obligations, cumulative obligations, and most recent RTOP coding. Entries are arranged alphabetically within state or country. Four cross indices are presented: (1) grant or contract number; (2) C.A.S.E. field or science or engineering; (3) NASA technical officer location; and (4) RTOP code.

Learning curves for transapical transcatheter aortic valve replacement in the PARTNER-I trial: Technical performance, success, and safety.

PubMed

Suri, Rakesh M; Minha, Sa'ar; Alli, Oluseun; Waksman, Ron; Rihal, Charanjit S; Satler, Lowell P; Greason, Kevin L; Torguson, Rebecca; Pichard, Augusto D; Mack, Michael; Svensson, Lars G; Rajeswaran, Jeevanantham; Lowry, Ashley M; Ehrlinger, John; Mick, Stephanie L; Tuzcu, E Murat; Thourani, Vinod H; Makkar, Raj; Holmes, David; Leon, Martin B; Blackstone, Eugene H

2016-09-01

Introduction of hybrid techniques, such as transapical transcatheter aortic valve replacement (TA-TAVR), requires skills that a heart team must master to achieve technical efficiency: the technical performance learning curve. To date, the learning curve for TA-TAVR remains unknown. We therefore evaluated the rate at which technical performance improved, assessed change in occurrence of adverse events in relation to technical performance, and determined whether adverse events after TA-TAVR were linked to acquiring technical performance efficiency (the learning curve). From April 2007 to February 2012, 1100 patients, average age 85.0 ± 6.4 years, underwent TA-TAVR in the PARTNER-I trial. Learning curves were defined by institution-specific patient sequence number using nonlinear mixed modeling. Mean procedure time decreased from 131 to 116 minutes within 30 cases (P = .06) and device success increased to 90% by case 45 (P = .0007). Within 30 days, 354 patients experienced a major adverse event (stroke in 29, death in 96), with possibly decreased complications over time (P ∼ .08). Although longer procedure time was associated with more adverse events (P < .0001), these events were associated with change in patient risk profile, not the technical performance learning curve (P = .8). The learning curve for TA-TAVR was 30 to 45 procedures performed, and technical efficiency was achieved without compromising patient safety. Although fewer patients are now undergoing TAVR via nontransfemoral access, understanding TA-TAVR learning curves and their relationship with outcomes is important as the field moves toward next-generation devices, such as those to replace the mitral valve, delivered via the left ventricular apex. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

[AWAKE CRANIOTOMY: IN SEARCH FOR OPTIMAL SEDATION].

PubMed

Kulikova, A S; Sel'kov, D A; Kobyakov, G L; Shmigel'skiy, A V; Lubnin, A Yu

2015-01-01

Awake craniotomy is a "gold standard"for intraoperative brain language mapping. One of the main anesthetic challenge of awake craniotomy is providing of optimal sedation for initial stages of intervention. The goal of this study was comparison of different technics of anesthesia for awake craniotomy. Materials and methods: 162 operations were divided in 4 groups: 76 cases with propofol sedation (2-4mg/kg/h) without airway protection; 11 cases with propofol sedation (4-5 mg/kg/h) with MV via LMA; 36 cases of xenon anesthesia; and 39 cases with dexmedetomidine sedation without airway protection. Results and discussion: brain language mapping was successful in 90% of cases. There was no difference between groups in successfulness of brain mapping. However in the first group respiratory complications were more frequent. Three other technics were more safer Xenon anesthesia was associated with ultrafast awakening for mapping (5±1 min). Dexmedetomidine sedation provided high hemodynamic and respiratory stability during the procedure.

75 FR 27375 - Postal Rate Case Management

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... POSTAL REGULATORY COMMISSION [Docket No. PI2010-3; Order No. 456] Postal Rate Case Management AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is seeking comments relevant to management of an anticipated exigent postal rate case. It has scheduled a technical conference...

[Technical feasibility of the implantation of a monorail stent system into the renal arteries without pre-dilatation].

PubMed

Neumann, C; Gschwendtner, M; Karnel, F; Mair, J; Dorffner, G; Dorffner, R

2005-01-01

To evaluate the technical feasibility of the implantation of the monorail RX Herculink system into the renal arteries without pre-dilatation. Forty-two patients (mean age 71 years) from four centers with a total of 44 renal artery stenoses underwent implantation of the RX Herculink stent. The mean grade of the stenosis was 83.8 %, the mean length 7.5 mm. The stenoses were ostial in 38 cases and in immediate proximity to the ostium in 6 cases. The mean follow-up-period was 57 weeks (24 - 176 weeks). In 42 cases, the implantation was successful without pre-dilatation. In 2 cases, pre-dilatation was carried out. In none of the cases, detachment of the stent from the balloon was observed. In one stenosis with a length of 17 mm, implantation of two stents was performed. In 9 cases, post-dilatation with a larger balloon or higher balloon pressure was necessary. Residual stenoses exceeding 30 % were not observed. Two patients developed local bleeding at the puncture site. During the follow-up, restenoses were observed in 5 stents after 26 to 126 weeks, which necessitated a second intervention in 3 cases (PTA in 2 cases, re-stenting in 1 case). The primary patency rate after 6 and 12 months was 0.92 +/- 0.056 according to Kaplan-Meier, the secondary patency rate after 6 and 12 months was 1.0 +/- 0.0. Implantation of the RX Herculink stent system into the renal arteries without pre-dilatation is technically feasible and safe. Even without pre-dilatation, the stent-system can be advanced through the stenosis without detachment. The complication rate is low. Our clinical results are comparable to previous studies.

Using On-scene EMS Responders' Assessment and Electronic Patient Care Records to Evaluate the Suitability of EMD-triaged, Low-acuity Calls for Secondary Nurse Triage in 911 Centers.

PubMed

Scott, Greg; Clawson, Jeff; Fivaz, Mark C; McQueen, Jennie; Gardett, Marie I; Schultz, Bryon; Youngquist, Scott; Olola, Christopher H O

2016-02-01

Using the Medical Priority Dispatch System (MPDS) - a systematic 911 triage process - to identify a large subset of low-acuity patients for secondary nurse triage in the 911 center is a largely unstudied practice in North America. This study examines the ALPHA-level subset of low-acuity patients in the MPDS to determine the suitability of these patients for secondary triage by evaluating vital signs and necessity of lights-and-siren transport, as determined by attending Emergency Medical Services (EMS) ambulance crews. The primary objective of this study was to determine the clinical status of MPDS ALPHA-level (low-acuity) patients, as determined by on-scene EMS crews' patient care records, in two US agencies. A secondary objective was to determine which ALPHA-level codes are suitable candidates for secondary triage by a trained Emergency Communication Nurse (ECN). In this retrospective study, one full year (2013) of both dispatch data and EMS patient records data, associated with all calls coded at the ALPHA-level (low-acuity) in the dispatch protocol, were collected. The primary outcome measure was the number and percentage of ALPHA-level codes categorized as low-acuity, moderate-acuity, high-acuity, and critical using four common vital signs to assign these categories: systolic blood pressure (SBP), pulse rate (PR), oxygen saturation (SpO2), and Glasgow Coma Score (GCS). Vital sign data were obtained from ambulance crew electronic patient care records (ePCRs). The secondary endpoint was the number and percentage of ALPHA-level codes that received a "hot" (lights-and-siren) transport. Out of 19,300 cases, 16,763 (86.9%) were included in the final analysis, after excluding cases from health care providers and those with missing data. Of those, 89% of all cases did not have even one vital sign indicator of unstable patient status (high or critical vital sign). Of all cases, only 1.1% were transported lights-and-siren. With the exception of the low-acuity, ALPHA-level seizure cases, the ALPHA-level patients are suitable to transfer for secondary triage in a best-practices, accredited, emergency medical dispatch center that utilizes the MPDS at very high compliance rates. The secondary nurse triage process should identify the few at-risk patients that exist in the low-acuity calls.

Skin conditions of baseball, cricket, and softball players.

PubMed

Farhadian, Joshua A; Tlougan, Brook E; Adams, Brian B; Leventhal, Jonathan S; Sanchez, Miguel R

2013-07-01

Each year in the United States over 80 million people participate in bat-and-ball sports, for example baseball and softball. Cricket, the world's second most popular sport, is enjoyed by hundreds of millions of participants in such countries as India, Pakistan, Australia, New Zealand, Bangladesh, South Africa, West Indies, Sri Lanka, United Kingdom, and Zimbabwe. Although any player can develop skin disease as a result of participation in these bat-and-ball sports, competitive team athletes are especially prone to skin problems related to infection, trauma, allergy, solar exposure, and other causes. These diseases can produce symptoms that hinder individual athletic performance and participation. In this review, we discuss the diagnosis and best-practice management of skin diseases that can develop as a result of participation in baseball, softball, and cricket.

Substance Abuse Disorders Treatment in El Salvador: Analysis of Policy-Making-Related Failure

PubMed Central

Dickson-Gómez, Julia

2016-01-01

Illicit drug use and substance abuse disorders have increased dramatically in developing countries during recent decades. Sadly, treatment for people diagnosed as manifesting and/or attributed with substance abuse disorders in developing countries is usually inadequate to meet demand, not evidence based, and of poor quality. In response, international health organizations have developed best-practice guidelines for substance user treatment in developing countries, although little research has evaluated their implementation. This opinion piece will examine one such effort to improve substance user treatment in El Salvador. It will be argued that the program failed (2007–2008) because of a lack of political will by the Salvadoran government through their Ministry of Health to effectively supervise, monitor, and subsidize substance user treatment. PMID:23186469

The innovative medicines initiative: a European response to the innovation challenge.

PubMed

Goldman, M

2012-03-01

The Innovative Medicines Initiative (IMI) was launched in 2008 as a large-scale public-private partnership between the European Commission and the European Federation of Pharmaceutical Industries and Associations (EFPIA). With a total budget of €2 billion, the IMI aims to boost the development of new medicines across Europe by implementing new collaborative endeavors between large pharmaceutical companies and other key actors in the health-care ecosystem, i.e., academic institutions, small and medium enterprises, patients, and regulatory authorities. Projects conducted by IMI consortia have already delivered meaningful results, providing proof-of-concept evidence for the efficiency of this new model of collaboration. In this article we review recent achievements of the IMI consortia and discuss the growing interest in the IMI as a best-practice model to reinvigorate drug development.

AutoQSAR: an automated machine learning tool for best-practice quantitative structure-activity relationship modeling.

PubMed

Dixon, Steven L; Duan, Jianxin; Smith, Ethan; Von Bargen, Christopher D; Sherman, Woody; Repasky, Matthew P

2016-10-01

We introduce AutoQSAR, an automated machine-learning application to build, validate and deploy quantitative structure-activity relationship (QSAR) models. The process of descriptor generation, feature selection and the creation of a large number of QSAR models has been automated into a single workflow within AutoQSAR. The models are built using a variety of machine-learning methods, and each model is scored using a novel approach. Effectiveness of the method is demonstrated through comparison with literature QSAR models using identical datasets for six end points: protein-ligand binding affinity, solubility, blood-brain barrier permeability, carcinogenicity, mutagenicity and bioaccumulation in fish. AutoQSAR demonstrates similar or better predictive performance as compared with published results for four of the six endpoints while requiring minimal human time and expertise.

Using a best-practice perioperative governance structure to implement better block scheduling.

PubMed

Heiser, Randy

2013-01-01

Achieving, developing, and maintaining a well-functioning OR scheduling system requires a well-designed perioperative governance structure. Traditional OR/surgery committees, consisting mainly of surgeons, have tried to provide this function but often have not succeeded. An OR governance model should be led by an OR executive committee that functions as a board of directors for the surgery program and works closely with the surgery department medical director and an OR advisory committee. Ideally, the OR executive committee should develop a block schedule that includes a mix of block, open, and urgent or emergent OR access, because this combination is most effective for improving OR use and adapting to changes in surgical procedure volume. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Translation of Nutritional Genomics into Nutrition Practice: The Next Step.

PubMed

Murgia, Chiara; Adamski, Melissa M

2017-04-06

Genetics is an important piece of every individual health puzzle. The completion of the Human Genome Project sequence has deeply changed the research of life sciences including nutrition. The analysis of the genome is already part of clinical care in oncology, pharmacology, infectious disease and, rare and undiagnosed diseases. The implications of genetic variations in shaping individual nutritional requirements have been recognised and conclusively proven, yet routine use of genetic information in nutrition and dietetics practice is still far from being implemented. This article sets out the path that needs to be taken to build a framework to translate gene-nutrient interaction studies into best-practice guidelines, providing tools that health professionals can use to understand whether genetic variation affects nutritional requirements in their daily clinical practice.

The Research Data Alliance

NASA Astrophysics Data System (ADS)

Fontaine, K. S.

2015-12-01

The Research Data Alliance (RDA) is an international organization created in 2012 to provide researchers with a forum for identifying and removing barriers to data sharing. Since then, RDA has gained over 3000 individual members, over three dozen organizational members, 47 Interest Groups, and 17 Working Groups, all focused on research data sharing. Interoperability is one instantiation of data sharing, but is not the only barrier to overcome. Technology limitations, discipline-specific cultures that do not support sharing, lack of best-practices, or lack of good definitions, are only three of a long list of situations preventing researchers from sharing their data. This presentation will cover how RDA has grown, some details on how the first eight solutions contribute to interoperability and sharing, and a sneak peek at what's in the pipeline.

Leveraging Social Capital of Persons With Intellectual Disabilities Through Facebook Participation: The Perspectives of Family Members and Direct Support Staff.

PubMed

Shpigelman, Carmit-Noa

2017-12-01

This study aimed to understand and describe the views of family members and direct support staff regarding the use of Facebook by persons with intellectual disability (ID) within the context of social capital. In-depth, semistructured interviews conducted with 16 family members and direct support staff of persons with ID who use Facebook revealed that most participants favored Facebook use by persons with ID for bonding and bridging social capital and for normalization. Most participants noted the empowering effect of online activity on persons with ID, yet some reported risks and usage difficulties. Although Facebook use enhances the well-being of persons with ID, findings highlighted the participants' need for formal guidelines regarding social media best-practices for people with ID.

Translation of Nutritional Genomics into Nutrition Practice: The Next Step

PubMed Central

Murgia, Chiara; Adamski, Melissa M.

2017-01-01

Genetics is an important piece of every individual health puzzle. The completion of the Human Genome Project sequence has deeply changed the research of life sciences including nutrition. The analysis of the genome is already part of clinical care in oncology, pharmacology, infectious disease and, rare and undiagnosed diseases. The implications of genetic variations in shaping individual nutritional requirements have been recognised and conclusively proven, yet routine use of genetic information in nutrition and dietetics practice is still far from being implemented. This article sets out the path that needs to be taken to build a framework to translate gene–nutrient interaction studies into best-practice guidelines, providing tools that health professionals can use to understand whether genetic variation affects nutritional requirements in their daily clinical practice. PMID:28383492

Numerical simulation of deformation and failure processes of a complex technical object under impact loading

NASA Astrophysics Data System (ADS)

Kraus, E. I.; Shabalin, I. I.; Shabalin, T. I.

2018-04-01

The main points of development of numerical tools for simulation of deformation and failure of complex technical objects under nonstationary conditions of extreme loading are presented. The possibility of extending the dynamic method for construction of difference grids to the 3D case is shown. A 3D realization of discrete-continuum approach to the deformation and failure of complex technical objects is carried out. The efficiency of the existing software package for 3D modelling is shown.

An eCommerce Development Case: Your Company's eCommerce Web Site

ERIC Educational Resources Information Center

Ballenger, Robert M.

2007-01-01

This case provides a real-world semester long project-oriented case study for students enrolled in an electronic commerce course that has a significant development component. The case provides the technical framework in the form of functional requirements for students to design and build a fully functional transaction processing e-commerce Web…

Great Apes and Biodiversity Offset Projects in Africa: The Case for National Offset Strategies

PubMed Central

Kormos, Rebecca; Kormos, Cyril F.; Humle, Tatyana; Lanjouw, Annette; Rainer, Helga; Victurine, Ray; Mittermeier, Russell A.; Diallo, Mamadou S.; Rylands, Anthony B.; Williamson, Elizabeth A.

