Options for Organizing the Tanker Airlift Control Center Flight Dispatch Function: An Exploratory Concept Study

DTIC Science & Technology

2000-06-01

it poised to fall? Am I prepared to pay the applicable capital gains tax ? Each of these questions could represent a decision frame. The...Center (FEDSIM). AMC Corporate Systems Analysis, Design , and Implementation PEP 18 TACC Project. Falls Chruch , VA: Federal Systems Integration and

45 CFR 1306.32 - Center-based program option.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Center-based program option. (a) Class size. (1) Head Start classes must be staffed by a teacher and an aide or two teachers and, whenever possible, a volunteer. (2) Grantees must determine their class size based on the predominant age of the children who will participate in the class and whether or not a...

Behavioral Health in the Patient Centered Medical Home: Meeting the Quadruple Aim Part 1

DTIC Science & Technology

2011-01-24

visits)  Pre-clinician diagnostic aid  Patient education materials  Psychosocial options  Care Facilitator assisted follow-up option  Aggressive...clinician diagnostic aid  Patient education materials  Psychosocial options  Care Facilitator assisted follow-up option  Aggressive facilitator outreach...visits)  Pre-clinician diagnostic aid  Patient education materials  Psychosocial options  Care Facilitator assisted follow-up option  Aggressive

Evaluation of Policy Options for Increasing the Availability of Primary Care Services in Rural Washington State.

PubMed

Friedberg, Mark W; Martsolf, Grant R; White, Chapin; Auerbach, David I; Kandrack, Ryan; Reid, Rachel O; Butcher, Emily; Yu, Hao; Hollands, Simon; Nie, Xiaoyu

2017-01-01

The Washington State legislature has recently considered several policy options to address a perceived shortage of primary care physicians in rural Washington. These policy options include opening the new Elson S. Floyd College of Medicine at Washington State University in 2017; increasing the number of primary care residency positions in the state; expanding educational loan-repayment incentives to encourage primary care physicians to practice in rural Washington; increasing Medicaid payment rates for primary care physicians in rural Washington; and encouraging the adoption of alternative models of primary care, such as medical homes and nurse-managed health centers, that reallocate work from physicians to nurse practitioners (NPs) and physician assistants (PAs). RAND Corporation researchers projected the effects that these and other policy options could have on the state's rural primary care workforce through 2025. They project a 7-percent decrease in the number of rural primary care physicians and a 5-percent decrease in the number of urban ones. None of the policy options modeled in this study, on its own, will offset this expected decrease by relying on physicians alone. However, combinations of these strategies or partial reallocation of rural primary care services to NPs and PAs via such new practice models as medical homes and nurse-managed health centers are plausible options for preserving the overall availability of primary care services in rural Washington through 2025.

PACS for imaging centers.

PubMed

Farnsworth, T J

2003-01-01

PACS can be a difficult and confusing decision for any radiology provider, but it can be an even more dynamic question for an outpatient imaging center. Every center represents a unique situation and requires a specialized solution. Typically, most of what is said and discussed about PACS concentrates on solutions and requirements for hospital radiology facilities. Administrators of imaging centers have different problems from hospital administrators, and they need different answers. For imaging centers, the financial justification for PACS may be less immediate than for hospitals. The first thing that must be understood is that no PAC system can make a typical imaging center completely filmless, at least not for quite a while. A hospital has the ability to dictate to its internal referring physicians how a radiological study is delivered, whereas in an imaging center environment, the roles are very much reversed. Once the justification are made for the financial viability of PACS in an imaging center, the next question is how to finance the acquisition of PACS. The decision will depend on how you cost justify your PACS, as well as the shape of your business model, and it will come to a decision between capital purchase or contracting with an application service provider, or ASP. Historically, in the hospital-dominated marketplace, PAC systems have been treated as capital acquisitions. However, for most imaging center, owning the system is more of a problem than a benefit. ASPs increasingly represent a successful alternative for imaging centers. One of the biggest things to consider with PACS is how to store all of those images. There are typically two options, on-site and off-site, with a new "hybrid" option surfacing more recently. Each option has benefits for the user, but the benefits of off-site storage are increasing as the technology advances. Some of the benefits are data security and access. Other issues to address are HIPAA compliance, standardized interfaces such as HL-7, Web access and the choice of view stations.

One health approach to influenza: assessment of critical issues and options.

PubMed

Powdrill, Thomas F; Nipp, Terry L; Rinderknecht, Jennifer L

2010-08-01

A task force of experts on influenza, public health, and animal health met at the conference One Health Approach to Influenza: Assessment of Critical Issues and Options in Washington, DC, on December 1-2, 2009. These experts discussed the role of the One Health approach in preparing for and responding to an influenza pandemic or other emerging zoonotic disease by using pandemic (H1N1) 2009 as a case study. The meeting was convened by the US Department of Homeland Security National Center for Foreign Animal and Zoonotic Disease Defense, and the National Institute of Allergy and Infectious Diseases/National Institutes of Health Western Regional Center of Excellence for Biodefense and Emerging Infectious Diseases.

A comparison of center-based vs. home-based daily hemodialysis for patients with end-stage renal disease.

PubMed

Kraus, Michael; Burkart, John; Hegeman, Rebecca; Solomon, Richard; Coplon, Norman; Moran, John

2007-10-01

Home hemodialysis has been a therapeutic option for almost 4 decades. The complexity of dialysis equipment has been a factor-limiting adoption of this modality. We performed a feasibility study to demonstrate the safety of center-based vs. home-based daily hemodialysis with the NxStage System One portable hemodialysis device. We also performed a retrospective analysis to determine if clinical effects previously associated with short-daily dialysis were also seen using this novel device. We conducted a prospective, 2-treatment, 2-period, open-label, crossover study of in-center hemodialysis vs. home hemodialysis in 32 patients treated at 6 U.S. centers. The 8-week In-Center Phase (6 days/week) was followed by a 2-week transition period and then followed by the 8-week Home Phase (6 days/week). We retrospectively collected data on hemodialysis treatment parameters immediately preceding the study in a subset of patients. Twenty-six out of 32 patients (81%) successfully completed the study. Successful delivery of at least 90% of prescribed fluid volume (primary endpoint) was achieved in 98.5% of treatments in-center and 97.3% at home. Total effluent volume as a percentage of prescribed volume was between 94% and 100% for all study weeks. The composite rate of intradialytic and interdialytic adverse events per 100 treatments was significantly higher for the In-Center Phase (5.30) compared with the Home Phase (2.10; p=0.007). Compared with the period immediately preceding the study, there were reductions in blood pressure, antihypertensive medications, and interdialytic weight gain. Daily home hemodialysis with a small, easy-to-use hemodialysis device is a viable dialysis option for end-stage renal disease patients capable of self/partner-administered dialysis.

Numbers of center points appropriate to blocked response surface experiments

NASA Technical Reports Server (NTRS)

Holms, A. G.

1979-01-01

Tables are given for the numbers of center points to be used with blocked sequential designs of composite response surface experiments as used in empirical optimum seeking. The star point radii for exact orthogonal blocking is presented. The center point options varied from a lower limit of one to an upper limit equal to the numbers proposed by Box and Hunter for approximate rotatability and uniform variance, and exact orthogonal blocking. Some operating characteristics of the proposed options are described.

Patient-centered and visual quality outcomes of premium cataract surgery: a systematic review.

PubMed

Wang, Sophia Y; Stem, Maxwell S; Oren, Gale; Shtein, Roni; Lichter, Paul R

2017-06-26

Over 8 million cataract surgeries are performed in the United States and the European Union annually, with many patients choosing to pay out of pocket for premium options including premium intraocular lens implants (IOLs) or laser-assisted cataract surgery (LACS). This report provides a systematic review evaluating patient-centered and visual quality outcomes comparing standard monofocal IOLs to premium cataract surgery options. PubMed and EMBASE were searched for publications published between January 1, 1980, and September 18, 2016, on multifocal, accommodative, and toric IOLs, monovision, and LACS, which reported on 1) dysphotopsias, 2) contrast sensitivity, 3) spectacle independence, 4) vision-related quality of life or patient satisfaction, and 5) IOL exchange. Multifocal lenses achieved higher rates of spectacle independence compared to monofocal lenses but also had higher reported frequency of dysphotopsia and worse contrast sensitivity, especially with low light or glare. Accommodative lenses were not associated with reduced contrast sensitivity or more dysphotopsia but had only modest improvements in spectacle independence compared to monofocal lenses. Studies of monovision did not target a sufficiently myopic outcome in the near-vision eye to achieve the full potential for spectacle independence. Patients reported high levels of overall satisfaction regardless of implanted IOL. No studies correlated patient-reported outcomes with patient expectations. Studies are needed to thoroughly compare patient-reported outcomes with concomitant patient expectations. In light of the substantial patient costs for premium options, patients and their surgeons will benefit from a better understanding of which surgical options best meet patients' expectations and how those expectations can be impacted by premium versus monofocal-including monovision-options.

Near-Earth Asteroid Retrieval Mission (ARM) Study

NASA Technical Reports Server (NTRS)

Brophy, John R.; Muirhead, Brian

2013-01-01

The Asteroid Redirect Mission (ARM) concept brings together the capabilities of the science, technology, and the human exploration communities on a grand challenge combining robotic and human space exploration beyond low Earth orbit. This paper addresses the key aspects of this concept and the options studied to assess its technical feasibility. Included are evaluations of the expected number of potential targets, their expected discovery rate, the necessity to adequately characterize candidate mission targets, the process to capture a non-cooperative asteroid in deep space, and the power and propulsion technology required for transportation back to the Earth-Moon system. Viable options for spacecraft and mission designs are developed. Orbits for storing the retrieved asteroid that are stable for more than a hundred years, yet allow for human exploration and commercial utilization of a redirected asteroid, are identified. The study concludes that the key aspects of finding, capturing and redirecting an entire small, near-Earth asteroid to the Earth-Moon system by the first half of the next decade are technically feasible. The study was conducted from January 2013 through March 2013 by the Jet Propulsion Laboratory (JPL) in collaboration with Glenn Research Center (GRC), Johnson Space Center (JSC), Langley Research Center (LaRC), and Marshall Space Flight Center (MSFC).

Environmental Assessment for Central Campus Complex John F. Kennedy Space Center, Florida

NASA Technical Reports Server (NTRS)

Dankert, Donald

2013-01-01

This Environmental Assessment addresses the Proposed Action to consolidate multiple facilities in the Kennedy Space Center (KSC) Industrial Area by constructing two new buildings in the existing headquarters area between NASA Parkway, 3rd Street, C Avenue, and D Avenue. Under the Proposed Action, the historic Headquarters Building will be demolished and a new building will be constructed closer to the Operations and Checkout Building by centering it on D A venue (Hunton Brady Architects, P A and Jones Edmunds and Associates, Inc. 2011). This option was selected from a group of 15 initial sketches as the most viable option during a Central Campus Complex Siting Study completed in February 2011. A No-Action Alternative is also presented in which no demolition or construction of new facilities would occur. Implementing the Proposed Action will have major impacts to cultural resources, while the remaining environmental impacts will be minor.

Reflection Spectromicroscopy for the Design of Nanopillar Optical Antenna Detectors

DTIC Science & Technology

2014-08-29

diameter of individual nanowires makes surface plasmon polariton (SPP) resonances an attractive option, as regular metal scattering centers can overcome...individual nanowires makes surface plasmon polariton (SPP) resonances an attractive option, as regular metal scattering centers can overcome the momentum...minimized. The ability to lithographically define the position and diameter of individual nanowires makes surface plasmon polariton (SPP) resonances an

The process of family-centered counseling for caregivers of persons with dementia: barriers, facilitators and benefits.

PubMed

Vernooij-Dassen, Myrra; Joling, Karlijn; van Hout, Hein; Mittelman, Mary Sherman

2010-08-01

Despite the high consistency of evidence in favor of person-centered care, little information is available on how person-centered and family-centered interventions are actually provided. The aim of this study is to gain insight into the provision of the effective New York University Caregiver Intervention (NYUCI) in order to enhance its implementation. This is a qualitative study using a grounded theory approach. Group interviews were carried out with three purposefully sampled counselors who had provided the NYUCI. Six themes were identified: (1) family problems, (2) ways to deal with these family problems, (3) barriers encountered by counselors, (4) ways to deal with these barriers, (5) facilitators or rewards of being a counselor, and (6) perceived effectiveness.The problem categories were (a) conflicts within families; (b) past experiences and personality; and (c) daily living with dementia. Ways of helping caregivers deal with these problems included problem clarification from the perspectives of the key players. An important barrier was reluctance to be helped. This was dealt with by acknowledging caregivers' need for control over situations. Additional effects of participation in the NYUCI observed by the counselors were reduction of anger and awareness of more and new options for dealing with dementia. Person- or family-centered care offers new perspectives on problems that are seemingly unmanageable. We hypothesize that seeing new and more options is a direct effect of this person-centered counseling. This might be an important outcome to be measured in future studies.

42 CFR 408.65 - Payment options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Payment options. 408.65 Section 408.65 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Individual Payment § 408.65 Payment options...

42 CFR 438.356 - State contract options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false State contract options. 438.356 Section 438.356 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE External Quality Review § 438.356 State contract options...

Contaminated product water as the source of Phialemonium curvatum bloodstream infection among patients undergoing hemodialysis.

PubMed

Rao, Carol Y; Pachucki, Constance; Cali, Salvatore; Santhiraj, Mangai; Krankoski, Kathi L K; Noble-Wang, Judith A; Leehey, David; Popli, Subhash; Brandt, Mary E; Lindsley, Mark D; Fridkin, Scott K; Arduino, Matthew J

2009-09-01

We investigated a cluster of cases of bloodstream infection (BSI) due to the mold Phialemonium at a hemodialysis center in Illinois and conducted a cohort study to identify risk factors. Environmental assessment and cohort study. A hemodialysis center in a tertiary care hospital. A case patient was defined as a person who underwent dialysis at the center and had a blood sample that tested positive for Phialemonium curvatum on culture. We reviewed microbiology and medical records and tested water, surface, and dialysate samples by culture. Molds isolated from environmental and clinical specimens were identified by their morphological features and confirmed by sequencing DNA. We identified 2 case patients with BSI due to P. curvatum. Both became febrile and hypotensive while undergoing dialysis on the same machine at the same treatment station, although on different days. Dialysis machines were equipped with waste handling option ports that are used to discard dialyzer priming fluid. We isolated P. curvatum from the product water (ie, water used for dialysis purposes) at 2 of 19 treatment stations, one of which was the implicated station. The source of P. curvatum was likely the water distribution system. To our knowledge, this is the first report of patients acquiring a mold BSI from contaminated product water. The route of exposure in these cases of BSI due to P. curvatum may be related to the malfunction and improper maintenance of the waste handling option ports. Waste handling option ports have been previously implicated as the source of bacterial BSI due to the backflow of waste fluid into a patient's blood line. No additional cases of infection were noted after remediation of the water distribution system and after discontinuing use of waste handling option ports at the facility.

42 CFR 447.51 - Requirements and options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Requirements and options. 447.51 Section 447.51 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES..., Premium Or Similar Cost Sharing Charge § 447.51 Requirements and options. (a) The plan must provide that...

Why Crisis Pregnancy Centers Are Legal but Unethical.

PubMed

Bryant, Amy G; Swartz, Jonas J

2018-03-01

Crisis pregnancy centers are organizations that seek to intercept women with unintended pregnancies who might be considering abortion. Their mission is to prevent abortions by persuading women that adoption or parenting is a better option. They strive to give the impression that they are clinical centers, offering legitimate medical services and advice, yet they are exempt from regulatory, licensure, and credentialing oversight that apply to health care facilities. Because the religious ideology of these centers' owners and employees takes priority over the health and well-being of the women seeking care at these centers, women do not receive comprehensive, accurate, evidence-based clinical information about all available options. Although crisis pregnancy centers enjoy First Amendment rights protections, their propagation of misinformation should be regarded as an ethical violation that undermines women's health. © 2018 American Medical Association. All Rights Reserved.

Developing brokered community transportation for seniors and people with disabilities.

PubMed

Marx, Jerry; Davis, Christie; Miftari, Caitlin; Salamone, Anne; Weise, Wendy

2010-01-01

Communities are exploring ways to increase transportation coordination to improve access for seniors. One such effort is a brokered transportation system in which one agency serves as the central point of contact for ride information or actually arranging transportation for clients of multiple programs by use of a combination of transportation services. A team of social work faculty and students from the University of New Hampshire (UNH) Social Work Outreach Center, a center that provides service learning opportunities to students, collaborated with a local coalition to investigate the specific transportation needs of the region's senior citizens. A total of 641 people participated in the survey. Results indicate that the study population experiences problems reliably meeting daily living needs due to inconsistent or unavailable private and public transportation options. Study findings also indicate the promising potential of brokered transportation systems, particularly for isolated seniors in rural and suburban areas with relatively limited public and private transportation options.

42 CFR 456.506 - Waiver options for Medicaid agency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Waiver options for Medicaid agency. 456.506 Section 456.506 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... options for Medicaid agency. (a) The agency may apply for a waiver at any time it has the procedures...

20 CFR 656.18 - Optional special recruitment and documentation procedures for college and university teachers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Optional special recruitment and... EMPLOYMENT OF ALIENS IN THE UNITED STATES Labor Certification Process § 656.18 Optional special recruitment... processing center. (b) Recruitment. The employer may recruit for college and university teachers under § 656...

How Do You Know When It's Time to Give up the Keys?

MedlinePlus

... older adults. http: / / www. eldercare. gov/ ELDERCARE. NET/ Public/ Resources/ Brochures/ docs/ Trans_ Options_ Panels. pdf National Center on Senior Transportation (NCST) Includes resources on transportation options for older ...

FHWA Traffic Noise Model (TNM) pavement effects implementation study : progress report 1

DOT National Transportation Integrated Search

2012-01-31

The Volpe Center Acoustics Facility, in support of the Federal Highway Administration (FHWA), investigated the implementation of pavement effects in the FHWA Traffic Noise Model (TNM). Three options were considered, resulting in the recommendation of...

Physiotherapists use a great variety of motor learning options in neurological rehabilitation, from which they choose through an iterative process: a retrospective think-aloud study.

PubMed

Kleynen, Melanie; Moser, Albine; Haarsma, Frederike A; Beurskens, Anna J; Braun, Susy M

2017-08-01

The goal of this study was to examine which motor learning options are applied by experienced physiotherapists in neurological rehabilitation, and how they choose between the different options. A descriptive qualitative approach was used. A purposive sample of five expert physiotherapists from the neurological ward of a rehabilitation center participated. Data were collected using nine videotaped therapy situations. During retrospective think-aloud interviews, the physiotherapists were instructed to constantly "think aloud" while they were watching their own videos. Five "operators" were identified: "act", "know", "observe", "assess" and "argue". The "act" operator consisted of 34 motor learning options, which were clustered into "instruction", "feedback" and "organization". The "know", "observe", "assess" and "argue" operators explained how therapists chose one of these options. The four operators seem to be interrelated and together lead to a decision to apply a particular motor learning option. Results show that the participating physiotherapists used a great variety of motor learning options in their treatment sessions. Further, the decision-making process with regard to these motor learning options was identified. Results may support future intervention studies that match the content and process of therapy in daily practice. The study should be repeated with other physiotherapists. Implications for Rehabilitation The study provided insight into the way experienced therapist handle the great variety of possible motor learning options, including concrete ideas on how to operationalize these options in specific situations. Despite differences in patients' abilities, it seems that therapists use the same underlying clinical reasoning process when choosing a particular motor learning option. Participating physiotherapists used more than the in guidelines suggested motor learning options and considered more than the suggested factors, hence adding practice based options of motor learning to the recommended ones in the guidelines. A think-aloud approach can be considered for peer-to-peer and student coaching to enhance discussion on the motor learning options applied and the underlying choices and to encourage research by practicing clinicians.

76 FR 10735 - Medicaid Program; Community First Choice Option

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-25

... Vol. 76 Friday, No. 38 February 25, 2011 Part III Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Part 441 Medicaid Program; Community First Choice Option...; [[Page 10736

Retrieval characteristics of the Bard Denali and Argon Option inferior vena cava filters.

PubMed

Dowell, Joshua D; Semaan, Dominic; Makary, Mina S; Ryu, John; Khayat, Mamdouh; Pan, Xueliang

2017-11-01

The purpose of this study was to compare the retrieval characteristics of the Option Elite (Argon Medical, Plano, Tex) and Denali (Bard, Tempe, Ariz) retrievable inferior vena cava filters (IVCFs), two filters that share a similar conical design. A single-center, retrospective study reviewed all Option and Denali IVCF removals during a 36-month period. Attempted retrievals were classified as advanced if the routine "snare and sheath" technique was initially unsuccessful despite multiple attempts or an alternative endovascular maneuver or access site was used. Patient and filter characteristics were documented. In our study, 63 Option and 45 Denali IVCFs were retrieved, with an average dwell time of 128.73 and 99.3 days, respectively. Significantly higher median fluoroscopy times were experienced in retrieving the Option filter compared with the Denali filter (12.18 vs 6.85 minutes; P = .046). Use of adjunctive techniques was also higher in comparing the Option filter with the Denali filter (19.0% vs 8.7%; P = .079). No significant difference was noted between these groups in regard to gender, age, or history of malignant disease. Option IVCF retrieval procedures required significantly longer retrieval fluoroscopy time compared with Denali IVCFs. Although procedure time was not analyzed in this study, as a surrogate, the increased fluoroscopy time may also have an impact on procedural direct costs and throughput. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Preliminary Assessment of Thrust Augmentation of NEP Based Missions

NASA Technical Reports Server (NTRS)

Chew, Gilbert; Pelaccio, Dennis G.; Chiroux, Robert; Pervan, Sherry; Rauwolf, Gerald A.; White, Charles

2005-01-01

Science Applications International Corporation (SAIC), with support from NASA Marshall Space Flight Center, has conducted a preliminary study to compare options for augmenting the thrust of a conventional nuclear electric propulsion (NEP) system. These options include a novel nuclear propulsion system concept known as Hybrid Indirect Nuclear Propulsion (HINP) and conventional chemical propulsion. The utility and technical feasibility of the HINP concept are assessed, and features and potential of this new in-space propulsion system concept are identified. As part of the study, SAIC developed top-level design tools to model the size and performance of an HINP system, as well as for several chemical propulsion options, including liquid and gelled propellants. A mission trade study was performed to compare a representative HINP system with chemical propulsion options for thrust augmentation of NEP systems for a mission to Saturn's moon Titan. Details pertaining to the approach, features, initial demonstration results for HINP model development, and the mission trade study are presented. Key technology and design issues associated with the HINP concept and future work recommendations are also identified.

Construction Management Oversight Options for UMTA

DOT National Transportation Integrated Search

1983-11-01

At the request of UMTA, a study team was formed on July 29, 1983 at the Transportation Systems Center (TSC) to conduct a review of the project management and grant monitoring procedures employed by the UMTA Regional Offices in projects involving larg...

Trade study: Liquid hydrogen transportation - Kennedy Space Center. [cost and operational effectivenss of shipping methods.

NASA Technical Reports Server (NTRS)

Gray, D. J.

1978-01-01

Cryogenic transportation methods for providing liquid hydrogen requirements are examined in support of shuttle transportation system launch operations at Kennedy Space Center, Florida, during the time frames 1982-1991 in terms of cost and operational effectiveness. Transportation methods considered included sixteen different options employing mobile semi-trailer tankers, railcars, barges and combinations of each method. The study concludes that the most effective method of delivering liquid hydrogen from the vendor production facility in New Orleans to Kennedy Space Center includes maximum utilization of existing mobile tankers and railcars supplemented by maximum capacity mobile tankers procured incrementally in accordance with shuttle launch rates actually achieved.

Smart Columbus : Systems Engineering Management Plan (SEMP) for Smart Columbus Demonstration Program

DOT National Transportation Integrated Search

2018-01-16

The Smart City Demonstration Program is intended to improve access through expanded mobility options in major job centers, enhance visitor experience by better connecting visitors to transportation options, stimulate regional economic prosperity and ...

Evaluating Space Weather Architecture Options to Support Human Deep Space Exploration of the Moon and Mars

NASA Astrophysics Data System (ADS)

Parker, L.; Minow, J.; Pulkkinen, A.; Fry, D.; Semones, E.; Allen, J.; St Cyr, C.; Mertens, C.; Jun, I.; Onsager, T.; Hock, R.

2018-02-01

NASA's Engineering and Space Center (NESC) is conducting an independent technical assessment of space environment monitoring and forecasting architecture options to support human and robotic deep space exploration.

Management options for recycling radioactive scrap metals

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

Dehmel, J.C.; MacKinney, J.; Bartlett, J.

1997-02-01

The feasibility and advantages of recycling radioactive scrap metals (RSM) have yet to be assessed, given the unique technical, regulatory, safety, and cost-benefit issues that have already been raised by a concerned recycling industry. As is known, this industry has been repeatedly involved with the accidental recycling of radioactive sources and, in some cases, with costly consequences. If recycling were deemed to be a viable option, it might have to be implemented with regulatory monitoring and controls. Its implementation may have to consider various and complex issues and address the requirements and concerns of distinctly different industries. There are threemore » basic options for the recycling of such scraps. They are: (1) recycling through the existing network of metal-scrap dealers and brokers, (2) recycling directly and only with specific steelmills, or (3) recycling through regional processing centers. Under the first option, scrap dealers and brokers would receive material from RSM generators and determine at which steelmills such scraps would be recycled. For the second option, RSM generators would deal directly with selected steelmills under specific agreements. For the third option, generators would ship scraps only to regional centers for processing and shipment to participating steelmills. This paper addresses the potential advantages of each option, identifies the types of arrangements that would need to be secured among all parties, and attempts to assess the receptivity of the recycling industry to each option.« less

Expansion of epicyclic gear dynamic analysis program

NASA Technical Reports Server (NTRS)

Boyd, Linda Smith; Pike, James A.

1987-01-01

The multiple mesh/single stage dynamics program is a gear tooth analysis program which determines detailed geometry, dynamic loads, stresses, and surface damage factors. The program can analyze a variety of both epicyclic and single mesh systems with spur or helical gear teeth including internal, external, and buttress tooth forms. The modifications refine the options for the flexible carrier and flexible ring gear rim and adds three options: a floating Sun gear option; a natural frequency option; and a finite element compliance formulation for helical gear teeth. The option for a floating Sun incorporates two additional degrees of freedom at the Sun center. The natural frequency option evaluates the frequencies of planetary, star, or differential systems as well as the effect of additional springs at the Sun center and those due to a flexible carrier and/or ring gear rim. The helical tooth pair finite element calculated compliance is obtained from an automated element breakup of the helical teeth and then is used with the basic gear dynamic solution and stress postprocessing routines. The flexible carrier or ring gear rim option for planetary and star spur gear systems allows the output torque per carrier and ring gear rim segment to vary based on the dynamic response of the entire system, while the total output torque remains constant.

Telecommunications Options Connect OCLC and Libraries to the Future: The Co-Evolution of OCLC Connectivity Options and the Library Computing Environment.

ERIC Educational Resources Information Center

Breeding, Marshall

1998-01-01

The Online Computer Library Center's (OCLC) access options have kept pace with the evolving trends in telecommunications and the library computing environment. As libraries deploy microcomputers and develop networks, OCLC offers access methods consistent with these environments. OCLC works toward reorienting its network paradigm through TCP/IP…

Fertility preservation: a pilot study to assess previsit patient knowledge quantitatively.

PubMed

Balthazar, Ursula; Fritz, Marc A; Mersereau, Jennifer E

2011-05-01

To provide a quantitative assessment of patient knowledge about fertility and fertility preservation treatment options before the initial fertility preservation consultation at a university-based fertility preservation center. Prospective pilot survey containing 13 items assessing patient knowledge about fertility preservation, including the available treatment options and their requirements, success rates, and associated risks. University-based IVF center. Women aged 18 to 41 years with illnesses requiring treatments posing a serious threat to future fertility who were referred for fertility preservation consultation between April 2009 and June 2010. None. Knowledge score. Forty-one eligible patients were identified, and all completed surveys before their consultation. A knowledge score was generated for each patient with 1 point awarded for each correct answer. Overall, patients had poor previsit fertility preservation knowledge (mean score 5.9±2.7). Higher knowledge scores were correlated with personal experience with infertility and previous exposure to fertility preservation treatment information. There was no correlation between knowledge score and age, relationship status, pregnancy history, education, or income. Patients seen for fertility preservation consultation at our university-based center generally tend to be in their early 30s, white, well educated, and married. Previsit knowledge about fertility preservation treatment options was poor and did not correlate with age, education, and relationship status. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

National Intelligent Transportation Systems Program Plan: Five-Year Horizon

DOT National Transportation Integrated Search

2013-06-01

This white paper is a follow-up to the Volpe Center report for FHWA, Ridesharing Options Analysis and Practitioners Toolkit. The white paper provides an update to current ridesharing options and further explores technology and policy develop...

Airline energy conservation options : summary options

DOT National Transportation Integrated Search

1973-07-27

In late May, 1973 the task of determining and evaluating measures for conserving fuel consumed by the airline industry was undertaken. This task was a part of the larger effort conducted by the Transportation Systems Center to determine measures that...

Fatigue Test Design: Scenarios for Biaxial Fatigue Testing of a 60-Meter Wind Turbine Blade

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

Post, Nathan

Current practice in commercial certification of wind turbine blades is to perform separate flap and lead-lag fatigue tests. The National Renewable Energy Laboratory has been researching and evaluating biaxial fatigue testing techniques and demonstrating various options, typically on smaller-scale test articles at the National Wind Technology Center. This report evaluates some of these biaxial fatigue options in the context of application to a multimegawatt blade certification test program at the Wind Technology Testing Center in Charlestown, Massachusetts.

What Women Want from Their Health Care Providers about Pregnancy Options Counseling: A Qualitative Study.

PubMed

French, Valerie A; Steinauer, Jody E; Kimport, Katrina

Unintended pregnancy is common in the United States, yet scant research has evaluated women's preferences on pregnancy options counseling. This study explores pregnant women's preferences for pregnancy options counseling from health care providers. We conducted semistructured interviews with pregnant women at a prenatal clinic and an abortion clinic. We asked women about recent discussions-or lack thereof-about pregnancy options (parenting, adoption, and abortion) with a clinician, and what they would want their provider to discuss about pregnancy options. We analyzed transcripts using modified grounded theory. We interviewed 10 women in prenatal care and 18 women seeking abortion. In both settings, most said clinicians should discuss pregnancy options with pregnant women and 1) respect patient autonomy, 2) avoid assumptions about a woman's desired pregnancy outcome, and 3) consider the patient-including her health and fertility intentions-beyond her pregnancy. Participants wanted their doctors to assess a pregnancy's individual circumstances to determine the appropriateness of options counseling. A few participants, including women who did and did not receive options counseling, reported they personally preferred not to receive such counseling. Explaining this preference, they cited preservation of privacy, having already made a decision for the pregnancy, or just not wanting to discuss abortion. Regarding best practices for providing options counseling, participants said it should be done in a routine manner, with discretion, and early in pregnancy. Pregnant women seeking both prenatal and abortion care broadly support options counseling. Discussion of pregnancy options, including abortion, provides patient-centered care and supports women's preferences. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Developing a Career Planning Center. Occupational Education Research Project Final Report.

ERIC Educational Resources Information Center

Kidd, Frank E.; Embry, Judy K.

Designed as a guide for those community college institutions developing a career planning center, this handbook presents a model for planning and implementing such a center. Options for centers are suggested for three levels of development and staffing: self-directed, intermediate, and comprehensive. Chapter 1 outlines the rationale and possible…

Secondary Writing Centers: Benefits of College and Secondary Collaboration.

ERIC Educational Resources Information Center

Brinkley, Ellen H.

Based on college writing center models, a number of high schools are deciding to establish writing centers, some of them in anticipation of competency tests in composition. Staffing can be the single most significant and expensive factor for secondary schools wanting to provide writing centers. Among the options for dealing with the staffing…

Offering Women Childbirth Choices: A Case for Nurse-Midwives and Free-Standing Birth Centers.

ERIC Educational Resources Information Center

Heffron, Marsha S.

2002-01-01

Describes the use of Certified Nurse Midwives and birth centers, examining how they present a safe, alternative maternity care option for low-risk women and discussing safety issues to consider with alternative childbirth experiences, birth center licensure and accreditation, cost effectiveness of freestanding birth centers, and client…

Denali, Tulip, and Option Inferior Vena Cava Filter Retrieval: A Single Center Experience.

PubMed

Ramaswamy, Raja S; Jun, Emily; van Beek, Darren; Mani, Naganathan; Salter, Amber; Kim, Seung K; Akinwande, Olaguoke

2018-04-01

To compare the technical success of filter retrieval in Denali, Tulip, and Option inferior vena cava filters. A retrospective analysis of Denali, Gunther Tulip, and Option IVC filters was conducted. Retrieval failure rates, fluoroscopy time, sedation time, use of advanced retrieval techniques, and filter-related complications that led to retrieval failure were recorded. There were 107 Denali, 43 Option, and 39 Tulip filters deployed and removed with average dwell times of 93.5, 86.0, and 131 days, respectively. Retrieval failure rates were 0.9% for Denali, 11.6% for Option, and 5.1% for Tulip filters (Denali vs. Option p = 0.018; Denali vs. Tulip p = 0.159; Tulip vs. Option p = 0.045). Median fluoroscopy time for filter retrieval was 3.2 min for the Denali filter, 6.75 min for the Option filter, and 4.95 min for the Tulip filter (Denali vs. Option p < 0.01; Denali vs. Tulip p < 0.01; Tulip vs. Option p = 0.67). Advanced retrieval techniques were used in 0.9% of Denali filters, 21.1% in Option filters, and 10.8% in Tulip filters (Denali vs. Option p < 0.01; Denali vs. Tulip p < 0.01; Tulip vs. Option p < 0.01). Filter retrieval failure rates were significantly higher for the Option filter when compared to both the Denali and Tulip filters. Retrieval of the Denali filter required significantly less amount of fluoroscopy time and use of advanced retrieval techniques when compared to both the Option and Tulip filters. The findings of this study indicate easier retrieval of the Denali and Tulip IVC filters when compared to the Option filter.

Guidelines for Reliable DC/DC Converters for Space Use

NASA Technical Reports Server (NTRS)

Plante, Jeannette; Shue, Jack

2008-01-01

NESC saw the need to study the persistent failure of DC/DC Converters during ground testing and in flight, motivated investigation of causes and mitigation options. Research indicated misapplication and device quality to be root causes. The study took 20 months. Team included multiple NASA Centers : JPL, JSC, MSFC, GSFC Project Background

Detection of semi-volatile organic compounds in permeable pavement infiltrate

EPA Science Inventory

Abstract The Edison Environmental Center (EEC) performs research on green infrastructure (GI) treatment options. One such treatment option is the use of permeable pavements. EEC constructed a parking lot comprised of three different permeable systems: permeable asphalt, porous ...

Student Work Safety Guidelines in Roadside Applications and Work Zones : Safety Guidelines for Transportation Researchers

DOT National Transportation Integrated Search

2018-01-01

The Smart City Demonstration Program is intended to improve access through expanded mobility options in major job centers, enhance visitor experience by better connecting visitors to transportation options, stimulate regional economic prosperity and ...

Trade Study of Multiple Thruster Options for the Mars Airplane Concept

NASA Technical Reports Server (NTRS)

Kuhl, Christopher A.; Gayle, Steven W.; Hunter, Craig A.; Kenney, Patrick S.; Scola, Salvatore; Paddock, David A.; Wright, Henry S.; Gasbarre, Joseph F.

2009-01-01

A trade study was performed at NASA Langley Research Center under the Planetary Airplane Risk Reduction (PARR) project (2004-2005) to examine the option of using multiple, smaller thrusters in place of a single large thruster on the Mars airplane concept with the goal to reduce overall cost, schedule, and technical risk. The 5-lbf (22N) thruster is a common reaction control thruster on many satellites. Thousands of these types of thrusters have been built and flown on numerous programs, including MILSTAR and Intelsat VI. This study has examined the use of three 22N thrusters for the Mars airplane propulsion system and compared the results to those of the baseline single thruster system.

Alternative Learning Centers: Another Option for Discipline Programs.

ERIC Educational Resources Information Center

Pare, John A.

1983-01-01

Describes the operation and effectiveness of the Alternative Learning Center program administered by James Madison Memorial High School in Madison (Wisconsin). The center permits the school to remove students committing breaches of school discipline from their classes without removing them from the educational environment altogether. (PGD)

Clinicopathological characteristics, diagnosis and treatment of melanoma in Serbia--the Melanoma Focus Study.

PubMed

Kandolf-Sekulović, Lidija; Babović, Nada; Jokić, Neven; Nikolin, Borislava; Nikolić, Dejan; Janjić, Zlata; Mijugković, Zeljko; Rajović, Milica; Novaković, Marijan; Pejcić, Ivica; Kovaević, Predrag; Mihajlović, Dragan; Roganović, Tatjana; Ferenc, Vicko; Nikolić, Jelena; Marinković, Marija; Bizetić, Zorana

2015-04-01

Treatment options for metastatic melanoma in Serbia are limited due to the lack of newly approved biologic agents and the lack of clinical studies. Also, there is a paucity of data regarding the treatment approaches in different tertiary centers and efficacy of available chemotherapy protocols. The aim of this study was to obtain more detailed data about treatment protocols in Serbia based on structured survey in tertiary oncology centers. Data about the melanoma patients treated in 2011 were analyzed from hospital databases in 6 referent oncology centers in Serbia, based on the structured survey, with the focus on metastatic melanoma patients (unresectable stage IIIC and IV). A total of 986 (79-315 in different centers) patients were treated, with 320 (32.45%) newly diagnosed patients. There were 317 patients in stage IIIC/IV, 77/317 aged < 50 years. At the time of diagnosis 47.3% of patients were < 60 years of age (24.2% < 40 years, 23% 50-59 years, 52.6% > 60 years). At initial diagnosis 12.5% of patients were in stage III and 4.5% in stage IV. The most common type was superficial spreading melanoma (50-660), followed by nodular melanoma (23.5-50%). Apart from the regional and distant lymph node metastases, the most frequent organs involved in stage IV disease were distant skin and soft tissues (12-55%), lungs (19-55.5%), liver (10-60%), and bones (3-10%). The first line therapy in stage IV metastatic melanoma was dacarbazine (DTIC) dimethyl-triazenoimidozole-carboxamide in 61-93% of the patients, while the second line varied between the centers. Disease control (complete response + partial response + stable disease) was achieved in 25.7% of the patients treated with the first line chemotherapy and 23.1% of the patients treated with the second line therapy, but the duration of response was short, in first-line therapy 6.66 +/- 3.36 months (median 6.75 months). More than 90% of patients were treated outside the clinical trials. Based on this survey, there is a large unmet need for the new treatment options for metastatic melanoma in Serbia. The development of national guidelines, and greater involvement in international clinical studies could lead to widening of treatment options for this chemotherapy resistant disease.

Feasibility and Design Options for a Potential Entity to Research the Comparative Effectiveness of Medical Treatments.

PubMed

Hussey, Peter S; Gillen, Emily M; McGlynn, Elizabeth A

2011-01-01

In 2008, the Massachusetts state legislature mandated an examination of the feasibility of the state's participation in establishing a comparative effectiveness center (CEC) and requested recommendations for the entity's design. "Comparative effectiveness" research involves the direct comparative assessment of the efficacy and cost-effectiveness of health care interventions and strategies. The center's findings would guide purchasing and payment decisions related to medical procedures, devices, drugs, and biologics by public- and private-sector organizations. The state has several options in terms of its approach to comparative effectiveness research. It could establish an interstate CEC that synthesizes existing findings for regional decisionmakers, it could establish an interstate CEC that supports new research, it could join an existing CEC, it could join the Drug Effectiveness Review Project and the Medicare Evidence-Based Decisions Project and also establish a regional center, or it could elect not to establish a CEC at all. An exploration of the options and the types of research that could be sponsored reveals that all of the options are potentially feasible, but the legislature's decision with regard to design must consider the level of prioritization of comparative effectiveness research relative to other approaches to improving health care quality and reducing spending growth.

Cost and Schedule Analytical Techniques Development: Option 2 Year

NASA Technical Reports Server (NTRS)

1997-01-01

This Final Report summarizes the activities performed by Science Applications International Corporation (SAIC) for the Option 2 Year from December 1, 1996 through November 30, 1997. The Final Report is in compliance with Paragraph 5 of Section F of the contract. This CSATD contract provides products and deliverable in the form of models, data bases, methodologies, studies and analyses for the NASA Marshall Space Flight Center's (MSFC) Engineering Cost Office (PPO3) the Program Plans and Requirements Officer (PP02), and other user organizations. Detailed Monthly Progress reports were submitted to MSFC in accordance with the contract's Statement of Work, Section TV "Reporting and Documentation". These reports spelled out each month's specific work accomplishments, deliverables submitted, major meetings held, and other pertinent information. This Final Report will summarize these activities at higher level. During this contract Option Year, SAIC expended 29,830 man-hours in tile performance of tasks called out in the Statement of Work and reported oil in this yearly Final Report. This represents approximately 16 full-time EPs. Included are the basis Huntsville-based team, plus SAIC specialists in San Diego, Ames Research Center, Chicago, and Colorado Springs performing specific tasks for which they are uniquely qualified.

42 CFR 457.410 - Health benefits coverage options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

42 CFR 457.410 - Health benefits coverage options.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

42 CFR 457.410 - Health benefits coverage options.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

42 CFR 457.410 - Health benefits coverage options.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

42 CFR 457.410 - Health benefits coverage options.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES...

Data transmission options for VMT data and fee collection centers.

DOT National Transportation Integrated Search

2002-11-01

The Oregon Road User Fee Task Force (RUFTF) is charged with developing a design for revenue collection for Oregon's roads and highways that will replace the current system for revenue collection for all light vehicles in the state. One option under c...

Student Feedback in Elementary Online Learning: A Phenomenological Study Using Person-Centered Instruction

ERIC Educational Resources Information Center

Smistad, Kirsten E.

2013-01-01

Online learning is becoming increasingly attractive as an option for learning at the K-12 level. However, most research in online learning is done with adults or university participants-a population with a different developmental level and different reasons for learning than those still in compulsory schooling. This study examined the phenomenon…

Space Operations Center system analysis study extension. Volume 4, book 2: SOC system analysis report

NASA Technical Reports Server (NTRS)

1982-01-01

The Space Operations Center (SOC) orbital space station research missions integration, crew requirements, SOC operations, and configurations are analyzed. Potential research and applications missions and their requirements are described. The capabilities of SOC are compared with user requirements. The SOC/space shuttle and shuttle-derived vehicle flight support operations and SOC orbital operations are described. Module configurations and systems options, SOC/external tank configurations, and configurations for geostationary orbits are described. Crew and systems safety configurations are summarized.

Patient Perceptions About Prediabetes and Preferences for Diabetes Prevention.

PubMed

O'Brien, Matthew J; Moran, Margaret R; Tang, Joyce W; Vargas, Maria C; Talen, Mary; Zimmermann, Laura J; Ackermann, Ronald T; Kandula, Namratha R

2016-12-01

The purpose of this study was to explore how adults with prediabetes perceive their risk of developing diabetes and examine their preferences for evidence-based treatment options to prevent diabetes. A qualitative study was conducted in 2 large Midwest primary care practices, involving in-depth semistructured interviews with 35 adult patients with prediabetes. This ethnically diverse (77% nonwhite) sample of middle-aged primary care patients exhibited multiple diabetes risk factors. Knowledge gaps about prediabetes and its medical management were pervasive. Most patients overestimated the risk of developing diabetes and were not familiar with evidence-based treatment options for prediabetes. They suggested that receiving brief, yet specific information about these topics during the study interview motivated them to act. The majority of participants considered both intensive lifestyle intervention and metformin acceptable treatment options. Many preferred initial treatment with intensive lifestyle intervention but would take metformin if their efforts at lifestyle change failed and their primary care physician recommended it. Some participants expressed wanting to combine both treatments. This qualitative study highlights potential opportunities to promote patient-centered dialogue about prediabetes in primary care settings. Providing patients specific information about the risk of developing diabetes and evidence-based treatment options to prevent or delay its onset may encourage action. Physicians' prediabetes counseling efforts should be informed by the finding that most patients consider both intensive lifestyle intervention and metformin acceptable treatment options. © 2016 The Author(s).

Transfemoral Filter Eversion Technique following Unsuccessful Retrieval of Option Inferior Vena Cava Filters: A Single Center Experience.

PubMed

Posham, Raghuram; Fischman, Aaron M; Nowakowski, Francis S; Bishay, Vivian L; Biederman, Derek M; Virk, Jaskirat S; Kim, Edward; Patel, Rahul S; Lookstein, Robert A

2017-06-01

This report describes the technical feasibility of using the filter eversion technique after unsuccessful retrieval attempts of Option and Option ELITE (Argon Medical Devices, Inc, Athens, Texas) inferior vena cava (IVC) filters. This technique entails the use of endoscopic forceps to evert this specific brand of IVC filter into a sheath inserted into the common femoral vein, in the opposite direction in which the filter is designed to be removed. Filter eversion was attempted in 25 cases with a median dwell time of 134 days (range, 44-2,124 d). Retrieval success was 100% (25/25 cases), with an overall complication rate of 8%. This technique warrants further study. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Community-Based Care

MedlinePlus

... our e-newsletter! Aging & Health A to Z Community-Based Care Basic Facts & Information A variety of healthcare options ... day care centers are either in churches or community centers. Adult day care is commonly used to care for people who ...

Cognitive and Affective Aspects of Creative Option Generation in Everyday Life Situations

PubMed Central

Schweizer, T. Sophie; Schmalenberger, Katja M.; Eisenlohr-Moul, Tory A.; Mojzisch, Andreas; Kaiser, Stefan; Funke, Joachim

2016-01-01

Which factors influence a human being’s ability to develop new perspectives and be creative? This ability is pivotal for any context in which new cognitions are required, such as innovative endeavors in science and art, or psychotherapeutic settings. In this article, we seek to bring together two research programs investigating the generation of creative options: On the one hand, research on option generation in the decision-making literature and, on the other hand, cognitive and clinical creativity research. Previous decision-making research has largely neglected the topic of generating creative options. Experiments typically provided participants with a clear set of options to choose from, but everyday life situations are less structured and allow countless ways to react. Before choosing an option, agents have to self-generate a set of options to choose from. Such option generation processes have only recently moved to the center of attention. The present study examines the creative quality of self-generated options in daily life situations. A student sample (N = 48) generated options for action in 70 briefly described everyday life scenarios. We rated the quality of the options on three dimensions of creativity- originality, feasibility, and divergence -and linked these qualities to option generation fluency (speed and number of generated options), situational features like the familiarity and the affective valence of the situation in which the options were generated, and trait measures of cognitive performance. We found that when situations were familiar to the participant, greater negative affective valence of the situation was associated with more originality and divergence of generated options. We also found that a higher option generation fluency was associated with a greater maximal originality of options. We complete our article with a joint research agenda for researchers in the decision-making field focusing on option generation and, on the other hand, researchers working on the cognitive and clinical aspects of creativity. PMID:27536258

Cognitive and Affective Aspects of Creative Option Generation in Everyday Life Situations.

PubMed

Schweizer, T Sophie; Schmalenberger, Katja M; Eisenlohr-Moul, Tory A; Mojzisch, Andreas; Kaiser, Stefan; Funke, Joachim

2016-01-01

Which factors influence a human being's ability to develop new perspectives and be creative? This ability is pivotal for any context in which new cognitions are required, such as innovative endeavors in science and art, or psychotherapeutic settings. In this article, we seek to bring together two research programs investigating the generation of creative options: On the one hand, research on option generation in the decision-making literature and, on the other hand, cognitive and clinical creativity research. Previous decision-making research has largely neglected the topic of generating creative options. Experiments typically provided participants with a clear set of options to choose from, but everyday life situations are less structured and allow countless ways to react. Before choosing an option, agents have to self-generate a set of options to choose from. Such option generation processes have only recently moved to the center of attention. The present study examines the creative quality of self-generated options in daily life situations. A student sample (N = 48) generated options for action in 70 briefly described everyday life scenarios. We rated the quality of the options on three dimensions of creativity- originality, feasibility, and divergence -and linked these qualities to option generation fluency (speed and number of generated options), situational features like the familiarity and the affective valence of the situation in which the options were generated, and trait measures of cognitive performance. We found that when situations were familiar to the participant, greater negative affective valence of the situation was associated with more originality and divergence of generated options. We also found that a higher option generation fluency was associated with a greater maximal originality of options. We complete our article with a joint research agenda for researchers in the decision-making field focusing on option generation and, on the other hand, researchers working on the cognitive and clinical aspects of creativity.

Public meeting: Western New York Nuclear Service Center options study. [Problem of West Valley plant

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

None

This document is a transcript of the meeting, with additional written comments. The main topic is the West Valley Processing Plant and how to dispose of it and its high-level wastes. Objective is to get public input on this topic. (DLC)

Schools of Choice: Their Political Role in Gifted Education

ERIC Educational Resources Information Center

Kaplan, Sandra N.

