26 CFR 54.9815-2715 - Summary of benefits and coverage and uniform glossary.

Code of Federal Regulations, 2013 CFR

2013-04-01

... definitions of standard insurance terms and medical terms so that consumers may compare health coverage and... the plan or coverage for common benefits scenarios (including pregnancy and serious or chronic medical... treatment plan for a specified medical condition during a specific period of time, based on recognized...

Expanding by Degrees: NSHE's Role in Building a New Nevada

ERIC Educational Resources Information Center

Nevada System of Higher Education, 2015

2015-01-01

In the fall of 2011, the Board of Regents released "The State and the System: NSHE Plan for Nevada's Colleges and Universities" (see ED525051). That plan, commonly referred to as the Board's "Strategic Directions," outlined specific goals for combining excellence and austerity to achieve student success. Since that time, the…

Five Levels of Curriculum Integration Defined, Refined, and Described.

ERIC Educational Resources Information Center

Schumacher, Donna H.

1995-01-01

Provides a description of five levels of curriculum integration at the middle level, specifically: departmentalization, reinforcement, complementary or shared units, webbed, and integrated themes. Discusses curriculum integration in relation to preservice and inservice programs, common planning time, team composition, time issues, and…

Common Core of a Different Sort: Putting Democracy at the Center of the Curriculum

ERIC Educational Resources Information Center

Beane, James A.

2013-01-01

Many policymakers, curriculum specialists, teachers and administrators, bloggers and other commentators have raised serious questions about the Common Core State Standards. One set of questions asks whether states and districts have the money for professional development, curriculum materials, planning time, and other logistics that would be…

Do Groundwater Management Plans Work? A statistical evaluation of the effectiveness of groundwater management plans towards achieving water supply and environmental objectives under a changing climate.

NASA Astrophysics Data System (ADS)

White, E.; Peterson, T. J.; Costelloe, J. F.; Western, A. W.; Carrara, E.

2017-12-01

Regulation of groundwater through the use of management plans is becoming increasingly prevalent as global groundwater levels decline. But plans are seldom systematically and quantitatively assessed for effectiveness. Instead, the state of an aquifer is commonly considered a proxy for plan effectiveness despite a lack of casaulity. Groundwater managers face myraid challenges such as finite resources, conflicting uses and the uncertainty inherent in any groundwater investigation. Groundwater models have been used to provide insights into what may happen to the aquifer under various levels of stress. Generally, these models simulate the impact of predefined stresses for a certain time-span. However, this is not how management occurs in reality. Managers only see a fraction of the aquifer and use this limited knowledgeto make aquifer-wide decisions. Also, management changes over time in response to aquifer state, and groundwater management plans commonly contain trigger levels in monitoring wells that prompt management intervention. In this way there is a feedback between the aquifer state and management that is rarely captured by groundwater management models. To capture this management/aquifer feedback, groundwater management was structured as a systems control problem, and using this framework, a testability assessment rubric developed. The rubric was applied to 15 Australian groundwater management plans and 47% of plans were found to be testable. To numerically quantify the effectiveness of groundwater managment, the impact of extraction restrictions was probabilistically assessed by simulating "the act of management" of a simple unconfined groundwater system using MODFLOW and Flopy. Water managers were privy only to head levels in a varying number of grid cells assigned as monitoring wells, and used that limited information to make allocation decisions at each time step. Extraction rates for each simulated management period were determined based upon the observed heads from the previous management period and adjusted depending upon triggers outlined in the management plan. The effectiveness of water restrictions as a management technique for the purpose of maintaining supply reliability under various decision making frequencies, aquifer response times and climate scenarios was explored.

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

PubMed

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

2013-06-01

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

Probabilistic Reasoning for Plan Robustness

NASA Technical Reports Server (NTRS)

Schaffer, Steve R.; Clement, Bradley J.; Chien, Steve A.

2005-01-01

A planning system must reason about the uncertainty of continuous variables in order to accurately project the possible system state over time. A method is devised for directly reasoning about the uncertainty in continuous activity duration and resource usage for planning problems. By representing random variables as parametric distributions, computing projected system state can be simplified in some cases. Common approximation and novel methods are compared for over-constrained and lightly constrained domains. The system compares a few common approximation methods for an iterative repair planner. Results show improvements in robustness over the conventional non-probabilistic representation by reducing the number of constraint violations witnessed by execution. The improvement is more significant for larger problems and problems with higher resource subscription levels but diminishes as the system is allowed to accept higher risk levels.

Tactical Mission Command (TMC)

DTIC Science & Technology

2016-03-01

capabilities to Army commanders and their staffs, consisting primarily of a user-customizable Common Operating Picture ( COP ) enabled with real-time... COP viewer and data management capability. It is a collaborative, visualization and planning application that also provides a common map display... COP ): Display the COP consisting of the following:1 Friendly forces determined by the commander including subordinate and supporting units at

Are virtual planning and guided surgery for head and neck reconstruction economically viable?

PubMed

Zweifel, Daniel Fritz; Simon, Christian; Hoarau, Remy; Pasche, Philippe; Broome, Martin

2015-01-01

Virtual planning and guided surgery with or without prebent or milled plates are becoming more and more common for mandibular reconstruction with fibular free flaps (FFFs). Although this excellent surgical option is being used more widely, the question of the additional cost of planning and cutting-guide production has to be discussed. In capped payment systems such additional costs have to be offset by other savings if there are no special provisions for extra funding. Our study was designed to determine whether using virtual planning and guided surgery resulted in time saved during surgery and whether this time gain resulted in self-funding of such planning through the time saved. All consecutive cases of FFF surgery were evaluated during a 2-year period. Institutional data were used to determine the price of 1 minute of operative time. The time for fibula molding, plate adaptation, and insetting was recorded. During the defined period, we performed 20 mandibular reconstructions using FFFs, 9 with virtual planning and guided surgery and 11 freehand cases. One minute of operative time was calculated to cost US $47.50. Multiplying this number by the time saved, we found that the additional cost of virtual planning was reduced from US $5,098 to US $1,231.50 with a prebent plate and from US $6,980 to US $3,113.50 for a milled plate. Even in capped health care systems, virtual planning and guided surgery including prebent or milled plates are financially viable. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Analysis of Multi-Flight Common Routes for Traffic Flow Management

NASA Technical Reports Server (NTRS)

Sheth, Kapil; Clymer, Alexis; Morando, Alex; Shih, Fu-Tai

2016-01-01

When severe convective weather requires rerouting aircraft, FAA traffic managers employ severe weather avoidance plans (e.g., Playbook routes, Coded Departure Routes, etc.) These routes provide pilots with safe paths around weather-affected regions, and provide controllers with predictable, and often well-established flight plans. However, they often introduce large deviations to the nominal flight plans, which may not be necessary as weather conditions change. If and when the imposed traffic management initiatives (TMIs) become stale, updated shorter path flight trajectories may be found en route, providing significant time-savings to the affected flights. Multiple Flight Common Routes (MFCR) is a concept that allows multiple flights that are within a specified proximity or region, to receive updated shorter flight plans in an operationally efficient manner. MFCR is believed to provide benefits to the National Airspace System (NAS) by allowing traffic managers to update several flight plans of en route aircraft simultaneously, reducing operational workload within the TMUs of all affected ARTCCs. This paper will explore some aspects of the MFCR concept by analyzing multiple flights that have been selected for rerouting by the NAS Constraint Evaluation and Notification Tool (NASCENT). Various methods of grouping aircraft with common or similar routes will be presented, along with a comparison of the efficacy of these methods.

EverVIEW: a visualization platform for hydrologic and Earth science gridded data

USGS Publications Warehouse

Romañach, Stephanie S.; McKelvy, James M.; Suir, Kevin J.; Conzelmann, Craig

2015-01-01

The EverVIEW Data Viewer is a cross-platform desktop application that combines and builds upon multiple open source libraries to help users to explore spatially-explicit gridded data stored in Network Common Data Form (NetCDF). Datasets are displayed across multiple side-by-side geographic or tabular displays, showing colorized overlays on an Earth globe or grid cell values, respectively. Time-series datasets can be animated to see how water surface elevation changes through time or how habitat suitability for a particular species might change over time under a given scenario. Initially targeted toward Florida's Everglades restoration planning, EverVIEW has been flexible enough to address the varied needs of large-scale planning beyond Florida, and is currently being used in biological planning efforts nationally and internationally.

Should I stay or should I go? The influence of individual and organizational factors on pharmacists' future work plans.

PubMed

Gaither, Caroline A; Nadkarni, Anagha; Mott, David A; Schommer, Jon C; Doucette, William R; Kreling, David H; Pedersen, Craig A

2007-01-01

To examine the association between individual (demographic) and organizational (work environment and workload) factors and pharmacists' future work plans and explore reasons for either leaving or staying with current employers (culture/climate factors). Cross-sectional study. United States in 2004. 1,263 pharmacists. Seven-page mail survey. Future work plans, time spent in practice activities, staffing levels, and actual and perceived workload and demographic variables. Overall, 15% of respondents reported that they planned to leave their current employer within the year subsequent to this survey. More than 50% reported that their workload had significantly increased in the previous year. Multivariate analyses showed that nonwhites were 2.1 times more likely to be planning to leave their current employer, compared with whites, and unmarried respondents were 1.7 times more likely to leave than were married individuals. More negative perceptions regarding the impact of workload on various personal, work, and patient care outcomes predicted leaving. A main factor that prompted their inclinations was described by 72% of leavers (insufficient and/or unqualified staff) and 49% of stayers (flexible scheduling). The most common reasons for staying were good salary and relationships with coworkers, while the most common reasons for leaving were a desire for change and stress/workload issues. Future work plans of pharmacists are influenced by a variety of individual, organizational, and culture/climate factors. While employers have little latitude for influencing demographic characteristics of employees, many organizational and culture/climate factors (scheduling, opportunities for interpersonal interactions, salary/benefits, staffing, and workload) can be addressed with the intent of reducing pharmacist turnover.

Interdisciplinary Middle School Teams as Professional Learning Communities

ERIC Educational Resources Information Center

Jackson, George Ellis, Jr.

2016-01-01

Problem: Interdisciplinary teaming has been noted as a critical element of the middle school model associated with higher student achievement. Yet, research on middle school teams' use of common planning time suggests that the majority of meeting time is spent discussing student behavior/issues, discussing student learning problems/issues, and…

Pre-Euroamerican distribution of pine warblers (Dendroica pinus) in Wisconsin: tool for setting regional conservation priorities

Treesearch

Anna M. Pidgeon; Lisa A. Schulte; David J. Mladenoff

2005-01-01

A common goal of conservation and management plans is to maintain populations of species of conservation concern at some historic level that was a product of environmental conditions at a time when they were less influenced by humans than at present (e.g., Wade 1993, Reijnders 1994, Polacheck et al. 1999). Conservation planning also includes consideration of the...

Succession planning in local health departments: results from a national survey.

PubMed

Darnell, Julie S; Campbell, Richard T

2015-01-01

Succession planning has received scant attention in the public health sector, despite its potential to generate operational efficiencies in a sector facing chronic budgetary pressures and an aging workforce. We examined the extent to which local health departments (LHDs) are engaged in succession planning and assessed the factors associated with having a succession plan. We conducted a national cross-sectional Web-based survey of workforce recruitment and retention activities in a sample of LHDs responding to the National Association of County & City Health Officials' 2010 Profile Study and then linked these data sets to fit a multivariable logistic regression model to explain why some LHDs have succession plans and others do not. Top executives in a national sample of LHDs. Presence or absence of succession planning. Two hundred twenty-five LHDs responded to the survey, yielding a 43.3% response rate, but no statistically significant differences between respondents and nonrespondents were detected. Only 39.5% reported having a succession plan. Performance evaluation activities are more common in LHDs with a succession plan than in LHDs without a plan. In adjusted analyses, the largest LHDs were 7 times more likely to have a succession plan than the smallest. Compared with state-governed LHDs, locally governed LHDs were 3.5 times more likely, and shared governance LHDs were 6 times more likely, to have a succession plan. Every additional year of experience by the top executive was associated with a 5% increase in the odds of having a succession plan. Local health departments that report high levels of concern about retaining staff (vs low concern) had 2.5 times higher adjusted odds of having a succession plan. This study provides the first national data on succession planning in LHDs and sheds light on LHDs' readiness to meet the workforce-related accreditation standards.

Vector-model-supported optimization in volumetric-modulated arc stereotactic radiotherapy planning for brain metastasis

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

Liu, Eva Sau Fan; Department of Health Technology and Informatics, The Hong Kong Polytechnic University; Wu, Vincent Wing Cheung

Long planning time in volumetric-modulated arc stereotactic radiotherapy (VMA-SRT) cases can limit its clinical efficiency and use. A vector model could retrieve previously successful radiotherapy cases that share various common anatomic features with the current case. The prsent study aimed to develop a vector model that could reduce planning time by applying the optimization parameters from those retrieved reference cases. Thirty-six VMA-SRT cases of brain metastasis (gender, male [n = 23], female [n = 13]; age range, 32 to 81 years old) were collected and used as a reference database. Another 10 VMA-SRT cases were planned with both conventional optimization and vector-model-supported optimization, followingmore » the oncologists' clinical dose prescriptions. Planning time and plan quality measures were compared using the 2-sided paired Wilcoxon signed rank test with a significance level of 0.05, with positive false discovery rate (pFDR) of less than 0.05. With vector-model-supported optimization, there was a significant reduction in the median planning time, a 40% reduction from 3.7 to 2.2 hours (p = 0.002, pFDR = 0.032), and for the number of iterations, a 30% reduction from 8.5 to 6.0 (p = 0.006, pFDR = 0.047). The quality of plans from both approaches was comparable. From these preliminary results, vector-model-supported optimization can expedite the optimization of VMA-SRT for brain metastasis while maintaining plan quality.« less

Responding to the Effects of Extreme Heat: Baltimore City's Code Red Program.

PubMed

Martin, Jennifer L

2016-01-01

Heat response plans are becoming increasingly more common as US cities prepare for heat waves and other effects of climate change. Standard elements of heat response plans exist, but plans vary depending on geographic location and distribution of vulnerable populations. Because heat events vary over time and affect populations differently based on vulnerability, it is difficult to compare heat response plans and evaluate responses to heat events. This article provides an overview of the Baltimore City heat response plan, the Code Red program, and discusses the city's response to the 2012 Ohio Valley/Mid Atlantic Derecho, a complex heat event. Challenges with and strategies for evaluating the program are reviewed and shared.

Time and truth in plans

NASA Technical Reports Server (NTRS)

Hazelton, Lyman R., Jr.

1990-01-01

Some of the logical components of a rule based planning and scheduling system are described. The researcher points out a deficiency in the conventional truth maintenance approach to this class of problems and suggests a new mechanism which overcomes the problem. This extension of the idea of justification truth maintenance may seem at first to be a small philosophical step. However, it embodies a process of basic human reasoning which is so common and automatic as to escape conscious detection without careful introspection. It is vital to any successful implementation of a rule based planning reasoner.

Sampling Plans for the Thrips Frankliniella schultzei (Thysanoptera: Thripidae) in Three Lettuce Varieties.

PubMed

Silva, Alisson R; Rodrigues-Silva, Nilson; Pereira, Poliana S; Sarmento, Renato A; Costa, Thiago L; Galdino, Tarcísio V S; Picanço, Marcelo C

2017-12-05

The common blossom thrips, Frankliniella schultzei Trybom (Thysanoptera: Thripidae), is an important lettuce pest worldwide. Conventional sampling plans are the first step in implementing decision-making systems into integrated pest management programs. However, this tool is not available for F. schultzei infesting lettuce crops. Thus, the objective of this work was to develop a conventional sampling plan for F. schultzei in lettuce crops. Two sampling techniques (direct counting and leaf beating on a white plastic tray) were compared in crisphead, looseleaf, and Boston lettuce varieties before and during head formation. The frequency distributions of F. schultzei densities in lettuce crops were assessed, and the number of samples required to compose the sampling plan was determined. Leaf beating on a white plastic tray was the best sampling technique. F. schultzei densities obtained with this technique were fitted to the negative binomial distribution with a common aggregation parameter (common K = 0.3143). The developed sampling plan is composed of 91 samples per field and presents low errors in its estimates (up to 20%), fast execution time (up to 47 min), and low cost (up to US $1.67 per sampling area). This sampling plan can be used as a tool for integrated pest management in lettuce crops, assisting with reliable decision making in different lettuce varieties before and during head formation. © The Author(s) 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Group consensus peer review in radiation oncology: commitment to quality.

PubMed

Duggar, W Neil; Bhandari, Rahul; Yang, Chunli Claus; Vijayakumar, Srinivasan

2018-03-27

Peer review, especially prospective peer review, has been supported by professional organizations as an important element in optimal Radiation Oncology practice based on its demonstration of efficacy at detecting and preventing errors prior to patient treatment. Implementation of peer review is not without barriers, but solutions do exist to mitigate or eliminate some of those barriers. Peer review practice at our institution involves three key elements: new patient conference, treatment planning conference, and chart rounds. The treatment planning conference is an adaptation of the group consensus peer review model from radiology which utilizes a group of peers reviewing each treatment plan prior to implementation. The peer group in radiation oncology includes Radiation Oncologists, Physician Residents, Medical Physicists, Dosimetrists, and Therapists. Thus, technical and clinical aspects of each plan are evaluated simultaneously. Though peer review is held in high regard in Radiation Oncology, many barriers commonly exist preventing optimal implementation such as time intensiveness, repetition, and distraction from clinic time with patients. Through the use of automated review tools and commitment by individuals and administration in regards to staffing, scheduling, and responsibilities, these barriers have been mitigated to implement this Group Consensus Peer Review model into a Radiation Oncology Clinic. A Group Consensus Peer Review model has been implemented with strategies to address common barriers to effective and efficient peer review.

Path planning and energy management of solar-powered unmanned ground vehicles

NASA Astrophysics Data System (ADS)

Kaplan, Adam

Many of the applications pertinent to unmanned vehicles, such as environmental research and analysis, communications, and information-surveillance and reconnaissance, benefit from prolonged vehicle operation time. Conventional efforts to increase the operational time of electric-powered unmanned vehicles have traditionally focused on the design of energy-efficient components and the identification of energy efficient search patterns, while little attention has been paid to the vehicle's mission-level path plan and power management. This thesis explores the formulation and generation of integrated motion-plans and power-schedules for solar-panel equipped mobile robots operating under strict energy constraints, which cannot be effectively addressed through conventional motion planning algorithms. Transit problems are considered to design time-optimal paths using both Balkcom-Mason and Pseudo-Dubins curves. Additionally, a more complicated problem to generate mission plans for vehicles which must persistently travel between certain locations, similar to the traveling salesperson problem (TSP), is presented. A comparison between one of the common motion-planning algorithms and experimental results of the prescribed algorithms, made possible by use of a test environment and mobile robot designed and developed specifically for this research, are presented and discussed.

Increasing accuracy of vehicle detection from conventional vehicle detectors - counts, speeds, classification, and travel time.

DOT National Transportation Integrated Search

2014-09-01

Vehicle classification is an important traffic parameter for transportation planning and infrastructure : management. Length-based vehicle classification from dual loop detectors is among the lowest cost : technologies commonly used for collecting th...

Supply chain planning classification

NASA Astrophysics Data System (ADS)

Hvolby, Hans-Henrik; Trienekens, Jacques; Bonde, Hans

2001-10-01

Industry experience a need to shift in focus from internal production planning towards planning in the supply network. In this respect customer oriented thinking becomes almost a common good amongst companies in the supply network. An increase in the use of information technology is needed to enable companies to better tune their production planning with customers and suppliers. Information technology opportunities and supply chain planning systems facilitate companies to monitor and control their supplier network. In spite if these developments, most links in today's supply chains make individual plans, because the real demand information is not available throughout the chain. The current systems and processes of the supply chains are not designed to meet the requirements now placed upon them. For long term relationships with suppliers and customers, an integrated decision-making process is needed in order to obtain a satisfactory result for all parties. Especially when customized production and short lead-time is in focus. An effective value chain makes inventory available and visible among the value chain members, minimizes response time and optimizes total inventory value held throughout the chain. In this paper a supply chain planning classification grid is presented based current manufacturing classifications and supply chain planning initiatives.

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

Roper, J; Bradshaw, B; Godette, K

Purpose: To create a knowledge-based algorithm for prostate LDR brachytherapy treatment planning that standardizes plan quality using seed arrangements tailored to individual physician preferences while being fast enough for real-time planning. Methods: A dataset of 130 prior cases was compiled for a physician with an active prostate seed implant practice. Ten cases were randomly selected to test the algorithm. Contours from the 120 library cases were registered to a common reference frame. Contour variations were characterized on a point by point basis using principle component analysis (PCA). A test case was converted to PCA vectors using the same process andmore » then compared with each library case using a Mahalanobis distance to evaluate similarity. Rank order PCA scores were used to select the best-matched library case. The seed arrangement was extracted from the best-matched case and used as a starting point for planning the test case. Computational time was recorded. Any subsequent modifications were recorded that required input from a treatment planner to achieve an acceptable plan. Results: The computational time required to register contours from a test case and evaluate PCA similarity across the library was approximately 10s. Five of the ten test cases did not require any seed additions, deletions, or moves to obtain an acceptable plan. The remaining five test cases required on average 4.2 seed modifications. The time to complete manual plan modifications was less than 30s in all cases. Conclusion: A knowledge-based treatment planning algorithm was developed for prostate LDR brachytherapy based on principle component analysis. Initial results suggest that this approach can be used to quickly create treatment plans that require few if any modifications by the treatment planner. In general, test case plans have seed arrangements which are very similar to prior cases, and thus are inherently tailored to physician preferences.« less

Experimenting with C2 Applications and Federated Infrastructures for Integrated Full-Spectrum Operational Environments in Support of Collaborative Planning and Interoperable Execution

DTIC Science & Technology

2004-06-01

Situation Understanding) Common Operational Pictures Planning & Decision Support Capabilities Message & Order Processing Common Operational...Pictures Planning & Decision Support Capabilities Message & Order Processing Common Languages & Data Models Modeling & Simulation Domain

Common Core Literacy Lesson Plans: Ready-to-Use Resources, K-5

ERIC Educational Resources Information Center

Davis, Lauren

2013-01-01

Schools nationwide are transitioning to the Common Core--our advice to you: Don't go it alone! Our new book, "Common Core Literacy Lesson Plans: Ready-to-Use Resources, K-5," shows you that teaching the Common Core State Standards in the elementary grades doesn't have to be intimidating! This easy-to-use guide provides model lesson plans for…

Workshop on Aeronautical Decision Making (ADM). Volume 2. Plenary Session with Presentations and Proposed Action Plan

DTIC Science & Technology

1992-08-01

programs have several common functional components dealing with: attention , crew, stress, mental attitude, and risk issues. The role which the five...five interrelated concept areas furnish "rules and tools" to help prevent common errors. For instance: 1. Attention management issues include...pilots must manage his/her attention in a timely manor and sequentially employ the other cockpit management tools (for controlling stress etc.). The text

When Two Heads Are Better.