2014-01-01

The development and private sectors are increasingly considering “biodiversity offsets” as a strategy to compensate for their negative impacts on biodiversity, including impacts on great apes and their habitats in Africa. In the absence of national offset policies in sub-Saharan Africa, offset design and implementation are guided by company internal standards, lending bank standards or international best practice principles. We examine four projects in Africa that are seeking to compensate for their negative impacts on great ape populations. Our assessment of these projects reveals that not all apply or implement best practices, and that there is little standardization in the methods used to measure losses and gains in species numbers. Even if they were to follow currently accepted best-practice principles, we find that these actions may still fail to contribute to conservation objectives over the long term. We advocate for an alternative approach in which biodiversity offset and compensation projects are designed and implemented as part of a National Offset Strategy that (1) takes into account the cumulative impacts of development in individual countries, (2) identifies priority offset sites, (3) promotes aggregated offsets, and (4) integrates biodiversity offset and compensation projects with national biodiversity conservation objectives. We also propose supplementary principles necessary for biodiversity offsets to contribute to great ape conservation in Africa. Caution should still be exercised, however, with regard to offsets until further field-based evidence of their effectiveness is available. PMID:25372894

Great apes and biodiversity offset projects in Africa: the case for national offset strategies.

PubMed

Kormos, Rebecca; Kormos, Cyril F; Humle, Tatyana; Lanjouw, Annette; Rainer, Helga; Victurine, Ray; Mittermeier, Russell A; Diallo, Mamadou S; Rylands, Anthony B; Williamson, Elizabeth A

2014-01-01

The development and private sectors are increasingly considering "biodiversity offsets" as a strategy to compensate for their negative impacts on biodiversity, including impacts on great apes and their habitats in Africa. In the absence of national offset policies in sub-Saharan Africa, offset design and implementation are guided by company internal standards, lending bank standards or international best practice principles. We examine four projects in Africa that are seeking to compensate for their negative impacts on great ape populations. Our assessment of these projects reveals that not all apply or implement best practices, and that there is little standardization in the methods used to measure losses and gains in species numbers. Even if they were to follow currently accepted best-practice principles, we find that these actions may still fail to contribute to conservation objectives over the long term. We advocate for an alternative approach in which biodiversity offset and compensation projects are designed and implemented as part of a National Offset Strategy that (1) takes into account the cumulative impacts of development in individual countries, (2) identifies priority offset sites, (3) promotes aggregated offsets, and (4) integrates biodiversity offset and compensation projects with national biodiversity conservation objectives. We also propose supplementary principles necessary for biodiversity offsets to contribute to great ape conservation in Africa. Caution should still be exercised, however, with regard to offsets until further field-based evidence of their effectiveness is available.

Percutaneous CT and Fluoroscopy-Guided Screw Fixation of Pathological Fractures in the Shoulder Girdle: Technical Report of 3 Cases

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

Garnon, Julien, E-mail: juliengarnon@gmail.com; Koch, Guillaume, E-mail: Guillaume.koch@gmail.com; Ramamurthy, Nitin, E-mail: Nitin-ramamurthy@hotmail.com

ObjectiveTo review our initial experience with percutaneous CT and fluoroscopy-guided screw fixation of pathological shoulder-girdle fractures.Materials and MethodsBetween May 2014 and June 2015, three consecutive oncologic patients (mean age 65 years; range 57–75 years) with symptomatic pathological shoulder-girdle fractures unsuitable for surgery and radiotherapy underwent percutaneous image-guided screw fixation. Fractures occurred through metastases (n = 2) or a post-ablation cavity (n = 1). Mechanical properties of osteosynthesis were adjudged superior to stand-alone cementoplasty in each case. Cannulated screws were placed under combined CT and fluoroscopic guidance with complementary radiofrequency ablation or cementoplasty to optimise local palliation and secure screw fixation, respectively, in two cases. Follow-up wasmore » undertaken every few weeks until mortality or most recent appointment.ResultsFour pathological fractures were treated in three patients (2 acromion, 1 clavicular, 1 coracoid). Mean size of associated lesion was 2.6 cm (range 1–4.5 cm). Technical success was achieved in all cases (100 %), without complications. Good palliation and restoration of mobility were observed in two cases at 2–3 months; one case could not be followed due to early post-procedural oncologic mortality.ConclusionPercutaneous image-guided shoulder-girdle osteosynthesis appears technically feasible with good short-term efficacy in this complex patient subset. Further studies are warranted to confirm these promising initial results.« less

Farmers' Knowledge Attributes Contribute to Attaining Higher Farm Technical Efficiency: A Transition Economy Case

ERIC Educational Resources Information Center

Manevska-Tasevska, Gordana

2013-01-01

Purpose: This study sought to explore how farmers' knowledge attributes influence the technical efficiency of their farms. In addition, farm efficiency was compared to the actual Macedonian Rural Development Programme (RDP) (2007-2013) and instruments considered to improve Macedonian education potential were evaluated. Design/methodology/approach:…

The Efficiency of Public Schools: The Case of Kuwait

ERIC Educational Resources Information Center

Burney, Nadeem A.; Johnes, Jill; Al-Enezi, Mohammed; Al-Musallam, Marwa

2013-01-01

This paper investigates the technical, and allocative efficiencies of public schools in Kuwait over four levels of schooling (kindergartens, primary, intermediate and secondary) and two periods (1999/2000 and 2004/2005) using data envelopment analysis. Mean pure technical efficiency varies between 0.695 and 0.852 across all levels of education;…

Power, Language, and Professional Choices: A Hermeneutic Approach To Teaching Technical Communication.

ERIC Educational Resources Information Center

Tillery, Denise

2001-01-01

Argues that the philosophical hermeneutics of Hans-Georg Gadamer provides a useful theoretical framework from which to discuss ethical issues in the technical communication classroom. Analyzes a previously published case study to demonstrate how hermeneutics can shed light on the ways that writers can be unconscious of ethical problems in their…

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

ERIC Educational Resources Information Center

Zawadski, Rick T.; Gee, Stephen

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

Using Video Materials in English for Technical Sciences: A Case Study

ERIC Educational Resources Information Center

Milosevic, Danica

2017-01-01

In the digital era, university instructors working in English for Technical Sciences (ETS) have opportunities, some might say obligations, to use audio-visual resources to motivate students. Such materials also call on cognitive and constructivist mechanisms thought to improve uptake of the target language (Tarnopolsky, 2012). This chapter reports…

Educational Choice Regarding Technical Education: Research with Case Study

ERIC Educational Resources Information Center

Kacerauskas, Tomas; Šaparauskas, Jonas

2017-01-01

In first part, the models, theories, mechanisms and presumptions, as well as the ideas of educational choice discourse have been scrutinized. In the second part, the survey on educational choice at Vilnius Gediminas Technical University, Lithuania has been presented. The methodology used in this research is a survey of respondents and survey…

Technical Education as a Tool for Ensuring Sustainable Development: A Case of India

ERIC Educational Resources Information Center

Sharma, Gagan Deep; Uppal, Raminder Singh; Mahendru, Mandeep

2016-01-01

This paper notes that education needs to essentially lead to sustainable development serving two-fold purpose--eradicating the problems of unemployment and poverty; and ensuring equitable distribution of wealth while ensuring the right understanding leading to a peaceful, prosperous and developed world. In its current state, technical education…

Challenges and Rewards of Teaching Intercultural Communication in a Technical Writing Course: A Case Study

ERIC Educational Resources Information Center

Cardenas, Diana L.

2012-01-01

Community-based projects immerse technical writing students in intercultural communication, addressing local needs and shaping documents in human terms. Students at a South Texas university work to establish communication with clients in a city-county health department to create effective documents and disseminate family health legislation. To…

"Is This Ethical?" A Survey of Opinion on Principles and Practices of Document Design.

ERIC Educational Resources Information Center

Dragga, Sam

1996-01-01

Reprints a corrected version of an article originally published in the volume 43, number 1 issue of this journal. Presents results of a national survey of technical communicators and technical communication teachers assessing the ethics of seven document design cases involving manipulation of typography, illustrations, and photographs. Offers…

A Feminist Perspective on Technical Communicative Action: Exploring How Alternative Worldviews Affect Environmental Remediation Efforts.

ERIC Educational Resources Information Center

Ross, Susan Mallon

1994-01-01

Describes the current practices in public environmental debate and reform movements as relevant to technical communicators. Reviews a case in which the Mohawk community clashed with the Environmental Protection Agency. Explores the clash of worldviews and shows how a feminist perspective might aid in such a conflict. (HB)

Brokering Boundaries: Literacy Change Agents at Work

ERIC Educational Resources Information Center

VanDeusen-MacLeod, Elizabeth A.

2009-01-01

The purpose of this mixed-method descriptive case study is to investigate the role technical assistance providers within the context of one state's large-scale literacy grant program. This study provides an in-depth examination of one state's technical assistance providers known as Reading First Facilitators (RFF) through the study of a group of…

Continuous Quality Improvement in a University Setting: The Case of the Department of Vocational and Technical Education at the University of Minnesota.

ERIC Educational Resources Information Center

Copa, George H.

1993-01-01

Discusses the application of continuous quality improvement principles in the Department of Vocational and Technical Education at the University of Minnesota. Reviews the processes that the department incorporated to implement this program and lists future steps and categories of action. (Author)

How Academic Teachers Perceive and Facilitate Creativity

ERIC Educational Resources Information Center

Bjørner, Thomas; Kofoed, Lise Busk

2013-01-01

We will present a case study result from a cross-disciplinary education called Medialogy, which is taught in the Technical and Science Faculty at Aalborg University. The aim of Medialogy is to facilitate creativity within technical solutions. The intention of this paper is to answer the following: how do the Medialogy teachers perceive creativity…

Transfer of knowledge in international cooperation: the Farmanguinhos - SMM case.

PubMed

Silva, Samuel Araujo Gomes da; Duarte, Roberto Gonzalez; Castro, José Márcio de

2017-01-01

To analyze the influence of four mechanisms of knowledge transfer (training, technical visits, expatriation, and standard operating procedures) on the different dimensions (potential and realized) of absorptive capacity in international technical cooperation. We examine the case of implementation of the Sociedade Moçambicana de Medicamentos. Data have been collected using semi-structured interviews (applied to 21 professionals of the Sociedade Moçambicana de Medicamentos, Farmanguinhos, FIOCRUZ, and Itamaraty) and official documents. The data of the interviews have been submitted to content analysis, using the software NVivo. Training and technical visits directly influenced the acquisition and, partly, the assimilation of knowledge. Expatriation contributed with the transformation of this knowledge from the development and refinement of operational routines. Finally, the definition of standard operating procedures allowed the Mozambican technicians to be the actors of the transformation of the knowledge previously acquired and assimilated and, at the same time, it laid the foundations for a future exploration of the knowledge. Training and technical visits mainly influence the potential absorptive capacity, while expatriation and standard operating procedures most directly affect the realized absorptive capacity.

Socio-technical issues and challenges in implementing safe patient handovers: insights from ethnographic case studies.

PubMed

Balka, Ellen; Tolar, Marianne; Coates, Shannon; Whitehouse, Sandra

2013-12-01

Ineffective handovers in patient care, including those where information loss occurs between care providers, have been identified as a risk to patient safety. Computerization of health information is often offered as a solution to improve the quality of care handovers and decrease adverse events related to patient safety. The purpose of this paper is to broaden our understanding of clinical handover as a patient safety issue, and to identify socio-technical issues which may come to bear on the success of computer based handover tools. Three in depth ethnographic case studies were undertaken. Field notes were transcribed and analyzed with the aid of qualitative data analysis software. Within case analysis was performed on each case, and subsequently, cross case analyses were performed. We identified five types of socio-technical issues which must be addressed if electronic handover tools are to succeed. The inter-dependencies of these issues are addressed in relation to arenas in which health care work takes place. We suggest that the contextual nature of information, ethical and medico-legal issues arising in relation to information handover, and issues related to data standards and system interoperability must be addressed if computerized health information systems are to achieve improvements in patient safety related to handovers in care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Authorship versus "credit" for participation in research: a case study of potential ethical dilemmas created by technical tools used by researchers and claims for authorship by their creators.

PubMed

Welker, James A; McCue, Jack D

2007-01-01

The distinction between authorship and other forms of credit for contribution to a publication has been a persisting controversy that has resulted in numerous guidelines outlining the expected contributions of those claiming authorship. While there have been flagrant, well-publicized deviations from widely accepted standards, they are largely outnumbered by cases that are not publicity-worthy, and therefore remain known to only those directly involved with the inappropriate conduct. We discuss the definition and ethical requirements of authorship, offer a case example of the authorship debate created by a technical tool at our institution, and review parallels that support and dispute the authorship claims of our software developers. Ultimately, we conclude that development of a technical tool that enables data collection does not adequately substitute for contributions to study design and manuscript preparation for authorship purposes. Unless the designers of such a technical tool prospectively participate as a part of the project, they would not have an adequate understanding of the publication's genesis to defend it publicly and cannot be listed as authors. Therefore, it is incumbent upon project members to invite tool developers to participate at the beginning of such projects, and for tool developers to contribute to study design and manuscript preparation when they desire authorship listings.

The socio-technical organisation of community pharmacies as a factor in the Electronic Prescription Service Release Two implementation: a qualitative study

PubMed Central

2012-01-01

Background The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2)) has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. Method We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. Results In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual model development process, we identified three approaches community pharmacies used to appropriate procedures in practice. These were ‘technically oriented’, ‘improvising’ or ‘socially oriented’. Conclusion We offer a model of different work approaches community pharmacies use to dispense, which suggests that when adopting a core technical element such as the EPS2 system of dispensing there could be variations in its successful adoption. Technically oriented pharmacies might find it easiest to integrate a similar artefact into work practice although needs EPS2 to synchronise effectively with existing technologies. Pharmacies adopting an improvising-approach have the potential to improve how they organise dispensing through EPS2 although they will need to improve how they apply their operating procedures. Socially oriented pharmacies will need to dramatically adapt their approach to dispensing since they usually rely on few technical tools. PMID:23256484

The socio-technical organisation of community pharmacies as a factor in the Electronic Prescription Service Release Two implementation: a qualitative study.

PubMed

Harvey, Jasmine; Avery, Anthony J; Waring, Justin; Barber, Nick

2012-12-20

The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2)) has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual model development process, we identified three approaches community pharmacies used to appropriate procedures in practice. These were 'technically oriented', 'improvising' or 'socially oriented'. We offer a model of different work approaches community pharmacies use to dispense, which suggests that when adopting a core technical element such as the EPS2 system of dispensing there could be variations in its successful adoption. Technically oriented pharmacies might find it easiest to integrate a similar artefact into work practice although needs EPS2 to synchronise effectively with existing technologies. Pharmacies adopting an improvising-approach have the potential to improve how they organise dispensing through EPS2 although they will need to improve how they apply their operating procedures. Socially oriented pharmacies will need to dramatically adapt their approach to dispensing since they usually rely on few technical tools.

Robotic Companions for Older People: A Case Study in the Wild.

PubMed

Doering, Nicola; Richter, Katja; Gross, Horst-Michael; Schroeter, Christof; Mueller, Steffen; Volkhardt, Michael; Scheidig, Andrea; Debes, Klaus

2015-01-01

Older people tend to have difficulties using unknown technical devices and are less willing to accept technical shortcomings. Therefore, a robot that is supposed to support older people in managing daily life has to adapt to the users' needs and capabilities that are very heterogeneous within the target group. The aim of the presented case study was to provide in-depth insights on individual usage patterns and acceptance of a mobile service robot in real live environments (i.e. in the users' homes). Results from three cases (users aged 67, 78 and 85 living in their own apartments) are reported. Findings on usability and user experience illustrate that the robot has considerable potential to be accepted to support daily living at home.

Evaluation of PDA Technical Report No 33. Statistical Testing Recommendations for a Rapid Microbiological Method Case Study.

PubMed

Murphy, Thomas; Schwedock, Julie; Nguyen, Kham; Mills, Anna; Jones, David

2015-01-01

New recommendations for the validation of rapid microbiological methods have been included in the revised Technical Report 33 release from the PDA. The changes include a more comprehensive review of the statistical methods to be used to analyze data obtained during validation. This case study applies those statistical methods to accuracy, precision, ruggedness, and equivalence data obtained using a rapid microbiological methods system being evaluated for water bioburden testing. Results presented demonstrate that the statistical methods described in the PDA Technical Report 33 chapter can all be successfully applied to the rapid microbiological method data sets and gave the same interpretation for equivalence to the standard method. The rapid microbiological method was in general able to pass the requirements of PDA Technical Report 33, though the study shows that there can be occasional outlying results and that caution should be used when applying statistical methods to low average colony-forming unit values. Prior to use in a quality-controlled environment, any new method or technology has to be shown to work as designed by the manufacturer for the purpose required. For new rapid microbiological methods that detect and enumerate contaminating microorganisms, additional recommendations have been provided in the revised PDA Technical Report No. 33. The changes include a more comprehensive review of the statistical methods to be used to analyze data obtained during validation. This paper applies those statistical methods to analyze accuracy, precision, ruggedness, and equivalence data obtained using a rapid microbiological method system being validated for water bioburden testing. The case study demonstrates that the statistical methods described in the PDA Technical Report No. 33 chapter can be successfully applied to rapid microbiological method data sets and give the same comparability results for similarity or difference as the standard method. © PDA, Inc. 2015.