2013-01-01

The concept of school choices has been historically referenced as options in educational philosophies, learning theories, curriculum designs, and program structures. Throughout time, "schools of choice" were defined by areas such as the Three Rs, the progressive movement of student-centered self-selected interest topics of study, classical…

Discourse-Pragmatic Features in English and Spanish among Bilinguals

ERIC Educational Resources Information Center

Kern, Joseph

2017-01-01

A great amount of sociolinguistic research in contact situations has centered on phonological and morphosyntactic variables, but studies of discourse-pragmatic features in contact situations are scarce and incipient. Discourse-pragmatic features are syntactically optional elements that are used to guide, structure, or express a stance towards…

Feasibility study of the Boeing Small Research Module (BSRM) concept

NASA Technical Reports Server (NTRS)

1975-01-01

The design, capabilities, and subsystem options for the Boeing Small Research Module (BSRM) are described. Specific scientific missions are defined based on NASA-Ames Research Center requirements and the BSRM capability to support these missions is discussed. Launch vehicle integration requirements and spacecraft operational features are also presented.

42 CFR 435.300 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Scope. 435.300 Section 435.300 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... AMERICAN SAMOA Optional Coverage of the Medically Needy § 435.300 Scope. This subpart specifies the option...

Transforming the Enterprise of Acquiring Public Sector Complex Systems

DTIC Science & Technology

2006-04-30

analytic equation that determines the value of a compound call option (see Geske , 1979; Cassimon et al., 2004). Another approach that is more...Park, MD: University of Maryland, Center for Public Policy and Private Enterprise. Geske , R. (1979). The valuation of compound options. Journal of

Facilitated IEP Meetings. PACER Center ACTion Information Sheets: PHP-c90

ERIC Educational Resources Information Center

PACER Center, 2014

2014-01-01

To help special education planning teams reach agreements, the Minnesota Department of Education, Compliance and Assistance, Alternative Dispute Resolution Services provide the option of facilitated IEP (Individualized Education Program) meetings. This option is available for IEP, IIIP (Individual Interagency Intervention Plan), and IFSP…

Optimal Operation of Data Centers in Future Smart Grid

NASA Astrophysics Data System (ADS)

Ghamkhari, Seyed Mahdi

The emergence of cloud computing has established a growing trend towards building massive, energy-hungry, and geographically distributed data centers. Due to their enormous energy consumption, data centers are expected to have major impact on the electric grid by significantly increasing the load at locations where they are built. However, data centers also provide opportunities to help the grid with respect to robustness and load balancing. For instance, as data centers are major and yet flexible electric loads, they can be proper candidates to offer ancillary services, such as voluntary load reduction, to the smart grid. Also, data centers may better stabilize the price of energy in the electricity markets, and at the same time reduce their electricity cost by exploiting the diversity in the price of electricity in the day-ahead and real-time electricity markets. In this thesis, such potentials are investigated within an analytical profit maximization framework by developing new mathematical models based on queuing theory. The proposed models capture the trade-off between quality-of-service and power consumption in data centers. They are not only accurate, but also they posses convexity characteristics that facilitate joint optimization of data centers' service rates, demand levels and demand bids to different electricity markets. The analysis is further expanded to also develop a unified comprehensive energy portfolio optimization for data centers in the future smart grid. Specifically, it is shown how utilizing one energy option may affect selecting other energy options that are available to a data center. For example, we will show that the use of on-site storage and the deployment of geographical workload distribution can particularly help data centers in utilizing high-risk energy options such as renewable generation. The analytical approach in this thesis takes into account service-level-agreements, risk management constraints, and also the statistical characteristics of the Internet workload and the electricity prices. Using empirical data, the performance of our proposed profit maximization models for data centers are evaluated, and the capability of data centers to benefit from participation in a variety of Demand Response programs is assessed.

Low-level radioactive waste disposal. Study of a conceptual nuclear energy center at Green River, Utah

NASA Astrophysics Data System (ADS)

Card, D. H.; Hunter, P. H.; Barg, D.; Desouza, F.; Felthauser, K.; Winkler, V.; White, R.

1982-02-01

The ramifications of constructing a nuclear energy center in an arid western region were studied. The alternatives for disposing of the low level waste on the site are compared with the alternative of transporting the waste to the nearest commercial waste disposal site for permanent disposal. Both radiological and nonradiological impacts on the local socioeconomic infrastructure and the environment are considered. Disposal on the site was found to cost considerably less than off site disposal with only negligible impacts associated with the disposal option on either mankind or the environment.

Sick child care options: what do working mothers prefer?

PubMed

Landis, S E; Earp, J A

1987-01-01

More than half of all mothers with children under age 6 are in the labor force. Working mothers must take off anywhere from 5.6 days to 28.8 days per employee per year to care for their sick children. In a survey of 134 working mothers with children in day care centers, 70% expressed an interest in sick child care options outside the home, especially a sick room at the child's regular day care center or an infirmary at the parent's workplace. Mothers who chose "out-of home care" were more likely to: be minority (p less than 0.01); be single parents (p = 0.06); earn less than $10,000 annually (p = 0.03); want their children with temperatures of 100-100.9 F to remain in school until the end of the day (p less than 0.01). Communities and day care centers serving especially lower income, minority or single-parent working mothers should consider investigating these out-of-home sick child care options; the savings to employers could be $2 to $12 billion per year, not to speak of the personal savings to the mothers themselves.

If you did not document it, it did not happen: rates of documentation of discussion of infertility risk in adolescent and young adult oncology patients' medical records.

PubMed

Quinn, Gwendolyn P; Block, Rebecca G; Clayman, Marla L; Kelvin, Joanne; Arvey, Sarah R; Lee, Ji-Hyun; Reinecke, Joyce; Sehovic, Ivana; Jacobsen, Paul B; Reed, Damon; Gonzalez, Luis; Vadaparampil, Susan T; Laronga, Christine; Lee, M Catherine; Pow-Sang, Julio; Eggly, Susan; Franklin, Anna; Shah, Bijal; Fulp, William J; Hayes-Lattin, Brandon

2015-03-01

The adolescent and young adult (AYA) population is underserved because of unique late-effect issues, particularly future fertility. This study sought to establish rates of documentation of discussion of risk of infertility, fertility preservation (FP) options, and referrals to fertility specialists in AYA patients' medical records at four cancer centers. All centers reviewed randomized records within the top four AYA disease sites (breast, leukemia/lymphoma, sarcoma, and testicular). Eligible records included those of patients: diagnosed in 2011, with no prior receipt of gonadotoxic therapy; age 18 to 45 years; with no multiple primary cancers; and for whom record was not second opinion. Quality Oncology Practice Initiative methods were used to evaluate documentation of discussion of risk of infertility, discussion of FP options, and referral to a fertility specialist. Of 231 records, 26% documented infertility risk discussion, 24% documented FP option discussion, and 13% documented referral to a fertility specialist. Records were less likely to contain evidence of infertility risk and FP option discussions for female patients (P = .030 and .004, respectively) and those with breast cancer (P = .021 and < .001, respectively). Records for Hispanic/Latino patients were less likely to contain evidence of infertility risk discussion (P = .037). Records were less likely to document infertility risk discussion, FP option discussion, and fertility specialist referral for patients age ≥ 40 years (P < .001, < .001, and .002, respectively) and those who already had children (all P < .001). The overall rate of documentation of discussion of FP is low, and results show disparities among specific groups. Although greater numbers of discussions may be occurring, there is a need to create interventions to improve documentation. Copyright © 2014 by American Society of Clinical Oncology.

Social Inequalities in Body Weight and Physical Activity: Exploring the Role of Fitness Centers

ERIC Educational Resources Information Center

McLaren, Lindsay; Rock, Melanie J.; McElgunn, Jamie

2012-01-01

Fitness centers are a viable option for physical activity, particularly in climates with significant weather variation. Due to variation in economic and social expressions of exclusivity, fitness centers may have some relation to social inequalities in physical inactivity and related health outcomes; thus, our objective was to explore this…

SLF Run & Walk

NASA Image and Video Library

2018-03-13

Kennedy Space Center Director Bob Cabana, center, is joined by a large group of center employees and guests as they participate in the KSC Walk Run on the Shuttle Landing Facility runway. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options in the spirit of friendly competition.

A Strategic Planning Model for Community Mental Health Centers.

ERIC Educational Resources Information Center

Del Pizzo, Les; And Others

1987-01-01

Describes a strategic plan developed at a community mental health center, the Summit Center for Human Development, to deal with its own survival while public demand increases, and federal and state programs are cut back. Examines current and prospective services and outlines directions for enhancing the mandated and optional services provided…

ASSESSMENT OF MAST IN EUROPEAN PATIENT-CENTERED TELEMEDICINE PILOTS.

PubMed

Ekeland, Anne Granstrøm; Grøttland, Astrid

2015-01-01

Model for ASsessment of Telemedicine Applications (MAST) is a health technology assessment (HTA) inspired framework for assessing the effectiveness and contribution to quality of telemedicine applications based on rigorous, scientific data. This study reports from a study of how it was used and perceived in twenty-one pilots of the European project RENEWING HEALTH (RH). The objectives of RH were to implement large-scale, real-life test beds for the validation and subsequent evaluation of innovative patient-centered telemedicine services. The study is a contribution to the appraisal of HTA methods. A questionnaire was administered for project leaders of the pilots. It included questions about use and usefulness of MAST for (i) preceding considerations, (ii) evaluation of outcomes within seven domains, and (iii) considerations of transferability. Free text spaces allowed for proposals of improvement. The responses covered all pilots. A quantitative summary of use and a qualitative analysis of usefulness were performed. MAST was used and considered useful for pilot evaluations. Challenges included problems to scientifically determine alternative service options and outcome within the seven domains. Proposals for improvement included process studies and adding domains of technological usability, responsible innovation, health literacy, behavior change, caregiver perspectives and motivational issues of professionals. MAST was used according to its structure. Its usefulness in patient centered pilots can be improved by adding new stakeholder groups. Interdependencies between scientific rigor, resources and timeliness should be addressed. Operational options for improvements include process studies, literature reviews and sequential mini-HTAs for identification of areas for more elaborate investigations.

Green Infrastructure Tool | EPA Center for Exposure ...

EPA Pesticide Factsheets

2016-03-07

Units option added – SI or US units. Default option is US units Additional options added to FTABLE such as clear FTABLE Significant digits for FTABLE calculations is changed to 5 Previously a default Cd value was used for calculations (under-drain and riser) but now a user-defined value option is given Conversion options added wherever necessary Default values of suction head and hydraulic conductivity are changed based on units selected in infiltration panel Default values of Cd for riser orifice and under-drain textboxes is changed to 0.6. Previously a default increment value of 0.1 is used for all the channel panels but now user can specify the increment

Choices for Mobility Independence: Transportation Options for Older Adults and People with Disabilities

MedlinePlus

... Organization. Photo credit: The Center for Volunteer Caregiving, Cary, NC (man entering car); Ryan Byers, Pocatello, ID ( ... Waite Park, MN; The Center for Volunteer Caregiving, Cary, NC Key Considerations. Safe, reliable transportation is critica ...

Biofeedback and Counseling for Stress and Anxiety among College Students

ERIC Educational Resources Information Center

Ratanasiripong, Paul; Sverduk, Kevin; Prince, Judy; Hayashino, Diane

2012-01-01

With the rise in stress and anxiety among college students, there is a need for more comprehensive and effective counseling options for counselors in college counseling centers. This study investigated the impact of using biofeedback and brief counseling in treating stress and anxiety in an ethnically diverse college student population. Results…

An Exploratory Study of Undergraduate Students' Referral Preferences

ERIC Educational Resources Information Center

Badura Brack, Amy; Runco, Daniel V.; Cadwallader, Leesa Anne; Kelley, Michael

2012-01-01

We surveyed undergraduate college students from the psychology subject pool (N = 73) about where they would refer a depressed friend for help. Students from this sample were most likely to refer friends to the counseling center followed by social support options. Students were comparatively least likely to refer to other professionals, indicating…

Quality of Prostate Cancer Treatment Information on Cancer Center Websites.

PubMed

Dulaney, Caleb; Barrett, Olivia Claire; Rais-Bahrami, Soroush; Wakefield, Daniel; Fiveash, John; Dobelbower, Michael

2016-04-20

Cancer center websites are trusted sources of internet information about treatment options for prostate cancer. The quality of information on these websites is unknown. The objective of this study was to evaluate the quality of information on cancer center websites addressing prostate cancer treatment options, outcomes, and toxicity. We evaluated the websites of all National Cancer Institute-designated cancer centers to determine if sufficient information was provided to address eleven decision-specific knowledge questions from the validated Early Prostate Cancer Treatment Decision Quality Instrument. We recorded the number of questions addressed, the number of clicks to reach the prostate cancer-specific webpage, evaluation time, and Spanish and mobile accessibility. Correlation between evaluation time and questions addressed were calculated using the Pearson coefficient. Sixty-three websites were reviewed. Eighty percent had a prostate cancer-specific webpage reached in a median of three clicks. The average evaluation time was 6.5 minutes. Information was available in Spanish on 24% of sites and 59% were mobile friendly. Websites provided sufficient information to address, on average, 19% of questions. No website addressed all questions. Evaluation time correlated with the number of questions addressed (R(2) = 0.42, p < 0.001). Cancer center websites provide insufficient information for men with localized prostate cancer due to a lack of information about and direct comparison of specific treatment outcomes and toxicities. Information is also less accessible in Spanish and on mobile devices. These data can be used to improve the quality and accessibility of prostate cancer treatment information on cancer center websites.

Radioisotope Stirling Generator Options for Pluto Fast Flyby Mission

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

Schock, Alfred

The preceding paper described conceptual designs and analytical results for five Radioisotope Thermoelectric Generator (RTG) options for the Pluto Fast Flyby (PFF) mission, and the present paper describes three Radioisotope Stirling Generator (RSG) options for the same mission. The RSG options are based on essentially the same radioisotope heat source modules used in previously flown RTGs and on designs and analyses of a 75-watt free-piston Stirling engine produced by Mechanical Technology Incorporated (MTI) for NASA's Lewis Research Center. The integrated system design options presented were generated in a Fairchild Space study sponsored by the Department of Energy's Office of Specialmore » Applications, in support of ongoing PFF mission and spacecraft studies that the Jet Propulsion Laboratory (JPL) is conducting for the National Aeronautics and Space Administration (NASA). That study's NASA-directed goal is to reduce the spacecraft mass from its baseline value of 166 kg to ~110 kg, which implies a mass goal of less than 10 kg for a power source able to deliver 69 watts(e) at the end of the 9.2-year mission. In general, the Stirling options were found to be lighter than the thermoelectric options described in the preceding paper. But they are less mature, requiring more development, and entailing greater programmatic risk. The Stirling power system mass ranged from 7.3 kg (well below the 10-kg goal) for a non-redundant system to 11.3 kg for a redundant system able to maintain full power if one of its engines fails. In fact, the latter system could deliver as much as 115 watts(e) if desired by the mission planners. There are 2 copies in the file.« less

42 CFR 422.105 - Special rules for self-referral and point of service option.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules for self-referral and point of service option. 422.105 Section 422.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Benefits and...

Alternative Fuels Data Center

Science.gov Websites

Plug-In Electric Vehicle (PEV) Charging Rate Incentive - Xcel Energy Xcel Energy offers two rate options to qualified residential customers for charging PEVs. The Electric Vehicle (EV) Rate and the Time -of-Day Plan are optional and require a separate meter. For rate information, including how to qualify

Assessment of short-sea shipping options for domestic applications.

DOT National Transportation Integrated Search

2009-12-23

This report has been prepared for Dr. Paul Rispin, Office of Naval Research (ONR), as part of the research conducted by the Volpe Center in collaboration with the Center for Commercial Deployment of Transportation Technologies (CCDoTT). The report, o...

In vitro antifungal activity of isavuconazole against 345 mucorales isolates collected at study centers in eight countries.

PubMed

Verweij, P E; González, G M; Wiedrhold, N P; Lass-Flörl, C; Warn, P; Heep, M; Ghannoum, M A; Guinea, J

2009-06-01

Although mucormycoses (formerly zygomycoses) are relatively uncommon, they are associated with high mortality and treatment options are limited. Isavuconazole is a novel, water soluble, broad-spectrum azole in clinical development for the treatment of invasive aspergillosis and candidiasis. The objective of this report was to collate data on the in vitro activity of isavuconazole against a collection of 345 diverse mucorales isolates, collected and tested at eight study centers in europe, mexico and North America. Each study center undertook minimum inhibitory concentration (MIC) susceptibility testing of their isolates, according to EUCAST or CLSI guidelines. Across all study centers, isavuconazole exhibited MIC(50 )values of 1-4 mg/l and MIC(90 )values of 4-16 mg/l against the five genera. There were also marked differences in MIC distributions, which could be ascribed to differences in inoculum and/or endpoint. EUCAST guidelines appeared to generate modal MICs 2-fold higher than CLSI. These results confirm that isavuconazole possesses at least partial antifungal activity against mucorales.

Retrofit energy studies of a recreation center

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

Haberl, J.S.; Claridge, D.

1985-01-01

Retrofit energy options for the Student Recreation Center at the University of Colorado have been evaluated using the DOE-2.1b simulation program. This building has two major systems that are not included in the program - an ice rink and a swimming pool. The approach used to model these systems and the use of the program for other applications not included in the program, such as duty cycling and night cycling of fans for freeze protection, are emphasized. Measures that help streamline the usage of the program on a minicomputer are also discussed.

Biobrane versus topical agents in the treatment of adult scald burns.

PubMed

Krezdorn, Nicco; Könneker, Sören; Paprottka, Felix Julian; Tapking, Christian; Mett, Tobias R; Brölsch, G Felix; Boyce, Maria; Ipaktchi, Ramin; Vogt, Peter M

2017-02-01

Limited data is available for treatment of scald lesions in adults. The use of the biosynthetic matrix Biobrane ® has been suggested as treatment option with more benefits over topical dressings. Application of Biobrane ® in scalds in our center led to a perceived increase of infection, secondary deepening, surgery and length of stay. We therefore assessed the effect of different treatment options in adult scalds in our center. We performed a retrospective cohort study of adult patients that have been admitted with scalds in our center between 2011 and 2014. We assessed two groups, group 1 with Biobrane ® as initial treatment and group 2 with topical treatment using polyhexanid hydrogel and fatty gauze. Primary outcome variables were rate of secondary deepening, surgery, infection (defined as positive microbiological swabs and antibiotic treatment) and length of stay. Total body surface area (TBSA) as well as diabetes mellitus (DM), hypertension, smoking and alcohol consumption as potential confounders were included. A total of 52 patients were included in this study. 36 patients received treatment with Biobrane ® and 16 with ointment and fatty gauze. No significant differences were found for age and TBSA whereas gender ratio was different (25/11 male/female in group 1 vs 4/12 in group 2, p=0.003). Rate of secondary deepening, surgery, infection as well as days of hospital stay (DOHS) were comparable. Logistic and multilinear regression showed TBSA to be a predictive factor for infection (p=0.041), and TBSA and age for length of stay (age p=0.036; TBSA p=0.042) in group 1. The use of Biobrane ® in adult scald lesions is safe and non-inferior to topical treatment options. In elder patients and larger TBSA Biobrane ® may increase the risk of infection or a prolonged stay in hospital. Level 3 - retrospective cohort study. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Fusion Centers: Issues and Options for Congress

DTIC Science & Technology

2007-07-06

financed and staffed by the states, and there is no one “model” for how a center should be structured. State and local law enforcement and criminal...Centers to Task the IC for Information and Receive “Feedback” . . . . . . . . . . . . . . . . . . 70 4e . Establish a Mechanism for Fusion Centers to Have...together nationally, represent a proactive tool to be used to fight a global jihadist adversary which has both centralized and decentralized elements

Fusion Centers: Issues and Options for Congress

DTIC Science & Technology

2008-01-18

largely financed and staffed by the states, and there is no one “model” for how a center should be structured. State and local law enforcement and...Information and Receive “Feedback” . . . . . . . . . . . . . . . . . . 69 4e . Establish a Mechanism for Fusion Centers to Have Input into the NIPF...intelligence fusion centers, particularly when networked together nationally, represent a proactive tool to be used to fight a global jihadist adversary which

A novel imaging approach for prostate cancer is tested in new clinical trial | Center for Cancer Research

Cancer.gov

Prostate cancer patients who have failed standard radiation therapy have the options of surgery, radioactive seed implantation or cryoablation. Deborah Citrin, M.D., of the Radiation Oncology Branch is leading a study of stereotactic body radiation therapy (SBRT) to treat prostate cancer that has recurred locally after standard radiation therapy. The goal of this study is to

Institutional options for VMT data and fee collection centers.

DOT National Transportation Integrated Search

2002-11-01

The objective of this report is an analysis of public vs. private data and fee collection centers for vehicle miles traveled (VMT) fees. This includes the identification and evaluation of issues that will affect the relative desirability of the two f...

Energy Action Day

NASA Image and Video Library

2017-10-25

NASA Kennedy Space Center employees attend the Energy Action Day event held in the center's Space Station Processing Facility. Part of Energy Awareness Month, the event featured subject matter experts in the area of solar energy, its connections to the space program and options for residential solar power.

Mobile ECMO - A divine technology or bridge to nowhere?

PubMed

Merkle, Julia; Djorjevic, Ilija; Sabashnikov, Anton; Kuhn, Elmar W; Deppe, Antje-Christin; Eghbalzadeh, Kaveh; Fattulayev, Javid; Hohmann, Christopher; Zeriouh, Mohamed; Kuhn-Régnier, Ferdinand; Choi, Yeong-Hoon; Mader, Navid; Wahlers, Thorsten

2017-10-01

Extracorporeal life support emerged as a salvage option in patients with therapy-refractory severe hemodynamic or respiratory failure. However, this promising therapy option has been limited by the use of experienced teams in highly specialized tertiary-care centers. Thus, in order to provide this standard of care in local hospitals and due to increasing evidence on improved outcomes using ECMO devices and setting for patients with heart and lung failure, an increasing number of experienced ECMO centers have launched mobile ECMO retrieval services in recent years. Areas covered: This review provides a summary on the current scientific status concerning use, indications and complications of mobile ECMO devices and services. A scientific literature research was conducted in MEDLINE, Embase, Cochrane and Web of Science databases using keywords denoted. Expert commentary: Mobile ECMO devices and setting offer severely ill patients refractory to maximal conventional treatment an option of hemodynamic and/or respiratory stabilization and subsequent transportation to specialized care centers for further treatment. Compared to in-hospital ECMO support, out-of-hospital mobile ECMO implantation, transport and retrieval of patients require additional organizational, logistical and clinical efforts. This review provides a summary on the current scientific status concerning use, indications and complications of mobile ECMO services.

The Pathways to Advancement Project: How States Can Expand Postsecondary Educational Opportunities for Working Adults. Issue Brief

ERIC Educational Resources Information Center

Mazzeo, Christopher; Strawn, Julie; Roberts, Brandon

2009-01-01

The Pathways to Advancement initiative was launched by the National Governors Association Center for Best Practices (NGA Center) to help governors and their policy advisors examine options and develop strategies for expanding working adults' access to and completion of postsecondary education. In September 2003, the NGA Center issued a request for…

Colleges Making SAT Optional as Admissions Requirement

ERIC Educational Resources Information Center

Gilroy, Marilyn

2007-01-01

This article reports that more colleges are dropping the SAT as a requirement for admission and, in many cases, these institutions are attracting a larger and more diverse pool of applicants. According to the National Center for Fair & Open Testing (FairTest), 740 schools have made the SATs optional. The list includes some of the nation's most…

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR...: General Requirement § 456.401 State plan UR requirements and options; UR plan required for intermediate care facility services. (a) The State plan must provide that— (1) UR is performed for each ICF that...

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR...: General Requirement § 456.401 State plan UR requirements and options; UR plan required for intermediate care facility services. (a) The State plan must provide that— (1) UR is performed for each ICF that...

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR...: General Requirement § 456.401 State plan UR requirements and options; UR plan required for intermediate care facility services. (a) The State plan must provide that— (1) UR is performed for each ICF that...

Mobile Wastewater Treatment Technology for Contingency Bases

DTIC Science & Technology

2012-05-24

Def nse Cent rgy and Environment Contingency Base Wastewater Treatment Options Option Advantages Disadvantages Tanking and Trucking Offsite Low...National Defense Center for Energy and Environment Mobile Wastewater Treatment f or Contingency Bases, May 2012 1 National Def nse Cent rgy and...Environment DoD Executive Agent Mobile Wastewater Treatment Technology for Contingency Bases Shan Abeywickrama, NDCEE/CTC Elizabeth Keysar

Reaching High-Risk Youth through Model AIDS Education Programs: A Case by Case Study.

ERIC Educational Resources Information Center

Center for Population Options, Washington, DC.

This report evaluates the High Risk Youth Demonstration Project, which is predicated on the idea that youth-serving agencies (YSAs) can be key sources for adolescent AIDS education. When the Center for Population Options (CPO) conceptualized a strategy for bringing AIDS education to underserved youth, it was responding to the following three areas…

Costs, needs must be balanced when buying computer systems.

PubMed

Krantz, G M; Doyle, J J; Stone, S G

1989-06-01

A healthcare institution must carefully examine its internal needs and external requirements before selecting an information system. The system's costs must be carefully weighed because significant computer cost overruns can cripple overall hospital finances. A New Jersey hospital carefully studied these issues and determined that a contract with a regional data center was its best option.

Employer Sponsored Child Care: Issues and Options.

ERIC Educational Resources Information Center

Conroyd, S. Danielle

This presentation describes the child care center at Detroit's Mount Carmel Hospital, a division of the Sisters of Mercy Health Corporation employing approximately 1,550 women. Discussion focuses on reasons for establishing the center, facility acquisition, program details, program management, developmental philosophy, parent involvement, policy…

Building America Case Study: New Town Builders' Power of Zero Energy Center, Denver, Colorado (Brochure)

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

Not Available

New Town Builders, a builder of energy efficient homes in Denver, Colorado, offers a zero energy option for all the homes it builds. To attract a wide range of potential homebuyers to its energy efficient homes, New Town Builders created a 'Power of Zero Energy Center' linked to its model home in the Stapleton community of Denver. This case study presents New Town Builders' marketing approach, which is targeted to appeal to homebuyers' emotions rather than overwhelming homebuyers with scientific details about the technology. The exhibits in the Power of Zero Energy Center focus on reduced energy expenses for themore » homeowner, improved occupant comfort, the reputation of the builder, and the lack of sacrificing the homebuyers' desired design features to achieve zero net energy in the home. The case study also contains customer and realtor testimonials related to the effectiveness of the Center in influencing homebuyers to purchase a zero energy home.« less

New Whole-House Solutions Case Study: New Town Builders' Power of Zero Energy Center - Denver, Colorado

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

None

New Town Builders, a builder of energy efficient homes in Denver, Colorado, offers a zero energy option for all the homes it builds. To attract a wide range of potential homebuyers to its energy efficient homes, New Town Builders created a "Power of Zero Energy Center" linked to its model home in the Stapleton community. This case study presents New Town Builders' marketing approach, which is targeted to appeal to homebuyers' emotions rather than overwhelming homebuyers with scientific details about the technology. The exhibits in the Power of Zero Energy Center focus on reduced energy expenses for the homeowner, improvedmore » occupant comfort, the reputation of the builder, and the lack of sacrificing the homebuyers' desired design features to achieve zero net energy in the home. This case study also contains customer and realtor testimonials related to the effectiveness of the Center in influencing homebuyers to purchase a zero energy home.« less

Towards a Unified Testing Framework for Single-Sided Deafness Studies: A Consensus Paper

PubMed Central

Van de Heyning, Paul; Távora-Vieira, Dayse; Mertens, Griet; Van Rompaey, Vincent; Rajan, Gunesh P.; Müller, Joachim; Hempel, John Martin; Leander, Daniel; Polterauer, Daniel; Marx, Mathieu; Usami, Shin-ichi; Kitoh, Ryosuke; Miyagawa, Maiko; Moteki, Hideaki; Smilsky, Kari; Baumgartner, Wolf-Dieter; Keintzel, Thomas Georg; Sprinzl, Georg Mathias; Wolf-Magele, Astrid; Arndt, Susan; Wesarg, Thomas; Zirn, Stefan; Baumann, Uwe; Weissgerber, Tobias; Rader, Tobias; Hagen, Rudolf; Kurz, Anja; Rak, Kristen; Stokroos, Robert; George, Erwin; Polo, Ruben; Medina, María del Mar; Henkin, Yael; Hilly, Ohad; Ulanovski, David; Rajeswaran, Ranjith; Kameswaran, Mohan; Di Gregorio, Maria Fernanda; Zernotti, Mario E.

2017-01-01

Background While hearing aids for a contralateral routing of signals (CROS-HA) and bone conduction devices have been the traditional treatment for single-sided deafness (SSD) and asymmetric hearing loss (AHL), in recent years, cochlear implants (CIs) have increasingly become a viable treatment choice, particularly in countries where regulatory approval and reimbursement schemes are in place. Part of the reason for this shift is that the CI is the only device capable of restoring bilateral input to the auditory system and hence of possibly reinstating binaural hearing. Although several studies have independently shown that the CI is a safe and effective treatment for SSD and AHL, clinical outcome measures in those studies and across CI centers vary greatly. Only with a consistent use of defined and agreed-upon outcome measures across centers can high-level evidence be generated to assess the safety and efficacy of CIs and alternative treatments in recipients with SSD and AHL. Methods This paper presents a comparative study design and minimum outcome measures for the assessment of current treatment options in patients with SSD/AHL. The protocol was developed, discussed, and eventually agreed upon by expert panels that convened at the 2015 APSCI conference in Beijing, China, and at the CI 2016 conference in Toronto, Canada. Results A longitudinal study design comparing CROS-HA, BCD, and CI treatments is proposed. The recommended outcome measures include (1) speech in noise testing, using the same set of 3 spatial configurations to compare binaural benefits such as summation, squelch, and head shadow across devices; (2) localization testing, using stimuli that rove in both level and spectral content; (3) questionnaires to collect quality of life measures and the frequency of device use; and (4) questionnaires for assessing the impact of tinnitus before and after treatment, if applicable. Conclusion A protocol for the assessment of treatment options and outcomes in recipients with SSD and AHL is presented. The proposed set of minimum outcome measures aims at harmonizing assessment methods across centers and thus at generating a growing body of high-level evidence for those treatment options. PMID:28319951

Hinterbrand Lodge Outdoor Education Center. Program Information.

ERIC Educational Resources Information Center

Dependents Schools (DOD), Washington, DC. European Area.

Describing Department of Defense Dependents Schools Europe (DODDSEUR) use of Hinterbrand Lodge Outdoor Education Center, this document is directed to sponsors wishing to take groups to Hinterbrand for one or more of the five program options (outdoor education week, teacher weekend, school-designed outdoor education program, administrative faculty…

Options for Sustaining School-Based Health Centers

ERIC Educational Resources Information Center

Swider, Susan M.; Valukas, Amy

2004-01-01

Several methods exist for financing and sustaining operations of school-based health centers (SBHCs). Promising sources of funds include private grants, federal grants, and state funding. Recently, federal regulation changes mandated that federal funding specifically for SBHCs go only to SBHCs affiliated with a Federally Qualified Health Center…

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false State plan UR requirements and options; UR plan required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control:...

42 CFR 456.401 - State plan UR requirements and options; UR plan required for intermediate care facility services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false State plan UR requirements and options; UR plan required for intermediate care facility services. 456.401 Section 456.401 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control:...

NOHIMS (Naval Occupational Health Information Management System) Users’ Guide: Introduction and OHS (Occupational Health System) Options.

DTIC Science & Technology

1984-06-26

irred. 2’. 4’.. Nava Het esarch CenterU 0i P. 0. Bx 8512 San iego Caiforia 2138917 P. W. SUMMARY The Naval Occupational Health information Management System (WHIMS...Introduction and OHS Options I. INTRODUCTION TO THE NAVY OCCUPATIONAL HEALTH INFORMATION MANAGEMENT SYSTEM (NOHIMS) The objective of NOHIMS is to provide an

Desire to Have Children Among Transgender People in Germany: A Cross-Sectional Multi-Center Study.

PubMed

Auer, Matthias K; Fuss, Johannes; Nieder, Timo O; Briken, Peer; Biedermann, Sarah V; Stalla, Günter K; Beckmann, Matthias W; Hildebrandt, Thomas

2018-05-01

Many trans individuals undergo medical interventions that result in irreversible loss of fertility. Little is known about their desire to have children and attitudes toward fertility preservation options. To study how the desire for children and the use of fertility preservation options varies among trans women and trans men in different transitioning stages in Germany. In this cross-sectional multi-center study, N = 99 trans women and N = 90 trans men were included. Of these, 26 of each sex were just about to start medical treatment. Outcome parameter were the prevalence and determinants of a desire to have children in trans persons. Before treatment, a desire for children was significantly higher in trans men compared to trans women (P = .016). In contrast, in those who had already started treatment, a current desire to have children was equally present in about one fourth of participants of both genders while the interest in having children in the future was significantly higher in trans women (69.9%) than in trans men (46.9%; P = .034). Although 76.1% of trans women and 76.6% of trans men indicated that they had at least thought about preserving germ cells before starting medical transition, only 9.6% of trans women and 3.1% of trans men had put this idea into practice. Most trans men in both groups indicated that insemination of a female partner with sperm from an unrelated donor was a suitable option to fulfill their child wish, potentially explaining their low interest in preserving their own germ cells. Finally, a logistic regression analysis accounting for potential confounders revealed that overall trans women were more than twice as likely to have a current desire to have children (odds ratio 2.58), and this wish was on average 5.3% lower with each year of increasing age. A low level of fertility preservation among trans persons is contrasted by a high level of desire for children. This highlights the importance of counseling trans individuals regarding fertility preservation options. To our knowledge, this is the first study that addresses desire to have children in a clinical sample of trans women. It is also the first that investigates this issue among trans men who have not started medical treatment, and the first comparison of both genders. A limitation for the generalization of our results is the special legal context in Germany that forbids oocyte donation for reciprocal in vitro fertilization. Reproductive desire is high among trans individuals, but the use of reproductive options is surprisingly low. Auer MK, Fuss J, Nieder TO, et al. Desire to Have Children Among Transgender People in Germany: A Cross-Sectional Multi-Center Study. J Sex Med 2018;15:757-767. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Lunar Transportation Facilities and Operations Study, option 2

NASA Technical Reports Server (NTRS)

1992-01-01

During the Option 2 period of the Lunar Transportation Facilities and Operations Study (LTFOS), a joint McDonnell Douglas Space Systems Company Kennedy Space Center (MDSSC-KSC) and National Aeronautics and Space Administration Kennedy Space Center (NASA-KSC) Study team conducted a comparison of the functional testing of the RL-10 and Space Shuttle Main Engine, a quick-look impact assessment of the Synthesis Group Report, and a detailed assessment of the Synthesis Group Report. The results of these KSC LTFOS team efforts are included. The most recent study task effort was a detailed assessment of the Synthesis Group Report. The assessment was conducted to determine the impact on planetary launch and landing facilities and operations. The result of that effort is a report entitled 'Analysis of the Synthesis Group Report, its Architectures and their Impacts on PSS Launch and Landing Operations' and is contained in Appendix A. The report is structured in a briefing format with facing pages as opposed to a narrative style. A quick-look assessment of the Synthesis Group Report was conducted to determine the impact of implementing the recommendations of the Synthesis Group on KSC launch facilities and operations. The data was documented in a presentation format as requested by Kennedy Space Center Technology and Advanced Projects Office and is included in Appendix B. Appendix C is a white paper on the comparison of the functional testing of the RL-10 and Space Shuttle Main Engine. The comparison was undertaken to provide insight regarding common test requirements that would be applicable to Lunar and Mars Excursion Vehicles (LEV and MEV).

Gray Infrastructure Tool | EPA Center for Exposure ...

EPA Pesticide Factsheets

2016-03-07

Natural channel with flood plain panel added Default depth increment of 0.5 is used for Natural Channel with FP Units option added – SI or US units. Default option is US units Conversion options added wherever necessary Additional options added to FTABLE such as clear FTABLE Significant digits for FTABLE calculations is changed to 4 Previously a default Cd value is used for calculations (under-drain and riser) but now a user defined value is used Default values of Cd for riser orifice and under-drain textboxes is changed to 0.6 Previously a default increment value of 0.1 is used for all the channel panels but now user can specify the increment

Shuttle-Derived Launch Vehicles' Capablities: An Overview

NASA Technical Reports Server (NTRS)

Rothschild, William J.; Bailey, Debra A.; Henderson, Edward M.; Crumbly, Chris

2005-01-01

Shuttle-Derived Launch Vehicle (SDLV) concepts have been developed by a collaborative team comprising the Johnson Space Center, Marshall Space Flight Center, Kennedy Space Center, ATK-Thiokol, Lockheed Martin Space Systems Company, The Boeing Company, and United Space Alliance. The purpose of this study was to provide timely information on a full spectrum of low-risk, cost-effective options for STS-Derived Launch Vehicle concepts to support the definition of crew and cargo launch requirements for the Space Exploration Vision. Since the SDLV options use high-reliability hardware, existing facilities, and proven processes, they can provide relatively low-risk capabilities to launch extremely large payloads to low Earth orbit. This capability to reliably lift very large, high-dollar-value payloads could reduce mission operational risks by minimizing the number of complex on-orbit operations compared to architectures based on multiple smaller launchers. The SDLV options also offer several logical spiral development paths for larger exploration payloads. All of these development paths make practical and cost-effective use of existing Space Shuttle Program (SSP) hardware, infrastructure, and launch and flight operations systems. By utilizing these existing assets, the SDLV project could support the safe and orderly transition of the current SSP through the planned end of life in 2010. The SDLV concept definition work during 2004 focused on three main configuration alternatives: a side-mount heavy lifter (approximately 77 MT payload), an in-line medium lifter (approximately 22 MT Crew Exploration Vehicle payload), and an in-line heavy lifter (greater than 100 MT payload). This paper provides an overview of the configuration, performance capabilities, reliability estimates, concept of operations, and development plans for each of the various SDLV alternatives. While development, production, and operations costs have been estimated for each of the SDLV configuration alternatives, these proprietary data have not been included in this paper.

Architectural Options for a Future Deep Space Optical Communications Network

NASA Technical Reports Server (NTRS)

Edwards, B. L.; Benjamin, T.; Scozzafava, J.; Khatri, F.; Sharma, J.; Parvin, B.; Liebrecht, P. E.; Fitzgerald, R. J.

2004-01-01

This paper provides an overview of different options at Earth to provide Deep Space optical communication services. It is based mainly on work done for the Mars Laser Communications Demonstration (MLCD) Project, a joint project between NASA's Goddard Space Flight Center (GSFC), the Jet Propulsion Laboratory, California Institute of Technology (JPL), and the Massachusetts Institute of Technology Lincoln Laboratory (MIT/LL). It also reports preliminary conclusions from the Tracking and Data Relay Satellite System Continuation Study at GSFC. A lasercom flight terminal will be flown on the Mars Telecommunications Orbiter (MTO) to be launched by NASA in 2009, and will be the first high rate deep space demonstration of this revolutionary technology.

Stafford Technical Center: Designing a Future for Architects and Builders

ERIC Educational Resources Information Center

Lucci, William, Jr.

2005-01-01

In this article, the author describes Stafford Technical Center's Engineering Technology Academy (ETA), in which students pursue a variety of educational and career options for anything connected to construction technologies--including drafting and design, architecture, and even work in historic preservation. In addition to technical skills,…

Evaluation Options for Family Resource Centers.

ERIC Educational Resources Information Center

Horsch, Karen, Ed.; Weiss, Heather B., Ed.

Family resource centers (FRC) are emerging as a promising program approach to solving urgent social problems. Evaluation plays an important role in learning how these programs work, what their impact is, and whether they should be expanded. However, FRCs pose unique challenges to evaluation. This report considers the challenges to evaluating FRCs,…

SLF Run/Walk for Safety and Health Month

NASA Image and Video Library

2018-03-13

Kennedy Space Center Director Bob Cabana speaks to center employees and guests before the KSC Walk Run on the Shuttle Landing Facility runway. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options in the spirit of friendly competition.

45 CFR 1306.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... option means Head Start services provided to children in both a center setting and through intensive work... the meeting held at the Head Start center between the child's teacher and the child's parents during... 45 Public Welfare 4 2013-10-01 2013-10-01 false Definitions. 1306.3 Section 1306.3 Public Welfare...

45 CFR 1306.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... option means Head Start services provided to children in both a center setting and through intensive work... the meeting held at the Head Start center between the child's teacher and the child's parents during... 45 Public Welfare 4 2014-10-01 2014-10-01 false Definitions. 1306.3 Section 1306.3 Public Welfare...

45 CFR 1306.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... option means Head Start services provided to children in both a center setting and through intensive work... the meeting held at the Head Start center between the child's teacher and the child's parents during... 45 Public Welfare 4 2012-10-01 2012-10-01 false Definitions. 1306.3 Section 1306.3 Public Welfare...

Differences between General and Talented Students' Perceptions of Their Career and Technical Education Experiences Compared to Their Traditional High School Experiences

ERIC Educational Resources Information Center

Gentry, Marcia; Peters, Scott J.; Mann, Rebecca L.

2007-01-01

Career and technical education represents an important and understudied educational option for high school students. This qualitative study utilized data from one exemplary career and technical education (CTE) center to address the question of how talented and general education students' part-time CTE experiences differed from their traditional…

What People Want, Why They Move, and What Happens After They Move: A Summary of Research in Retirement Housing.

ERIC Educational Resources Information Center

Parr, Joyce; And Others

This document presents an overview of research in retirement housing which focuses on studying individuals' adaptation to retirement housing, consulting on the design of retirement housing, and conducting community surveys to assess the interest in living options for older persons. The terms congregate housing, continuing care retirement centers,…

Shared decision making in the management of children with newly diagnosed immune thrombocytopenia.

PubMed

Beck, Carolyn E; Boydell, Katherine M; Stasiulis, Elaine; Blanchette, Victor S; Llewellyn-Thomas, Hilary; Birken, Catherine S; Breakey, Vicky R; Parkin, Patricia C

2014-10-01

This study aimed to examine the treatment decision-making process for children hospitalized with newly diagnosed immune thrombocytopenia (ITP). Using focus groups, we studied children with ITP, parents of children with ITP, and health care professionals, inquiring about participants' experience with decision support and decision making in newly diagnosed ITP. Data were examined using thematic analysis. Themes that emerged from children were feelings of "anxiety, fear, and confusion"; the need to "understand information"; and "treatment choice," the experience of which was age dependent. For parents, "anxiety, fear, and confusion" was a dominant theme; "treatment choice" revealed that participants felt directed toward intravenous immune globulin (IVIG) for initial treatment. For health care professionals, "comfort level" highlighted factors contributing to professionals' comfort with offering options; "assumptions" were made about parental desire for participation in shared decision making (SDM) and parental acceptance of treatment options; "providing information" was informative regarding modes of facilitating SDM; and "treatment choice" revealed a discrepancy between current practice (directed toward IVIG) and the ideal of SDM. At our center, families of children with newly diagnosed ITP are not experiencing SDM. Our findings support the implementation of SDM to facilitate patient-centered care for the management of pediatric ITP.

A prospective cohort study of treatment decision-making for prostate cancer following participation in a multidisciplinary clinic.

PubMed

Hurwitz, Lauren M; Cullen, Jennifer; Elsamanoudi, Sally; Kim, Daniel J; Hudak, Jane; Colston, Maryellen; Travis, Judith; Kuo, Huai-Ching; Porter, Christopher R; Rosner, Inger L

2016-05-01

Patients diagnosed with prostate cancer (PCa) are presented with several treatment options of similar efficacy but varying side effects. Understanding how and why patients make their treatment decisions, as well as the effect of treatment choice on long-term outcomes, is critical to ensuring effective, patient-centered care. This study examined treatment decision-making in a racially diverse, equal-access, contemporary cohort of patients with PCa counseled on treatment options at a multidisciplinary clinic. A prospective cohort study was initiated at the Walter Reed National Military Medical Center (formerly Walter Reed Army Medical Center) in 2006. Newly diagnosed patients with PCa were enrolled before attending a multidisciplinary clinic. Patients completed surveys preclinic and postclinic to assess treatment preferences, reasons for treatment choice, and decisional regret. As of January 2014, 925 patients with PCa enrolled in this study. Surgery (54%), external radiation (20%), and active surveillance (12%) were the most common primary treatments for patients with low- and intermediate-risk PCa, whereas patients with high-risk PCa chose surgery (34%) or external radiation with neoadjuvant hormones (57%). Treatment choice differed by age at diagnosis, race, comorbidity status, and calendar year in both univariable and multivariable analyses. Patients preferred to play an active role in the decision-making process and cited doctors at the clinic as the most helpful source of treatment-related information. Almost all patients reported satisfaction with their decision. This is one of the first prospective cohort studies to examine treatment decision-making in an equal-access, multidisciplinary clinic setting. Studies of this cohort would aid in understanding and improving the PCa decision-making process. Published by Elsevier Inc.

Women's preferences regarding infant or maternal antiretroviral prophylaxis for prevention of mother-to-child transmission of HIV during breastfeeding and their views on Option B+ in Dar es Salaam, Tanzania.

PubMed

Ngarina, Matilda; Tarimo, Edith A M; Naburi, Helga; Kilewo, Charles; Mwanyika-Sando, Mary; Chalamilla, Guerino; Biberfeld, Gunnel; Ekstrom, Anna Mia

2014-01-01

The WHO 2010 guidelines for prevention of mother-to-child transmission (PMTCT) of HIV recommended prophylactic antiretroviral treatment (ART) either for infants (Option A) or mothers (Option B) during breastfeeding for pregnant women with a CD4 count of >350 cell/µL in low-income countries. In 2012, WHO proposed that all HIV-infected pregnant women should receive triple ART for life (B+) irrespective of CD4 count. Tanzania has recently switched from Option A to B+, with a few centers practicing B. However, more information on the real-life feasibility of these options is needed. This qualitative study explored women's preferences for Option A vs B and their views on Option B+ in Dar es Salaam, Tanzania. We conducted four focus group discussions with a total of 27 pregnant women with unknown HIV status, attending reproductive and child health clinics, and 31 in-depth interviews among HIV-infected pregnant and post-delivery women, 17 of whom were also asked about B+. Most participants were in favor of Option B compared to A. The main reasons for choosing Option B were: HIV-associated stigma, fear of drug side-effects on infants and difficult logistics for postnatal drug adherence. Some of the women asked about B+ favored it as they agreed that they would eventually need ART for their own survival. Some were against B+ anticipating loss of motivation after protecting the child, fearing drug side-effects and not feeling ready to embark on lifelong medication. Some were undecided. Option B was preferred. Since Tanzania has recently adopted Option B+, women with CD4 counts of >350 cell/µL should be counseled about the possibility to "opt-out" from ART after cessation of breastfeeding. Drug safety and benefits, economic concerns and available resources for laboratory monitoring and evaluation should be addressed during B+ implementation to enhance long-term feasibility and effectiveness.

Development of Less Toxic Treatment Strategies for Metastatic and Drug-Resistant Breast Cancer Using Noninvasive Optical Monitoring

DTIC Science & Technology

2017-09-01

models has been evaluated, with one good option, the Py230 cell lines, as our choice for use in future studies . We have conducted the first study ... Study of Progressive Resistance Major Task 6: dDOS fabrication Subtask 15: Design /Fabricate dDOS system and new custom dDOS probe 6-24 Dr...until year 3 of the study , based on current accrual trends with our clinical collaborators at the Boston Medical Center for different projects, the

Impact of Healthy Vending Machine Options in a Large Community Health Organization.

PubMed

Grivois-Shah, Ravi; Gonzalez, Juan R; Khandekar, Shashank P; Howerter, Amy L; O'Connor, Patrick A; Edwards, Barbara A

2017-01-01

To determine whether increasing the proportion of healthier options in vending machines decreases the amount of calories, fat, sugar, and sodium vended, while maintaining total sales revenue. This study evaluated the impact of altering nutritious options to vending machines throughout the Banner Health organization by comparing vended items' sales and nutrition information over 6 months compared to the same 6 months of the previous year. Twenty-three locations including corporate and patient-care centers. Changing vending machine composition toward more nutritious options. Comparisons of monthly aggregates of sales, units vended, calories, fat, sodium, and sugar vended by site. A pre-post analysis using paired t tests comparing 6 months before implementation to the equivalent 6 months postimplementation. Significant average monthly decreases were seen for calories (16.7%, P = .002), fat (27.4%, P ≤ .0001), sodium (25.9%, P ≤ .0001), and sugar (11.8%, P = .045) vended from 2014 to 2015. Changes in revenue and units vended did not change from 2014 to 2015 ( P = .58 and P = .45, respectively). Increasing the proportion of healthier options in vending machines from 20% to 80% significantly lowered the amount of calories, sodium, fat, and sugar vended, while not reducing units vended or having a negative financial impact.

The Governance Divide: A Report on a Four-State Study on Improving College Readiness and Success. National Center Report #05-3

ERIC Educational Resources Information Center

Venezia, Andrea; Callan, Patrick M.; Finney, Joni E.; Kirst, Michael W.; Usdan, Michael D.

2005-01-01

This report, supported by case studies in Florida (ED508098), Georgia (ED508099), New York (ED508100), and Oregon (ED508101), identifies and examines policy options available to states that are interested in creating sustained K-16 reform. The findings move the K-16 agenda forward by proposing a set of state policy levers that can be used to…

The afterlife for retiring deans and other senior medical administrators.

PubMed

Tannen, Richard L

2008-11-01

Career options for individuals leaving the administrative role as dean of a school of medicine or other senior administrative positions are considered. Options discussed include retirement and a variety of other positions both within schools of medicines and in other venues. Many opportunities exist for a challenging and fulfilling career path after leaving the role as a senior administrator in an academic medical center.

Psychosocial factors and therapeutic approaches in the context of sexual history taking in men: a study conducted among Swiss general practitioners and urologists.