ERIC Educational Resources Information Center

Prosise, Roger; Mauer, Ellen

2000-01-01

An Illinois district is reaping the benefits of a teacher job-sharing program. Planners must consider daily common planning time; notification deadlines for job-sharing decisions and finding partners; requirements for attendance at school meetings and functions; effects on salary, benefits, and tenure; and eligibility requirements. (MLH)

Roth 401(k): asking the right questions.

PubMed

Joyner, James F

2006-01-01

Roth 401(k) provisions are a newly available feature of 401(k) plans. Roth 401(k) provisions are after-tax savings that generally are tax-free at the time of distribution. Questions arise for plan sponsors about whether the new feature is beneficial, and to whom, and what needs to be done if the plan sponsor decides to offer this provision to its employees. This article tries to answer some of those common questions, including a simple computational analysis to try to answer the important question of how much an employee-participant genuinely benefits from this savings approach. Some practical issues of implementation are touched on, and some unanswered questions are identified.

The use of 3D planning in facial surgery: preliminary observations.

PubMed

Hoarau, R; Zweifel, D; Simon, C; Broome, M

2014-12-01

Three-dimensional (3D) planning is becoming a more commonly used tool in maxillofacial surgery. At first used only virtually, 3D planning now also enables the creation of useful intraoperative aids such as cutting guides, which decrease the operative difficulty. In our center, we have used 3D planning in various domains of facial surgery and have investigated the advantages of this technique. We have also addressed the difficulties associated with its use. 3D planning increases the accuracy of reconstructive surgery, decreases operating time, whilst maintaining excellent esthetic results. However, its use is restricted to osseous reconstruction at this stage and once planning has been undertaken, it cannot be reversed or altered intraoperatively. Despite the attractive nature of this new tool, its uses and practicalities must be further evaluated. In particular, cost-effectiveness, hospital stay, and patient perceived benefits must be assessed. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

The costs of changing an intended action: movement planning, but not execution, interferes with verbal working memory.

PubMed

Spiegel, M A; Koester, D; Weigelt, M; Schack, T

2012-02-16

How much cognitive effort does it take to change a movement plan? In previous studies, it has been shown that humans plan and represent actions in advance, but it remains unclear whether or not action planning and verbal working memory share cognitive resources. Using a novel experimental paradigm, we combined in two experiments a grasp-to-place task with a verbal working memory task. Participants planned a placing movement toward one of two target positions and subsequently encoded and maintained visually presented letters. Both experiments revealed that re-planning the intended action reduced letter recall performance; execution time, however, was not influenced by action modifications. The results of Experiment 2 suggest that the action's interference with verbal working memory arose during the planning rather than the execution phase of the movement. Together, our results strongly suggest that movement planning and verbal working memory share common cognitive resources. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Development Roadmap of an Evolvable and Extensible Multi-Mission Telecom Planning and Analysis Framework

NASA Technical Reports Server (NTRS)

Cheung, Kar-Ming; Tung, Ramona H.; Lee, Charles H.

2003-01-01

In this paper, we describe the development roadmap and discuss the various challenges of an evolvable and extensible multi-mission telecom planning and analysis framework. Our long-term goal is to develop a set of powerful flexible telecommunications analysis tools that can be easily adapted to different missions while maintain the common Deep Space Communication requirements. The ability of re-using the DSN ground models and the common software utilities in our adaptations has contributed significantly to our development efforts measured in terms of consistency, accuracy, and minimal effort redundancy, which can translate into shorter development time and major cost savings for the individual missions. In our roadmap, we will address the design principles, technical achievements and the associated challenges for following telecom analysis tools (i) Telecom Forecaster Predictor - TFP (ii) Unified Telecom Predictor - UTP (iii) Generalized Telecom Predictor - GTP (iv) Generic TFP (v) Web-based TFP (vi) Application Program Interface - API (vii) Mars Relay Network Planning Tool - MRNPT.

RISK MANAGEMENT OF SEDIMENT STRESS: A FRAMEWORK FOR SEDIMENT RISK MANAGEMENT RESEARCH

EPA Science Inventory

Research related to the ecological risk management of sediment stress in watersheds is placed under a common conceptual framework in order to help promote the timely advance of decision support methods for aquatic resource managers and watershed-level planning. The proposed risk ...

Using Common Planning Time to Foster Professional Learning

ERIC Educational Resources Information Center

Dever, Robin; Lash, Martha J.

2013-01-01

Increased emphasis on meeting state standards, more stringent requirements for designation as highly qualified, and intensified accountability for student performance have foisted new expectations upon teachers and stimulated changes in professional development models in which the greater urgency is clearly to attend to the teacher's role as…

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

Coburn, Natalie, E-mail: natalie.coburn@swahs.health.nsw.gov.au; Beldham-Collins, Rachael; Radiation Oncology Network, Westmead Cancer Care Centre, University of Sydney, Sydney, New South Wales

Protocols commonly implemented in radiotherapy work areas may be classified as being either rigid (class solution) or flexible. Because formal evaluation of these protocol types has not occurred within the literature, we evaluated the efficiency of a rigid compared with flexible prostate planning protocol by assessing a series of completed 3D conformal prostate plans. Twenty prostate cancer patients with an average age of 70 years (range, 52-77) and sizes comprising 8 small, 10 medium, and 2 large were planned on the Phillips Pinnacle treatment planning system 6 times by radiation therapists with <2 years, 2-5 years, and >5 years ofmore » experience using a rigid and flexible protocol. Plans were critiqued using critical organ doses, confirmation numbers, and conformity index. Plans were then classified as being acceptable or not. Plans produced with the flexible protocol were 53% less likely to require modification (OR 0.47, 95% CI: 0.26, 0.84, p = 0.01). Planners with >5 years of experience were 78% more likely to produce plans requiring modification (OR 1.78, 95% CI: 1.12, 2.83, P = 0.02). Plans according to the flexible protocol took longer (112 min) compared with the time taken using a rigid protocol (68 min) (p < 0.001). The results suggest that further studies are needed; however, we propose that all radiation therapy planners should start with the same limitations, and if an acceptable plan is not reached, then flexibility should be given to improve the plan to meet the desired results.« less

Sector activities and lessons learned around initial implementation of the United States national physical activity plan.

PubMed

Evenson, Kelly R; Satinsky, Sara B

2014-08-01

National plans are increasingly common but infrequently evaluated. The 2010 United States National Physical Activity Plan (NPAP) provided strategies to increase population levels of physical activity. This paper describes (i) the initial accomplishments of the NPAP sector teams, and (ii) results from a process evaluation to determine how the sectors operated, their cross-sector collaboration, challenges encountered, and positive experiences. During 2011, a quarterly reporting system was developed to capture sector-level activities. A year-end interview derived more detailed information. Interviews with 12 sector leads were recorded, transcribed verbatim, and analyzed for common themes. The 6 sectors worked on goals from the implementation plan that focused broadly on education, promotion, intervention, policy, collaboration, and evaluation. Through year-end interviews, themes were generated around operations, goal setting, and cross-sector collaboration. Challenges to the NPAP work included lack of funding and time, the need for marketing and promotion, and organizational support. Positive experiences included collaboration, efficiency of work, enhanced community dynamic, and accomplishments toward NPAP goals. These initial results on the NPAP sector teams can be used as a baseline assessment for future monitoring. The lessons learned may be useful to other practitioners developing evaluations around state- or national-level plans.

Sector Activities and Lessons Learned Around Initial Implementation of the United States National Physical Activity Plan

PubMed Central

Evenson, Kelly R.; Satinsky, Sara B.

2016-01-01

Background National plans are increasingly common but infrequently evaluated. The 2010 United States National Physical Activity Plan (NPAP) provided strategies to increase population levels of physical activity. This paper describes (i) the initial accomplishments of the NPAP sector teams, and (ii) results from a process evaluation to determine how the sectors operated, their cross-sector collaboration, challenges encountered, and positive experiences. Methods During 2011, a quarterly reporting system was developed to capture sector-level activities. A year-end interview derived more detailed information. Interviews with 12 sector leads were recorded, transcribed verbatim, and analyzed for common themes. Results The 6 sectors worked on goals from the implementation plan that focused broadly on education, promotion, intervention, policy, collaboration, and evaluation. Through year-end interviews, themes were generated around operations, goal setting, and cross-sector collaboration. Challenges to the NPAP work included lack of funding and time, the need for marketing and promotion, and organizational support. Positive experiences included collaboration, efficiency of work, enhanced community dynamic, and accomplishments toward NPAP goals. Conclusions These initial results on the NPAP sector teams can be used as a baseline assessment for future monitoring. The lessons learned may be useful to other practitioners developing evaluations around state- or national-level plans. PMID:24176800

Effects of planned, mistimed and unwanted pregnancies on the use of prenatal health services in sub-Saharan Africa: a multicountry analysis of Demographic and Health Survey data.

PubMed

Amo-Adjei, Joshua; Anamaale Tuoyire, Derek

2016-12-01

We analysed the extent of planned, mistimed and unwanted pregnancies and how they predict optimal use of prenatal (timing and number of antenatal) care services in 30 African countries. We pooled data from Demographic and Health Surveys conducted in 30 African countries between 2006 and 2015. We described the extent of mistimed and unwanted pregnancies and further used mixed effects logistic and Poisson regression estimation techniques to examine the impacts of planned, mistimed and unwanted pregnancies on the use of prenatal health services. In total, 73.65% of pregnancies in all countries were planned. Mistimed pregnancy ranged from 7.43% in Burkina Faso to 41.33% in Namibia. Unwanted pregnancies were most common in Swaziland (39.54%) and least common in Niger (0.74%). Timely (first trimester) initiation of ANC was 37% overall in all countries; the multicountry average number of ANC visits was optimal [4.1; 95% CI: 4.1-4.2] but with notable disparities between countries. Overall, mistimed and unwanted pregnancies were strongly associated with late ANC attendance and fewer visits women made in the pooled analysis. Unintended pregnancies are critical risks to achieving improved maternal health in respect of early and optimal ANC coverage for women in Africa. Programmes targeted at advancing coverage of ANC in Africa need to deploy contextually appropriate mechanisms to prevent unintended pregnancies. © 2016 John Wiley & Sons Ltd.

Route planning with transportation network maps: an eye-tracking study.

PubMed

Grison, Elise; Gyselinck, Valérie; Burkhardt, Jean-Marie; Wiener, Jan Malte

2017-09-01

Planning routes using transportation network maps is a common task that has received little attention in the literature. Here, we present a novel eye-tracking paradigm to investigate psychological processes and mechanisms involved in such a route planning. In the experiment, participants were first presented with an origin and destination pair before we presented them with fictitious public transportation maps. Their task was to find the connecting route that required the minimum number of transfers. Based on participants' gaze behaviour, each trial was split into two phases: (1) the search for origin and destination phase, i.e., the initial phase of the trial until participants gazed at both origin and destination at least once and (2) the route planning and selection phase. Comparisons of other eye-tracking measures between these phases and the time to complete them, which depended on the complexity of the planning task, suggest that these two phases are indeed distinct and supported by different cognitive processes. For example, participants spent more time attending the centre of the map during the initial search phase, before directing their attention to connecting stations, where transitions between lines were possible. Our results provide novel insights into the psychological processes involved in route planning from maps. The findings are discussed in relation to the current theories of route planning.

SU-G-BRC-14: Multi-Lesion, Multi-Rx, Brain Radiosurgery with Novel Single Isocenter Technique

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

Honig, N; Alani, S; Schlocker, A

Purpose: There is a strong trend to treat multiple brain metastases with radiosurgery rather than whole brain irradiation. This feasibility study investigates a novel planning technique for radio-surgical treatment of multiple brain lesions with differing dose prescriptions, a single isocenter, and dynamic conformal arcs. The novel technique will be compared to the well-established single-isocenter volumetric modulated arc therapy (VMAT) technique commonly used for treating brain lesions. Methods: Six patients with metastatic brain lesions were selected for a prospective treatment planning study to evaluate Interdigitating MLC Dynamic Conformal Arc (IMDCA) technique. Arcs were planned for simultaneous irradiation to maximize beam deliverymore » efficiency. To accommodate varying PTV dose prescriptions, selected arcs were re-irradiated in reverse. Beam weights were adjusted until all prescription constraints were met. The number of lesions ranged between 2 to 4 (mode = 3). For comparison, SRS VMAT plans were generated utilizing an established single-isocenter, 3 arc planning template. All plans were compared by means of Paddick conformity index (PCI), RTOG Conformity Index (RCI), gradient index (GI), and the normal brain volume receiving 10% (V10) of the highest prescription dose. The monitor units and delivery time were tabulated for each plan. Results: IMDCA achieved conformal plans (PCI = 0.72±0.03, RCI = 1.33±0.03) with steep dose fall-off (GI = 3.79±0.03) on average for all of the plans evaluated. The VMAT plans had slightly better conformity (PCI = 0.85 ± 0.03, RCI = 1.13 ± 0.03) than IMDCA, but overall worse GI (4.29 ± 0.06). IMDCA plans had lower V10% values, required 50% fewer MUs, and had 34% shorter beam delivery time on average compared to VMAT plans. Conclusion: IMDCA plans with varying dose prescriptions for multiple lesions, had comparable dosimetric coverage as VMAT plans, but were obtained with significantly lower integral dose, fewer monitor units, and quicker delivery time.« less

45 CFR 147.200 - Summary of benefits and coverage and uniform glossary.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SBC must include the following: (A) Uniform definitions of standard insurance terms and medical terms... or coverage for common benefits scenarios (including pregnancy and serious or chronic medical... treatment plan for a specified medical condition during a specific period of time, based on recognized...

45 CFR 147.200 - Summary of benefits and coverage and uniform glossary.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SBC must include the following: (A) Uniform definitions of standard insurance terms and medical terms... or coverage for common benefits scenarios (including pregnancy and serious or chronic medical... treatment plan for a specified medical condition during a specific period of time, based on recognized...

45 CFR 147.200 - Summary of benefits and coverage and uniform glossary.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SBC must include the following: (A) Uniform definitions of standard insurance terms and medical terms... or coverage for common benefits scenarios (including pregnancy and serious or chronic medical... treatment plan for a specified medical condition during a specific period of time, based on recognized...

Seabed Geoacoustic Planning Support for the QPE Uncertainty DRI

DTIC Science & Technology

2007-09-30

40% CaCO3 from planktonic foraminfera and pteropod shells associated with upwelling. • Rock fragments are common and abundant constituents of...variable over seasonal time scales. • On outer shelf and slope, presence of deep thermogenic methane leads to mud volcanoes (5-40 m in height; radii ~20

Facilitating Change through Integrated Strategic Planning

ERIC Educational Resources Information Center

Freeman, Jerrid P.; Wilmes, David M.

2009-01-01

Planners strive to develop the best programs and strategies to enhance student learning and advance their institutional mission while meeting their desired outcomes. This work, while rewarding, can be time intensive and demanding and developing new initiatives is not without risks. Some common reasons these efforts fail include: lack of buy-in…

Using Time-Lines in Assessment

ERIC Educational Resources Information Center

Carr, Elizabeth; Counsell, Christine

2014-01-01

Bridging a twenty-year gap in their practice, Elizabeth Carr and Christine Counsell bring out the similarities in their use of timelines in their planning, teaching and assessment. What they also have in common is the fact that their experimentation with timelines as a way of strengthening cumulative knowledge emerged in remarkably similar policy…

Effect of driving experience on anticipatory look-ahead fixations in real curve driving.

PubMed

Lehtonen, Esko; Lappi, Otto; Koirikivi, Iivo; Summala, Heikki

2014-09-01

Anticipatory skills are a potential factor for novice drivers' curve accidents. Behavioural data show that steering and speed regulation are affected by forward planning of the trajectory. When approaching a curve, the relevant visual information for online steering control and for planning is located at different eccentricities, creating a need to disengage the gaze from the guidance of steering to anticipatory look-ahead fixations over curves. With experience, peripheral vision can be increasingly used in the visual guidance of steering. This could leave experienced drivers more gaze time to invest on look-ahead fixations over curves, facilitating the trajectory planning. Eighteen drivers (nine novices, nine experienced) drove an instrumented vehicle on a rural road four times in both directions. Their eye movements were analyzed in six curves. The trajectory of the car was modelled and divided to approach, entry and exit phases. Experienced drivers spent less time on the road-ahead and more time on the look-ahead fixations over the curves. Look-ahead fixations were also more common in the approach than in the entry phase of the curve. The results suggest that with experience drivers allocate greater part of their visual attention to trajectory planning. Copyright © 2014 Elsevier Ltd. All rights reserved.

Features of resilience

DOE PAGES

Connelly, Elizabeth B.; Allen, Craig R.; Hatfield, Kirk; ...

2017-02-20

The National Academy of Sciences (NAS) definition of resilience is used here to organize common concepts and synthesize a set of key features of resilience that can be used across diverse application domains. The features in common include critical functions (services), thresholds, cross-scale (both space and time) interactions, and memory and adaptive management. We propose a framework for linking these features to the planning, absorbing, recovering, and adapting phases identified in the NAS definition. As a result, the proposed delineation of resilience can be important in understanding and communicating resilience concepts.

Features of resilience

USGS Publications Warehouse

Connelly, Elizabeth B.; Allen, Craig R.; Hatfield, Kirk; Palma-Oliveira, José M.; Woods, David D.; Linkov, Igor

2017-01-01

The National Academy of Sciences (NAS) definition of resilience is used here to organize common concepts and synthesize a set of key features of resilience that can be used across diverse application domains. The features in common include critical functions (services), thresholds, cross-scale (both space and time) interactions, and memory and adaptive management. We propose a framework for linking these features to the planning, absorbing, recovering, and adapting phases identified in the NAS definition. The proposed delineation of resilience can be important in understanding and communicating resilience concepts.

Lesson Planning with the Common Core

ERIC Educational Resources Information Center

Estes, Linda A.; McDuffie, Amy Roth; Tate, Cathie

2014-01-01

Planning a lesson can be similar to planning a road trip--a metaphor the authors use to describe how they applied research and theory to their lesson planning process. A map and mode of transportation, the Common Core State Standards for Mathematics (CCSSM) and textbooks as resources, can lead to desired destinations, such as students engaging in…

A continuous arc delivery optimization algorithm for CyberKnife m6.

PubMed

Kearney, Vasant; Descovich, Martina; Sudhyadhom, Atchar; Cheung, Joey P; McGuinness, Christopher; Solberg, Timothy D

2018-06-01

This study aims to reduce the delivery time of CyberKnife m6 treatments by allowing for noncoplanar continuous arc delivery. To achieve this, a novel noncoplanar continuous arc delivery optimization algorithm was developed for the CyberKnife m6 treatment system (CyberArc-m6). CyberArc-m6 uses a five-step overarching strategy, in which an initial set of beam geometries is determined, the robotic delivery path is calculated, direct aperture optimization is conducted, intermediate MLC configurations are extracted, and the final beam weights are computed for the continuous arc radiation source model. This algorithm was implemented on five prostate and three brain patients, previously planned using a conventional step-and-shoot CyberKnife m6 delivery technique. The dosimetric quality of the CyberArc-m6 plans was assessed using locally confined mutual information (LCMI), conformity index (CI), heterogeneity index (HI), and a variety of common clinical dosimetric objectives. Using conservative optimization tuning parameters, CyberArc-m6 plans were able to achieve an average CI difference of 0.036 ± 0.025, an average HI difference of 0.046 ± 0.038, and an average LCMI of 0.920 ± 0.030 compared with the original CyberKnife m6 plans. Including a 5 s per minute image alignment time and a 5-min setup time, conservative CyberArc-m6 plans achieved an average treatment delivery speed up of 1.545x ± 0.305x compared with step-and-shoot plans. The CyberArc-m6 algorithm was able to achieve dosimetrically similar plans compared to their step-and-shoot CyberKnife m6 counterparts, while simultaneously reducing treatment delivery times. © 2018 American Association of Physicists in Medicine.

77 FR 38344 - Medallion Financial Corp.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... increasing the maximum number of shares of Applicant's common stock (``Common Stock'') available for issuance... Amended Director Plan. Under the Amended Director Plan, a maximum of 200,000 shares of Applicant's Common... shares of Applicant's Common Stock that may be issued to any one Eligible Director. The Amended Director...

Planning for the Future of Your Child with a Disabliity. Second Edition.

ERIC Educational Resources Information Center

O'Leary, Edward, Ed.; Trotter, Susan, Ed.

The handbook provides parents of children with disabilities guidance on planning for the child's future needs with special attention to resources and laws of Iowa. Section 1 gives a Future Planning Checklist and definitions of common legal terms. Section 2 addresses estates, trusts, and wills and provides common estate planning questions and…

Is it time for a comprehensive approach in older home care clients' care planning in Finland?

PubMed

Turjamaa, Riitta; Hartikainen, Sirpa; Kangasniemi, Mari; Pietilä, Anna-Maija

2015-06-01

Home-care services require access to high quality information. Apart from the provision of right-time organised planning of care and to document information about clients' needs, in home care, the care planning is intended to facilitate continuity and individual nursing through nursing documentation of the assessment of the client. The aim was to describe the contents of older (+75 years) home-care clients' electronic care and service plans and to evaluate how the clients' resources have been taken into account. The data were collected from the care and service plans (n = 437) of home-care services during July 2010. The data were analysed by quantitative methods and by thematic content analysis. Based on the analysis, medication was the most reported component in all plans (92.7%); other commonly reported components were self-care (85.4%) and coping (78.0%). Components within respiratory, follow-up treatment, life cycle and health behaviour were forgotten. Most of the care and service plans were designed from the home-care professionals' point of view but the plans lacked the perspective of older clients. To be able to promote older home clients' ability to live at home, home-care planning needs to be individually designed and must take into account clients' needs and their perspectives regarding meaningful activities and social relationships. In addition, there is a need to develop a more comprehensive care planning system, based on the clients' individual needs and standards of care planning. © 2014 Nordic College of Caring Science.

Emerging roles for biomedical librarians: a survey of current practice, challenges, and changes.