Endoscopic Management of Bile Leakage after Liver Transplantation

PubMed Central

Oh, Dongwook; Lee, Sung Koo; Song, Tae Jun; Park, Do Hyun; Lee, Sang Soo; Seo, Dong-Wan; Kim, Myung-Hwan

2015-01-01

Background/Aims Endoscopic retrograde cholangiopancreatography (ERCP) can be an effective treatment for bile leakage after liver transplantation. We evaluated the efficacy of endoscopic treatment in liver transplantation in patients who developed bile leaks. Methods Forty-two patients who developed bile leaks after liver transplantation were included in the study. If a bile leak was observed on ERCP, a sphincterotomy was performed, and a nasobiliary catheter was then inserted. If a bile leak was accompanied by a bile duct stricture, either the stricture was dilated with balloons, followed by nasobiliary catheter insertion across the bile duct stricture, or endoscopic retrograde biliary drainage was performed. Results In the bile leakage alone group (22 patients), endoscopic treatment was technically successful in 19 (86.4%) and clinically successful in 17 (77.3%) cases. Among the 20 patients with bile leaks with bile duct strictures, endoscopic treatment was technically successful in 13 (65.0%) and clinically successful in 10 (50.0%) cases. Among the 42 patients who underwent ERCP, technical success was achieved in 32 (76.2%) cases and clinical success was achieved in 27 (64.3%) cases. Conclusions ERCP is an effective and safe therapeutic modality for bile leaks after liver transplantation. ERCP should be considered as an initial therapeutic modality in post-liver transplantation patients. PMID:25717048

Inequity-aversion and relative kindness intention jointly determine the expenditure of effort in project teams

PubMed Central

Rapoport, Amnon; Zhao, Rui

2017-01-01

The literature on team cooperation has neglected the effects of relative kindness intention on cooperation, which we measure by comparing the kindness intentions of an agent to her group members to the kindness shown by other members to this same agent. We argue that the agent’s emotional reaction to material payoff inequity is not constant, but rather affected by her relative kindness intention. Then, we apply the model to team projects with multiple partners and investigate how inequity-aversion and relative kindness intention jointly influence team cooperation. We first consider the case of homogeneous agents, where their marginal productivity levels and technical capacities are the same, and then consider the case of heterogeneous agents, where their marginal productivity levels and technical capacities are not the same. Our results show that inequity-aversion has no effect on effort expenditure in the former case, but does affect it in the latter case. The consideration of relative kindness intention may impact the agents’ optimal cooperative effort expenditure when their technical capacities are different. In addition, it is beneficial for team cooperation, and might not only reduce the negative impact but also enhance the positive impact of inequity-aversion on the agents’ effort expenditures. PMID:28459853

Executive Headteachers: What's in a Name? Case Study Compendium

ERIC Educational Resources Information Center

Wespieser, Karen, Ed.

2016-01-01

This Case Study Compendium provides an overview of the 12 cases that were investigated as part of the study "Executive Headteachers: What's in a Name?'" (Lord et al., 2016). The case study overviews are based on in-depth analysis and research as described in the full report (ibid) and the Technical Appendix (Harland and Bernardinelli,…

ICARUSS, the Integrated Care for the Reduction of Secondary Stroke trial: rationale and design of a randomized controlled trial of a multimodal intervention to prevent recurrent stroke in patients with a recent cerebrovascular event, ACTRN = 12611000264987.

PubMed

Joubert, J; Davis, S M; Hankey, G J; Levi, C; Olver, J; Gonzales, G; Donnan, G A

2015-07-01

The majority of strokes, both ischaemic and haemorrhagic, are attributable to a relatively small number of risk factors which are readily manageable in primary care setting. Implementation of best-practice recommendations for risk factor management is calculated to reduce stroke recurrence by around 80%. However, risk factor management in stroke survivors has generally been poor at primary care level. A model of care that supports long-term effective risk factor management is needed. To determine whether the model of Integrated Care for the Reduction of Recurrent Stroke (ICARUSS) will, through promotion of implementation of best-practice recommendations for risk factor management reduce the combined incidence of stroke, myocardial infarction and vascular death in patients with recent stroke or transient ischaemic attack (TIA) of the brain or eye. A prospective, Australian, multicentre, randomized controlled trial. Academic stroke units in Melbourne, Perth and the John Hunter Hospital, New South Wales. 1000 stroke survivors recruited as from March 2007 with a recent (<3 months) stroke (ischaemic or haemorrhagic) or a TIA (brain or eye). Randomization and data collection are performed by means of a central computer generated telephone system (IVRS). Exposure to the ICARUSS model of integrated care or usual care. The composite of stroke, MI or death from any vascular cause, whichever occurs first. Risk factor management in the community, depression, quality of life, disability and dementia. With 1000 patients followed up for a median of one-year, with a recurrence rate of 7-10% per year in patients exposed to usual care, the study will have at least 80% power to detect a significant reduction in primary end-points The ICARUSS study aims to recruit and follow up patients between 2007 and 2013 and demonstrate the effectiveness of exposure to the ICARUSS model in stroke survivors to reduce recurrent stroke or vascular events and promote the implementation of best practice risk factor management at primary care level. © 2015 World Stroke Organization.

Exploring Teachers' Perceptions of Wikis for Learning Classroom Cases

ERIC Educational Resources Information Center

Quek, Choon Lang; Wang, Qiyun

2014-01-01

This paper explores three potential affordances (social, technical and pedagogical) of wikis in the context of designing 32 teachers' learning of classroom management cases. Two learning environments were designed and two groups of the teacher-participants posted their own written and audio cases, identified problems, discussed and proposed…

An Analysis of Technical Observations in Insider Theft of Intellectual Property Cases

DTIC Science & Technology

2011-02-01

Of the 50 cases, 52 percent involved stolen trade secrets. This seems intuitive because trade se- crets generally provide a company with a...was removable me- dia. Of the cases identified, 80 percent involved trade secrets. Of the insiders who stole trade se- crets using removable media

78 FR 41039 - 36(b)(1) Arms Sales Notification

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-09

... under Consideration for Purchase: follow-on equipment and support for Finland's F-18 Mid-Life Upgrade..., publications and technical documentation, personnel training and training equipment, U.S. Government and...) Military Department: Navy (GAU) (v) Prior Related Cases: FMS case SAA--$2.4 billion--9Jun92 FMS case SAB...

Solar For Schools: A Case Study in Identifying and Implementing Solar Photovoltaic (PV) Projects in Three California School Districts

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

Kandt, A.

2011-01-01

The Department of Energy's (DOE) Solar America Showcase program seeks to accelerate demand for solar technologies among key end use market sectors. As part of this activity, DOE provides technical assistance through its national laboratories to large-scale, high-visibility solar installation projects. The Solar Schools Assessment and Implementation Project (SSAIP) in the San Francisco Bay Area was selected for a 2009 DOE Solar America Showcase award. SSAIP was formed through the efforts of the nonprofit Sequoia Foundation and includes three school districts: Berkeley, West Contra Costa, and Oakland Unified School Districts. This paper summarizes the technical assistance efforts that resulted frommore » this technical assistance support. It serves as a case study and reference document detailing the steps and processes that could be used to successfully identify, fund, and implement solar photovoltaics (PV) projects in school districts across the country.« less

Technical and economic assessment of processes for the production of butanol and acetone

NASA Technical Reports Server (NTRS)

1982-01-01

This report represents a preliminary technical and economic evaluation of a process which produces mixed solvents (butaol/acetone/ethanol) via fermentation of sugars derived from renewable biomass resources. The objective is to assess the technology of producing butanol/acetone from biomass, and select a viable process capable of serving as a base case model for technical and economic analysis. It is anticipated that the base case process developed herein can then be used as the basis for subsequent studies concerning biomass conversion processes capable of producing a wide range of chemicals. The general criteria utilized in determining the design basis for the process are profit potential and non-renewable energy displacement potential. The feedstock chosen, aspen wood, was selected from a number of potential renewable biomass resources as the most readily available in the United States and for its relatively large potential for producing reducing sugars.

Fluoroscopic removal of retrievable self-expandable metal stents in patients with malignant oesophageal strictures: Experience with a non-endoscopic removal system.

PubMed

Kim, Pyeong Hwa; Song, Ho-Young; Park, Jung-Hoon; Zhou, Wei-Zhong; Na, Han Kyu; Cho, Young Chul; Jun, Eun Jung; Kim, Jun Ki; Kim, Guk Bae

2017-03-01

To evaluate clinical outcomes of fluoroscopic removal of retrievable self-expandable metal stents (SEMSs) for malignant oesophageal strictures, to compare clinical outcomes of three different removal techniques, and to identify predictive factors of successful removal by the standard technique (primary technical success). A total of 137 stents were removed from 128 patients with malignant oesophageal strictures. Primary overall technical success and removal-related complications were evaluated. Logistic regression models were constructed to identify predictive factors of primary technical success. Primary technical success rate was 78.8 % (108/137). Complications occurred in six (4.4 %) cases. Stent location in the upper oesophagus (P=0.004), stricture length over 8 cm (P=0.030), and proximal granulation tissue (P<0.001) were negative predictive factors of primary technical success. If granulation tissue was present at the proximal end, eversion technique was more frequently required (P=0.002). Fluoroscopic removal of retrievable SEMSs for malignant oesophageal strictures using three different removal techniques appeared to be safe and easy. The standard technique is safe and effective in the majority of patients. The presence of proximal granulation tissue, stent location in the upper oesophagus, and stricture length over 8 cm were negative predictive factors for primary technical success by standard extraction and may require a modified removal technique. • Fluoroscopic retrievable SEMS removal is safe and effective. • Standard removal technique by traction is effective in the majority of patients. • Three negative predictive factors of primary technical success were identified. • Caution should be exercised during the removal in those situations. • Eversion technique is effective in cases of proximal granulation tissue.

Developing a Template for Electronic Portfolios in Career and Technical Education

ERIC Educational Resources Information Center

Fowler, Matthew

2012-01-01

The purposes of this multiple case study were to determine if manufacturing and services sector employers found value in the use of an ePortfolio in the hiring process, and to develop a suggested template for an ePortfolio format to be used within career and technical education. Electronic portfolios "allow students to showcase their…

Managerial Competency Needs and Training Requests: The Case of the Spanish Tourist Industry.

ERIC Educational Resources Information Center

Agut, Sonia; Grau, Rosa

2002-01-01

A study analyzed the gap between required and existing management competency levels and acquired data on 80 Spanish hotel/restaurant managers' self-identified training needs. Deficits were found in 10 of 15 technical and 12 of 21 generic competencies. Managers requested training only in technical areas, not generic competencies. (Contains 42…

How Do Professional Learning Communities Foster Strong Career and Technical Education Programs of Study in Illinois Public High Schools?

ERIC Educational Resources Information Center

Custable, Wendy

2013-01-01

This research study examines how Illinois public high school Career and Technical Education educational leaders employ best practices in providing all students rigorous, relevant, and equitable learning experiences within a professional learning community structure. This study utilized a mixed method two-tier case study methodology. Tier one…

Case Studies on Technical and Vocational Education in Asia and the Pacific. An Overview.

ERIC Educational Resources Information Center

Haas, Adrian

A project considered issues that might contribute toward raising the status of technical and vocational education (TVE) in Asia and the Pacific region. It also provided a review of TVE in Australia, Bangladesh, China, Fiji, India, Indonesia, Iran, Japan, Republic of Korea, Malaysia, Pakistan, Thailand, and Vietnam. Researchers involved in the…

Deans of Career and Technical Education: Charting the Course to Senior Administration

ERIC Educational Resources Information Center

Levin, Shelley Zarovsky

2010-01-01

The purpose of this study was to explore the essential leadership practices, abilities, and experiences of Deans of Career and Technical Education (CTE) and to consider how these Deans of CTE fit into the succession process of the community college. A qualitative case study was conducted with three dyads of career Deans and their supervising…

The Relevance of Feenberg's Critical Theory of Technology to Critical Visual Literacy: The Case of Scientific and Technical Illustrations

ERIC Educational Resources Information Center

Northcut, Kathryn M.

2007-01-01

Andrew Feenberg's critical theory of technology is an underutilized, relatively unknown resource in technical communication which could be exploited not only for its potential clarification of large social issues that involve our discipline, but also specifically toward the development of a critical theory of illustrations. Applications of…

AIDS: An ICT Model for Integrating Teaching, Learning and Research in Technical University Education in Ghana

ERIC Educational Resources Information Center

Asabere, Nana; Togo, Gilbert; Acakpovi, Amevi; Torby, Wisdom; Ampadu, Kwame

2017-01-01

Information and Communication Technologies (ICT) has changed the way we communicate and carry out certain daily activities. Globally, ICT has become an essential means for disseminating information. Using Accra Technical University in Ghana as a case study, this paper proposes an ICT model called Awareness Incentives Demand and Support (AIDS). Our…

Teaching a "Critical Accessibility Case Study": Developing Disability Studies Curricula for the Technical Communication Classroom

ERIC Educational Resources Information Center

Browning, Ella R.; Cagle, Lauren E.

2017-01-01

As technical communication (TC) instructors, it is vital that we continue reimagining our curricula as the field itself is continually reimagined in light of new technologies, genres, workplace practices, and theories--theories such as those from disability studies scholarship. Here, the authors offer an approach to including disability studies in…

Can You Increase Teacher Engagement with Evaluation Simply by Improving the Evaluation System?

ERIC Educational Resources Information Center

Moskal, Adon C. M.; Stein, Sarah J.; Golding, Clinton

2016-01-01

We know various factors can influence how teaching staff engage with student evaluation, such as institutional policies or staff beliefs. However, little research has investigated the influence of the technical processes of an evaluation system. In this article, we present a case study of the effects of changing the technical system for…

A Case Study of an Ameliorable Career/Technical School: An Exploration of Principal/Teacher Relationships

ERIC Educational Resources Information Center

Glover, Joan

2012-01-01

This participatory action research study explored principal/teacher relationships in an ameliorable career/technical school located in the mid-west United States. This study examined how teachers in this school perceive their relationship with the principal and how a principal perceives her relationship with the teachers. This empirical inquiry…

Design and sampling plan optimization for RT-qPCR experiments in plants: a case study in blueberry

USDA-ARS?s Scientific Manuscript database

The qPCR assay has become a routine technology in plant biotechnology and agricultural research. It is unlikely to be technically improved in the near future, but there are still challenges which center around minimizing the variability in results and transparency when reporting technical data in su...

Offshore Teaching Practice in the Australia-Pacific Technical College: A Case Study in the South Pacific

ERIC Educational Resources Information Center

Bailey, Anthony

2011-01-01

This paper investigates teaching practices at the Australia-Pacific Technical College (APTC), which comprise a unique official development assistance (ODA) program funded by the Government of Australia (GoA) and managed through the Australian Agency for International Development (AusAid) with the aim of training and equipping workers from the…

Data Mining and Predictive Modeling in Institutional Advancement: How Ten Schools Found Success. Technical Report

ERIC Educational Resources Information Center

Luperchio, Dan

2009-01-01

This technical report, produced in partnership by the Council for Advancement and Support of Education (CASE) and SPSS Inc., explores the promise of data mining alumni records at educational institutions. Working with individual alumni records from The Johns Hopkins Zanvyl Krieger School of Arts and Sciences, a predictive regression model is…

Technical and Vocational Education and Training in Fiji--An Overview. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Delailomaloma, N. H.

The Fiji economy has undergone structural transformation as the importance of agriculture, construction, social and community services, finance, and insurance declined, whereas that of hotels and catering, transportation, communication, and mining rose. Capacity utilization, including absorption of already trained and educated people into…

47 CFR 90.723 - Selection and assignment of frequencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... stations will be considered by the Commission on a case-by-case basis upon submission of a technical analysis indicating that at least 10 dB protection will be provided to an existing Phase I station's...

[Technical considerations on 222 cases of esophageal anastomosis using a stapler].