PubMed

Platano, Giacomo; Margraf, Jürgen; Alder, Judith; Bitzer, Johannes

2008-11-01

Male sexual dysfunction is a common medical condition, which is addressed mainly from a biomedical perspective by Swiss general practitioners (GPs) and urologists as the results of part I of our study showed. A psychosocial orientation in sexual history taking (SHT) leads to a truly patient-centered approach and is crucial for improving therapy decisions related to sexual dysfunction. To analyze to what extent Swiss GPs and urologists have a psychosocial orientation in SHT, and what therapeutic options they focus on when confronted with male sexual dysfunction. A semistructured interview was developed and used in face-to-face encounters with 25 GPs and 25 urologists. Content and frequency of interview responses. The GPs and urologists differed significantly from each other in 5 out of 22 psychosocial factors. Summarizing these psychosocial factors in four domains showed a difference between the GPs and urologists in only one domain. Both groups focus on an open conversation as their approach in SHT. No GP and only a minority of urologists based their diagnosis on criteria of the International Classification of Diseases (10th edition) (ICD-10) or Diagnostic and Statistical Manual of Mental Disorders (4th edition) (DSM-IV). The GPs and urologists differed significantly from each other in 4 out of 16 combinations resulting from the given therapeutic options and form of sexual dysfunction. The urologists focus more strongly on medication as a therapeutic option. The results of part II additionally justify establishing guidelines and training resources related to SHT in Switzerland. Swiss physicians should be encouraged to apply a more psychosocial orientation in SHT. This will contribute to a better patient-centered approach with positive consequences on physicians' therapeutic decisions. Optimizing the approach in SHT and the choice of therapeutic options may better facilitate real sexual satisfaction for the patient and ultimately result in fewer health insurance costs.

Is acupuncture an acceptable option in stroke rehabilitation? A survey of stroke patients.

PubMed

Yam, Winnie; Wilkinson, Jenny M

2010-01-01

Stroke is a leading cause of morbidity and mortality and stroke survivors make up the largest group of patients in rehabilitation. These individuals also have one of the longest lengths of stay in rehabilitation. It has been suggested that acupuncture may be beneficial in post-stroke rehabilitation and in this study we examine how stroke patients value acupuncture and their perceptions of acupuncture as a rehabilitation treatment option. A questionnaire was distributed to individuals undergoing post-stroke rehabilitation at three rehabilitation centers attached to hospitals in Toronto, Canada. Two hundred and seventy-three individuals completed the questionnaire with the respondent group comprising mainly males (62%) over 65 years of age (68%). Overall 29% had used acupuncture with 16% receiving acupuncture treatment for stroke related conditions. Almost all respondents (98%) wanted to know more about acupuncture in stroke rehabilitation and 87% would consider acupuncture as a treatment option. Few (8%) reported that they had advanced level knowledge about acupuncture, with most reporting a basic (48%) or intermediate (33%) level which recognized that acupuncture used fine needles to produce a therapeutic response. Those with prior acupuncture experience expected to pay more for treatment. The main factors influencing decisions to use acupuncture were practitioner competency (84%), cost (65%) and sterilization concerns (40%). This study demonstrates that there is willingness by patients attending conventional hospital-based rehabilitation centers to consider acupuncture in stroke rehabilitation and that lack of knowledge about this treatment is not a barrier to use. Copyright 2010 Elsevier Ltd. All rights reserved.

NASA Research Center Contributions to Space Shuttle Return to Flight (SSRTF)

NASA Technical Reports Server (NTRS)

Cockrell, Charles E., Jr.; Barnes, Robert S.; Belvin, Harry L.; Allmen, John; Otero, Angel

2005-01-01

Contributions provided by the NASA Research Centers to key Space Shuttle return-to-flight milestones, with an emphasis on debris and Thermal Protection System (TPS) damage characterization, are described herein. Several CAIB recommendations and Space Shuttle Program directives deal with the mitigation of external tank foam insulation as a debris source, including material characterization as well as potential design changes, and an understanding of Orbiter TPS material characteristics, damage scenarios, and repair options. Ames, Glenn, and Langley Research Centers have performed analytic studies, conducted experimental testing, and developed new technologies, analysis tools, and hardware to contribute to each of these recommendations. For the External Tank (ET), these include studies of spray-on foam insulation (SOFI), investigations of potential design changes, and applications of advanced non-destructive evaluation (NDE) technologies to understand ET TPS shedding during liftoff and ascent. The end-to-end debris assessment included transport analysis to determine the probabilities of impact for various debris sources. For the Orbiter, methods were developed, and validated through experimental testing, to determine thresholds for potential damage of Orbiter TPS components. Analysis tools were developed and validated for on-orbit TPS damage assessments, especially in the area of aerothermal environments. Advanced NDE technologies were also applied to the Orbiter TPS components, including sensor technologies to detect wing leading edge impacts during liftoff and ascent. Work is continuing to develop certified TPS repair options and to develop improved methodologies for reinforced carbon-carbon (RCC) damage progression to assist in on-orbit repair decision philosophy.

Marking 15 years of the Genetic and Rare Diseases Information Center

PubMed Central

Lewis, Janine; Snyder, Michelle; Hyatt-Knorr, Henrietta

2017-01-01

BACKGROUND: The Genetic and Rare Diseases Information Center (GARD), a program of the National Center for Advancing Translational Sciences, was established in 2002 to assist the public in finding reliable, timely, and easy-to-understand information about genetic and/or rare diseases in English or Spanish. OBJECTIVE: A review of longitudinal data on GARD inquiries from 2002 to 2016 and assessment of the results of two user satisfaction surveys were conducted to understand the demographics and needs of GARD customers over time. METHODS: Since 2002, GARD has collected anonymized data while responding to questions received via e-mail, website, telephone, fax, letter, or TTY. Between 2002 and 2016 GARD received a total of 60,106 inquiries. User satisfaction surveys were conducted in 2006 and 2014, in which users self-selected to participate. RESULTS: The annual number of inquiries has risen steadily since 2002. Inquiries are overwhelmingly from educated female patients, family, and friends seeking disease-specific information, treatment options, referrals, and research studies. Most users report satisfaction with the experience. CONCLUSIONS: Rare disease patients and their families face challenges in finding information about their symptoms or diagnosis, prognosis, treatment options, significance for family members, and research opportunities. Lack of available clinical expertise can leave patients, their family, and friends with little choice but to become knowledgeable on their own. GARD fills a critical need by providing the public with vetted, evidence-based information that empowers people to engage in their own health care and seek research studies of relevance. PMID:29152459

Current Therapeutic Options for Esophageal Motor Disorders as Defined by the Chicago Classification.

PubMed

Zerbib, Frank; Roman, Sabine

2015-07-01

With the development of high-resolution manometry and specific metrics to characterize esophageal motility, the Chicago Classification has become the gold standard for the diagnosis of esophageal motor disorders. Major and significant disorders, that is, never observed in healthy subjects, are achalasia, esophagogastric junction outflow obstruction, distal esophageal spasm, absent peristalsis, and hypercontractile (Jackhammer) esophagus. Achalasia subtyping is relevant to predict the response to endoscopic and surgical therapies as several studies suggest that, pneumatic dilation is less effective than Heller myotomy, in type III achalasia. Peroral endoscopic myotomy, initially developed in expert centers, is a promising technique for the treatment of achalasia. The medical therapeutic options for distal esophageal spasm and hypercontractile esophagus are smooth muscle relaxants and pain modulators. Intraesophageal injection of botulinum toxin might be an interesting option for treatment of these disorders but further studies are required to determine the optimal injection protocol and the best candidates based on manometric patterns. The treatment of hypotensive motility disorders is disappointing and relies mainly on dietary and lifestyle changes as no effective esophageal prokinetic is currently available.

International Space Station (ISS) External Thermal Control System (ETCS) Loop A Pump Module (PM) Jettison Options Assessment

NASA Technical Reports Server (NTRS)

Murri, Daniel G.; Dwyer Cianciolo, Alicia; Shidner, Jeremy D.; Powell, Richard W.

2014-01-01

On December 11, 2013, the International Space Station (ISS) experienced a failure of the External Thermal Control System (ETCS) Loop A Pump Module (PM). To minimize the number of extravehicular activities (EVA) required to replace the PM, jettisoning the faulty pump was evaluated. The objective of this study was to independently evaluate the jettison options considered by the ISS Trajectory Operations Officer (TOPO) and to provide recommendations for safe jettison of the ETCS Loop A PM. The simulation selected to evaluate the TOPO options was the NASA Engineering and Safety Center's (NESC) version of Program to Optimize Simulated Trajectories II (POST2) developed to support another NESC assessment. The objective of the jettison analysis was twofold: (1) to independently verify TOPO posigrade and retrograde jettison results, and (2) to determine jettison guidelines based on additional sensitivity, trade study, and Monte Carlo (MC) analysis that would prevent PM recontact. Recontact in this study designates a propagated PM trajectory that comes within 500 m of the ISS propagated trajectory. An additional simulation using Systems Tool Kit (STK) was run for independent verification of the POST2 simulation results. Ultimately, the ISS Program removed the PM jettison option from consideration. However, prior to the Program decision, the retrograde jettison option remained part of the EVA contingency plan. The jettison analysis presented showed that, in addition to separation velocity/direction and the atmosphere conditions, the key variables in determining the time to recontact the ISS is highly dependent on the ballistic number (BN) difference between the object being jettisoned and the ISS.

Antelope Valley Community College District Education Center.

ERIC Educational Resources Information Center

Newmyer, Joe

An analysis is provided of a proposal to the Board of Governors of the California Community Colleges by the Antelope Valley Community College District (AVCCD) to develop an education center in Palmdale to accommodate rapid growth. First, pros and cons are discussed for the following major options: (1) increase utilization and/or expand the…

Energy Action Day

NASA Image and Video Library

2017-10-25

John Sherwin of the Florida Solar Energy Center in Cocoa speaks during the Energy Action Day employee event held in NASA Kennedy Space Center's Space Station Processing Facility. Part of Energy Awareness Month, the event featured subject matter experts in the area of solar energy, its connections to the space program and options for residential solar power.

Integrating Training in Family-Centered Practices in Context: Implications for Implementing Change Activities.

ERIC Educational Resources Information Center

Granlund, Mats; Bjorck-Akesson, Eva

2000-01-01

This article discusses in-service training of Swedish professionals in family-centered intervention for families with children with disabilities. The training, which has been implemented on an interdisciplinary team basis in the context of ordinary habilitation services, is described as one of several options for fostering improvement within an…

Incident Energy Focused Design and Validation for the Floating Potential Probe

NASA Technical Reports Server (NTRS)

Fincannon, James

2002-01-01

Utilizing the spacecraft shadowing and incident energy analysis capabilities of the NASA Glenn Research Center Power and Propulsion Office's SPACE System Power Analysis for Capability Evaluation) computer code, this paper documents the analyses for various International Space Station (ISS) Floating Potential Probe (EPP) preliminary design options. These options include various solar panel orientations and configurations as well as deployment locations on the ISS. The incident energy for the final selected option is characterized. A good correlation between the predicted data and on-orbit operational telemetry is demonstrated. Minor deviations are postulated to be induced by degradation or sensor drift.

Propulsion Technology Assessment: Science and Enabling Technologies to Explore the Interstellar Medium

NASA Technical Reports Server (NTRS)

Hopkins, Randall C.; Thomas, Herbert D.; Wiegmann, Bruce M.; Heaton, Andrew F.; Johnson, Les; Baysinger, Michael F.; Beers, Benjamin R.

2016-01-01

Led by the Keck Institute for Space Studies at the California Institute of Technology, the Advanced Concepts Office at NASA's George C. Marshall Space Flight Center conducted a study to assess what low-thrust advanced propulsion system candidates, existing and near term, could deliver a small, Voyager-like satellite to our solar system's heliopause, approximately 100 AU from the center of the sun, within 10 years and within a 2025-2035 launch window. The advanced propulsion system trade study consisted of three candidates, including a Magnetically Shielded Miniature (MaSMi) Hall thruster, a solar sail and an electric sail. Two aerial densities, and thus characteristic accelerations, 0.426 mm/sq s and 0.664 mm/sq s were analyzed for the solar sail option in order understand the impact of near and long term development of this technology. Similarly, two characteristic accelerations, 1 mm/s2 and 2 mm/sq s, were also analyzed for the electric sail option in addition to tether quantities of 10 and 20, respectively, and individual tether length of 20 km. A second analysis was conducted to determine what existing solid rocket motor kick stage(s) would be required to provide additional thrust at various points in the trajectory, assuming an earth departure characteristic energy capability provided by a Space Launch System (SLS) Block 1B vehicle architecture carrying an 8.4 meter payload fairing. Two trajectory profiles were considered, including an escape trajectory using a Jupiter gravity assist (E-Ju), and an escape trajectory first performing a Jupiter gravity assist followed by an Oberth maneuver around the sun and an optional Saturn gravity assist (E-Ju-Su-Sa). The Oberth maneuver would need to be performed very close to the sun, wherein this study assumed a perihelion distance of approximately 11 solar radii, or 0.05 AU, away from the surface. The heat shield technology required to perform this type of ambitious maneuver was assumed to be similar to that of NASA's Solar Probe Plus mission, which is slated to launch in July 2018. With respect to a SLS Block 1B earth departure characteristic energy capability of 100 km2/sq s for the E-Ju trajectory option, results indicated that compared to having no advanced propulsion system onboard, both the MaSMi Hall thruster and solar sail options subtract approximately 8 to 10 years from the total trip time while the electric sail outperforms all options by subtracting up to 20 years. With respect to an average kick stage velocity capability of 2.5 to 3.5 km/s at perihelion, the most sensitive segment of the E-Ju-Su-Sa trajectory option, results indicated that both the MaSMi Hall thrust and solar sail options only subtract 1 to 3 years from the total trip time whereas the electric sail again outperforms all other options by subtracting up to 5 years. In other words, if the Technology Readiness Level of an electric sail could be increased in time, this propulsion technology could not only enable a satellite to reach 100 AU in 10 years but it could potentially do so even faster. Completing such an ambitious mission in that short of a timespan would be very attractive to many as it would be well within the average career span of any of those involved.

Propulsion Technology Assessment: Science and Enabling Technologies to Explore the Interstellar Medium

NASA Technical Reports Server (NTRS)

Hopkins, Randall C.; Thomas, Herbert D.; Wiegmann, Bruce M.; Heaton, Andrew F.; Johnson, Les; Baysinger, Michael F.; Beers, Benjamin R.

2016-01-01

As part of a larger effort led by the Keck Institute for Space Studies at the California Institute of Technology, the Advanced Concepts Office at NASA’s George C. Marshall Space Flight Center conducted a study to assess what low-thrust advanced propulsion system candidates, existing and near term, could deliver a small, Voyager-like satellite to our solar system’s heliopause, approximately 100 AU from the center of the sun, within 10 years and within a 2025 to 2035 launch window. The advanced propulsion system trade study consisted of three candidates, including a Magnetically Shielded Miniature (MaSMi) Hall thruster, a solar sail and an electric sail. Two aerial densities, and thus characteristic accelerations, 0.426 mm/s(exp 2) and 0.664 mm/s(exp 2), were analyzed for the solar sail option in order understand the impact of near and long term development of this technology. Similarly, two characteristic accelerations, 1 mm/s(exp 2) and 2 mm/s(exp 2), were also analyzed for the electric sail option in addition to tether quantities of 10 and 20, respectively, and individual tether length of 20 km. A second analysis was conducted to determine what existing solid rocket motor kick stage(s) would be required to provide additional thrust at various points in the trajectory, assuming an earth departure characteristic energy capability provided by a Space Launch System (SLS) Block 1B vehicle architecture carrying an 8.4 meter payload fairing. Two trajectory profiles were considered, including an escape trajectory using a Jupiter gravity assist (E-Ju), and an escape trajectory first performing a Jupiter gravity assist followed by an Oberth maneuver around the sun and an optional Saturn gravity assist (E-Ju-Su-Sa). The Oberth maneuver would need to be performed very close to the sun, wherein this study assumed a perihelion distance of approximately 11 solar radii, or 0.05 AU, away from the surface. The heat shield technology required to perform this type of ambitious maneuver was assumed to be similar to that of NASA’s Solar Probe Plus mission, which is slated to launch in July 2018. With respect to a SLS Block 1B earth departure characteristic energy capability of 100 km(exp 2)/s(exp 2) for the E-Ju trajectory option, results indicated that compared to having no advanced propulsion system onboard, both the MaSMi Hall thruster and solar sail options subtract approximately 8 to 10 years from the total trip time while the electric sail outperforms all options by subtracting up to 20 years. With respect to an average kick stage velocity capability of 2.5 to 3.5 km/s at perihelion, the most sensitive segment of the E-Ju-Su-Sa trajectory option, results indicated that both the MaSMi Hall thrust and solar sail options only subtract 1 to 3 years from the total trip time whereas the electric sail again outperforms all other options by subtracting up to 5 years. In other words, if the Technology Readiness Level of an electric sail could be increased in time, this propulsion technology could not only enable a satellite to reach 100 AU in 10 years but it could potentially do so even faster. Completing such an ambitious mission in that short of a timespan would be very attractive to many as it would be well within the average career span of any of those involved.

Propulsion Technology Assessment: Science & Enabling Technologies to Explore the Interstellar Medium

NASA Technical Reports Server (NTRS)

Hopkins, Randall C.; Thomas, Herbert D.; Wiegmann, Bruce M.; Heaton, Andrew F.; Johnson, Les; Baysinger, Michael F.; Beers, Benjamin R.

2015-01-01

As part of a larger effort led by the Keck Institute for Space Studies at the California Institute of Technology, the Advanced Concepts Office at NASA's George C. Marshall Space Flight Center conducted a study to assess what low-thrust advanced propulsion system candidates, existing and near term, could deliver a small, Voyager-like satellite to our solar system's heliopause, approximately 100 AU from the center of the sun, within 10 years and within a 2025 to 2035 launch window. The advanced propulsion system trade study consisted of three candidates, including a Magnetically Shielded Miniature (MaSMi) Hall thruster, a solar sail and an electric sail. Two aerial densities, and thus characteristic accelerations, 0.426 mm/s2 and 0.664 mm/s2, were analyzed for the solar sail option in order understand the impact of near and long term development of this technology. Similarly, two characteristic accelerations, 1 mm/s2 and 2 mm/s2, were also analyzed for the electric sail option in addition to tether quantities of 10 and 20, respectively, and individual tether length of 20 km. A second analysis was conducted to determine what existing solid rocket motor kick stage(s) would be required to provide additional thrust at various points in the trajectory, assuming an earth departure characteristic energy capability provided by a Space Launch System (SLS) Block 1B vehicle architecture carrying an 8.4 meter payload fairing. Two trajectory profiles were considered, including an escape trajectory using a Jupiter gravity assist (E-Ju), and an escape trajectory first performing a Jupiter gravity assist followed by an Oberth maneuver around the sun and an optional Saturn gravity assist (E-Ju-Su-Sa). The Oberth maneuver would need to be performed very close to the sun, wherein this study assumed a perihelion distance of approximately 11 solar radii, or 0.05 AU, away from the surface. The heat shield technology required to perform this type of ambitious maneuver was assumed to be similar to that of NASA's Solar Probe Plus mission, which is slated to launch in July 2018. With respect to a SLS Block 1B earth departure characteristic energy capability of 100 sq km/s2 for the E-Ju trajectory option, results indicated that compared to having no advanced propulsion system onboard, both the MaSMi Hall thruster and solar sail options subtract approximately 8 to 10 years from the total trip time while the electric sail outperforms all options by subtracting up to 20 years. With respect to an average kick stage velocity capability of 2.5 to 3.5 km/s at perihelion, the most sensitive segment of the E-Ju-Su-Sa trajectory option, results indicated that both the MaSMi Hall thrust and solar sail options only subtract 1 to 3 years from the total trip time whereas the electric sail again outperforms all other options by subtracting up to 5 years. In other words, if the Technology Readiness Level of an electric sail could be increased in time, this propulsion technology could not only enable a satellite to reach 100 AU in 10 years but it could potentially do so even faster. Completing such an ambitious mission in that short of a timespan would be very attractive to many as it would be well within the average career span of any of those involved.

Main drive selection for the Windstorm Simulation Center

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

Lacy, J.M.; Earl, J.S.

1998-02-01

Operated by the Partnership for Natural Disaster Reduction, the Windstorm Simulation Center (WSC) will be a structural test center dedicated to studying the performance of civil structural systems subjected to hurricanes, tornadoes, and other storm winds. Within the WSC, a bank of high-power fans, the main drive, will produce the high velocity wind necessary to reproduce these storms. Several options are available for the main drive, each with advantages and liabilities. This report documents a study to identify and evaluate all candidates available, and to select the most promising system such that the best possible combination of real-world performance attributesmore » is achieved at the best value. Four broad classes of candidate were identified: electric motors, turbofan aircraft engines, turboshaft aircraft engines, and turboshaft industrial engines. Candidate systems were evaluated on a basis of technical feasibility, availability, power, installed cost, and operating cost.« less

University of Texas M.D. Anderson Cancer Center

MedlinePlus

... Clinical Trials Cancer Genomics Laboratory Cancer Prevention and ... Shot is revolutionizing the conventional medical research approach to rapidly translate findings into patient treatment options ...

Subscale Acoustic Testing: Comparison of ALAT and ASMAT

NASA Technical Reports Server (NTRS)

Houston, Janice D.; Counter, Douglas

2014-01-01

The liftoff phase induces acoustic loading over a broad frequency range for a launch vehicle. These external acoustic environments are then used in the prediction of internal vibration responses of the vehicle and components which result in the qualification levels. Thus, predicting these liftoff acoustic environments is critical to the design requirements of any launch vehicle. If there is a significant amount of uncertainty in the predictions or if acoustic mitigation options must be implemented, a subscale acoustic test is a feasible pre-launch test option. This paper compares the acoustic measurements of two different subscale tests: the 2% Ares Liftoff Acoustic Test conducted at Stennis Space Center and the 5% Ares I Scale Model Acoustic Test conducted at Marshall Space Flight Center.

Selecting Treatments and Monitoring Outcomes: The Circle of Evidence-Based Practice and Client-Centered Care in Treating a Preschool Child Who Stutters

ERIC Educational Resources Information Center

Ratner, Nan Bernstein

2018-01-01

Purpose: The purpose of the present clinical forum is to compare how 2 clinicians might select among therapy options for a preschool-aged child who presents with stuttering close to onset. Method: I discuss approaches to full evaluation of the child's profile, advisement of evidence-based practice options open to the family, the need for…

Hepatocellular carcinoma in a large medical center of China over a 10-year period: evolving therapeutic option and improving survival.

PubMed

Zhu, Qianqian; Li, Na; Zeng, Xiaoyan; Han, Qunying; Li, Fang; Yang, Cuiling; Lv, Yi; Zhou, Zhihua; Liu, Zhengwen

2015-02-28

Hepatocellular carcinoma (HCC) is among the most common and lethal cancers worldwide, especially in China. We retrospectively analyzed data from patients who were diagnosed and treated HCC between 2002 and 2011 in a large hospital in northwest China and compared the data between periods 2002-2006 (P1) and 2007-2011 (P2). 2045 patients were included in analysis. The HCC stages at diagnosis according to the Barcelona clinic liver cancer staging system had no significant change. Treatment options of liver transplantation, transcatheter arterial chemoembolization and other therapy decreased while percutaneous local ablation and supportive care increased from P1 to P2. Options of surgical resection and systematic therapy had no significant change. Patient survival rates at 1, 3 and 5 years significantly improved from P1 to P2. The treatments with increasing option trend had a higher magnitude of survival increase and vise versa. Over the last 10 years, the patient survival had a significant increase which was mainly a result of the optimal therapeutic selections according to disease stages in this center. However, the proportion of patients diagnosed at early stages of HCC remained low and did not increase, a result calling for implementing surveillance system for at risk patients.

Management of lymphatic malformations in children.

PubMed

Bagrodia, Naina; Defnet, Ann M; Kandel, Jessica J

2015-06-01

To review the literature on lymphatic malformations and to provide current opinion about the management of these lesions. Current treatment options include nonoperative management, surgery, sclerotherapy, radiofrequency ablation, and laser therapy. New therapies are emerging, including sildenafil, propranolol, sirolimus, and vascularized lymph node transfer. The primary focus of management centers on the patient's quality of life. Multimodal treatment of lymphatic malformations continues to expand as new information about the biology and genetics of these lesions is discovered, in addition to knowledge gained from clinical practice. A patient-centered approach should guide timing and modality of treatment. Continued study of lymphatic malformations will increase and solidify a treatment algorithm for these complicated lesions.

AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for NASA Stennis Space Center

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

Schey, Stephen; Francfort, Jim

Federal agencies are mandated to purchase alternative fuel vehicles, increase consumption of alternative fuels, and reduce petroleum consumption. Available plug-in electric vehicles (PEVs) provide an attractive option in the selection of alternative fuel vehicles. PEVs, which consist of both battery electric vehicles (BEVs) and plug-in hybrid electric vehicles (PHEVs), have significant advantages over internal combustion engine (ICE) vehicles in terms of energy efficiency, reduced petroleum consumption, and reduced production of greenhouse gas (GHG) emissions, and they provide performance benefits with quieter, smoother operation. This study intended to evaluate the extent to which NASA Stennis Space Center (Stennis) could convert partmore » or all of their fleet of vehicles from petroleum-fueled vehicles to PEVs.« less

The Center for Children and Families at Risk: A Facilitating Environment.

ERIC Educational Resources Information Center

Eisenstein-Naveh, Antonina Rosa

2003-01-01

The Centers for Children and Families at Risk are family treatment settings, which were established by the Ministry of Welfare in Israel. Their purpose was to provide an alternative option to the removal of children from their homes. This article discusses how a special model of therapy developed from ongoing dialogue between the staff and…

42 CFR 137.178 - May Self-Governance Tribes store patient records at the Federal Records Centers?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false May Self-Governance Tribes store patient records at... SELF-GOVERNANCE Operational Provisions Records § 137.178 May Self-Governance Tribes store patient records at the Federal Records Centers? Yes, at the option of a Self-Governance Tribe, patient records may...

Responses to "Intention to Leave, Anticipated Reasons for Leaving, and 12-Month Turnover of Child Care Center Staff."

ERIC Educational Resources Information Center

Whitehead, Linda; Russell, Susan

1997-01-01

Two practitioners address problem of employee turnover in child care centers. The first plan argues for comprehensive wage raises, increased benefits, and low cost options to workers that increase flexibility. The second strategy advocates continuing education opportunities, special mentoring programs, and bonuses or raises paid early in the…

Interview with Brian Kearsey about the Founding of Crossroads School, Brewster, NY.

ERIC Educational Resources Information Center

Kearsey, Brian; Kearsey, Kathy

2000-01-01

A husband and wife team of Montessori-trained teachers started a private school in Brewster (New York) that also serves as a home school resource center. Their practices include mixed-age grouping, learner-centered instruction, optional standardized tests, parents in the classrooms, and frequent field trips. They endured 3 years of dealing with…

West Europe Report

DTIC Science & Technology

1986-06-24

distinction has to be made between Cavaco Silva and the other party leaders. After Alberto Joao Jardim condemned the PSD’s Rules Committee for the...After Porto (PSD) and Braga (PS), S. Joao da Madeira (CDS), a center of indus- trial development celebrating its new status as a city, will be next. On...Joaquim Aguiar and Joao Carlos Espada, ponder the options: all options. Teresa de Sousa, Sa Carneiro’s former secretary recently arrived from

IMP: Interactive mass properties program. Volume 1: Program description

NASA Technical Reports Server (NTRS)

Stewart, W. A.

1976-01-01

A method of computing a weights and center of gravity analysis of a flight vehicle using interactive graphical capabilities of the Adage 340 computer is described. The equations used to calculate area, volume, and mass properties are based on elemental surface characteristics. The input/output methods employ the graphic support of the Adage computer. Several interactive program options are available for analyzing the mass properties of a vehicle. These options are explained.

Incentives for Blood Donation: A Discrete Choice Experiment to Analyze Extrinsic Motivation.

PubMed

Sadler, Andrew; Shi, Ling; Bethge, Susanne; Mühlbacher, Axel

2018-04-01

Background: Demographic trends affect size and age structure of populations. One of the consequences will be an increasing need for blood products to treat age-related diseases. Donation services rely on voluntariness and charitable motivation. It might be questioned whether there will be sufficient blood supply with voluntary donation. The present study focused on elicitation of preferences for incentives and aimed to contribute to the discussion on how to increase donation rates. Methods: A self-administered discrete choice experiment (DCE) was applied. Respondents were repeatedly asked to choose between hypothetical blood donation centers. In case of reluctance to receiving incentives a none-option was included. Random parameter logit (RPL) and latent class models (LCM) were used for analysis. Results: The study sample included 416 college students from the US and Germany. Choice decisions were significantly influenced by the characteristics of the donation center in the DCE. Incentives most preferred were monetary compensation, paid leave, and blood screening test. LCM identified subgroups with preference heterogeneity. Small subgroups indicated moderate to strong aversion to incentives. Conclusion: The majority of the sample positively responded to incentives and indicated a willingness to accept incentives. In face of future challenges, the judicious use and appropriate utilization of incentives might be an option to motivate potential donors and should be open to discussion.

Transputer parallel processing at NASA Lewis Research Center

NASA Technical Reports Server (NTRS)

Ellis, Graham K.

1989-01-01

The transputer parallel processing lab at NASA Lewis Research Center (LeRC) consists of 69 processors (transputers) that can be connected into various networks for use in general purpose concurrent processing applications. The main goal of the lab is to develop concurrent scientific and engineering application programs that will take advantage of the computational speed increases available on a parallel processor over the traditional sequential processor. Current research involves the development of basic programming tools. These tools will help standardize program interfaces to specific hardware by providing a set of common libraries for applications programmers. The thrust of the current effort is in developing a set of tools for graphics rendering/animation. The applications programmer currently has two options for on-screen plotting. One option can be used for static graphics displays and the other can be used for animated motion. The option for static display involves the use of 2-D graphics primitives that can be called from within an application program. These routines perform the standard 2-D geometric graphics operations in real-coordinate space as well as allowing multiple windows on a single screen.

Nuclear Thermal Propulsion Mars Mission Systems Analysis and Requirements Definition

NASA Technical Reports Server (NTRS)

Mulqueen, Jack; Chiroux, Robert C.; Thomas, Dan; Crane, Tracie

2007-01-01

This paper describes the Mars transportation vehicle design concepts developed by the Marshall Space Flight Center (MSFC) Advanced Concepts Office. These vehicle design concepts provide an indication of the most demanding and least demanding potential requirements for nuclear thermal propulsion systems for human Mars exploration missions from years 2025 to 2035. Vehicle concept options vary from large "all-up" vehicle configurations that would transport all of the elements for a Mars mission on one vehicle. to "split" mission vehicle configurations that would consist of separate smaller vehicles that would transport cargo elements and human crew elements to Mars separately. Parametric trades and sensitivity studies show NTP stage and engine design options that provide the best balanced set of metrics based on safety, reliability, performance, cost and mission objectives. Trade studies include the sensitivity of vehicle performance to nuclear engine characteristics such as thrust, specific impulse and nuclear reactor type. Tbe associated system requirements are aligned with the NASA Exploration Systems Mission Directorate (ESMD) Reference Mars mission as described in the Explorations Systems Architecture Study (ESAS) report. The focused trade studies include a detailed analysis of nuclear engine radiation shield requirements for human missions and analysis of nuclear thermal engine design options for the ESAS reference mission.

Gastroesophageal Reflux Management with the LINX® System for Gastroesophageal Reflux Disease Following Laparoscopic Sleeve Gastrectomy.

PubMed

Desart, Kenneth; Rossidis, Georgios; Michel, Michael; Lux, Tamara; Ben-David, Kfir

2015-10-01

Laparoscopic sleeve gastrectomy (LSG) has gained significant popularity in the USA, and consequently resulted in patients experiencing new-onset gastroesophageal reflux disease (GERD) following this bariatric procedure. Patients with GERD refractory to medical therapy present a more challenging situation limiting the surgical options to further treat the de novo GERD symptoms since the gastric fundus to perform a fundoplication is no longer an option. The aim of this study is to determine if the LINX® magnetic sphincter augmentation system is a safe and effective option for patients with new gastroesophageal reflux disease following laparoscopic sleeve gastrectomy. This study was conducted at the University Medical Center. This is a retrospective review of seven consecutive patients who had a laparoscopic LINX® magnetic sphincter device placement for patients with refractory gastroesophageal reflux disease after laparoscopic sleeve gastrectomy between July 2014 and April 2015. All patients were noted to have self-reported greatly improved gastroesophageal reflux symptoms 2-4 weeks after their procedure. They were all noted to have statistically significant improved severity and frequency of their reflux, regurgitation, epigastric pain, sensation of fullness, dysphagia, and cough symptoms in their postoperative GERD symptoms compared with their preoperative evaluation. This is the first reported pilot case series, illustrating that the LINX® device is a safe and effective option in patients with de novo refractory gastroesophageal reflux disease after a laparoscopic sleeve gastrectomy despite appropriate weight loss.

Skylab

NASA Image and Video Library

1973-05-01

Engineers from the Marshall Space Flight Center (MSFC) and its contractors were testing the twin-pole sunshade at the Skylab mockup in the MSFC Building 4619. The Skylab Orbital Workshop (OWS) lost its thermal protection shield during launch on May 14, 1963. Without the heat shield, the temperature inside the OWS became dangerously high, rendering the workshop uninhabitable and threatened deterioration of the interior insulation and adhesive. Engineers from the MSFC, its contractors, and NASA persornel at other centers worked day and night for several days to develop the way to save the Skylab OWS. Eventually, they developed, tested, rehearsed, and approved three repair options. These options included a parasol sunshade and a twin-pole sunshade to restore the temperature inside the workshop, and a set of metal cutting tools to free the jammed solar panel.

Values and options in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers

PubMed Central

2013-01-01

Background Communication about prognosis and treatment choices is essential for informed decision making in advanced cancer. This article describes an investigation designed to facilitate communication and decision making among oncologists, patients with advanced cancer, and their caregivers. Methods/design The Values and Options in Cancer Care (VOICE) Study is a National Cancer Institute sponsored randomized controlled trial conducted in the Rochester/Buffalo, NY and Sacramento, CA regions. A total of 40 oncologists, approximately 400 patients with advanced cancer, and their family/friend caregivers (one per patient, when available) are expected to enroll in the study. Drawing upon ecological theory, the intervention uses a two-pronged approach: oncologists complete a multifaceted tailored educational intervention involving standardized patient instructors (SPIs), and patients and caregivers complete a coaching intervention to facilitate prioritizing and discussing questions and concerns. Follow-up data will be collected approximately quarterly for up to three years. Discussion The intervention is hypothesized to enhance patient-centered communication, quality of care, and patient outcomes. Analyses will examine the effects of the intervention on key elements of physician-patient-caregiver communication (primary outcomes), the physician-patient relationship, shared understanding of prognosis, patient well-being, and health service utilization (secondary outcomes). Trial registration Clinical Trials Identifier: NCT01485627 PMID:23570278

SLF Run/Walk for Safety and Health Month

NASA Image and Video Library

2018-03-13

From his vantage point atop a stepladder near the finish line, Kennedy Space Center Director Bob Cabana speaks to center employees and guests before the KSC Walk Run on the Shuttle Landing Facility runway. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options in the spirit of friendly competition.

Data base management system and display software for the National Geophysical Data Center geomagnetic CD-ROM's

NASA Technical Reports Server (NTRS)

Papitashvili, N. E.; Papitashvili, V. O.; Allen, J. H.; Morris, L. D.

1995-01-01

The National Geophysical Data Center has the largest collection of geomagnetic data from the worldwide network of magnetic observatories. The data base management system and retrieval/display software have been developed for the archived geomagnetic data (annual means, monthly, daily, hourly, and 1-minute values) and placed on the center's CD-ROM's to provide users with 'user-oriented' and 'user-friendly' support. This system is described in this paper with a brief outline of provided options.

For Patients | Center for Cancer Research

Cancer.gov

All patients with primary liver cancer referred to the National Cancer Institute are presented and discussed at a weekly interdisciplinary tumor board to identify the best and most effective treatment option

Meet EPA Physical Scientist Lukas Oudejans

EPA Pesticide Factsheets

Lukas Oudejans, Ph.D. is a physical scientist working in EPA’s National Homeland Security Research Center. His research focuses on preparing cleanup options for the agency following a disaster incident.

Interventional Therapy for Upper Extremity Deep Vein Thrombosis

PubMed Central

Carlon, Timothy A.; Sudheendra, Deepak

2017-01-01

Approximately 10% of all deep vein thromboses occur in the upper extremity, and that number is increasing due to the use of peripherally inserted central catheters. Sequelae of upper extremity deep vein thrombosis (UEDVT) are similar to those for lower extremity deep vein thrombosis (LEDVT) and include postthrombotic syndrome and pulmonary embolism. In addition to systemic anticoagulation, there are multiple interventional treatment options for UEDVT with the potential to reduce the incidence of these sequelae. To date, there have been no randomized trials to define the optimal management strategy for patients presenting with UEDVT, so many conclusions are drawn from smaller, single-center studies or from LEDVT research. In this article, the authors describe the evidence for the currently available treatment options and an approach to a patient with acute UEDVT. PMID:28265130

A real options approach to clinical faculty salary structure.

PubMed

Kahn, Marc J; Long, Hugh W

2012-01-01

One can use the option theory model originally developed to price financial opportunities in security markets to analyze many other economic arrangements such as the salary structures of clinical faculty in an academic medical center practice plan. If one views the underlying asset to be the portion (labeled "salary") of the economic value of the collections made for the care provided patients by the physician, then a salary guarantee can be considered a put option provided the physician, the guarantee having value to the physician only when the actual salary earned is less than the salary guarantee. Similarly, within an incentive plan, a salary cap can be thought of as a call option provided to the practice plan since a salary cap only has value to the practice plan when a physician's earnings exceed the cap. Further, based on analysis of prior earnings, the Black-Scholes options pricing model can be used both to price each option and to determine a financially neutral balance between a salary guarantee and a salary cap by equating the prices of the implied put and call options. We suggest that such analysis is superior to empirical methods for setting clinical faculty salary structure in the academic practice plan setting.

NASA's EOSDIS: options for data providers

NASA Astrophysics Data System (ADS)

Khalsa, Siri J.; Ujhazy, John E.

1995-12-01

EOSDIS, the data and information system being developed by NASA to support interdisciplinary earth science research into the 21st century, will do more than manage and distribute data from EOS-era satellites. It will also promote the exchange of data, tools, and research results across disciplinary, agency, and national boundaries. This paper describes the options that data providers will have for interacting with the EOSDIS Core System (ECS), the infrastructure of EOSDIS. The options include: using the ECS advertising service to announce the availability of data at the provider's site; submitting a candidate data set to one of the Distributed Active Archive Centers (DAACs); establishing a data server that will make the data accessible via ECS and establishing Local Information Manager (LIM) which would make the data available for multi-site searches. One additional option is through custom gateway interfaces which would provide access to existing data archives. The gateway, data server, and LIM options require the implementation of ECS code at the provider site to insure proper protocols. The advertisement and ingest options require no part of ECS design to reside at the provider site.

Cost and Schedule Analytical Techniques Development

NASA Technical Reports Server (NTRS)

1998-01-01

This Final Report summarizes the activities performed by Science Applications International Corporation (SAIC) under contract NAS 8-40431 "Cost and Schedule Analytical Techniques Development Contract" (CSATD) during Option Year 3 (December 1, 1997 through November 30, 1998). This Final Report is in compliance with Paragraph 5 of Section F of the contract. This CSATD contract provides technical products and deliverables in the form of parametric models, databases, methodologies, studies, and analyses to the NASA Marshall Space Flight Center's (MSFC) Engineering Cost Office (PP03) and the Program Plans and Requirements Office (PP02) and other user organizations. Detailed Monthly Reports were submitted to MSFC in accordance with the contract's Statement of Work, Section IV "Reporting and Documentation". These reports spelled out each month's specific work performed, deliverables submitted, major meetings conducted, and other pertinent information. Therefore, this Final Report will summarize these activities at a higher level. During this contract Option Year, SAIC expended 25,745 hours in the performance of tasks called out in the Statement of Work. This represents approximately 14 full-time EPs. Included are the Huntsville-based team, plus SAIC specialists in San Diego, Ames Research Center, Tampa, and Colorado Springs performing specific tasks for which they are uniquely qualified.

Royal Canadian Mounted Police National Operations Center Layout Study and Design Options

DTIC Science & Technology

2012-03-01

for the individual requirements are as follows: 1. UFC: United Facilities Criteria (Department of Defense, 2008); 2. ISO 11064: Ergonomic Design ...NOC is required to accommodate additional personnel above and beyond the existing seated capacity. As such, the proposed design needs to improve the...for Standardization. (2000). 1SO 11064 - Ergonomic Design of Control Centres. Larson, C. E., & LaFasto, F. M. (1989). Teamwork: What must go right

The National Center for Collaboration in Medical Modeling and Simulation

DTIC Science & Technology

2005-05-01

universities) to determine the best development strategies . The M~dical Modeling and Simulation Database (MMSD) has been created. The MMSD consists of two web... learner to obtain experience and skill prior to interacting with patients in vivo. The increasing focus on issues of patient safety, health care costs...additional option when considering how to best to maximize their educational resources. While the results of this study suggest that VR simulators are useful

Research Plan of the Department of Systems Engineering and the Operations Research Center for the Academic Year 2006

DTIC Science & Technology

2005-09-01

Facilities Layout o Scope problem with client in terms of options for M&S facilities layouts with regards to infrastructure, personnel... Facilities Layout o Develop M&S Installation Facilities Layout Design(s) Requirements and Milestones: • Scope problem with client (systems on which...objectives of this study are to (a) identify the desired technology and facilities layouts which would enhance inter-installation simulation

Clinical trial aims to improve outcomes for children and young adults with primary brain tumors | Center for Cancer Research

Cancer.gov

Central nervous system (CNS) tumors are the most common solid tumors among children and account for up to 25 percent of all childhood cancer cases. With few treatment options available at the time of recurrence or progression, this multicenter study will test the safety and efficacy of a drug that boosts the function of the immune system to fight tumors. Read more…

RNAi Mediated Silencing of LRRK2G2019S in Parkinson’s Disease

DTIC Science & Technology

2013-08-01

CONTRACTING ORGANIZATION : Georgetown University Medical Center Washington DC 20057-2197 REPORT DATE: August 2013 TYPE OF REPORT: Final Option...georgetown.edu, xs37@georgetown.edu 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Georgetown University Medical...Center 8. PERFORMING ORGANIZATION REPORT NUMBER Washington DC 20057- 2197 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS

Exploring Opportunities for Efficiency and Joint Provision of Services Using Nonappropriated Funds

DTIC Science & Technology

2016-01-01

analyzed two of them: accounting and employee benefits. RAND assessed the rec- ommendations’ costs , detailed the potential challenges, and identified...Consolidated Service Center: This option would standardize all accounting , including the SGL, cost - center structures, and core feeder and financial...ings of about $100 million would go toward replacing its out- dated accounting system. The analysis considered the costs of developing, deploying

Acquiring Technical Data With Renewable Real Options

DTIC Science & Technology

2016-04-30

Development, and Engineering Center, 2009). Faced with diminishing sources for M2 .50 caliber machine gun parts , an Army engineering center entered the...data needed for life cycle sustainment functions such as maintenance or competitive spare parts procurement, but this expectation is more complicated...than it seems (DoD, 2015). The needs and timing for competitive spare parts procurement are uncertain, and changes in system configuration or

Options for organization and operation of space applications transfer centers

NASA Technical Reports Server (NTRS)

Robinson, A. C.; Madigan, J. A.

1976-01-01

The benefits of developing regional facilities for transfer of NASA developed technology are discussed. These centers are designed to inform, persuade, and serve users. Included will be equipment for applications and demonstrations of the processes, a library, training facilities, and meeting rooms. The staff will include experts in the various techniques, as well as personnel involved in finding and persuading potential users.

Mars 2024/2026 Pathfinder Mission: Mars Architectures, Systems, and Technologies for Exploration and Resources Project

NASA Technical Reports Server (NTRS)

Zeitlin, Nancy; Mueller, Robert; Muscatello, Anthony

2015-01-01

Integrate In Situ Resource Utilization (ISRU) sub-systems and examine advanced capabilities and technologies to verify Mars 2024 Forward architecture precursor pathfinder options: Integrated spacecraft/surface infrastructure fluid architecture: propulsion, power, life support center dot Power system feed and propellant scavenging from propulsion system center dot High quality oxygen for life support and EVA Fluid/cryogenic zero-loss transfer and long-term storage center dot Rapid depot-to-rover/spacecraft center dot Slow ISRU plant-to-ascent vehicle Integration of ISRU consumable production center dot Oxygen only from Mars atmosphere carbon dioxide center dot Oxygen, fuel, water, from extraterrestrial soil/regolith Test bed to evaluate long duration life, operations, maintenance on hardware, sensors, and autonomy

Chemical Engineering at NASA

NASA Technical Reports Server (NTRS)

Collins, Jacob

2008-01-01

This viewgraph presentation is a review of the career paths for chemicals engineer at NASA (specifically NASA Johnson Space Center.) The author uses his personal experience and history as an example of the possible career options.

45 CFR 1340.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... day care, group day care, and center-based day care; and, at State option, any other settings in which... each of the several States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin...

Alternative Fuels Data Center: Biodiesel Equipment Options

Science.gov Websites

, particularly higher blends, have a solvent affect and will "clean out" and absorb contamination left , and vents. There is equipment compatible with higher level biodiesel blends for all these equipment

Design of 3 GeV booster ring lattice

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

Etisken, O., E-mail: ozgur.etisken@cern.ch; Ciftci, A. K., E-mail: abbas.kenan.ciftci@cern.ch

2016-03-25

The aim of this study is to design of a 3 GeV booster ring for the 3 GeV storage ring. Electrons are needed to be accelerated to 3.0 GeV from 0.15 GeV energy. In this frame, we studied on two options for booster ring; a compact booster and the booster that shares the same tunnel with the storage ring. The lattice type has been chosen FODO for both options, lattice parameters are calculated, sextupole magnets are used to decrease dynamic aperture problem and dynamic aperture calculations are also made with considering of the necessary conditions. After designing and calculating ofmore » the parameters, these designs have been compared with each other. In addition to this comparison, these booster design parameters have been compared with some world centers design parameters and the reliability of the booster design is seen. Beam optics, OPA and Elegant simulation programs have been used in the study calculations.« less

Fission Surface Power System Initial Concept Definition

NASA Technical Reports Server (NTRS)

2010-01-01

Under the NASA Exploration Technology Development Program (ETDP) and in partnership with the Department of Energy (DOE), NASA has embarked on a project to develop Fission Surface Power (FSP) technology. The primary goals of the project are to 1) develop FSP concepts that meet expected surface power requirements at reasonable cost with added benefits over other options, 2) establish a hardwarebased technical foundation for FSP design concepts and reduce overall development risk, 3) reduce the cost uncertainties for FSP and establish greater credibility for flight system cost estimates, and 4) generate the key products to allow NASA decision-makers to consider FSP as a preferred option for flight development. The FSP project was initiated in 2006 as the Prometheus Program and the Jupiter Icy Moons Orbiter (JIMO) mission were phased-out. As a first step, NASA Headquarters commissioned the Affordable Fission Surface Power System Study to evaluate the potential for an affordable FSP development approach. With a cost-effective FSP strategy identified, the FSP team evaluated design options and selected a Preliminary Reference Concept to guide technology development. Since then, the FSP Preliminary Reference Concept has served as a point-of-departure for several NASA mission architecture studies examining the use of nuclear power and has provided the foundation for a series of "Pathfinder" hardware tests. The long-term technology goal is a Technology Demonstration Unit (TDU) integrated system test using full-scale components and a non-nuclear reactor simulator. The FSP team consists of Glenn Research Center (GRC), Marshall Space Flight Center (MSFC) and the DOE National Laboratories at Los Alamos (LANL), Idaho (INL), Oak Ridge (ORNL), and Sandia (SNL). The project is organized into two main elements: Concept Definition and Risk Reduction. Under Concept Definition, the team performs trade studies, develops analytical tools, and formulates system concepts. Under Risk Reduction the team develops hardware prototypes and conducts laboratory-based testing.

Improvement of the knee center of rotation during walking after opening wedge high tibial osteotomy.

PubMed

Kim, Kyungsoo; Feng, Jun; Nha, Kyung Wook; Park, Won Man; Kim, Yoon Hyuk

2015-06-01

Accurate measurement of the center of rotation of the knee joint is indispensable for prediction of joint kinematics and kinetics in musculoskeletal models. However, no study has yet identified the knee center of rotations during several daily activities before and after high tibial osteotomy surgery, which is one surgical option for treating knee osteoarthritis. In this study, an estimation method for determining the knee joint center of rotation was developed by applying the optimal common shape technique and symmetrical axis of rotation approach techniques to motion-capture data and validated for typical activities (walking, squatting, climbing up stairs, walking down stairs) of 10 normal subjects. The locations of knee joint center of rotations for injured and contralateral knees of eight subjects with osteoarthritis, both before and after high tibial osteotomy surgery, were then calculated during walking. It was shown that high tibial osteotomy surgery improved the knee joint center of rotation since the center of rotations for the injured knee after high tibial osteotomy surgery were significantly closer to those of the normal healthy population. The difference between the injured and contralateral knees was also generally reduced after surgery, demonstrating increased symmetry. These results indicate that symmetry in both knees can be recovered in many cases after high tibial osteotomy surgery. Moreover, the recovery of center of rotation in the injured knee was prior to that of symmetry. This study has the potential to provide fundamental information that can be applied to understand abnormal kinematics in patients, diagnose knee joint disease, and design a novel implants for knee joint surgeries. © IMechE 2015.