PubMed

Crum, Janet A; Cooper, I Diane

2013-10-01

This study is intended to (1) identify emerging roles for biomedical librarians and determine how common these roles are in a variety of library settings, (2) identify barriers to taking on new roles, and (3) determine how librarians are developing the capacity to take on new roles. A survey was conducted of librarians in biomedical settings. Most biomedical librarians are taking on new roles. The most common roles selected by survey respondents include analysis and enhancement of user experiences, support for social media, support for systematic reviews, clinical informationist, help for faculty or staff with authorship issues, and implementation of researcher profiling and collaboration tools. Respondents in academic settings are more likely to report new roles than hospital librarians are, but some new roles are common in both settings. Respondents use a variety of methods to free up time for new roles, but predominant methods vary between directors and librarians and between academic and hospital respondents. Lack of time is the biggest barrier that librarians face when trying to adopt new roles. New roles are associated with increased collaboration with individuals and/or groups outside the library. This survey documents the widespread incorporation of new roles in biomedical libraries in the United States, as well as the barriers to adopting these roles and the means by which librarians are making time for them. The results of the survey can be used to inform strategic planning, succession planning, library education, and career development for biomedical librarians.

Common Progress Monitoring Omissions: Planning and Practice. Progress Monitoring Brief #1

ERIC Educational Resources Information Center

National Center on Response to Intervention, 2013

2013-01-01

Progress monitoring, one of the essential components of Response to Intervention (RTI), is characterized by repeated measurement of academic performance that is conducted at least monthly. The process may be used to assess students' academic performance over time, to quantify student rates of improvement or responsiveness to instruction, and to…

The Empower Program, K-2: Concrete Strategies for Positive Behavioral Support

ERIC Educational Resources Information Center

Baker, Rachel

2016-01-01

Let's face it--teaching can be stressful. In this generation of Common Core Standards and highstakes testing, educators are often left without the time to plan positive behavioral supports or the sanity to cultivate compassionate relationships with their students. Even though they understand the critical relationship between behavior and…

Why Evaluations Fail: To Achieve Meaningful Results, Address These Common Challenges

ERIC Educational Resources Information Center

Killion, Joellen

2017-01-01

Evaluation of professional learning illuminates the interactions that occur in the implementation of planned learning experiences and the necessary supports designed to improve professional practice and its effects on students. It investigates how a set of actions designed to achieve defined short- and long-term outcomes occur over time and how…

Finding Connections: Using Accounting Concepts in a Career Planning Class

ERIC Educational Resources Information Center

Wang, Michelle

2013-01-01

In higher education, the most common challenge for students is the ability to find a connection between one subject that they have learned and another subject. Thus, students' learning becomes compartmentalized and piecemeal. For instance, accounting students may find attending a drawing class boring and a waste of time. Science students may…

Computer-Aided Experiment Planning toward Causal Discovery in Neuroscience.

PubMed

Matiasz, Nicholas J; Wood, Justin; Wang, Wei; Silva, Alcino J; Hsu, William

2017-01-01

Computers help neuroscientists to analyze experimental results by automating the application of statistics; however, computer-aided experiment planning is far less common, due to a lack of similar quantitative formalisms for systematically assessing evidence and uncertainty. While ontologies and other Semantic Web resources help neuroscientists to assimilate required domain knowledge, experiment planning requires not only ontological but also epistemological (e.g., methodological) information regarding how knowledge was obtained. Here, we outline how epistemological principles and graphical representations of causality can be used to formalize experiment planning toward causal discovery. We outline two complementary approaches to experiment planning: one that quantifies evidence per the principles of convergence and consistency, and another that quantifies uncertainty using logical representations of constraints on causal structure. These approaches operationalize experiment planning as the search for an experiment that either maximizes evidence or minimizes uncertainty. Despite work in laboratory automation, humans must still plan experiments and will likely continue to do so for some time. There is thus a great need for experiment-planning frameworks that are not only amenable to machine computation but also useful as aids in human reasoning.

Flight plan optimization

NASA Astrophysics Data System (ADS)

Dharmaseelan, Anoop; Adistambha, Keyne D.

2015-05-01

Fuel cost accounts for 40 percent of the operating cost of an airline. Fuel cost can be minimized by planning a flight on optimized routes. The routes can be optimized by searching best connections based on the cost function defined by the airline. The most common algorithm that used to optimize route search is Dijkstra's. Dijkstra's algorithm produces a static result and the time taken for the search is relatively long. This paper experiments a new algorithm to optimize route search which combines the principle of simulated annealing and genetic algorithm. The experimental results of route search, presented are shown to be computationally fast and accurate compared with timings from generic algorithm. The new algorithm is optimal for random routing feature that is highly sought by many regional operators.

Development of a residual acceleration data reduction and dissemination plan

NASA Technical Reports Server (NTRS)

Rogers, Melissa J. B.

1992-01-01

A major obstacle in evaluating the residual acceleration environment in an orbiting space laboratory is the amount of data collected during a given mission: gigabytes of data will be available as SAMS units begin to fly regularly. Investigators taking advantage of the reduced gravity conditions of space should not be overwhelmed by the accelerometer data which describe these conditions. We are therefore developing a data reduction and analysis plan that will allow principal investigators of low-g experiments to create experiment-specific residual acceleration data bases for post-flight analysis. The basic aspects of the plan can also be used to characterize the acceleration environment of earth orbiting laboratories. Our development of the reduction plan is based on the following program of research: the identification of experiment sensitivities by order of magnitude estimates and numerical modelling; evaluation of various signal processing techniques appropriate for the reduction, supplementation, and dissemination of residual acceleration data; and testing and implementation of the plan on existing acceleration data bases. The orientation of the residual acceleration vector with respect to some set of coordinate axes is important for experiments with known directional sensitivity. Orientation information can be obtained from the evaluation of direction cosines. Fourier analysis is commonly used to transform time history data into the frequency domain. Common spectral representations are the amplitude spectrum which gives the average of the components of the time series at each frequency and the power spectral density which indicates the power or energy present in the series per unit frequency interval. The data reduction and analysis scheme developed involves a two tiered structure to: (1) identify experiment characteristics and mission events that can be used to limit the amount of accelerator data an investigator should be interested in; and (2) process the data in a way that will be meaningful to the experiment objectives. A general outline of the plan is given.

Planning for the Leicester City Football Club victory parade.

PubMed

Halse, Martin

2017-01-01

This paper details the multiagency planning for and delivery of the Leicester City Football Club victory parade at the end of the 2015/16 football season to celebrate the team winning the Barclays Premier League. This is compared and contrasted with the planning and delivery of the reinterment of the mortal remains of King Richard III, which took place in Leicester a little more than 12 months prior. Both events were unprecedentedly high-profile for a comparatively small city and the routes involved had much in common. However, the amount of time to plan each event differed greatly: approximately 18 months for the reinterment and just five weeks for the victory parade. The events were largely un-ticketed but with very different crowd profiles. This paper describes the background to both events; their context and setting; the structure of the planning groups; contingency planning considerations and implementation; pre-event exercises; command, control and coordination arrangements; business continuity issues; communications and lessons learned.

Surgical orthodontics.

PubMed

Strohl, Alexis M; Vitkus, Lauren

2017-08-01

The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

Reliability, return periods, and risk under nonstationarity

NASA Astrophysics Data System (ADS)

Read, Laura K.; Vogel, Richard M.

2015-08-01

Water resources design has widely used the average return period as a concept to inform management and communication of the risk of experiencing an exceedance event within a planning horizon. Even though nonstationarity is often apparent, in practice hydrologic design often mistakenly assumes that the probability of exceedance, p, is constant from year to year which leads to an average return period To equal to 1/p; this expression is far more complex under nonstationarity. Even for stationary processes, the common application of an average return period is problematic: it does not account for planning horizon, is an average value that may not be representative of the time to the next flood, and is generally not applied in other areas of water planning. We combine existing theoretical and empirical results from the literature to provide the first general, comprehensive description of the probabilistic behavior of the return period and reliability under nonstationarity. We show that under nonstationarity, the underlying distribution of the return period exhibits a more complex shape than the exponential distribution under stationary conditions. Using a nonstationary lognormal model, we document the increased complexity and challenges associated with planning for future flood events over a planning horizon. We compare application of the average return period with the more common concept of reliability and recommend replacing the average return period with reliability as a more practical way to communicate event likelihood in both stationary and nonstationary contexts.

That's why it's a 5-year program: resident acquisition of anorectal disease management competence.

PubMed

Miller, Seth; Sohn, Vance; Causey, Marlin Wayne; Martin, Matthew; Brown, Tommy; Steele, Scott

2012-04-01

Although surgical residents are expected to be proficient in the diagnosis and management of anorectal pathology upon graduation, there is little data related to the timing and degree of proficiency acquired during training. Prospective study of new patients presenting to a colorectal surgical clinic for evaluation of anorectal complaints over a 3-y period. Trainees performed an initial evaluation and recorded their exam findings, diagnosis, and treatment plan. A separate evaluation by a staff colorectal surgeon was performed, with results compared by an independent reviewer. A total of 236 patient evaluations were included. The accuracy of referral diagnosis was significantly better when originated from a surgeon than from all other referral sources (91.7% versus 59.1%, P = 0.031). The most common conditions were internal hemorrhoids (25%), anal fissures (22%), and external hemorrhoids (19.5%). Internal hemorrhoids were most commonly misdiagnosed as external hemorrhoids (58%). Anal fissures were missed 38% of the time, and were most often given the diagnosis of internal hemorrhoids (45%). Residents also demonstrated difficulty in identifying thrombosis in external hemorrhoids, with a 45% error rate. Medical students and residents had an overall correct primary diagnosis of 69.5%; however, there was a significant improvement in the accuracy of diagnosis from medical students and interns to upper level residents (62.9% versus 81.2%, P = 0.003). Medical treatment plans agreed between resident and staff in 74%, the surgical management agreed in 62%, and overall the residents had the correct diagnosis and corresponding treatment plan in 44%. Additional adjunctive procedures were proposed in 66 patients with residents stating the correct adjunct in 79%. The most frequently missed adjuncts were endorectal ultrasound (34%) and colonoscopy (28%). Surgical trainees demonstrated significant deficiencies in the ability to evaluate and manage anorectal pathology; however, marked improvement occurred with time in training. Common areas of misdiagnosis and therapeutic errors were identified which could aid in curriculum development. Published by Elsevier Inc.

End-of-life care of oncology inpatients: Are we getting it right?

PubMed

Batten, Monique; Nguyen, Bella; Burke, Brandon; Harryanto, Hilman; Mitchell, Imogen; Davis, Alison

2018-06-13

To examine the current patterns of end-of-life care of medical oncology patients dying in an Australian tertiary acute hospital setting in order to determine potential areas for improvement. A retrospective observational study was undertaken of 295 consecutive adult medical oncology inpatients dying between 2010 and 2015. Charts were reviewed for evidence of (1) resuscitation plans, (2) acute interventions in the 48-h period prior to death, (3) palliative care involvement and (4) recognition of the dying patient and comfort care plans. At the time of death, 98% of patients had a resuscitation plan, 71% of which were completed by the medical oncology team. Fifty-nine percent of medical emergency team reviews occurred in patients without a documented resuscitation plan. Within 48 h of death, active interventions were still being given to 64% of patients in the total patient population. Comfort care plans were documented in 86% of patients; however, 62% of these were only documented within 48 h of death and 20% of patients with a documented comfort care plan still received noncomfort measures. There was a high level of documented resuscitation plans, comfort care plans and recognition of dying. However, active interventions were common within 48 h of death, and comfort care plans and recognition of dying often occurred late. These data indicate a gap between documenting a resuscitation plan and providing timely and appropriate end-of-life care. Understanding the gaps in delivering appropriate care provides an opportunity for improving end-of-life care. © 2018 John Wiley & Sons Australia, Ltd.

Strategic planning processes and hospital financial performance.

PubMed

Kaissi, Amer A; Begun, James W

2008-01-01

Many common management practices in healthcare organizations, including the practice of strategic planning, have not been subject to widespread assessment through empirical research. If management practice is to be evidence-based, evaluations of such common practices need to be undertaken. The purpose of this research is to provide evidence on the extent of strategic planning practices and the association between hospital strategic planning processes and financial performance. In 2006, we surveyed a sample of 138 chief executive officers (CEOs) of hospitals in the state of Texas about strategic planning in their organizations and collected financial information on the hospitals for 2003. Among the sample hospitals, 87 percent reported having a strategic plan, and most reported that they followed a variety of common practices recommended for strategic planning-having a comprehensive plan, involving physicians, involving the board, and implementing the plan. About one-half of the hospitals assigned responsibility for the plan to the CEO. We tested the association between these planning characteristics in 2006 and two measures of financial performance for 2003. Three dimensions of the strategic planning process--having a strategic plan, assigning the CEO responsibility for the plan, and involving the board--are positively associated with earlier financial performance. Further longitudinal studies are needed to evaluate the cause-and-effect relationship between planning and performance.

76 FR 34903 - Revisions to Framework Adjustment 45 to the Northeast Multispecies Fishery Management Plan and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... Management Plan and Sector Annual Catch Entitlements; Updated Annual Catch Limits for Sectors and the Common... (ACLs) for common pool vessels (common pool sub-ACLs), ACLs for sector vessels (sector sub-ACLs), and... number of participants electing to fish in either sectors or the common pool fishery in FY 2011. DATES...

The Timeseries Toolbox - A Web Application to Enable Accessible, Reproducible Time Series Analysis

NASA Astrophysics Data System (ADS)

Veatch, W.; Friedman, D.; Baker, B.; Mueller, C.

2017-12-01

The vast majority of data analyzed by climate researchers are repeated observations of physical process or time series data. This data lends itself of a common set of statistical techniques and models designed to determine trends and variability (e.g., seasonality) of these repeated observations. Often, these same techniques and models can be applied to a wide variety of different time series data. The Timeseries Toolbox is a web application designed to standardize and streamline these common approaches to time series analysis and modeling with particular attention to hydrologic time series used in climate preparedness and resilience planning and design by the U. S. Army Corps of Engineers. The application performs much of the pre-processing of time series data necessary for more complex techniques (e.g. interpolation, aggregation). With this tool, users can upload any dataset that conforms to a standard template and immediately begin applying these techniques to analyze their time series data.

The Army/Air Force RAMCAD (Reliability and Maintainability Computer-Aided Design) Program Progress Report Through September 1989

DTIC Science & Technology

1990-01-01

deal with platforms and their weapons. Two approaches emerged from this effort. The first plan was to address the benefits and the problems involved in...inadam~ or on a remnoftd lcod oompLusr. 3. The Nwaiguior tabthe DGMSIt aD wWe rq4he datatote ApicadwProW tip FaMW Tebs. *4. The didaI formailed for...demonstrated the benefits to be gained in time and training cost of a common method for operating different computer programs. It is this common mode of

Climatic droplet keratopathy, exfoliation syndrome, and cataract.

PubMed Central

Resnikoff, S; Filliard, G; Dell'Aquila, B

1991-01-01

During a countrywide survey we assessed the prevalence of climatic droplet keratopathy (CDK) in a randomised sample of 2446 subjects representative of the population of the Republic of Djibouti. The investigation of the relationship between CDK and two diseases considered to be related to exposure to ultra-violet light--namely, exfoliation syndrome and cataract--was planned as a case control study. In the rural area prevalence of CDK was five times higher than in the urban one (2.8% vs 0.5%) and varied according to districts. The highest rates were observed where the inhabitants' activities were related to the sea. The case control study revealed that the opacification of the lens was about three times commoner in patients with CDK than in patients without CDK (p = 0.03) and that the exfoliation syndrome was about six times commoner in patients with CDK than in controls of similar age, sex, climatic conditions, and lens status (p = 0.02). Moreover, we noticed that the sequelae of corneal perforations were about 30 times commoner in patients with CDK than in controls of similar age (p less than 0.00001). PMID:1768663

[Lightning strikes and lightning injuries in prehospital emergency medicine. Relevance, results, and practical implications].

PubMed

Hinkelbein, J; Spelten, O; Wetsch, W A

2013-01-01

Up to 32.2% of patients in a burn center suffer from electrical injuries. Of these patients, 2-4% present with lightning injuries. In Germany, approximately 50 people per year are injured by a lightning strike and 3-7 fatally. Typically, people involved in outdoor activities are endangered and affected. A lightning strike usually produces significantly higher energy doses as compared to those in common electrical injuries. Therefore, injury patterns vary significantly. Especially in high voltage injuries and lightning injuries, internal injuries are of special importance. Mortality ranges between 10 and 30% after a lightning strike. Emergency medical treatment is similar to common electrical injuries. Patients with lightning injuries should be transported to a regional or supraregional trauma center. In 15% of all cases multiple people may be injured. Therefore, it is of outstanding importance to create emergency plans and evacuation plans in good time for mass gatherings endangered by possible lightning.

Toward Identifying Needed Investments in Modeling and Simulation Tools for NEO Deflection Planning

NASA Technical Reports Server (NTRS)

Adams, Robert B.

2009-01-01

Its time: a) To bring planetary scientists, deflection system investigators and vehicle designers together on the characterization/mitigation problem. b) To develop a comprehensive trade space of options. c) To trade options under a common set of assumptions and see what comparisons on effectiveness can be made. d) To explore the synergy that can be had with proposed scientific and exploration architectures while interest in NEO's are at an all time high.

Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

PubMed Central

Tessema, Gizachew Assefa; Streak Gomersall, Judith; Mahmood, Mohammad Afzal; Laurence, Caroline O.

2016-01-01

Background Improving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa. Methods Quantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings. Results From 4334 records, 11 studies (eight quantitative, three qualitative) met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client’s waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as ‘pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers’ behaviour. Conclusion There is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary pre-requisites for taking contraceptive methods are important to improve the quality of care in family planning services. Strategies to improve provider behavior and competency are important. Moreover, strategies that minimize client waiting time and ensure client confidentiality should be implemented to ensure quality of care in family planning services. However, no strong evidence based conclusions and recommendations may be drawn from the evidence. Future studies are needed to identify the most important factors associated with quality of care in family planning services in a wider range of African countries. PMID:27812124

Short-Term Faculty Members: A National Dilemma and a Local Solution.

ERIC Educational Resources Information Center

Killingsworth, M. Jimmie; And Others

1989-01-01

Surveys English department chairs nationwide, examining the status of full-time non-tenure-track teachers in English departments of PhD-granting institutions. Finds that universities commonly hire short-term lecturers to teach when regular faculty members are "too expensive" for the job. Reports a plan adopted by Texas Tech University to deal with…

Practical Solutions to Practically Every Problem: The Early Childhood Teacher's Manual.

ERIC Educational Resources Information Center

Saifer, Steffen

This book is designed to help early childhood teachers deal with common problems that arise in all aspects of their work. Part one addresses daily dilemmas such as schedule planning, meal and nap times, art, and outdoor play. Part two covers classroom concerns such as the physical environment, curriculum, individual student needs, field trips,…

Dispelling 10 Common Disaster Recovery Myths: Lessons Learned from Hurricane Katrina and Other Disasters

ERIC Educational Resources Information Center

Landry, Brett J. L.; Koger, M. Scott

2006-01-01

Disasters happen all the time; yet despite this, many organizations are caught unprepared or make unrealistic assumptions. These factors create environments that will fail during a disaster. Most information technology (IT) curricula do not cover disaster recovery (DR) plans and strategies in depth. The unfortunate result is that most new computer…

Identifying Belief-Based Targets for the Promotion of Leisure-Time Walking

ERIC Educational Resources Information Center

Rhodes, Ryan E.; Blanchard, Chris M.; Courneya, Kerry S.; Plotnikoff, Ronald C.

2009-01-01

Walking is the most common type of physical activity (PA) and the likely target of efforts to increase PA. No studies, however, have identified the belief-level correlates for walking using the theory of planned behavior. This study elicits salient beliefs about walking and evaluates beliefs that may be most important for walking-promotion…

VSP - Discussion: The Common Interest on Planning Hulls and Plan for Collaboration Studies between NSWC and KRISO - Washington DC

DTIC Science & Technology

2016-03-07

planning hulls and plan for N62909-15-1-2052 collaboration studies between NSWC and KRISO - Washington DC Sb. GRANT NUMBER N62909-15-1-2052 Sc. PROGRAM...be carried out in MASK’s facilities. We discussed common interests on planing hulls , and made plans for collaboration studies between NSWC and KRISO... hull forms for satisfying the requirements of the project. Model tests and analyses are required to assess the maneuvering and seakeeping performance

The association between education and induced abortion for three cohorts of adults in Finland.

PubMed

Väisänen, Heini

2015-01-01

This paper explores whether the likelihood of abortion by education changed over time in Finland, where comprehensive family planning services and sexuality education have been available since the early 1970s. This subject has not previously been studied longitudinally with comprehensive and reliable data. A unique longitudinal set of register data of more than 250,000 women aged 20-49 born in 1955-59, 1965-69, and 1975-79 was analysed, using descriptive statistics, concentration curves, and discrete-time event-history models. Women with basic education had a higher likelihood of abortion than others and the association grew stronger for later cohorts. Selection into education may explain this phenomenon: although it was fairly common to have only basic education in the 1955-59 cohort, it became increasingly unusual over time. Thus, even though family planning services were easily available, socio-economic differences in the likelihood of abortion remained.

Net present biodiversity value and the design of biodiversity offsets.

PubMed

Overton, Jacob McC; Stephens, R T Theo; Ferrier, Simon

2013-02-01

There is an urgent need to develop sound theory and practice for biodiversity offsets to provide a better basis for offset multipliers, to improve accounting for time delays in offset repayments, and to develop a common framework for evaluating in-kind and out-of-kind offsets. Here, we apply concepts and measures from systematic conservation planning and financial accounting to provide a basis for determining equity across type (of biodiversity), space, and time. We introduce net present biodiversity value (NPBV) as a theoretical and practical measure for defining the offset required to achieve no-net-loss. For evaluating equity in type and space we use measures of biodiversity value from systematic conservation planning. Time discount rates are used to address risk of non-repayment, and loss of utility. We illustrate these concepts and measures with two examples of biodiversity impact-offset transactions. Considerable further work is required to understand the characteristics of these approaches.

Changes in Regional Ventilation During Treatment and Dosimetric Advantages of CT Ventilation Image Guided Radiation Therapy for Locally Advanced Lung Cancer.