PubMed

Liboni, A; Zamboni, P; Mari, C; Uzzau, A; Salomoni, C; Brunelli, G; Buccoliero, F; Donini, I

1989-05-01

The Authors report their experience with 222 esophagoenteric anastomoses, performed in 211 cases for malignant neoplasms (middle and lower third) of the esophagus or stomach. Particularly, they have performed 4 Sujura operations, 31 esophagogastric, 4 esophagocolic, 183 esophagojejunal anastomoses utilizing SPTU, ILS and EEA circular stapler. GIA was used in the preparation of the stomach before esophagogastroplasty. Mortality rate of the manual period (1970-1980: 114 cases operated) was 14.5% versus 2.2% of the stapling period (1981-1987: 222 cases operated). From the technical point of view reasons of the superiority of stapled technique are discussed and summarized as follows: 1) space not favourable for handsewn anastomoses; 2) stapled technique allows the surgeon to save anastomoses vascularization; 3) the stapler performs the suture simultaneously so to reduce tensile strength on the anastomoses and the fragile esophageal wall especially; 4) stapled agraphes are fixed in three points vs. the two points of the handsewn stitches.

EPA Technical Support Centers (TSC): FY14 Lessons ...

EPA Pesticide Factsheets

EPA’s Technical Support Centers (TSC) included in ORD’s Safe and Healthy Communities (SHC) Research Action Plan fill the need for supplying subject-matter experts to continually assess state-of-the-art research and practices and channel this information to users in both direct applications (i.e., site-specific technical support) and general applications (i.e., technical transfer activities such as technical guidance documents, conferences, or workshops) . The TSCs are charged with providing solutions by: 1) linking EPA research to Agency decision-makers; 2) applying best practices to real world field applications; and 3) channeling feedback from field application to research communities. The TSP goal is to provide Regional Remedial Project Managers (RPMs), Corrective Action Staff, and On-Scene Coordinators (OSCs) with a diverse set of readily-accessible resources for technical assistance. This research summary provides six case studies – two from each of the three TSCs (Ground Water Technical Support Center, Engineering Technical Support Center, and Site Characterization Technical Support Center) – to exemplify and summarize the variety of TSC approaches that contribute to fulfilling the TSP mission. EPA’s Technical Support Centers (TSC) included in ORD’s Safe and Healthy Communities (SHC) Research Action Plan fill the need for supplying subject-matter experts to continually assess state-of-the-art research and practices and channel this informati

Stent migration following endoscopic suture fixation of esophageal self-expandable metal stents: a systematic review and meta-analysis.

PubMed

Law, Ryan; Prabhu, Anoop; Fujii-Lau, Larissa; Shannon, Carol; Singh, Siddharth

2018-02-01

Covered self-expandable metal stents (SEMS) are utilized for the management of benign and malignant esophageal conditions; however, covered SEMS are prone to migration. Endoscopic suture fixation may mitigate the migration risk of covered esophageal SEMS. Hence, we conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of endoscopic suture fixation for covered esophageal SEMS. Following PRISMA guidelines, we performed a systematic review from 2011 to 2016 to identify studies (case control/case series) reporting the technical success and migration rate of covered esophageal SEMS following endoscopic suture fixation. We searched multiple electronic databases and conference proceedings. We calculated pooled rates (and 95% confidence intervals [CI]) of technical success and stent migration using a random effects model. We identified 14 studies (212 patients) describing covered esophageal SEMS placement with endoscopic suture fixation. When reported, SEMS indications included leak/fistula (n = 75), stricture (n = 65), perforation (n = 10), and achalasia (n = 4). The pooled technical success rate was 96.7% (95% CI 92.3-98.6), without heterogeneity (I 2  = 0%). We identified 29 SEMS migrations at rate of 15.9% (95% CI 11.4-21.6), without heterogeneity (I 2  = 0%). Publication bias was observed, and using the trim-and-fill method, a more conservative estimate for stent migration was 17.0%. Suture-related adverse events were estimated to occur in 3.7% (95% CI 1.6-8.2) of cases. Endoscopic suture fixation of covered esophageal SEMS appears to reduce stent migration when compared to published rates of non-anchored SEMS. However, SEMS migration still occurs in approximately 1 out of 6 cases despite excellent immediate technical success and low risk of suture-related adverse events.

Technical proficiency in hand-assisted laparoscopic colon and rectal surgery: determining how many cases are required to achieve mastery.

PubMed

Pendlimari, Rajesh; Holubar, Stefan D; Dozois, Eric J; Larson, David W; Pemberton, John H; Cima, Robert R

2012-04-01

To determine how many cases are required to achieve technical proficiency for hand-assisted laparoscopic surgery (HALS). Retrospective study. Tertiary care hospital. Using a prospective database, all HALS colorectal resections from 2003 to 2009 by 2 surgeons (A and B) were reviewed. Over 6 years, surgeons A and B performed 397 and 322 cases. Change-Point Analysis (CUSUM) was used to define the number of cases required to effect improvement in operative time. Cases before and after the change point were considered as being in the "learning period" and "skilled period." Operative time; short-term outcomes. The change point occurred after 108 and 105 cases for surgeons A and B, respectively. The learning period and skilled period were similar with respect to age, sex, body mass index, prior abdominal surgery, medical comorbidities, and American Society of Anesthesiologists class. Mean overall operative time decreased from 263 to 185 minutes (P < .001). The decrease in mean operative duration for specific resections were as follows: right colectomy, 35 minutes (P = .003); left colectomy, 63 minutes (P = .006); sigmoid colectomy, 63 minutes (P < .001); anterior resection, 70 minutes (P < .001); coloanal anastomosis, 52 minutes (P = .003); subtotal colectomy, 75 minutes (P < .001); and total proctocolectomy with ileal reservoir, 80 minutes (P < .001). Intraoperative complications and conversion rate were similar, but overall morbidity, infectious complications, readmissions, and length of stay were all significantly (P < .05) lower during the skilled period. For HALS colorectal resection, technical proficiency occurred after approximately 105 cases, and increased surgeon experience resulted in improved short-term outcomes. These data suggest that the learning curve for HALS colorectal resection will extend beyond fellowship training for many colorectal surgeons.

Software Safety Risk in Legacy Safety-Critical Computer Systems

NASA Technical Reports Server (NTRS)

Hill, Janice L.; Baggs, Rhoda

2007-01-01

Safety Standards contain technical and process-oriented safety requirements. Technical requirements are those such as "must work" and "must not work" functions in the system. Process-Oriented requirements are software engineering and safety management process requirements. Address the system perspective and some cover just software in the system > NASA-STD-8719.13B Software Safety Standard is the current standard of interest. NASA programs/projects will have their own set of safety requirements derived from the standard. Safety Cases: a) Documented demonstration that a system complies with the specified safety requirements. b) Evidence is gathered on the integrity of the system and put forward as an argued case. [Gardener (ed.)] c) Problems occur when trying to meet safety standards, and thus make retrospective safety cases, in legacy safety-critical computer systems.

International Approaches for Nuclear Waste Disposal in Geological Formations: Report on Fifth Worldwide Review

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

Faybishenko, Boris; Birkholzer, Jens; Persoff, Peter

2016-09-01

The goal of the Fifth Worldwide Review is to document evolution in the state-of-the-art of approaches for nuclear waste disposal in geological formations since the Fourth Worldwide Review that was released in 2006. The last ten years since the previous Worldwide Review has seen major developments in a number of nations throughout the world pursuing geological disposal programs, both in preparing and reviewing safety cases for the operational and long-term safety of proposed and operating repositories. The countries that are approaching implementation of geological disposal will increasingly focus on the feasibility of safely constructing and operating their repositories in short-more » and long terms on the basis existing regulations. The WWR-5 will also address a number of specific technical issues in safety case development along with the interplay among stakeholder concerns, technical feasibility, engineering design issues, and operational and post-closure safety. Preparation and publication of the Fifth Worldwide Review on nuclear waste disposal facilitates assessing the lessons learned and developing future cooperation between the countries. The Report provides scientific and technical experiences on preparing for and developing scientific and technical bases for nuclear waste disposal in deep geologic repositories in terms of requirements, societal expectations and the adequacy of cases for long-term repository safety. The Chapters include potential issues that may arise as repository programs mature, and identify techniques that demonstrate the safety cases and aid in promoting and gaining societal confidence. The report will also be used to exchange experience with other fields of industry and technology, in which concepts similar to the design and safety cases are applied, as well to facilitate the public perception and understanding of the safety of the disposal approaches relative to risks that may increase over long times frames in the absence of a successful implementation of final dispositioning.« less

Development of requirements on safety cases of machine industry products for power engineering

NASA Astrophysics Data System (ADS)

Aronson, K. E.; Brezgin, V. I.; Brodov, Yu. M.; Gorodnova, N. V.; Kultyshev, A. Yu.; Tolmachev, V. V.; Shablova, E. G.

2016-12-01

This article considers security assurance for power engineering machinery in the design and production phases. The Federal Law "On Technical Regulation" and the Customs Union Technical Regulations "On Safety of Machinery and Equipment" are analyzed in the legal, technical, and economic aspect with regard to power engineering machine industry products. From the legal standpoint, it is noted that the practical enforcement of most norms of the Law "On Technical Regulation" makes it necessary to adopt subordinate statutory instruments currently unavailable; moreover, the current level of adoption of technical regulations leaves much to be desired. The intensive integration processes observed in the Eurasian Region in recent years have made it a more pressing task to harmonize the laws of the region's countries, including their technical regulation framework. The technical aspect of analyzing the technical regulation of the Customs Union has been appraised by the IDEF0 functional modeling method. The object of research is a steam turbine plant produced at the turbine works. When developing the described model, we considered the elaboration of safety case (SC) requirements from the standpoint of the chief designer of the turbine works as the person generally responsible for the elaboration of the SC document. The economic context relies on risk analysis and appraisal methods. In their respect, these are determined by the purposes and objectives of analysis, complexity of considered objects, availability of required data, and expertise of specialists hired to conduct the analysis. The article proposes the description of all sources of hazard and scenarios of their actualization in all production phases of machinery life cycle for safety assurance purposes. The detection of risks and hazards allows forming the list of unwanted events. It describes the sources of hazard, various risk factors, conditions for their rise and development, tentative risk appraisals, and elaboration of tentative guidelines for reducing hazard and risk levels.

Globus Nexus: A Platform-as-a-Service Provider of Research Identity, Profile, and Group Management.

PubMed

Chard, Kyle; Lidman, Mattias; McCollam, Brendan; Bryan, Josh; Ananthakrishnan, Rachana; Tuecke, Steven; Foster, Ian

2016-03-01

Globus Nexus is a professionally hosted Platform-as-a-Service that provides identity, profile and group management functionality for the research community. Many collaborative e-Science applications need to manage large numbers of user identities, profiles, and groups. However, developing and maintaining such capabilities is often challenging given the complexity of modern security protocols and requirements for scalable, robust, and highly available implementations. By outsourcing this functionality to Globus Nexus, developers can leverage best-practice implementations without incurring development and operations overhead. Users benefit from enhanced capabilities such as identity federation, flexible profile management, and user-oriented group management. In this paper we present Globus Nexus, describe its capabilities and architecture, summarize how several e-Science applications leverage these capabilities, and present results that characterize its scalability, reliability, and availability.

Globus Nexus: A Platform-as-a-Service provider of research identity, profile, and group management

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

Chard, Kyle; Lidman, Mattias; McCollam, Brendan

Globus Nexus is a professionally hosted Platform-as-a-Service that provides identity, profile and group management functionality for the research community. Many collaborative e-Science applications need to manage large numbers of user identities, profiles, and groups. However, developing and maintaining such capabilities is often challenging given the complexity of modern security protocols and requirements for scalable, robust, and highly available implementations. By outsourcing this functionality to Globus Nexus, developers can leverage best-practice implementations without incurring development and operations overhead. Users benefit from enhanced capabilities such as identity federation, flexible profile management, and user-oriented group management. In this paper we present Globus Nexus,more » describe its capabilities and architecture, summarize how several e-Science applications leverage these capabilities, and present results that characterize its scalability, reliability, and availability.« less

Guidelines for measuring cardiac physiology in mice

PubMed Central

Kassiri, Zamaneh; Virag, Jitka A. I.; de Castro Brás, Lisandra E.; Scherrer-Crosbie, Marielle

2018-01-01

Cardiovascular disease is a leading cause of death, and translational research is needed to understand better mechanisms whereby the left ventricle responds to injury. Mouse models of heart disease have provided valuable insights into mechanisms that occur during cardiac aging and in response to a variety of pathologies. The assessment of cardiovascular physiological responses to injury or insult is an important and necessary component of this research. With increasing consideration for rigor and reproducibility, the goal of this guidelines review is to provide best-practice information regarding how to measure accurately cardiac physiology in animal models. In this article, we define guidelines for the measurement of cardiac physiology in mice, as the most commonly used animal model in cardiovascular research. Listen to this article’s corresponding podcast at http://ajpheart.podbean.com/e/guidelines-for-measuring-cardiac-physiology-in-mice/. PMID:29351456

Bauxite Mining and Alumina Refining

PubMed Central

Frisch, Neale; Olney, David

2014-01-01

Objective: To describe bauxite mining and alumina refining processes and to outline the relevant physical, chemical, biological, ergonomic, and psychosocial health risks. Methods: Review article. Results: The most important risks relate to noise, ergonomics, trauma, and caustic soda splashes of the skin/eyes. Other risks of note relate to fatigue, heat, and solar ultraviolet and for some operations tropical diseases, venomous/dangerous animals, and remote locations. Exposures to bauxite dust, alumina dust, and caustic mist in contemporary best-practice bauxite mining and alumina refining operations have not been demonstrated to be associated with clinically significant decrements in lung function. Exposures to bauxite dust and alumina dust at such operations are also not associated with the incidence of cancer. Conclusions: A range of occupational health risks in bauxite mining and alumina refining require the maintenance of effective control measures. PMID:24806720

[The German program for disease management guidelines: evaluation by use of quality indicators].

PubMed

Kopp, Ina B; Geraedts, Max; Jäckel, Wilfried H; Altenhofen, Lutz; Thomeczek, Christian; Ollenschläger, Günter

2007-08-15

The Program for National Disease Management Guidelines (German DM-CPG Program) in Germany aims at the implementation of best-practice recommendations for prevention, acute care, rehabilitation and chronic care in the setting of disease management programs and integrated health-care systems. Like other guidelines, DM-CPG need to be assessed regarding their influence on structures, processes and outcomes of care. However, quality assessment in integrated health-care systems is challenging. On the one hand, a multitude of potential domains for measurement, actors and perspectives need to be considered. On the other hand, measures need to be identified that assess the function of the diagnostic and therapeutic chain in terms of cooperation and coordination of care. The article reviews methods and use of quality indicators in the context of the German DM-CPG Program.

Bauxite mining and alumina refining: process description and occupational health risks.

PubMed

Donoghue, A Michael; Frisch, Neale; Olney, David

2014-05-01

To describe bauxite mining and alumina refining processes and to outline the relevant physical, chemical, biological, ergonomic, and psychosocial health risks. Review article. The most important risks relate to noise, ergonomics, trauma, and caustic soda splashes of the skin/eyes. Other risks of note relate to fatigue, heat, and solar ultraviolet and for some operations tropical diseases, venomous/dangerous animals, and remote locations. Exposures to bauxite dust, alumina dust, and caustic mist in contemporary best-practice bauxite mining and alumina refining operations have not been demonstrated to be associated with clinically significant decrements in lung function. Exposures to bauxite dust and alumina dust at such operations are also not associated with the incidence of cancer. A range of occupational health risks in bauxite mining and alumina refining require the maintenance of effective control measures.