The Center for Aerospace Research: A NASA Center of Excellence at North Carolina Agricultural and Technical State University

NASA Technical Reports Server (NTRS)

Lai, Steven H.-Y.

1992-01-01

This report documents the efforts and outcomes of our research and educational programs at NASA-CORE in NCA&TSU. The goal of the center was to establish a quality aerospace research base and to develop an educational program to increase the participation of minority faculty and students in the areas of aerospace engineering. The major accomplishments of this center in the first year are summarized in terms of three different areas, namely, the center's research programs area, the center's educational programs area, and the center's management area. In the center's research programs area, we focus on developing capabilities needed to support the development of the aerospace plane and high speed civil transportation system technologies. In the educational programs area, we developed an aerospace engineering option program ready for university approval.

DEVELOPMENT OF AN ANTIBIOTIC OPTIONS INDEX FOR ANTIBIOTIC RESISTANCE MONITORING.

PubMed

Manomayitthikan, Taweesuk; Borlace, Glenn N; Kessomboon, Nusaraporn

2016-11-01

Using antibiogram data to indicate the overall antibiotic resistance of a pathogen is complicated by the multiple antibiotic susceptibilities reported in the antibiogram. The objectives of this study were to develop and determine the benefits of an Antibiotic Options Index (AOI); an index that summarizes antibiotic susceptibility data for a pathogen by presenting it as the availability of antibiotic treatment options. The AOI was calculated using antibiogram data for the seven most commonly isolated pathogens from the National Antimicrobial Resistance Surveillance Center of Thailand between 1998 and 2014 and was classified as acceptable (AOI ≥ 0.8) or unacceptable (AOI < 0.8) based on the availability of treatment options. The AOI identified two problematic pathogens: Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus (MRSA). For A. baumannii, the probability of having at least two viable antibiotic treatment options (AOIm2) decreased from an acceptable level (0.93) in 1998 to an unacceptable level (0.53) in 2014 and for MRSA the AOIm2 decreased from an acceptable level (0.82) in 1998 to an unacceptable level (0.47) in 2014. By including the idea that the problem with increasing antibiotic resistance is a problem with treating infections, the AOI effectively compiles susceptibility data to present it as the probability of having effective antibiotic treatment. This index is calculated from widely available antibiogram data, making it more suitable to be used to monitor antibiotic resistance at the hospital, provincial and national levels.

Declining average daily census. Part 1: Implications and options.

PubMed

Weil, T P

1985-12-01

A national trend toward declining average daily (inpatient) census (ADC) started in late 1982 even before the Medicare prospective payment system began. The decrease in total days will continue despite an increasing number of aged persons in the U.S. population. This decline could have been predicted from trends during 1978 to 1983, such as increasing available beds but decreasing occupancy, 100 percent increases in hospital expenses, and declining lengths of stay. Assuming that health care costs will remain as a relatively fixed part of the gross national product and no major medical advances will occur in the next five years, certain implications and options exist for facilities experiencing a declining ADC. This article discusses several considerations: Attempts to improve market share; Reduction of full-time equivalent employees; Impact of greater acuity of illness among remaining inpatients; Implications of increasing the number of physicians on medical staffs; Option of a closed medical staff by clinical specialty; Unbundling with not-for-profit and profit-making corporations; Review of mergers, consolidations, and multihospital systems to decide when this option is most appropriate; Sale of a not-for-profit hospital to an investor-owned chain, with implications facing Catholic hospitals choosing this option; Impact and difficulty of developing meaningful alternative health care systems with the hospital's medical staff; Special problems of teaching hospitals; The social issue of the hospital shifting from the community's health center to a cost center; Increased turnover of hospital CEOs; With these in mind, institutions can then focus on solutions that can sometimes be used in tandem to resolve this problem's impact. The second part of this article will discuss some of them.

PROFILE user's guide

NASA Technical Reports Server (NTRS)

Collins, L.; Saunders, D.

1986-01-01

User information for program PROFILE, an aerodynamics design utility for refining, plotting, and tabulating airfoil profiles is provided. The theory and implementation details for two of the more complex options are also presented. These are the REFINE option, for smoothing curvature in selected regions while retaining or seeking some specified thickness ratio, and the OPTIMIZE option, which seeks a specified curvature distribution. REFINE uses linear techniques to manipulate ordinates via the central difference approximation to second derivatives, while OPTIMIZE works directly with curvature using nonlinear least squares techniques. Use of programs QPLOT and BPLOT is also described, since all of the plots provided by PROFILE (airfoil coordinates, curvature distributions) are achieved via the general purpose QPLOT utility. BPLOT illustrates (again, via QPLOT) the shape functions used by two of PROFILE's options. The programs were designed and implemented for the Applied Aerodynamics Branch at NASA Ames Research Center, Moffett Field, California, and written in FORTRAN and run on a VAX-11/780 under VMS.

Beyond an “Either-Or” Approach to Home- and Center-Based Child Care: Comparing Children and Families who Combine Care Types with Those Who Use Just One

PubMed Central

Gordon, Rachel A.; Colaner, Anna; Usdansky, Margaret L.; Melgar, Claudia

2013-01-01

Most research focuses on preschoolers’ primary non-parental child care arrangement despite evidence that multiple arrangements are relatively common. Using the nationally-representative Early Childhood Longitudinal Study, Birth Cohort, we compare characteristics and outcomes of families whose 4-year olds attend both home- and center-based child care with those who attend either home- or center-based care exclusively or receive no non-parental care at all. We find that about one fifth of 4-year olds attend both home- and center-based child care. Mothers’ priorities for care (getting their child ready for school, matching their families’ cultural background) and perceptions of good local care options predict their combining home- and center-based care. Preschoolers score higher on reading and math assessments, on average, when they attend centers, alone or in combination with home-based child care, than when they are cared for only in homes, either by their parents or by others. Preschoolers’ average socioemotional outcomes generally do not differ between families who do and who do not combine care types. Implications for research and policy are discussed. PMID:24187434

Alternative Fuels Data Center: Natural Gas Vehicle Availability

Science.gov Websites

options for converting conventional vehicles to run on natural gas. Pre-Owned Vehicles Learn about buying and selling pre-owned alternative fuel and advanced technology vehicles. More Information For more

Over the Counter & Complementary Therapies

MedlinePlus

... a Parkinson’s Foundation Center of Excellence. 0 ‹ Medical Marijuana up Exercise › Sample Title of Item (also a link) Treatment Prescription Medications Surgical Treatment Options Medical Marijuana Over the Counter & Complementary Therapies Exercise Clinical Trials ...

Manned Mars mission cost estimate

NASA Technical Reports Server (NTRS)

Hamaker, Joseph; Smith, Keith

1986-01-01

The potential costs of several options of a manned Mars mission are examined. A cost estimating methodology based primarily on existing Marshall Space Flight Center (MSFC) parametric cost models is summarized. These models include the MSFC Space Station Cost Model and the MSFC Launch Vehicle Cost Model as well as other modes and techniques. The ground rules and assumptions of the cost estimating methodology are discussed and cost estimates presented for six potential mission options which were studied. The estimated manned Mars mission costs are compared to the cost of the somewhat analogous Apollo Program cost after normalizing the Apollo cost to the environment and ground rules of the manned Mars missions. It is concluded that a manned Mars mission, as currently defined, could be accomplished for under $30 billion in 1985 dollars excluding launch vehicle development and mission operations.

External validity of the pediatric cardiac quality of life inventory

PubMed Central

Marino, Bradley S.; Drotar, Dennis; Cassedy, Amy; Davis, Richard; Tomlinson, Ryan S.; Mellion, Katelyn; Mussatto, Kathleen; Mahony, Lynn; Newburger, Jane W.; Tong, Elizabeth; Cohen, Mitchell I.; Helfaer, Mark A.; Kazak, Anne E.; Wray, Jo; Wernovsky, Gil; Shea, Judy A.; Ittenbach, Richard

2012-01-01

Purpose The Pediatric Cardiac Quality of Life Inventory (PCQLI) is a disease-specific, health-related quality of life (HRQOL) measure for pediatric heart disease (HD). The purpose of this study was to demonstrate the external validity of PCQLI scores. Methods The PCQLI development site (Development sample) and six geographically diverse centers in the United States (Composite sample) recruited pediatric patients with acquired or congenital HD. Item response option variability, scores [Total (TS); Disease Impact (DI) and Psychosocial Impact (PI) subscales], patterns of correlation, and internal consistency were compared between samples. Results A total of 3,128 patients and parent participants (1,113 Development; 2,015 Composite) were analyzed. Response option variability patterns of all items in both samples were acceptable. Inter-sample score comparisons revealed no differences. Median item–total (Development, 0.57; Composite, 0.59) and item–subscale (Development, DI 0.58, PI 0.59; Composite, DI 0.58, PI 0.56) correlations were moderate. Subscale–subscale (0.79 for both samples) and subscale–total (Development, DI 0.95, PI 0.95; Composite, DI 0.95, PI 0.94) correlations and internal consistency (Development, TS 0.93, DI 0.90, PI 0.84; Composite, TS 0.93, DI 0.89, PI 0.85) were high in both samples. Conclusion PCQLI scores are externally valid across the US pediatric HD population and may be used for multi-center HRQOL studies. PMID:21188538

Constipation and Outcomes of Cecostomy.

PubMed

Arya, Shruti; Gupta, Nancy; Gupta, Rahul; Aggarwal, Arun

Constipation, defined as delay or difficulty in defecation, present for 2 or more weeks, is a common problem encountered by both primary and specialty medical providers. There are no randomized controlled trials on the use of antegrade enemas in the pediatric population. Most published papers are based on the experience at a particular center. The aim of this article is to describe the pathophysiology of constipation, review the contribution of colonic manometry to the diagnosis of constipation, summarize the advancements in the management of constipation through the use of antegrade enemas, and study the outcomes of cecostomy at different centers. This study is a comprehensive literature review generated by computerized search of literature, supplemented by review of monographs and textbooks in pathology, gastroenterology, and surgery. Literature search was performed using the publications from 1997 to 2012. The search included publications of all types presenting or reviewing data on cecostomy. The antegrade continence enema is a therapeutic option for defecation disorders when maximal conventional therapy is not successful. Symptoms of defecation disorders in children with different underlying etiologies improve significantly after a cecostomy is created. In addition, there is a benefit on the patients' physical activity, healthcare utilization, and general well-being. Based on the review of published literature it seems that antegrade enemas are a successful therapeutic option in children with severe constipation and/or fecal incontinence. With the advent of cecostomy buttons, patient compliance and the overall cosmetic appearance have improved.

Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO): protocol for an educational intervention study.

PubMed

Sanchez, Katherine; Eghaneyan, Brittany H; Trivedi, Madhukar H

2016-07-29

Barriers to depression treatment among Hispanic populations include persistent stigma, inadequate doctor patient communication (DPC) and resultant sub-optimal use of anti-depressant medications. Stigma is primarily perpetuated due to inadequate disease literacy and cultural factors. Common concerns about depression treatments among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking psychotropic medications. The current manuscript presents the study protocol for the Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO) study funded by the Center for Medicare and Medicaid Services (CMS) Grants to Support the Hispanic Health Services Research Grant Program. DESEO will implement universal screening with a self-report depression screening tool (the 9-item Patient Health Questionnaire (PHQ-9)) that is presented through a customized web application and a Depression Education Intervention (DEI) designed to increase disease literacy, and dispel myths about depression and its treatment among Hispanic patients thus reducing stigma and increasing treatment engagement. This project will be conducted at one community health center whose patient population is majority Hispanic. The target enrollment for recruitment is 350 patients over the 24-month study period. A one-group, pretest-posttest design will be used to asses knowledge of depression and its treatment and related stigma before, immediately after, and one month post intervention. Primary care settings often are the gateway to identifying undiagnosed mental health disorders, particularly for people with comorbid physical health conditions. This study is unique in that it aims to examine the specific role of patient education as an intervention to increase engagement in depression treatment. By participating in the DEI, it is expected that patients will have time to understand treatment options, participate in shared decision-making with their provider, and increase engagement in treatment of depression which might lead to improved overall health. It is also expected that implementation of the iPad Depression Screening application will increase provider awareness of the incidence and prevalence of depression in their own practice and improve the performance and care the clinic provides. The study was registered with: NCT02491034 July 2, 2015.

Information channels and the dynamics of uptake of living kidney donors: a retrospective study in a reference area.

PubMed

Vidal Blandino, M; Gentil Govantes, M A; Cabello Chaves, V; Pereira Palomo, P; Bernal Blanco, G; Gonzalez Roncero, F M; Fijo Viota, J; Medina López, R

2011-01-01

Activity in renal transplantation at our center continues to grow due to the gradual increase in living donor kidney transplantations (LDKT). Our objective was to describe the generation process of living donation in our area of influence including two provinces and 18 chronic kidney disease (CKD) treatment units in particular the origin of paired donor/recipients and information channels. We included all actual and discarded potential donors from 2005 to 2009. History and telephone interviews provided a description of the cases, sources and process information. Among 95 potential pairs we performed 44 LDKT during this period. The recipients were predialysis (38%), on dialysis (54%), or after prior transplantation (8%). Among the 10 dialysis centers, the referral rate ranged between 0 and 8.6 pairs per 100 patients. We contacted 78 (83%) donors for an interview, among whom 53% first learned of LDKT when the recipient already had advanced CKD at predialysis or dialysis stages. Television was the main means of this first knowledge (38%), followed by the health care staff. LDKT was not primarily a treatment option offered by the nephrologist for 65% of subjects; however, the nephrologists were the major reference sources followed by the Internet and transplant coordinators. The majority of donations are initiated before the recipient is on dialysis, but eventuates predialysis in only 38% of cases. The possibility of being referred seems to be influenced by the recipient's treatment center. We need a more proactive role of nephrologists to offer this therapeutic option. This study identified the importance of public information to identify targets and design strategies to disseminate quality information on LDKT. Copyright © 2011 Elsevier Inc. All rights reserved.

[Public free anonymous HIV testing centers: cost analysis and financing options].

PubMed

Dozol, Adrien; Tribout, Martin; Labalette, Céline; Moreau, Anne-Christine; Duteil, Christelle; Bertrand, Dominique; Segouin, Christophe

2011-01-01

The services of general interest provided by hospitals, such as free HIV clinics, have been funded since 2005 by a lump sum covering all costs. The allocation of the budget was initially determined based on historical and declarative data. However, the French Ministry of Health (MoH) recently outlined new rules for determining the allocation of financial resources and contracting hospitals for each type of services of general interest provided. The aim of this study was to estimate the annual cost of a public free anonymous HIV-testing center and to assess the budgetary implications of new financing systems. Three financing options were compared: the historic block grant; a mixed system recommended by the MoH associating a lump sum covering the recurring costs of an average center and a variable part based on the type and volume of services provided; and a fee-for-services system. For the purposes of this retrospective study, the costs and activity data of the HIV testing clinic of a public hospital located in the North of Paris were obtained for 2007. The costs were analyzed from the perspective of the hospital. The total cost was estimated at 555,698 euros. Personnel costs accounted for 31% of the total costs, while laboratory expenses accounted for 36% of the total costs. While the estimated deficit was 292,553 euros under the historic system, the financial balance of the clinic was found to be positive under a fee-for-services system. The budget allocated to the HIV clinic under the system recommended by the MoH covers most of the current expenses of the HIV clinic while meeting the requirements of free confidential care.

Rainwater Harvesting for Military Installations -The Time is Now

DTIC Science & Technology

2010-06-01

Alternate Water Sources US Army Corps of Engineers® Engineer Research and Development Center - Water Reuse - Desalination - Produced Water...RAINWATER HARVESTING - Ground Water Recharge - Graywater Reuse - Sewer Mining Other Water Use/Alternate Water Sources Options What can be done to increase...WATER NO TOME El AGUA .. US Army Corps of Engineers® Engineer Research and Development Center Mitchell Physics RWH 386,800 GPY AC 1,058,300 GPY

Simultaneous Vascular Targeting and Tumor Targeting of Cerebral Breast Cancer Metastases Using a T Cell Receptor Mimic Antibody

DTIC Science & Technology

2015-05-01

ORGANIZATION : Texas Tech University Health Sciences Center Lubbock, TX 79430 REPORT DATE: May 2015 TYPE OF REPORT: Annual...PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Texas Tech University Health Sciences Center 3601...now available to treat the primary tumor and metastatic disease in peripheral organs . Unfortunately, current therapeutic options for brain metastases

User Guide for the Anvil Threat Cooridor Forecast Tool V2.4 for AWIPS

NASA Technical Reports Server (NTRS)

Barett, Joe H., III; Bauman, William H., III

2008-01-01

The Anvil Tool GUI allows users to select a Data Type, toggle the map refresh on/off, place labels, and choose the Profiler Type (source of the KSC 50 MHz profiler data), the Date- Time of the data, the Center of Plot, and the Station (location of the RAOB or 50 MHz profiler). If the Data Type is Models, the user selects a Fcst Hour (forecast hour) instead of Station. There are menus for User Profiles, Circle Label Options, and Frame Label Options. Labels can be placed near the center circle of the plot and/or at a specified distance and direction from the center of the circle (Center of Plot). The default selection for the map refresh is "ON". When the user creates a new Anvil Tool map with Refresh Map "ON, the plot is automatically displayed in the AWIPS frame. If another Anvil Tool map is already displayed and the user does not change the existing map number shown at the bottom of the GUI, the new Anvil Tool map will overwrite the old one. If the user turns the Refresh Map "OFF", the new Anvil Tool map is created but not automatically displayed. The user can still display the Anvil Tool map through the Maps dropdown menu* as shown in Figure 4.

Analysis of Convective Weather Impact on Pre-Departure Routing of Flights from Fort Worth Center to New York Center

NASA Technical Reports Server (NTRS)

Arneson, Heather; Bombelli, Alessandro; Segarra-Torne, Adria; Tse, Elmer

2017-01-01

In response to severe weather conditions, Traffic Managers specify flow constraints and reroutes to route air traffic around affected regions of airspace. Providing analysis and recommendations of available reroute options and associated airspace capacities would assist Traffic Managers in making more efficient decisions in response to convective weather. These recommendations can be developed by examining historical data to determine which previous reroute options were used in similar weather and traffic conditions. This paper describes the initial steps and methodology used towards this goal. The focus of this work is flights departing from Fort Worth Center destined for New York Center. Dominant routing structures used in the absence of convective weather are identified. A method to extract relevant features from the large volume of weather data available to quantify the impact of convective weather on this routing structure over a given time range is presented. Finally, a method of estimating flow rate capacity along commonly used routes during convective weather events is described. Results show that the flow rates drop exponentially as a function of the values of the proposed feature and that convective weather on the final third of the route was found to have a greater impact on the flow rate restriction than other portions of the route.

A novel imaging approach for prostate cancer is tested in new clinical trial | Center for Cancer Research

Cancer.gov

Prostate cancer patients who have failed standard radiation therapy have the options of surgery, radioactive seed implantation or cryoablation. Deborah Citrin, M.D., of the Radiation Oncology Branch is leading a study of stereotactic body radiation therapy (SBRT) to treat prostate cancer that has recurred locally after standard radiation therapy. The goal of this study is to use a novel imaging approach to guide treatment and to define the best dose of SBRT for patients whose prostate cancer has recurred after standard radiotherapy. Read more...

An accelerated line-by-line option for MODTRAN combining on-the-fly generation of line center absorption within 0.1 cm-1 bins and pre-computed line tails

NASA Astrophysics Data System (ADS)

Berk, Alexander; Conforti, Patrick; Hawes, Fred

2015-05-01

A Line-By-Line (LBL) option is being developed for MODTRAN6. The motivation for this development is two-fold. Firstly, when MODTRAN is validated against an independent LBL model, it is difficult to isolate the source of discrepancies. One must verify consistency between pressure, temperature and density profiles, between column density calculations, between continuum and particulate data, between spectral convolution methods, and more. Introducing a LBL option directly within MODTRAN will insure common elements for all calculations other than those used to compute molecular transmittances. The second motivation for the LBL upgrade is that it will enable users to compute high spectral resolution transmittances and radiances for the full range of current MODTRAN applications. In particular, introducing the LBL feature into MODTRAN will enable first-principle calculations of scattered radiances, an option that is often not readily available with LBL models. MODTRAN will compute LBL transmittances within one 0.1 cm-1 spectral bin at a time, marching through the full requested band pass. The LBL algorithm will use the highly accurate, pressure- and temperature-dependent MODTRAN Padé approximant fits of the contribution from line tails to define the absorption from all molecular transitions centered more than 0.05 cm-1 from each 0.1 cm-1 spectral bin. The beauty of this approach is that the on-the-fly computations for each 0.1 cm-1 bin will only require explicit LBL summing of transitions centered within a 0.2 cm-1 spectral region. That is, the contribution from the more distant lines will be pre-computed via the Padé approximants. The status of the LBL effort will be presented. This will include initial thermal and solar radiance calculations, validation calculations, and self-validations of the MODTRAN band model against its own LBL calculations.

The Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF) Registry: Rationale and Design.

PubMed

Stewart, Elizabeth A; Lytle, Barbara L; Thomas, Laine; Wegienka, Ganesa R; Jacoby, Vanessa; Diamond, Michael P; Nicholson, Wanda K; Anchan, Raymond M; Venable, Sateria; Wallace, Kedra; Marsh, Erica E; Maxwell, George L; Borah, Bijan J; Catherino, William H; Myers, Evan R

2018-05-08

To design and establish a uterine fibroid (UF) registry based in the United States (US) to provide comparative effectiveness data regarding UF treatment. We report here the design and initial recruitment for the Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF) registry (Clinicaltrials.gov, NCT02260752), funded by the Agency for Healthcare Research and Quality (AHRQ) in collaboration with the-Patient-Centered Outcomes Research Institute (PCORI). COMPARE-UF is designed to help answer critical questions about treatment options for women with symptomatic UF. Women undergoing a procedure for UF (hysterectomy, myomectomy [abdominal, hysteroscopic, vaginal and laparoscopic/robotic], endometrial ablation, radiofrequency fibroid ablation, uterine artery embolization, magnetic resonance guided focused ultrasound or progestin-releasing intrauterine device insertion) at one of the COMPARE-UF sites are invited to participate in a prospective registry with three years follow-up for post-procedural outcomes. Enrolled participants provide annual follow-up through an online portal or through traditional phone contact. A central data abstraction center provides information obtained from imaging, operative or procedural notes and pathology reports. Women with uterine fibroids and other stakeholders are a key part of the COMPARE-UF registry and participate at all points from study design to dissemination of results. We built a network of nine clinical sites across the US with expertise in the care of women with UF to capture geographic, racial, ethnic and procedural diversity. Of the initial 2031 women enrolled in COMPARE-UF, 42% are self-identified as Black or African-American and 40% are age 40 years or younger with 16% of participants under age 35. Women undergoing myomectomy comprise the largest treatment group at 46% of all procedures with laparoscopic or robotic myomectomy comprising the largest subset of myomectomies at 19% of all procedures. Hysterectomy is the second most common treatment within the registry at 38%. In response to priorities identified by our patient stakeholders, the initial aims within COMPARE-UF will address how different procedures used to treat UF compare in terms of long-lasting symptom relief, potential for recurrence, medical complications, improvement in quality of life and sexual function, age at menopause, and fertility and pregnancy outcomes. COMPARE-UF will generate evidence on the comparative effectiveness of different procedural options for UF, in order to help patients and their caregivers make informed decisions that best meet an individual patient's short- and long-term preferences. Building upon this infrastructure, the COMPARE-UF team of investigators and stakeholders, including patients, collaborate to identify future priorities for expanding the registry, such assessing the efficacy of medical therapies for UF. COMPARE-UF results will be disseminated directly to patients, providers, and other stakeholders using traditional academic pathways, as well as innovative methods, including a variety of social media platforms. Given demographic differences among women undergoing different UF treatments, assessing comparative effectiveness for this disease through clinical trials will remain difficult. Therefore, this registry provides optimized evidence to help patients and their providers better understand the pros and cons of different treatment options so that they can make more informed decisions. Copyright © 2018. Published by Elsevier Inc.

Reducing Unintended Pregnancies Through Web-Based Reproductive Life Planning and Contraceptive Action Planning among Privately Insured Women: Study Protocol for the MyNewOptions Randomized, Controlled Trial.

PubMed

Chuang, Cynthia H; Velott, Diana L; Weisman, Carol S; Sciamanna, Christopher N; Legro, Richard S; Chinchilli, Vernon M; Moos, Merry-K; Francis, Erica B; Confer, Lindsay N; Lehman, Erik B; Armitage, Christopher J

2015-01-01

The Affordable Care Act mandates that most women of reproductive age with private health insurance have full contraceptive coverage with no out-of-pocket costs, creating an actionable time for women to evaluate their contraceptive choices without cost considerations. The MyNewOptions study is a three-arm, randomized, controlled trial testing web-based interventions aimed at assisting privately insured women with making contraceptive choices that are consistent with their reproductive goals. Privately insured women between the ages of 18 and 40 not intending pregnancy were randomly assigned to one of three groups: 1) a reproductive life planning (RLP) intervention, 2) a reproductive life planning enriched with contraceptive action planning (RLP+) intervention, or 3) an information only control group. Both the RLP and RLP+ guide women to identify their individualized reproductive goals and contraceptive method requirements. The RLP+ additionally includes a contraceptive action planning component, which uses if-then scenarios that allow the user to problem solve situations that make it difficult to be adherent to their contraceptive method. All three groups have access to a reproductive options library containing information about their contraceptive coverage and the attributes of alternative contraceptive methods. Women completed a baseline survey with follow-up surveys every 6 months for 2 years concurrent with intervention boosters. Study outcomes include contraceptive use and adherence. ClinicalTrials.gov identifier: NCT02100124. Results from the MyNewOptions study will demonstrate whether web-based reproductive life planning, with or without contraceptive action planning, helps insured women make patient-centered contraceptive choices compared with an information-only control condition. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Current treatment options for the management of esophageal cancer

PubMed Central

Mawhinney, Mark R; Glasgow, Robert E

2012-01-01

In recent years, esophageal cancer characteristics and management options have evolved significantly. There has been a sharp increase in the frequency of esophageal adenocarcinoma and a decline in the frequency of squamous cell carcinoma. A more comprehensive understanding of prognostic factors influencing outcome has also been developed. This has led to more management options for esophageal cancer at all stages than ever before. A multidisciplinary, team approach to management in a high volume center is the preferred approach. Each patient should be individually assessed based on type of cancer, local or regional involvement, and his or her own functional status to determine an appropriate treatment regimen. This review will discuss management of esophageal cancer relative to disease progression and patient functional status. PMID:23152702

Life cycle cost analysis of a stand-alone PV system in rural Kenya

NASA Astrophysics Data System (ADS)

Daly, Emma

The purpose of this quantitative research study was to determine the economic feasibility of a stand-alone PV system to electrify a rural area in Kenya. The research conducted involved a comprehensive review of all the relevant literature associated with the study. Methodologies were extrapolated from this extensive literature to develop a model for the complete design and economic analysis of a stand-alone PV system. A women's center in rural Kenya was used as a worked example to demonstrate the workings of the model. The results suggest that electrifying the center using a stand-alone PV system is an economically viable option which is encouraging for the surrounding area. This model can be used as a business model to determine the economic feasibility of a stand-alone PV system in alternative sites in Kenya.

Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies - Chances and Challenges for Effective and Efficient Patient Management.

PubMed

Sadick, Maliha; Dally, Franz Josef; Schönberg, Stefan O; Stroszczynski, Christian; Wohlgemuth, Walter A

2017-10-01

Background  Radiology is an interdisciplinary field dedicated to the diagnosis and treatment of numerous diseases and is involved in the development of multimodal treatment concepts. Method  Interdisciplinary case management, a broad spectrum of diagnostic imaging facilities and dedicated endovascular radiological treatment options are valuable tools that allow radiology to set up an interdisciplinary center for vascular anomalies. Results  Image-based diagnosis combined with endovascular treatment options is an essential tool for the treatment of patients with highly complex vascular diseases. These vascular anomalies can affect numerous parts of the body so that a multidisciplinary treatment approach is required for optimal patient care. Conclusion  This paper discusses the possibilities and challenges regarding effective and efficient patient management in connection with the formation of an interdisciplinary center for vascular anomalies with strengthening of the clinical role of radiologists. Key points   · Vascular anomalies, which include vascular tumors and malformations, are complex to diagnose and treat.. · There are far more patients with vascular anomalies requiring therapy than interdisciplinary centers for vascular anomalies - there is currently a shortage of dedicated interdisciplinary centers for vascular anomalies in Germany that can provide dedicated care for affected patients.. · Radiology includes a broad spectrum of diagnostic and minimally invasive therapeutic tools which allow the formation of an interdisciplinary center for vascular anomalies for effective, efficient and comprehensive patient management.. Citation Format · Sadick M, Dally FJ, Schönberg SO et al. Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies - Chances and Challenges for Effective and Efficient Patient Management. Fortschr Röntgenstr 2017; 189: 957 - 966. © Georg Thieme Verlag KG Stuttgart · New York.

Alternative Fuels Data Center: Equipment Options for E85 Fueling Systems

Science.gov Websites

equipment includes an overfill protection device, a leak detection device, shear valves, fill and vapor caps protection, leak detection, shear valves, fill and vapor caps, adaptors, containment sumps, and all

Alternative Fuels Data Center: Flexible Fuel Vehicle Availability

Science.gov Websites

options for converting vehicles to run on E85 and other ethanol-gasoline blends. Pre-Owned Vehicles Learn about buying and selling pre-owned alternative fuel and advanced vehicles. Learn More Interested in

Psychotherapy for Suicidal Clients.

ERIC Educational Resources Information Center

Lester, David

1994-01-01

Reviews various systems of psychotherapy for suitability for suicidal clients. Discusses psychoanalysis, cognitive therapy, primal therapy, transactional analysis, Gestalt therapy, reality therapy, person-centered therapy, existential analysis, and Jungian analysis in light of available treatment options. Includes 36 citations. (Author/CRR)

The Career Motivation Process Program

ERIC Educational Resources Information Center

Garrison, Clifford; And Others

1975-01-01

Describes the Career Motivation Process (CMP) program, an experimental approach to career counseling incorporating both the "personality" approach, which centers around personal self-examination, and the "decision-making" approach, which emphasizes the collection of information about possible career options. (JG)

Intersection management using in-vehicle speed advisory/adaptation : final report.

DOT National Transportation Integrated Search

2016-08-30

In recent years, connected vehicles (CVs) and automated vehicles (AVs) have emerged as a : realistic and viable transportation option. Research centers and companies have dedicated : substantial efforts to the technology, motivated largely by the pot...

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

Curtin, D.P.

The process analyzed involves non-production, laboratory environment use of trichloroethylene for the cleaning of semiconductor devices. The option selection centered on the replacement of the trichloroethylene with a non-hazardous material. This process waste assessment was performed as part of a pilot project.

How to do human-subjects research if you do not have an institutional review board.

PubMed

Rice, Todd W

2008-10-01

Biomedical research with human subjects has expanded outside of traditional medical centers and hospitals into other health care entities, such as rehabilitation facilities, free-standing out-patient treatment centers, and even home-health agencies. Regardless of the location, federal regulations mandate that all human-subjects research must be overseen by an institutional review board (IRB) or ethics committee to ensure the research abide by the Code of Federal Regulations. Consequently, all human-subjects research must be reviewed and approved by an IRB prior to initiation of any research procedures. Unfortunately, many of these nontraditional research facilities do not have easy access to an IRB. This does not render such research exempt from federal oversight. Clinicians at these facilities have viable options for obtaining IRB approval and legally conducting such research. This paper outlines the available options and their pros and cons.

Toward Verification of USM3D Extensions for Mixed Element Grids

NASA Technical Reports Server (NTRS)

Pandya, Mohagna J.; Frink, Neal T.; Ding, Ejiang; Parlette, Edward B.

2013-01-01

The unstructured tetrahedral grid cell-centered finite volume flow solver USM3D has been recently extended to handle mixed element grids composed of hexahedral, prismatic, pyramidal, and tetrahedral cells. Presently, two turbulence models, namely, baseline Spalart-Allmaras (SA) and Menter Shear Stress Transport (SST), support mixed element grids. This paper provides an overview of the various numerical discretization options available in the newly enhanced USM3D. Using the SA model, the flow solver extensions are verified on three two-dimensional test cases available on the Turbulence Modeling Resource website at the NASA Langley Research Center. The test cases are zero pressure gradient flat plate, planar shear, and bump-inchannel. The effect of cell topologies on the flow solution is also investigated using the planar shear case. Finally, the assessment of various cell and face gradient options is performed on the zero pressure gradient flat plate case.

Airship Industry Study

NASA Technical Reports Server (NTRS)

Hochstetler, Ron; Chachad, Girish; Melton, John

2016-01-01

There is an ongoing Government interest in the potential of airships for cargo transport; Conducting vertical or near-vertical airlift of heavy, outsized freight with little or no ground infrastructure is an attractive cargo transport option. USTRANSCOM wanted to understand the principal issues that are holding back commercial development of airship transports. NASA Ames Research Center was commissioned by USTRANSCOM to study the airship industry’s ability to design, develop, and operate cargo airships. Principal study objectives were to identify: (1) Current and near term state of the cargo airship industry; (2) Roadblocks hindering cargo airship development; (3) Steps needed to remove impediments to cargo airship deployment.

Impacts of Low-Flow and Stream-Temperature Changes on Endangered Atlantic Salmon - Current Research

USGS Publications Warehouse

Dudley, Robert W.; Hodgkins, Glenn A.; Letcher, Benjamin H.

2008-01-01

Recent climate studies in New England and the northeastern United States have shown evidence of physical changes over time, including trends toward earlier snowmelt runoff, decreasing river ice, and increasing spring water temperatures. A U.S. Geological Survey (USGS) study funded by the National Global Warming and Wildlife Science Center will be investigating changes in summer low streamflows and stream temperatures and the potential effects of those changes on endangered Atlantic salmon populations. The study also will evaluate management options that would be most likely to mitigate the effects of any changes in streamflow and temperature.

Veteran satisfaction and treatment preferences in response to a posttraumatic stress disorder specialty clinic orientation group.

PubMed

Schumm, Jeremiah A; Walter, Kristen H; Bartone, Anne S; Chard, Kathleen M

2015-06-01

To maximize accessibility to evidence-based treatments for posttraumatic stress disorder (PTSD), the United States Department of Veterans Affairs (VA) has widely disseminated cognitive processing therapy (CPT) and prolonged exposure (PE) therapy to VA clinicians. However, there is a lack of research on veteran preferences when presented with a range of psychotherapy and medication options. This study uses a mixed-method approach to explore veteran satisfaction with a VA PTSD specialty clinic pre-treatment orientation group, which provides education about available PTSD treatment options. This study also tested differences in treatment preference in response to the group. Participants were 183 US veterans. Most were White, male, and referred to the clinic by a VA provider. Results indicated high satisfaction with the group in providing an overview of services and helping to inform treatment choice. Most preferred psychotherapy plus medications (63.4%) or psychotherapy only (30.1%). Participants endorsed a significantly stronger preference for CPT versus other psychotherapies. PE was significantly preferred over nightmare resolution therapy and present-centered therapy, and both PE and cognitive-behavioral conjoint therapy were preferred over virtual reality exposure therapy. Results suggest that by informing consumers about evidence-based treatments for PTSD, pre-treatment educational approaches may increase consumer demand for these treatment options. Published by Elsevier Ltd.

L1C signal design options

USGS Publications Warehouse

Betz, J.W.; Cahn, C.R.; Dafesh, P.A.; Hegarty, C.J.; Hudnut, K.W.; Jones, A.J.; Keegan, R.; Kovach, K.; Lenahan, L.S.; Ma, H.H.; Rushanan, J.J.; Stansell, T.A.; Wang, C.C.; Yi, S.K.

2006-01-01

Design activities for a new civil signal centered at 1575.42 MHz, called L1C, began in 2003, and the Phase 1 effort was completed in 2004. The L1C signal design has evolved and matured during a Phase 2 design activity that began in 2005. Phase 2 has built on the initial design activity, guided by responses to international user surveys conducted during Phase 1. A common core of signal characteristics has been developed to provide advances in robustness and performance. The Phase 2 activity produced five design options, all drawing upon the core signal characteristics, while representing different blends of characteristics and capabilities. A second round of international user surveys was completed to solicit advice concerning these design options. This paper provides an update of the L1C design process, and describes the current L1C design options. Initial performance estimates are presented for each design option, displaying trades between signal tracking robustness, the speed and robustness of clock and ephemeris data, and the rate and robustness of other data message contents. Planned remaining activities are summarized, leading to optimization of the L1C design.

Comparison of Node-Centered and Cell-Centered Unstructured Finite-Volume Discretizations: Inviscid Fluxes

NASA Technical Reports Server (NTRS)

Diskin, Boris; Thomas, James L.

2010-01-01

Cell-centered and node-centered approaches have been compared for unstructured finite-volume discretization of inviscid fluxes. The grids range from regular grids to irregular grids, including mixed-element grids and grids with random perturbations of nodes. Accuracy, complexity, and convergence rates of defect-correction iterations are studied for eight nominally second-order accurate schemes: two node-centered schemes with weighted and unweighted least-squares (LSQ) methods for gradient reconstruction and six cell-centered schemes two node-averaging with and without clipping and four schemes that employ different stencils for LSQ gradient reconstruction. The cell-centered nearest-neighbor (CC-NN) scheme has the lowest complexity; a version of the scheme that involves smart augmentation of the LSQ stencil (CC-SA) has only marginal complexity increase. All other schemes have larger complexity; complexity of node-centered (NC) schemes are somewhat lower than complexity of cell-centered node-averaging (CC-NA) and full-augmentation (CC-FA) schemes. On highly anisotropic grids typical of those encountered in grid adaptation, discretization errors of five of the six cell-centered schemes converge with second order on all tested grids; the CC-NA scheme with clipping degrades solution accuracy to first order. The NC schemes converge with second order on regular and/or triangular grids and with first order on perturbed quadrilaterals and mixed-element grids. All schemes may produce large relative errors in gradient reconstruction on grids with perturbed nodes. Defect-correction iterations for schemes employing weighted least-square gradient reconstruction diverge on perturbed stretched grids. Overall, the CC-NN and CC-SA schemes offer the best options of the lowest complexity and secondorder discretization errors. On anisotropic grids over a curved body typical of turbulent flow simulations, the discretization errors converge with second order and are small for the CC-NN, CC-SA, and CC-FA schemes on all grids and for NC schemes on triangular grids; the discretization errors of the CC-NA scheme without clipping do not converge on irregular grids. Accurate gradient reconstruction can be achieved by introducing a local approximate mapping; without approximate mapping, only the NC scheme with weighted LSQ method provides accurate gradients. Defect correction iterations for the CC-NA scheme without clipping diverge; for the NC scheme with weighted LSQ method, the iterations either diverge or converge very slowly. The best option in curved geometries is the CC-SA scheme that offers low complexity, second-order discretization errors, and fast convergence.

Major Corporation Seeks to Give Back, Funds Boarding School and Professional Development Center: Eagle Rock School and Professional Development Center, Estes Park, Colorado

ERIC Educational Resources Information Center

Stewart, Sarah

2016-01-01

Eagle Rock, a high school for 15- to 18-year-olds, serves 72 students at risk for dropping out of school. Most come from families who cannot afford any other options. The school provides full scholarships for all students and accepts only students who have not succeeded in traditional settings and want to attend the school. Its programs are…

Energy Action Day

NASA Image and Video Library

2017-10-25

Anuj Chokshi of FPL, center, speaks during the Energy Action Day employee event held in NASA Kennedy Space Center's Space Station Processing Facility. Part of Energy Awareness Month, the event featured subject matter experts in the area of solar energy, its connections to the space program and options for residential solar power. From left to right are Chuck Tatro of NASA's Launch Services Program; Sam Ball of NASA Kennedy's Engineering directorate; Chokshi; and Bill McMullen of Southern Power.

Integrating Condom Skills into Family-Centered Prevention: Efficacy of the Strong African American Families–Teen Program

PubMed Central

Kogan, Steven M.; Yu, Tianyi; Brody, Gene H.; Chen, Yi-fu; DiClemente, Ralph J.; Wingood, Gina M.; Corso, Phaedra S.

2012-01-01

Purpose The Strong African American Families–Teen (SAAF–T) program, a family-centered preventive intervention that included an optional condom skills unit, was evaluated to determine whether it prevented unprotected intercourse and increased condom efficacy among rural African American adolescents. Ancillary analyses were conducted to identify factors that predicted youth attendance of the condom skills unit. Methods African American 16-year-olds (N = 502) and their primary caregivers were randomly assigned to SAAF–T (n = 252) or an attention control (n = 250) intervention. SAAF–T families participated in a 5-week family skills training program that included an optional condom skills unit. All families completed in-home pretest, posttest, and long-term follow-up interviews during which adolescents reported on their sexual behavior, condom use, and condom efficacy. Because condom use was addressed only in an optional unit that required caregiver consent, we analyzed efficacy using Complier Average Causal Effect (CACE) analyses. Results Attendance in both SAAF–T and the attention control intervention averaged 4 of 5 sessions; 70% of SAAF–T youth attended the condom skills unit. CACE models indicated that SAAF–T was efficacious in reducing unprotected intercourse and increasing condom efficacy among rural African American high school students. Exploratory analyses indicated that religious caregivers were more likely than nonreligious caregivers to have their youth attend the condom skills unit. Conclusions Results suggest that brief condom skills educational modules in the context of a family-centered program are feasible and reduce risk for sexually transmitted infections and unplanned pregnancies. PMID:22824447

Real Time Maintenance Approval and Required IMMT Coordination

NASA Technical Reports Server (NTRS)

Burchell, S.

2016-01-01

Payloads are assessed for nominal operations. Payload Developers have the option of performing a maintenance hazard assessment (MHA) for potential maintenance activities. When POIC (Payload Operations and Integration Center) Safety reviews an OCR calling for a maintenance procedure, we cannot approve it without a MHA. If no MHA exists, we contact MER (Mission Evaluation Room) Safety. Depending on the nature of the problem, MER Safety has the option to: Analyze and grant approval themselves; Direct the payload back to the ISRP (Integrated Safety Review Panel); Direct the payload to the IMMT (Increment Mission Management Team).

Data reduction formulas for the 16-foot transonic tunnel: NASA Langley Research Center, revision 2

NASA Technical Reports Server (NTRS)

Mercer, Charles E.; Berrier, Bobby L.; Capone, Francis J.; Grayston, Alan M.

1992-01-01

The equations used by the 16-Foot Transonic Wind Tunnel in the data reduction programs are presented in nine modules. Each module consists of equations necessary to achieve a specific purpose. These modules are categorized in the following groups: (1) tunnel parameters; (2) jet exhaust measurements; (3) skin friction drag; (4) balance loads and model attitudes calculations; (5) internal drag (or exit-flow distribution); (6) pressure coefficients and integrated forces; (7) thrust removal options; (8) turboprop options; and (9) inlet distortion.

Case for Deploying Complex Systems Utilizing Commodity Components

NASA Technical Reports Server (NTRS)

Bryant, Barry S.; Pitts, R. Lee; Ritter, George

2003-01-01

This viewgraph representation presents a study of the transition of computer networks and software engineering at the Huntsville Operations Support Center (HOSC) from a client/server UNIX based system to a client/server system based on commodity priced and open system components. Topics covered include: an overview of HOSC ground support systems, an analysis for changes to the existing ground support system, an analysis of options considered for the transition to a new system, and a consideration of goals for a new system.

Innovation Incubator: LiquidCool Solutions Technical Evaluation. Laboratory Study and Demonstration Results of a Directed-Flow, Liquid Submerged Server for High-Efficiency Data Centers

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

Kozubal, Eric J

LiquidCool Solutions (LCS) has developed liquid submerged server (LSS) technology that changes the way computer electronics are cooled. The technology provides an option to cool electronics by the direct contact flow of dielectric fluid (coolant) into a sealed enclosure housing all the electronics of a single server. The intimate dielectric fluid contact with electronics improves the effectiveness of heat removal from the electronics.

Trade Space Assessment for Human Exploration Mission Design

NASA Technical Reports Server (NTRS)

Joosten, B. Kent

2006-01-01

Many human space exploration mission architecture assessments have been performed over the years by diverse organizations and individuals. Direct comparison of metrics among these studies is extremely difficult due to widely varying assumptions involving projected technology readiness, mission goals, acceptable risk criteria, and socio-political environments. However, constant over the years have been the physical laws of celestial dynamics and rocket propulsion systems. A finite diverse yet finite architecture trade space should exist which captures methods of human exploration - particularly of the Moon and Mars - by delineating technical trades and cataloging the physically realizable options of each. A particular architectural approach should then have a traceable path through this "trade tree". It should be pointed out that not every permutation of paths will result in a physically realizable mission approach, but cataloging options that have been examined by past studies should help guide future analysis. This effort was undertaken in two phases by multi-center NASA working groups in the spring and summer of 2004 using more than thirty years of past studies to "flesh out" the Moon-Mars human exploration trade space. The results are presented, not as a "trade tree", which would be unwieldy, but as a "menu" of potential technical options as a function of mission phases. This is envisioned as a tool to aid future mission designers by offering guidance to relevant past analyses.

Employees' views on home-based, after-hours telephone triage by Dutch GP cooperatives.

PubMed

Backhaus, Ramona; van Exel, Job; de Bont, Antoinette

2013-11-04

Dutch out-of-hours (OOH) centers find it difficult to attract sufficient triage staff. They regard home-based triage as an option that might attract employees. Specially trained nurses are supposed to conduct triage by telephone from home for after-hours medical care. The central aim of this research is to investigate the views of employees of OOH centers in The Netherlands on home-based telephone triage in after-hours care. The study is a Q methodology study. Triage nurses, general practitioners (GPs) and managers of OOH centers ranked 36 opinion statements on home-based triage. We interviewed 10 participants to help develop and validate the statements for the Q sort, and 77 participants did the Q sort. We identified four views on home-based telephone triage. Two generally favor home-based triage, one highlights some concerns and conditions, and one opposes it out of concern for quality. The four views perceive different sources of credibility for nurse triagists working from home. Home-based telephone triage is a controversial issue among triage nurses, GPs and managers of OOH centers. By identifying consensus and dissension among GPs, triagists, managers and regulators, this study generates four perspectives on home-based triage. In addition, it reveals the conditions considered important for home-based triage.

Employees’ views on home-based, after-hours telephone triage by Dutch GP cooperatives

PubMed Central

2013-01-01

Background Dutch out-of-hours (OOH) centers find it difficult to attract sufficient triage staff. They regard home-based triage as an option that might attract employees. Specially trained nurses are supposed to conduct triage by telephone from home for after-hours medical care. The central aim of this research is to investigate the views of employees of OOH centers in The Netherlands on home-based telephone triage in after-hours care. Methods The study is a Q methodology study. Triage nurses, general practitioners (GPs) and managers of OOH centers ranked 36 opinion statements on home-based triage. We interviewed 10 participants to help develop and validate the statements for the Q sort, and 77 participants did the Q sort. Results We identified four views on home-based telephone triage. Two generally favor home-based triage, one highlights some concerns and conditions, and one opposes it out of concern for quality. The four views perceive different sources of credibility for nurse triagists working from home. Conclusion Home-based telephone triage is a controversial issue among triage nurses, GPs and managers of OOH centers. By identifying consensus and dissension among GPs, triagists, managers and regulators, this study generates four perspectives on home-based triage. In addition, it reveals the conditions considered important for home-based triage. PMID:24188407

Costs Associated with Surgically Treated Cases of Abdominal Cystic Echinococcosis: A Single Center's Experience from 2008 to 2014, Pavia, Italy

PubMed Central

Narra, Roberta; Maestri, Marcello; Budke, Christine M.; Tamarozzi, Francesca; Mariconti, Mara; Nicoletti, Giovanni J.; Rinaldi, Francesca; Brunetti, Enrico

2016-01-01

Cystic echinococcosis (CE) is a globally distributed zoonosis caused by the Echinococcus granulosus sensu lato species complex. Four approaches are available for treatment of abdominal CE: surgery, percutaneous aspiration, chemotherapy with albendazole, and watch-and-wait. Allocation of patients to these different treatment options mainly depends on the stage of the cystic lesion. However, as available guidelines are not widely followed, surgery is often applied even without the correct indication outside referral centers. This is not only a disadvantage for the patient, but also a waste of money. In this study, we evaluated the cost of the surgical approach for abdominal CE by analyzing hospitalization costs for 14 patients admitted to the General Surgery Ward at the “San Matteo” Hospital Foundation in Pavia, Italy, from 2008 through 2014. We found that the total cost of a single hospitalization, including hospital stay, surgical intervention, personnel, drugs, and administrative costs ranged from €5,874 to 23,077 (median €11,033) per patient. Our findings confirm that surgery can be an expensive option. Therefore, surgical intervention should be limited to cyst types that do not benefit from nonsurgical therapies and appropriate case management can best be accomplished by using a cyst stage-specific approach. PMID:27273641

Energy Action Day

NASA Image and Video Library

2017-10-25

NASA Kennedy Space Center's Sam Ball, third from left, speaks during the Energy Action Day employee event held in NASA Kennedy Space Center's Space Station Processing Facility. Part of Energy Awareness Month, the event featured subject matter experts in the area of solar energy, its connections to the space program and options for residential solar power. From left to right are Nick Murdock, energy and water program manager at Kennedy; Chuck Tatro of NASA's Launch Services Program; Ball; Anuj Chokshi of FPL; Bill McMullen of Southern Power; John Sherwin of the Florida Solar Energy Center in Cocoa; and Lorraine Koss of the Brevard County Solar Co-op.