PubMed

Yamamoto, Tokihiro; Kabus, Sven; Bal, Matthieu; Bzdusek, Karl; Keall, Paul J; Wright, Cari; Benedict, Stanley H; Daly, Megan E

2018-05-04

Lung functional image guided radiation therapy (RT) that avoids irradiating highly functional regions has potential to reduce pulmonary toxicity following RT. Tumor regression during RT is common, leading to recovery of lung function. We hypothesized that computed tomography (CT) ventilation image-guided treatment planning reduces the functional lung dose compared to standard anatomic image-guided planning in 2 different scenarios with or without plan adaptation. CT scans were acquired before RT and during RT at 2 time points (16-20 Gy and 30-34 Gy) for 14 patients with locally advanced lung cancer. Ventilation images were calculated by deformable image registration of four-dimensional CT image data sets and image analysis. We created 4 treatment plans at each time point for each patient: functional adapted, anatomic adapted, functional unadapted, and anatomic unadapted plans. Adaptation was performed at 2 time points. Deformable image registration was used for accumulating dose and calculating a composite of dose-weighted ventilation used to quantify the lung accumulated dose-function metrics. The functional plans were compared with the anatomic plans for each scenario separately to investigate the hypothesis at a significance level of 0.05. Tumor volume was significantly reduced by 20% after 16 to 20 Gy (P = .02) and by 32% after 30 to 34 Gy (P < .01) on average. In both scenarios, the lung accumulated dose-function metrics were significantly lower in the functional plans than in the anatomic plans without compromising target volume coverage and adherence to constraints to critical structures. For example, functional planning significantly reduced the functional mean lung dose by 5.0% (P < .01) compared to anatomic planning in the adapted scenario and by 3.6% (P = .03) in the unadapted scenario. This study demonstrated significant reductions in the accumulated dose to the functional lung with CT ventilation image-guided planning compared to anatomic image-guided planning for patients showing tumor regression and changes in regional ventilation during RT. Copyright © 2018 Elsevier Inc. All rights reserved.

Biodistribution of 99mTc-MAA on SPECT/CT performed for 90Y radioembolization therapy planning: a pictorial review.

PubMed

Bailey, J J; Dewaraja, Y; Hubers, D; Srinivasa, R N; Frey, K A

2017-10-01

To evaluate the frequency of 99mTc-MAA uptake in extrahepatic organs during 90Y radioembolization therapy planning. This retrospective case series of 70 subjects who underwent 99mTc-MAA hepatic artery perfusion studies between January 2014 and July 2016 for 90Y radioembolization therapy planning at our institution involved direct image review for all subjects, with endpoints recorded: lung shunt fraction, extrahepatic radiotracer uptake, time from MAA injection to imaging. Combined planar and SPECT/CT imaging findings in the 70 subjects demonstrated lung shunt fraction measurements of less than 10% in 53 (76%) subjects and greater than 10% in 17 (24%) subjects. All patients demonstrated renal cortical uptake, 23 (33%) demonstrated salivary gland uptake, 23 (33%) demonstrated thyroid uptake, and 32 (46%) demonstrated gastric mucosal uptake, with significant overlap between these groups. The range of elapsed times between MAA injection and initial imaging was 41-138 min, with a mean of 92 min. There was no correlation between time to imaging and the presence of extrahepatic radiotracer uptake at any site. During hepatic artery perfusion scanning for 90Y radioembolization therapy planning, extrahepatic uptake is common, particularly in the kidney, salivary gland, thyroid and gastric mucosa, and is hypothesized to result from breakdown of 99mTc-MAA over time. Given the breakdown to smaller aggregates and ultimately pertechnetate, this should not be a contraindication to actual Y-90 microsphere therapy. Although we found no correlation between time to imaging and extrahepatic uptake, most of our injection to imaging times were relatively short.

Quality assurance of HDR prostate plans: program implementation at a community hospital.

PubMed

Rush, Jennifer B; Thomas, Michael D

2005-01-01

Adenocarcinoma of the prostate is currently the most commonly diagnosed cancer in men in the United States, and the second leading cause of cancer mortality. The utilization of radiation therapy is regarded as the definitive local therapy of choice for intermediate- and high-risk disease, in which there is increased risk for extracapsular extension, seminal vesicle invasion, or regional node involvement. High-dose-rate (HDR) brachytherapy is a logical treatment modality to deliver the boost dose to an external beam radiation therapy (EBRT) treatment to increase local control rates. From a treatment perspective, the utilization of a complicated treatment delivery system, the compressed time frame in which the procedure is performed, and the small number of large dose fractions make the implementation of a comprehensive quality assurance (QA) program imperative. One aspect of this program is the QA of the HDR treatment plan. Review of regulatory and medical physics professional publications shows that substantial general guidance is available. We provide some insight to the implementation of an HDR prostate plan program at a community hospital. One aspect addressed is the utilization of the low-dose-rate (LDR) planning system and the use of existing ultrasound image sets to familiarize the radiation therapy team with respect to acceptable HDR implant geometries. Additionally, the use of the LDR treatment planning system provided a means to prospectively determine the relationship between the treated isodose volume and the product of activity and time for the department's planning protocol prior to the first HDR implant. For the first 12 HDR prostate implants, the root-mean-square (RMS) deviation was 3.05% between the predicted product of activity and time vs. the actual plan values. Retrospective re-evaluation of the actual implant data reduced the RMS deviation to 2.36%.

A multilevel probabilistic beam search algorithm for the shortest common supersequence problem.

PubMed

Gallardo, José E

2012-01-01

The shortest common supersequence problem is a classical problem with many applications in different fields such as planning, Artificial Intelligence and especially in Bioinformatics. Due to its NP-hardness, we can not expect to efficiently solve this problem using conventional exact techniques. This paper presents a heuristic to tackle this problem based on the use at different levels of a probabilistic variant of a classical heuristic known as Beam Search. The proposed algorithm is empirically analysed and compared to current approaches in the literature. Experiments show that it provides better quality solutions in a reasonable time for medium and large instances of the problem. For very large instances, our heuristic also provides better solutions, but required execution times may increase considerably.

The interventional radiology business plan.

PubMed

Beheshti, Michael V; Meek, Mary E; Kaufman, John A

2012-09-01

Strategic planning and business planning are processes commonly employed by organizations that exist in competitive environments. Although it is difficult to prove a causal relationship between formal strategic/business planning and positive organizational performance, there is broad agreement that formal strategic and business plans are components of successful organizations. The various elements of strategic plans and business plans are not common in the vernacular of practicing physicians. As health care becomes more competitive, familiarity with these tools may grow in importance. Herein we provide an overview of formal strategic and business planning, and offer a roadmap for an interventional radiology-specific plan that may be useful for organizations confronting competitive and financial threats. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

Emerging roles for biomedical librarians: a survey of current practice, challenges, and changes

PubMed Central

Crum, Janet A.; Cooper, I. Diane

2013-01-01

Objective: This study is intended to (1) identify emerging roles for biomedical librarians and determine how common these roles are in a variety of library settings, (2) identify barriers to taking on new roles, and (3) determine how librarians are developing the capacity to take on new roles. Methods: A survey was conducted of librarians in biomedical settings. Results: Most biomedical librarians are taking on new roles. The most common roles selected by survey respondents include analysis and enhancement of user experiences, support for social media, support for systematic reviews, clinical informationist, help for faculty or staff with authorship issues, and implementation of researcher profiling and collaboration tools. Respondents in academic settings are more likely to report new roles than hospital librarians are, but some new roles are common in both settings. Respondents use a variety of methods to free up time for new roles, but predominant methods vary between directors and librarians and between academic and hospital respondents. Lack of time is the biggest barrier that librarians face when trying to adopt new roles. New roles are associated with increased collaboration with individuals and/or groups outside the library. Conclusion and Implications: This survey documents the widespread incorporation of new roles in biomedical libraries in the United States, as well as the barriers to adopting these roles and the means by which librarians are making time for them. The results of the survey can be used to inform strategic planning, succession planning, library education, and career development for biomedical librarians. PMID:24163599

Common Core Literacy Lesson Plans: Ready-to-Use Resources, 9-12

ERIC Educational Resources Information Center

Davis, Lauren

2013-01-01

Schools nationwide are transitioning to the Common Core--our advice to you: Be prepared, but don't go it alone! Our new book, "Common Core Literacy Lesson Plans: Ready-to-Use Resources, 9-12," shows you that teaching the Common Core State Standards in high school doesn't have to be intimidating! This easy-to-use guide meets the particular needs of…

Common Core Literacy Lesson Plans: Ready-to-Use Resources, 6-8

ERIC Educational Resources Information Center

Davis, Lauren

2013-01-01

Schools nationwide are transitioning to the Common Core--our advice to you: Don't go it alone! Our new book, "Common Core Literacy Lesson Plans: Ready-to-Use Resources, 6-8," shows you that teaching the Common Core State Standards in the middle grades doesn't have to be intimidating! This easy-to-use guide meets the particular needs of middle…

Enhancement on infectious diseases nursing plan information system.

PubMed

Yeh, Mei-Lin; Hao, Te-Hui; Hsu, Chien-Yeh

2009-01-01

Based on researches, the most time-consuming nursing activities, in teaching hospital, are: room patrols, the blood pressure survey, the body temperature pulse breath survey, the nursing record maintenance. The nursing record is one way to communicate data. It can allow the medical service team to understand what measures the nursing staff once did for sickness, as well as responses from sickness. Nevertheless, it is the key component to utilize the record with a clinical nursing plan, so as to provide a proficient health management. Since the maintenance of nursing plan is costly and time-consuming, therefore, it is essential to establish the nursing plan information system, which can effectively promote the nursing quality. This research main body comes from one infectious disease division nursing plan information system, which was developed in 1992, and its data base covers entire courtyard compatibility and various faculties characteristic nursing plan. The nursing staff often complained that this system is not user-friendly, its contents are not comprehensive, and sometimes it does not let staff choose the right diagnosis. Therefore this research is based on history analysis and the questionnaire survey procedure first, the infectious disease nursing plan use number of times, the frequency and the project content, then by the literature scientific theory and result of the improvement group discussion together. The original 38 infectious disease division nursing plan will be expanded to 45 nursing plans. Moreover, the common 38 infectious disease code (ICD-9), and its corresponding diagnosis items, shall automatically appear in the disease diagnose code field, so it would be better off for the nursing staff to set up the nursing plan efficiently. Infectious disease division nursing plan information system utilization ratio is promoted 9.6-folds, according to research outcome. Each task consumes 3.68 minutes beforehand-including computer program operation, the printing of nursing plan, and now it turned out that it shall not take more than 3.08 minutes. The time efficiency is raised by 17% (0.6 minute). Yet only 17% of the users are satisfied with it before, and now 74% nursing staffs are happy with the new tool.Therefore, it shall not only improve our service quality, but also save labor cost by using this information supplementary system.

Training for planning tumour resection: augmented reality and human factors.

PubMed

Abhari, Kamyar; Baxter, John S H; Chen, Elvis C S; Khan, Ali R; Peters, Terry M; de Ribaupierre, Sandrine; Eagleson, Roy

2015-06-01

Planning surgical interventions is a complex task, demanding a high degree of perceptual, cognitive, and sensorimotor skills to reduce intra- and post-operative complications. This process requires spatial reasoning to coordinate between the preoperatively acquired medical images and patient reference frames. In the case of neurosurgical interventions, traditional approaches to planning tend to focus on providing a means for visualizing medical images, but rarely support transformation between different spatial reference frames. Thus, surgeons often rely on their previous experience and intuition as their sole guide is to perform mental transformation. In case of junior residents, this may lead to longer operation times or increased chance of error under additional cognitive demands. In this paper, we introduce a mixed augmented-/virtual-reality system to facilitate training for planning a common neurosurgical procedure, brain tumour resection. The proposed system is designed and evaluated with human factors explicitly in mind, alleviating the difficulty of mental transformation. Our results indicate that, compared to conventional planning environments, the proposed system greatly improves the nonclinicians' performance, independent of the sensorimotor tasks performed ( ). Furthermore, the use of the proposed system by clinicians resulted in a significant reduction in time to perform clinically relevant tasks ( ). These results demonstrate the role of mixed-reality systems in assisting residents to develop necessary spatial reasoning skills needed for planning brain tumour resection, improving patient outcomes.

Strategic planning for the International Space Station

NASA Technical Reports Server (NTRS)

Griner, Carolyn S.

1990-01-01

The concept for utilization and operations planning for the International Space Station Freedom was developed in a NASA Space Station Operations Task Force in 1986. Since that time the concept has been further refined to definitize the process and products required to integrate the needs of the international user community with the operational capabilities of the Station in its evolving configuration. The keystone to the process is the development of individual plans by the partners, with the parameters and formats common to the degree that electronic communications techniques can be effectively utilized, while maintaining the proper level and location of configuration control. The integration, evaluation, and verification of the integrated plan, called the Consolidated Operations and Utilization Plan (COUP), is being tested in a multilateral environment to prove out the parameters, interfaces, and process details necessary to produce the first COUP for Space Station in 1991. This paper will describe the concept, process, and the status of the multilateral test case.

Comparison of optimization algorithms in intensity-modulated radiation therapy planning

NASA Astrophysics Data System (ADS)

Kendrick, Rachel

Intensity-modulated radiation therapy is used to better conform the radiation dose to the target, which includes avoiding healthy tissue. Planning programs employ optimization methods to search for the best fluence of each photon beam, and therefore to create the best treatment plan. The Computational Environment for Radiotherapy Research (CERR), a program written in MATLAB, was used to examine some commonly-used algorithms for one 5-beam plan. Algorithms include the genetic algorithm, quadratic programming, pattern search, constrained nonlinear optimization, simulated annealing, the optimization method used in Varian EclipseTM, and some hybrids of these. Quadratic programing, simulated annealing, and a quadratic/simulated annealing hybrid were also separately compared using different prescription doses. The results of each dose-volume histogram as well as the visual dose color wash were used to compare the plans. CERR's built-in quadratic programming provided the best overall plan, but avoidance of the organ-at-risk was rivaled by other programs. Hybrids of quadratic programming with some of these algorithms seems to suggest the possibility of better planning programs, as shown by the improved quadratic/simulated annealing plan when compared to the simulated annealing algorithm alone. Further experimentation will be done to improve cost functions and computational time.

WE-DE-201-04: Cross Validation of Knowledge-Based Treatment Planning for Prostate LDR Brachytherapy Using Principle Component Analysis

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

Roper, J; Ghavidel, B; Godette, K

Purpose: To validate a knowledge-based algorithm for prostate LDR brachytherapy treatment planning. Methods: A dataset of 100 cases was compiled from an active prostate seed implant service. Cases were randomized into 10 subsets. For each subset, the 90 remaining library cases were registered to a common reference frame and then characterized on a point by point basis using principle component analysis (PCA). Each test case was converted to PCA vectors using the same process and compared with each library case using a Mahalanobis distance to evaluate similarity. Rank order PCA scores were used to select the best-matched library case. Themore » seed arrangement was extracted from the best-matched case and used as a starting point for planning the test case. Any subsequent modifications were recorded that required input from a treatment planner to achieve V100>95%, V150<60%, V200<20%. To simulate operating-room planning constraints, seed activity was held constant, and the seed count could not increase. Results: The computational time required to register test-case contours and evaluate PCA similarity across the library was 10s. Preliminary analysis of 2 subsets shows that 9 of 20 test cases did not require any seed modifications to obtain an acceptable plan. Five test cases required fewer than 10 seed modifications or a grid shift. Another 5 test cases required approximately 20 seed modifications. An acceptable plan was not achieved for 1 outlier, which was substantially larger than its best match. Modifications took between 5s and 6min. Conclusion: A knowledge-based treatment planning algorithm for prostate LDR brachytherapy is being cross validated using 100 prior cases. Preliminary results suggest that for this size library, acceptable plans can be achieved without planner input in about half of the cases while varying amounts of planner input are needed in remaining cases. Computational time and planning time are compatible with clinical practice.« less

Task-level control for autonomous robots

NASA Technical Reports Server (NTRS)

Simmons, Reid

1994-01-01

Task-level control refers to the integration and coordination of planning, perception, and real-time control to achieve given high-level goals. Autonomous mobile robots need task-level control to effectively achieve complex tasks in uncertain, dynamic environments. This paper describes the Task Control Architecture (TCA), an implemented system that provides commonly needed constructs for task-level control. Facilities provided by TCA include distributed communication, task decomposition and sequencing, resource management, monitoring and exception handling. TCA supports a design methodology in which robot systems are developed incrementally, starting first with deliberative plans that work in nominal situations, and then layering them with reactive behaviors that monitor plan execution and handle exceptions. To further support this approach, design and analysis tools are under development to provide ways of graphically viewing the system and validating its behavior.

Space station common module power system network topology and hardware development

NASA Technical Reports Server (NTRS)

Landis, D. M.

1985-01-01

Candidate power system newtork topologies for the space station common module are defined and developed and the necessary hardware for test and evaluation is provided. Martin Marietta's approach to performing the proposed program is presented. Performance of the tasks described will assure systematic development and evaluation of program results, and will provide the necessary management tools, visibility, and control techniques for performance assessment. The plan is submitted in accordance with the data requirements given and includes a comprehensive task logic flow diagram, time phased manpower requirements, a program milestone schedule, and detailed descriptions of each program task.

Computer-aided position planning of miniplates to treat facial bone defects

PubMed Central

Wallner, Jürgen; Gall, Markus; Chen, Xiaojun; Schwenzer-Zimmerer, Katja; Reinbacher, Knut; Schmalstieg, Dieter

2017-01-01

In this contribution, a software system for computer-aided position planning of miniplates to treat facial bone defects is proposed. The intra-operatively used bone plates have to be passively adapted on the underlying bone contours for adequate bone fragment stabilization. However, this procedure can lead to frequent intra-operatively performed material readjustments especially in complex surgical cases. Our approach is able to fit a selection of common implant models on the surgeon’s desired position in a 3D computer model. This happens with respect to the surrounding anatomical structures, always including the possibility of adjusting both the direction and the position of the used osteosynthesis material. By using the proposed software, surgeons are able to pre-plan the out coming implant in its form and morphology with the aid of a computer-visualized model within a few minutes. Further, the resulting model can be stored in STL file format, the commonly used format for 3D printing. Using this technology, surgeons are able to print the virtual generated implant, or create an individually designed bending tool. This method leads to adapted osteosynthesis materials according to the surrounding anatomy and requires further a minimum amount of money and time. PMID:28817607

Computer-aided position planning of miniplates to treat facial bone defects.

PubMed

Egger, Jan; Wallner, Jürgen; Gall, Markus; Chen, Xiaojun; Schwenzer-Zimmerer, Katja; Reinbacher, Knut; Schmalstieg, Dieter

2017-01-01

In this contribution, a software system for computer-aided position planning of miniplates to treat facial bone defects is proposed. The intra-operatively used bone plates have to be passively adapted on the underlying bone contours for adequate bone fragment stabilization. However, this procedure can lead to frequent intra-operatively performed material readjustments especially in complex surgical cases. Our approach is able to fit a selection of common implant models on the surgeon's desired position in a 3D computer model. This happens with respect to the surrounding anatomical structures, always including the possibility of adjusting both the direction and the position of the used osteosynthesis material. By using the proposed software, surgeons are able to pre-plan the out coming implant in its form and morphology with the aid of a computer-visualized model within a few minutes. Further, the resulting model can be stored in STL file format, the commonly used format for 3D printing. Using this technology, surgeons are able to print the virtual generated implant, or create an individually designed bending tool. This method leads to adapted osteosynthesis materials according to the surrounding anatomy and requires further a minimum amount of money and time.

78 FR 34928 - Revisions to Framework Adjustment 50 to the Northeast Multispecies Fishery Management Plan and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

... Management Plan and Sector Annual Catch Entitlements; Updated Annual Catch Limits for Sectors and the Common... either sectors or the common pool fishery. DATES: Effective June 10, 2013, through April 30, 2014. FOR... to vessels not enrolled in a sector (referred to as the common pool). This allocation is also...

Planning Resource Guide.

ERIC Educational Resources Information Center

RP Group of California Community Colleges, Santa Ana.

The Planning Resource Guide by the RP Group of California Community Colleges was created to provide practical planning assistance. It contains four sections, including: (1) a basic conceptual framework for planning; (2) common planning definitions for colleges; (3) planning steps and samples of planning structures; and (4) suggestions for linking…

Effects of ship traffic on seabirds in offshore waters: implications for marine conservation and spatial planning.

PubMed

Schwemmer, Philipp; Mendel, Bettina; Sonntag, Nicole; Dierschke, Volker; Garthe, Stefan

2011-07-01

Most anthropogenic influences on marine ecosystems, except for river- or terrestrial-borne pollution, involve some sort of vessel activity. Increasing anthropogenic activities mean that many countries are being forced to develop spatial planning schemes, while at the same time implementing conservation sites for sensitive species at sea. The effects of ship traffic on seabirds sensitive to human disturbance are currently too poorly understood to allow for the development of proper planning and conservation guidelines. We therefore used aerial surveys and experimental disturbance to elucidate the effects of passing ships on the distribution patterns, habitat loss, and species-specific flight reactions of birds, as well as the potential for habituation. Loons (Gavia spp.) showed clear avoidance of areas with high shipping intensity. Flush distances of four sea duck species differed significantly, with the longest distances recorded for Common Scoters (Melanitta nigra) and the shortest for Common Eiders (Somateria mollissima). Flush distance was positively related to flock size. Among all the sea duck species studied, the duration of temporary habitat loss was longest for Common Scoters. We found indications of habituation in sea ducks within areas of channeled traffic. However, it is questionable if habituation to free-ranging ships is likely to occur, because of their unpredictable nature. We therefore recommend that spatial planning should aim to channel ship traffic wherever possible to avoid further habitat fragmentation and to allow for habituation, at least in some species. Information on the effects of shipping on other seabird species and during different periods of the year is urgently needed, together with information on the effects of different types of boats, including recreational and fishing vessels.

Implementation of a dose gradient method into optimization of dose distribution in prostate cancer 3D-CRT plans

PubMed Central

Giżyńska, Marta K.; Kukołowicz, Paweł F.; Kordowski, Paweł

2014-01-01

Aim The aim of this work is to present a method of beam weight and wedge angle optimization for patients with prostate cancer. Background 3D-CRT is usually realized with forward planning based on a trial and error method. Several authors have published a few methods of beam weight optimization applicable to the 3D-CRT. Still, none on these methods is in common use. Materials and methods Optimization is based on the assumption that the best plan is achieved if dose gradient at ICRU point is equal to zero. Our optimization algorithm requires beam quality index, depth of maximum dose, profiles of wedged fields and maximum dose to femoral heads. The method was tested for 10 patients with prostate cancer, treated with the 3-field technique. Optimized plans were compared with plans prepared by 12 experienced planners. Dose standard deviation in target volume, and minimum and maximum doses were analyzed. Results The quality of plans obtained with the proposed optimization algorithms was comparable to that prepared by experienced planners. Mean difference in target dose standard deviation was 0.1% in favor of the plans prepared by planners for optimization of beam weights and wedge angles. Introducing a correction factor for patient body outline for dose gradient at ICRU point improved dose distribution homogeneity. On average, a 0.1% lower standard deviation was achieved with the optimization algorithm. No significant difference in mean dose–volume histogram for the rectum was observed. Conclusions Optimization shortens very much time planning. The average planning time was 5 min and less than a minute for forward and computer optimization, respectively. PMID:25337411

Optimal harvesting of fish stocks under a time-varying discount rate.