Developing antitobacco mass media campaign messages in a low-resource setting: experience from the Kingdom of Tonga

PubMed Central

Sugden, C; Phongsavan, P; Gloede, S; Filiai, S; Tongamana, V O

2017-01-01

Tobacco use has become the leading cause of preventable death in Tonga, a small island nation in the South Pacific. One pragmatic and economical strategy to address this worrying trend is to adapt effective antitobacco mass media materials developed in high-income countries for local audiences. Using Tonga as an example, this paper shares the practical steps involved in adapting antitobacco campaign materials for local audiences with minimal resources, a limited budget and without the need for an external production team. The Tongan experience underscores the importance of an adaptation process that draws from evidence-based best-practice models and engages local and regional stakeholders to ensure that campaign materials are tailored to the local context and are embedded within a mix of antitobacco strategies. PMID:26969171

Globus Nexus: A Platform-as-a-Service Provider of Research Identity, Profile, and Group Management

PubMed Central

Lidman, Mattias; McCollam, Brendan; Bryan, Josh; Ananthakrishnan, Rachana; Tuecke, Steven; Foster, Ian

2015-01-01

Globus Nexus is a professionally hosted Platform-as-a-Service that provides identity, profile and group management functionality for the research community. Many collaborative e-Science applications need to manage large numbers of user identities, profiles, and groups. However, developing and maintaining such capabilities is often challenging given the complexity of modern security protocols and requirements for scalable, robust, and highly available implementations. By outsourcing this functionality to Globus Nexus, developers can leverage best-practice implementations without incurring development and operations overhead. Users benefit from enhanced capabilities such as identity federation, flexible profile management, and user-oriented group management. In this paper we present Globus Nexus, describe its capabilities and architecture, summarize how several e-Science applications leverage these capabilities, and present results that characterize its scalability, reliability, and availability. PMID:26688598

The future of tic disorder treatment.

PubMed

Bennett, Shannon M; Keller, Alex E; Walkup, John T

2013-11-01

Competing theories on the etiology and treatment of chronic tic disorders and Tourette syndrome have long made the search for efficacious intervention more challenging for patients and families seeking to reduce functional impairment related to tic symptoms. These symptoms were historically posited to be either psychological in origin, leading to the long tradition of psychoanalytic psychotherapy for tics, or biological in nature, particularly since the advent of successful treatments using neuroleptic medications. Current thinking about the phenomenology of tic disorders comes from growing empirical evidence as well as advances in neuroscience and genetics research and reveals a biological vulnerability that is exacerbated by physiological arousal related to environmental or interpersonal stress. This manuscript summarizes the evolution of this knowledge base and describes current best-practice recommendations for patients, families, and clinicians. © 2013 New York Academy of Sciences.

First-year Analysis of the Operating Room Black Box Study.

PubMed

Jung, James J; Jüni, Peter; Lebovic, Gerald; Grantcharov, Teodor

2018-06-18

To characterize intraoperative errors, events, and distractions, and measure technical skills of surgeons in minimally invasive surgery practice. Adverse events in the operating room (OR) are common contributors of morbidity and mortality in surgical patients. Adverse events often occur due to deviations in performance and environmental factors. Although comprehensive intraoperative data analysis and transparent disclosure have been advocated to better understand how to improve surgical safety, they have rarely been done. We conducted a prospective cohort study in 132 consecutive patients undergoing elective laparoscopic general surgery at an academic hospital during the first year after the definite implementation of a multiport data capture system called the OR Black Box to identify intraoperative errors, events, and distractions. Expert analysts characterized intraoperative distractions, errors, and events, and measured trainee involvement as main operator. Technical skills were compared, crude and risk-adjusted, among the attending surgeon and trainees. Auditory distractions occurred a median of 138 times per case [interquartile range (IQR) 96-190]. At least 1 cognitive distraction appeared in 84 cases (64%). Medians of 20 errors (IQR 14-36) and 8 events (IQR 4-12) were identified per case. Both errors and events occurred often in dissection and reconstruction phases of operation. Technical skills of residents were lower than those of the attending surgeon (P = 0.015). During elective laparoscopic operations, frequent intraoperative errors and events, variation in surgeons' technical skills, and a high amount of environmental distractions were identified using the OR Black Box.

Three-dimensional path planning software-assisted transjugular intrahepatic portosystemic shunt: a technical modification.

PubMed

Tsauo, Jiaywei; Luo, Xuefeng; Ye, Linchao; Li, Xiao

2015-06-01

This study was designed to report our results with a modified technique of three-dimensional (3D) path planning software assisted transjugular intrahepatic portosystemic shunt (TIPS). 3D path planning software was recently developed to facilitate TIPS creation by using two carbon dioxide portograms acquired at least 20° apart to generate a 3D path for overlay needle guidance. However, one shortcoming is that puncturing along the overlay would be technically impossible if the angle of the liver access set and the angle of the 3D path are not the same. To solve this problem, a prototype 3D path planning software was fitted with a utility to calculate the angle of the 3D path. Using this, we modified the angle of the liver access set accordingly during the procedure in ten patients. Failure for technical reasons occurred in three patients (unsuccessful wedged hepatic venography in two cases, software technical failure in one case). The procedure was successful in the remaining seven patients, and only one needle pass was required to obtain portal vein access in each case. The course of puncture was comparable to the 3D path in all patients. No procedure-related complication occurred following the procedures. Adjusting the angle of the liver access set to match the angle of the 3D path determined by the software appears to be a favorable modification to the technique of 3D path planning software assisted TIPS.

Structural Elaboration of Technical and Vocational Education and Training Systems in Developing Countries: The Cases of Sri Lanka and Bangladesh

ERIC Educational Resources Information Center

Maurer, Markus

2012-01-01

While technical and vocational education and training (TVET) is re-emerging on the agenda of many development agencies and governments of developing countries alike, there remains a serious lack of theoretically grounded literature on how skills formation systems in developing countries change over time, and how these transformations are…

Teachers' Skills and ICT Integration in Technical and Vocational Education and Training TVET: A Case of Khartoum State-Sudan

ERIC Educational Resources Information Center

Ramadan, Abdelmoiz; Chen, Xiaohui; Hudson, Laura L.

2018-01-01

Information and communication technology (ICT) elicited rapidly dissemination over the world. For its impact in Sudan, the national government has been energized the institutions to implement ICT in every sector. This study examined the Sudanese teachers' skills and ICT integration in technical and vocational education and training TVET in…

Writing the Trenches: What Students of Technical Writing and Literature Can Learn Together

ERIC Educational Resources Information Center

Baake, Ken; Shelton, Jen

2017-01-01

We argue for a course in which students analyze writing about a common topic--in this case World War I--from multiple genres (e.g., poetry and technical manuals). We address the divide between instruction in pragmatic and literary writing and calls to bridge that gap. Students working in disparate areas of English learn the strengths and the…

Improving Curriculum Development Practices in a Technical Vocational Community College: Examining Effects of a Professional Development Arrangement for Middle Managers

ERIC Educational Resources Information Center

Albashiry, Nabeel M.; Voogt, Joke M.; Pieters, Jules M.

2015-01-01

Learning about curriculum development is critical for middle managers of technical vocational institutions in order to assume curriculum leadership in maintaining and enhancing the quality and relevance of their educational programs. This case study reports on the design and effects of a professional development arrangement (PDA), with such a…

Technical Cooperation with Iran: A Case Study of Opportunities and Policy Implications for the United States. Report to the Agency for International Development.

ERIC Educational Resources Information Center

Agency for International Development (Dept. of State), Washington, DC.

This report concerns aspects of the United States' changing policies for providing economic and technical assistance to developing nations. Of primary importance in a review of relationships with those rapidly developing nations no longer eligible for concessional assistance from the Agency for International Development (AID) are the possible…

Technical and Non-Technical Education and the Employability of Engineering Graduates: An Indian Case Study

ERIC Educational Resources Information Center

Gokuladas, V. K.

2010-01-01

India's substantial growth in recent years has resulted in a significant increase in demand for engineers. Information technology companies, now a major part of the Indian private sector, have been prominent in such recruitment, but the competences they seek in engineering students appear to be different in terms of priorities from those sought by…

Monitoring the Effect of Internet Use on Students Behavior Case Study: Technical Faculty Bor, University of Belgrade

ERIC Educational Resources Information Center

Niculovic, Milica; Zivkovic, Dragana; Manasijevic, Dragan; Strbac, Nada

2012-01-01

A large number of criteria for evaluating Internet addiction have been developed recently. The research of Internet addiction among students of the Technical faculty in Bor, University of Belgrade has been conducted and its results are presented in this paper. The study included 270 students using criteria of Young's Internet Addiction Test. In…

Norm-Aware Socio-Technical Systems

NASA Astrophysics Data System (ADS)

Savarimuthu, Bastin Tony Roy; Ghose, Aditya

The following sections are included: * Introduction * The Need for Norm-Aware Systems * Norms in human societies * Why should software systems be norm-aware? * Case Studies of Norm-Aware Socio-Technical Systems * Human-computer interactions * Virtual environments and multi-player online games * Extracting norms from big data and software repositories * Norms and Sustainability * Sustainability and green ICT * Norm awareness through software systems * Where To, From Here? * Conclusions

Communities of Practice as a Technical Assistance Strategy: A Single-Case Study of State Systems Change

ERIC Educational Resources Information Center

Linehan, Patrice Cunniff

2010-01-01

This study examined how one state approached the integration of policy and practice by forming communities of practice (CoP), defined as groups of people who share a set of problems and interact regularly to solve them (Wenger, McDermott, & Snyder, 2002). Policymakers have created strategies known as technical assistance (TA) to bridge the…

Is Three-Dimensional Videography the Cutting Edge of Surgical Skill Acquisition?

ERIC Educational Resources Information Center

Roach, Victoria A.; Brandt, Michael G.; Moore, Corey C.; Wilson, Timothy D.

2012-01-01

The process of learning new surgical technical skills is vital to the career of a surgeon. The acquisition of these new skills is influenced greatly by visual-spatial ability (VSA) and may be difficult for some learners to rapidly assimilate. In many cases, the role of VSA on the acquisition of a novel technical skill has been explored; however,…

Enterprise Planning for Change; Co-ordination of Manpower and Technical Planning. Industrial Relations Aspects of Manpower Policy, No. 5.

ERIC Educational Resources Information Center

Wedderburn, Dorothy

Forty case studies made by research teams of independents or governmental agencies in Austria, Canada, France, Germany, Norway, Sweden, United Kingdom, and the United States were analyzed to provide managements and trade unions with illustrations of present systems of technical and manpower changes at the enterprise level and to describe the…

Cultural Literacy and Student Engagement: The Case of Technical and Vocational Education and Training (TVET) in Hong Kong

ERIC Educational Resources Information Center

Hui, Sammy King Fai; Cheung, Hoi Yan

2015-01-01

Technical and vocational education and training (TVET) is often seen to be constraining and focused on specific skill development for specific occupations. This goal is at odds with the demands of a knowledge economy that requires more general educational outcomes for an uncertain and unpredictable labour market. For this reason, Hui (2012) has…

Knowledge Sharing and Dialogue among Information Technology Workers: A Case Study Using a Public Works Department

ERIC Educational Resources Information Center

Harrison, Priscilla

2013-01-01

The problem addressed in this study is the willingness or reluctance of information technology (IT) knowledge workers and managers to share knowledge. The purpose of the study was to examine the willingness or unwillingness of technical personnel in IT to share technical knowledge and the issues surrounding their reluctance, if any. The study…

Transfer of knowledge in international cooperation: the Farmanguinhos – SMM case

PubMed Central

da Silva, Samuel Araujo Gomes; Duarte, Roberto Gonzalez; de Castro, José Márcio

2017-01-01

ABSTRACT OBJECTIVE To analyze the influence of four mechanisms of knowledge transfer (training, technical visits, expatriation, and standard operating procedures) on the different dimensions (potential and realized) of absorptive capacity in international technical cooperation. METHODS We examine the case of implementation of the Sociedade Moçambicana de Medicamentos. Data have been collected using semi-structured interviews (applied to 21 professionals of the Sociedade Moçambicana de Medicamentos, Farmanguinhos, FIOCRUZ, and Itamaraty) and official documents. The data of the interviews have been submitted to content analysis, using the software NVivo. RESULTS Training and technical visits directly influenced the acquisition and, partly, the assimilation of knowledge. Expatriation contributed with the transformation of this knowledge from the development and refinement of operational routines. Finally, the definition of standard operating procedures allowed the Mozambican technicians to be the actors of the transformation of the knowledge previously acquired and assimilated and, at the same time, it laid the foundations for a future exploration of the knowledge. CONCLUSIONS Training and technical visits mainly influence the potential absorptive capacity, while expatriation and standard operating procedures most directly affect the realized absorptive capacity. PMID:29166441

The Role of the Technical Specialist in Disaster Response and Recovery

NASA Astrophysics Data System (ADS)

Curtis, J. C.

2017-12-01

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

TurboTech Technical Evaluation Automated System

NASA Technical Reports Server (NTRS)

Tiffany, Dorothy J.

2009-01-01

TurboTech software is a Web-based process that simplifies and semiautomates technical evaluation of NASA proposals for Contracting Officer's Technical Representatives (COTRs). At the time of this reporting, there have been no set standards or systems for training new COTRs in technical evaluations. This new process provides boilerplate text in response to interview style questions. This text is collected into a Microsoft Word document that can then be further edited to conform to specific cases. By providing technical language and a structured format, TurboTech allows the COTRs to concentrate more on the actual evaluation, and less on deciding what language would be most appropriate. Since the actual word choice is one of the more time-consuming parts of a COTRs job, this process should allow for an increase in quantity of proposals evaluated. TurboTech is applicable to composing technical evaluations of contractor proposals, task and delivery orders, change order modifications, requests for proposals, new work modifications, task assignments, as well as any changes to existing contracts.

Sensitivity analysis of the add-on price estimate for the silicon web growth process

NASA Technical Reports Server (NTRS)

Mokashi, A. R.

1981-01-01

The web growth process, a silicon-sheet technology option, developed for the flat plate solar array (FSA) project, was examined. Base case data for the technical and cost parameters for the technical and commercial readiness phase of the FSA project are projected. The process add on price, using the base case data for cost parameters such as equipment, space, direct labor, materials and utilities, and the production parameters such as growth rate and run length, using a computer program developed specifically to do the sensitivity analysis with improved price estimation are analyzed. Silicon price, sheet thickness and cell efficiency are also discussed.

True aneurysm of the proximal occipital artery: Case report.

PubMed

Illuminati, Giulio; Cannistrà, Marco; Pizzardi, Giulia; Pasqua, Rocco; Frezzotti, Francesca; Calio', Francesco G

2018-01-01

True aneurysms of the proximal occipital artery are rare, may cause neurological symptoms due to compression of the hypoglossal nerve and their resection may be technically demanding. The case of an aneurysm of the proximal occipital artery causing discomfort and tongue deviation by compression on the hypoglossal nerve is reported. Postoperative course after resection was followed by complete regression of symptoms. Surgical resection, as standard treatment of aneurysms of the occipital artery, with the eventual technical adjunct of intubation by the nose is effective in durably relieving symptoms and preventing aneurysm-related complication. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Piloting a Collaborative Web-Based System for Testing ICD-11.

PubMed

Donada, Marc; Kostanjsek, Nenad; Della Mea, Vincenzo; Celik, Can; Jakob, Robert

2017-01-01

The 11^th revision of the International Classification of Diseases (ICD-11), for the first time in ICD history, deployed web-based collaboration of experts and ICT tools. To ensure that ICD-11 is working well, it needs to be systematically field tested in different settings, across the world. This will be done by means of a number of experiments. In order to support its implementation, a web-based system (ICDfit) has been designed and developed. The present paper illustrates the current prototype of the system and its technical testing. the system has been designed according to WHO requirements, and implemented using PHP and MySQL. Then, a preliminary technical test has been designed and run in January 2016, involving 8 users. They had to carry out double coding, that is, coding case summaries with both ICD-10 and ICD-11, and answering quick questions on the coding difficulty. the 8 users coded 632 cases each, spending an average of 163 seconds per case. While we found an issue in the mechanism used to record coding times, no further issues were found. the proposed system seems to be technically adequate for supporting future ICD-11 testing.

Successful revascularization of chronic total occlusion of lower extremity arteries: a wire only and bail out use of re-entry device approach.

PubMed

Langhoff, R; Stumpe, S; Treitl, M; Schulte, K L

2013-10-01

The management of progressive peripheral artery disease experienced a vast change in paradigms over the last decades for the benefit of minimal invasive therapy as a first-line strategy. With the constant development of new devices, materials and dedicated access strategies, more complex lesions can be managed but the limitations to successfully treat chronic total occlusions are still the challenge to re-enter the true lumen. The aim of this retrospective study was to investigate, if a "wire only" strategy leads to an acceptable success rate in a mixed cohort of CTO lesions and to what extend re-entry devices are used. We retrospectively analyzed patients treated at the Vascular Center Berlin between 2011 and 2013 with chronic total occlusion out of a prospective conducted database (Endovascular MILestones - EMIL) for demographics, risk factors, co-morbidities, technical success rates, lesion characteristics and use of guidewires as well as re-entry systems. A total of 128 patients with 146 lesions, which represent a subgroup of all the cases performed in our center, following a predefined treatment algorithm for chronic total occlusions (CTOs), have been analyzed. We achieved a technical success in 133 (91.1%) of all cases following a "wire only" strategy. Out of 13 (8.9%) CTOs with technical failure in 7 (53.9%) CTOs a re-entry device (Off-Road®) with a 100% technical success has been used. In 91.1% of chronic total occlusion lesions the use of 2 wires only (88.7%) led to a successful recanalization. A "wire only" strategy followed by the use of a re-entry device as a bail out strategy, led to a total of 140 (96%) lesions to be successfully recanalized. In more than 90% of all cases with chronic total occlusion of peripheral lower extremity arteries, endovascular intervention has been successful following a "wire only" strategy. When deciding to use a re-entry device, in case of a failure of a proper wire re-entry at the reconstitution point, a technical success rate of 100% was achieved. Therefore following a strict wire algorithm and considering the use of a re-entry system as a bail out strategy will lead to a successful minimal invasive management of chronic total occlusion in nearly 100% of the cases with TASC II A - D lesions.