PubMed

Thielker, Jovanna; Bendella, Habib; Gaudin, Robert A; Grosheva, Maria; Volk, Fabian Gerd; Guntinas-Lichius, Orlando

2018-06-01

There are numerous reasons for facial palsy, which range from idiopathic palsy (Bell's palsy) to destruction of the facial nerve by a malignant salivary gland tumor. If the chance of spontaneous recovery is low or there is no drug therapy available, surgery is a therapeutical option. Recently, larger studies were published by specialized centers which enable a more individualized therapeutical concept to achieve tone, symmetry and movement of the paralyzed face based on a detailed preoperative assessment. An important therapy target is the improvement of patient´s quality of life. In the present article, we systematically review the important diagnostic steps and, directly derived from this, the indications for surgical options for reanimation of the mimic function. Furthermore, we provide an overview about a variety of postoperative adjuvant measures as well as on new objective assessment tools to evaluate the therapy results. © Georg Thieme Verlag KG Stuttgart · New York.

Optimum allocation for a dual-frame telephone survey.

PubMed

Wolter, Kirk M; Tao, Xian; Montgomery, Robert; Smith, Philip J

2015-12-01

Careful design of a dual-frame random digit dial (RDD) telephone survey requires selecting from among many options that have varying impacts on cost, precision, and coverage in order to obtain the best possible implementation of the study goals. One such consideration is whether to screen cell-phone households in order to interview cell-phone only (CPO) households and exclude dual-user household, or to take all interviews obtained via the cell-phone sample. We present a framework in which to consider the tradeoffs between these two options and a method to select the optimal design. We derive and discuss the optimum allocation of sample size between the two sampling frames and explore the choice of optimum p , the mixing parameter for the dual-user domain. We illustrate our methods using the National Immunization Survey , sponsored by the Centers for Disease Control and Prevention.

A Tabletop Persistent-Mode, Liquid-Helium-Free, 1.5-T/90-mm MgB2 “Finger” MRI Magnet for Osteoporosis Screening: Two Design Options

PubMed Central

Park, Dongkeun; Bascuñán, Juan; Michael, Philip C.; Iwasa, Yukikazu

2017-01-01

In this paper we present two design options for a tabletop liquid-helium-free, persistent-mode 1.5-T/90-mm MgB2 “finger” MRI magnet for osteoporosis screening. Both designs, one with and the other without an iron yoke, satisfy the following criteria: 1) 1.5-T center field with a 90-mm room-temperature bore for a finger to be placed at the magnet center; 2) spatial field homogeneity of <5 ppm over a 20-mm diameter of spherical volume (DSV); 3) persistent-mode operation with temporal stability of <0.1 ppm/hr; 4) liquid-helium-free operation; 5) 5-gauss fringe field radius of <50 cm from the magnet center; and 6) small and light enough for placement on an exam table. Although the magnet is designed to operate nominally at 10 K, maintained by a cryocooler, it has a 5-K temperature margin to keep its 1.5-T persistent field up to 15 K. The magnet will be immersed in a volume of solid nitrogen (SN2) that provides additional thermal mass when the cryocooler is switched off to provide a vibration-free measurement environment. The SN2 enables the magnet to maintain its persistent field over a period of time sufficient for quiescent measurement, while still limiting the magnet operating temperature to ≤15 K. We discuss first pros and cons of each design, and then further studies of our proposed MgB2 finger MRI magnet. PMID:29456437

A Tabletop Persistent-Mode, Liquid-Helium-Free, 1.5-T/90-mm MgB2 "Finger" MRI Magnet for Osteoporosis Screening: Two Design Options.

PubMed

Park, Dongkeun; Bascuñán, Juan; Michael, Philip C; Iwasa, Yukikazu

2018-04-01

In this paper we present two design options for a tabletop liquid-helium-free, persistent-mode 1.5-T/90-mm MgB 2 "finger" MRI magnet for osteoporosis screening. Both designs, one with and the other without an iron yoke, satisfy the following criteria: 1) 1.5-T center field with a 90-mm room-temperature bore for a finger to be placed at the magnet center; 2) spatial field homogeneity of <5 ppm over a 20-mm diameter of spherical volume (DSV); 3) persistent-mode operation with temporal stability of <0.1 ppm/hr; 4) liquid-helium-free operation; 5) 5-gauss fringe field radius of <50 cm from the magnet center; and 6) small and light enough for placement on an exam table. Although the magnet is designed to operate nominally at 10 K, maintained by a cryocooler, it has a 5-K temperature margin to keep its 1.5-T persistent field up to 15 K. The magnet will be immersed in a volume of solid nitrogen (SN 2 ) that provides additional thermal mass when the cryocooler is switched off to provide a vibration-free measurement environment. The SN 2 enables the magnet to maintain its persistent field over a period of time sufficient for quiescent measurement, while still limiting the magnet operating temperature to ≤15 K. We discuss first pros and cons of each design, and then further studies of our proposed MgB 2 finger MRI magnet.

Enrichment Zoning Options for the Small Nuclear Rocket Engine (SNRE)

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

Bruce G. Schnitzler; Stanley K. Borowski

2010-07-01

Advancement of U.S. scientific, security, and economic interests through a robust space exploration program requires high performance propulsion systems to support a variety of robotic and crewed missions beyond low Earth orbit. In NASA’s recent Mars Design Reference Architecture (DRA) 5.0 study (NASA-SP-2009-566, July 2009), nuclear thermal propulsion (NTP) was again selected over chemical propulsion as the preferred in-space transportation system option because of its high thrust and high specific impulse (-900 s) capability, increased tolerance to payload mass growth and architecture changes, and lower total initial mass in low Earth orbit. An extensive nuclear thermal rocket technology development effortmore » was conducted from 1955-1973 under the Rover/NERVA Program. The Small Nuclear Rocket Engine (SNRE) was the last engine design studied by the Los Alamos National Laboratory during the program. At the time, this engine was a state-of-the-art design incorporating lessons learned from the very successful technology development program. Past activities at the NASA Glenn Research Center have included development of highly detailed MCNP Monte Carlo transport models of the SNRE and other small engine designs. Preliminary core configurations typically employ fuel elements with fixed fuel composition and fissile material enrichment. Uniform fuel loadings result in undesirable radial power and temperature profiles in the engines. Engine performance can be improved by some combination of propellant flow control at the fuel element level and by varying the fuel composition. Enrichment zoning at the fuel element level with lower enrichments in the higher power elements at the core center and on the core periphery is particularly effective. Power flattening by enrichment zoning typically results in more uniform propellant exit temperatures and improved engine performance. For the SNRE, element enrichment zoning provided very flat radial power profiles with 551 of the 564 fuel elements within 1% of the average element power. Results for this and alternate enrichment zoning options for the SNRE are compared.« less

“Waiting for DAAs”: A retrospective chart review of patients with untreated hepatitis C in Rwanda

PubMed Central

Gupta, Neil; Kabahizi, Jules; Mukabatsinda, Constance; Walker, Timothy David; Musabeyezu, Emmanuel; Kiromera, Athanase; Steiner, Kevin; Mukherjee, Joia; Nsanzimana, Sabin; Mbituyumuremyi, Aimable

2017-01-01

Background Access to treatment for hepatitis C virus (HCV) in sub-Saharan Africa is extremely limited. With the advent of direct acting antivirals (DAAs), highly effective and easy-to-deliver oral regimens are now available on the global market. This study was conducted to understand the background and characteristics of a national cohort of patients with HCV infection enrolled in care and awaiting therapy with DAAs. Methods and findings We conducted a retrospective chart review of all adult patients with confirmed HCV infection who were currently enrolled in care and treatment at the four existing hepatitis referral centers in Rwanda. Patient charts at these centers were reviewed, and routinely collected data were recorded and analyzed. Overall, 253 patients were identified; median age was 56 years (IQR: 43, 65), and 149 (58.9%) were female. Median viral load was 688,736 IU/ml and 96.7% were HCV genotype 4. As classified by FIB-4 score, 64.8% of the patients had moderate to severe fibrosis. Fibrosis stage was associated with age (OR 1.12, CI 1.09–1.17), but not with time since diagnosis, gender, treatment center, or type of insurance. There was a low frequency of documented co-morbid conditions, including hypertension, diabetes, HIV, and hepatitis B virus. Conclusions Compared to an estimated 55,000 patients eligible for HCV treatment in Rwanda, this study identified only 253 patients currently diagnosed and engaged in care, highlighting an immense treatment gap in HCV, likely due to the lack of accessible and affordable screening, diagnostic, and treatment modalities. The patients that were enrolled in care had a disproportionately advanced fibrosis stage, possibly indicating late presentation to care or lack of treatment options. In the context of newly available and effective treatment options, this study supports the overall need to accelerate access to HCV screening, diagnostics, and care and treatment services in resource-limited settings in sub-Saharan Africa. PMID:28323868

"Waiting for DAAs": A retrospective chart review of patients with untreated hepatitis C in Rwanda.

PubMed

Gupta, Neil; Kabahizi, Jules; Mukabatsinda, Constance; Walker, Timothy David; Musabeyezu, Emmanuel; Kiromera, Athanase; Van Nuil, Jennifer Ilo; Steiner, Kevin; Mukherjee, Joia; Nsanzimana, Sabin; Mbituyumuremyi, Aimable

2017-01-01

Access to treatment for hepatitis C virus (HCV) in sub-Saharan Africa is extremely limited. With the advent of direct acting antivirals (DAAs), highly effective and easy-to-deliver oral regimens are now available on the global market. This study was conducted to understand the background and characteristics of a national cohort of patients with HCV infection enrolled in care and awaiting therapy with DAAs. We conducted a retrospective chart review of all adult patients with confirmed HCV infection who were currently enrolled in care and treatment at the four existing hepatitis referral centers in Rwanda. Patient charts at these centers were reviewed, and routinely collected data were recorded and analyzed. Overall, 253 patients were identified; median age was 56 years (IQR: 43, 65), and 149 (58.9%) were female. Median viral load was 688,736 IU/ml and 96.7% were HCV genotype 4. As classified by FIB-4 score, 64.8% of the patients had moderate to severe fibrosis. Fibrosis stage was associated with age (OR 1.12, CI 1.09-1.17), but not with time since diagnosis, gender, treatment center, or type of insurance. There was a low frequency of documented co-morbid conditions, including hypertension, diabetes, HIV, and hepatitis B virus. Compared to an estimated 55,000 patients eligible for HCV treatment in Rwanda, this study identified only 253 patients currently diagnosed and engaged in care, highlighting an immense treatment gap in HCV, likely due to the lack of accessible and affordable screening, diagnostic, and treatment modalities. The patients that were enrolled in care had a disproportionately advanced fibrosis stage, possibly indicating late presentation to care or lack of treatment options. In the context of newly available and effective treatment options, this study supports the overall need to accelerate access to HCV screening, diagnostics, and care and treatment services in resource-limited settings in sub-Saharan Africa.

Effects-based strategy development through center of gravity and target system analysis

NASA Astrophysics Data System (ADS)

White, Christopher M.; Prendergast, Michael; Pioch, Nicholas; Jones, Eric K.; Graham, Stephen

2003-09-01

This paper describes an approach to effects-based planning in which a strategic-theater-level mission is refined into operational-level and ultimately tactical-level tasks and desired effects, informed by models of the expected enemy response at each level of abstraction. We describe a strategy development system that implements this approach and supports human-in-the-loop development of an effects-based plan. This system consists of plan authoring tools tightly integrated with a suite of center of gravity (COG) and target system analysis tools. A human planner employs the plan authoring tools to develop a hierarchy of tasks and desired effects. Upon invocation, the target system analysis tools use reduced-order models of enemy centers of gravity to select appropriate target set options for the achievement of desired effects, together with associated indicators for each option. The COG analysis tools also provide explicit models of the causal mechanisms linking tasks and desired effects to one another, and suggest appropriate observable indicators to guide ISR planning, execution monitoring, and campaign assessment. We are currently implementing the system described here as part of the AFRL-sponsored Effects Based Operations program.

78 FR 20927 - Tobacco Products Scientific Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-08

...., Rockville, MD 20850, 1-877-287- 1373. Contact Person: Caryn Cohen, Center for Tobacco Products, Food and Drug Administration, 9200 Corporate Blvd., Rockville, MD 20850, 1-877- 287-1373 (choose option 5..., an order from [[Page 20928

Operations Manual for the National Center for Physical Acoustics Infrasound Microphone

DTIC Science & Technology

2013-02-01

thumbdrive.) There are three sections of the configuration file that can be edited: sensorConfig, adcConfig and autoControl . Modifying any other...for autoControl autoControl = { options = ( { doSchedule = 0; if nonzero, hourly scheduler is enabled

Designing Communication and Learning Environments.

ERIC Educational Resources Information Center

Gayeski, Diane M., Ed.

Designing and remodeling educational facilities are becoming more complex with options that include computer-based collaboration, classrooms with multimedia podiums, conference centers, and workplaces with desktop communication systems. This book provides a collection of articles that address educational facility design categorized in the…

Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.

PubMed

Nahm, Eun-Shim; Diblasi, Catherine; Gonzales, Eva; Silver, Kristi; Zhu, Shijun; Sagherian, Knar; Kongs, Katherine

2017-04-01

Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current personal health record and patient portal implementation process. Further studies are needed using larger samples in other settings to ascertain if these results are generalizable to other populations.

Exploring Effective Decision Making through Human-Centered and Computational Intelligence Methods

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

Han, Kyungsik; Cook, Kristin A.; Shih, Patrick C.

Decision-making has long been studied to understand a psychological, cognitive, and social process of selecting an effective choice from alternative options. Its studies have been extended from a personal level to a group and collaborative level, and many computer-aided decision-making systems have been developed to help people make right decisions. There has been significant research growth in computational aspects of decision-making systems, yet comparatively little effort has existed in identifying and articulating user needs and requirements in assessing system outputs and the extent to which human judgments could be utilized for making accurate and reliable decisions. Our research focus ismore » decision-making through human-centered and computational intelligence methods in a collaborative environment, and the objectives of this position paper are to bring our research ideas to the workshop, and share and discuss ideas.« less

Water Efficient Installations - A New Army Guidance Document

DTIC Science & Technology

2010-06-01

Toilets 1.28 gpf or less, 50 manuf., 500+ models Required in CA Dual flush options also available WaterSense program provides certification and...lose 8760 to 219,000 gal/year Broken flush valve on toilet can lose 40 gal/hour US Army Corps of Engineers® Engineer Research and Development Center...Engineer Research and Development Center Toilets and Urinals ULFTs Ultra-Low Flush Toilet , also called low flow 1.28 gpf to 1.6 gpf HETs High Efficiency

PROFILE: Airfoil Geometry Manipulation and Display. User's Guide

NASA Technical Reports Server (NTRS)

Collins, Leslie; Saunders, David

1997-01-01

This report provides user information for program PROFILE, an aerodynamics design utility for plotting, tabulating, and manipulating airfoil profiles. A dozen main functions are available. The theory and implementation details for two of the more complex options are also presented. These are the REFINE option, for smoothing curvature in selected regions while retaining or seeking some specified thickness ratio, and the OPTIMIZE option, which seeks a specified curvature distribution. Use of programs QPLOT and BPLOT is also described, since all of the plots provided by PROFILE (airfoil coordinates, curvature distributions, pressure distributions)) are achieved via the general-purpose QPLOT utility. BPLOT illustrates (again, via QPLOT) the shape functions used by two of PROFILE's options. These three utilities should be distributed as one package. They were designed and implemented for the Applied Aerodynamics Branch at NASA Ames Research Center, Moffett Field, California. They are all written in FORTRAN 77 and run on DEC and SGI systems under OpenVMS and IRIX.

Patient-centered medical homes: will health care reform provide new options for rural communities and providers?

PubMed

Bolin, Jane N; Gamm, Larry; Vest, Joshua R; Edwardson, Nick; Miller, Thomas R

2011-01-01

Many are calling for the expansion of the patient-centered medical home model into rural and underserved populations as a transformative strategy to address issues of access, efficiency, quality, and sustainability in the delivery of health care. Patient-centered medical homes have been touted as a promising cost-saving model for comprehensive management of persons with chronic diseases and disabilities, but it is unclear how rural practitioners in medically underserved areas will implement the patient-centered medical home. This article examines how the Patient Protection & Affordable Care Act of 2010 will enhance rural providers' ability to provide patient-centered care and services contemplated under the Act in a comprehensive, coordinated, cost-effective way despite leaner budgets and health workforce shortages.

Crew Transfer Options for Servicing of Geostationary Satellites

NASA Technical Reports Server (NTRS)

Cerro, Jeffrey A.

2012-01-01

In 2011, NASA and DARPA undertook a study to examine capabilities and system architecture options which could be used to provide manned servicing of satellites in Geostationary Earth Orbit (GEO). The study focused on understanding the generic nature of the problem and examining technology requirements, it was not for the purpose of proposing or justifying particular solutions. A portion of this study focused on assessing possible capabilities to efficiently transfer crew between Earth, Low Earth Orbit (LEO), and GEO satellite servicing locations. This report summarizes the crew transfer aspects of manned GEO satellite servicing. Direct placement of crew via capsule vehicles was compared to concepts of operation which divided crew transfer into multiple legs, first between earth and LEO and second between LEO and GEO. In space maneuvering via purely propulsive means was compared to in-space maneuvering which utilized aerobraking maneuvers for return to LEO from GEO. LEO waypoint locations such as equatorial, Kennedy Space Center, and International Space Station inclinations were compared. A discussion of operational concepts is followed by a discussion of appropriate areas for technology development.

Low/Medium Density Biomass, Coastal and Ocean Carbon: A Carbon Cycle Mission

NASA Technical Reports Server (NTRS)

Esper, Jaime; Gervin, Jan; Kirchman, Frank; Middleton, Elizabeth; Knox, Robert; Gregg, Watson; Mannino, Antonio; McClain, Charles; Herman, Jay; Hall, Forrest

2003-01-01

As part of the Global Carbon Cycle research effort, an agency-wide planning initiative was organized between October 2000 and June 2001 by the NASA Goddard Space Flight Center (GSFC) at the behest of the Associate Administrator for Earth Science. The goal was to define future research and technology development activities needed for implementing a cohesive scientific observation plan. A timeline for development of missions necessary to acquire the selected new measurements was laid out, and included missions for low - medium density terrestrial biomass / coastal ocean / and ocean carbon. This paper will begin with the scientific justification and measurement requirements for these specific activities, explore the options for having separate or combined missions, and follow-up with an implementation study centered on a hyperspectral imager at geosynchronous altitudes.

Using Distributed Operations to Enable Science Research on the International Space Station

NASA Technical Reports Server (NTRS)

Bathew, Ann S.; Dudley, Stephanie R. B.; Lochmaier, Geoff D.; Rodriquez, Rick C.; Simpson, Donna

2011-01-01

In the early days of the International Space Station (ISS) program, and as the organization structure was being internationally agreed upon and documented, one of the principal tenets of the science program was to allow customer-friendly operations. One important aspect of this was to allow payload developers and principle investigators the flexibility to operate their experiments from either their home sites or distributed telescience centers. This telescience concept was developed such that investigators had several options for ISS utilization support. They could operate from their home site, the closest telescience center, or use the payload operations facilities at the Marshall Space Flight Center in Huntsville, Alabama. The Payload Operations Integration Center (POIC) processes and structures were put into place to allow these different options to its customers, while at the same time maintain its centralized authority over NASA payload operations and integration. For a long duration space program with many scientists, researchers, and universities expected to participate, it was imperative that the program structure be in place to successfully facilitate this concept of telescience support. From a payload control center perspective, payload science operations require two major elements in order to make telescience successful within the scope of the ISS program. The first element is decentralized control which allows the remote participants the freedom and flexibility to operate their payloads within their scope of authority. The second element is a strong ground infrastructure, which includes voice communications, video, telemetry, and commanding between the POIC and the payload remote site. Both of these elements are important to telescience success, and both must be balanced by the ISS program s documented requirements for POIC to maintain its authority as an integration and control center. This paper describes both elements of distributed payload operations and discusses the benefits and drawbacks.

Exploration of how women make treatment decisions after a breast cancer diagnosis.

PubMed

Spittler, Cheryl A; Pallikathayil, Leonie; Bott, Marjorie

2012-09-01

To examine the information needs of women after receiving a diagnosis of breast cancer, investigate how decisions about treatment options are made, and assess personal responses to the decisions made. Mixed-methods approach using quantitative and qualitative data. The University of Kansas Medical Center and Quinn Plastic Surgery Center, both in the midwestern United States. 102 breast cancer survivors who had completed all forms of treatment for at least three months and less than five years. Phase I participants completed five questionnaires about informational needs, confidence and satisfaction with the decision, decisional regret, and conflict. In phase II, 15 participants were purposively sampled from the 102 survivors to participate in a focus group session. Data analysis included frequencies and multiple regression for phase I and qualitative content analysis for phase II. Informational needs, confidence and satisfaction with the decision, and decisional regret and conflict. The variables (widowed, confidence and satisfaction with decision, and decisional conflict and regret) significantly (p = 0.01) accounted for 14% of the variance in informational needs. Two themes emerged from the study: (a) feelings, thoughts, and essential factors that impact treatment considerations, and (b) tips for enhancing treatment consideration options. The study's results show that women viewed informational needs as very important in making treatment decisions after being diagnosed with breast cancer. The treatment team should provide the information, with consideration of the patient's personal preferences, that will assist women to make informed, confident, and satisfied decisions about treatment choices.

Congenital oval or round window anomaly with or without abnormal facial nerve course: surgical results for 15 ears.

PubMed

Thomeer, Henricus; Kunst, Henricus; Verbist, Berit; Cremers, Cor

2012-07-01

To describe the audiometric results in a consecutive series of patients with congenital ossicular aplasia (Class 4a) or dysplasia of the oval and/or round window (Class 4b), which might include a possible anomalous course of the facial nerve. Retrospective chart study. Tertiary referral center. A tertiary referral center study with a total of 14 patients with congenital minor ear anomalies as part of a consecutive series (n = 89) who underwent exploratory tympanotomies (15 ears). Audiometric results. In 8 of 15 ears, ossicular reconstruction was attempted. In the short term (1 mo), there was a serviceable hearing outcome (air-bone gap closure to within 25 dB) in 4 ears. However, the long-term results showed deterioration because of an increased air-bone gap in all but 1 ear. No facial nerve lesion was observed postoperatively. Congenital dysplasia or aplasia of the oval and/or round window is an uncommon congenital minor ear anomaly. Classical microsurgical opportunities are rare in this group of anomalies. Newer options for hearing rehabilitation, such as the osseointegrated passive bone conduction devices, have become viable alternatives for conventional air conduction hearing devices. In the near future, upcoming active bone conduction devices might become the most preferred surgical option. In cases in which the facial nerve is only partially overlying the oval window, a type of malleostapedotomy procedure might result in a serviceable postoperative hearing level.

Early infant diagnosis of HIV infection using DNA-PCR at a referral center: an 8 years retrospective analysis.

PubMed

Olana, Tolessa; Bacha, Tigist; Worku, Walelign; Tadesse, Birkneh Tilahun

2016-01-01

Over the last decade, Ethiopia adopted different strategies of prevention of mother to child transmission of HIV (PMTCT). Prior to implementation of Option A in 2011, there was no provision of prophylaxis for PMTCT. With 'Option A', PMTCT interventions relied on maternal CD4 count. In early 2013, ''Option B+'' has been started; with this option, antiretroviral therapy is started and continued for life to any HIV positive pregnant mother irrespective of CD4 count with an enhanced treatment for the baby. Though there are a number of studies which evaluated the effectiveness of PMTCT interventions, the current study assessed the real-world effectiveness of PMTCT options in a setting where there is limitation of resources. This study tried to address three questions: what proportion of babies tested by DNA-PCR are HIV infected in the first 2 months of life? How does the type of PMTCT intervention affect presence of HIV infection at this age? What are the factors affecting HIV transmission, after controlling for type of PMCT-HIV intervention? We assessed records of 624 registered HIV exposed infants and 412 mothers who were delivered at Bishoftu Hospital from May 2006 to August 2014. Presence of HIV infection at 6-8 weeks of age was assessed from the records. Maternal and infant risk factors for infection at this age were analyzed. Data were collected using standard data abstraction format and were analyzed using SPSS version 20. Among all the infants who were delivered at the hospital during the study period, 624/936 (66.7 %) had undergone early infant diagnosis at 6-8 weeks. Twenty-seven (4.3 %) were positive for HIV DNA PCR at the age of 6-8 weeks. None of the infants who received ''Option B+'' had a positive HIV DNA PCR result. HIV infection rate was highest among those who took either no prophylaxis or single dose Nevirapine (11.5 and 11.1 % respectively). Those who took single dose Nevirapine and Zidovudine had HIV positivity rate of 3.9 %. Many of the covariates which were shown to be predictors on bivariate analysis were found not to be independent predictors on multivariate analysis. PMTCT ''Option B+'' resulted in zero HIV infection rates among the included infants. There was a high loss to follow up rate at 6-8 weeks of age. The authors recommend that a better strategy of linkage to care and treatment should be devised for HIV exposed infants.

Remote Iliac Artery Endarterectomy: A Case Series and Systematic Review.

PubMed

Bekken, Joost A; de Boer, Sanne W; van der Sluijs, Rogier; Jongsma, Hidde; de Vries, Jean-Paul P M; Fioole, Bram

2018-02-01

To evaluate the long-term results of remote iliac artery endarterectomy (RIAE) in 2 vascular referral centers and review existing literature. A retrospective analysis was conducted of 109 consecutive patients (mean age 64.2±10.7 years; 72 men) who underwent 113 RIAE procedures for lower limb ischemia from January 2004 to August 2015 at 2 vascular centers. The majority of limbs (82, 72.6%) had TASC II D lesions (31 TASC II C). Primary outcome measures were primary, assisted primary, and secondary patency. A comprehensive literature search was performed in the PubMed and EMBASE databases to identify all English-language studies published after 1990 reporting the results of RIAE. Technical success was achieved in 95 (84.1%) of the 113 procedures. The complication rate was 13.7%, and 30-day mortality was 0%. At 5 years, primary patency was 78.2%, assisted primary patency was 83.4%, and secondary patency was 86.7%. Hemodynamic success was obtained in 91.7% of patients, and clinical improvement was observed in 95.2%. Freedom from major amputation was 94.7% at 5 years. The systematic review comprised 6 studies including 419 RIAEs, and pooled data showed results similar to the current study. For external iliac artery occlusions extending into the common femoral artery, RIAE appears to be a valuable hybrid treatment option. It combines acceptable morbidity and low mortality with good long-term patency. It has some advantages over an open surgical iliofemoral bypass or complete endovascular revascularization and could be the best treatment option in selected cases.

Summit Station Skiway Cost Analysis

DTIC Science & Technology

2016-07-01

Laboratory (CRREL) U.S. Army Engineer Research and Development Center (ERDC) 72 Lyme Road Hanover, NH 03755-1290 Final Report Approved for...cargo loads. To explore further skiway improvement and cost saving techniques, this report reviews alternative maintenance and construction options...3 2.2 Maintenance

Universal Design: Process, Principles, and Applications

ERIC Educational Resources Information Center

Burgstahler, Sheryl

2009-01-01

Designing any product or environment involves the consideration of many factors, including aesthetics, engineering options, environmental issues, safety concerns, industry standards, and cost. Typically, designers focus their attention on the average user. In contrast, universal design (UD), according to the Center for Universal Design," is…

42 CFR 417.576 - Final settlement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... capita costs incurred in furnishing covered services to its Medicare enrollees, determined in accordance... January 1, 1996, the costs of hospital and SNF services paid by Medicare's intermediaries under the option...

Oncologists partner with Watson on genomics.

PubMed

2015-08-01

A new collaboration between IBM Watson Health and more than a dozen cancer centers uses the power of cognitive computing to dramatically reduce the time it takes to analyze data from patients' DNA and identify targeted treatment options. ©2015 American Association for Cancer Research.

SLF Run & Walk

NASA Image and Video Library

2018-03-13

Kennedy Space Center Director Bob Cabana approaches the finish line at the KSC Walk Run on the Shuttle Landing Facility runway. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options in the spirit of friendly competition.

SLF Run & Walk

NASA Image and Video Library

2018-03-13

A line of Kennedy Space Center employees and guests stretches down the Shuttle Landing Facility Runway during the KSC Walk Run. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options in the spirit of friendly competition.

Investigating the Experiences of Childhood Cancer Patients and Parents Participating in Optional Nontherapeutic Clinical Research Studies in the UK

PubMed Central

Errington, Julie; Malik, Ghada; Evans, Julie; Baston, Jenny; Parry, Annie; Price, Lisa; Johnstone, Hina; Peters, Selena; Oram, Victoria; Howe, Karen; Whiteley, Emma; Tunnacliffe, Jane

2016-01-01

Background While the majority of childhood cancer clinical trials are treatment related, additional optional research investigations may be carried out that do not directly impact on treatment. It is essential that these studies are conducted ethically and that the experiences of families participating in these studies are as positive as possible. Methods A questionnaire study was carried out to investigate the key factors that influence why families choose to participate in optional nontherapeutic research studies, the level of understanding of the trials involved, and the experiences of participation. Results A total of 100 participants from six UK centers were studied; 77 parents, 10 patients >16 years, and 13 patients aged 8–15 years. Ninety‐seven percent of parents and 90% of patients felt that information provided prior to study consent was of the right length, with 52% of parents and 65% of patients fully understanding the information provided. Seventy‐four percent of parents participated in research studies in order to “do something important”, while 74% of patients participated “to help medical staff”. Encouragingly, <5% of participants felt that their clinical care would be negatively affected if they did not participate. Positive aspects of participation included a perception of increased attention from medical staff. Negative aspects included spending longer periods in hospital and the requirement for additional blood samples. Ninety‐six percent of parents and 87% of patients would participate in future studies. Conclusions The study provides an insight into the views of childhood cancer patients and their parents participating in nontherapeutic clinical research studies. Overwhelmingly, the findings suggest that participation is seen as a positive experience. PMID:26928983

Investigating the Experiences of Childhood Cancer Patients and Parents Participating in Optional Nontherapeutic Clinical Research Studies in the UK.

PubMed

Errington, Julie; Malik, Ghada; Evans, Julie; Baston, Jenny; Parry, Annie; Price, Lisa; Johnstone, Hina; Peters, Selena; Oram, Victoria; Howe, Karen; Whiteley, Emma; Tunnacliffe, Jane; Veal, Gareth J

2016-07-01

While the majority of childhood cancer clinical trials are treatment related, additional optional research investigations may be carried out that do not directly impact on treatment. It is essential that these studies are conducted ethically and that the experiences of families participating in these studies are as positive as possible. A questionnaire study was carried out to investigate the key factors that influence why families choose to participate in optional nontherapeutic research studies, the level of understanding of the trials involved, and the experiences of participation. A total of 100 participants from six UK centers were studied; 77 parents, 10 patients >16 years, and 13 patients aged 8-15 years. Ninety-seven percent of parents and 90% of patients felt that information provided prior to study consent was of the right length, with 52% of parents and 65% of patients fully understanding the information provided. Seventy-four percent of parents participated in research studies in order to "do something important", while 74% of patients participated "to help medical staff". Encouragingly, <5% of participants felt that their clinical care would be negatively affected if they did not participate. Positive aspects of participation included a perception of increased attention from medical staff. Negative aspects included spending longer periods in hospital and the requirement for additional blood samples. Ninety-six percent of parents and 87% of patients would participate in future studies. The study provides an insight into the views of childhood cancer patients and their parents participating in nontherapeutic clinical research studies. Overwhelmingly, the findings suggest that participation is seen as a positive experience. © 2016 The Authors. Pediatric Blood & Cancer, published by Wiley Periodicals, Inc.

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

PubMed

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

2018-01-16

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

Computations for the 16-foot transonic tunnel, NASA, Langley Research Center, revision 1

NASA Technical Reports Server (NTRS)

Mercer, Charles E.; Berrier, Bobby L.; Capone, Francis J.; Grayston, Alan M.; Sherman, C. D.

1987-01-01

The equations used by the 16 foot transonic tunnel in the data reduction programs are presented in eight modules. Each module consists of equations necessary to achieve a specific purpose. These modules are categorized in the following groups: tunnel parameters; jet exhaust measurements; skin friction drag; balance loads and model attitudes calculations; internal drag (or exit-flow distributions); pressure coefficients and integrated forces; thrust removal options; and turboprop options. This document is a companion document to NASA TM-83186, A User's Guide to the Langley 16 Foot Transonic Tunnel, August 1981.

Hierarchical and hybrid energy storage devices in data centers: Architecture, control and provisioning.

PubMed

Sun, Mengshu; Xue, Yuankun; Bogdan, Paul; Tang, Jian; Wang, Yanzhi; Lin, Xue

2018-01-01

Recently, a new approach has been introduced that leverages and over-provisions energy storage devices (ESDs) in data centers for performing power capping and facilitating capex/opex reductions, without performance overhead. To fully realize the potential benefits of the hierarchical ESD structure, we propose a comprehensive design, control, and provisioning framework including (i) designing power delivery architecture supporting hierarchical ESD structure and hybrid ESDs for some levels, as well as (ii) control and provisioning of the hierarchical ESD structure including run-time ESD charging/discharging control and design-time determination of ESD types, homogeneous/hybrid options, ESD provisioning at each level. Experiments have been conducted using real Google data center workloads based on realistic data center specifications.

Hierarchical and hybrid energy storage devices in data centers: Architecture, control and provisioning

PubMed Central

Xue, Yuankun; Bogdan, Paul; Tang, Jian; Wang, Yanzhi; Lin, Xue

2018-01-01

Recently, a new approach has been introduced that leverages and over-provisions energy storage devices (ESDs) in data centers for performing power capping and facilitating capex/opex reductions, without performance overhead. To fully realize the potential benefits of the hierarchical ESD structure, we propose a comprehensive design, control, and provisioning framework including (i) designing power delivery architecture supporting hierarchical ESD structure and hybrid ESDs for some levels, as well as (ii) control and provisioning of the hierarchical ESD structure including run-time ESD charging/discharging control and design-time determination of ESD types, homogeneous/hybrid options, ESD provisioning at each level. Experiments have been conducted using real Google data center workloads based on realistic data center specifications. PMID:29351553

Long-term treatment outcomes of acromegaly patients presenting biochemically-uncontrolled at a tertiary pituitary center.

PubMed

Carmichael, John D; Broder, Michael S; Cherepanov, Dasha; Chang, Eunice; Mamelak, Adam; Said, Qayyim; Neary, Maureen P; Bonert, Vivien

2017-08-04

Acromegaly is a rare, slowly progressive disorder resulting from excessive growth hormone (GH) production by a pituitary somatotroph tumor. The objective of this study was to examine acromegaly treatment outcomes during long-term care at a specialized pituitary center in patients presenting with lack of biochemical control. Data came from an acromegaly registry at the Cedars-Sinai Medical Center Pituitary Center (center). Acromegaly patients included in this study were those who presented biochemically-uncontrolled for care at the center. Biochemical control status, based on serum insulin-like growth factor-1 values, was determined at presentation and at study end. Patient characteristics and acromegaly treatments were reported before and after presentation by presenting treatment status and final biochemical control status. Data on long-term follow-up were recorded from 1985 through June 2013. Seventy-four patients presented uncontrolled: 40 untreated (54.1%) and 34 (45.9%) previously-treated. Mean (SD) age at diagnosis was 43.2 (14.7); 32 (43.2%) were female patients. Of 65 patients with tumor size information, 59 (90.8%) had macroadenomas. Prior treatments among the 34 previously-treated patients were pituitary surgery alone (47.1%), surgery and medication (41.2%), and medication alone (11.8%). Of the 40 patients without prior treatment, 82.5% achieved control by study end. Of the 34 with prior treatment, 50% achieved control by study end. This observational study shows that treatment outcomes of biochemically-uncontrolled acromegaly patients improve with directed care, particularly for those that initially present untreated. Patients often require multiple modalities of treatment, many of which are offered with the highest quality at specialized pituitary centers. Despite specialized care, some patients were not able to achieve biochemical control with methods of treatment that were available at the time of their treatment, showing the need for additional treatment options.

Improving Dementia Long-Term Care

PubMed Central

Shih, Regina A.; Concannon, Thomas W.; Liu, Jodi L.; Friedman, Esther M.

2014-01-01

Abstract In 2010, 15 percent of Americans older than age 70 had dementia, and the number of new dementia cases among those 65 and older is expected to double by the year 2050. As the baby boomer generation ages, many older adults will require dementia-related long-term services and supports (LTSS). This blueprint is the only national document to date that engages local, state, and national stakeholders to specifically focus on policy options at the intersection of dementia and LTSS. The authors undertook five major tasks that resulted in a prioritized list of policy options and research directions to help decisionmakers improve the dementia LTSS delivery system, workforce, and financing. These were to (1) identify weaknesses in the LTSS system that may be particularly severe for persons with dementia; (2) review national and state strategies addressing dementia or LTSS policy; (3) identify policy options from the perspective of a diverse group of stakeholders; (4) evaluate the policy options; and (5) prioritize policy options by impact and feasibility. Stakeholders identified 38 policy options. RAND researchers independently evaluated these options against prespecified criteria, settling on 25 priority options. These policy options can be summarized into five objectives for the dementia LTSS system: (1) increase public awareness of dementia to reduce stigma and promote earlier detection; (2) improve access to and use of LTSS; (3) promote high-quality, person- and caregiver-centered care; (4) provide better support for family caregivers of people with dementia; and (5) reduce the burden of dementia LTSS costs on individuals and families. This policy blueprint provides a foundation upon which to build consensus among a larger set of stakeholders to set priorities and the sequencing of policy recommendations. PMID:28083331

Decision algorithm for data center vortex beam receiver

NASA Astrophysics Data System (ADS)

Kupferman, Judy; Arnon, Shlomi

2017-12-01

We present a new scheme for a vortex beam communications system which exploits the radial component p of Laguerre-Gauss modes in addition to the azimuthal component l generally used. We derive a new encoding algorithm which makes use of the spatial distribution of intensity to create an alphabet dictionary for communication. We suggest an application of the scheme as part of an optical wireless link for intra data center communication. We investigate the probability of error in decoding, for several detector options.

Para Candidatos en Programas de Centros de Cuidado y Educacion Infantil con Bebes y "Toddlers": Asociado en Desarrollo Infantil Sistema de Evaluacion y Normas de Competencia CDA (Infant/Toddler Caregivers in Center-Based Programs: The Child Development Associate Assessment System and Competency Standards).

ERIC Educational Resources Information Center

Council for Early Childhood Professional Recognition, Washington, DC.

This Spanish-language booklet outlines the requirements of the Child Development Associate (CDA) credential for caregivers working in center-based infant and toddler day care programs. Part 1 provides an overview of the CDA credentialing system and the various options, settings, standards, and stages of the CDA assessment system. Part 2 explains…

Computer-Supplemented Structural Drill Practice Versus Computer-Supplemented Semantic Drill Practice by Beginning College German Students: A Comparative Experiment

DTIC Science & Technology

1979-01-01

language education in recent years can be seen in the movement from a teacher- to a learner -centered approach. The best evidence of a teacher-centered...most dramatic effect on how the learner is viewed. The learner now is recognized as an active participant in the learning process rather than as a... best , is optional. Cognitive psychologists, such as Ausubel, and many foreign language educators (Rivers, 1976; Grittner, 1977) believe that practice

Optimizing parameter choice for FSL-Brain Extraction Tool (BET) on 3D T1 images in multiple sclerosis.

PubMed

Popescu, V; Battaglini, M; Hoogstrate, W S; Verfaillie, S C J; Sluimer, I C; van Schijndel, R A; van Dijk, B W; Cover, K S; Knol, D L; Jenkinson, M; Barkhof, F; de Stefano, N; Vrenken, H

2012-07-16

Brain atrophy studies often use FSL-BET (Brain Extraction Tool) as the first step of image processing. Default BET does not always give satisfactory results on 3DT1 MR images, which negatively impacts atrophy measurements. Finding the right alternative BET settings can be a difficult and time-consuming task, which can introduce unwanted variability. To systematically analyze the performance of BET in images of MS patients by varying its parameters and options combinations, and quantitatively comparing its results to a manual gold standard. Images from 159 MS patients were selected from different MAGNIMS consortium centers, and 16 different 3DT1 acquisition protocols at 1.5 T or 3T. Before running BET, one of three pre-processing pipelines was applied: (1) no pre-processing, (2) removal of neck slices, or (3) additional N3 inhomogeneity correction. Then BET was applied, systematically varying the fractional intensity threshold (the "f" parameter) and with either one of the main BET options ("B" - bias field correction and neck cleanup, "R" - robust brain center estimation, or "S" - eye and optic nerve cleanup) or none. For comparison, intracranial cavity masks were manually created for all image volumes. FSL-FAST (FMRIB's Automated Segmentation Tool) tissue-type segmentation was run on all BET output images and on the image volumes masked with the manual intracranial cavity masks (thus creating the gold-standard tissue masks). The resulting brain tissue masks were quantitatively compared to the gold standard using Dice overlap coefficient (DOC). Normalized brain volumes (NBV) were calculated with SIENAX. NBV values obtained using for SIENAX other BET settings than default were compared to gold standard NBV with the paired t-test. The parameter/preprocessing/options combinations resulted in 20,988 BET runs. The median DOC for default BET (f=0.5, g=0) was 0.913 (range 0.321-0.977) across all 159 native scans. For all acquisition protocols, brain extraction was substantially improved for lower values of "f" than the default value. Using native images, optimum BET performance was observed for f=0.2 with option "B", giving median DOC=0.979 (range 0.867-0.994). Using neck removal before BET, optimum BET performance was observed for f=0.1 with option "B", giving median DOC 0.983 (range 0.844-0.996). Using the above BET-options for SIENAX instead of default, the NBV values obtained from images after neck removal with f=0.1 and option "B" did not differ statistically from NBV values obtained with gold-standard. Although default BET performs reasonably well on most 3DT1 images of MS patients, the performance can be improved substantially. The removal of the neck slices, either externally or within BET, has a marked positive effect on the brain extraction quality. BET option "B" with f=0.1 after removal of the neck slices seems to work best for all acquisition protocols. Copyright © 2012 Elsevier Inc. All rights reserved.

Arcjet Tests of Different Gap-Filler Options for the Orion PICA Heatshield

NASA Technical Reports Server (NTRS)

Skokova, Kristina; Ellerby, Donald; Blosser, Max; Venkatapathy, Ethiraj; Bouslog, Stan; Reuther, James

2009-01-01

PICA (Phenolic Infiltrated Carbon Ablator) is one of the candidate thermal protection materials for the Orion vehicle. Because PICA is fabricated in blocks, gaps exist between the blocks, similar to the individual ceramic tiles of the Shuttle thermal protection system. The results of this work focus on arcjet test results of different gap-filler options for PICA, performed as part of the Orion TPS Advanced Development Project. The arcjet tests were performed at NASA Ames Research Center on stagnation models 4 inches in diameter at conditions representative of Orion flight conditions for both Lunar and Low Earth Orbit return. Performance of gap-filler options was evaluated based on the extent of backface temperature change, as compared to PICA without gaps, and on the extent of flow penetration into the gap, evident from the gap opening and widening.

Advancing non-directive pregnancy options counseling skills: A pilot Study on the use of blended learning with an online module and simulation.

PubMed

Lupi, Carla; Ward-Peterson, Melissa; Chang, Winnie

2016-10-01

Limitations on didactic time pose barriers to teaching non-directive pregnancy options counseling. This study set out to explore the use of an online module to support trainee performance in a pregnancy options counseling standardized-patient exercise implemented among third-year medical students, and to examine the effect of clinical experience on student performance. An online module was developed. A convenience sample of forty-six student performances in a family medicine clerkship participated in a standardized patient exercise. Trained faculty rated performances. Students completed a self-assessment and provided feedback on the online module. Chi-square and Mann-Whitney-U tests were used to analyze data. Three coders qualitatively examined narrative student comments. Thirty-four students passed, 11 achieved a minimal pass, and one failed. The mean global rating from faculty was 2.8 (pass). Students with prior clinical experience significantly outperformed those without on the global rating scale with mean scores of 3.1 compared to 2.7, respectively (p=.044). All students agreed that the online module helped prepare them for the exercise. Qualitative analysis of students' feedback on the module revealed strengths in content and pedagogy. In their self-assessments, all but two students referred to content explicitly conveyed in the module. All students agreed that an online module supported their performance of non-directive pregnancy options counseling skills. Prior clinical experience was associated with improved performance. This module, along with the simulated exercise, can be implemented as a blended learning exercise without additional faculty teaching effort in standardized patient resource centers. Students agreed that an online module facilitates simulated performance of non-directive pregnancy options counseling skills. Future work should compare the impact of this approach to others, and explore the additional training needed to maintain and build on initial learning. Copyright © 2016 Elsevier Inc. All rights reserved.

PubMed Central

Lux, Michael P.; Janni, Wolfgang; Hartkopf, Andreas D.; Nabieva, Naiba; Taran, Florin-Andrei; Overkamp, Friedrich; Kolberg, Hans-Christian; Hadji, Peyman; Tesch, Hans; Ettl, Johannes; Huober, Jens B.; Lüftner, Diana; Wallwiener, Markus; Müller, Volkmar; Beckmann, Matthias W.; Belleville, Erik; Fehm, Tanja N.; Wallwiener, Diethelm; Brucker, Sara Y.; Schneeweiss, Andreas; Fasching, Peter A.

2017-01-01

In recent years, numerous new therapy options for patients with breast cancer have been developed in clinical studies, with some options already approved for routine treatment. As the speed at which innovations are introduced increases, the importance of conferences also increases, as conferences are where the data underpinning new therapies are usually presented for the first time. This review looks at publications of the ASCO (American Society of Clinical Oncology) and ESMO (European Society of Medical Oncology) conferences in 2017, summarizes them and evaluates them in the context of existing data. The focus is on new insights for neoadjuvant therapy and new treatment options in the metastatic setting, such as the use of CDK4/6 inhibitors or PARP inhibitors. The first results of treatments with checkpoint inhibitors are presented. With the patent expiry of trastuzumab, a number of study results for trastuzumab biosimilars have also been published. The digitization of patient care provides the first results on quality of life and prognosis of patients with advanced cancer. Digital communications between patients and physicians are being evaluated in several studies in Germany. As the discussion about patient-relevant endpoints for patients in the metastatic setting continues, overall survival rates from studies of big endocrine-based therapies are urgently needed. Preliminary analyses of small study cohorts offer initial insights. In the context of improving patient care, in the coming years, questions will center on which patients particularly benefit from certain therapies and which patients need particular protection from specific side effects. Questions about these predictors are raised in many scientific projects as attention increasingly focuses on this topic. PMID:29269955

42 CFR 436.300 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Scope. 436.300 Section 436.300 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS Optional Coverage of the...

42 CFR 436.200 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Scope. 436.200 Section 436.200 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN GUAM, PUERTO RICO, AND THE VIRGIN ISLANDS Options for Coverage as...

Evaluation of School Library Media Centers: Demonstrating Quality.

ERIC Educational Resources Information Center

Everhart, Nancy

2003-01-01

Discusses ways to evaluate school library media programs and how to demonstrate quality. Topics include how principals evaluate programs; sources of evaluative data; national, state, and local instruments; surveys and interviews; Colorado benchmarks; evaluating the use of electronic resources; and computer reporting options. (LRW)

42 CFR 436.300 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Scope. 436.300 Section 436.300 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... Medically Needy § 436.300 Scope. This subpart specifies the option for coverage of medically needy...

SLF Run & Walk

NASA Image and Video Library

2018-03-13

Kennedy Space Center employees and guests are off to a running start at the KSC Walk Run on the Shuttle Landing Facility runway. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options in the spirit of friendly competition.

New Synthetic Methods for Hypericum Natural Products

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

Jeon, Insik

Organic chemistry has served as a solid foundation for interdisciplinary research areas, such as molecular biology and medicinal chemistry. An understanding of the biological activities and structural elucidations of natural products can lead to the development of clinically valuable therapeutic options. The advancements of modern synthetic methodologies allow for more elaborate and concise natural product syntheses. The theme of this study centers on the synthesis of natural products with particularly challenging structures and interesting biological activities. The synthetic expertise developed here will be applicable to analog syntheses and to other research problems.

Stratospheric CCN sampling program. [volcanology, Mount Saint Helens

NASA Technical Reports Server (NTRS)

Rogers, C. F.; Hudson, J. G.

1982-01-01

Two one liter grab samples of stratospheric aerosol were returned from each of six U-2 sampling missions. Cloud condensation nuclei (CCN) spectra from each sample were obtained. Interest was centered on the effects of volcanic activity. Spurious particle generation was found to be a serious problem in container 9 LFT and a much smaller problem in container 9 RT. Initial studies of an option for improved sample containers and values were completed. A CCN spectrometer, able to operate at an internal pressure of 300 mb, was designed.

Proceedings of the Near-Earth-Object Interception Workshop

NASA Technical Reports Server (NTRS)

Canavan, G. J. (Editor); Solem, J. C. (Editor); Rather, John D. G. (Editor)

1993-01-01

The National Aeronautics and Space Administration Headquarters sponsored the Near-Earth-Object Interception Workshop hosted by the Los Alamos National Laboratory on 14-16 Jan. 1992 at the J. Robert Oppenheimer Study Center in Los Alamos, New Mexico. The Workshop evaluated the issues involved in intercepting celestial objects that could hit the Earth. It covered the technologies for acquiring, tracking, and homing, as well as those for sending interceptors to inspect, rendezvous with, land on, irradiate, deflect, or destroy them. This report records the presentations and technical options reviewed.