PubMed

Duncan, Stephen; Hepburn, Cameron; Papachristodoulou, Antonis

2011-01-21

Optimal control theory has been extensively used to determine the optimal harvesting policy for renewable resources such as fish stocks. In such optimisations, it is common to maximise the discounted utility of harvesting over time, employing a constant time discount rate. However, evidence from human and animal behaviour suggests that we have evolved to employ discount rates which fall over time, often referred to as "hyperbolic discounting". This increases the weight on benefits in the distant future, which may appear to provide greater protection of resources for future generations, but also creates challenges of time-inconsistent plans. This paper examines harvesting plans when the discount rate declines over time. With a declining discount rate, the planner reduces stock levels in the early stages (when the discount rate is high) and intends to compensate by allowing the stock level to recover later (when the discount rate will be lower). Such a plan may be feasible and optimal, provided that the planner remains committed throughout. However, in practice there is a danger that such plans will be re-optimized and adjusted in the future. It is shown that repeatedly restarting the optimization can drive the stock level down to the point where the optimal policy is to harvest the stock to extinction. In short, a key contribution of this paper is to identify the surprising severity of the consequences flowing from incorporating a rather trivial, and widely prevalent, "non-rational" aspect of human behaviour into renewable resource management models. These ideas are related to the collapse of the Peruvian anchovy fishery in the 1970's. Copyright © 2010 Elsevier Ltd. All rights reserved.

A comparison between anisotropic analytical and multigrid superposition dose calculation algorithms in radiotherapy treatment planning

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

Wu, Vincent W.C., E-mail: htvinwu@polyu.edu.hk; Tse, Teddy K.H.; Ho, Cola L.M.

2013-07-01

Monte Carlo (MC) simulation is currently the most accurate dose calculation algorithm in radiotherapy planning but requires relatively long processing time. Faster model-based algorithms such as the anisotropic analytical algorithm (AAA) by the Eclipse treatment planning system and multigrid superposition (MGS) by the XiO treatment planning system are 2 commonly used algorithms. This study compared AAA and MGS against MC, as the gold standard, on brain, nasopharynx, lung, and prostate cancer patients. Computed tomography of 6 patients of each cancer type was used. The same hypothetical treatment plan using the same machine and treatment prescription was computed for each casemore » by each planning system using their respective dose calculation algorithm. The doses at reference points including (1) soft tissues only, (2) bones only, (3) air cavities only, (4) soft tissue-bone boundary (Soft/Bone), (5) soft tissue-air boundary (Soft/Air), and (6) bone-air boundary (Bone/Air), were measured and compared using the mean absolute percentage error (MAPE), which was a function of the percentage dose deviations from MC. Besides, the computation time of each treatment plan was recorded and compared. The MAPEs of MGS were significantly lower than AAA in all types of cancers (p<0.001). With regards to body density combinations, the MAPE of AAA ranged from 1.8% (soft tissue) to 4.9% (Bone/Air), whereas that of MGS from 1.6% (air cavities) to 2.9% (Soft/Bone). The MAPEs of MGS (2.6%±2.1) were significantly lower than that of AAA (3.7%±2.5) in all tissue density combinations (p<0.001). The mean computation time of AAA for all treatment plans was significantly lower than that of the MGS (p<0.001). Both AAA and MGS algorithms demonstrated dose deviations of less than 4.0% in most clinical cases and their performance was better in homogeneous tissues than at tissue boundaries. In general, MGS demonstrated relatively smaller dose deviations than AAA but required longer computation time.« less

Spot Scanning Proton Therapy for Malignancies of the Base of Skull: Treatment Planning, Acute Toxicities, and Preliminary Clinical Outcomes

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

Grosshans, David R., E-mail: dgrossha@mdanderson.org; Zhu, X. Ronald; Melancon, Adam

2014-11-01

Purpose: To describe treatment planning techniques and early clinical outcomes in patients treated with spot scanning proton therapy for chordoma or chondrosarcoma of the skull base. Methods and Materials: From June 2010 through August 2011, 15 patients were treated with spot scanning proton therapy for chordoma (n=10) or chondrosarcoma (n=5) at a single institution. Toxicity was prospectively evaluated and scored weekly and at all follow-up visits according to Common Terminology Criteria for Adverse Events, version 3.0. Treatment planning techniques and dosimetric data were recorded and compared with those of passive scattering plans created with clinically applicable dose constraints. Results: Tenmore » patients were treated with single-field-optimized scanning beam plans and 5 with multifield-optimized intensity modulated proton therapy. All but 2 patients received a simultaneous integrated boost as well. The mean prescribed radiation doses were 69.8 Gy (relative biological effectiveness [RBE]; range, 68-70 Gy [RBE]) for chordoma and 68.4 Gy (RBE) (range, 66-70) for chondrosarcoma. In comparison with passive scattering plans, spot scanning plans demonstrated improved high-dose conformality and sparing of temporal lobes and brainstem. Clinically, the most common acute toxicities included fatigue (grade 2 for 2 patients, grade 1 for 8 patients) and nausea (grade 2 for 2 patients, grade 1 for 6 patients). No toxicities of grades 3 to 5 were recorded. At a median follow-up time of 27 months (range, 13-42 months), 1 patient had experienced local recurrence and a second developed distant metastatic disease. Two patients had magnetic resonance imaging-documented temporal lobe changes, and a third patient developed facial numbness. No other subacute or late effects were recorded. Conclusions: In comparison to passive scattering, treatment plans for spot scanning proton therapy displayed improved high-dose conformality. Clinically, the treatment was well tolerated, and with short-term follow-up, disease control rates and toxicity profiles were favorable.« less

Principles of Strategic Communication for a New Global Commons

DTIC Science & Technology

2008-06-06

to help realize these ends and objectives, however, requires the USG to inculcate these principles into their strategies and plans (ends), resource...principles into their strategies and plans (ends), adequately resource the needed capabilities (ways), and use their methods (means) that can best achieve...Communication Commons and National Security Planning Process 75 Chart 5 Attention-Action Cycle 76 Chart 6 Continuum of Expectation

77 FR 37816 - Revisions to Framework Adjustment 47 to the Northeast Multispecies Fishery Management Plan and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

... Management Plan and Sector Annual Catch Entitlements; Updated Annual Catch Limits for Sectors and the Common... either sectors or the common pool fishery. DATES: Effective June 22, 2012, through April 30, 2013. FOR... for GOM cod on May 1, 2012 (77 FR 25623), consistent with the Council's request. The common pool and...

A multi-disciplinary approach to the removal of emerging contaminants in municipal wastewater treatment plans in New York State, 2003-2004

USGS Publications Warehouse

Philips, Patrick J.; Stinson, Beverley; Zaugg, Steven D.; Furlong, Edward T.; Kolpin, Dana W.; Esposito, Kathleen; Bodniewicz, B.; Pape, R.; Anderson, J.

2005-01-01

The second phase of the study focused on one of the most common wastewater treatment processes operated in the United States, the Activated Sludge process. Using four controlled parallel activated sludge pilots, a more detailed assessment of the impact of Sludge Retention Time (SRT) on the reduction or removal of ECs was performed.

Exploring the role of wood waste landfills in early detection of non-native alien wood-boring beetles

Treesearch

Davide Rassati; Massimo Faccoli; Lorenzo Marini; Robert A. Haack; Andrea Battisti; Edoardo Petrucco Toffolo

2015-01-01

Non-native wood-boring beetles (Coleoptera) represent one of the most commonly intercepted groups of insects at ports worldwide. The development of early detection methods is a crucial step when implementing rapid response programs so that non-native wood-boring beetles can be quickly detected and a timely action plan can be produced. However, due to the limited...

Tactical Unit Data and Decision Requirements for Urban Operations

DTIC Science & Technology

2008-10-01

maneuverability, sensor optimization, weapon effects, terrain), and develop rich but lightweight information structures and architecture . Specifically, the goal...tion structure and systemic architecture that enable sharing common data in near real-time, and mission planning and analysis software for U-BE...Building Function Verify mosque and identify possi- ble schools or meeting places Identify types of cinema (stage/theatre) or other similar nearby

Calculating five types of typical underpayments.

PubMed

Welter, T; Stevenson, P

2001-10-01

Underpayments to providers under their payer agreements are a cause of many thousands of dollars in lost revenue. Providers should devise a plan to make certain that payments made to them are accurate, on time, and adhere to other contractual obligations. The importance of developing and implementing such a plan is substantiated by the fact that nearly 100 percent of a provider's commercial business is under contract. As a starting point, providers may wish to focus on five common types of underpayments: underfunding due to late payments; fee-schedule changes that are contractually disallowed; miscalculation of performance-based bonuses and errors in risk-payment reconciliations; inappropriate denials or inappropriate downcoding of claims; and non-payments. The successful execution of a plan to identify and resolve problems and recover payments owed relies on the provider's ability to document and prove that payment is due.

Adult learning theories: implications for learning and teaching in medical education: AMEE Guide No. 83.

PubMed

Taylor, David C M; Hamdy, Hossam

2013-11-01

There are many theories that explain how adults learn and each has its own merits. This Guide explains and explores the more commonly used ones and how they can be used to enhance student and faculty learning. The Guide presents a model that combines many of the theories into a flow diagram which can be followed by anyone planning learning. The schema can be used at curriculum planning level, or at the level of individual learning. At each stage of the model, the Guide identifies the responsibilities of both learner and educator. The role of the institution is to ensure that the time and resources are available to allow effective learning to happen. The Guide is designed for those new to education, in the hope that it can unravel the difficulties in understanding and applying the common learning theories, whilst also creating opportunities for debate as to the best way they should be used.

Advanced space system concepts and their orbital support needs (1980 - 2000). Volume 4: Detailed data. Part 2: Program plans and common support needs (a study of the commonality of space vehicle applications to future national needs

NASA Technical Reports Server (NTRS)

Bekey, I.; Mayer, H. L.; Wolfe, M. G.

1976-01-01

The methodology of alternate world future scenarios is utilized for selecting a plausible, though not advocated, set of future scenarios each of which results in a program plan appropriate for the respective environment. Each such program plan gives rise to different building block and technology requirements, which are analyzed for common need between the NASA and the DoD for each of the alternate world scenarios. An essentially invariant set of system, building block, and technology development plans is presented at the conclusion, intended to allow protection of most of the options for system concepts regardless of what the actual future world environment turns out to be. Thus, building block and technology needs are derived which support: (1) each specific world scenario; (2) all the world scenarios identified in this study; or (3) generalized scenarios applicable to almost any future environment. The output included in this volume consists of the building blocks, i.e.: transportation vehicles, orbital support vehicles, and orbital support facilities; the technology required to support the program plans; identification of their features which could support the DoD and NASA in common; and a complete discussion of the planning methodology.

The association between education and induced abortion for three cohorts of adults in Finland

PubMed Central

Väisänen, Heini

2015-01-01

This paper explores whether the likelihood of abortion by education changed over time in Finland, where comprehensive family planning services and sexuality education have been available since the early 1970s. This subject has not previously been studied longitudinally with comprehensive and reliable data. A unique longitudinal set of register data of more than 250,000 women aged 20–49 born in 1955–59, 1965–69, and 1975–79 was analysed, using descriptive statistics, concentration curves, and discrete-time event-history models. Women with basic education had a higher likelihood of abortion than others and the association grew stronger for later cohorts. Selection into education may explain this phenomenon: although it was fairly common to have only basic education in the 1955–59 cohort, it became increasingly unusual over time. Thus, even though family planning services were easily available, socio-economic differences in the likelihood of abortion remained. PMID:26449684

Use of Models in Urban Transportation Planning

DOT National Transportation Integrated Search

1973-04-01

The report describes the most commonly used models in urban transportation planning. A background on urban transportation planning is given including changes in planning objectives and the effects of Federal legislation. General concepts and problems...

Can we improve patient safety?

PubMed

Corbally, Martin Thomas

2014-01-01

Despite greater awareness of patient safety issues especially in the operating room and the widespread implementation of surgical time out World Health Organization (WHO), errors, especially wrong site surgery, continue. Most such errors are due to lapses in communication where decision makers fail to consult or confirm operative findings but worryingly where parental concerns over the planned procedure are ignored or not followed through. The WHO Surgical Pause/Time Out aims to capture these errors and prevent them, but the combination of human error and complex hospital environments can overwhelm even robust safety structures and simple common sense. Parents are the ultimate repository of information on their child's condition and planned surgery but are traditionally excluded from the process of Surgical Pause and Time Out, perhaps to avoid additional stress. In addition, surgeons, like pilots, are subject to the phenomenon of "plan-continue-fail" with potentially disastrous outcomes. If we wish to improve patient safety during surgery and avoid wrong site errors then we must include parents in the Surgical Pause/Time Out. A recent pilot study has shown that neither staff nor parents found it added to their stress, but, moreover, 100% of parents considered that it should be a mandatory component of the Surgical Pause nor does it add to the stress of surgery. Surgeons should be required to confirm that the planned procedure is in keeping with the operative findings especially in extirpative surgery and this "step back" should be incorporated into the standard Surgical Pause. It is clear that we must improve patient safety further and these simple measures should add to that potential.

Self-guided training for deep brain stimulation planning using objective assessment.

PubMed

Holden, Matthew S; Zhao, Yulong; Haegelen, Claire; Essert, Caroline; Fernandez-Vidal, Sara; Bardinet, Eric; Ungi, Tamas; Fichtinger, Gabor; Jannin, Pierre

2018-04-04

Deep brain stimulation (DBS) is an increasingly common treatment for neurodegenerative diseases. Neurosurgeons must have thorough procedural, anatomical, and functional knowledge to plan electrode trajectories and thus ensure treatment efficacy and patient safety. Developing this knowledge requires extensive training. We propose a training approach with objective assessment of neurosurgeon proficiency in DBS planning. To assess proficiency, we propose analyzing both the viability of the planned trajectory and the manner in which the operator arrived at the trajectory. To improve understanding, we suggest a self-guided training course for DBS planning using real-time feedback. To validate the proposed measures of proficiency and training course, two experts and six novices followed the training course, and we monitored their proficiency measures throughout. At baseline, experts planned higher quality trajectories and did so more efficiently. As novices progressed through the training course, their proficiency measures increased significantly, trending toward expert measures. We developed and validated measures which reliably discriminate proficiency levels. These measures are integrated into a training course, which quantitatively improves trainee performance. The proposed training course can be used to improve trainees' proficiency, and the quantitative measures allow trainees' progress to be monitored.

A common control signal and a ballistic stage can explain the control of coordinated eye-hand movements.

PubMed

Gopal, Atul; Murthy, Aditya

2016-06-01

Voluntary control has been extensively studied in the context of eye and hand movements made in isolation, yet little is known about the nature of control during eye-hand coordination. We probed this with a redirect task. Here subjects had to make reaching/pointing movements accompanied by coordinated eye movements but had to change their plans when the target occasionally changed its position during some trials. Using a race model framework, we found that separate effector-specific mechanisms may be recruited to control eye and hand movements when executed in isolation but when the same effectors are coordinated a unitary mechanism to control coordinated eye-hand movements is employed. Specifically, we found that performance curves were distinct for the eye and hand when these movements were executed in isolation but were comparable when they were executed together. Second, the time to switch motor plans, called the target step reaction time, was different in the eye-alone and hand-alone conditions but was similar in the coordinated condition under assumption of a ballistic stage of ∼40 ms, on average. Interestingly, the existence of this ballistic stage could predict the extent of eye-hand dissociations seen in individual subjects. Finally, when subjects were explicitly instructed to control specifically a single effector (eye or hand), redirecting one effector had a strong effect on the performance of the other effector. Taken together, these results suggest that a common control signal and a ballistic stage are recruited when coordinated eye-hand movement plans require alteration. Copyright © 2016 the American Physiological Society.

A common control signal and a ballistic stage can explain the control of coordinated eye-hand movements

PubMed Central

Gopal, Atul

2016-01-01

Voluntary control has been extensively studied in the context of eye and hand movements made in isolation, yet little is known about the nature of control during eye-hand coordination. We probed this with a redirect task. Here subjects had to make reaching/pointing movements accompanied by coordinated eye movements but had to change their plans when the target occasionally changed its position during some trials. Using a race model framework, we found that separate effector-specific mechanisms may be recruited to control eye and hand movements when executed in isolation but when the same effectors are coordinated a unitary mechanism to control coordinated eye-hand movements is employed. Specifically, we found that performance curves were distinct for the eye and hand when these movements were executed in isolation but were comparable when they were executed together. Second, the time to switch motor plans, called the target step reaction time, was different in the eye-alone and hand-alone conditions but was similar in the coordinated condition under assumption of a ballistic stage of ∼40 ms, on average. Interestingly, the existence of this ballistic stage could predict the extent of eye-hand dissociations seen in individual subjects. Finally, when subjects were explicitly instructed to control specifically a single effector (eye or hand), redirecting one effector had a strong effect on the performance of the other effector. Taken together, these results suggest that a common control signal and a ballistic stage are recruited when coordinated eye-hand movement plans require alteration. PMID:26888104

JPL space robotics: Present accomplishments and future thrusts

NASA Astrophysics Data System (ADS)

Weisbin, C. R.; Hayati, S. A.; Rodriguez, G.

1994-10-01

Complex missions require routine and unscheduled inspection for safe operation. The purpose of research in this task is to facilitate structural inspection of the planned Space Station while mitigating the need for extravehicular activity (EVA), and giving the operator supervisory control over detailed and somewhat mundane, but important tasks. The telerobotic system enables inspection relative to a given reference (e.g., the status of the facility at the time of the last inspection) and alerts the operator to potential anomalies for verification and action. There are two primary objectives of this project: (1) To develop technologies that enable well-integrated NASA ground-to-orbit telerobotics operations, and (2) to develop a prototype common architecture workstation which implements these capabilities for other NASA technology projects and planned NASA flight applications. This task develops and supports three telerobot control modes which are applicable to time delay operation: Preview teleoperation, teleprogramming, and supervised autonomy.

JPL space robotics: Present accomplishments and future thrusts

NASA Technical Reports Server (NTRS)

Weisbin, C. R.; Hayati, S. A.; Rodriguez, G.

1994-01-01

Complex missions require routine and unscheduled inspection for safe operation. The purpose of research in this task is to facilitate structural inspection of the planned Space Station while mitigating the need for extravehicular activity (EVA), and giving the operator supervisory control over detailed and somewhat mundane, but important tasks. The telerobotic system enables inspection relative to a given reference (e.g., the status of the facility at the time of the last inspection) and alerts the operator to potential anomalies for verification and action. There are two primary objectives of this project: (1) To develop technologies that enable well-integrated NASA ground-to-orbit telerobotics operations, and (2) to develop a prototype common architecture workstation which implements these capabilities for other NASA technology projects and planned NASA flight applications. This task develops and supports three telerobot control modes which are applicable to time delay operation: Preview teleoperation, teleprogramming, and supervised autonomy.

The Best Laid Plans: An Examination of School Plan Quality and Implementation in a School Improvement Initiative

ERIC Educational Resources Information Center

Strunk, Katharine O.; Marsh, Julie A.; Bush-Mecenas, Susan C.; Duque, Matthew R.

2016-01-01

Purpose: A common strategy used in school improvement efforts is a mandated process of formal planning, yet little is known about the quality of plans or the relationship between plan quality and implementation. This mixed-methods article investigates plan quality, factors associated with plan quality, and the relationship between plan quality and…

Environmental control and life support system requirements and technology needs for advanced manned space missions

NASA Technical Reports Server (NTRS)

Powell, Ferolyn T.; Sedej, Melaine; Lin, Chin

1987-01-01

NASA has completed an environmental control and life support system (ECLSS) technology R&D plan for advanced missions which gave attention to the drivers (crew size, mission duration, etc.) of a range of manned missions under consideration. Key planning guidelines encompassed a time horizon greater than 50 years, funding resource requirements, an evolutionary approach to goal definition, and the funding of more than one approach to satisfy a given perceived requirement. Attention was given to the ECLSS requirements of transportation and service vehicles, platforms, bases and settlements, ECLSS functions and average load requirements, unique drivers for various missions, and potentially exploitable commonalities among vehicles and habitats.

Robust Computer-Assisted Laser Treatment Using Real-Time Retinal Tracking

DTIC Science & Technology

2001-10-25

Abstract- We propose a new computerized system to accurately guide laser shots to the diseased areas within the retina based on predetermined...image registration I. INTRODUCTION Diabetic retinopathy resulting from long term diabetes mellitus is one of the common diseases that lead to choroidal...have a strong impact on the effectiveness of such procedures. In this work, we propose a new computerized treatment planning system for laser treatment

Adaptability in Crisis Management: The Role of Organizational Structure

DTIC Science & Technology

2013-06-01

individuals to make optimal decisions under constraints of high risk, uncertainty, high workload, and time pressure (see, e.g., Brehmer, 2007 ). There is...et al., 2003; Hallam & Stammers , 1981). For instance, Hallam and Stammers (1981) showed that the impact of variations in task complexity on team...each team member. FIRESCOPE, a commonly used crisis intervention plan developed in California (Office of Emergency Services, 2007 ) is a good

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

Covington, E; Younge, K; Chen, X

Purpose: To evaluate the effectiveness of an automated plan check tool to improve first-time plan quality as well as standardize and document performance of physics plan checks. Methods: The Plan Checker Tool (PCT) uses the Eclipse Scripting API to check and compare data from the treatment planning system (TPS) and treatment management system (TMS). PCT was created to improve first-time plan quality, reduce patient delays, increase efficiency of our electronic workflow, and to standardize and partially automate plan checks in the TPS. A framework was developed which can be configured with different reference values and types of checks. One examplemore » is the prescribed dose check where PCT flags the user when the planned dose and the prescribed dose disagree. PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user. A PDF report is created and automatically uploaded into the TMS. Prior to and during PCT development, errors caught during plan checks and also patient delays were tracked in order to prioritize which checks should be automated. The most common and significant errors were determined. Results: Nineteen of 33 checklist items were automated with data extracted with the PCT. These include checks for prescription, reference point and machine scheduling errors which are three of the top six causes of patient delays related to physics and dosimetry. Since the clinical roll-out, no delays have been due to errors that are automatically flagged by the PCT. Development continues to automate the remaining checks. Conclusion: With PCT, 57% of the physics plan checklist has been partially or fully automated. Treatment delays have declined since release of the PCT for clinical use. By tracking delays and errors, we have been able to measure the effectiveness of automating checks and are using this information to prioritize future development. This project was supported in part by P01CA059827.« less

Integrated Data & Analysis in Support of Informed and Transparent Decision Making

NASA Astrophysics Data System (ADS)

Guivetchi, K.