A multi-institutional survey of interventional radiology for type II endoleaks after endovascular aortic repair: questionnaire results from the Japanese Society of Endoluminal Metallic Stents and Grafts in Japan.

PubMed

Ogawa, Yukihisa; Nishimaki, Hiroshi; Osuga, Keigo; Ikeda, Osamu; Hongo, Norio; Iwakoshi, Shinichi; Kawasaki, Ryota; Woodhams, Reiko; Yamaguchi, Masato; Kamiya, Mika; Kanematsu, Masayuki; Honda, Masanori; Kaminou, Toshio; Koizumi, Jun; Kichikawa, Kimihiko

2016-08-01

To investigate the current status of interventional radiology (IR) procedures for a type II endoleak (T2EL) in Japan, and to identify the technical aspects that affect treatment results. A retrospective survey was conducted by distributing questionnaires to 25 institutions. The eligibility criteria were endovascular aortic repair (EVAR) performed using commercial stent grafts and IR performed for T2EL between January 2007 and December 2013. Technical success was defined as disappearance of the EL on digital subtraction angiography immediately after embolization, and imaging success was defined as no EL on contrast-enhanced computed tomography within 6 months. Statistical comparisons of the number of involved branches, embolization level, embolic material, and changes in aneurysm size were made between the imaging success and imaging failure groups. The technical and imaging success rates were also compared between the initial therapy and repeat groups. A total of 166 cases were investigated. Initial therapy was performed in 147 cases (88.6 %), with repeat therapy in 19 cases (11.4 %). Transcatheter arterial embolization (TAE) was used most frequently, in 161 cases (97 %), with direct puncture (DP) used in 5 cases (3 %). Both coil embolization for the branches and NBCA embolization for the sac were frequently chosen. The technical success rate was 83.2 % (TAE group), and the imaging success rate was 46.5 % (TAE + DP groups). Branch + sac embolization was performed more frequently in the imaging success group. There was no significant difference in the number of involved branches or embolic material between the imaging success and imaging failure groups. Enlargement of the aneurysm was more frequently seen in the imaging failure group. There were no significant differences in the technical success and imaging success rates between the initial therapy and repeat groups. This is the first report of a multi-institutional questionnaire survey of IR procedures for T2EL after EVAR in Japan that was conducted to determine the current status. Enlargement of aneurysm size after embolization was more frequently seen in the imaging failure group. It is important to embolize both branch and sac to achieve imaging success, regardless of embolic material. Long-term outcomes need to be investigated.

Improving Quality Metric Adherence to Minimally Invasive Breast Biopsy among Surgeons Within a Multihospital Health Care System.

PubMed

Tjoe, Judy A; Greer, Danielle M; Ihde, Sue E; Bares, Diane A; Mikkelson, Wendy M; Weese, James L

2015-09-01

Minimally invasive breast biopsy (MIBB) is the procedure of choice for diagnosing breast lesions indeterminate for malignancy. Multihospital health care systems face challenges achieving systemwide adherence to standardized guidelines among surgeons with varying practice patterns. This study tested whether providing individual feedback about surgeons' use of MIBB to diagnose breast malignancies improved quality metric adherence across a large health care organization. We conducted a prospective matched-pairs study to test differences (or lack of agreement) between periods before and after intervention. All analytical cases of primary breast cancer diagnosed during 2011 (period 1) and from July 2012 to June 2013 (period 2) across a multihospital health care system were reviewed for initial diagnosis by MIBB or open surgical biopsy. Open surgical biopsy was considered appropriate care only if MIBB could not be performed for reasons listed in the American Society of Breast Surgeons' quality measure for preoperative diagnosis of breast cancer. Individual and systemwide results of adherence to the MIBB metric during period 1 were sent to each surgeon in June 2012 and were later compared with period 2 results using McNemar's test of marginal homogeneity for matched binary responses. Forty-six surgeons were evaluated on use of MIBB to diagnose breast cancer. In period 1, metric adherence for 100% of cases was achieved by 37 surgeons, for a systemwide 100% compliance rate of 80.4%. After notification of individual performance, 44 of 46 surgeons used MIBB solely or otherwise appropriate care to diagnose breast cancer, which improved systemwide compliance to 95.7%. Providing individual and systemwide performance results to surgeons can increase self-awareness of practice patterns when diagnosing breast cancer, leading to standardized best-practice care across a large health care organization. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Let’s agree on the casing of Lidar

USGS Publications Warehouse

Deering, Carol; Stoker, Jason M.

2014-01-01

Is it lidar, Lidar, LiDAR, LIDAR, LiDar, LiDaR, or liDAR? A comprehensive review of the scientific/technical literature reveals seven different casings of this short form for light detection and ranging. And there could be more.

IVHS Institutional Issues And Case Studies: Help/Cresent Case Study

DOT National Transportation Integrated Search

1997-04-01

This report presents the results of research on procurement-related legal and non-technical issues which may be viewed as constraints to the deployment of Intelligent Transportation Systems (ITS). It focuses on state and local practices when federal ...

An urgent need for building technical capacity for rapid diagnosis of multidrug-resistant tuberculosis (MDR-TB) among new cases: A case report from Maharashtra, India.

PubMed

Atre, Sachin

2015-01-01

Multidrug-resistant tuberculosis (MDR-TB), the prevalence of which has increased across the globe in recent years, is a serious threat to public health. Timely diagnosis of MDR-TB, especially among new TB cases, is essential to facilitate appropriate treatment, which can prevent further emergence of drug resistance and its spread in the population. The present case report from India aims to address some operational challenges in diagnosing MDR-TB among new cases and potential measures to overcome them. It argues that even after seven years of implementing the DOTS-Plus program for controlling MDR-TB, India still lacks the technical capacity for rapid MDR-TB diagnosis. The case report underscores an urgent need to explore the use of WHO-endorsed techniques such as Xpert MTB/Rif and commercial assays such as Genotype MTBDR for rapid diagnosis of MDR-TB among new cases. Suitable applications may be found for other TB high-burden countries where MDR-TB is a major concern. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Trends in liability affecting technical writers

NASA Technical Reports Server (NTRS)

Driskill, L. P.

1981-01-01

Liability of technical writers for defective products is explored. Documents generated during a product's life cycle (including design memos, design tests, clinical trials, trial use reports, letters, and proposals) become relevant because they are likely to become the only available means of showing that the product was not defectively designed. These documents become the evidence that the product underwent balanced and well considered planning, development, testing, quality control, and field testing. The predicted increased involvement of technical writers in the prevention and defense of product liability claims is cited in view of a greater number of cases turning on "failure to warn".

Building Science-Relevant Literacy with Technical Writing in High School

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

Girill, T R

2006-06-02

By drawing on the in-class work of an on-going literacy outreach project, this paper explains how well-chosen technical writing activities can earn time in high-school science courses by enabling underperforming students (including ESL students) to learn science more effectively. We adapted basic research-based text-design and usability techniques into age-appropriate exercises and cases using the cognitive apprenticeship approach. This enabled high-school students, aided by explicit guidelines, to build their cognitive maturity, learn how to craft good instructions and descriptions, and apply those skills to better note taking and technical talks in their science classes.

Overview of EPA's Approach to Developing Prospective Case Studies Technical Workshop: Case Studies to Assess Potential Impacts of Hydraulic Fracturing on Drinking Water Resources

EPA Science Inventory

One component of the United States Environmental Protection Agency's (EPA) study of the potential impacts of hydraulic fracturing on drinking water resources is prospective case studies, which are being conducted to more fully understand and assess if and how site specific hydrau...

A Real-Life Case Study of Audit Interactions--Resolving Messy, Complex Problems

ERIC Educational Resources Information Center

Beattie, Vivien; Fearnley, Stella; Hines, Tony

2012-01-01

Real-life accounting and auditing problems are often complex and messy, requiring the synthesis of technical knowledge in addition to the application of generic skills. To help students acquire the necessary skills to deal with these problems effectively, educators have called for the use of case-based methods. Cases based on real situations (such…

How can sludge dewatering devices be assessed? Development of a new DSS and its application to real case studies.

PubMed

Bertanza, Giorgio; Papa, Matteo; Canato, Matteo; Collivignarelli, Maria Cristina; Pedrazzani, Roberta

2014-05-01

A key issue in biological Waste Water Treatment Plants (WWTPs) operation is represented by the sludge management. Mechanical dewatering is a crucial stage for sludge volume reduction; though, being a costly operation, its optimization is required. We developed an original experimental methodology to evaluate the technical (dewatering efficiency) and financial (total treatment costs) performance of dewatering devices, which might be used as a DSS (Decision Support System) for WWTP managers. This tool was then applied to two real case studies for comparing, respectively, three industrial size centrifuges, and two different operation modes of the same machine (fixed installation vs. outsourcing service). In both the cases, the best option was identified, based jointly on economic and (site-specific) technical evaluations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Percutaneous endoscopic lumbar discectomy via contralateral approach: a technical case report.

PubMed

Kim, Jin-Sung; Choi, Gun; Lee, Sang-Ho

2011-08-01

Technical case report. The authors report a new percutaneous endoscopic lumbar discectomy (PELD) technique for the treatment of lumbar disc herniation via a contralateral approach. When there are highly down-migrated lumbar disc herniation along just medial to pedicle and narrow ipsilateral intervertebral foramen, the conventional PELD is not easily accessible via ipsilateral transforaminal route. Five patients manifested gluteal and leg pain because of a soft disc herniation at the L4-L5 level. Transforaminal PELD via a contralateral approach was performed to remove the herniated fragment, achieving complete decompression of the nerve root. The symptom was relieved and the patient was discharged the next day. When a conventional transforaminal PELD is difficult because of some anatomical reasons, PELD via a contralateral route could be a good alternative option in selected cases.

Higher education provision using systems thinking approach - case studies

NASA Astrophysics Data System (ADS)

Dhukaram, Anandhi Vivekanandan; Sgouropoulou, Cleo; Feldman, Gerald; Amini, Ardavan

2018-01-01

The purpose of this paper is to highlight the complexities involved in higher education provision and how systems thinking and socio-technical systems (STS) thinking approach can be used to understand the education ecosystem. Systems thinking perspective is provided using two case studies: the development of European Learner Mobility (EuroLM) service and the delivery of Enterprise System Management (ESM) course at the Birmingham City University, UK. The case studies present how systems thinking using STS approaches like applied organisational change and Cognitive Work Analysis can be used to capture a conceptual model of the education system for understanding the interactions and relationships between the people, technology, processes and the organisations. Using systems thinking perspective, EuroLM has developed a set of technical standards addressed to the European systems developers and ESM delivery ensures that students communicate and collaborate.

Strategies for Implementing AIDS/HIV Policy Guidelines in Developmental and Mental Health Services: A Background and Checklist for Advocates. AIDS Technical Report, No. 3.

ERIC Educational Resources Information Center

Harvey, David C.

This technical report is part of a series on AIDS/HIV (Acquired Immune Deficiency Syndrome/Human Immunodeficiency Virus) and is intended to help link various legal advocacy organizations providing services to persons with mental illness or developmental disabilities. Through a series of case examples, questions, background information, and…

Choosing Schools and Choosing Content: The Case of Career and Technical Education. Issue Focus

ERIC Educational Resources Information Center

Rosen, Rachel

2017-01-01

The public discussion around school choice often focuses on the types of schools families can choose from--public, charter, magnet, or private--and the importance of having a choice, rather than on the content of what they may be choosing. In the high school choice process, some form of career and technical education (CTE) is likely to arise as an…

Technical Training in the MNCs in Malaysia: A Case Study Analysis of the Petrochemical Industry

ERIC Educational Resources Information Center

Hooi, Lai Wan

2010-01-01

Purpose: The aim of this paper is to gain insight into some of the types of training and development practices that are carried out in the chemical industry for technical workers. A salient focus of the study is to make a comparative analysis of four MNCs, which were selected based on equity ownership, to ascertain whether T&D practices are…

Learning from Experience Case Studies of the Hyper-X Project

NASA Technical Reports Server (NTRS)

Peebles, Curtis

2009-01-01

The Hyper-X project (X-43A) provides a number of "lessons learned" which can be applied to other aerospace project. The specific areas examined were the selection of the goals of the Hyper-X. How the technical unknowns and assumptions were handled. The final lesson was the ambiguous nature of risk assessment, and how trying to remove a technical unknown can have unintended consequences.

Integrating Nuclear Energy to Oilfield Operations – Two Case Studies

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

Eric P. Robertson; Lee O. Nelson; Michael G. McKellar

2011-11-01

Fossil fuel resources that require large energy inputs for extraction, such as the Canadian oil sands and the Green River oil shale resource in the western USA, could benefit from the use of nuclear power instead of power generated by natural gas combustion. This paper discusses the technical and economic aspects of integrating nuclear energy with oil sands operations and the development of oil shale resources. A high temperature gas reactor (HTGR) that produces heat in the form of high pressure steam (no electricity production) was selected as the nuclear power source for both fossil fuel resources. Both cases weremore » based on 50,000 bbl/day output. The oil sands case was a steam-assisted, gravity-drainage (SAGD) operation located in the Canadian oil sands belt. The oil shale development was an in-situ oil shale retorting operation located in western Colorado, USA. The technical feasibility of the integrating nuclear power was assessed. The economic feasibility of each case was evaluated using a discounted cash flow, rate of return analysis. Integrating an HTGR to both the SAGD oil sands operation and the oil shale development was found to be technically feasible for both cases. In the oil sands case, integrating an HTGR eliminated natural gas combustion and associated CO2 emissions, although there were still some emissions associated with imported electrical power. In the in situ oil shale case, integrating an HTGR reduced CO2 emissions by 88% and increased natural gas production by 100%. Economic viabilities of both nuclear integrated cases were poorer than the non-nuclear-integrated cases when CO2 emissions were not taxed. However, taxing the CO2 emissions had a significant effect on the economics of the non-nuclear base cases, bringing them in line with the economics of the nuclear-integrated cases. As we move toward limiting CO2 emissions, integrating non-CO2-emitting energy sources to the development of energy-intense fossil fuel resources is becoming increasingly important. This paper attempts to reduce the barriers that have traditionally separated fossil fuel development and application of nuclear power and to promote serious discussion of ideas about hybrid energy systems.« less

Medical Malpractice Litigation Following Arthroscopic Surgery.

PubMed

Shah, Kalpit N; Eltorai, Adam E M; Perera, Sudheesha; Durand, Wesley M; Shantharam, Govind; Owens, Brett D; Daniels, Alan H

2018-04-10

Our study aims to analyze a variety of factors involving malpractice lawsuits following arthroscopy, focusing on reasons for lawsuit and establishing predictors for the outcome of the lawsuit. Two legal databases, VerdictSearch and Westlaw, were queried for arthroscopic cases in adult patients. For all included cases, clinical and demographic data were recorded. The effects of plaintiff demographics, joint involved, lawsuit allegation, case ruling, and size of indemnity payments were assessed. Of the 240 included cases, 62 (26%) resulted in plaintiff verdict, 160 (67%) resulted in defense verdict, and 18 (8%) were settled without trial. Plaintiff demographics (age and sex) had no effect on the case ruling. There was no statistical difference between indemnity awards for plaintiff verdicts ($1,013,494) and settled cases ($848,331; P = .13). Patient death was noted in 20 cases (8.3%); a significantly higher proportion of these cases were settled versus went to trial (P = .0022), including 19 patients (95%) who had knee arthroscopy and 16 deaths (80%) resulting from a pulmonary embolus. Plaintiff verdict or settlement were seen significantly more frequently for vascular complications and wrong-sided surgery. Alternatively, defense verdicts followed lawsuits alleging surgeon technical error. Wrong-sided surgery, retained instruments, deep venous thrombosis, and postoperative infections were seen at a significantly higher proportion after knee arthroscopy than after arthroscopy of other joints. Similarly, neurological injury was significantly associated with elbow and hip arthroscopy, while allegations of technical error by the surgeon and block-related complications were associated with shoulder arthroscopy. Plaintiff verdict or settlement were seen for vascular complications and wrong-sided surgery, while defense verdicts followed lawsuits alleging surgeon technical error and block-related complications. We also identified types of allegations that were associated with arthroscopy of different joints. All but one case of patient death (20 cases) were noted to involve knee arthroscopy, and an overwhelming majority resulted due to a pulmonary embolism. This information helps the arthroscopic surgeon better counsel patients and employ strategies to mitigate preventable complications. Level IV, case series. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2017-12-01

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

Use of antegrade dissection re-entry in coronary chronic total occlusion percutaneous coronary intervention in a contemporary multicenter registry.