Is usage of a wellness center associated with improved quality of life?

PubMed

Clark, Matthew M; Jenkins, Sarah M; Limoges, Katherine A; Hagen, Philip T; Lackore, Kandace A; Harris, Ann M; Werneburg, Brooke L; Warren, Beth A; Olsen, Kerry D

2013-01-01

There is limited documentation regarding the potential quality of life (QOL) benefits associated with use of a worksite wellness center. Therefore, the aim of this study was to examine the relationship between potential QOL change and use of a worksite wellness center during a 12-month period. Analysis of an annual QOL wellness center member survey and wellness center use during a 12-month time period. A worksite wellness center. A total of 1151 employee wellness center members, average age of 39.5 years, 69.7% female, and 43.5% reported being overweight. Members of the worksite wellness center have access to a range of fitness options, including exercise classes, water aerobics, an indoor track, strength training, and aerobic conditioning equipment. Additionally, nutritional classes are offered, and there is a wellness café. For resiliency, members can participate in wellness coaching or a stress-reduction group program. Participants completed a baseline QOL survey and a second QOL survey 1 year later. An electronic entry system tracked use of the wellness center. Participants were divided into four wellness center use quartiles: low users (less than once every 2 weeks), below-average users, above-average users, and high users (two to three visits per week). High users reported experiencing improvements in their physical QOL (p < .0001) compared with the low users. Additionally, low users experienced a greater decline in their mental QOL (p = .05) compared with high users. In a large sample of employees, use of a wellness center during a 12-month period was associated with benefits for physical QOL. QOL is an important domain of wellness; therefore, in addition to measuring physiologic changes, examining potential QOL changes may be another important outcome measure for wellness centers.

Costs Associated with Surgically Treated Cases of Abdominal Cystic Echinococcosis: A Single Center's Experience from 2008 to 2014, Pavia, Italy.

PubMed

Narra, Roberta; Maestri, Marcello; Budke, Christine M; Tamarozzi, Francesca; Mariconti, Mara; Nicoletti, Giovanni J; Rinaldi, Francesca; Brunetti, Enrico

2016-08-03

Cystic echinococcosis (CE) is a globally distributed zoonosis caused by the Echinococcus granulosus sensu lato species complex. Four approaches are available for treatment of abdominal CE: surgery, percutaneous aspiration, chemotherapy with albendazole, and watch-and-wait. Allocation of patients to these different treatment options mainly depends on the stage of the cystic lesion. However, as available guidelines are not widely followed, surgery is often applied even without the correct indication outside referral centers. This is not only a disadvantage for the patient, but also a waste of money. In this study, we evaluated the cost of the surgical approach for abdominal CE by analyzing hospitalization costs for 14 patients admitted to the General Surgery Ward at the "San Matteo" Hospital Foundation in Pavia, Italy, from 2008 through 2014. We found that the total cost of a single hospitalization, including hospital stay, surgical intervention, personnel, drugs, and administrative costs ranged from €5,874 to 23,077 (median €11,033) per patient. Our findings confirm that surgery can be an expensive option. Therefore, surgical intervention should be limited to cyst types that do not benefit from nonsurgical therapies and appropriate case management can best be accomplished by using a cyst stage-specific approach. © The American Society of Tropical Medicine and Hygiene.

Mechanical lithotripsy of pancreatic and biliary stones: complications and available treatment options collected from expert centers.

PubMed

Thomas, Miriam; Howell, Douglas A; Carr-Locke, David; Mel Wilcox, C; Chak, Amitabh; Raijman, Isaac; Watkins, James L; Schmalz, Michael J; Geenen, Joseph E; Catalano, Marc F

2007-09-01

PD and common bile duct (CBD) stones often require mechanical lithotripsy (ML) at ERCP for successful extraction. The frequency and spectrum of complications is not well described in the literature. To describe the frequency and spectrum of complications of ML. A comprehensive retrospective review of cases requiring ML of large or resistant PC and/or CBD stones using a 46-point data questionnaire on type(s) of complication, treatment attempted, and success of treatment. The study involved 7 tertiary referral centers with 712 ML cases (643 biliary and 69 pancreatic). Overall incidence of complications were: 4-4% (31/712); 23/643 biliary, 8/69 pancreatic; 21 single, 10 multiple. Biliary complications: trapped (TR)/broken (BR) basket (N = 11), wire fracture (FX) (N = 8), broken (BR) handle (N = 7), perforation/duct injury (N = 3). Pancreatic complications: TR/BR basket (N = 7), wire FX (N = 4), BR handle (N = 5), pancreatic duct leak (N = 1). Endoscopic intervention successfully treated complications in 29/31 cases (93.5%). Biliary group treatments: sphincterotomy (ES) extension (N = 7), electrohydraulic lithotripsy (EHL) (N = 11), stent (N = 3), per-oral Soehendra lithotripsy (N = 8), surgery (N = 1), extracorporeal lithotripsy (N = 5), and dislodge stones/change basket (N = 4). Pancreatic group treatments: ES extension (N = 3), EHL (N = 2), stent (N = 5), Soehendra lithotriptor (N = 4), dislodge stones/change basket (N = 2), extracorporeal lithotripsy (ECL) (N = 1), surgery (N = 1). Perforated viscus patient died at 30 days. The majority of ML in expert centers involved the bile duct. The complication rate of pancreatic ML is threefold greater than biliary lithotripsy. The most frequent complication of biliary and pancreatic ML is trapped/broken baskets. Extension of ES and EHL are the most frequently utilized treatment options.

32 CFR 86.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 231. (f) Child Development Center (CDC). An installation facility or part of a facility used for child... personnel provided in CDCs, family child care (FCC) homes, and alternative child care options. The care... explicit conduct (or any simulation of such conduct) or the rape, molestation, prostitution, or any other...

32 CFR 86.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 231. (f) Child Development Center (CDC). An installation facility or part of a facility used for child... personnel provided in CDCs, family child care (FCC) homes, and alternative child care options. The care... explicit conduct (or any simulation of such conduct) or the rape, molestation, prostitution, or any other...

Universal Design in Postsecondary Education: Process, Principles, and Applications

ERIC Educational Resources Information Center

Burgstahler, Sheryl

2009-01-01

Designing any product or environment involves the consideration of many factors, including aesthetics, engineering options, environmental issues, safety concerns, industry standards, and cost. Typically, designers focus their attention on the average user. In contrast, universal design (UD), according to the Center for Universal Design, "is…

Process waste assessment: Petroleum jelly removal from semiconductor die using trichloroethylene

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

Curtin, D.P.

The process analyzed involves non-production, laboratory environment use of trichloroethylene for the cleaning of semiconductor devices. The option selection centered on the replacement of the trichloroethylene with a non-hazardous material. This process waste assessment was performed as part of a pilot project.

Alternative Fuels Data Center: E85 Codes and Standards

Science.gov Websites

Development Equipment Options Equipment Installation Codes, Standards, & Safety Vehicles Laws & ; Incentives Ethanol Codes, Standards, and Safety The U.S. Environmental Protection Agency's (EPA) Office of -Gasoline Blends. The Occupational Safety and Health Administration (OSHA) regulates some fuel-dispensing

42 CFR 441.470 - Service budget elements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Service budget elements. 441.470 Section 441.470 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Optional Self-Directed Personal Assistance Services Program § 441.470 Service budget elements. A service...

42 CFR 441.470 - Service budget elements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Service budget elements. 441.470 Section 441.470 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Optional Self-Directed Personal Assistance Services Program § 441.470 Service budget elements. A service...

42 CFR 441.470 - Service budget elements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Service budget elements. 441.470 Section 441.470 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Optional Self-Directed Personal Assistance Services Program § 441.470 Service budget elements. A service...

42 CFR 441.470 - Service budget elements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Service budget elements. 441.470 Section 441.470 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Optional Self-Directed Personal Assistance Services Program § 441.470 Service budget elements. A service...

42 CFR 403.815 - Special rules concerning States.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Special rules concerning States. 403.815 Section 403.815 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Transitional Assistance Program § 403.815 Special rules concerning States. (a) Optional State payment of...

Alternative Fuels Data Center: Publications

Science.gov Websites

, advanced vehicles, and regulated fleets. Keyword Category Search more search options close × Filter by Journal Articles & Abstracts Newsletters Presentations Reports Choose one or more categories to search Propane Vehicles Diesel Vehicles Fuel Economy Idle Reduction Vehicle Conversions Search Latest Additions

Entrepreneurship in the Eighties. Monograph. Volume 3, Number 2.

ERIC Educational Resources Information Center

Oldham, Lea Leever

Vocational schools are an excellent breeding ground for entrepreneurs. In addition to such programs as the Free Enterprise Project at the Auburn Career Center (Lake County, Ohio), some vocational schools, including Auburn, offer optional, short-term entrepreneurial programs. Entrepreneurship training in secondary educational institutions is…

SLF Run/Walk for Safety and Health Month

NASA Image and Video Library

2018-03-13

Kennedy Space Center employees and guests cross the finish line during the KSC Walk Run on the Shuttle Landing Facility runway. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options in the spirit of friendly competition.

SLF Run/Walk for Safety and Health Month

NASA Image and Video Library

2018-03-13

Kennedy Space Center employees and guests approach the finish line during the KSC Walk Run on the Shuttle Landing Facility runway. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options in the spirit of friendly competition.

SLF Run/Walk for Safety and Health Month

NASA Image and Video Library

2018-03-13

Kennedy Space Center Director Bob Cabana approaches the finish line at the KSC Walk Run on the Shuttle Landing Facility runway. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options in the spirit of friendly competition.

SLF Run/Walk for Safety and Health Month

NASA Image and Video Library

2018-03-13

A line of Kennedy Space Center employees and guests stretches down the Shuttle Landing Facility Runway during the KSC Walk Run. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options in the spirit of friendly competition.

32 CFR 806b.1 - Summary of revisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... for the Air Force Privacy Program from Air Force Communications and Information Center to the Air Force Chief Information Officer; prescribes Air Force Visual Aid 33-276, Privacy Act Label as optional... are new or have major changes; changes appeal processing from Air Force Communications and Information...

Family Day Homes: Get Organized with Information Systems.

ERIC Educational Resources Information Center

Dague, Mindy

1999-01-01

Notes that record keeping and management are critical aspects of home day care centers. Highlights options for tools, including calendars, loose-leaf notebooks, ledgers, computer spreadsheet software, and file boxes. Provides guidelines for organizing information as well as particular information necessary regarding provider, parent, and child.…

Code inspection instructional validation

NASA Technical Reports Server (NTRS)

Orr, Kay; Stancil, Shirley

1992-01-01

The Shuttle Data Systems Branch (SDSB) of the Flight Data Systems Division (FDSD) at Johnson Space Center contracted with Southwest Research Institute (SwRI) to validate the effectiveness of an interactive video course on the code inspection process. The purpose of this project was to determine if this course could be effective for teaching NASA analysts the process of code inspection. In addition, NASA was interested in the effectiveness of this unique type of instruction (Digital Video Interactive), for providing training on software processes. This study found the Carnegie Mellon course, 'A Cure for the Common Code', effective for teaching the process of code inspection. In addition, analysts prefer learning with this method of instruction, or this method in combination with other methods. As is, the course is definitely better than no course at all; however, findings indicate changes are needed. Following are conclusions of this study. (1) The course is instructionally effective. (2) The simulation has a positive effect on student's confidence in his ability to apply new knowledge. (3) Analysts like the course and prefer this method of training, or this method in combination with current methods of training in code inspection, over the way training is currently being conducted. (4) Analysts responded favorably to information presented through scenarios incorporating full motion video. (5) Some course content needs to be changed. (6) Some content needs to be added to the course. SwRI believes this study indicates interactive video instruction combined with simulation is effective for teaching software processes. Based on the conclusions of this study, SwRI has outlined seven options for NASA to consider. SwRI recommends the option which involves creation of new source code and data files, but uses much of the existing content and design from the current course. Although this option involves a significant software development effort, SwRI believes this option will produce the most effective results.

A Ground Systems Architecture Transition for a Distributed Operations System

NASA Technical Reports Server (NTRS)

Sellers, Donna; Pitts, Lee; Bryant, Barry

2003-01-01

The Marshall Space Flight Center (MSFC) Ground Systems Department (GSD) recently undertook an architecture change in the product line that serves the ISS program. As a result, the architecture tradeoffs between data system product lines that serve remote users versus those that serve control center flight control teams were explored extensively. This paper describes the resulting architecture that will be used in the International Space Station (ISS) payloads program, and the resulting functional breakdown of the products that support this architecture. It also describes the lessons learned from the path that was followed, as a migration of products cause the need to reevaluate the allocation of functions across the architecture. The result is a set of innovative ground system solutions that is scalable so it can support facilities of wide-ranging sizes, from a small site up to large control centers. Effective use of system automation, custom components, design optimization for data management, data storage, data transmissions, and advanced local and wide area networking architectures, plus the effective use of Commercial-Off-The-Shelf (COTS) products, provides flexible Remote Ground System options that can be tailored to the needs of each user. This paper offers a description of the efficiency and effectiveness of the Ground Systems architectural options that have been implemented, and includes successful implementation examples and lessons learned.

Campus Health Centers' Lack of Information Regarding Providers: A Content Analysis of Division-I Campus Health Centers' Provider Websites.

PubMed

Perrault, Evan K

2018-07-01

Campus health centers are a convenient, and usually affordable, location for college students to obtain health care. Staffed by licensed and trained professionals, these providers can generally offer similar levels of care that providers at off-campus clinics can deliver. Yet, previous research finds students may forgo this convenient, on-campus option partially because of a lack of knowledge regarding the quality of providers at these campus clinics. This study sought to examine where this information deficit may come from by analyzing campus health centers' online provider information. All Division-I colleges or universities with an on-campus health center, which had information on their websites about their providers (n = 294), had their providers' online information analyzed (n = 2,127 providers). Results revealed that schools commonly offer professional information (e.g., provider specialties, education), but very little about their providers outside of the medical context (e.g., hobbies) that would allow a prospective student patient to more easily relate. While 181 different kinds of credentials were provided next to providers' names (e.g., MD, PA-C, FNP-BC), only nine schools offered information to help students understand what these different credentials meant. Most schools had information about their providers within one-click of the homepage. Recommendations for improving online information about campus health center providers are offered.

Counseling women with early pregnancy failure: utilizing evidence, preserving preference.

PubMed

Wallace, Robin R; Goodman, Suzan; Freedman, Lori R; Dalton, Vanessa K; Harris, Lisa H

2010-12-01

To apply principles of shared decision-making to EPF management counseling. To present a patient treatment priority checklist developed from review of available literature on patient priorities for EPF management. Review of evidence for patient preferences; personal, emotional, physical and clinical factors that may influence patient priorities for EPF management; and the clinical factors, resources, and provider bias that may influence current practice. Women have strong and diverse preferences for EPF management and report higher satisfaction when treated according to these preferences. However, estimates of actual treatment patterns suggest that current practice does not reflect the evidence for safety and acceptability of all options, or patient preferences. Multiple practice barriers and biases exist that may be influencing provider counseling about options for EPF management. Choosing management for EPF is a preference-sensitive decision. A patient-centered approach to EPF management should incorporate counseling about all treatment options. Providers can integrate a counseling model into EPF management practice that utilizes principles of shared decision-making and an organized method for eliciting patient preferences, priorities, and concerns about treatment options. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Ion implantation and diamond-like coatings of aluminum alloys

NASA Astrophysics Data System (ADS)

Malaczynski, G. W.; Hamdi, A. H.; Elmoursi, A. A.; Qiu, X.

1997-04-01

In an attempt to increase the wear resistance of some key automotive components, General Motors Research and Development Center initiated a study to determine the potential of surface modification as a means of improving the tribological properties of automotive parts, and to investigate the feasibility of mass producing such parts. This paper describes the plasma immersion ion implantation system that was designed for the study of various options for surface treatment, and it discusses bench testing procedures used for evaluating the surface-treated samples. In particular, both tribological and microstructural analyses are discussed for nitrogen implants and diamond-like hydrocarbon coatings of some aluminum alloys.

A Feasability Study of the Wheel Electrostatic Spectrometer

NASA Technical Reports Server (NTRS)

Johansen, Michael Ryan; Phillips, James Ralph; Kelley, Joshua David; Mackey, Paul J.; Holbert, Eirik; Clements, Gregory R.; Calle, Carlos I.

2014-01-01

Mars rover missions rely on time-consuming, power-exhausting processes to analyze the Martian regolith. A low power electrostatic sensor in the wheels of a future Mars rover could be used to quickly determine when the rover is driving over a different type of regolith. The Electrostatics and Surface Physics Laboratory at NASA's Kennedy Space Center developed the Wheel Electrostatic Spectrometer as a feasibility study to investigate this option. In this paper, we discuss recent advances in this technology to increase the repeatability of the tribocharging experiments, along with supporting data. In addition, we discuss the development of a static elimination tool optimized for Martian conditions.

CO2 heat pumps for commercial building applications with simultaneous heating and cooling demand

NASA Astrophysics Data System (ADS)

Dharkar, Supriya

Many commercial buildings, including data centers, hotels and hospitals, have a simultaneous heating and cooling demand depending on the season, occupation and auxiliary equipment. A data center on the Purdue University, West Lafayette campus is used as a case study. The electrical equipment in data centers produce heat, which must be removed to prevent the equipment temperature from rising to a certain level. With proper integration, this heat has the potential to be used as a cost-effective energy source for heating the building in which the data center resides or the near-by buildings. The proposed heat pump system utilizes carbon dioxide with global warming potential of 1, as the refrigerant. System simulations are carried out to determine the feasibility of the system for a 12-month period. In addition, energy, environmental and economic analyses are carried out to show the benefits of this alternative technology when compared to the conventional system currently installed in the facility. Primary energy savings of ~28% to ~61%, a payback period of 3 to 4.5 years and a decrease in the environmental impact value by ~36% makes this system an attractive option. The results are then extended to other commercial buildings.

PCI-based WILDFIRE reconfigurable computing engines

NASA Astrophysics Data System (ADS)

Fross, Bradley K.; Donaldson, Robert L.; Palmer, Douglas J.

1996-10-01

WILDFORCE is the first PCI-based custom reconfigurable computer that is based on the Splash 2 technology transferred from the National Security Agency and the Institute for Defense Analyses, Supercomputing Research Center (SRC). The WILDFORCE architecture has many of the features of the WILDFIRE computer, such as field- programmable gate array (FPGA) based processing elements, linear array and crossbar interconnection, and high- performance memory and I/O subsystems. New features introduced in the PCI-based WILDFIRE systems include memory/processor options that can be added to any processing element. These options include static and dynamic memory, digital signal processors (DSPs), FPGAs, and microprocessors. In addition to memory/processor options, many different application specific connectors can be used to extend the I/O capabilities of the system, including systolic I/O, camera input and video display output. This paper also discusses how this new PCI-based reconfigurable computing engine is used for rapid-prototyping, real-time video processing and other DSP applications.

[Genetic obesity: new diagnostic options].

PubMed

de Vries, T I; Alsters, S I M; Kleinendorst, L; van Haaften, G; van der Zwaag, B; Van Haelst, M M

2017-01-01

- Obesity is an important risk factor for morbidity and premature death, as well as a contributing factor to psychosocial problems. The incidence of obesity has increased dramatically over the last few decades.- Obesity is considered to be a multifactorial condition in which both environmental factors and genetic factors play a part.- In approximately 5% of patients with morbid obesity, a monogenic cause can be identified. Mutations in the MC4R gene are the most frequently occurring monogenic cause of obesity.- The department of Genetics at the VU University Medical Center Amsterdam offers morbidly obese patients a diagnostic analysis of 50 obesity-associated genes. - An underlying obesity-associated genetic defect can influence patient response to certain treatments. Therefore, if the gene defect is known, it can be taken into account when considering treatment options.- The understanding of the genetics of obesity will significantly contribute to research into the development of personalized treatment options.

Educational Equity Options. A Resource Bibliography.

ERIC Educational Resources Information Center

Martino, Susan; Watson, Jennifer

This selected list of educational resources includes 44 video items, 23 books, 9 posters, and 24 educational equity organizations and resource centers. Video materials and books are classified according to appropriate age groups and student abilities. All items are annotated. Topics of the videos and books include career choices, special needs…

Immune Suppression Enhances Effectiveness of Mesothelioma Targeted Immunotoxin | Center for Cancer Research

Cancer.gov

Malignant mesothelioma is an aggressive cancer of the linings of the organs in the chest and the abdomen and is often caused by exposure to asbestos. Although patients with localized disease may be treated effectively with surgery, those with more-advanced mesothelioma have few approved treatment options.

Preschool Adequacy and Efficiency in California. Issues, Policy Options, and Recommendations

DTIC Science & Technology

2009-01-01

the classroom environment that focus on emotional support, classroom management, and student engagement . The high rate overall of participation in...Organization, and Student Engagement domains of the CLASS, all of which were close to or exceeded an average score of 5 for all children in center-based

Developing Online Courses: A Human-Centered Approach.

ERIC Educational Resources Information Center

Branon, Rovy; Beatty, Brian; Wilson, Jack

Companies and universities are increasingly moving to online delivery for much of their training and education needs, and designing and building quality distance education is a challenge facing many organizations. Option Six is an independent company that is building customized e-learning solutions. Over the last 2 years, the instructional…

NDPC-SD Data Probes Worksheet

ERIC Educational Resources Information Center

National Dropout Prevention Center for Students with Disabilities, 2011

2011-01-01

This worksheet from the National Dropout Prevention Center for Students with Disabilities (NDPC-SD) is an optional tool to help schools organize multiple years of student and program data for the purpose of identifying school-completion needs that can be addressed through the implementation of research-based interventions. It is designed for use…

NSU Undergraduate Academic Advising Center

Science.gov Websites

NSU has to offer undergraduate students. Student Life Learn why the years you spend at NSU will be , dentistry, law, and psychology. Certificate Receive a graduate level certificate to enhance your skills II teams. Living on Campus On campus housing options for undergraduate and graduate students. Clubs

Alternative Fuels Data Center

Science.gov Websites

Charging Rate Incentive - Georgia Power Georgia Power offers a Plug-in Electric Vehicle (PEV) time -of-use electricity rate for residential customers who own an electric or plug-in hybrid electric vehicle. The PEV rate is optional and does not require a separate meter. For more information, see the

Online Writing Labs (OWLs): A Taxonomy of Options and Issues.

ERIC Educational Resources Information Center

Harris, Muriel; Pemberton, Michael

1995-01-01

Offers an overview and schema for understanding frequently used network technologies available for Online Writing Labs (OWLs)--electronic mail, gopher, World Wide Web, newsgroups, synchronous chat systems, and automated file retrieval systems. Considers ways writing centers' choices among these technologies are impacted by user access, network…

Teachers on Teaching: In a Child's Kitchen

ERIC Educational Resources Information Center

Schenkelberg, Elizabeth

2003-01-01

A new preschool teacher centers her class' curriculum on cooking. She is surprised to learn that not only are cooking options limited by children's health concerns, but young children do not embrace new foods and flavors. Respecting the children's preferences, the teacher adapts the cooking theme to the children's differences and needs.

29 CFR 553.227 - Outside employment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... such details and take disciplinary action against those who fail to do so. (e) Section 7(p)(1) applies... convention center during concerts or sports events. If the officers perform such work at their own option... overtime compensation. (f) The principles in paragraphs (d) and (e) of this section with respect to special...

32 CFR 806b.1 - Summary of revisions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... for the Air Force Privacy Program from Air Force Communications and Information Center to the Air Force Chief Information Officer; prescribes Air Force Visual Aid 33-276, Privacy Act Label as optional; adds the E-Gov Act of 2002 requirement for a Privacy Impact Assessment for all information systems that...

32 CFR 806b.1 - Summary of revisions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... for the Air Force Privacy Program from Air Force Communications and Information Center to the Air Force Chief Information Officer; prescribes Air Force Visual Aid 33-276, Privacy Act Label as optional; adds the E-Gov Act of 2002 requirement for a Privacy Impact Assessment for all information systems that...

32 CFR 806b.1 - Summary of revisions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... for the Air Force Privacy Program from Air Force Communications and Information Center to the Air Force Chief Information Officer; prescribes Air Force Visual Aid 33-276, Privacy Act Label as optional; adds the E-Gov Act of 2002 requirement for a Privacy Impact Assessment for all information systems that...

Energy Action Day

NASA Image and Video Library

2017-10-25

Bill McCullen of Southern Power speaks to NASA Kennedy Space Center employees during the Energy Action Day event held in Kennedy's Space Station Processing Facility. Part of Energy Awareness Month, the event featured subject matter experts in the area of solar energy, its connections to the space program and options for residential solar power.

SLF Run/Walk for Safety and Health Month

NASA Image and Video Library

2018-03-13

Kennedy Space Center employees and guests head toward the start line for the KSC Walk Run on the Shuttle Landing Facility runway. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options in the spirit of friendly competition.

Catalyst Schools: The Catholic Ethos and Public Charter Schools

ERIC Educational Resources Information Center

Proehl, Rebecca A.; Starnes, Heather; Everett, Shirley

2015-01-01

During the past decade, Catholic leaders have been exploring options to revitalize the faltering Catholic school system especially in urban centers. One route being explored by dioceses and religious orders is opening what have been called "religious charter schools." Though not technically religious schools, they integrate many of the…

Current options in inguinal hernia repair in adult patients

PubMed Central

Kulacoglu, H

2011-01-01

Inguinal hernia is a very common problem. Surgical repair is the current approach, whereas asymptomatic or minimally symptomatic hernias may be good candidate for watchful waiting. Prophylactic antibiotics can be used in centers with high rate of wound infection. Local anesthesia is a suitable and economic option for open repairs, and should be popularized in day-case setting. Numerous repair methods have been described to date. Mesh repairs are superior to "nonmesh" tissue-suture repairs. Lichtenstein repair and endoscopic/laparoscopic techniques have similar efficacy. Standard polypropylene mesh is still the choice, whereas use of partially absorbable lightweight meshes seems to have some advantages. PMID:22435019

Complex Care Options for Patients With Advanced Heart Failure Approaching End of Life.

PubMed

Wordingham, Sara E; McIlvennan, Colleen K; Dionne-Odom, J Nicholas; Swetz, Keith M

2016-02-01

Care for patients with advanced cardiac disease continues to evolve in a complex milieu of therapeutic options, advanced technological interventions, and efforts at improving patient-centered care and shared decision-making. Despite improvements in quality of life and survival with these interventions, optimal supportive care across the advanced illness trajectory remains diverse and heterogeneous. Herein, we outline challenges in prognostication, communication, and caregiving in advanced heart failure and review the unique needs of patients who experience frequent hospitalizations, require chronic home inotropic support, and who have implantable cardioverter-defibrillators and mechanical circulatory support in situ, to name a few.

Geothermal space heating for the Senior Citizens Center at Truth or Consequences, New Mexico. Final report

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

Mancini, T.R.; Chaturvedi, L.N.; Gebhard, T.G.

A demonstration project to heat the Senior Citizens Center at Truth or Consequences, New Mexico with geothermal waters is described. There were three phases to the project: Phase I - design and permitting; Phase II - installation of the heating system and well drilling; and Phase III - operation of the system. All three phases went well and there was only one major problem encountered. This was that the well which was drilled to serve as the geothermal source was dry. This could not have been anticipated and there was, as a contingency plan, the option of using an existingmore » sump in the Teen Center adjacent to the Senior Citizens Center as the geothermal source. The system was made operational in August of 1981 and has virtually supplied all of the heat to the Senior Citizens Center during this winter.« less

Target marketing for the hospital-based wellness center.

PubMed

Cangelosi, J D

1997-01-01

The American population is aging, medical technology is advancing, and life expectancies are on the rise. At the same time hospitals are looking for additional sources of income due to the pressures of government regulations and managed care. One of the options for hospitals looking for additional sources of income is the hospital-based but free-standing comprehensive wellness and fitness center. Such centers go beyond the facilities, programs and services offered by traditional health and fitness centers. In addition to physical fitness programs, hospital-based wellness centers offer programs in CPR, nutrition, weight control and many other programs of interest to an aging but active American populace. This research documents the hospital industry, wellness industry and the prospects of success or failure for he hospital attempting such a venture. The focus of the research is the experience of a particular hospital with regard to the programs, facilities and services deemed most important by its target market.

Indications for eye removal over a 13-year period at an ophthalmology referral center in São Paulo, Brazil.

PubMed

Hime, Bernardo; Isenberg, Jordan; Rocha, Gustavo; Lowen, Marcia; Morales, Melina; Fernandes, Bruno Franco; Belfort, Rubens N

2017-01-01

To analyze the indications and types of eye removal at Latin America's highest-volume ophthalmic reference center in São Paulo, Brazil. A retrospective analysis was conducted of surgical pathological reports in the electronic database of the Ophthalmology Department of the Universidade Federal de São Paulo Hospital of patients who underwent eye-removal procedures between January 2000 and December 2012. A total of 412 cases met the inclusion criteria for this study. The most common indications for eye removal were ocular melanoma and retinoblastoma, representing 35.4% and 31.1% of the total cases, respectively. Other frequent indications included endophthalmitis (6.3%), nonspecific inflammation (4.1%), squamous cell carcinoma (3.6%), panophthalmitis (3.4%), and phthisis bulbi (1.2%). The remaining indications accounted for 14.8% of all cases, with each accounting for <1% of the total cases. Enucleation was the most common eye-removal procedure seen in our study. The two most common indications for eye removal were ocular melanoma and retinoblastoma. Alternative treatment options are effective in limiting the need for eye removal but are constrained by our public center's so cioeconomic context.

Service of Remembrance: a comprehensive cancer center's response to bereaved family members.

PubMed

Knight, Louise; Cooper, Rhonda S; Hypki, Cinder

2012-01-01

Comprehensive cancer centers that offer an array of clinical trials and treatment options often experience significant patient mortality rates. Bereavement resources may not be routinely incorporated into the service delivery model in these specialty hospitals. In response, an interdisciplinary team at one cancer center proposed, planned, and implemented an annual Service of Remembrance. The incorporation of music, poetry, and visual arts was important in designing a program that would provide a meaningful, spiritual experience. A community artist who designed an interactive memorial art piece played a pivotal role. This article outlines the process of institutional culture change and describes future challenges in the implementation of this type of bereavement service.

Review of lunar telescope studies at MSFC

NASA Astrophysics Data System (ADS)

Hilchey, John D.; Nein, Max E.

1993-09-01

In the near future astronomers can take advantage of the lunar surface as the new 'high ground' from which to study the universe. Optical telescopes placed and operated on the lunar surface would be successors to NASA's Great Observatories. Four telescopes, ranging in aperture from a 16-m, IR/Vis/UV observatory down to a 1-m, UV 'transit' instrument, have been studied by the Lunar Telescope Working Group and the LUTE (lunar telescope ultraviolet experiment) Task Team of the Marshall Space Flight Center (MSFC). This paper presents conceptual designs of the telescopes, provides descriptions of the telescope subsystem options selected for each concept, and outlines the potential evolution of their science capabilities.

Remote hearing aid fitting: Tele-audiology in the context of Brazilian Public Policy

PubMed Central

Penteado, Silvio Pires; Ramos, Sueli de Lima; Battistella, Linamara Rizzo; Marone, Silvio Antonio Monteiro; Bento, Ricardo Ferreira

2012-01-01

Summary Introduction: Currently, the Brazilian government has certificated nearly 140 specialized centers in hearing aid fittings through the Brazilian National Health System (SUS). Remote fitting through the Internet can allow a broader and more efficient coverage with a higher likelihood of success for patients covered by the SUS, as they can receive fittings from their own homes instead of going to the few and distant specialized centers. Aim: To describe a case of remote fitting between 2 cities, with revision of the literature. Method: Computer gears, a universal interface, and hearing aids were used. Case study: An audiologist located in a specialized center introduced a new hearing aid and its fitting procedure to a remote center (200 km away). The specialized center helped the remote center in fitting a hearing aid in 2 patients, and performed fitting in one of its own patients. The whole process was done through the Internet with audio and video in real time. Results: Three patients were fitted remotely. Three audiologists were remotely trained on how to fit the hearing aids. Conclusions: Remote fitting of hearing aids is possible through the Internet, as well as further supplying technical training to a remote center about the fitting procedures. Such a technological approach can help the government advance public policies on hearing rehabilitation, as patients can be motivated about maintaining their use of hearing aids with the option to ask for help in the comfort of their own homes. PMID:25991960

Space Transportation Systems Technologies

NASA Technical Reports Server (NTRS)

Laue, Jay H.

2001-01-01

This document is the final report by the Science Applications International Corporation (SAIC) on contracted support provided to the National Aeronautics and Space Administration (NASA) under Contract NAS8-99060, 'Space Transportation Systems Technologies'. This contract, initiated by NASA's Marshall Space Flight Center (MSFC) on February 8, 1999, was focused on space systems technologies that directly support NASA's space flight goals. It was awarded as a Cost-Plus-Incentive-Fee (CPIF) contract to SAIC, following a competitive procurement via NASA Research Announcement, NRA 8-21. This NRA was specifically focused on tasks related to Reusable Launch Vehicles (RLVs). Through Task Area 3 (TA-3), "Other Related Technology" of this NRA contract, SAIC extensively supported the Space Transportation Directorate of MSFC in effectively directing, integrating, and setting its mission, operations, and safety priorities for future RLV-focused space flight. Following an initially contracted Base Year (February 8, 1999 through September 30, 1999), two option years were added to the contract. These were Option Year 1 (October 1, 1999 through September 30, 2000) and Option Year 2 (October 1, 2000 through September 30, 2001). This report overviews SAIC's accomplishments for the Base Year, Option Year 1, and Option Year 2, and summarizes the support provided by SAIC to the Space Transportation Directorate, NASA/MSFC.

Trying to optimise the German version of the OPTION scale regarding the dyadic aspect of shared decision making.

PubMed

Keller, H; Hirsch, O; Müller-Engelmann, M; Heinzel-Gutenbrunner, M; Krones, T; Donner-Banzhoff, N

2013-01-01

The OPTION scale ("observing patient involvement in decision making") assesses the extent to which clinicians involve patients in decisions across a range of situations in clinical practice. It so far just covers physician behavior. We intended to modify the scoring of the OPTION scale to incorporate active patient behavior in consultations. Modification was done on scoring level, attempting a dyadic, relationship-centred approach in that high ratings can be evoked also by the behaviour of active patients. The German version of the OPTION scale was compared with a modified version by analysing video recordings of primary care consultations dealing with cardiovascular prevention. Fifteen general practitioners provided 40 videotaped consultations. Videos were analysed by two rater pairs and two experts in shared decision making (SDM). Reliability measures of the modified version were lower than those of the original scale. Significant associations of the dichotomised scale with the expert SDM rating as well as with physicians' expertise in SDM were only found for the modified OPTION scale. Receiver Operating Characteristic (ROC) analyses confirmed a valid differentiation between the presence of SDM (yes/no) on total score level, even though the cut-off point was quite low. Standard deviations of the single items in the modified version were higher compared to the original OPTION scale, while the means of total scores were similar. The original OPTION scale is physician-centered and neglects the activity and a possible self-involvement of the patient. Our modified instruction was able to capture the dyadic element partially. The development of a separate dyadic instrument might be more promising.

Solar Feasibility Study May 2013 - San Carlos Apache Tribe

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

Rapp, Jim; Duncan, Ken; Albert, Steve

2013-05-01

The San Carlos Apache Tribe (Tribe) in the interests of strengthening tribal sovereignty, becoming more energy self-sufficient, and providing improved services and economic opportunities to tribal members and San Carlos Apache Reservation (Reservation) residents and businesses, has explored a variety of options for renewable energy development. The development of renewable energy technologies and generation is consistent with the Tribe’s 2011 Strategic Plan. This Study assessed the possibilities for both commercial-scale and community-scale solar development within the southwestern portions of the Reservation around the communities of San Carlos, Peridot, and Cutter, and in the southeastern Reservation around the community of Bylas.more » Based on the lack of any commercial-scale electric power transmission between the Reservation and the regional transmission grid, Phase 2 of this Study greatly expanded consideration of community-scale options. Three smaller sites (Point of Pines, Dudleyville/Winkleman, and Seneca Lake) were also evaluated for community-scale solar potential. Three building complexes were identified within the Reservation where the development of site-specific facility-scale solar power would be the most beneficial and cost-effective: Apache Gold Casino/Resort, Tribal College/Skill Center, and the Dudleyville (Winkleman) Casino.« less

Para Candidatos en Programas de Centros de Cuidado y Educacion Infantil con Ninos de Edad Pre-escolar: Asociado en Desarrollo Infantil Sistema de Evaluacion y Normas de Competencia CDA (Preschool Caregivers in Center-Based Programs: The Child Development Associate Assessment System and Competency Standards).

ERIC Educational Resources Information Center

Council for Early Childhood Professional Recognition, Washington, DC.

This Spanish-language booklet outlines the requirements of the Child Development Associate (CDA) credential for preschool teachers or caregivers who work in center-based preschool day care programs. Part 1 provides an overview of the CDA credentialing system and the various options, settings, standards, and stages of the CDA assessment system.…

Assessing the Fire Risk for a Historic Hangar

NASA Technical Reports Server (NTRS)

Datta, Koushik; Morrison, Richard S.

2010-01-01

NASA Ames Research Center (ARC) is evaluating options of reuse of its historic Hangar 1. As a part of this evaluation, a qualitative fire risk assessment study was performed to evaluate the potential threat of combustion of the historic hangar. The study focused on the fire risk trade-off of either installing or not installing a Special Hazard Fire Suppression System in the Hangar 1 deck areas. The assessment methodology was useful in discussing the important issues among various groups within the Center. Once the methodology was deemed acceptable, the results were assessed. The results showed that the risk remained in the same risk category, whether Hangar 1 does or does not have a Special Hazard Fire Suppression System. Note that the methodology assessed the risk to Hangar 1 and not the risk to an aircraft in the hangar. If one had a high value aircraft, the aircraft risk analysis could potentially show a different result. The assessed risk results were then communicated to management and other stakeholders.

Advanced Space Transportation Program (ASTP)

NASA Image and Video Library

2000-04-03

This is a computer generated image of a Shuttle launch utilizing 2nd generation Reusable Launch Vehicle (RLV) flyback boosters, a futuristic concept that is currently undergoing study by NASA's Space Launch Initiative (SLI) Propulsion Office, managed by the Marshall Space Fight Center in Huntsville, Alabama, working in conjunction with the Agency's Glenn Research Center in Cleveland, Ohio. Currently, after providing thrust to the Space Shuttle, the solid rocket boosters are parachuted into the sea and are retrieved for reuse. The SLI is considering vehicle concepts that would fly first-stage boosters back to a designated landing site after separation from the orbital vehicle. These flyback boosters would be powered by several jet engines integrated into the booster capable of providing over 100,000 pounds of thrust. The study will determine the requirements for the engines, identify risk mitigation activities, and identify costs associated with risk mitigation and jet engine development and production, as well as determine candidate jet engine options to pursue for the flyback booster.

Morbidity and Mortality of Live Lung Donation: Results from the RELIVE study

PubMed Central

Yusen, R.D.; Hong, B.A.; Messersmith, E.E.; Gillespie, B.W.; Lopez, B.M.; Brown, K.L.; Odim, J.; Merion, R.M.; Barr, M.L.

2014-01-01

The Renal and Lung Living Donors Evaluation Study (RELIVE) assesses outcomes of live lung (lobectomy) donors. This is a retrospective cohort study at University of Southern California (USC) and Washington University (WASHU) Medical Centers (1993–2006), using medical records to assess morbidity and national databases to ascertain post-donation survival and lung transplantation. Serious complications were those requiring significant treatment, potentially life-threatening, or leading to prolonged hospitalization. The 369 live lung donors (287 USC, 82 WASHU) were predominantly white, non-Hispanic, and male; 72% had a biological relationship to the recipient, and 30% were recipient parents. Serious complications occurred in 18% of donors; 2.2% underwent reoperation, and 6.5% had an early rehospitalization. The two centers had significantly different incidences of serious complications (p<0.001). No deaths occurred and no donors underwent lung transplantation during 4,000+ person-years of follow-up (death: minimum 4, maximum 17 years; transplant: minimum 5, maximum 19). Live lung donation remains a potential option for recipients when using deceased donor lungs lacks feasibility. However, the use of two live donors for each recipient and the risk of morbidity associated with live lung donation do not justify this approach when deceased lung donors remain available. Center effects and long-term outcomes require further evaluation. PMID:25039865

Economic implications of home births and birth centers: a structured review.

PubMed

Henderson, Jane; Petrou, Stavros

2008-06-01

It is widely perceived that home births and birth centers may help decrease the costs of maternity care for women with uncomplicated pregnancies and deliveries. This structured review examines the literature relating to the economic implications of home births and birth center care compared with hospital maternity care. The bibliographic databases MEDLINE (from 1950), CINAHL (from 1982), EMBASE (from 1980), and an "in-house" database, Econ2, were searched for relevant English language publications using MeSH and free text terms. Data were extracted with respect to the study design, inclusion criteria, clinical and cost results, and details of what was included in the cost calculations. Eleven studies were included from the United Kingdom, United States, Australia, and Canada. Two studies focused on home births versus other forms and locations of care, whereas nine focused on birth centers versus other forms and locations of care. Resource use was generally lower for women cared for at home and in birth centers due to lower rates of intervention, shorter lengths of stay, or both. However, this fact did not always translate into lower costs because, in the U.K. where many studies were conducted, more midwives of a higher grade were employed to manage the birth centers than are usually employed in maternity units, and because of costs of converting existing facilities into delivery rooms. The quality of much of the literature was poor, although no studies were excluded for this reason. Selection bias was likely to be a problem in those studies not based on randomized controlled trials because, even where birth center eligibility was applied throughout, women who choose to deliver at home or in a birth center are likely to be different in terms of expectations and approach from women choosing to deliver in hospital. This review highlights the paucity of economic literature relating to home births and birth centers. Differences in results between studies may be attributed to differences in health care systems, differences in methods used, and differences in costs included. Further economic research that involves detailed bottom-up costing of alternative options for place of birth and measures multiple outcomes, including women's preferences, would help address the question of whether out-of-hospital birth is beneficial in economic terms.

Early pregnancy failure management among family physicians.

PubMed

Wallace, Robin; Dehlendorf, Christine; Vittinghoff, Eric; Gold, Katherine J; Dalton, Vanessa K

2013-03-01

Family physicians, as primary care providers for reproductive-aged women, frequently initiate or refer patients for management of early pregnancy failure (EPF). Safe and effective options for EPF treatment include expectant management, medical management with misoprostol, and aspiration in the office or operating room. Current practice does not appear to reflect patient preferences or to utilize the most cost-effective treatments. We compared characteristics and practice patterns among family physicians who do and do not provide multiple options for EPF care. We performed a secondary analysis of a national survey of women's health providers to describe demographic and practice characteristics among family physicians who care for women with EPF. We used multivariate logistic regression to identify correlates of providing more than one option for EPF management. The majority of family physicians provide only one option for EPF; expectant management was most frequently used among our survey respondents. Misoprostol and office-based aspiration were rarely used. Providing more than one option for EPF management was associated with more years in practice, smaller county population, larger proportions of Medicaid patients, intrauterine contraception provision, and prior training in office-based aspiration. Family physicians are capable of providing a comprehensive range of options for EPF management in the outpatient setting but few providers currently do so. To create a more patient-centered and cost-effective model of care for EPF, additional resources should be directed at education, skills training, and system change initiatives to prepare family physicians to offer misoprostol and office-based aspiration to women with EPF.

Long-term Prognosis After Lung Transplantation: A Monocentric Study in 510 Patients.

PubMed

Montoro Ballesteros, F; Sánchez Fernández, J J; Vaquero Barrios, J M; Redel Montero, J; Cobos Ceballos, M J; Esteban Amarilla, C; Palomares Muriana, A M; Santos Luna, F

2018-03-01

Lung transplantation is the final treatment option in patients with respiratory failure. Morbidity and mortality rates associated with the management of complications is high despite advances. Postoperative complications include acute transplant rejection, bronchiolitis obliterans, and infections. Because of that, the success of this treatment option depends on the correct choice of donor and candidates to receive a transplant. This study aims to perform a survival analysis of transplanted patients in our center and determine predictive variables of mortality. This study is a retrospective assessment of data collected from 510 patients at the Hospital University Reina Sofía from October 1993 to December 31, 2016. Patients who were retransplanted were excluded. We collected data regarding basal characteristics of the donors and candidates to receive a transplant. We analyzed the impact in terms of future survival of basal variables from donor and donor recipients. Five hundred ten patients were included (average age 44 ± 17 years, 69% male), with a maximum follow-up period of 21.6 years (average follow-up 4.52 years, interquartile ratio: 0.13 to 6.97 years). Two hundred twenty-seven patients died (54.3% of the total amount). The influence of donor's basal characteristics on mortality was analyzed; moreover, the relationship between basal variables and survival were analyzed using univariate analysis. Available variables were analyzed through multivariate analysis. Lung transplantation is a treatment option with an acceptable risk of morbidity and mortality. Increased awareness of features of evolution could help to reduce postoperative complications. Copyright © 2018 Elsevier Inc. All rights reserved.

Gasification and combustion technologies of agro-residues and their application to rural electric power systems in India

NASA Astrophysics Data System (ADS)

Bharadwaj, Anshu

Biomass based power generation has the potential to add up to 20,000 MW of distributed capacity in India close to the rural load centers. However, the present production of biomass-based electricity is modest, contributing a mere 300 MW of installed capacity. In this thesis, we shall examine some of the scientific, technological and policy issues concerned with the generation and commercial viability of biomass-based electric power. We first consider the present status of biomass-based power in India and make an attempt to understand the reasons for low utilization. Our analysis suggests that the small-scale biomass power plants (<100 kW) when used for village electrification have a low Plant Load Factor (PLF) that adversely affects their economic viability. Medium Scale units (0.5 MW--5 MW) do not appear attractive because of the costs involved in the biomass transportation. There is thus a merit in considering power plants that use biomass available in large quantities in agro-processing centers such as rice or sugar mills where power plants of capacities in excess of 5 MW are possible without biomass transportation. We then simulate a biomass gasification combustion cycle using a naturally aspirated spark ignition engine since it can run totally on biomass gas. The gasifier and engine are modeled using the chemical equilibrium approach. The simulation is used to study the impact of fuel moisture and the performance of different biomass feedstock. Biomass power plants when used for decentralized power generation; close to the rural load centers can solve some of the problems of rural power supply: provide voltage support, reactive power and peak shaving. We consider an innovative option of setting up a rural electricity micro-grid using a decentralized biomass power plant and selected a rural feeder in Tumkur district, Karnataka for three-phase AC load flow studies. Our results suggest that this option significantly reduces the distribution losses and improves the voltage profiles. We examine a few innovative policy options for making a rural micro-grid economically viable and also a pricing mechanism for reactive power and wheeling. We next consider co-firing biomass and coal in utility boilers as an attractive option for biomass utilization because of low capital costs; high efficiency of utility boilers; lower CO2 emissions (per kWh) and also lower NOx and SO2. However, efficiency derating of the boilers caused by unburnt carbon in the fly ash is a major concern of the utilities. We develop a computational fluid dynamics (CFD) based model to understand the impact of co-firing on utility boilers. A detailed biomass devolatilization sub-model is also developed to study the importance of intra-particle heat and mass transport. Finally, we conduct an experimental study of the pyrolysis of rice husk. We conducted single particle experiments in a Confocal Scanning Laser Microscope (CSLM) at the Department of Material Science and Engineering, Carnegie Mellon University coupled with Scanning Electron Microscope (SEM) analysis of partially and fully combusted particles. Our results seem to indicate that the role of silica fibers is not merely to act as geometric shields for the carbon atoms. Instead there appears to be a strong and thermally resistant inter-molecular bonding that prevents carbon conversion. Therefore, it may not be possible to achieve full carbon conversion.

[Activities of Goddard Earth Sciences and Technology Center, Maryland University

NASA Technical Reports Server (NTRS)

2003-01-01

The Goddard Space Flight Center (GSFC) is recognized as a world leader in the application of remote sensing and modeling aimed at improving knowledge of the Earth system. The Goddard Earth Sciences Directorate plays a central role in NASA's Earth Observing System and the U.S. Global Change Research Program. Goddard Earth Sciences and Technology (GEST) is organized as a cooperative agreement with the GSFC to promote excellence in the Earth sciences, and is a consortium of universities and corporations (University of Maryland Baltimore County, Howard University, Hampton University, Caelum Research Corporation and Northrop Grumman Corporation). The aim of this new program is to attract and introduce promising students in their first or second year of graduate studies to Oceanography and Earth system science career options through hands-on instrumentation research experiences on coastal processes at NASA's Wallops Flight Facility on the Eastern Shore of Virginia.

What Do Patients Want? Patient Preference in Wound Care

PubMed Central

Corbett, Lisa Q.; Ennis, William J.

2014-01-01

Patient preferences are statements made or actions taken by consumers that reflect their desirability of a range of health options. The concept occupies an increasingly prominent place at the center of healthcare reform, and is connected to all aspects of healthcare, including discovery, research, delivery, outcome, and payment. Patient preference research has focused on shared decisions, decisional aids, and clinical practice guideline development, with limited study in acute and chronic wound care populations. The wound care community has focused primarily on patient focused symptoms and quality of life measurement. With increasing recognition of wound care as a medical specialty and as a public health concern that consumes extensive resources, attention to the preferences of end-users with wounds is necessary. This article will provide an overview of related patient-centered concepts and begin to establish a framework for consideration of patient preference in wound care. PMID:25126474

Venus Global Reference Atmospheric Model

NASA Technical Reports Server (NTRS)

Justh, Hilary L.