2012-12-01

The California Water Plan includes a framework for improving water reliability, environmental stewardship, and economic stability through two initiatives - integrated regional water management to make better use of local water sources by integrating multiple aspects of managing water and related resources; and maintaining and improving statewide water management systems. The Water Plan promotes ways to develop a common approach for data standards and for understanding, evaluating, and improving regional and statewide water management systems, and for common ways to evaluate and select from alternative management strategies and projects. The California Water Plan acknowledges that planning for the future is uncertain and that change will continue to occur. It is not possible to know for certain how population growth, land use decisions, water demand patterns, environmental conditions, the climate, and many other factors that affect water use and supply may change by 2050. To anticipate change, our approach to water management and planning for the future needs to consider and quantify uncertainty, risk, and sustainability. There is a critical need for information sharing and information management to support over-arching and long-term water policy decisions that cross-cut multiple programs across many organizations and provide a common and transparent understanding of water problems and solutions. Achieving integrated water management with multiple benefits requires a transparent description of dynamic linkages between water supply, flood management, water quality, land use, environmental water, and many other factors. Water Plan Update 2013 will include an analytical roadmap for improving data, analytical tools, and decision-support to advance integrated water management at statewide and regional scales. It will include recommendations for linking collaborative processes with technical enhancements, providing effective analytical tools, and improving and sharing data and information. Specifically, this includes achieving better integration and consistency with other planning activities; obtaining consensus on quantitative deliverables; building a common conceptual understanding of the water management system; developing common schematics of the water management system; establishing modeling protocols and standards; and improving transparency and exchange of Water Plan information.

Sleep, Recovery, and Performance in Sports.

PubMed

Malhotra, Raman K

2017-08-01

Poor sleep can lead to decreases in performance and recovery for athletes. Sleep disorders and symptoms are commonly seen in athletes, and may be unrecognized. It is important to educate athletes on adequate duration, quality, and timing of sleep. Interventions may include changes to practice times or careful planning for travel to games in different time zones. It is important to screen and treat sleep disorders such as sleep apnea and insomnia that are seen in some athletes. In patients who suffer concussion, it is important to address sleep issues, as poor sleep can prolong or exacerbate other concussion symptoms. Copyright © 2017 Elsevier Inc. All rights reserved.

Marketing strategies for vascular practitioners.

PubMed

Satiani, Anand; Satiani, Bhagwan

2009-09-01

A common misconception is that marketing is synonymous with advertising. Marketing by physicians has undergone a transformation from the earlier unacceptable slick sales pitches to a more common sense, tasteful, comprehensive, and well thought out plan to reach potential patients. Marketing is a much broader concept comprising four aspects: product, price, promotion, and place. Marketing activities for a medical practice include not only external but internal tactics. Publicly available resources are available to assist physicians in developing and targeting the plan towards a narrow patient demographic. The marketing process includes: determining objectives, identifying resources, defining target population, honing a message, outlining a media plan, implementing the plan, and finally, evaluating the success or failure of the marketing campaign. A basic knowledge of marketing combined with a common sense approach can yield dividends for those practices that need the service. For surgical practices that exist in heavily populated urban areas with significant competition, a well thought out marketing plan can assist the practice in reaching out to new groups of patients and maintaining the existing patient base.

State and local retirement plans: innovation and renovation.

PubMed

Rajnes, D

2001-07-01

This Special Report/Issue Brief examines the universe of state and local retirement plans. It describes how these plans have developed and continue to evolve in a number of areas, including plan features, regulatory framework, governance, and asset management. While these retirement programs differ in many respects from private-sector plans, the disparity in some areas has narrowed. This report also includes a discussion of trends and the underlying forces for change. Public-sector retirement programs provide an important source of pension coverage in the United States, and are a significant part of the total retirement market: Combined public-sector retirement assets (state, local, and federal governments) comprised 29 percent of the $11.2 trillion U.S. retirement market in 1998. State and local plans are dominant in the public-sector retirement market, holding $2.7 trillion in assets, compared with $696 billion held by federal plans (both military and civilian). More than 16 million individuals are employed by state and local jurisdictions in the United States. State and local retirement plans share certain common features because of the environment in which they operate. Legal statutes, governance, and tradition all play a role in defining what is sometimes referred to as a "public-sector culture." Despite common features, there is considerable diversity among public-sector retirement plans. To attract and retain a skilled work force, public-sector employers have increased their use of defined contribution (DC) plans to supplement defined benefit (DB) plans (or, to a lesser extent, replace or serve as an alternative to them) and improve cost-of-living adjustments. At the same time, a combined federal-state regulatory framework has encouraged certain plan design features, unavailable in the private sector, which include multiple tiers for successive generations of employees in a single plan and different strategies to increase portability. State and local retirement plans reflect an increasing role by the federal government in pension system design and operation, which has led to greater complexity in such areas as Social Security participation and deferred compensation arrangements. Complexity can be expected to increase with the recent passage of P.L. 107-16, the Economic Growth and Tax Relief Reconciliation Act of 2001. The latest full-year data included in this report are for 1999 and in some cases 2000. After this report went to press, the Federal Reserve issued significantly revised quarterly data for state, local, and federal retirement plan assets, which were not incorporated in this Issue Brief.

Interprofessional Education and Practice Guide No. 7: Development, implementation, and evaluation of a large-scale required interprofessional education foundational programme.

PubMed

Shrader, Sarah; Hodgkins, Renee; Laverentz, Delois; Zaudke, Jana; Waxman, Michael; Johnston, Kristy; Jernigan, Stephen

2016-09-01

Health profession educators and administrators are interested in how to develop an effective and sustainable interprofessional education (IPE) programme. We describe the approach used at the University of Kansas Medical Centre, Kansas City, United States. This approach is a foundational programme with multiple large-scale, half-day events each year. The programme is threaded with common curricular components that build in complexity over time and assures that each learner is exposed to IPE. In this guide, lessons learned and general principles related to the development of IPE programming are discussed. Important areas that educators should consider include curriculum development, engaging leadership, overcoming scheduling barriers, providing faculty development, piloting the programming, planning for logistical coordination, intentionally pairing IP facilitators, anticipating IP conflict, setting clear expectations for learners, publicising the programme, debriefing with faculty, planning for programme evaluation, and developing a scholarship and dissemination plan.

Sequential quadratic programming-based fast path planning algorithm subject to no-fly zone constraints

NASA Astrophysics Data System (ADS)

Liu, Wei; Ma, Shunjian; Sun, Mingwei; Yi, Haidong; Wang, Zenghui; Chen, Zengqiang

2016-08-01

Path planning plays an important role in aircraft guided systems. Multiple no-fly zones in the flight area make path planning a constrained nonlinear optimization problem. It is necessary to obtain a feasible optimal solution in real time. In this article, the flight path is specified to be composed of alternate line segments and circular arcs, in order to reformulate the problem into a static optimization one in terms of the waypoints. For the commonly used circular and polygonal no-fly zones, geometric conditions are established to determine whether or not the path intersects with them, and these can be readily programmed. Then, the original problem is transformed into a form that can be solved by the sequential quadratic programming method. The solution can be obtained quickly using the Sparse Nonlinear OPTimizer (SNOPT) package. Mathematical simulations are used to verify the effectiveness and rapidity of the proposed algorithm.

Spatial and Temporal Eye–Hand Coordination Relies on the Parietal Reach Region

PubMed Central

Hauschild, Markus; Wilke, Melanie; Andersen, Richard A.

2014-01-01

Coordinated eye movements are crucial for precision control of our hands. A commonly believed neural mechanism underlying eye–hand coordination is interaction between the neural networks controlling each effector, exchanging, and matching information, such as movement target location and onset time. Alternatively, eye–hand coordination may result simply from common inputs to independent eye and hand control pathways. Thus far, it remains unknown whether and where either of these two possible mechanisms exists. A candidate location for the former mechanism, interpathway communication, includes the posterior parietal cortex (PPC) where distinct effector-specific areas reside. If the PPC were within the network for eye–hand coordination, perturbing it would affect both eye and hand movements that are concurrently planned. In contrast, if eye–hand coordination arises solely from common inputs, perturbing one effector pathway, e.g., the parietal reach region (PRR), would not affect the other effector. To test these hypotheses, we inactivated part of PRR in the macaque, located in the medial bank of the intraparietal sulcus encompassing the medial intraparietal area and area 5V. When each effector moved alone, PRR inactivation shortened reach but not saccade amplitudes, compatible with the known reach-selective activity of PRR. However, when both effectors moved concurrently, PRR inactivation shortened both reach and saccade amplitudes, and decoupled their reaction times. Therefore, consistent with the interpathway communication hypothesis, we propose that the planning of concurrent eye and hand movements causes the spatial information in PRR to influence the otherwise independent eye control pathways, and that their temporal coupling requires an intact PRR. PMID:25232123

Common Data Format: New XML and Conversion Tools

NASA Astrophysics Data System (ADS)

Han, D. B.; Liu, M. H.; McGuire, R. E.

2002-12-01

Common Data Format (CDF) is a self-describing platform-independent data format for storing, accessing, and manipulating scalar and multidimensional scientific data sets. Significant benefit has accrued to specific science communities from their use of standard formats within those communities. Examples include the International Solar Terrestrial Physics (ISTP) community in using CDF for traditional space physics data (fields, particles and plasma, waves, and images), the worldwide astronomical community in using FITS (Flexible Image Transport System) for solar data (primarily spectral images), the NASA Planetary community in using Planetary Data System (PDS) Labels, and the earth science community in using Hierarchical Data Format (HDF). Scientific progress in solar-terrestrial physics continues to be impeded by the multiplicity of available standards for data formats and dearth of general data format translators. As a result, scientists today spend a significant amount of time translating data into the format they are familiar with for their research. To minimize this unnecessary data translation time and to allow more research time, the CDF office located at GSFC National Space Science Data Center (NSSDC) has developed HDF-to-CDF and FITS-to-CDF translators, and employed the eXtensible Markup Language (XML) technology to facilitate and promote data interoperability within the space science community. We will present the current status of the CDF work including the conversion tools that have been recently developed, conversion tools that are planned in the near future, share some of the XML experiences, and use the discussion to gain community feedback to our planned future work.

Learning from conservation planning for the U.S. National Wildlife Refuges.

PubMed

Meretsky, Vicky J; Fischman, Robert L

2014-10-01

The U.S. National Wildlife Refuge System has nearly completed its first round of unit-level, comprehensive conservation plans (CCPs) and will soon begin required revisions. Laws and policies governing refuge planning emphasize ecological integrity, landscape-scale conservation, and adaptive management. We evaluated 185 CCPs completed during 2005-2011, which cover 324 of 555 national wildlife refuges. We reviewed CCP prescriptions addressing 5 common conservation issues (habitat and game, nongame, imperiled, and invasive species) and 3 specialized topics (landscape-scale conservation, climate change, and environmental quality). Common conservation issues received prescriptions in >90% of CCPs. Specialized topics received more variable treatment. Prescriptions for aquatic connectivity, water quantity, and climate-change impacts increased over the study period. Except for climate change, direct actions were the most common type of management prescription, followed by plans or studies. Most CCPs stated a commitment to adaptive management and prescribed monitoring for common conservation objectives; other aspects of planning for adaptive management were often lacking, despite strong support for adaptive management in the conservation planning literature. To better address refuge-specific threats, we recommend that revised plans explicitly match identified refuge issues with prescriptions, particularly for under-represented concerns such as novel pests and pathogens. We recommend incorporating triggers into monitoring frameworks and specifying actions that will occur when threshold values are reached to improve support for adaptive management. Revised CCPs should better reflect work that refuges already undertake to extend conservation objectives beyond their borders and better engage with regional conservation efforts to continue this work. More thorough landscape-scale threat assessments and explicit prioritization of planned actions would further improve conservation effectiveness. Excellent examples of all recommended practices exist within the CCPs we examined; sharing best planning practices would improve planning efficiency within the refuge system. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of the Society for Conservation Biology.

Use of cone-beam imaging to correct for catheter displacement in high dose-rate prostate brachytherapy.

PubMed

Holly, Rick; Morton, Gerard C; Sankreacha, Raxa; Law, Niki; Cisecki, Thomas; Loblaw, D Andrew; Chung, Hans T

2011-01-01

To determine the magnitude of catheter displacement between time of planning and time of treatment delivery for patients undergoing high dose-rate (HDR) brachytherapy, the dosimetric impact of catheter displacement, and the ability to improve dosimetry by catheter readjustment. Twenty consecutive patients receiving single fraction HDR brachytherapy underwent kilovoltage cone-beam CT in the treatment room before treatment. If catheter displacement was apparent, catheters were adjusted and imaging repeated. Both sets of kilovoltage cone-beam CT image sets were coregistered off-line with the CT data set used for planning with rigid fusion of anatomy based on implanted fiducials. Catheter displacement was measured on both sets of images and dosimetry calculated. Mean internal displacement of catheters was 11mm. This would have resulted in a decrease in mean volume receiving 100% of prescription dose (V(100)) from the planned 97.6% to 77.3% (p<0.001), a decrease of the mean dose to 90% of the prostate (D(90)) from 110.5% to 72.9% (p<0.001), and increase in dose to 10% of urethra (urethra D(10)) from 118% to 125% (p=0.0094). Each 1cm of catheter displacement resulted in a 20% decrease in V(100) and 36% decrease in D(90). Catheter readjustment resulted in a final treated mean V(100) of 90.2% and D(90) of 97.4%, both less than planned. Mean urethra D(10) remained higher at126% (p=0.0324). Significantly, internal displacement of HDR catheters commonly occurs between time of CT planning and treatment delivery, even when only a single fraction is used. The adverse effects on dosimetry can be partly corrected by readjustment of catheter position. Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Strategic Environmental Assessment in Germany - Practice and open questions

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

Weiland, Ulrike, E-mail: uweiland@uni-leipzig.d

2010-04-15

Eight years after the enactment of the EU Strategic Environmental Assessment Directive (2001/42/EC) () it is time to investigate where and how SEA are being implemented in Germany in order to find out open questions and research needs. In this study, we analysed in which planning types SEA are common practice, and where can deficits be identified, and to what extent differences occur between spatial and sectoral planning with respect to carrying out SEA. Pressing challenges in performing SEA as well as open questions are addressed such as the handling of cumulative effects and the interrelationships between the environmental factors,more » and how the monitoring of environmental effects is considered by the practitioners. The results show that SEA is well implemented in local land-use planning, regional planning, and in local landscape planning, while the implementation in sectoral planning varies widely. The SEA in clean air planning is looked at in more detail, because this is discussed controversially in the specialist field, and obstacles against SEA are identified in this field. Finally some new topics are addressed for which solutions in spatial and environmental planning including SEA must be found, e.g. the consideration of biological diversity and the potential role of SEA in climate change. A European study on the identified open questions and their handling in different contexts and countries may allow for a qualitative amendment in practice.« less

Benefits and Perceptions of Public Health Accreditation Among Health Departments Not Yet Applying.

PubMed

Heffernan, Megan; Kennedy, Mallory; Siegfried, Alexa; Meit, Michael

To identify the benefits and perceptions among health departments not yet participating in the public health accreditation program implemented by the Public Health Accreditation Board (PHAB). Quantitative and qualitative data were gathered via Web-based surveys of health departments that had not yet applied for PHAB accreditation (nonapplicants) and health departments that had been accredited for 1 year. Respondents from 150 nonapplicant health departments and 57 health departments that had been accredited for 1 year. The majority of nonapplicant health departments are reportedly conducting a community health assessment (CHA), community health improvement plan (CHIP), and health department strategic plan-3 documents that are required to be in place before applying for PHAB accreditation. To develop these documents, most nonapplicants are reportedly referencing PHAB requirements. The most commonly reported perceived benefits of accreditation among health departments that planned to or were undecided about applying for accreditation were as follows: increased awareness of strengths and weaknesses, stimulated quality improvement (QI) and performance improvement activities, and increased awareness of/focus on QI. Nonapplicants that planned to apply reported a higher level of these perceived benefits. Compared with health departments that had been accredited for 1 year, nonapplicants were more likely to report that their staff had no or limited QI knowledge or familiarity. The PHAB accreditation program has influenced the broader public health field-not solely health departments that have undergone accreditation. Regardless of their intent to apply for accreditation, nonapplicant health departments are reportedly referencing PHAB guidelines for developing the CHA, CHIP, and health department strategic plan. Health departments may experience benefits associated with accreditation prior to their formal involvement in the PHAB accreditation process. The most common challenge for health departments applying for accreditation is identifying the time and resources to dedicate to the process.

Enhanced Specification and Verification for Timed Planning

DTIC Science & Technology

2009-02-28

Scheduling Problem The job-shop scheduling problem ( JSSP ) is a generic resource allocation problem in which common resources (“machines”) are required...interleaving of all processes Pi with the non-delay and mutual exclusion constraints: JSSP =̂ |||0<i6n Pi Where mutual-exclusion( JSSP ) For every complete...execution of JSSP (which terminates), its associated sched- ule S is a feasible schedule. An optimal schedule is a trace of JSSP with the minimum ending

Plan of Action and Milestones for Navy Combustion Toxicity.

DTIC Science & Technology

1981-01-01

widespread gasoline fire. This type of hit would be equivalent to today’s cruise missile threat and would cause shipboard plastic materials to burn...NAVSUP). Toxi - city experiments are under program element 61153N at the Naval Medical Research and Development Command. Fundamental research on combustion...smoke toxicants were discussed and a method of estimating these limits for the more common toxi - cants was presented. The tenability time (TL), also

Work Plan: Phase II Investigation at the Former CCC/USDA Grain Storage Facility in Montgomery City, Missouri

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

LaFreniere, Lorraine M

From September 1949 until September 1966, the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) leased property at the southeastern end of Montgomery City, Missouri, for the operation of a grain storage facility. During this time, commercial grain fumigants containing carbon tetrachloride were commonly used by the CCC/USDA and the private grain storage industry to preserve grain in their facilities.

Long Range Plan: 1992-1995.

ERIC Educational Resources Information Center

Pennsylvania Coll. of Technology, Williamsport.

Intended to enhance strategic planning and enable staff to work as a team toward a shared vision and common goals, this report presents the 1992-95 long-range plan of the Pennsylvania College of Technology (PCT). Part I defines long-range planning; describes the structure and use of the plan at PCT; presents PCT's philosophy, mission, and vision…

A Typology of Alternative Compensation Plans

ERIC Educational Resources Information Center

Sailer, Robert Conrad

2017-01-01

This study created a typology of alternative teacher-compensation plans in use in Wisconsin as of the fall of 2015. Eight plan types were identified with defining, common, and unique components. Of 125 districts that reported alternative plans, the most prevalent reported type was a hybrid type that combined components. Hybrid plans were found to…

2008 Federal Radionavigation Plan

DOT National Transportation Integrated Search

2009-01-01

The Federal Radionavigation Plan (FRP) is the official source of radionavigation policy and planning for the Federal Government. The FRP covers common-use, Federally operated radionavigation systems. This edition of the FRP combines the Federal Radio...

A common stochastic accumulator with effector-dependent noise can explain eye-hand coordination

PubMed Central

Gopal, Atul; Viswanathan, Pooja

2015-01-01

The computational architecture that enables the flexible coupling between otherwise independent eye and hand effector systems is not understood. By using a drift diffusion framework, in which variability of the reaction time (RT) distribution scales with mean RT, we tested the ability of a common stochastic accumulator to explain eye-hand coordination. Using a combination of behavior, computational modeling and electromyography, we show how a single stochastic accumulator to threshold, followed by noisy effector-dependent delays, explains eye-hand RT distributions and their correlation, while an alternate independent, interactive eye and hand accumulator model does not. Interestingly, the common accumulator model did not explain the RT distributions of the same subjects when they made eye and hand movements in isolation. Taken together, these data suggest that a dedicated circuit underlies coordinated eye-hand planning. PMID:25568161

Pregnancy and autoimmune connective tissue diseases

PubMed Central

Marder, Wendy; Littlejohn, Emily A

2016-01-01

The autoimmune connective tissue diseases predominantly affect women and often occur during the reproductive years. Thus, specialized issues in pregnancy planning and management are commonly encountered in this patient population. This chapter provides a current overview of pregnancy as a risk factor for onset of autoimmune disease, considerations related to the course of pregnancy in several autoimmune connective tissue diseases, and disease management and medication issues before and during pregnancy and the postpartum period. A major theme that has emerged across these inflammatory diseases is that active maternal disease during pregnancy is associated with adverse pregnancy outcomes, and that maternal and fetal health can be optimized when conception is planned during times of inactive disease and through maintaining treatment regimens compatible with pregnancy. PMID:27421217

The next 25 years: Industrialization of space - Rationale for planning

NASA Technical Reports Server (NTRS)

Von Puttkamer, J.

1977-01-01

A methodology for planning the industralization of space is discussed. The suggested approach combines the extrapolative ('push') approach, in which alternative futures are projected on the basis of past and current trends and tendencies, with the normative ('pull') view, in which an ideal state in the far future is postulated and policies and decisions are directed toward its attainment. Time-reversed vectors of the future are tied to extrapolated, trend-oriented vectors of the quasi-present to identify common plateaus or stepping stones in technological development. Important steps in the industrialization of space to attain the short-range goals of production of space-derived energy, goods and services and the long-range goal of space colonization are discussed.

Gazetteer of hydrologic characteristics of streams in Massachusetts; Blackstone River basin

USGS Publications Warehouse

Wandle, S.W.; Phipps, A.F.