PubMed

Danek, Barbara Anna; Karatasakis, Aris; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Yeh, Robert W; Jaffer, Farouc A; Patel, Mitul; Bahadorani, John; Lombardi, William L; Wyman, Michael R; Grantham, J Aaron; Doing, Anthony; Moses, Jeffrey W; Kirtane, Ajay; Parikh, Manish; Ali, Ziad A; Kalra, Sanjog; Kandzari, David E; Lembo, Nicholas; Garcia, Santiago; Rangan, Bavana V; Thompson, Craig A; Banerjee, Subhash; Brilakis, Emmanouil S

2016-07-01

We assessed efficacy and safety of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using antegrade dissection re-entry (ADR). We examined outcomes of ADR among 1313 CTO PCIs performed at 11 US centers between 2012-2015. 84.1% of patients were men. Prevalence of prior coronary artery bypass graft surgery was 34.3%. Overall technical and procedural success were 90.1% and 88.7%, respectively. In-hospital major adverse cardiovascular events (MACE) occurred in 31 patients (2.4%). ADR was used in 458 cases (34.9%), and was the first strategy in 169 cases (12.9%). ADR cases were angiographically more complex than non-ADR cases (mean J-CTO score: 2.8±1.2 vs. 2.4±1.2, p<0.001). ADR was performed using the CrossBoss catheter in 246 of 458 (53.7%) and the Stingray system in 251 ADR cases (54.8%). Compared with non-ADR cases, ADR cases had lower technical (86.9% vs. 91.8%, p=0.005) and procedural success (85.0% vs. 90.7%, p=0.002), but similar risk for MACE (2.9% vs. 2.2%, p=0.42). ADR was associated with longer procedure and fluoroscopy time, and higher patient air kerma dose and contrast volume (all p<0.001). After excluding retrograde cases, ADR and antegrade wire escalation (AWE) had similar technical success (92.7% vs. 94.2%, p=0.43), procedural success (91.8% vs. 94.1%, p=0.23), and MACE (2.1% vs. 0.6%, p=0.12). ADR is used relatively frequently in contemporary CTO PCI, especially for challenging lesions and after failure of other strategies. ADR is associated with similar success rates and risk for complications as compared with AWE, and is important for achieving high procedural success. Published by Elsevier Ireland Ltd.

Use of Antegrade Dissection Re-entry in Coronary Chronic Total Occlusion Percutaneous Coronary Intervention in a Contemporary Multicenter Registry

PubMed Central

Danek, Barbara Anna; Karatasakis, Aris; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Yeh, Robert W.; Jaffer, Farouc A.; Patel, Mitul; Bahadorani, John; Lombardi, William L.; Wyman, Michael R.; Grantham, J. Aaron; Doing, Anthony; Moses, Jeffrey W.; Kirtane, Ajay; Parikh, Manish; Ali, Ziad; Kalra, Sanjog; Kandzari, David E.; Lembo, Nicholas; Garcia, Santiago; Rangan, Bavana V.; Thompson, Craig A.; Banerjee, Subhash; Brilakis, Emmanouil S.

2016-01-01

Background We assessed efficacy and safety of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using antegrade dissection re-entry (ADR). Methods We examined outcomes of ADR among 1,313 CTO PCIs performed at 11 US centers between 2012-2015. Results 84.1% of patients were men. Prevalence of prior coronary artery bypass graft surgery was 34.3%. Overall technical and procedural success were 90.1% and 88.7%, respectively. In-hospital major adverse cardiovascular events (MACE) occurred in 31 patients (2.4%). ADR was used in 458 cases (34.9%), and was the first strategy in 169 cases (12.9 %). ADR cases were angiographically more complex than non-ADR cases (mean J-CTO score: 2.8±1.2 vs. 2.4±1.2, p<0.001). ADR was performed using the CrossBoss catheter in 246 of 458 (53.7%) and the Stingray system in 251 ADR cases (54.8%). Compared with non-ADR cases, ADR cases had lower technical (86.9% vs. 91.8%, p=0.005) and procedural success (85.0% vs. 90.7%, p=0.002), but similar risk for MACE (2.9% vs. 2.2%, p=0.42). ADR was associated with longer procedure and fluoroscopy time, and higher patient air kerma dose and contrast volume (all p<0.001). After excluding retrograde cases, ADR and antegrade wire escalation (AWE) had similar technical success (92.7% vs. 94.2%, p=0.43) procedural success (91.8% vs. 94.1%, p=0.23), and MACE (2.1% vs. 0.6%, p=0.12). Conclusions ADR is used relatively frequently in contemporary CTO PCI, especially for challenging lesions and after failure of other strategies. ADR is associated with similar success rates and risk for complications as compared with AWE, and is important for achieving high procedural success. PMID:27088405

How much is too much assessment? Insight into assessment-driven student learning gains in large-scale undergraduate microbiology courses.

PubMed

Wang, Jack T H; Schembri, Mark A; Hall, Roy A

2013-01-01

Designing and implementing assessment tasks in large-scale undergraduate science courses is a labor-intensive process subject to increasing scrutiny from students and quality assurance authorities alike. Recent pedagogical research has provided conceptual frameworks for teaching introductory undergraduate microbiology, but has yet to define best-practice assessment guidelines. This study assessed the applicability of Biggs' theory of constructive alignment in designing consistent learning objectives, activities, and assessment items that aligned with the American Society for Microbiology's concept-based microbiology curriculum in MICR2000, an introductory microbiology course offered at the University of Queensland, Australia. By improving the internal consistency in assessment criteria and increasing the number of assessment items explicitly aligned to the course learning objectives, the teaching team was able to efficiently provide adequate feedback on numerous assessment tasks throughout the semester, which contributed to improved student performance and learning gains. When comparing the constructively aligned 2011 offering of MICR2000 with its 2010 counterpart, students obtained higher marks in both coursework assignments and examinations as the semester progressed. Students also valued the additional feedback provided, as student rankings for course feedback provision increased in 2011 and assessment and feedback was identified as a key strength of MICR2000. By designing MICR2000 using constructive alignment and iterative assessment tasks that followed a common set of learning outcomes, the teaching team was able to effectively deliver detailed and timely feedback in a large introductory microbiology course. This study serves as a case study for how constructive alignment can be integrated into modern teaching practices for large-scale courses.

Principles and Practices Fostering Inclusive Excellence: Lessons from the Howard Hughes Medical Institute's Capstone Institutions.

PubMed

DiBartolo, Patricia Marten; Gregg-Jolly, Leslie; Gross, Deborah; Manduca, Cathryn A; Iverson, Ellen; Cooke, David B; Davis, Gregory K; Davidson, Cameron; Hertz, Paul E; Hibbard, Lisa; Ireland, Shubha K; Mader, Catherine; Pai, Aditi; Raps, Shirley; Siwicki, Kathleen; Swartz, Jim E

Best-practices pedagogy in science, technology, engineering, and mathematics (STEM) aims for inclusive excellence that fosters student persistence. This paper describes principles of inclusivity across 11 primarily undergraduate institutions designated as Capstone Awardees in Howard Hughes Medical Institute's (HHMI) 2012 competition. The Capstones represent a range of institutional missions, student profiles, and geographical locations. Each successfully directed activities toward persistence of STEM students, especially those from traditionally underrepresented groups, through a set of common elements: mentoring programs to build community; research experiences to strengthen scientific skill/identity; attention to quantitative skills; and outreach/bridge programs to broaden the student pool. This paper grounds these program elements in learning theory, emphasizing their essential principles with examples of how they were implemented within institutional contexts. We also describe common assessment approaches that in many cases informed programming and created traction for stakeholder buy-in. The lessons learned from our shared experiences in pursuit of inclusive excellence, including the resources housed on our companion website, can inform others' efforts to increase access to and persistence in STEM in higher education. © 2016 P. M. DiBartolo, L. Gregg-Jolly, D. Gross, C. A. Manduca, E. Iverson, et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Not just a fisherman's wife: Women's contribution to health and wellbeing in commercial fishing.

PubMed

Kilpatrick, Sue; King, Tanya J; Willis, Karen

2015-04-01

To explore the role of women in fishing industry organisations and communities in promoting best-practice health behaviours among fishers in Australia. This paper reports aspects of research that examined how the fishing industry can best support physical health and mental well-being of fishers. The study employed a mixed-methods, multisite case study approach. Data were gathered from face-to-face and phone interactions. Two sites in Victoria and one in Western Australia. Thirty-one male fishers, including commercial licence owners, skippers, deckhands, three female family members, three fishing association representatives, one local government representative, two health care providers, and three regional health planning and funding bodies. Not applicable. Not applicable. Often unrecognised, women associated with the fishing industry are integral to the promotion of good health for fishers. They are key to identifying health issues (particularly mental health issues) and proposing community-based health and well-being strategies. They often do so by incorporating health information and activities into 'soft entry points' - informal, non-health service mechanisms by which fishers can access health information and health services. While not working at the industry coalface, women have a stake, and are key players, in the commercial fishing industry. Their knowledge of, and credibility within, fishing enterprises makes them valuable sources of information about health issues facing the industry and effective strategies to address them. This expertise should be applied in conjunction with industry associations and health providers to achieve better health outcomes for fishers and their families. © 2015 National Rural Health Alliance Inc.

From SARS to Avian Influenza: The Role of International Factors in China's Approach to Infectious Disease Control.

PubMed

Goldizen, Fiona C

2016-01-01

Over the past decades global environmental change, globalization, urbanization, and the rise in movement of people have increased the risk for pandemic disease outbreaks. As environmental exposures do not respect state borders, a globalist concept of global health response has developed, which requires transparency and cooperation for coordinated responses to disease outbreaks. Countries that avoid cooperation on health issues for social or political reasons can endanger the global community. The aim of this study was to examine the rapid change in China's infectious disease policy between 2000 and 2013, from actively rejecting the assistance of international health experts during the HIV/AIDS and severe acute respiratory syndrome crises to following best-practice disease response policies and cooperating with international health actors during the 2013 avian influenza outbreak. Using international relations theory, I examined whether international political factors had a major influence on this change. Using the case studies of international reputation, socialization with international organizations, and the securitization of infectious disease, this study examined the influence of international and domestic pressures on Chinese infectious disease policy. Although international relations theory, especially theories popular in global health diplomacy literature, provide valuable insight into the role of international factors and foreign policy interests in China's changing approach to infectious disease control, it cannot provide viable explanations without considering the domestic interests of the Chinese government. Analysis of state responses to infectious disease using international relations theories must consider domestic political factors. Copyright © 2016 The Author. Published by Elsevier Inc. All rights reserved.

The Low Temperature Annealing of 7.62 mm Brass Cartridge Cases: Stress Corrosion Susceptibility

DTIC Science & Technology

1980-06-01

the artificiel low temperature atinealing. The degrees of cracking in the lower walls of the cartridge cases were found to decrease with increasing...Assurance - Air Force Deputy Director Scientific and Technical Intelligence , "Joint Intelligence Organisation Head, Engineering Development

Implementing Stakeholders' Access to Expertise: Experimenting on Nuclear Installations' Safety Cases - 12160

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

Gilli, Ludivine; Charron, Sylvie

2012-07-01

In 2009 and 2010, the Institute for Nuclear Safety and Radiation Protection (IRSN) led two pilot actions dealing with nuclear installations' safety cases. One concerned the periodical review of the French 900 MWe nuclear reactors, the other concerned the decommissioning of a workshop located on the site of Areva's La Hague fuel-reprocessing plant site in Northwestern France. The purpose of both these programs was to test ways for IRSN and a small number of stakeholders (Non-Governmental Organizations (NGOs) members, local elected officials, etc.) to engage in technical discussions. The discussions were intended to enable the stakeholders to review future applicationsmore » and provide valuable input. The test cases confirmed there is a definite challenge in successfully opening a meaningful dialogue to discuss technical issues, in particular the fact that most expertise reports were not public and the conflict that exists between the contrary demands of transparency and confidentiality of information. The test case also confirmed there are ways to further improvement of stakeholders' involvement. (authors)« less

Outcomes of Percutaneous Coronary Interventions for Chronic Total Occlusion Performed by Highly Experienced Japanese Specialists: The First Report From the Japanese CTO-PCI Expert Registry.

PubMed

Suzuki, Yoriyasu; Tsuchikane, Etsuo; Katoh, Osamu; Muramatsu, Toshiya; Muto, Makoto; Kishi, Koichi; Hamazaki, Yuji; Oikawa, Yuji; Kawasaki, Tomohiro; Okamura, Atsunori

2017-11-13

This report describes the registry and presents an initial analysis of outcomes for the different PCI approaches taken by the specialists. Strategies for percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) are complex. The Japanese Board of CTO Interventional Specialists has developed a prospective, nonrandomized registry of patients undergoing CTO-PCIs performed by 41 highly experienced Japanese specialists. Over the study period of January 2014 to December 2015, the registry included 2,846 consecutive CTO-PCI cases undertaken in Japan. The authors compared clinical outcomes between the different PCI approaches, following the intention-to-treat principle. The overall technical success rate of the procedures was 89.9%. The specialists frequently chose a retrograde approach as the primary CTO-PCI strategy (in 27.8% of cases). The technical success rate of the primary antegrade approach was significantly better than that of the primary retrograde approach (91.0% vs. 87.3%; p < 0.0001). The technical success rate decreased to 78.0% with the rescue retrograde approach. Parallel guidewire crossing and intravascular ultrasound-guided wire crossing were performed after guidewire escalation during antegrade CTO-PCI with a high technical success rate (75.0% to 88.9%). Severe lesion calcification was a strong predictor of failed CTO-PCI. CTO-PCI performed by highly experienced specialists achieved a high technical success rate. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Clinical success of implant-supported and tooth-implant-supported double crown-retained dentures.

PubMed

Bernhart, Gunda; Koob, Andreas; Schmitter, Marc; Gabbert, Olaf; Stober, Thomas; Rammelsberg, Peter

2012-08-01

The objective of this retrospective study was to compare biological and technical complications of implant-supported and tooth-implant-supported double crown-retained dentures (DCRDs) with those of tooth-supported DCRDs. Sixty-three DCRDs were monitored. One study group included 16 prostheses with a combination of implants and natural teeth as double crowns (ti group), whereas in the second study group, 19 dentures were retained exclusively on implants (ii group); a third study group with 28 exclusively tooth-supported dentures served as controls (tt group). Tooth loss, implant failure, and technical complications (loss of retention of primary crown, abutment screw loosening, loss of facing, fracture of resin denture teeth and fracture of saddle resin) were analysed. During the observation period of 24 months, no implants or teeth were lost in the ti group and three technical complications were recorded. In the ii group, two implants were lost, two cases of peri-implantitis occurred and four technical complications were observed. In the tt group, two cases of tooth loss and seven technical complications were observed. At the time of the last examination, all prostheses of the ti group and the ii group were functional. Patients of these two study groups reported high satisfaction with both function and aesthetics with no significant difference between the two groups. Treatment with DCRDs showed comparable results in the three study groups. The 2-year results indicate that double crowns can be recommended for implant and combined tooth-implant-retained dentures.

Prospective Multicenter Study on the Challenges Inherent to Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction.

PubMed

Yang, Min Jae; Kim, Jin Hong; Hwang, Jae Chul; Yoo, Byung Moo; Lee, Sang Hyub; Ryu, Ji Kon; Kim, Yong-Tae; Woo, Sang Myung; Lee, Woo Jin; Jeong, Seok; Lee, Don Haeng

2018-06-22

Although endoscopic bilateral stent-in-stent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic reintervention. This study aimed to evaluate the technical feasibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases with technical success. Stent occlusion occurred in 63.2% of patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Large cell-type stents for endoscopic bilateral stent-in-stent placement showed acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

Ontogeny of a surgical technique: Robotic kidney transplantation with regional hypothermia.