2017-01-01

Venus Global Reference Atmospheric Model (Venus-GRAM) is an engineering-level atmospheric model developed by MSFC that is widely used for diverse mission applications including: Systems design; Performance analysis; Operations planning for aerobraking, Entry, Descent and Landing, and aerocapture; Is not a forecast model; Outputs include density, temperature, pressure, wind components, and chemical composition; Provides dispersions of thermodynamic parameters, winds, and density; Optional trajectory and auxiliary profile input files Has been used in multiple studies and proposals including NASA Engineering and Safety Center (NESC) Autonomous Aerobraking and various Discovery proposals; Released in 2005; Available at: https://software.nasa.gov/software/MFS-32314-1.

Retrieval of Non-Print Information with Recommendations for Gallaudet College.

ERIC Educational Resources Information Center

Edwards, Fern

With the purpose of designing a learning center to fit the instructional programs of Gallaudet College, a review of the literature and visits to 20 schools and colleges were made and options considered for the provision of nonprint materials. The costs, advantages, and utility of various nonprint retrieval systems are analyzed, specifically…

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Code of Federal Regulations, 2011 CFR

2011-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs...

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Code of Federal Regulations, 2010 CFR

2010-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs...

Making School Choice Work

ERIC Educational Resources Information Center

DeArmond, Michael; Jochim, Ashley; Lake, Robin

2014-01-01

School choice is increasingly the new normal in urban education. But in cities with multiple public school options, how can civic leaders create a choice system that works for all families, whether they choose a charter or district public school? To answer this question, the Center on Reinventing Public Education (CRPE) researchers surveyed 4,000…

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Code of Federal Regulations, 2012 CFR

2012-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs...

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Code of Federal Regulations, 2013 CFR

2013-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs...

42 CFR 413.210 - Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.

Code of Federal Regulations, 2014 CFR

2014-10-01

... disease (ESRD) prospective payment system. 413.210 Section 413.210 Public Health CENTERS FOR MEDICARE... REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs...

Knowing Where You're Going: Planning for Meaningful Course Closure

ERIC Educational Resources Information Center

Burgess-Van Aken, Barbara

2017-01-01

A literature review on approaches to a final course session reveals a dearth of attention to the issue. Options for last-day activities fall into three categories: professor-centered, activity-focused, and student-driven. Using the criterion that meaningful course closure calls for last-day activities that engage students in reflection not only…

Sociopolitical Development in Educational Systems: From Margins to Center

ERIC Educational Resources Information Center

Kirshner, Ben; Hipolito-Delgado, Carlos; Zion, Shelley

2015-01-01

This is a challenging moment for supporters of public education: the status quo is untenable but the options offered by "reformers" appear equally dangerous. In this context we need arguments for the democratic purposes of education that offer an alternative to existing inequities on one hand and technocratic or privatized solutions on…

Final evaluation of the acoustics of the APS conference center

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

Restrepo, J.M.

Along with a description of the changes that I prescribed on the original design, this report is an evaluation of the acoustical properties of the new Advanced Photon Source Auditorium at Argonne National Laboratory. Acoustical deficiencies in the hall are presented with several options for their expedient and economical solution.

Laying the Groundwork: The Journey of an Urban High School District Implementing a College Readiness Initiative

ERIC Educational Resources Information Center

Franco, Antonia O.

2012-01-01

National and state education reforms are centered on developing higher academic expectations and standards to ensure students transitions into postsecondary options, college and career ready. What does this national emphasis signify for urban school districts that are educating a significant proportion of first-generation students and that…

Improving legumes for pasture, cover crops, living mulch, and green manure

USDA-ARS?s Scientific Manuscript database

With growing interest in alternative legumes for uses beyond hay, farmers are requesting options to meet their needs. This article explains two efforts in which the U.S. Dairy Forage Research Center is involved. The two efforts include: 1) kura clover seed production so producers have access to kura...

An Integrative Approach to Foreign Language Teaching: Choosing Among the Options. ACTFL Foreign Language Education Series, Vol. 8.

ERIC Educational Resources Information Center

Jarvis, Gilbert A., Ed.

This volume on foreign language teaching and learning concerns the following topics: lifelong learning, small-group learning, the minicourse, student attitudes toward foreign languages, problems in secondary schools, humanistic education, curricula in uncommonly taught languages, foreign languages in elementary and adolescent-centered education,…

Community College of Rhode Island.

ERIC Educational Resources Information Center

Liston, Edward J.

1999-01-01

Describes the history, mission, financing, and enrollment of the Community College of Rhode Island (CCRI). Presents CCRI's goals: (1) expand the use of technology; (2) be more responsive to the business community and assist in strengthening the economy of the state; (3) become more student-centered; and (4) become a first-stop option for high…

After-School Math PLUS (ASM+) Final Evaluation Report

ERIC Educational Resources Information Center

Academy for Educational Development, 2007

2007-01-01

This report summarizes findings from the Academy for Educational Development's (AED's) evaluation of After-School Math PLUS (ASM+). This program was designed to help students find the math in everyday experiences and create awareness about the importance of math skills for future career options. The evaluation was conducted by AED's Center for…

Integration of Computers into a Course on Biostatistics

ERIC Educational Resources Information Center

Gjerde, Craig L.

1977-01-01

The biostatistics course for undergraduate medical and dental students at the University of Connecticut Health Center is taught by the Keller Plan, and students can use computers to analyze data sets and to score their unit tests. The computer is an essential tool for data analysis and an attractive option for test scoring. (LBH)

75 FR 3742 - Medicare Program; Meeting of the Advisory Panel on Medicare Education; Cancellation of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-22

... * * * on the coverage options provided under [Medicare Advantage] in order to promote an active, informed..., National Hispanic Council on Aging; Stephen L. Fera, Vice President, Social Mission Programs, Independence Blue Cross; Clayton Fong, President and Chief Executive Officer, National Asian Pacific Center on Aging...

47 CFR 73.674 - Digital television transition notices by broadcasters.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PSAs and crawls with antenna notices. (7) Rescanning notices—Beginning April 1, 2009, all stations must...) of this section may replace up to 25 percent of their daily PSAs and crawls with rescanning notices... PSAs and crawls with help center notices. (c) Consumer Education Campaign Option One: (1) From March 27...

SLF Run/Walk for Safety and Health Month

NASA Image and Video Library

2018-03-13

Kennedy Space Center employees hold up signs showing their commitment to safety after crossing the finish line at the KSC Walk Run. The annual event, part of Kennedy’s Safety and Health Days, offers 10K, 5K and 2-mile options on the Shuttle Landing Facility runway in the spirit of friendly competition.

Conflict Resolution Strategies Adopted from Parenting Coordination: Assisting High-Conflict Coparenting Students

ERIC Educational Resources Information Center

Henry, Wilma J.; Mitcham, Michelle A.; Henry, Lynette M.

2013-01-01

This article examines the challenges faced by nontraditional college students who are coparents as a result of divorce. The need for college counseling centers to have counseling options designed to assist this special population in successfully completing their academic pursuits is presented. Conflict resolution techniques based on the Parenting…

42 CFR 435.640 - Protected Medicaid eligibility for individuals eligible in December 1973.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Protected Medicaid eligibility for individuals eligible in December 1973. 435.640 Section 435.640 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Requirements and Options § 435.640 Protected Medicaid eligibility for individuals eligible in December 1973. In...

42 CFR 435.640 - Protected Medicaid eligibility for individuals eligible in December 1973.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Protected Medicaid eligibility for individuals eligible in December 1973. 435.640 Section 435.640 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Requirements and Options § 435.640 Protected Medicaid eligibility for individuals eligible in December 1973. In...

42 CFR 435.640 - Protected Medicaid eligibility for individuals eligible in December 1973.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Protected Medicaid eligibility for individuals eligible in December 1973. 435.640 Section 435.640 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Requirements and Options § 435.640 Protected Medicaid eligibility for individuals eligible in December 1973. In...

42 CFR 435.640 - Protected Medicaid eligibility for individuals eligible in December 1973.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Protected Medicaid eligibility for individuals eligible in December 1973. 435.640 Section 435.640 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Requirements and Options § 435.640 Protected Medicaid eligibility for individuals eligible in December 1973. In...

42 CFR 441.454 - Use of cash.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Use of cash. 441.454 Section 441.454 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... applicable, using the cash option to choose to use the financial management entity for some or all of the...

42 CFR 441.454 - Use of cash.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Use of cash. 441.454 Section 441.454 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL... applicable, using the cash option to choose to use the financial management entity for some or all of the...

Manatee County Displaced Homemakers Program. Final Report from July 1, 1983 to August 31, 1984.

ERIC Educational Resources Information Center

Joynes, Margot

In the Displaced Homemaker project at the New Options Center in Manatee County, Bradenton, Florida, clients were displaced homemakers, single household heads needing training, homemakers seeking full-time employment, and anyone interested in jobs or training nontraditional to his/her sex. Various outreach methods--public service announcements,…

Orbit Determination Issues for Libration Point Orbits

NASA Technical Reports Server (NTRS)

Beckman, Mark; Bauer, Frank (Technical Monitor)

2002-01-01

Libration point mission designers require knowledge of orbital accuracy for a variety of analyses including station keeping control strategies, transfer trajectory design, and formation and constellation control. Past publications have detailed orbit determination (OD) results from individual libration point missions. This paper collects both published and unpublished results from four previous libration point missions (ISEE (International Sun-Earth Explorer) -3, SOHO (Solar and Heliospheric Observatory), ACE (Advanced Composition Explorer) and MAP (Microwave Anisotropy Probe)) supported by Goddard Space Flight Center's Guidance, Navigation & Control Center. The results of those missions are presented along with OD issues specific to each mission. All past missions have been limited to ground based tracking through NASA ground sites using standard range and Doppler measurement types. Advanced technology is enabling other OD options including onboard navigation using seaboard attitude sensors and the use of the Very Long Baseline Interferometry (VLBI) measurement Delta Differenced One-Way Range (DDOR). Both options potentially enable missions to reduce coherent dedicated tracking passes while maintaining orbital accuracy. With the increased projected loading of the DSN (Deep Space Network), missions must find alternatives to the standard OD scenario.

Development of a rapidly deployed Department of Energy emergency response element.

PubMed

Tighe, R J; Riland, C A; Hopkins, R C

2000-02-01

The Federal Radiological Emergency Response Plan (FRERP) directs the Department of Energy (DOE) to maintain a viable, timely, and fully documented response option capable of supporting the responsible Lead Federal Agency in the event of a radiological emergency impacting any state or United States territory (e.g., CONUS). In addition, the DOE maintains a response option to support radiological emergencies outside the continental United States (OCONUS). While the OCONUS mission is not governed by the FRERP, this response is operationally similar to that assigned to the DOE by the FRERP The DOE is prepared to alert, activate, and deploy radiological response teams to augment the Radiological Assistance Program and/or local responders. The Radiological Monitoring and Assessment Center (RMAC) is a phased response that integrates with the Federal Radiological Monitoring and Assessment Center (FRMAC) in CONUS environments and represents a stand-alone DOE response for OCONUS environments. The FRMAC/RMAC Phase I was formally "stood up" as an operational element in April 1999. The FRMAC/RMAC Phase II proposed "stand-up" date is midyear 2000.

Assessment of MSFC's supervisory training programs and courses. [marshall space flight center

NASA Technical Reports Server (NTRS)

Brindley, T. A.

1982-01-01

Courses and special programs to train supervisors at Marshall Space Flight Center (MSFC) were to determine the adequacy of the present MSFC Supervisory Training Program and to recommend changes, if appropriate. The content, procedures, and student evaluations of the required Office of Personnel Management (OPM) 80 hours training for supervisors, the optional 120 hours, the MSFC Management Development Program (MDP), NASA's Management Education Program (MEP), various OPM and special contract programs, pertinent procedural guidelines, regulations, and letters, as well as various MSFC computer reports which indicate who took what training were analyzed. Various interviews with MSFC personnel involved in training are included. Recommendations consist of: (1) the choice of courses selected for the basic required OPM 80 hours be improved; (2) the optional 120 hours be discontinued and a shorter module be developed dealing with managerial decision making and human relations skills; (3) the MDP and MEP be continued as at present; and (4) that a broad array of developmental strategies be incorporated to provide a variety of opportunities for supervisory improvement.

Recommendations to Facilitate Expanded Access to Investigational Therapies for Seriously Ill Patients

PubMed Central

Jerome, Rebecca N.; Edwards, Terri L.; Boswell, Haley C.; Bernard, Gordon R.; Harris, Paul A.; Pulley, Jill M.

2015-01-01

When clinical trial enrollment is not an option for seriously ill patients whose illnesses have not responded to approved treatment options, those patients and their physicians may consider gaining access to investigational therapies through a pathway established by the Food and Drug Administration (FDA) called expanded access. However, recent events have highlighted the challenging dynamics involved in accessing investigational therapies through expanded access that include a complex interplay of factors involving the patient, physician, drug company, FDA, and, increasingly, social media. The authors offer several potential strategies to streamline what is otherwise an arduous process for all involved. (1) The drug company should prospectively determine whether it will establish an expanded access program for specific drugs. (2) A central clearinghouse for companies should support registration of expanded access drugs for suitable patients. (3) The determination of whether a patient fits criteria would be made by an independent review board of clinicians. (4) An independent coordinating center is needed; academic health centers are ideally suited for that role. (5) Adequate financing of the costs of therapy need to be in place to make expanded access a reality, given frequent lack of payor coverage for therapies. (6) Further enhancement of regulatory pathways, approaches, or rules would promote expanded access. (7) Patients should explicitly acknowledge the limited data available. (8) There should be a shared, secure, technical platform to facilitate expanded access. All the authors’ strategies present important prospects for improving treatment options for the most seriously ill patients. PMID:26445080

Justifying Clinical Nudges.

PubMed

Gorin, Moti; Joffe, Steven; Dickert, Neal; Halpern, Scott

2017-03-01

The shift away from paternalistic decision-making and toward patient-centered, shared decision-making has stemmed from the recognition that in order to practice medicine ethically, health care professionals must take seriously the values and preferences of their patients. At the same time, there is growing recognition that minor and seemingly irrelevant features of how choices are presented can substantially influence the decisions people make. Behavioral economists have identified striking ways in which trivial differences in the presentation of options can powerfully and predictably affect people's choices. Choice-affecting features of the decision environment that do not restrict the range of choices or significantly alter the incentives have come to be known as "nudges." Although some have criticized conscious efforts to influence choice, we believe that clinical nudges may often be morally justified. The most straightforward justification for nudge interventions is that they help people bypass their cognitive limitations-for example, the tendency to choose the first option presented even when that option is not the best for them-thereby allowing people to make choices that best align with their rational preferences or deeply held values. However, we argue that this justification is problematic. We argue that, if physicians wish to use nudges to shape their patients' choices, the justification for doing so must appeal to an ethical and professional standard, not to patients' preferences. We demonstrate how a standard with which clinicians and bioethicists already are quite familiar-the best-interest standard-offers a robust justification for the use of nudges. © 2017 The Hastings Center.

Governing Academic Medical Center Systems: Evaluating and Choosing Among Alternative Governance Approaches.

PubMed

Chari, Ramya; O'Hanlon, Claire; Chen, Peggy; Leuschner, Kristin; Nelson, Christopher

2018-02-01

The ability of academic medical centers (AMCs) to fulfill their triple mission of patient care, medical education, and research is increasingly being threatened by rising financial pressures and resource constraints. Many AMCs are, therefore, looking to expand into academic medical systems, increasing their scale through consolidation or affiliation with other health care systems. As clinical operations grow, though, the need for effective governance becomes even more critical to ensure that the business of patient care does not compromise the rest of the triple mission. Multi-AMC systems, a model in which multiple AMCs are governed by a single body, pose a particular challenge in balancing unity with the needs of component AMCs, and therefore offer lessons for designing AMC governance approaches. This article describes the development and application of a set of criteria to evaluate governance options for one multi-AMC system-the University of California (UC) and its five AMCs. Based on a literature review and key informant interviews, the authors identified criteria for evaluating governance approaches (structures and processes), assessed current governance approaches using the criteria, identified alternative governance options, and assessed each option using the identified criteria. The assessment aided UC in streamlining governance operations to enhance their ability to respond efficiently to change and to act collectively. Although designed for UC and a multi-AMC model, the criteria may provide a systematic way for any AMC to assess the strengths and weaknesses of its governance approaches.

First on-line survey of an international multidisciplinary working group (MightyMedic) on current practice in diagnosis, therapy and follow-up of dyslipidemias.

PubMed

Stefanutti, C; D'Alessandri, G; Petta, A; Harada-Shiba, M; Julius, U; Soran, H; Moriarty, P M; Romeo, S; Drogari, E; Jaeger, B R

2015-05-01

The MightyMedic (Multidisciplinary International Group for Hemapheresis TherapY and MEtabolic DIsturbances Contrast) Working Group has been founded in 2013. The leading idea was to establish an international network of interdisciplinary nature aimed at working to cross national borders research projects, clinical trials, educational initiatives (meetings, workshops, summer schools) in the field of metabolic diseases, namely hyperlipidemias, and diabetes, preventive cardiology, and atherosclerosis. Therapeutic apheresis, its indications and techniques, is a parallel field of investigation. The first on-line survey of the Group has been completed in the first half of 2014. The survey included # 24 Centers in Italy, Germany, Greece, UK, Sweden, Japan and USA. Relevant data have been collected on current practice in diagnosis, therapy and follow-up of dyslipidemias. 240 subjects with hyperlipidemia and treated with lipoprotein apheresis have been reported in the survey, but a large percentage of patients (35%) who could benefit from this therapeutic option are still treated by conventional drug approach. Genetic molecular diagnosis is performed in only 33% of patients while Lipoprotein(a) (Lp(a)) is included in cardiovascular disease risk assessment in 71% of participating Centers. New detailed investigations and prospective multicenter studies are needed to evaluate changes induced by the impact of updated indications and strategies, as well as new treatment options, targeting standardization of therapeutic and diagnostic approaches. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Skylab

NASA Image and Video Library

1973-05-01

Sixty-three seconds after the launch of the modified Saturn V vehicle carrying the Skylab cluster, engineers in the operation support and control center saw an unexpected telemetry indication that signalled that damages occurred on one solar array and the micrometeoroid shield during the launch. Still unoccupied, the Skylab was stricken with the loss of the heat shield and sunlight beat mercilessly on the lab's sensitive skin. Internal temperatures soared, rendering the the station uninhabitable, threatening foods, medicines, films, and experiments. The launch of the first marned Skylab (Skylab-2) mission was delayed until methods were devised to repair and salvage the workshop. Personnel from other NASA Centers and industries quickly joined the Marshall Space Flight Center (MSFC) in efforts to save the damaged Skylab. They worked day and night for the next several days. Eventually the MSFC developed, tested, rehearsed, and approved three repair options. These options included a parasol sunshade and a twin-pole sunshade to restore the temperature inside the workshop, and a set of metal cutting tools to free the jammed solar panel. This photograph was taken during a discussion of the methods of the twin-pole Sun shield by (left to right) Astronaut Alan Bean, MSFC Director Dr. Rocco Petrone, Astronaut Edward Gibson, and MSFC engineer Richard Heckman. Dr. William Lucas, who became MSFC Director after Dr. Petrone left MSFC in March of 1974, is standing.

Effective follow-up consultations: the importance of patient-centered communication and shared decision making.

PubMed

Brand, Paul L P; Stiggelbout, Anne M

2013-12-01

Paediatricians spend a considerable proportion of their time performing follow-up visits for children with chronic conditions, but they rarely receive specific training on how best to perform such consultations. The traditional method of running a follow-up consultation is based on the doctor's agenda, and is problem-oriented. Patients and parents, however, prefer a patient-centered, and solution-focused approach. Although many physicians now recognize the importance of addressing the patient's perspective in a follow-up consultation, a number of barriers hamper its implementation in practice, including time constraints, lack of appropriate training, and a strong tradition of the biomedical, doctor-centered approach. Addressing the patient's perspective successfully can be achieved through shared decision making, clinicians and patients making decisions together based on the best clinical evidence. Research shows that shared decision making not only increases patient, parent, and physician satisfaction with the consultation, but also may improve health outcomes. Shared decision making involves building a physician-patient-parent partnership, agreeing on the problem at hand, laying out the available options with their benefits and risks, eliciting the patient's views and preferences on these options, and agreeing on a course of action. Shared decision making requires specific communication skills, which can be learned, and should be mastered through deliberate practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

Case Studies in Describing Scientific Research Efforts as Linked Data

NASA Astrophysics Data System (ADS)

Gandara, A.; Villanueva-Rosales, N.; Gates, A.

2013-12-01

The Web is growing with numerous scientific resources, prompting increased efforts in information management to consider integration and exchange of scientific resources. Scientists have many options to share scientific resources on the Web; however, existing options provide limited support to scientists in annotating and relating research resources resulting from a scientific research effort. Moreover, there is no systematic approach to documenting scientific research and sharing it on the Web. This research proposes the Collect-Annotate-Refine-Publish (CARP) Methodology as an approach for guiding documentation of scientific research on the Semantic Web as scientific collections. Scientific collections are structured descriptions about scientific research that make scientific results accessible based on context. In addition, scientific collections enhance the Linked Data data space and can be queried by machines. Three case studies were conducted on research efforts at the Cyber-ShARE Research Center of Excellence in order to assess the effectiveness of the methodology to create scientific collections. The case studies exposed the challenges and benefits of leveraging the Semantic Web and Linked Data data space to facilitate access, integration and processing of Web-accessible scientific resources and research documentation. As such, we present the case study findings and lessons learned in documenting scientific research using CARP.

Juvenile recurrent parotitis: a retrospective comparison of sialendoscopy versus conservative therapy.

PubMed

Schneider, Helgard; Koch, Michael; Künzel, Julian; Gillespie, M Boyd; Grundtner, Philipp; Iro, Heinrich; Zenk, Johannes

2014-02-01

There are several therapeutic approaches to treat juvenile recurrent parotitis. The aim of this study was to compare sialendoscopy, including prophylactic cortisone irrigation, with observation and a conservative approach of antibiotic therapy alone. Retrospective study, tertiary clinical center. The charts of patients treated for juvenile recurrent parotitis between November 2004 and June 2011 were reviewed. Initial acute flares were always treated with a course of antibiotics. Subsequent treatment consisted of either salivary gland endoscopy including cortisone irrigation or additional pure antibiotic therapy. Patients treated with salivary endoscopy were compared to patients treated with antibiotics alone with regard to the number of inflammatory episodes and pain intensity pre- and posttreatment. Thirty-six patients were treated during the period of study, 15 with salivary endoscopy with cortisone irrigation and 21 with antibiotic therapy alone. A significant reduction in recurrent episodes and pain intensity following therapy was found in both groups. With respect to these two outcomes, the comparison showed two therapeutic options of equal merit. Salivary gland endoscopy is an option in the management of juvenile recurrent parotitis that helps in confirming the diagnosis and that also provides therapeutic intervention. However, although there are further advantages, the definitive value of salivary gland endoscopy requires ongoing evaluation in further prospective studies. 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Feasibility study of the neutron dose for real-time image-guided proton therapy: A Monte Carlo study

NASA Astrophysics Data System (ADS)

Kim, Jin Sung; Shin, Jung Suk; Kim, Daehyun; Shin, Eunhyuk; Chung, Kwangzoo; Cho, Sungkoo; Ahn, Sung Hwan; Ju, Sanggyu; Chung, Yoonsun; Jung, Sang Hoon; Han, Youngyih

2015-07-01

Two full rotating gantries with different nozzles (multipurpose nozzle with MLC, scanning dedicated nozzle) for a conventional cyclotron system are installed and being commissioned for various proton treatment options at Samsung Medical Center in Korea. The purpose of this study is to use Monte Carlo simulation to investigate the neutron dose equivalent per therapeutic dose, H/D, for X-ray imaging equipment under various treatment conditions. At first, we investigated the H/D for various modifications of the beamline devices (scattering, scanning, multi-leaf collimator, aperture, compensator) at the isocenter and at 20, 40 and 60 cm distances from the isocenter, and we compared our results with those of other research groups. Next, we investigated the neutron dose at the X-ray equipment used for real-time imaging under various treatment conditions. Our investigation showed doses of 0.07 ~ 0.19 mSv/Gy at the X-ray imaging equipment, depending on the treatment option and interestingly, the 50% neutron dose reduction was observed due to multileaf collimator during proton scanning treatment with the multipurpose nozzle. In future studies, we plan to measure the neutron dose experimentally and to validate the simulation data for X-ray imaging equipment for use as an additional neutron dose reduction method.

Isolated renal hydatid disease: experience at the queen rania urology center, the king hussein medical center.

PubMed

Abu-Qamar, Adnan A; Aljader, Khalaf M; Habboub, Hazem

2004-01-01

In this retrospective study, we present our experience on the diagnosis and management of isolated Hydatid disease of the kidneys. Between January 1999 and January 2003, eight patients were diagnosed to have Hydatid disease of the kidney and constituted the subjects of this study. Their age ranged between 20 and 63 years age (mean 40); there were five males and three females. Loin pain was the commonest mode of presentation in these patients. Investigations performed included urine analysis, serological tests, eosinophil count and relevant radiological studies. Urine analysis showed hydatiduria in one patient, the Casoni's test was positive in two, Ghedini skin test was positive in three and eosinophilia was noted in two other patients. All patients were treated surgically using loin supracostal extra-peritoneal approach. Total nephrectomy was performed in five patients, partial nephrectomy in one while excision of the cyst was performed in two patients. Our report suggests that a combination of various investigative modalities with a high index of suspicion is necessary in establishing the correct diagnosis. Surgery remains the main option of treatment for renal hydatid disease.

Evaluation of center-cut separations applying simulated moving bed chromatography with 8 zones.

PubMed

Santos da Silva, Francisco Vitor; Seidel-Morgenstern, Andreas

2016-07-22

Different multi-column options to perform continuous chromatographic separations of ternary mixtures have been proposed in order to overcome limitations of batch chromatography. One attractive option is given by simulated moving bed chromatography (SMB) with 8 zones, a process that offers uninterrupted production, and, potentially, improved economy. As in other established ternary separation processes, the separation sequence is crucial for the performance of the process. This problem is addressed here by computing and comparing optimal performances of the two possibilities assuming linear adsorption isotherms. The conclusions are presented in a decision tree which can be used to guide the selection of system configuration and operation. Copyright © 2016 Elsevier B.V. All rights reserved.

Technology Transfer Challenges: A Case Study of User-Centered Design in NASA's Systems Engineering Culture

NASA Technical Reports Server (NTRS)

Quick, Jason

2009-01-01

The Upper Stage (US) section of the National Aeronautics and Space Administration's (NASA) Ares I rocket will require internal access platforms for maintenance tasks performed by humans inside the vehicle. Tasks will occur during expensive critical path operations at Kennedy Space Center (KSC) including vehicle stacking and launch preparation activities. Platforms must be translated through a small human access hatch, installed in an enclosed worksite environment, support the weight of ground operators and be removed before flight - and their design must minimize additional vehicle mass at attachment points. This paper describes the application of a user-centered conceptual design process and the unique challenges encountered within NASA's systems engineering culture focused on requirements and "heritage hardware". The NASA design team at Marshall Space Flight Center (MSFC) initiated the user-centered design process by studying heritage internal access kits and proposing new design concepts during brainstorming sessions. Simultaneously, they partnered with the Technology Transfer/Innovative Partnerships Program to research inflatable structures and dynamic scaffolding solutions that could enable ground operator access. While this creative, technology-oriented exploration was encouraged by upper management, some design stakeholders consistently opposed ideas utilizing novel, untested equipment. Subsequent collaboration with an engineering consulting firm improved the technical credibility of several options, however, there was continued resistance from team members focused on meeting system requirements with pre-certified hardware. After a six-month idea-generating phase, an intensive six-week effort produced viable design concepts that justified additional vehicle mass while optimizing the human factors of platform installation and use. Although these selected final concepts closely resemble heritage internal access platforms, challenges from the application of the user-centered process provided valuable lessons for improving future collaborative conceptual design efforts.

International accreditation of ambulatory surgical centers and medical tourism.

PubMed

McGuire, Michael F

2013-07-01

The two forces that have driven the increase in accreditation of outpatient ambulatory surgery centers (ASC's) in the United States are reimbursement of facility fees by Medicare and commercial insurance companies, which requires either accreditation, Medicare certification, or state licensure, and state laws which mandate one of these three options. Accreditation of ASC's internationally has been driven by national requirements and by the competitive forces of "medical tourism." The three American accrediting organizations have all developed international programs to meet this increasing demand outside of the United States. Copyright © 2013. Published by Elsevier Inc.

Becoming an Independent Community Mental Health Center: Perils of the Process

PubMed Central

Adams, Milton S.

1978-01-01

Over the past 12 years, since the inception of the Community Mental Health Center (CMHC) movement, there has been increasing concern that local communities have more input; in fact, that they actually have the opportunity to operate the mental health programs that they deem necessary for their communities.1 Under the Amendments to the Community Mental Health Act (P.L.94-63) 1975, CMHCs were given such options as independence or governance. The whole process of governance presents numerous problems as well as opportunities. An overview of the vicissitudes of this process is presented in this paper. PMID:702582

CHoosing Options for Insomnia in Cancer Effectively (CHOICE): Design of a patient centered comparative effectiveness trial of acupuncture and cognitive behavior therapy for insomnia.

PubMed

Garland, Sheila N; Gehrman, Philip; Barg, Frances K; Xie, Sharon X; Mao, Jun J

2016-03-01

Insomnia is a prevalent and persistent side effect of cancer, which if left unaddressed, can be unremitting and negatively influence physical and mental well-being. Acupuncture and Cognitive Behavioral Therapy (CBT) are commonly used non-pharmacological treatments that are efficacious for treating insomnia in cancer patients; however, little is known about the comparative effectiveness of these options. The goal of personalized medicine is to determine which treatments are most effective for which individuals, and patient preference for treatment is a particularly important contributor to adherence and outcomes. Here we describe the design of a clinical trial that begins to determine how best to personalize the treatment of insomnia for cancer survivors. This project is a randomized controlled comparative effectiveness trial with a nested qualitative study comparing acupuncture and CBT for insomnia and co-morbid symptoms in a heterogeneous sample of 160 cancer survivors. The primary aim is to determine which treatment is associated with the largest reduction in insomnia severity. The secondary aim is to examine the demographic, clinical, and psychological characteristics that predict and/or moderate treatment effect. Patients will receive ten treatments of acupuncture or 7 sessions of CBT over eight weeks and complete validated patient-reported outcome measures of sleep and co-morbid symptoms at baseline, mid-treatment, post-treatment, and at three-months to assess durability of effect. The results of the proposed study have the potential to improve healthcare outcomes by helping cancer survivors and their caregivers make informed and evidence-based decisions, leading to patient-centered and personalized care for cancer survivors with insomnia. Copyright © 2016 Elsevier Inc. All rights reserved.

What’s Important to the Patient?: Informational Needs of Patients Making Decisions about Hepatitis C Treatment

PubMed Central

Evon, Donna M.; Golin, Carol E.; Stoica, Teodora; Jones, Rachel; Willis, Sarah; Galanko, Joseph; Fried, Michael W.

2017-01-01

Background & Objectives Multiple treatment options with direct-acting antivirals (DAAs) are now available for hepatitis C virus (HCV). Study aims were to understand (1) The informational topics patients want to have to make informed treatment decisions; (2) The importance patients place on each topic; and (3) The topics patients prioritize as most important. Methods Mixed methods study utilizing two samples recruited from an academic liver center. Participants were not currently on treatment. Sample I (n=45) free-listed all informational topics deemed important to decision-making. Raw responses were coded into several broad and subcategories. Sample II (n=38) rated the importance of the subcategories from Sample I and ranked their highest priorities on two surveys, one containing topics for which sufficient research existed to inform patients (“static”), and the other containing topics that would require additional research. Results The topics listed by Sample I fell into 6 broad categories with 17 total subcategories. The most oft-cited informational topics were harms of treatment (100%), treatment benefits (62%) and treatment regimen details (84%). Sample II rated 16 of 17 subcategories as “pretty important’ or “extremely important.” Sample II prioritized (1) viral cure, (2) long-term survival, and (3) side effects on the survey of topics requiring additional research, and (1) liver disease, (2) lifestyle changes, and (3) medication details on the second survey of the most important static topics patients needed. Conclusions Patients weighed several informational topics to make an informed decision about HCV treatment. These findings lay the groundwork for future patient-centered outcomes research in HCV and patient-provider communication to enhance patients’ informed decision-making regarding DAA treatment options. PMID:27882509

Lunar-based optical telescopes: Planning astronomical tools of the twenty-first century

NASA Astrophysics Data System (ADS)

Hilchey, J. D.; Nein, M. E.

1995-02-01

A succession of optical telescopes, ranging in aperture from 1 to 16 m or more, can be deployed and operated on the lunar surface over the next half-century. These candidates to succeed NASA's Great Observatories would capitalize on the unique observational advantages offered by the Moon. The Lunar Telescope Working Group and the LUTE Task Team of the George C. Marshall Space Flight Center (MSFC) have assessed the feasibility of developing and deploying these facilities. Studies include the 16-m Large Lunar Telescope (LLT); the Lunar Cluster Telescope Experiment (LCTE), a 4-m precursor to the LLT; the 2-m Lunar Transit Telescope (LTT); and its precursor, the 1-m Lunar Ultraviolet Telescope Experiment (LUTE). The feasibility of developing and deploying each telescope was assessed and system requirements and options for supporting technologies, subsystems, transportation, and operations were detailed. Influences of lunar environment factors and site selection on telescope design and operation were evaluated, and design approaches and key tradeoffs were established. This paper provides an overview of the study results. Design concepts and brief system descriptions are provided, including subsystem and mission options selected for the concepts.

Choice of crystal surface finishing for a dual-ended readout depth-of-interaction (DOI) detector.

PubMed

Fan, Peng; Ma, Tianyu; Wei, Qingyang; Yao, Rutao; Liu, Yaqiang; Wang, Shi

2016-02-07

The objective of this study was to choose the crystal surface finishing for a dual-ended readout (DER) DOI detector. Through Monte Carlo simulations and experimental studies, we evaluated 4 crystal surface finishing options as combinations of crystal surface polishing (diffuse or specular) and reflector (diffuse or specular) options on a DER detector. We also tested one linear and one logarithm DOI calculation algorithm. The figures of merit used were DOI resolution, DOI positioning error, and energy resolution. Both the simulation and experimental results show that (1) choosing a diffuse type in either surface polishing or reflector would improve DOI resolution but degrade energy resolution; (2) crystal surface finishing with a diffuse polishing combined with a specular reflector appears a favorable candidate with a good balance of DOI and energy resolution; and (3) the linear and logarithm DOI calculation algorithms show overall comparable DOI error, and the linear algorithm was better for photon interactions near the ends of the crystal while the logarithm algorithm was better near the center. These results provide useful guidance in DER DOI detector design in choosing the crystal surface finishing and DOI calculation methods.

A Complexity Metric for Automated Separation

NASA Technical Reports Server (NTRS)

Aweiss, Arwa

2009-01-01

A metric is proposed to characterize airspace complexity with respect to an automated separation assurance function. The Maneuver Option metric is a function of the number of conflict-free trajectory change options the automated separation assurance function is able to identify for each aircraft in the airspace at a given time. By aggregating the metric for all aircraft in a region of airspace, a measure of the instantaneous complexity of the airspace is produced. A six-hour simulation of Fort Worth Center air traffic was conducted to assess the metric. Results showed aircraft were twice as likely to be constrained in the vertical dimension than the horizontal one. By application of this metric, situations found to be most complex were those where level overflights and descending arrivals passed through or merged into an arrival stream. The metric identified high complexity regions that correlate well with current air traffic control operations. The Maneuver Option metric did not correlate with traffic count alone, a result consistent with complexity metrics for human-controlled airspace.

Expanding the Lester Hill Experience: A Report on Two 'Branch Office' Simulations

ERIC Educational Resources Information Center

Melvin, Opal B.

1976-01-01

Describes use of the Lester Hill Office Simulation, a program taught at the Tishomingo County Area Vocational-Technical Center in Mississippi. A fictitious company which provides students with the opportunity to gain realistic office experience in a classroom setting. Suggested ideas and optional activities can be used by teachers as a starting…

Simulation Packages Expand Aircraft Design Options

NASA Technical Reports Server (NTRS)

2013-01-01

In 2001, NASA released a new approach to computational fluid dynamics that allows users to perform automated analysis on complex vehicle designs. In 2010, Palo Alto, California-based Desktop Aeronautics acquired a license from Ames Research Center to sell the technology. Today, the product assists organizations in the design of subsonic aircraft, space planes, spacecraft, and high speed commercial jets.

CASTOR: Widely Distributed Scalable Infospaces

DTIC Science & Technology

2008-11-01

1  i Progress against Planned Objectives Enable nimble apps that react fast as...generation of scalable, reliable, ultra- fast event notification in Linux data centers. • Maelstrom, a spin-off from Ricochet, offers a powerful new option...out potential enhancements to WS-EVENTING and WS-NOTIFICATION based on our work. Potential impact for the warflighter. QSM achieves extremely fast

78 FR 30873 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to a...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

..., administered by Space and Naval Warfare Systems Command (SPAWAR) Systems Center (SSC), would be moved... stream of water under high pressure) would be another option to loosen piles that could not be removed... which are frequency, wavelength, velocity, and amplitude. Frequency is the number of pressure waves that...

The Indian Vocational Education and Training (VET) System: Status, Challenges, and Options

ERIC Educational Resources Information Center

Kotamraju, Pradeep

2014-01-01

India is at the cusp of becoming an economic powerhouse. For that to happen, however, the country needs to alter its workforce education system by reengineering the Indian Vocational Education and Training (VET) System. India's VET strategy includes creating basic work-centered common curriculum for the unskilled; developing a more flexible and…

7 CFR 226.9 - Assignment of rates of reimbursement for centers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... participating in the Program in that State. These methods are: (1) Meals times rates payment, which involves... comparison to the costs incurred by the institution for the meal service; and, (2) Meals times rates or... where the State agency has chosen the option to implement a meals times rates payment system State-wide...

7 CFR 226.9 - Assignment of rates of reimbursement for centers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... participating in the Program in that State. These methods are: (1) Meals times rates payment, which involves... comparison to the costs incurred by the institution for the meal service; and, (2) Meals times rates or... where the State agency has chosen the option to implement a meals times rates payment system State-wide...

Escalante Pueblo Curriculum: An Educator's Guide to the Exhibits and Sites at the Anasazi Heritage Center.

ERIC Educational Resources Information Center

Craig, Suzan M. W.

Colorado's residents are reminded of the land's past residents, the Northern San Juan Ancestral Puebloans. Their artifacts are encountered throughout the state. What can people learn from the Ancestral Puebloans about how to live on this landscape? The "Escalante Pueblo Curriculum" is designed to enhance a teacher's options for…

Alternative Fuels Data Center: Coca-Cola Bottling Co. Brings Hybrids to New

Science.gov Websites

as a great example of a viable clean transportation option for similar fleets. " Rebecca Otte commitment to a more sustainable community and serves as a great example of a viable clean transportation , individual bottling companies now operate these vehicles. For example, Coca-Cola Bottling Company United

Alternative Fuels Data Center: Memorandums of Understanding-Broadening

Science.gov Websites

to more affordable NGVs for government fleets. In Oklahoma, for example, the post-RFP cost of a Dodge commented. In another example, the Oklahoma Secretary of Energy and Environment held a series of town hall releasing NGV models and providing additional options for consumers and fleets alike. For example, General

Issues and Options: Energizing for the Future. Proceedings of the Annual Conference of Region II, National University Continuing Education Association (Skytop, Pennsylvania, October 1988).

ERIC Educational Resources Information Center

Kowalik, Thomas F., Comp.; Pula, James S., Comp.

The following 13 papers are included in this document: "Enrollment Management through Marketing and Advising" (Hoppin, Grimm); "Matching Institutions to Individual Needs: The Emerging Role of the Consortia" (Miller); "Institutional Ego or Institutional Access" (Ice); "Creating Integrated, Student-Centered Curricula" (Pula); "Creative Collaboration…

Failure Is Not an Option (TM). Six Principles That Guide Student Achievement in High-Performing Schools

ERIC Educational Resources Information Center

Blankstein, Alan M.

2004-01-01

The author builds upon a foundation which identifies courageous school leadership and the professional learning community as the center of effective school reform. The author offers six guiding principles steps for creating and sustaining a high-performing school: (1) Common mission, vision, values, and goals: (2) Systems for prevention and…

Alternative Fuels Data Center: Medium-Duty Vehicle Idle Reduction

Science.gov Websites

vehicle's regular heat-transfer system and are mounted in the engine compartment. The heater draws gasoline or diesel from the fuel tank to heat the vehicle's coolant and pumps the heated coolant through the starts. Waste-Heat Recovery Systems Another option for keeping a vehicle warm is an energy recovery

Future on the fringes.

PubMed

Carlson, L K

2001-01-01

Set against the palm trees, riotous flowers, and golf courses of LaQuinta Resort and Spa in California is something new -- a destination health center. Minutes from seaweed wraps and hot stone massage is the option of comprehensive health evaluations (including 150 diagnostic tests and genetic testing), longevity medicine, sports medicine, health coaches, and an array of personal wellness and corporate health programs.

CHARACTERISTICS OF SPILLED OILS, FUELS, AND PETROLEUM PRODUCTS: 3A. SIMULATION OF OIL SPILLS AND DISPERSANTS UNDER CONDITIONS OF UNCERTAINTY

EPA Science Inventory

At the request of the US EPA Oil Program Center, ERD is developing an oil spill model that focuses on fate and transport of oil components under various response scenarios. This model includes various simulation options, including the use of chemical dispersing agents on oil sli...

Alternative Fuels Data Center: Municipality with a Mission: Georgia Fleet

Science.gov Websites

different alternative fuels, based on mission needs, with the goal of saving money, reducing its combined. The vehicles have logged more than 90,000 problem-free miles and are projected to save the options before investing any time and money in new fuels and technologies. He directed Curtis to the

CAFES 2009 New Student Survey Report. Survey Research Center Report 2010/3

ERIC Educational Resources Information Center

Speerstra, Mandy; Trechter, David

2010-01-01

During Academic Day, September 1, 2009, incoming freshmen and transfer students in the College of Agriculture, Food and Environmental Sciences (CAFES) were asked to complete a one-page questionnaire designed to find out: (1) how they learned about UW-River Falls as an option for their tertiary education; (2) what factors most influenced their…

42 CFR 413.82 - Direct GME payments: Special rules for States that formerly had a waiver from Medicare...

Code of Federal Regulations, 2011 CFR

2011-10-01

... formerly had a waiver from Medicare reimbursement principles. 413.82 Section 413.82 Public Health CENTERS... OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL... of a State reimbursement control system under section 1886(c) of the Act, section 402 of the Social...

42 CFR 413.82 - Direct GME payments: Special rules for States that formerly had a waiver from Medicare...

Code of Federal Regulations, 2013 CFR

2013-10-01

... formerly had a waiver from Medicare reimbursement principles. 413.82 Section 413.82 Public Health CENTERS... OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL... of a State reimbursement control system under section 1886(c) of the Act, section 402 of the Social...

42 CFR 413.82 - Direct GME payments: Special rules for States that formerly had a waiver from Medicare...

Code of Federal Regulations, 2014 CFR

2014-10-01

... formerly had a waiver from Medicare reimbursement principles. 413.82 Section 413.82 Public Health CENTERS... OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL... of a State reimbursement control system under section 1886(c) of the Act, section 402 of the Social...

42 CFR 413.82 - Direct GME payments: Special rules for States that formerly had a waiver from Medicare...

Code of Federal Regulations, 2012 CFR

2012-10-01

... formerly had a waiver from Medicare reimbursement principles. 413.82 Section 413.82 Public Health CENTERS... OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL... of a State reimbursement control system under section 1886(c) of the Act, section 402 of the Social...

76 FR 28251 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-16

... establish pricing for customers who are not co-located in the Exchange's data center, but require shared cabinet space and power for optional routers, switches, or modems to support their direct circuit...'' space and a maximum power of 125 Watts per U space. Currently, non co-located customers are assessed...

Acoustic Seaglider (trademark) for Beaked Whale Detection

DTIC Science & Technology

2011-09-30

are given below. • • • • • Four channels, 16-bit digitization 250kHz maximum aggregate sample rate Plug-in passive filters ( TTE ) Optional...0 was of Seagliders SG 178 and SG179 at the Atlantic Undersea Test and Evaluation Center (AUTEC), between 6JUN20 I 0 and 11 JUN20 10. The Seagliders

Energy Action Day

NASA Image and Video Library

2017-10-25

Chuck Tatro of NASA's Launch Services Program discusses the use of solar arrays on space science missions during the Energy Action Day employee event held in Kennedy Space Center's Space Station Processing Facility. Part of Energy Awareness Month, the event featured subject matter experts in the area of solar energy, its connections to the space program and options for residential solar power.

How do you keto? Survey of North American pediatric ketogenic diet centers.

PubMed

Jung, Da Eun; Joshi, Sucheta M; Berg, Anne T

2015-06-01

We surveyed ketogenic diet centers in North America about their practices surrounding the ketogenic diet. An internet survey was disseminated via REDCap(©) to North American ketogenic diet centers identified from the Charlie Foundation and Ketocal(©) websites. Fifty-six centers responded. In addition to physicians, nurses and dieticians, ketogenic teams included social workers (39%), feeding specialists (14%), educational liaisons (4%), psychologists (5%), and pharmacists (36%). A child attending school (2%), non-English speaking family (19%), single-parent family (0%), and oral feeding (6%) were rarely considered barriers. Overall, the diet was considered the first or second (0%), third or fourth (67%), fifth or sixth (29%), and last resort treatment (4%) by centers. It was considered the first or second treatment for GLUT1 disease (86%) and third or fourth for Dravet (63%), West (71%), and Doose (65%) syndromes. Ketogenic diet is no longer a last resort option. Traditional barriers do not influence its use. © The Author(s) 2014.

Meeting the public health challenge of pain in later life: what role can senior centers play?

PubMed

Tobias, Karen R; Lama, Sonam D; Parker, Samantha J; Henderson, Charles R; Nickerson, Allison J; Reid, M Carrington

2014-12-01

Interest in nonpharmacologic approaches for managing pain continues to grow. The aim of this study was to determine the types of pain-relevant programs offered by senior centers and whether the programs varied by clients' race/ethnicity status and center size. A telephone survey was conducted. Respondents were presented with a list of 15 programs and the option to choose "other" and asked (1) whether the activity was offered and, if so, how often; (2) if they believed the programs had value for seniors with pain; and (3) whether the classes were advertised as a means of achieving pain relief. Of 204 center staff contacted, 195 (95.6%) participated. The most common programs offered were movement-based, including exercise (by 91.8% of the centers), dance (72.3%), walking clubs (71.8%), yoga (65.6%), and Tai Chi (53.3%) classes. Creative arts programs were also frequently offered, including music (58.5%) and fine arts (47.7%). Programs such as stress management (27%) and relaxation (26%) classes were less commonly offered. Most respondents identified movement-based programs as helpful for seniors with pain, but few identified creative arts classes as potentially beneficial. The programs/classes offered were infrequently advertised as a means of helping seniors manage pain and varied by clients' race/ethnicity status and center size. Programs that have potential utility for older adults with pain are commonly offered by senior centers. Future research should determine optimal strategies for engaging older adults in these programs in the senior center setting. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

What Opportunities, When?: A Framework for Student Career Development

NASA Astrophysics Data System (ADS)

MacDonald, H.

2007-12-01

Geoscience faculty and departments have an important role to play in the professional development of their students for careers in the geosciences or other fields. We can promote career development of students at different career stages (e.g., first year students, geoscience majors, and graduate students) and in various ways by 1) providing information about jobs and careers, 2) encouraging exploration of options, 3) providing experiences throughout their program that develop skills, knowledge, and attitudes, and 4) supporting students in their job search. For example, in teaching general education classes, we can provide information about jobs and careers in the geosciences, showing images of specific geoscientists and discussing what they do, providing examples of practical applications of course content, and describing job prospects and potential salaries. For majors, this type of information could be presented by seminar speakers, through career panels, and via alumni newsletters. Exploration of options could include research and/or teaching experiences, internships, informational interviews, and involvement with a campus career services center. Courses throughout the curriculum as well as co-curricular experiences serve to provide experiences that develop skills, knowledge, and attitudes that will be useful for a range of jobs. Departments can support the job search by providing networking opportunities for students and alumni, widely distributing job announcements and encouraging individual students, offering departmental sessions on graduate school, different career options, and /or the job search process, conducting mock interviews and resume review sessions, and fostering connections between students and alumni. In all of this, we need to be supportive of student choices. Overall, faculty can help students make more informed career decisions and develop skills that will be of value in their career through a variety of strategies, work with students as an advisor or mentor to help them explore career options, and collaborate with the career service center on campus.

When less is more: Effects of the availability of strategic options on regulating negative emotions.