1984-01-01

The Blackstone River basin encompasses 335 square miles in south-central Massachusetts, including parts of Bristol, Middlesex, Norfolk, and Worcester Counties. Drainage areas, using the latest available 1:24,000 scale topographic maps, were computed for the first time for streams draining more than 3 square miles and were recomputed for data-collection sites. Streamflow characteristics, were calculated using a new data base with records through 1980. These characteristics include annual and monthly flow statistics, duration of daily flow values, and the annual 7-day mean low flow at the 2-year and 10-year recurrence intervals. The 7-day, 10-year low-flow values are presented for 31 partial-record sites and the procedures used to determine the hydrologic characteristics of the basin are summarized. Basin characteristics representing 14 commonly used indices to estimate various streamflows are presented for the six gaged streams in the Blackstone River basin. This gazetteer will aid in the planning and siting of water-resources-related activities and will provide a common data base for governmental agencies and the engineering and planning communities. (USGS)

Gazetteer of hydrologic characteristics of streams in Massachusetts; Housatonic River basin

USGS Publications Warehouse

Wandle, S.W.; Lippert, R.G.

1984-01-01

The Housatonic River basin includes streams that drain 504 square miles in western Massachusetts and 30.5 square miles in eastern New York. Drainage areas, using the latest available 1:24,000 scale topographic maps, were computed for the first time for streams draining more than 3 square miles and were recomputed for data-collection sites. Streamflow characteristics for four gaged streams were calculated using a new data base with daily flow records through 1981. These characteristics include annual and monthly flow statistics, duration of daily flow values, and the annual 7-day mean low flow at the 2-year and 10-year recurrence intervals. Seven-day low-flow statistics are presented for 52 partial-record sites, and the procedures used to determine the hydrologic characteristics of the basin are summarized. Basin characteristics representing 14 commonly used indices to estimate various streamflows are provided for selected gaging stations. This gazetteer will aid in the planning and siting of water-resources related activities and will provide a common data base for governmental agencies and the engineering and planning communities. (USGS)

47 CFR 52.13 - North American Numbering Plan Administrator.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false North American Numbering Plan Administrator. 52.13 Section 52.13 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) NUMBERING Administration § 52.13 North American Numbering Plan Administrator. (a) The North American Numbering Plan Administrator ...

A Rapid Decision Sampling Plan for Implementing Area—Wide Management of the Red Palm Weevil, Rhynchophorus ferrugineus, in Coconut Plantations of India

PubMed Central

Faleiro, J. R.; Ashok Kumar, J.

2008-01-01

The red palm weevil Rhynchophorus ferrugineus Olivier (Curculionidae/Rhynchophoridae/Dryophthoridae) is a lethal pest of young coconut palms, Cocos nucifera L. (Arecales: Arecaceae), with a highly aggregated population distribution pattern. R. ferrugineus is managed in several coconut growing countries using area-wide pheromone based programmes that need a substantial commitment of funds over a period of time. Often, decisions to implement area-wide management of R. ferrugineus are based on pheromone trap captures in surveillance traps and or infestation reports. Implementing area-wide management of this pest on the basis of such data can be inaccurate, as it may either under or over estimate the pest intensity in the field. This study presents sampling plans for rapid and accurate classification of R. ferrugineus infestation in coconut plantations of India by inspecting palms to detect infestation in a sequence until a decision to either implement or not to initiate area-wide management of R. ferrugineus can be made. The sampling plans are based on a common aggregation index of 3.45, assumed action threshold values of either 1.0 (plan A) or 0.5 (plan B) per cent infested palms and a risk factor of making the wrong decision set at 0.05. Using plans A and B, if the cummulative number of infested palms in a young 1 hectare coconut plantation is zero out of 150 palms for both plans, then area-wide management is not required, while on the other hand, if the cummulative number of infested palms for the same area is 6 (plan A), or 5 (plan B), then area-wide management of R. ferrugineus is essential. The proposed sampling plans are efficient tools in decision making, particularly at very low and high levels of infestation and can also be used to assess the performance of R. ferrugineus IPM programmes that are in progress. These plans not only save time and money as only a small area needs to be sampled to arrive at a correct decision, but are also efficient in rating the infestation level accurately. PMID:20337561

A rapid decision sampling plan for implementing area-wide management of the red palm weevil, Rhynchophorus ferrugineus, in coconut plantations of India.

PubMed

Faleiro, J R; Ashok Kumar, J

2008-01-01

The red palm weevil Rhynchophorus ferrugineus Olivier (Curculionidae/Rhynchophoridae/Dryophthoridae) is a lethal pest of young coconut palms, Cocos nucifera L. (Arecales: Arecaceae), with a highly aggregated population distribution pattern. R. ferrugineus is managed in several coconut growing countries using area-wide pheromone based programmes that need a substantial commitment of funds over a period of time. Often, decisions to implement area-wide management of R. ferrugineus are based on pheromone trap captures in surveillance traps and or infestation reports. Implementing area-wide management of this pest on the basis of such data can be inaccurate, as it may either under or over estimate the pest intensity in the field. This study presents sampling plans for rapid and accurate classification of R. ferrugineus infestation in coconut plantations of India by inspecting palms to detect infestation in a sequence until a decision to either implement or not to initiate area-wide management of R. ferrugineus can be made. The sampling plans are based on a common aggregation index of 3.45, assumed action threshold values of either 1.0 (plan A) or 0.5 (plan B) per cent infested palms and a risk factor of making the wrong decision set at 0.05. Using plans A and B, if the cumulative number of infested palms in a young 1 hectare coconut plantation is zero out of 150 palms for both plans, then area-wide management is not required, while on the other hand, if the cumulative number of infested palms for the same area is 6 (plan A), or 5 (plan B), then area-wide management of R. ferrugineus is essential. The proposed sampling plans are efficient tools in decision making, particularly at very low and high levels of infestation and can also be used to assess the performance of R. ferrugineus IPM programmes that are in progress. These plans not only save time and money as only a small area needs to be sampled to arrive at a correct decision, but are also efficient in rating the infestation level accurately.

Do Values Drive the Plan? Investigating the Nature and Role of Organizational Values in University Strategic Planning

ERIC Educational Resources Information Center

Mueller, Robin Alison

2015-01-01

Strategic planning is a common practice at higher education institutions. Furthermore, it is assumed that identifying organizational values is an essential part of the planning process. Values are often construed as foundational elements of strategic thinking that serve to "drive the plan". However, there is little conceptual or applied…

Scenario Planning: A Phenomenological Examination of Influence on Organizational Learning and Decision-Making in a K-12 Public Education System

ERIC Educational Resources Information Center

Deklotz, Patricia F.

2013-01-01

Organizations commonly engage in long range planning to direct decisions. Scenario planning, one method of private sector planning, is recognized as useful when organizations are facing uncertainty. Scenario planning engages the organization in a process that produces plausible stories, called scenarios, describing the organization in several…

Macro-Language Planning for Multilingual Education: Focus on Programmes and Provision

ERIC Educational Resources Information Center

Taylor-Leech, Kerry; Liddicoat, Anthony J.

2014-01-01

This overview identifies some common features of macro-level language planning and briefly summarises the changing approaches to the analysis of macro-planning in the field. It previews six cases of language-in-education planning in response to linguistic diversity presented by the contributors to this issue. The cases show how macro-planning can…

Studies of air traffic forecasts, airspace load and the effect of ADS-B via satellites on flight times

NASA Astrophysics Data System (ADS)

Zhong, Z. W.; Ridhwan Salleh, Saiful; Chow, W. X.; Ong, Z. M.

2016-10-01

Air traffic forecasting is important as it helps stakeholders to plan their budgets and facilities. Thus, three most commonly used forecasting models were compared to see which model suited the air passenger traffic the best. General forecasting equations were also created to forecast the passenger traffic. The equations could forecast around 6.0% growth from 2015 onwards. Another study sought to provide an initial work for determining a theoretical airspace load with relevant calculations. The air traffic was simulated to investigate the current airspace load. Logical and reasonable results were obtained from the modelling and simulations. The current utilization percentages for airspace load per hour and the static airspace load in the interested airspace were found to be 6.64% and 11.21% respectively. Our research also studied how ADS-B would affect the time taken for aircraft to travel. 6000 flights departing from and landing at the airport were studied. New flight plans were simulated with improved flight paths due to the implementation of ADS-B, and flight times of all studied flights could be improved.

Real-time dose calculation and visualization for the proton therapy of ocular tumours

NASA Astrophysics Data System (ADS)

Pfeiffer, Karsten; Bendl, Rolf

2001-03-01

A new real-time dose calculation and visualization was developed as part of the new 3D treatment planning tool OCTOPUS for proton therapy of ocular tumours within a national research project together with the Hahn-Meitner Institut Berlin. The implementation resolves the common separation between parameter definition, dose calculation and evaluation and allows a direct examination of the expected dose distribution while adjusting the treatment parameters. The new tool allows the therapist to move the desired dose distribution under visual control in 3D to the appropriate place. The visualization of the resulting dose distribution as a 3D surface model, on any 2D slice or on the surface of specified ocular structures is done automatically when adapting parameters during the planning process. In addition, approximate dose volume histograms may be calculated with little extra time. The dose distribution is calculated and visualized in 200 ms with an accuracy of 6% for the 3D isodose surfaces and 8% for other objects. This paper discusses the advantages and limitations of this new approach.

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

PubMed Central

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

2009-01-01

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

An Empirical Assessment of Administration and Planning Activity and Their Impact on the Realization of Sustainability-Related Initiatives and Programs in Higher Education

ERIC Educational Resources Information Center

Semeraro, Elizabeth; Boyd, Neil M.

2017-01-01

Purpose: Administrators in higher-education settings routinely create planning documents that help steer the organization in mission-centric ways. In the area of sustainability planning, strategic plans, sustainability plans and climate action plans are the most common methods used. The purpose of this study is to evaluate if specific forms of…

A scenario for a web-based radiation treatment planning structure: A new tool for quality assurance procedure?

PubMed

Kouloulias, V E; Ntasis, E; Poortmans, Ph; Maniatis, T A; Nikita, K S

2003-01-01

The desire to develop web-based platforms for remote collaboration among physicians and technologists is becoming a great challenge. In this paper we describe a web-based radiotherapy treatment planning (WBRTP) system to facilitate decentralized radiotherapy services by allowing remote treatment planning and quality assurance (QA) of treatment delivery. Significant prerequisites are digital storage of relevant data as well as efficient and reliable telecommunication system between collaborating units. The system of WBRTP includes video conferencing, display of medical images (CT scans, dose distributions etc), replication of selected data from a common database, remote treatment planning, evaluation of treatment technique and follow-up of the treated patients. Moreover the system features real-time remote operations in terms of tele-consulting like target volume delineation performed by a team of experts at different and distant units. An appraisal of its possibilities in quality assurance in radiotherapy is also discussed. As a conclusion, a WBRTP system would not only be a medium for communication between experts in oncology but mainly a tool for improving the QA in radiotherapy.

Multi-Criteria GIS Analyses with the Use of Uavs for the Needs of Spatial Planning

NASA Astrophysics Data System (ADS)

Zawieska, D.; Markiewicz, J.; Turek, A.; Bakuła, K.; Kowalczyk, M.; Kurczyński, Z.; Ostrowski, W.; Podlasiak, P.

2016-06-01

Utilization of Unmanned Aerial Systems (UAVs) in agriculture, forestry, or other environmental contexts has recently become common. However, in the case of spatial planning, the role of UAVs still seems to be underestimated. At present, sections of municipal development use UAVs mainly for promotional purposes (films, folders, brochures, etc.). The use of UAVs for spatial management provides results, first of all, in the form of savings in human resources and time; however, more frequently, it is also connected with financial savings (given the decreasing cost of UAVs and photogrammetric software). The performed research presented here relates to the possibilities of using UAVs to update planning documents, and, in particular, to update the study of conditions and directions of spatial management and preparation of local plans for physical management. Based on acquired photographs with a resolution of 3 cm, a cloud of points is generated, as well as 3D models and the true orthophotomap. These data allow multi-criteria spatial analyses. Additionally, directions of development and changes in physical management are analysed for the given area.

Wrap-up session

NASA Technical Reports Server (NTRS)

Holland, Geoffrey

1992-01-01

Listening to the case studies that were presented it became quite evident that the best data management systems were the ones where data managers and research scientists worked as a team developed in the early stages of project planning. Examples that were given included WOCE Data Assembly Centres e.g., Drifters, the Global Temperature Salinity Pilot Project (GTSPP) collaboration with Joint Analyses Centres in the U.S. and Australia, and JGOFS/BOFS development of Topical Centres. While each of these has some elements unique to the project, each had brought together 'teams' of Principal Investigators (PI's) and data management experts at an early stage of project development. Conversely, projects which had considered data management as a totally separate activity with lower priority often failed to provide the service required to meet scientific objectives. Therefore, the following actions should be brought to the attention of relevant groups within the IOC and other international organizations: (1) Publicize, at the national and international level, underway data/scientist collaborations that may be used as models in planning for the future. (2) Reduce adversarial situations where data managers and scientists appear to be in competition. (3) Colocation and other forms of collaboration often results in very high quality data sets and more timely data submission. Improved timeliness of data submissions was a common theme throughout the workshop and must be considered an important element in all future plans. Improvements in timely submission of data were noted. In order to continue this trend the advantages of timely submission of data must be stressed to those planning new ocean science projects.

A dosimetric comparison of real-time adaptive and non-adaptive radiotherapy: A multi-institutional study encompassing robotic, gimbaled, multileaf collimator and couch tracking.

PubMed

Colvill, Emma; Booth, Jeremy; Nill, Simeon; Fast, Martin; Bedford, James; Oelfke, Uwe; Nakamura, Mitsuhiro; Poulsen, Per; Worm, Esben; Hansen, Rune; Ravkilde, Thomas; Scherman Rydhög, Jonas; Pommer, Tobias; Munck Af Rosenschold, Per; Lang, Stephanie; Guckenberger, Matthias; Groh, Christian; Herrmann, Christian; Verellen, Dirk; Poels, Kenneth; Wang, Lei; Hadsell, Michael; Sothmann, Thilo; Blanck, Oliver; Keall, Paul

2016-04-01

A study of real-time adaptive radiotherapy systems was performed to test the hypothesis that, across delivery systems and institutions, the dosimetric accuracy is improved with adaptive treatments over non-adaptive radiotherapy in the presence of patient-measured tumor motion. Ten institutions with robotic(2), gimbaled(2), MLC(4) or couch tracking(2) used common materials including CT and structure sets, motion traces and planning protocols to create a lung and a prostate plan. For each motion trace, the plan was delivered twice to a moving dosimeter; with and without real-time adaptation. Each measurement was compared to a static measurement and the percentage of failed points for γ-tests recorded. For all lung traces all measurement sets show improved dose accuracy with a mean 2%/2mm γ-fail rate of 1.6% with adaptation and 15.2% without adaptation (p<0.001). For all prostate the mean 2%/2mm γ-fail rate was 1.4% with adaptation and 17.3% without adaptation (p<0.001). The difference between the four systems was small with an average 2%/2mm γ-fail rate of <3% for all systems with adaptation for lung and prostate. The investigated systems all accounted for realistic tumor motion accurately and performed to a similar high standard, with real-time adaptation significantly outperforming non-adaptive delivery methods. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Building successful coalitions for promoting advance care planning.

PubMed

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

2006-01-01

Advance care planning (ACP) has had few successful initiatives. This qualitative study explores the challenges and successes of an advance care planning coalition in Wisconsin called Life Planning 2000 using key informant interviews (n = 24) and grounded theory. Major themes included: commitment (the need for leadership, recruitment of key members, and funding); cohesiveness (disparate groups collaborating toward a common purpose), and outcomes (shift in paradigm from signing documents to process of advanced care planning, new-found collaborative relationships, and educational tool development). Coalitions need to define short-, intermediate-, and long-term goals that result in measurable outcomes and an evaluation process. Resources must be commensurate with goals. Strong leadership, paid staff adequate funding, and the collaboration of diverse groups working toward common goals are the basic requirements of a successful coalition.

Connecting the Learning Organization, Strategic Planning, and Public Relations.

ERIC Educational Resources Information Center

Thornton, Bill; Perreault, George

2002-01-01

Examines common perceptions about barriers to effective strategic planning in school districts. Argues that primary barrier to effective use of strategic planning in schools is the failure of educators to fully understand the strategic planning process itself. Discusses the components of a learning organization. Links learning organizations with…

Forest Resource Management Plans: A Sustainability Approach

ERIC Educational Resources Information Center

Pile, Lauren S.; Watts, Christine M.; Straka, Thomas J.

2012-01-01

Forest Resource Management Plans is the capstone course in many forestry and natural resource management curricula. The management plans are developed by senior forestry students. Early management plans courses were commonly technical exercises, often performed on contrived forest "tracts" on university-owned or other public lands, with a goal of…

42 CFR 457.710 - State plan requirements: Strategic objectives and performance goals.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... The State's strategic objectives, performance goals and performance measures must include a common... 42 Public Health 4 2010-10-01 2010-10-01 false State plan requirements: Strategic objectives and...) ALLOTMENTS AND GRANTS TO STATES Strategic Planning, Reporting, and Evaluation § 457.710 State plan...

Attitudes toward retirement of ophthalmology department chairs.

PubMed

Dodds, David W; Cruz, Oscar A; Israel, Heidi

2013-07-01

To identify common perceptions and ideas about preparation and planning for retirement of chairs of academic departments of ophthalmology, determining areas of particular stress and proposing ways to better prepare for retirement. Cross-sectional study. One-hundred sixteen chairs of academic departments of ophthalmology in the United States. A confidential online survey emailed to ophthalmology chairs. Surveys assessed demographics; current work schedule; perceptions, preparation, and planning for retirement; and retirement training for faculty and residents. Ninety-six department chairs responded to the survey (82% response rate). Most chairs anticipate retiring around age 70. Significantly, only 9% are looking forward to retirement. Reasons for delaying retirement include keeping active (37%), income/insurance/benefits (20%), and maintaining lifestyle (17%). The most common concern is financing retirement (46%). Forty percent anticipate their reason for retirement will be because of age or health, whereas 20% anticipate fatigue or burnout. Nearly half of the respondents have no specific plan upon retirement. Most respondents anticipate pursuing other interests (43%); 32% intend to spend time with family, vacationing, and travelling. Younger respondents are more concerned with the financial aspects of retirement while more senior respondents appear to delay retirement to keep active or because they enjoy their work. Retirement is a source of stress for many ophthalmology department chairs and many indicate financial preparation is their major concern. Despite this, the major reason for putting off retirement is a desire to keep active. Developing a retirement plan eases stress and engenders a feeling of confidence about the future. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Costs and Trends in Utilization of Low-value Services Among Older Adults With Commercial Insurance or Medicare Advantage.

PubMed

Carter, Elizabeth A; Morin, Pamela E; Lind, Keith D

2017-11-01

Overutilization of low-value services (unnecessary or minimally beneficial tests or procedures) has been cited as a large contributor to the high costs of health care in the United States. To analyze trends in utilization of low-value services from 2009 to 2014 among commercial and Medicare Advantage (MA) enrollees 50 and older. A retrospective analysis of deidentified claims obtained from the OptumLab Data Warehouse. Adults 50 and older enrolled in commercial plans and adults 65 and older enrolled in MA plans between 2009 and 2014. Costs and utilization of 16 low-value services in the following categories: cancer screening, imaging, and invasive procedures. The most commonly performed low-value service was imaging of the head for syncope, at rates of 33%-39% in commercial enrollees and 45% in MA enrollees. The least common service was peripheral artery stenting (<1%) in commercial enrollees, and laminectomy (0.15% in 2009) and renal artery stenting in MA enrollees (0.07% in 2014). Renal artery stenting decreased by roughly 75% over the study period, the largest decrease in utilization, with ∼$30 million and $10 million in reduced spending for commercial and MA plans and enrollees, respectively. Spending on these services in 2014 totaled $317.6 million for commercial and $100.8 million for MA health plans. Clinicians, researchers, and policymakers should strive to reach consensus on methods for more reliably and accurately identifying low-value service utilization. Greater consistency would facilitate monitoring use of low-value services and changing clinical practice patterns over time.

Automated planning of tangential breast intensity-modulated radiotherapy using heuristic optimization.

PubMed

Purdie, Thomas G; Dinniwell, Robert E; Letourneau, Daniel; Hill, Christine; Sharpe, Michael B

2011-10-01

To present an automated technique for two-field tangential breast intensity-modulated radiotherapy (IMRT) treatment planning. A total of 158 planned patients with Stage 0, I, and II breast cancer treated using whole-breast IMRT were retrospectively replanned using automated treatment planning tools. The tools developed are integrated into the existing clinical treatment planning system (Pinnacle(3)) and are designed to perform the manual volume delineation, beam placement, and IMRT treatment planning steps carried out by the treatment planning radiation therapist. The automated algorithm, using only the radio-opaque markers placed at CT simulation as inputs, optimizes the tangential beam parameters to geometrically minimize the amount of lung and heart treated while covering the whole-breast volume. The IMRT parameters are optimized according to the automatically delineated whole-breast volume. The mean time to generate a complete treatment plan was 6 min, 50 s ± 1 min 12 s. For the automated plans, 157 of 158 plans (99%) were deemed clinically acceptable, and 138 of 158 plans (87%) were deemed clinically improved or equal to the corresponding clinical plan when reviewed in a randomized, double-blinded study by one experienced breast radiation oncologist. In addition, overall the automated plans were dosimetrically equivalent to the clinical plans when scored for target coverage and lung and heart doses. We have developed robust and efficient automated tools for fully inversed planned tangential breast IMRT planning that can be readily integrated into clinical practice. The tools produce clinically acceptable plans using only the common anatomic landmarks from the CT simulation process as an input. We anticipate the tools will improve patient access to high-quality IMRT treatment by simplifying the planning process and will reduce the effort and cost of incorporating more advanced planning into clinical practice. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

Intraspecific morphological and genetic variation of common species predicts ranges of threatened ones

PubMed Central

Fuller, Trevon L.; Thomassen, Henri A.; Peralvo, Manuel; Buermann, Wolfgang; Milá, Borja; Kieswetter, Charles M.; Jarrín-V, Pablo; Devitt, Susan E. Cameron; Mason, Eliza; Schweizer, Rena M.; Schlunegger, Jasmin; Chan, Janice; Wang, Ophelia; Schneider, Christopher J.; Pollinger, John P.; Saatchi, Sassan; Graham, Catherine H.; Wayne, Robert K.; Smith, Thomas B.

2013-01-01

Predicting where threatened species occur is useful for making informed conservation decisions. However, because they are usually rare, surveying threatened species is often expensive and time intensive. Here, we show how regions where common species exhibit high genetic and morphological divergence among populations can be used to predict the occurrence of species of conservation concern. Intraspecific variation of common species of birds, bats and frogs from Ecuador were found to be a significantly better predictor for the occurrence of threatened species than suites of environmental variables or the occurrence of amphibians and birds. Fully 93 per cent of the threatened species analysed had their range adequately represented by the geographical distribution of the morphological and genetic variation found in seven common species. Both higher numbers of threatened species and greater genetic and morphological variation of common species occurred along elevation gradients. Higher levels of intraspecific divergence may be the result of disruptive selection and/or introgression along gradients. We suggest that collecting data on genetic and morphological variation in common species can be a cost effective tool for conservation planning, and that future biodiversity inventories include surveying genetic and morphological data of common species whenever feasible. PMID:23595273

Validation of Mission Plans Through Simulation

NASA Astrophysics Data System (ADS)

St-Pierre, J.; Melanson, P.; Brunet, C.; Crabtree, D.