PubMed

Sood, Akshay; McCulloch, Peter; Dahm, Philipp; Ahlawat, Rajesh; Jeong, Wooju; Bhandari, Mahendra; Menon, Mani

2016-01-01

Innovation is a hallmark of surgical practice. It is generally accepted that a new procedure will undergo technical changes during its evolution; however, quantitative accounts of the process are limited. Multiple groups, including our own, have recently described a minimally-invasive approach to conventional kidney transplantation (KT) operation. Unique to our experience is a structured development of the technique within the confines of a safe surgical innovation framework - the IDEAL framework (idea, development, exploration, assessment, long-term monitoring; stages 0-4). We here provide a first-hand narrative of the progress of robotic KT operation from preclinical trial to clinical application. Overall, 54 patients underwent robotic KT with regional hypothermia successfully. Major technical changes including selection of optimal patient position (flank vs. lithotomy), robotic instrumentation, vascular occlusion method (bulldog vs. tourniquet) and suture material (prolene vs. GoreTex) occurred early during the procedure development (IDEAL stage 0, preclinical). Minor technical changes such as utilization of the aortic punch for arteriotomy (case 3), use of barbed suture during ureteroneocystostomy (case 6) and extraperitonealization of the graft kidney (case 6) that increased the efficiency and safety of the procedure continued throughout procedure development (IDEAL stages 1-2, clinical stages). We demonstrate that a surgical technique evolves continually; although, the majority of technical alterations occur early in the life-cycle of the procedure. Development of a new technique within the confines a structured surgical innovation framework allows for evidence based progression of the technique and may minimize the risk of harm to the patient. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Three-Dimensional Path Planning Software-Assisted Transjugular Intrahepatic Portosystemic Shunt: A Technical Modification

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

Tsauo, Jiaywei, E-mail: 80732059@qq.com; Luo, Xuefeng, E-mail: luobo-913@126.com; Ye, Linchao, E-mail: linchao.ye@siemens.com

2015-06-15

PurposeThis study was designed to report our results with a modified technique of three-dimensional (3D) path planning software assisted transjugular intrahepatic portosystemic shunt (TIPS).Methods3D path planning software was recently developed to facilitate TIPS creation by using two carbon dioxide portograms acquired at least 20° apart to generate a 3D path for overlay needle guidance. However, one shortcoming is that puncturing along the overlay would be technically impossible if the angle of the liver access set and the angle of the 3D path are not the same. To solve this problem, a prototype 3D path planning software was fitted with a utility to calculate themore » angle of the 3D path. Using this, we modified the angle of the liver access set accordingly during the procedure in ten patients.ResultsFailure for technical reasons occurred in three patients (unsuccessful wedged hepatic venography in two cases, software technical failure in one case). The procedure was successful in the remaining seven patients, and only one needle pass was required to obtain portal vein access in each case. The course of puncture was comparable to the 3D path in all patients. No procedure-related complication occurred following the procedures.ConclusionsAdjusting the angle of the liver access set to match the angle of the 3D path determined by the software appears to be a favorable modification to the technique of 3D path planning software assisted TIPS.« less

Patient-specific rehearsal prior to EVAR: a pilot study.

PubMed

Desender, L; Rancic, Z; Aggarwal, R; Duchateau, J; Glenck, M; Lachat, M; Vermassen, F; Van Herzeele, I

2013-06-01

This study aims to evaluate feasibility, face validity, influence on technical factors and subjective sense of utility of patient-specific rehearsal (PsR) prior to endovascular aortic aneurysm repair (EVAR). A prospective, multicentre pilot study. Patients suitable for EVAR were enrolled and a three-dimensional (3D) model of the patient's anatomy was generated. Less than 24 h prior to the real case, rehearsals were conducted in the laboratory or clinical angiosuite. Technical metrics were recorded during both procedures. A subjective questionnaire was used to evaluate realism, technical and human factor aspects (scale 1-5). Ten patients were enrolled. In one case, the treatment plan was altered based on PsR. In 7/9 patients, the rehearsal significantly altered the optimal C-arm position for the proximal landing zone and an identical fluoroscopy angle was chosen in the real procedure. All team members found the rehearsal useful for selecting the optimal fluoroscopy angle (median 4). The realism of the EVAR procedure simulation was rated highly (median 4). All team members found the PsR useful to prepare the individual team members and the entire team (median 4). PsR for EVAR permits creation of realistic case studies. Subjective evaluation indicates that it may influence optimal C-arm angles and be valuable to prepare the entire team. A randomised controlled trial (RCT) is planned to evaluate how this technology may influence technical and team performance, ultimately leading to improved patient safety. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Making the Case for Reusable Booster Systems: The Operations Perspective

NASA Technical Reports Server (NTRS)

Zapata, Edgar

2012-01-01

Presentation to the Aeronautics Space Engineering Board National Research Council Reusable Booster System: Review and Assessment Committee. Addresses: the criteria and assumptions used in the formulation of current RBS plans; the methodologies used in the current cost estimates for RBS; the modeling methodology used to frame the business case for an RBS capability including: the data used in the analysis, the models' robustness if new data become available, and the impact of unclassified government data that was previously unavailable and which will be supplied by the USAF; the technical maturity of key elements critical to RBS implementation and the ability of current technology development plans to meet technical readiness milestones.

Non-front-fanged colubroid snakes: a current evidence-based analysis of medical significance.

PubMed

Weinstein, Scott A; White, Julian; Keyler, Daniel E; Warrell, David A

2013-07-01

Non-front-fanged colubroid snakes (NFFC; formerly and artificially taxonomically assembled as "colubrids") comprise about 70% of extant snake species and include several taxa now known to cause lethal or life threatening envenoming in humans. Although the medical risks of bites by only a handful of species have been documented, a growing number of NFFC are implicated in medically significant bites. The majority of these snakes have oral products (Duvernoy's secretions, or venoms) with unknown biomedical properties and their potential for causing harm in humans is unknown. Increasingly, multiple NFFC species are entering the commercial snake trade posing an uncertain risk. Published case reports describing NFFC bites were assessed for evidence-based value, clinical detail and verified species identification. These data were subjected to meta-analysis and a hazard index was generated for select taxa. Cases on which we consulted or personally treated were included and subjected to the same assessment criteria. Cases involving approximately 120 species met the selection criteria, and a small subset designated Hazard Level 1 (most hazardous), contained 5 species with lethal potential. Recommended management of these cases included antivenom for 3 species, Dispholidus typus, Rhabdophis tiginis, Rhabdophis subminiatus, whereas others in this subset without commercially available antivenoms (Thelotornis spp.) were treated with plasma/erythrocyte replacement therapy and supportive care. Heparin, antifibrinolytics and/or plasmapheresis/exchange transfusion have been used in the management of some Hazard Level 1 envenomings, but evidence-based analysis positively contraindicates the use of any of these interventions. Hazard Level 2/3 species were involved in cases containing mixed quality data that implicated these taxa (e.g. Boiga irregularis, Philodryas olfersii, Malpolon monspessulanus) with bites that caused rare systemic effects. Recommended management may include use of acetylcholinesterase inhibitors (e.g. neostigmine) and wound care on a case-by-case basis. Hazard level 3 species comprised a larger group capable of producing significant local effects only, often associated with a protracted bite (eg Heterodon nasicus, Borikenophis (Alsophis) portoricensis, Platyceps (Coluber) rhodorachis). Management is restricted to wound care. Bites by Hazard level 4 species comprised the majority of surveyed taxa and these showed only minor effects of no clinical importance. This study has produced a comprehensive evidence-based listing of NFFC snakes tabulated against medical significance of bites, together with best-practice management recommendations. This analysis assumes increasing importance, as there is growing exposure to lesser-known NFFC snakes, particularly in captive collections that may uncover further species of significance in the future. Careful and accurate documentation of bites by verified species of NFFC snakes is required to increase the evidence base and establish the best medical management approach for each species. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Evolving Curricular Models in Culinary Arts: An Instrumental Case Study of a Technical Field

ERIC Educational Resources Information Center

Cossio, Allison

2016-01-01

The purpose of this research study was to examine how chefs and other individuals in the food industry understood the field of culinary arts. This study used an instrumental case study with purposeful sampling of multiple cases. Through a series of open-ended interviews using snowball-sampling strategy that concluded with 45 participants sharing…

Simplified Interface to Complex Memory Hierarchies 1.x

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

Lang, Michael; Ionkov, Latchesar; Williams, Sean

2017-02-21

Memory systems are expected to get evermore complicated in the coming years, and it isn't clear exactly what form that complexity will take. On the software side, a simple, flexible way of identifying and working with memory pools is needed. Additionally, most developers seek code portability and do not want to learn the intricacies of complex memory. Hence, we believe that a library for interacting with complex memory systems should expose two kinds of abstraction: First, a low-level, mechanism-based interface designed for the runtime or advanced user that wants complete control, with its focus on simplified representation but with allmore » decisions left to the caller. Second, a high-level, policy-based interface designed for ease of use for the application developer, in which we aim for best-practice decisions based on application intent. We have developed such a library, called SICM: Simplified Interface to Complex Memory.« less

Mobile text messaging for health: a systematic review of reviews.

PubMed

Hall, Amanda K; Cole-Lewis, Heather; Bernhardt, Jay M

2015-03-18

The aim of this systematic review of reviews is to identify mobile text-messaging interventions designed for health improvement and behavior change and to derive recommendations for practice. We have compiled and reviewed existing systematic research reviews and meta-analyses to organize and summarize the text-messaging intervention evidence base, identify best-practice recommendations based on findings from multiple reviews, and explore implications for future research. Our review found that the majority of published text-messaging interventions were effective when addressing diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence for antiretroviral therapy. However, we found limited evidence across the population of studies and reviews to inform recommended intervention characteristics. Although strong evidence supports the value of integrating text-messaging interventions into public health practice, additional research is needed to establish longer-term intervention effects, identify recommended intervention characteristics, and explore issues of cost-effectiveness.

Conducted electrical weapons within healthcare: a comprehensive use of force model.

PubMed

Ho, Jeffrey D; Williams, Martin F; Coplen, Michael J

2014-01-01

Healthcare settings are experiencing increased amounts of violent activity that are challenging to the health care security profession. There is difficulty in addressing this issue completely. Some of this difficulty is because of factors that include inexperienced and untrained clinicians and administrators that are often the decision-makers in the health care setting. As part of an effective solution, we propose that a security plan, including a comprehensive use of force program incorporating conducted electrical weapons, is a necessary and best-practice goal. This paper outlines the background of the problem and discusses the challenges we encountered in reaching this goal as well as the benefits we have discovered along the way. This paper will be beneficial to any healthcare security professional that is interested in enhancing or improving their current health care security use of force model to further counter the increasing violent activity in their respective healthcare setting.

Mobile Text Messaging for Health: A Systematic Review of Reviews

PubMed Central

Hall, Amanda K.; Cole-Lewis, Heather; Bernhardt, Jay M.

2015-01-01

The aim of this systematic review of reviews is to identify mobile text-messaging interventions designed for health improvement and behavior change and to derive recommendations for practice. We have compiled and reviewed existing systematic research reviews and meta-analyses to organize and summarize the text-messaging intervention evidence base, identify best-practice recommendations based on findings from multiple reviews, and explore implications for future research. Our review found that the majority of published text-messaging interventions were effective when addressing diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence for antiretroviral therapy. However, we found limited evidence across the population of studies and reviews to inform recommended intervention characteristics. Although strong evidence supports the value of integrating text-messaging interventions into public health practice, additional research is needed to establish longer-term intervention effects, identify recommended intervention characteristics, and explore issues of cost-effectiveness. PMID:25785892

When Playing Meets Learning: Methodological Framework for Designing Educational Games

NASA Astrophysics Data System (ADS)

Linek, Stephanie B.; Schwarz, Daniel; Bopp, Matthias; Albert, Dietrich

Game-based learning builds upon the idea of using the motivational potential of video games in the educational context. Thus, the design of educational games has to address optimizing enjoyment as well as optimizing learning. Within the EC-project ELEKTRA a methodological framework for the conceptual design of educational games was developed. Thereby state-of-the-art psycho-pedagogical approaches were combined with insights of media-psychology as well as with best-practice game design. This science-based interdisciplinary approach was enriched by enclosed empirical research to answer open questions on educational game-design. Additionally, several evaluation-cycles were implemented to achieve further improvements. The psycho-pedagogical core of the methodology can be summarized by the ELEKTRA's 4Ms: Macroadaptivity, Microadaptivity, Metacognition, and Motivation. The conceptual framework is structured in eight phases which have several interconnections and feedback-cycles that enable a close interdisciplinary collaboration between game design, pedagogy, cognitive science and media psychology.

Recommendations for Internet-Based Qualitative Health Research With Hard-to-Reach Populations

PubMed Central

Wilkerson, J. Michael; Iantaffi, Alex; Grey, Jeremy A.; Bockting, Walter O.; Simon Rosser, B. R.

2014-01-01

Researchers new to online qualitative health research frequently have questions about how to transfer knowledge of offline data collection to an online environment. In this article, we present best-practice guidelines derived from the literature and our experience to help researchers determine if an online qualitative study design is appropriate for their research project and, if so, when to begin data collection with a hard-to-reach population. Researchers should reflect on administrative, population, and data collection considerations when deciding between online and offline data collection. Decisions must be made regarding whether to conduct interviews or focus groups, to collect data using asynchronous or synchronous methods, and to use only text or incorporate visual media. Researchers should also reflect on human subjects, recruitment, research instrumentation, additional data collection, and public relations considerations when writing protocols to guide the research team’s response to various situations. Our recommendations direct researchers’ reflection on these considerations. PMID:24623662

Food safety considerations for innovative nutrition solutions.

PubMed

Byrd-Bredbenner, Carol; Cohn, Marjorie Nolan; Farber, Jeffrey M; Harris, Linda J; Roberts, Tanya; Salin, Victoria; Singh, Manpreet; Jaferi, Azra; Sperber, William H

2015-07-01

Failure to secure safe and affordable food to the growing global population leads far too often to disastrous consequences. Among specialists and other individuals, food scientists have a key responsibility to improve and use science-based tools to address risk and advise food handlers and manufacturers with best-practice recommendations. With collaboration from production agriculture, food processors, state and federal agencies, and consumers, it is critical to implement science-based strategies that address food safety and that have been evaluated for effectiveness in controlling and/or eliminating hazards. It is an open question whether future food safety concerns will shift in priority given the imperatives to supply sufficient food. This report brings together leading food safety experts to address these issues with a focus on three areas: economic, social, and policy aspects of food safety; production and postharvest technology for safe food; and innovative public communication for food safety and nutrition. © 2015 New York Academy of Sciences.

Automated recommendation for cervical cancer screening and surveillance.

PubMed

Wagholikar, Kavishwar B; MacLaughlin, Kathy L; Casey, Petra M; Kastner, Thomas M; Henry, Michael R; Hankey, Ronald A; Peters, Steve G; Greenes, Robert A; Chute, Christopher G; Liu, Hongfang; Chaudhry, Rajeev

2014-01-01

Because of the complexity of cervical cancer prevention guidelines, clinicians often fail to follow best-practice recommendations. Moreover, existing clinical decision support (CDS) systems generally recommend a cervical cytology every three years for all female patients, which is inappropriate for patients with abnormal findings that require surveillance at shorter intervals. To address this problem, we developed a decision tree-based CDS system that integrates national guidelines to provide comprehensive guidance to clinicians. Validation was performed in several iterations by comparing recommendations generated by the system with those of clinicians for 333 patients. The CDS system extracted relevant patient information from the electronic health record and applied the guideline model with an overall accuracy of 87%. Providers without CDS assistance needed an average of 1 minute 39 seconds to decide on recommendations for management of abnormal findings. Overall, our work demonstrates the feasibility and potential utility of automated recommendation system for cervical cancer screening and surveillance.

Radio Frequency Identification (RFID) for Naval Medical Treatment Facilities (MTF)

DTIC Science & Technology

2006-09-01

education and develop my technical knowledge in the field of Information Technology Management. The skills and understanding I gained from my...place, preventing the need for manipulation. The passes can also be used to locate skiers in case of injuries or for the location of children. RFID...created and backed by the leaders of the industry [24]. Intellectual property, patents, 42 intimate technical knowledge and publicity are all