PubMed

Bigman, Yochanan E; Sheppes, Gal; Tamir, Maya

2017-09-01

Research in several domains suggests that having strategic options is not always beneficial. In this paper, we tested whether having strategic options (vs. not) is helpful or harmful for regulating negative emotions. In 5 studies (N = 151) participants were presented with 1 or more strategic options prior to watching aversive images and using the selected strategic option. Across studies, we found that people reported less intense negative emotions when the strategy they used to regulate their emotions was presented as a single option, rather than as 1 of several options. This was regardless of whether people could choose between the options (Studies 3-5) or not (Studies 1, 2, and 4), and specific to negative (but not neutral) images (Study 5). A sixth study addressed an explanation based on demand characteristics, showing that participants expected to feel more positive when having more than 1 option. The findings indicate that having strategic options for regulating negative emotions can sometimes be costly. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Efficacy and Safety of Azelaic Acid 15% Foam in the Treatment of Truncal Acne Vulgaris.

PubMed

Hoffman, Lauren K; Del Rosso, James Q; Kircik, Leon H

2017-06-01

INTRODUCTION: Truncal acne is often associated with facial acne, but there are fewer options for an effective topical treatment on the trunk. Given the advent of foam formulations with enhanced percutaneous absorption and convenient application due to easy spreadability on skin, the previously held idea that effective treatment of truncal acne requires oral treatment is challenged. Azelaic acid cream has been previously approved for acne vulgaris, thus azelaic acid foam may be a viable treatment option for truncal acne.

STUDY DESIGN: A single-center, open label pilot study was conducted to investigate the efficacy and safety of azelaic acid 15% foam as a treatment modality for moderate truncal acne. Use for facial acne was also allowed and monitored during the study.

RESULTS: Twice-daily application of azelaic acid 15% foam to affected areas resulted in a 1-grade reduction in truncal investigator global assessment (IGA) scores in nearly all patients (16/18). Eight out of 18 patients (44%) were rated as Clear or Almost Clear in the trunk by the end of the study. There were also improvements in facial IGA scores; 9 of 18 patients (50%) exhibited a 1-grade improvement in IGA scores and 11 of 18 were Clear or Almost Clear by the end of the study. A significant reduction in lesion counts was found throughout the study and the medication was well tolerated.

CONCUSION: Azelaic acid 15% foam was effective in treating moderate truncal acne and facial acne in this pilot study. Given the efficacy and convenience of the foam vehicle, azelaic acid may be considered as a viable option for treatment of acne vulgaris, including on the trunk. Further studies are suggested in a larger population of patients, including adult females with acne.

J Drugs Dermatol. 2017;16(6):534-538.

Bariatric surgery: a viable treatment option for patients with severe mental illness.

PubMed

Shelby, Sarah R; Labott, Susan; Stout, Rebecca A

2015-01-01

Although bariatric surgery has become a recognized treatment for obesity, its utility among patients with severe psychiatric disorders has not been extensively studied. A few studies have reported similar weight loss outcomes in these patients, but psychiatric status after bariatric surgery has been studied only minimally, and it is unknown if exacerbation of the mental illness affects weight loss. The aim of this study was to shed greater light on the issue of serious mental illness and bariatric surgery. Specifically, do patients with a diagnosis of schizophrenia, bipolar I, and bipolar II have poorer weight loss outcomes postbariatric surgery than the general bariatric surgery population? Also, do patients with these diagnoses experience an exacerbation of psychiatric symptoms after bariatric surgery, and if so, is the exacerbation of these disorders linked to poorer weight loss results? Midwest university medical center. A medical record review of approximately 1500 bariatric patients in a Midwest university medical center was conducted to identify those patients with diagnoses of schizophrenia, bipolar I, and bipolar II. Information was gathered on bariatric surgery outcomes and changes in psychiatric status postsurgery. Eighteen patients were identified as undergoing bariatric surgery and having a diagnosis of schizophrenia, bipolar I, or bipolar II. Weight loss in this group was significant and comparable to expected outcomes of absolute weight lost, changes in body mass index, and percentage excess weight loss for patients in the typical bariatric population. Postsurgery psychiatric status was known on 10 patients. All 10 patients experienced some exacerbation of psychiatric problems yet weight loss outcomes were still as expected. Bariatric surgery is a viable obesity treatment option for patients with schizophrenia, bipolar I, and bipolar II disorders. Symptom exacerbations occurred postsurgery, although it is not clear if these were due to the surgery or would have occurred in the normal course of the illness. Copyright © 2015 American Society for Bariatric Surgery. All rights reserved.

Status of Liquid Oxygen/Liquid Methane Injector Study for a Mars Ascent Engine

NASA Technical Reports Server (NTRS)

Trinh, Huu Ogyic; Cramer, John M.

1998-01-01

Preliminary mission studies for human exploration of Mars have been performed at Marshall Space Flight Center (MSFC). These studies indicate that for non-toxic chemical rockets only a cryogenic propulsion system would provide high enough performance to be considered for a Mars ascent vehicle. Although the mission is possible with Earth-supplied propellants for this vehicle, utilization of in-situ propellants is highly attractive. This option would significantly reduce the overall mass of the return vehicle. Consequently, the cost of the mission would be greatly reduced because the number and size of the Earth launch vehicle(s) needed for the mission decrease. NASA/Johnson Space Center has initiated several concept studies (2) of in-situ propellant production plants. Liquid oxygen (LOX) is the primary candidate for an in-situ oxidizer. In-situ fuel candidates include methane (CH4), ethylene (C2H4), and methanol (CH3OH). MSFC initiated a technology development program for a cryogenic propulsion system for the Mars human exploration mission in 1998. One part of this technology program is the effort described here: an evaluation of propellant injection concepts for a LOX/liquid methane Mars Ascent Engine (MAE) with an emphasis on light-weight, high efficiency, reliability, and thermal compatibility. In addition to the main objective, hot-fire tests of the subject injectors will be used to test other key technologies including light-weight combustion chamber materials and advanced ignition concepts. This state-of-the-art technology will then be applied to the development of a cryogenic propulsion system that will meet the requirements of the planned Mars sample return (MSR) mission. The current baseline propulsion system for the MSR mission uses a storable propellant combination [monomethyl hydrazine/mixed oxides of nitrogen-25(MMH/MON-25)]. However, a mission option that incorporates in-situ propellant production and utilization for the ascent stage is being carefully considered as a subscale precursor to a future human mission to Mars.

Adherence to Antiretroviral Therapy During and After Pregnancy: Cohort Study on Women Receiving Care in Malawi's Option B+ Program.

PubMed

Haas, Andreas D; Msukwa, Malango T; Egger, Matthias; Tenthani, Lyson; Tweya, Hannock; Jahn, Andreas; Gadabu, Oliver J; Tal, Kali; Salazar-Vizcaya, Luisa; Estill, Janne; Spoerri, Adrian; Phiri, Nozgechi; Chimbwandira, Frank; van Oosterhout, Joep J; Keiser, Olivia

2016-11-01

 Adherence to antiretroviral therapy (ART) is crucial to preventing mother-to-child transmission of human immunodeficiency virus (HIV) and ensuring the long-term effectiveness of ART, yet data are sparse from African routine care programs on maternal adherence to triple ART.  We analyzed data from women who started ART at 13 large health facilities in Malawi between September 2011 and October 2013. We defined adherence as the percentage of days "covered" by pharmacy claims. Adherence of ≥90% was deemed adequate. We calculated inverse probability of censoring weights to adjust adherence estimates for informative censoring. We used descriptive statistics, survival analysis, and pooled logistic regression to compare adherence between pregnant and breastfeeding women eligible for ART under Option B+, and nonpregnant and nonbreastfeeding women who started ART with low CD4 cell counts or World Health Organization clinical stage 3/4 disease.  Adherence was adequate for 73% of the women during pregnancy, for 66% in the first 3 months post partum, and for about 75% during months 4-21 post partum. About 70% of women who started ART during pregnancy and breastfeeding adhered adequately during the first 2 years of ART, but only about 30% of them had maintained adequate adherence at every visit. Risk factors for inadequate adherence included starting ART with an Option B+ indication, at a younger age, or at a district hospital or health center.  One-third of women retained in the Option B+ program adhered inadequately during pregnancy and breastfeeding, especially soon after delivery. Effective interventions to improve adherence among women in this program should be implemented. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.

Surgical Interventions for Advanced Parameningeal Rhabdomyosarcoma of Children and Adolescents.

PubMed

Choi, Paul J; Iwanaga, Joe; Tubbs, R Shane; Yilmaz, Emre

2018-01-09

Owing to its rarity, rhabdomyosarcoma of the head and neck (HNRMS) has seldom been discussed in the literature. As most of the data is based only on the retrospective experiences of tertiary healthcare centers, there are difficulties in formulating a standard treatment protocol. Moreover, the disease is poorly understood at its pathological, genetic, and molecular levels. For instance, 20% of all histological assessment is inaccurate; even an experienced pathologist can confuse rhabdomyosarcoma (RMS) with neuroblastoma, Ewing's sarcoma, and lymphoma. RMS can occur sporadically or in association with genetic syndromes associated with predisposition to other cancers such as Li-Fraumeni syndrome and neurofibromatosis type 1 (von Recklinghausen disease). Such associations have a potential role in future gene therapies but are yet to be fully confirmed. Currently, chemotherapies are ineffective in advanced or metastatic disease and there is lack of targeted chemotherapy or biological therapy against RMS. Also, reported uses of chemotherapy for RMS have not produced reasonable responses in all cases. Despite numerous molecular and biological studies during the past three decades, the chemotherapeutic regimen remains unchanged. This vincristine, actinomycin, cyclophosphamide (VAC) regime, described in Kilman, et al. (1973) and Koop, et al. (1963), has achieved limited success in controlling the progression of RMS. Thus, the pathogenesis of RMS remains poorly understood despite extensive modern trials and more than 30 years of studies exploring the chemotherapeutic options. This suggests a need to explore surgical options for managing the disease. Surgery is the single most critical therapy for pediatric HNRMS. However, very few studies have explored the surgical management of pediatric HNRMS and there is no standard surgical protocol. The aim of this review is to explore and address such issues in the hope of maximizing the number of options available for young patients with HNRMS.

Viral Oncolysis — Can Insights from Measles Be Transferred to Canine Distemper Virus?

PubMed Central

Lapp, Stefanie; Pfankuche, Vanessa M.; Baumgärtner, Wolfgang; Puff, Christina

2014-01-01

Neoplastic diseases represent one of the most common causes of death among humans and animals. Currently available and applied therapeutic options often remain insufficient and unsatisfactory, therefore new and innovative strategies and approaches are highly needed. Periodically, oncolytic viruses have been in the center of interest since the first anecdotal description of their potential usefulness as an anti-tumor treatment concept. Though first reports referred to an incidental measles virus infection causing tumor regression in a patient suffering from lymphoma several decades ago, no final treatment concept has been developed since then. However, numerous viruses, such as herpes-, adeno- and paramyxoviruses, have been investigated, characterized, and modified with the aim to generate a new anti-cancer treatment option. Among the different viruses, measles virus still represents a highly interesting candidate for such an approach. Numerous different tumors of humans including malignant lymphoma, lung and colorectal adenocarcinoma, mesothelioma, and ovarian cancer, have been studied in vitro and in vivo as potential targets. Moreover, several concepts using different virus preparations are now in clinical trials in humans and may proceed to a new treatment option. Surprisingly, only few studies have investigated viral oncolysis in veterinary medicine. The close relationship between measles virus (MV) and canine distemper virus (CDV), both are morbilliviruses, and the fact that numerous tumors in dogs exhibit similarities to their human counterpart, indicates that both the virus and species dog represent a highly interesting translational model for future research in viral oncolysis. Several recent studies support such an assumption. It is therefore the aim of the present communication to outline the mechanisms of morbillivirus-mediated oncolysis and to stimulate further research in this potentially expanding field of viral oncolysis in a highly suitable translational animal model for the benefit of humans and dogs. PMID:24921409

Interest of pregnant women in the use of SMS (short message service) text messages for the improvement of perinatal and postnatal care.

PubMed

Cormick, Gabriela; Kim, Natalie A; Rodgers, Ashlei; Gibbons, Luz; Buekens, Pierre M; Belizán, José M; Althabe, Fernando

2012-08-06

Mobile health (mHealth) is emerging as a useful tool to improve healthcare access especially in the developing world, where limited access to health services is linked to poor antenatal care, and maternal and perinatal mortality.The objective of this study is to 1) understand pregnant women's access and usage of cell phones and 2) survey the health information needs and interests in a population attending public hospitals and health centers of two cities in Argentina. This information is not available and it is the basis to develop a strategy for improving maternal care via cell phones. Questionnaires were verbally administered to pregnant women who were attending an antenatal care visit in community health centers and public hospitals in Rosario, Santa Fe and Mercedes, Corrientes. Participants were 18 years of age or older and had previously given birth. The data obtained was qualitative and analyzed using SPSS version 18. A total of 147 pregnant women meeting inclusion criteria (Rosario: 63; Mercedes: 84) were approached and verbally consented to participate. The average age was 29.5 years, most lived in urban areas (89%) with a mean travel time of 43.4 minutes required to get to the health center and 57.3 minutes to get the hospital.Ninety-six percent of women (n = 140) responded that they would like to receive text messages and cell phone calls with information regarding prenatal care, although the topics and period of time to receive information varied greatly. Considering the vast majority of the interviewed women had access to and were interested in receiving text messages and calls with educational information regarding pregnancy and infant health, pregnant women in Argentina could benefit from such an mHealth program. The low access to Internet suggests it is not an option for this population; however, this cannot be assumed as representative of the country's situation.To retain active participation, other forms of health communication, such as a 2-way text message systems or toll-free numbers, could be considered in the future. Cost of use and implementing these options should be studied.

Same-sex reproduction: medical treatment options and psychosocial considerations.

PubMed

Greenfeld, Dorothy A; Seli, Emre

2016-06-01

This review provides an overview of the historical significance of assisted reproduction for gay men and women, discusses current reproductive options for same-sex couples, addresses psychosocial considerations unique to these couples, and reviews the current literature addressing medical and psychosocial aspects of same-sex reproduction. Growing numbers of men and women openly self-identify as gay and lesbian. Accompanying this openness is an increased public acceptance of same-sex relationships and same-sex marriage. The combination of gay/lesbian self-determination and mounting public acceptance of same-sex unions has led these individuals and couples to increasingly seek parenthood through assisted reproduction. Recent studies describe relationship satisfaction in gay couples after assisted reproduction and more positive functioning and less stress associated with parenthood when compared with heterosexual parents. Motivations for parenthood are the same for same-sex couples and heterosexual couples alike. However, achieving the goal of parenthood can be a much greater endeavor medically and psychologically for same-sex couples. Fertility treatment centers increasingly recognize issues unique to gay men and women and are increasingly welcoming.

Radioisotope Heater Unit-Based Stirling Power Convertor Development at NASA Glenn Research Center

NASA Technical Reports Server (NTRS)

Wilson, Scott D.; Geng, Steven M.; Penswick, Lawrence; Schmitz, Paul C.

2017-01-01

Stirling Radioisotope Power Systems (RPS) are being developed as an option to provide power on future space science missions where robotic spacecraft will orbit, flyby, land or rove. A variety of mission concepts have been studied by NASA and the U. S. Department of Energy that would utilize RPS for landers, probes, and rovers and only require milliwatts to tens of watts of power. These missions would contain science measuring instruments that could be distributed across planetary surfaces or near objects of interest in space solar flux insufficient for using solar cells. A low power Stirling convertor is being developed to provide an RPS option for future low power applications. Initial concepts convert heat available from several Radioisotope Heater Units to electrical power for spacecraft instruments and communication. Initial development activity includes defining and evaluating a variety of Stirling configurations and selecting one for detailed design, research of advanced manufacturing methods that could simplify fabrication, evaluating thermal interfaces, characterizing components and subassemblies to validate design codes, and preparing for an upcoming demonstration of proof of concept in a laboratory environment.

[Fingolimod compassionate use program: case study on the concept of a therapy option for multiple sclerosis prior to marketing approval].

PubMed

Haas, J; Linker, R A; Hartung, H P; Meergans, M; Ortler, S; Tracik, F

2012-12-01

In order to meet the needs of therapy of multiple sclerosis (MS) new immune therapies with a user-friendly application and better effectiveness together with good tolerability are necessary. With respect to its potential to improve MS therapy, patients with a high medical need were given access to Fingolimod even before marketing approval. Therefore, a compassionate use program unique in the field of MS was initiated. In total 137 centers participated (75 % outpatient neurologists and 25 % hospitals). Within 19 weeks 135 patients were enrolled to receive Fingolimod. The patients in the compassionate use program can be representatively described as showing hardly controllable disease activity and progression with currently available, often poorly tolerated therapy. The compassionate use program for these patients offered better control of the disease with Fingolimod. The adverse events were as expected. The Fingolimod compassionate use program demonstrated the need for this new therapeutic option. Patients who were not yet sufficiently treated were provided with an effective therapy with a good safety profile and a user-friendly administration form.

Endovascular Treatment of Dural Arteriovenous Fistulas: Single Center Experience

PubMed Central

Oh, Jae-Sang; Oh, Hyuk-Jin; Shim, Jai-Joon; Bae, Hack-Gun; Lee, Kyeong-Seok

2016-01-01

Objective Treatment of intracranial dural arteriovenous fistulas (dAVFs) remains a challenge. However, after introduction of Onyx, transarterial approach is the preferred treatment option in many centers. We report our experience of dAVFs embolization with special emphasis on transarterial approach. Methods Seventeen embolization procedures were performed in 13 patients with dAVFs between Jan 2009 and Oct 2014. Clinical symptoms, location and type of fistulas, embolization methods, complications, radiological and clinical outcomes were evaluated using charts and PACS images. Results All 13 patients had symptomatic lesions. The locations of fistulas were transverse-sigmoid sinus in 6, middle fossa dura in 4, cavernous sinus in 2, and superior sagittal sinus in 1 patient. Cognard types were as follows : I in 4, IIa in 2, IIa+IIb in 5, and IV in 2. Embolization procedures were performed ≥2 times in 3 patients. Nine patients were treated with transarterial Onyx embolization alone. One of these required direct surgical puncture of middle meningeal artery. Complete obliteration of fistulas was achieved in 11/13 (85%) patients. There were no complications except for 1 case of Onyx migration in cavernous dAVF. Modified Rankin scale score at post-operative 3 months were 0 in 11, and 3 in 2 patients. Conclusion Transarterial Onyx embolization can be a first line therapeutic option in patients with dAVFs. However, transvenous approach should be tried first in cavernous sinus dAVF because of the risk of intracranial migration of liquid embolic materials. Furthermore, combined surgical endovascular approach can be considered as a useful option in inaccessible route. PMID:26885282

Improving Conceptual Design for Launch Vehicles. The Bimese Concept: A Study of Mission and Economic Options

NASA Technical Reports Server (NTRS)

Olds, John R.; Tooley, Jeffrey

1999-01-01

This report summarizes key activities conducted in the third and final year of the cooperative agreement NCC1-229 entitled "Improving Conceptual Design for Launch Vehicles." This project has been funded by the Vehicle Analysis Branch at NASA's Langley Research Center in Hampton, VA. Work has been performed by the Space Systems Design Lab (SSDL) at the Georgia Institute of Technology, Atlanta, GA. Accomplishments during the first and second years of this project have been previously reported in annual progress reports. This report will focus on the third and final year of the three year activity.

Photodarkening kinetics in a high-power YDFA versus CW or short-pulse seed conditions

NASA Astrophysics Data System (ADS)

Jolly, Alain; Vinçont, Cyril; Boullet, Johan

2017-02-01

We propose an innovating model to describe the kinetics of competing photo-darkening and photo-bleaching phenomena in high-power, Ytterbium-Doped-Fibre-Amplifiers. This model makes use of aggregated species of trivalent Ytterbium and divalent ions, which operate as primarily efficient color-centers. This ensures multi-photon excitation, partly from the pump and partly from the signal. The fit of numerical computations with dedicated experiments help to validate our theoretical assumptions, in the definition of the involved physics. Potential applications of this study include further discussions for the selection of processing options with fibre-manufacturers and the optimization of operating conditions.

Orbital Space Solar Power Option for a Lunar Village

NASA Technical Reports Server (NTRS)

Johnson, L.

2017-01-01

The international community is increasingly interested in returning humans to the Moon and this time establishing a permanent lunar base. There are several system level constraints that will drive the location for the base, chief among which are the need for continuous power and communications with the Earth. The NASA George C. Marshall Space Flight Center (MSFC) performed a study of placing an operational space based solar power station in lunar orbit to beam energy to the lunar base, or village, eliminating the need for the base to be located at the south pole or for it to be equipped with a fission power source.

Fort Collins Science Center: Policy Analysis and Science Assistance

USGS Publications Warehouse

Lamb, Berton L.

2004-01-01

PASA's mission is to integrate biological, social, and economic research so that resource managers can use the resulting information to make informed decisions and resolve resource management conflicts. PASA scientists pursue and conduct scientific analyses that help agencies and Native American tribes to (1) identify impending policy controversies and areas where social and natural science research is needed to address future policy questions; (2) develop methods and approaches to assist researchers in preparing scientific evidence; (3) assess habitat alteration in a manner consistent with policy needs; and (4) evaluate policy options. Branch scientists also evaluate policy options (e.g., effects of different land treatments, fish and wildlife management practices, or visitor/recreation management practices) in response to specific questions faced by policymakers and managers.

Study design options in evaluating gene-environment interactions: practical considerations for a planned case-control study of pediatric leukemia.

PubMed

Goodman, Michael; Dana Flanders, W

2007-04-01

We compare methodological approaches for evaluating gene-environment interaction using a planned study of pediatric leukemia as a practical example. We considered three design options: a full case-control study (Option I), a case-only study (Option II), and a partial case-control study (Option III), in which information on controls is limited to environmental exposure only. For each design option we determined its ability to measure the main effects of environmental factor E and genetic factor G, and the interaction between E and G. Using the leukemia study example, we calculated sample sizes required to detect and odds ratio (OR) of 2.0 for E alone, an OR of 10 for G alone and an interaction G x E of 3. Option I allows measuring both main effects and interaction, but requires a total sample size of 1,500 cases and 1,500 controls. Option II allows measuring only interaction, but requires just 121 cases. Option III allows calculating the main effect of E, and interaction, but not the main effect of G, and requires a total of 156 cases and 133 controls. In this case, the partial case-control study (Option III) appears to be more efficient with respect to its ability to answer the research questions for the amount of resources required. The design options considered in this example are not limited to observational epidemiology and may be applicable in studies of pharmacogenomics, survivorship, and other areas of pediatric ALL research.

Satisloh centering technology developments past to present

NASA Astrophysics Data System (ADS)

Leitz, Ernst Michael; Moos, Steffen

2015-10-01

The centering of an optical lens is the grinding of its edge profile or contour in relationship to its optical axis. This is required to ensure that the lens vertex and radial centers are accurately positioned within an optical system. Centering influences the imaging performance and contrast of an optical system. Historically, lens centering has been a purely manual process. Along its 62 years of assembling centering machines, Satisloh introduced several technological milestones to improve the accuracy and quality of this process. During this time more than 2.500 centering machines were assembled. The development went from bell clamping and diamond grinding to Laser alignment, exchange chuckor -spindle systems, to multi axis CNC machines with integrated metrology and automatic loading systems. With the new centering machine C300, several improvements for the clamping and grinding process were introduced. These improvements include a user friendly software to support the operator, a coolant manifold and "force grinding" technology to ensure excellent grinding quality and process stability. They also include an air bearing directly driven centering spindle to provide a large working range of lenses made of all optical materials and diameters from below 10 mm to 300 mm. The clamping force can be programmed between 7 N and 1200 N to safely center lenses made of delicate materials. The smaller C50 centering machine for lenses below 50 mm diameter is available with an optional CNC loading system for automated production.

Evidence-based review of diabetic macular edema management: Consensus statement on Indian treatment guidelines

PubMed Central

Das, Taraprasad; Aurora, Ajay; Chhablani, Jay; Giridhar, Anantharaman; Kumar, Atul; Raman, Rajiv; Nagpal, Manish; Narayanan, Raja; Natarajan, Sundaram; Ramasamay, Kim; Tyagi, Mudit; Verma, Lalit

2016-01-01

The purpose of the study was to review the current evidence and design a diabetic macular edema (DME) management guideline specific for India. The published DME guidelines from different organizations and publications were weighed against the practice trends in India. This included the recently approved drugs. DME management consisted of control of diabetes and other associated systemic conditions, such as hypertension and hyperlipidemia, and specific therapy to reduce macular edema. Quantification of macular edema is precisely made with the optical coherence tomography and treatment options include retinal laser, intravitreal anti-vascular endothelial growth factors (VEGF), and implantable dexamethasone. Specific use of these modalities depends on the presenting vision and extent of macular involvement. Invariable eyes with center-involving macular edema benefit from intravitreal anti-VEGF or dexamethasone implant therapy, and eyes with macular edema not involving the macula center benefit from retinal laser. The results are illustrated with adequate case studies and frequently asked questions. This guideline prepared on the current published evidence is meant as a guideline for the treating physicians. PMID:26953019

A report from the European Association for the Study of the Liver's 50th International Liver Congress (April 22-26 - Vienna, Austria).

PubMed

Rabasseda, X

2015-04-01

While Vienna's Prater park offers a varied selection of options, from theme parks to lush gardens and prairies to enjoy the sun, the nearby Messe Wien convention center was the focus of attention in April 2015 for all the scientists, researchers and clinicians interested in viral hepatitis, nonalcoholic steatohepatitis, hepatocellular carcinoma and a variety of other liver diseases. Treatments and potential new therapeutic strategies for these hepatopathies were discussed during the 50th International Liver Congress organized by the European Association for the Study of the Liver. Echoing epidemiological facts and a high social interest for hepatitis C virus infection, new findings with investigational and potential new therapies for the disease centered much of the attention at the conference. Nevertheless, new research was also reported related to potential improvements in how other liver diseases, particularly hepatitis B virus infection, hepatocellular carcinoma and a range of inflammatory and immune-mediated liver diseases, including rare hereditary diseases that should never be forgotten. Copyright 2015 Prous Science, S.A.U. or its licensors. All rights reserved.

The use of an automated interactive voice response system to manage medication identification calls to a poison center.

PubMed

Krenzelok, Edward P; Mrvos, Rita

2009-05-01

In 2007, medication identification requests (MIRs) accounted for 26.2% of all calls to U.S. poison centers. MIRs are documented with minimal information, but they still require an inordinate amount of work by specialists in poison information (SPI). An analysis was undertaken to identify options to reduce the impact of MIRs on both human and financial resources. All MIRs (2003-2007) to a certified regional poison information center were analyzed to determine call patterns and staffing. The data were used to justify an efficient and cost-effective solution. MIRs represented 42.3% of the 2007 call volume. Optimal staffing would require hiring an additional four full-time equivalent SPI. An interactive voice response (IVR) system was developed to respond to the MIRs. The IVR was used to develop the Medication Identification System that allowed the diversion of up to 50% of the MIRs, enhancing surge capacity and allowing specialists to address the more emergent poison exposure calls. This technology is an entirely voice-activated response call management system that collects zip code, age, gender and drug data and stores all responses as .csv files for reporting purposes. The query bank includes the 200 most common MIRs, and the system features text-to-voice synthesis that allows easy modification of the drug identification menu. Callers always have the option of engaging a SPI at any time during the IVR call flow. The IVR is an efficient and effective alternative that creates better staff utilization.

Chemical Facility Security: Reauthorization, Policy Issues, and Options for Congress

DTIC Science & Technology

2009-07-13

Process Safety, American Institute of Chemical Engineers , before the Senate Committee on Environment and Public Works, June 21, 2006, S.Hrg. 109-1044. See...example, Testimony by Dennis C. Hendershot, Staff Consultant, Center for Chemical Process Safety, American Institute of Chemical Engineers , before...CRS Report for Congress Prepared for Members and Committees of Congress Chemical Facility Security: Reauthorization, Policy Issues, and

National Centers for Environmental Prediction

Science.gov Websites

the number of threads used. HWRF group cannot access Zeus and Jet for real-time data transfers from nodes used.). All single jobs will be run on one rack and will not share with parallel jobs. No official change the group when using tag_rstprod (-g option). autotag_rstprod is a script that tags all files. It

Alternative Fuels Data Center

Science.gov Websites

Natural Gas and Propane Tax Effective January 1, 2019, propane, compressed natural gas (CNG), and liquefied natural gas (LNG) will be subject to an excise tax at a rate of $0.04 per gasoline gallon equivalent (GGE), plus a $0.01 ninth-cent fuel tax, a $0.01 local option fuel tax, and an additional variable

Antisense Oligonucleotide Therapy for Patients with Advanced Cancer | Center for Cancer Research

Cancer.gov

Colorectal cancer (CRC) is the second leading cause of cancer-related death in the U.S. Improvements in therapy have increased the survival of patients with CRC from 10 months to two years, but for patients who stop responding to treatments, such as irinotecan, options for additional therapy are limited. Antisense oligonucleotides (ASOs) may offer advantages over traditional

Phase II trial suggests new drug can shrink tumors in advanced ovarian cancer | Center for Cancer Research

Cancer.gov

In an ongoing phase II trial led by Jung-Min Lee, M.D., an Investigator in CCR’s Women’s Malignancies Branch, using the drug prexasertib led to decreases in tumor size in patients with advanced ovarian cancer, known as high-grade serious ovarian carcinoma, who currently have limited treatment options. Read more…

Ketamine-a returning option for procedural sedation and analgesia in adults.

PubMed

O'Malley, Patricia Anne

2014-01-01

I am a clinical nurse specialist in a busy trauma center. Increasingly, we are using ketamine for procedures and pain management in adults. I thought ketamine was appropriate only for pediatric patients. Why has ketamine emerged again for adults? Also, we have seen a few cases of ketamine abuse over the past 3 months. Is ketamine abuse becoming more prevalent?

46 CFR 67.218 - Optional filing of instruments in portable document format as attachments to electronic mail.

Code of Federal Regulations, 2010 CFR

2010-10-01

... recording under § 67.200 may be submitted in portable document format (.pdf) as an attachment to electronic... submitted for filing in .pdf format pertains to a vessel that is not a currently documented vessel, a... with the National Vessel Documentation Center or must be submitted in .pdf format with the instrument...

Does Patient Time Spent Viewing Computer-Tailored Colorectal Cancer Screening Materials Predict Patient-Reported Discussion of Screening with Providers?

ERIC Educational Resources Information Center

Sanders, Mechelle; Fiscella, Kevin; Veazie, Peter; Dolan, James G.; Jerant, Anthony

2016-01-01

The main aim is to examine whether patients' viewing time on information about colorectal cancer (CRC) screening before a primary care physician (PCP) visit is associated with discussion of screening options during the visit. We analyzed data from a multi-center randomized controlled trial of a tailored interactive multimedia computer program…

Potential impacts of advanced aerodynamic technology on air transportation system productivity

NASA Technical Reports Server (NTRS)

Bushnell, Dennis M. (Editor)

1994-01-01

Summaries of a workshop held at NASA Langley Research Center in 1993 to explore the application of advanced aerodynamics to airport productivity improvement are discussed. Sessions included discussions of terminal area productivity problems and advanced aerodynamic technologies for enhanced high lift and reduced noise, emissions, and wake vortex hazard with emphasis upon advanced aircraft configurations and multidisciplinary solution options.

High-Performance Computing Data Center Cooling System Energy Efficiency |

Science.gov Websites

approaches involve a cooling distribution unit (CDU) (2), which interfaces with the facility cooling loop and to the energy recovery water (ERW) loop (5), which is a closed-loop system. There are three heat rejection options for this IT load: When possible, heat energy from the energy recovery loop is transferred

Characteristics of a bottomland hardwood forest under greentree reservoir management in East Central Arkansas

Treesearch

Michael R. Guttery; Andrew W. Ezell

2006-01-01

Greentree reservoirs are a viable option for creating habitat and hunting opportunities for migrating waterfowl. Unfortunately, the prolonged annual flooding often associated with greentree reservoir management can be highly detrimental to many of the desirable tree species in these stands. In the summer of 2004, a total of 327 plot centers were established in a...

Community Voices: California Preschool Directors Speak on Policy Options. Working Paper 07-1

ERIC Educational Resources Information Center

Fuller, Bruce; Gesicki, Kathryn; Sweo, Thea; Jung, Sunyoung

2007-01-01

California continues to widen access to local child care and preschool programs--albeit in fits and starts--for a variety of families. About 65% of all four year-olds statewide now attend a preschool center. Government spends $3.6 billion on early care and education programs statewide, including a three-fold increase in state spending since 1996.…

The evolution of epilepsy surgery between 1991 and 2011 in nine major epilepsy centers across the United States, Germany, and Australia

PubMed Central

Jehi, Lara; Friedman, Daniel; Carlson, Chad; Cascino, Gregory; Dewar, Sandra; Elger, Christian; Engel, Jerome; Knowlton, Robert; Kuzniecky, Ruben; McIntosh, Anne; O’Brien, Terence J.; Spencer, Dennis; Sperling, Michael R.; Worrell, Gregory; Bingaman, Bill; Gonzalez-Martinez, Jorge; Doyle, Werner; French, Jacqueline

2016-01-01

Summary Objective Epilepsy surgery is the most effective treatment for select patients with drug-resistant epilepsy. In this article, we aim to provide an accurate understanding of the current epidemiologic characteristics of this intervention, as this knowledge is critical for guiding educational, academic, and resource priorities. Methods We profile the practice of epilepsy surgery between 1991 and 2011 in nine major epilepsy surgery centers in the United States, Germany, and Australia. Clinical, imaging, surgical, and histopathologic data were derived from the surgical databases at various centers. Results Although five of the centers performed their highest number of surgeries for mesial temporal sclerosis (MTS) in 1991, and three had their highest number of MTS surgeries in 2001, only one center achieved its peak number of MTS surgeries in 2011. The most productive year for MTS surgeries varied then by center; overall, the nine centers surveyed performed 48% (95% confidence interval [CI] −27.3% to −67.4%) fewer such surgeries in 2011 compared to either 1991 or 2001, whichever was higher. There was a parallel increase in the performance of surgery for nonlesional epilepsy. Further analysis of 5/9 centers showed a yearly increase of 0.6 ± 0.07% in the performance of invasive electroencephalography (EEG) without subsequent resections. Overall, although MTS was the main surgical substrate in 1991 and 2001 (proportion of total surgeries in study centers ranging from 33.3% to 70.2%); it occupied only 33.6% of all resections in 2011 in the context of an overall stable total surgical volume. Significance These findings highlight the major aspects of the evolution of epilepsy surgery across the past two decades in a sample of well-established epilepsy surgery centers, and the critical current challenges of this treatment option in addressing complex epilepsy cases requiring detailed evaluations. Possible causes and implications of these findings are discussed. PMID:26250432

Skylab

NASA Image and Video Library

1973-05-01

The Saturn V vehicle, carrying the unmarned orbital workshop for the Skylab-1 mission, lifted off successfully and all systems performed normally. Sixty-three seconds into flight, engineers in the operation support and control center saw an unexpected telemetry indication that signalled that damages occurred on one solar array and the micrometeoroid shield during the launch. The micrometeoroid shield, a thin protective cylinder surrounding the workshop protecting it from tiny space particles and the sun's scorching heat, ripped loose from its position around the workshop. This caused the loss of one solar wing and jammed the other. Still unoccupied, the Skylab was stricken with the loss of the heat shield and sunlight beat mercilessly on the lab's sensitive skin. Internal temperatures soared, rendering the station uninhabitable, threatening foods, medicines, films, and experiments. This image, taken during a fly-around inspection by the Skylab-2 crew, shows the damaged meteoroid shield being held by a thin aluminum strap entangled with green-hued remnants of the lost heat shield. The Marshall Space Flight Center (MSFC) developed, tested, rehearsed, and approved three repair options. These options included a parasol sunshade and a twin-pole sunshade to restore the temperature inside the workshop, and a set of metal cutting tools to free the jammed solar panel.

Place Matters in Non-Traditional Migration Areas: Exploring Barriers to Healthcare for Latino Immigrants by Region, Neighborhood, and Community Health Center.

PubMed

Topmiller, Michael; Zhen-Duan, Jenny; Jacquez, Farrah J; Vaughn, Lisa M

2017-12-01

This paper identifies differences in adult Latino immigrant barriers to healthcare in the Cincinnati area in Hamilton County, OH, on three levels: by region, by neighborhood, and by community health center. Secondary data analysis was performed on 439 surveys. Respondents were aggregated by the geographic regions and neighborhoods where they live and by two community health centers where they receive care. Outcome measures included pragmatic and skill barrier indices adapted from the Barriers to Care Questionnaire (BCQ); the pragmatics index consists logistical barriers, including transportation and cost; the skills index is made up of items related to navigating the healthcare system, including communicating with physicians and completing paperwork. The results indicate that immigrant Latinos living in western Cincinnati and northern Hamilton County face significantly higher pragmatic barriers to care, while Latino immigrants going to a community health center in western Cincinnati have significantly fewer pragmatic and skill barriers than immigrants utilizing a nearby community health center. Because healthcare options for undocumented immigrants do not improve with the Affordable Care Act, community health centers will continue to serve as their primary source of care. This is particularly true in non-traditional migration areas, where immigrants tend to be isolated and lack resources. Efforts to improve access to healthcare for immigrant Latinos require place-based approaches that allow for targeted resources to improve care in these locations. This study helps to fill that need by identifying variation in barriers to care on multiple levels and offering strategies to alleviate these barriers.

The cognitive and neural basis of option generation and subsequent choice.

PubMed

Kaiser, Stefan; Simon, Joe J; Kalis, Annemarie; Schweizer, Sophie; Tobler, Philippe N; Mojzisch, Andreas

2013-12-01

Decision-making research has thoroughly investigated how people choose from a set of externally provided options. However, in ill-structured real-world environments, possible options for action are not defined by the situation but have to be generated by the agent. Here, we apply behavioral analysis (Study 1) and functional magnetic resonance imaging (Study 2) to investigate option generation and subsequent choice. For this purpose, we employ a new experimental task that requires participants to generate options for simple real-world scenarios and to subsequently decide among the generated options. Correlational analysis with a cognitive test battery suggests that retrieval of options from long-term memory is a relevant process during option generation. The results of the fMRI study demonstrate that option generation in simple real-world scenarios recruits the anterior prefrontal cortex. Furthermore, we show that choice behavior and its neural correlates differ between self-generated and externally provided options. Specifically, choice between self-generated options is associated with stronger recruitment of the dorsal anterior cingulate cortex. This impact of option generation on subsequent choice underlines the need for an expanded model of decision making to accommodate choice between self-generated options.

Applying the OTV to lunar logistics

NASA Technical Reports Server (NTRS)

Willcockson, W. H.

1988-01-01

The Orbit Transfer Vehicle (OTV), representing the next generation of upper stages, has recently been studied in a Phase A concept definition study managed by NASA's Marshall Space Flight Center. The vehicle has been previously defined as strictly an orbit-to-orbit type transfer device. Recently its application to the task of lunar surface logistics was investigated. Transfer options to the surface were considered which included direct transfer, and transfer via lunar orbit as well as the L1 libration point. The subsystem modifications required to enable lunar landings were established for the following elements: aerobrake, main propulsion system, landing legs, primary structure, and avionics. It is concluded that the majority of the basic systems required for efficient transfer to the lunar surface are already contained in the OTV.

Outer Planet Exploration with Advanced Radioisotope Electric Propulsion

NASA Technical Reports Server (NTRS)

Oleson, Steven; Gefert, Leon; Patterson, Michael; Schreiber, Jeffrey; Benson, Scott; McAdams, Jim; Ostdiek, Paul

2002-01-01

In response to a request by the NASA Deep Space Exploration Technology Program, NASA Glenn Research Center conducted a study to identify advanced technology options to perform a Pluto/Kuiper mission without depending on a 2004 Jupiter Gravity Assist, but still arriving before 2020. A concept using a direct trajectory with small, sub-kilowatt ion thrusters and Stirling radioisotope power systems was shown to allow the same or smaller launch vehicle class as the chemical 2004 baseline and allow a launch slip and still flyby in the 2014 to 2020 timeframe. With this promising result the study was expanded to use a radioisotope power source for small electrically propelled orbiter spacecraft for outer planet targets such as Uranus, Neptune, and Pluto.

Demands and challenges for patients with sickle-cell disease requiring hematopoietic stem cell transplantation in Saudi Arabia.

PubMed

Alsultan, Abdulrahman; Jastaniah, Wasil; Al Afghani, Sameera; Al Bagshi, Muneer H; Nasserullah, Zaki; Al-Suliman, Ahmed M; Alabdulaali, Mohammed K

2016-09-01

Allogeneic HSCT is the only curative treatment for SCD. In this study, we estimated the number of Saudi patients with SCD who are candidates for HSCT. We used the presence of overt stroke, recurrent ACS, and frequent severe pain crisis as indications for HSCT. We calculated the frequencies of these complications among a Saudi SCD cohort of 376 patients with SCD, 250 from SW and 126 from Eastern (E) provinces. We found that 59 (23.6%) of SW patients were transplant candidates compared to 22 (17.4%) from E province. It is estimated that about 61 000 patients with SCD live in Saudi Arabia. Thus, the projected number of Saudi patients with SCD who are candidates for HSCT is 10 536 patients. Of those, 2148 are children. The burden of SCD on HSCT centers in Saudi Arabia is substantial and is difficult currently to meet the demand. We recommend recruiting/training more transplant physicians and nurses, expand current capacity of centers if feasible, and open new transplant centers to make HSCT a practical therapeutic option for patients with severe SCD in Saudi Arabia. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Systematization of primary headache: current and future prospects].

PubMed

Odinak, M M; Iskra, D A

2014-02-01

The article is devoted to the current state of the problem of systematization of primary headaches and main clinical forms. The conceptual evolution of ideas about the classification of certain options of cephalgia and identified major trends for its improvement is given. Verification of types and subtypes of individual cephalgia can present a significant challenge even for experienced neurologists, neurosurgeons, and internists. In this regard in most European countries and the US. have set up specialized centers for the treatment of headaches. Concluded that in the short term in the national health care system, including. Including the Armed Forces, it is advisable to create such centers.

Youth with cerebral palsy with differing upper limb abilities: how do they access computers?

PubMed

Davies, T Claire; Chau, Tom; Fehlings, Darcy L; Ameratunga, Shanthi; Stott, N Susan

2010-12-01

To identify the current level of awareness of different computer access technologies and the choices made regarding mode of access by youth with cerebral palsy (CP) and their families. Survey. Two tertiary-level rehabilitation centers in New Zealand and Canada. Youth (N=60) with CP, Manual Ability Classification Scale (MACS) levels I to V, age 13 to 25 years. Not applicable. Questionnaire. Fifty (83%) of the 60 youth were aware of at least 1 available assistive technology (AT), such as touch screens and joysticks. However, only 34 youth (57%) were familiar with the accessibility options currently available in the most common operating systems. Thirty-three (94%) of 35 youth who were MACS I and II used a standard mouse and keyboard, while few chose to use assistive technology or accessibility options. In contrast, 10 (40%) of 25 youth who were MACS III to V used a variety of assistive technologies such as touch screens, joysticks, trackballs, and scanning technologies. This group also had the highest use of accessibility options, although only 15 (60%) of the 25 were aware of them. Most youth with CP were aware of, and used, assistive technologies to enhance their computer access but were less knowledgeable about accessibility options. Accessibility options allow users to modify their own computer interface and can thus enhance computer access for youth with CP. Clinicians should be knowledgeable enough to give informed advice in this area of computer access, thus ensuring that all youth with CP can benefit from both AT and accessibility options, as required. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Development of a decision aid to inform patients' and families' renal replacement therapy selection decisions.

PubMed

Ameling, Jessica M; Auguste, Priscilla; Ephraim, Patti L; Lewis-Boyer, LaPricia; DePasquale, Nicole; Greer, Raquel C; Crews, Deidra C; Powe, Neil R; Rabb, Hamid; Boulware, L Ebony

2012-12-01

Few educational resources have been developed to inform patients' renal replacement therapy (RRT) selection decisions. Patients progressing toward end stage renal disease (ESRD) must decide among multiple treatment options with varying characteristics. Complex information about treatments must be adequately conveyed to patients with different educational backgrounds and informational needs. Decisions about treatment options also require family input, as families often participate in patients' treatment and support patients' decisions. We describe the development, design, and preliminary evaluation of an informational, evidence-based, and patient-and family-centered decision aid for patients with ESRD and varying levels of health literacy, health numeracy, and cognitive function. We designed a decision aid comprising a complementary video and informational handbook. We based our development process on data previously obtained from qualitative focus groups and systematic literature reviews. We simultaneously developed the video and handbook in "stages." For the video, stages included (1) directed interviews with culturally appropriate patients and families and preliminary script development, (2) video production, and (3) screening the video with patients and their families. For the handbook, stages comprised (1) preliminary content design, (2) a mixed-methods pilot study among diverse patients to assess comprehension of handbook material, and (3) screening the handbook with patients and their families. The video and handbook both addressed potential benefits and trade-offs of treatment selections. The 50-minute video consisted of demographically diverse patients and their families describing their positive and negative experiences with selecting a treatment option. The video also incorporated health professionals' testimonials regarding various considerations that might influence patients' and families' treatment selections. The handbook was comprised of written words, pictures of patients and health care providers, and diagrams describing the findings and quality of scientific studies comparing treatments. The handbook text was written at a 4th to 6th grade reading level. Pilot study results demonstrated that a majority of patients could understand information presented in the handbook. Patient and families screening the nearly completed video and handbook reviewed the materials favorably. This rigorously designed decision aid may help patients and families make informed decisions about their treatment options for RRT that are well aligned with their values.

Offering Patients Therapy Options in Unplanned Start (OPTiONS): Implementation of an educational program is feasible and effective.

PubMed

Machowska, Anna; Alscher, Mark Dominik; Vanga, Satyanarayana Reddy; Koch, Michael; Aarup, Michael; Qureshi, Abdul Rashid; Lindholm, Bengt; Rutherford, Peter

2017-01-13

Patients with unplanned dialysis start (UPS) have worse clinical outcomes than non-UPS patients, and receive peritoneal dialysis (PD) less frequently. In the OPTiONS study of UPS patients, an educational programme (UPS-EP) aiming at improving care of UPS patients by facilitating care pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients. This non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European countries (Austria, Germany, Denmark, France, United Kingdom and Sweden) who prior to inclusion presented acutely, or were being followed by nephrologists but required urgent dialysis commencement by an acutely placed CVC or PD catheter. Effects of UPS-EP on choice and final decision of dialysis therapy and outcomes within 12 months of follow up were analysed. Among 270 UPS patients who had an unplanned start to dialysis, 214 were able to receive and 203 complete UPS-EP while 56 patients - who were older (p = 0.01) and had higher Charlson comorbidity index (CCI; p < 0.01) - did not receive UPS-EP. Among 177 patients who chose dialysis modality after UPS-EP, 103 (58%) chose PD (but only 86% of them received PD) and 74 (42%) chose HD (95% received HD). Logistic regression analysis showed that diabetes 1.88 (1.05 - 3.37) and receiving UPS-EP, OR = 4.74 (CI, 2.05 - 10.98) predicted receipt of PD. Patients choosing PD had higher CCI (p = 0.01), higher prevalence of congestive heart failure (p < 0.01) and myocardial infarction (p = 0.02), and were more likely in-patients (p = 0.02) or referred from primary care (p = 0.02). One year survival did not differ significantly between PD and HD patients. Peritonitis and bacteraemia rates were better than international guideline standards. UPS-EP predicted patient use of PD but 14% of those choosing PD after UPS-EP still did not receive the modality they preferred. Patient survival in patients choosing and/or receiving PD was similar to HD despite age and comorbidity disadvantages of the PD groups.

Congenital Heart Defects in Adults : A Field Guide for Cardiologists

PubMed Central

Romfh, Anitra; Pluchinotta, Francesca Romana; Porayette, Prashob; Valente, Anne Marie; Sanders, Stephen P.

2013-01-01

Advances in cardiology and cardiac surgery allow a large proportion of patients with congenital heart defects to survive into adulthood. These patients frequently develop complications characteristic of the defect or its treatment. Consequently, adult cardiologists participating in the care of these patients need a working knowledge of the more common defects. Occasionally, patients with congenital heart defects such as atrial septal defect, Ebstein anomaly or physiologically corrected transposition of the great arteries present for the first time in adulthood. More often patients previously treated in pediatric cardiology centers have transitioned to adult congenital heart disease centers for ongoing care. Some of the more important defects in this category are tetralogy of Fallot, transposition of the great arteries, functionally single ventricle defects, and coarctation. Through this field guide, we provide an overview of the anatomy of selected defects commonly seen in an adult congenital practice using pathology specimens and clinical imaging studies. In addition, we describe the physiology, clinical presentation to the adult cardiologist, possible complications, treatment options, and outcomes. PMID:24294540

Space station data system analysis/architecture study. Task 3: Trade studies, DR-5, volume 2

NASA Technical Reports Server (NTRS)

1985-01-01

Results of a Space Station Data System Analysis/Architecture Study for the Goddard Space Flight Center are presented. This study, which emphasized a system engineering design for a complete, end-to-end data system, was divided into six tasks: (1); Functional requirements definition; (2) Options development; (3) Trade studies; (4) System definitions; (5) Program plan; and (6) Study maintenance. The Task inter-relationship and documentation flow are described. Information in volume 2 is devoted to Task 3: trade Studies. Trade Studies have been carried out in the following areas: (1) software development test and integration capability; (2) fault tolerant computing; (3) space qualified computers; (4) distributed data base management system; (5) system integration test and verification; (6) crew workstations; (7) mass storage; (8) command and resource management; and (9) space communications. Results are presented for each task.