2002-01-01

The purpose of a spacecraft mission planning system is to automatically generate safe and optimized mission plans for a single spacecraft, or more functioning in unison. The system verifies user input syntax, conformance to commanding constraints, absence of duty cycle violations, timing conflicts, state conflicts, etc. Present day constraint-based systems with state-based predictive models use verification rules derived from expert knowledge. A familiar solution found in Mission Operations Centers, is to complement the planning system with a high fidelity spacecraft simulator. Often a dedicated workstation, the simulator is frequently used for operator training and procedure validation, and may be interfaced to actual control stations with command and telemetry links. While there are distinct advantages to having a planning system offer realistic operator training using the actual flight control console, physical verification of data transfer across layers and procedure validation, experience has revealed some drawbacks and inefficiencies in ground segment operations: With these considerations, two simulation-based mission plan validation projects are under way at the Canadian Space Agency (CSA): RVMP and ViSION. The tools proposed in these projects will automatically run scenarios and provide execution reports to operations planning personnel, prior to actual command upload. This can provide an important safeguard for system or human errors that can only be detected with high fidelity, interdependent spacecraft models running concurrently. The core element common to these projects is a spacecraft simulator, built with off-the- shelf components such as CAE's Real-Time Object-Based Simulation Environment (ROSE) technology, MathWork's MATLAB/Simulink, and Analytical Graphics' Satellite Tool Kit (STK). To complement these tools, additional components were developed, such as an emulated Spacecraft Test and Operations Language (STOL) interpreter and CCSDS TM/TC encoders and decoders. This paper discusses the use of simulation in the context of space mission planning, describes the projects under way and proposes additional venues of investigation and development.

No Magic Bullet: A Theory-Based Meta-Analysis of Markov Transition Probabilities in Studies of Service Systems for Persons With Mental Disabilities.

PubMed

Leff, Hugh Stephen; Chow, Clifton M; Graves, Stephen C

2017-03-01

A random-effects meta-analysis of studies that used Markov transition probabilities (TPs) to describe outcomes for mental health service systems of differing quality for persons with serious mental illness was implemented to improve the scientific understanding of systems performance, to use in planning simulations to project service system costs and outcomes over time, and to test a theory of how outcomes for systems varying in quality differ. Nineteen systems described in 12 studies were coded as basic (B), maintenance (M), and recovery oriented (R) on the basis of descriptions of services provided. TPs for studies were aligned with a common functional-level framework, converted to a one-month time period, synthesized, and compared with theory-based expectations. Meta-regression was employed to explore associations between TPs and characteristics of service recipients and studies. R systems performed better than M and B systems. However, M systems did not perform better than B systems. All systems showed negative as well as positive TPs. For approximately one-third of synthesized TPs, substantial interstudy heterogeneity was noted. Associations were found between TPs and service recipient and study variables Conclusions: Conceptualizing systems as B, M, and R has potential for improving scientific understanding and systems planning. R systems appear more effective than B and M systems, although there is no "magic bullet" system for all service recipients. Interstudy heterogeneity indicates need for common approaches to reporting service recipient states, time periods for TPs, service recipient attributes, and service system characteristics. TPs found should be used in Markov simulations to project system effectiveness and costs of over time.

Provisional Title: Safety Analysis of Brentuximab Vedotin From the Phase 3 AETHERA Trial in Hodgkin Lymphoma in the Posttransplant Consolidation Setting.

PubMed

Nademanee, A; Sureda, A; Stiff, P; Holowiecki, J; Abidi, M; Hunder, N N; Pecsok, M; Uttarwar, M; Purevjal, I; Sweetenham, J

2018-05-30

The phase 3 AETHERA trial demonstrated brentuximab vedotin's (BV) efficacy as consolidation therapy in patients with classical Hodgkin lymphoma (HL) at high risk of relapse or progression following autologous hematopoietic stem cell transplant (auto-HSCT; hazard ratio [HR]=0.57; P<0.001). The objective of this analysis is to provide further detail on the most common and clinically important treatment-emergent adverse events (TEAEs) in the AETHERA BV arm including their occurrence and management. AEs of clinical importance occurring in patients who participated in AETHERA (BV + best supportive care [BSC], n=165; placebo + BSC, n=164) were evaluated for time to onset, manageability through dose modification, and resolution. As previously reported, peripheral neuropathy (PN; 67%), infections (60%), and neutropenia (35%) were the most common BV-associated TEAEs. Neutropenia was managed with dose delays and granulocyte colony-stimulating factor; no dose reductions or discontinuations were required. The majority (57%) of PN cases were managed with dose delays and reductions. The median time to PN onset was 13.7 (range, 0.1-47.4) weeks. After end of treatment, PN continued to resolve; symptom resolution was similar to that in the placebo arm at 3 years, demonstrating reversibility. BV had no significant impact on preexisting PN. Patients with PN-related dose modifications had progression-free survival (PFS) comparable to patients without. Other less common but serious AEs, including pulmonary toxicities, hepatotoxicity, and cardiotoxicity, were rare in both arms and managed with BV dose modifications or discontinuations. Secondary malignancies were rare and reported in patients with comorbidities or other risk factors. Consolidation therapy with BV for patients with HL at high risk of relapse after auto-HSCT is associated with sustained PFS. The most common AEs in the BV arm were manageable and reversible. Awareness of these AEs and management approaches will enable healthcare providers and patients to plan the safest and most effective treatment plan. Copyright © 2018. Published by Elsevier Inc.

Pancreatic cancer planning: Complex conformal vs modulated therapies.

PubMed

Chapman, Katherine L; Witek, Matthew E; Chen, Hongyu; Showalter, Timothy N; Bar-Ad, Voichita; Harrison, Amy S

2016-01-01

To compare the roles of intensity-modulated radiation therapy (IMRT) and volumetric- modulated arc therapy (VMAT) therapy as compared to simple and complex 3-dimensional chemoradiotherpy (3DCRT) planning for resectable and borderline resectable pancreatic cancer. In all, 12 patients who received postoperative radiotherapy (8) or neoadjuvant concurrent chemoradiotherapy (4) were evaluated retrospectively. Radiotherapy planning was performed for 4 treatment techniques: simple 4-field box, complex 5-field 3DCRT, 5 to 6-field IMRT, and single-arc VMAT. All volumes were approved by a single observer in accordance with Radiation Therapy Oncology Group (RTOG) Pancreas Contouring Atlas. Plans included tumor/tumor bed and regional lymph nodes to 45Gy; with tumor/tumor bed boosted to 50.4Gy, at least 95% of planning target volume (PTV) received the prescription dose. Dose-volume histograms (DVH) for multiple end points, treatment planning, and delivery time were assessed. Complex 3DCRT, IMRT, and VMAT plans significantly (p < 0.05) decreased mean kidney dose, mean liver dose, liver (V30, V35), stomach (D10%), stomach (V45), mean right kidney dose, and right kidney (V15) as compared with the simple 4-field plans that are most commonly reported in the literature. IMRT plans resulted in decreased mean liver dose, liver (V35), and left kidney (V15, V18, V20). VMAT plans decreased small bowel (D10%, D15%), small bowel (V35, V45), stomach (D10%, D15%), stomach (V35, V45), mean liver dose, liver (V35), left kidney (V15, V18, V20), and right kidney (V18, V20). VMAT plans significantly decreased small bowel (D10%, D15%), left kidney (V20), and stomach (V45) as compared with IMRT plans. Treatment planning and delivery times were most efficient for simple 4-field box and VMAT. Excluding patient setup and imaging, average treatment delivery was within 10minutes for simple and complex 3DCRT, IMRT, and VMAT treatments. This article shows significant improvements in 3D plan performance with complex planning over the more frequently compared 3- or 4-field simple 3D planning techniques. VMAT plans continue to demonstrate potential for the most organ sparing. However, further studies are required to identify if dosimetric benefits associated with inverse optimized planning can be translated into clinical benefits and if these treatment techniques are value-added therapies for this group of patients with cancer. Published by Elsevier Inc.

Designing Star Quality S.O.S. Lesson Plans. Tips

ERIC Educational Resources Information Center

Small, Ruth V.

2007-01-01

Once a lesson plan has been submitted to S.O.S., it goes to two independent evaluators, who review every part of the plan, from the title to related standards, using a common rubric. Each section of the lesson plan is rated as either Acceptable, Needs Improvement, or Unacceptable. The collective ratings of all sections of the lesson plan are then…

Peer education in the commons: a new approach to reference services.

PubMed

Neal, Ruth E; Ajamie, Lauren F; Harmon, Karen D; Kellerby, Carissa D; Schweikhard, April J

2010-10-01

In planning for a new library construction project for the University of Oklahoma-Tulsa, graduate students enrolled in the University of Oklahoma (OU) School of Library and Information Studies collaborated in an innovative effort to develop a commons-based reference service. By first considering a philosophical approach to the need for a commons, blending in the experiences of other libraries that have created similar spaces, and focusing on the workflow issues likely to be encountered by the graduate assistants staffing the commons itself, this planning team developed an uncommon peer-to-peer approach to reference and education services, one focused on the patron as student.

New York State Middle Schools and Instructional Scheduling, Teaming and Common Planning: A Descriptive Study

ERIC Educational Resources Information Center

Corey, Chad; Babo, Gerard

2016-01-01

Data regarding the type of instructional scheduling utilized along with the use of teaming and common planning at the middle school level has not been collected nor reported on the New York State School Report Card, and therefore it is not known whether and how middle schools are implementing these three school supports. Consequently, the purpose…

Interactive, open source, travel time scenario modelling: tools to facilitate participation in health service access analysis.

PubMed

Fisher, Rohan; Lassa, Jonatan

2017-04-18

Modelling travel time to services has become a common public health tool for planning service provision but the usefulness of these analyses is constrained by the availability of accurate input data and limitations inherent in the assumptions and parameterisation. This is particularly an issue in the developing world where access to basic data is limited and travel is often complex and multi-modal. Improving the accuracy and relevance in this context requires greater accessibility to, and flexibility in, travel time modelling tools to facilitate the incorporation of local knowledge and the rapid exploration of multiple travel scenarios. The aim of this work was to develop simple open source, adaptable, interactive travel time modelling tools to allow greater access to and participation in service access analysis. Described are three interconnected applications designed to reduce some of the barriers to the more wide-spread use of GIS analysis of service access and allow for complex spatial and temporal variations in service availability. These applications are an open source GIS tool-kit and two geo-simulation models. The development of these tools was guided by health service issues from a developing world context but they present a general approach to enabling greater access to and flexibility in health access modelling. The tools demonstrate a method that substantially simplifies the process for conducting travel time assessments and demonstrate a dynamic, interactive approach in an open source GIS format. In addition this paper provides examples from empirical experience where these tools have informed better policy and planning. Travel and health service access is complex and cannot be reduced to a few static modeled outputs. The approaches described in this paper use a unique set of tools to explore this complexity, promote discussion and build understanding with the goal of producing better planning outcomes. The accessible, flexible, interactive and responsive nature of the applications described has the potential to allow complex environmental social and political considerations to be incorporated and visualised. Through supporting evidence-based planning the innovative modelling practices described have the potential to help local health and emergency response planning in the developing world.

Radiotherapy beyond cancer: Target localization in real-time MRI and treatment planning for cardiac radiosurgery

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

Ipsen, S.; Blanck, O.; Rades, D.

2014-12-15

Purpose: Atrial fibrillation (AFib) is the most common cardiac arrhythmia that affects millions of patients world-wide. AFib is usually treated with minimally invasive, time consuming catheter ablation techniques. While recently noninvasive radiosurgery to the pulmonary vein antrum (PVA) in the left atrium has been proposed for AFib treatment, precise target location during treatment is challenging due to complex respiratory and cardiac motion. A MRI linear accelerator (MRI-Linac) could solve the problems of motion tracking and compensation using real-time image guidance. In this study, the authors quantified target motion ranges on cardiac magnetic resonance imaging (MRI) and analyzed the dosimetric benefitsmore » of margin reduction assuming real-time motion compensation was applied. Methods: For the imaging study, six human subjects underwent real-time cardiac MRI under free breathing. The target motion was analyzed retrospectively using a template matching algorithm. The planning study was conducted on a CT of an AFib patient with a centrally located esophagus undergoing catheter ablation, representing an ideal case for cardiac radiosurgery. The target definition was similar to the ablation lesions at the PVA created during catheter treatment. Safety margins of 0 mm (perfect tracking) to 8 mm (untracked respiratory motion) were added to the target, defining the planning target volume (PTV). For each margin, a 30 Gy single fraction IMRT plan was generated. Additionally, the influence of 1 and 3 T magnetic fields on the treatment beam delivery was simulated using Monte Carlo calculations to determine the dosimetric impact of MRI guidance for two different Linac positions. Results: Real-time cardiac MRI showed mean respiratory target motion of 10.2 mm (superior–inferior), 2.4 mm (anterior–posterior), and 2 mm (left–right). The planning study showed that increasing safety margins to encompass untracked respiratory motion leads to overlapping structures even in the ideal scenario, compromising either normal tissue dose constraints or PTV coverage. The magnetic field caused a slight increase in the PTV dose with the in-line MRI-Linac configuration. Conclusions: The authors’ results indicate that real-time tracking and motion compensation are mandatory for cardiac radiosurgery and MRI-guidance is feasible, opening the possibility of treating cardiac arrhythmia patients completely noninvasively.« less

Causal modeling of self-concept, job satisfaction, and retention of nurses.

PubMed

Cowin, Leanne S; Johnson, Maree; Craven, Rhonda G; Marsh, Herbert W

2008-10-01

The critical shortage of nurses experienced throughout the western world has prompted researchers to examine one major component of this complex problem - the impact of nurses' professional identity and job satisfaction on retention. A descriptive correlational design with a longitudinal element was used to examine a causal model of nurses' self-concept, job satisfaction, and retention plans in 2002. A random sample of 2000 registered nurses was selected from the state registering authority listing. A postal survey assessing multiple dimensions of nurses' self-concept (measured by the nurse self-concept questionnaire), job satisfaction (measured by the index of work satisfaction) was undertaken at Time 1 (n=528) and 8 months later at Time 2 (n=332) (including retention plans (measured by the Nurse Retention Index). Using confirmatory factor analysis, correlation matrices and path analysis, measurement and structural models were examined on matching pairs of data from T1 and T2 (total sample N=332). Nurses' self-concept was found to have a stronger association with nurses' retention plans (B=.45) than job satisfaction (B=.28). Aspects of pay and task were not significantly related to retention plans, however, professional status (r=.51), and to a lesser extent, organizational policies (r=.27) were significant factors. Nurses' general self-concept was strongly related (r=.57) to retention plans. Strategies or interventions requiring implementation and evaluation include: counseling to improve nurse general self-concept, education programs and competencies in health communication between health professionals, reporting of nurse-initiated programs with substantial patient benefit, nurse-friendly organizational policies, common health team learning opportunities, and autonomous practice models.

25 CFR 700.721 - Range management plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Range management plans. 700.721 Section 700.721 Indians... Lands Grazing § 700.721 Range management plans. The Commissioner (or his designee) and the permittees of each range unit will meet as a group and develop a Range Management Plan for the common use of the...

Planning for Future Forms of Education: Towards an Educational and Educational Facilities Planning Model.

ERIC Educational Resources Information Center

Leu, Donald J.

The author provides an overview and conceptualization of the total educational and educational facility planning process. The presentation attempts to provide a simple practical outline for local planners, so they may actively engage in relevant educational facility planning, and a common conceptual base, so the various components of Project…

Special Planning for Special Spaces. Selected Articles from "Planning for Higher Education."

ERIC Educational Resources Information Center

Rickes, Persis, Ed.

This collection contains articles from the journal "Planning for Higher Education" organized around four core spaces commonly found on a college or university campus. Following an introduction, Section 2, "Cultural Spaces," contains these articles: (1) "Planning the Successful Performing Arts Facility" (Wendell Brase, v18 n3); (2) "Frontier…

Dynamic Integration of Value Information into a Common Probability Currency as a Theory for Flexible Decision Making

PubMed Central

Christopoulos, Vassilios; Schrater, Paul R.

2015-01-01

Decisions involve two fundamental problems, selecting goals and generating actions to pursue those goals. While simple decisions involve choosing a goal and pursuing it, humans evolved to survive in hostile dynamic environments where goal availability and value can change with time and previous actions, entangling goal decisions with action selection. Recent studies suggest the brain generates concurrent action-plans for competing goals, using online information to bias the competition until a single goal is pursued. This creates a challenging problem of integrating information across diverse types, including both the dynamic value of the goal and the costs of action. We model the computations underlying dynamic decision-making with disparate value types, using the probability of getting the highest pay-off with the least effort as a common currency that supports goal competition. This framework predicts many aspects of decision behavior that have eluded a common explanation. PMID:26394299

Palliative Care in Heart Failure.

PubMed

Sood, Abhinav; Dobbie, Krista; Wilson Tang, W H

2018-04-19

This review illustrates the dynamic role of palliative care in heart failure management and encapsulates the commonly utilized pharmacologic and non-pharmacologic therapeutic strategies for symptom palliation in heart failure. In addition, we provide our experience regarding patient care issues common to the domain of heart failure and palliative medicine which are commonly encountered by heart failure teams. Addition of palliative care to conventional heart failure management plan results in improvement in quality of life, anxiety, depression, and spiritual well-being among patients. Palliative care should not be confused with hospice care. Palliative care teams should be involved early in the care of heart failure patients with the aims of improving symptom palliation, discussing goals of care and improving quality of life without compromising utilization of evidence-based heart failure therapies. A consensus on the appropriate timing of involvement and evidence for many symptom palliation therapies is still emerging.

Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case–control study

PubMed Central

2014-01-01

Background Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. Methods A case–control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15–49 years were interviewed using structured questionnaires. A logistic regression was fitted. Results Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. Conclusion While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates. PMID:25117887

Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case-control study.

PubMed

Eliason, Sebastian; Awoonor-Williams, John K; Eliason, Cecilia; Novignon, Jacob; Nonvignon, Justice; Aikins, Moses

2014-08-13

Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district. A case-control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15-49 years were interviewed using structured questionnaires. A logistic regression was fitted. Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives. While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.

Reproductive health in women following abdominal organ transplant

PubMed Central

Sarkar, Monika; Bramham, Kate; Moritz, Michael J.; Coscia, Lisa

2018-01-01

Fertility is commonly impaired in women with end-stage kidney and liver disease, although most women will have restoration of fertility within 1 year of transplant. Family planning is therefore critical to discuss with reproductive-aged transplant recipients in the early posttransplant period, in order to ensure timely initiation of contraception, and optimal timing for conception. For women seeking pregnancy, the risks to the mother, graft, and baby should be discussed, including evaluation of immunosuppression safety and potential for adjusting medications prior to conception. With an increasing number of transplant patients now breastfeeding, immunosuppression safety in lactation continues to carry great importance. PMID:29446243

Orbital transfer vehicle launch operations study. Volume 2: Detailed summary

NASA Technical Reports Server (NTRS)

1986-01-01

A series of Operational Design Drivers were identified. Several of these could have significant impact(s) on program costs. These recommendations, for example, include such items as: complete factory assembly and checkout prior to shipment to the ground launch site to make significant reductions in time required at the launch site as well as overall manpower required to do this work; minimize use of nonstandard equipment when orbiter provided equipment is available; and require commonality (or interchangeability) of subsystem equipment elements that are common to the space station, Orbit Maneuvering Vehicles, and/or Orbit Transfer Vehicles. Several additional items were identified that will require a significant amount of management attention (and direction) to resolve. Key elements of the space based processing plans are discussed.

KSC Education Technology Research and Development Plan

NASA Technical Reports Server (NTRS)

Odell, Michael R. L.

2003-01-01

Educational technology is facilitating new approaches to teaching and learning science, technology, engineering, and mathematics (STEM) education. Cognitive research is beginning to inform educators about how students learn providing a basis for design of more effective learning environments incorporating technology. At the same time, access to computers, the Internet and other technology tools are becoming common features in K-20 classrooms. Encouraged by these developments, STEM educators are transforming traditional STEM education into active learning environments that hold the promise of enhancing learning. This document illustrates the use of technology in STEM education today, identifies possible areas of development, links this development to the NASA Strategic Plan, and makes recommendations for the Kennedy Space Center (KSC) Education Office for consideration in the research, development, and design of new educational technologies and applications.

Client value models provide a framework for rational library planning (or, phrasing the answer in the form of a question).

PubMed

Van Moorsel, Guillaume

2005-01-01

Libraries often do not know how clients value their product/ service offerings. Yet at a time when the mounting costs for library support are increasingly difficult to justify to the parent institution, the library's ability to gauge the value of its offerings to clients has never been more critical. Client Value Models (CVMs) establish a common definition of value elements-or a "value vocabulary"-for libraries and their clients, thereby providing a basis upon which to make rational planning decisions regarding product/service acquisition and development. The CVM concept is borrowed from business and industry, but its application has a natural fit in libraries. This article offers a theoretical consideration and practical illustration of CVM application in libraries.

Why are You Late?: Investigating the Role of Time Management in Time-Based Prospective Memory

PubMed Central

Waldum, Emily R; McDaniel, Mark A.

2016-01-01

Time-based prospective memory tasks (TBPM) are those that are to be performed at a specific future time. Contrary to typical laboratory TBPM tasks (e.g., “hit the “z” key every 5 minutes”), many real-world TBPM tasks require more complex time-management processes. For instance to attend an appointment on time, one must estimate the duration of the drive to the appointment and then utilize this estimate to create and execute a secondary TBPM intention (e.g., “I need to start driving by 1:30 to make my 2:00 appointment on time”). Future under- and overestimates of drive time can lead to inefficient TBPM performance with the former lending to missed appointments and the latter to long stints in the waiting room. Despite the common occurrence of complex TBPM tasks in everyday life, to date, no studies have investigated how components of time management, including time estimation, affect behavior in such complex TBPM tasks. Therefore, the current study aimed to investigate timing biases in both older and younger adults and further to determine how such biases along with additional time management components including planning and plan fidelity influence complex TBPM performance. Results suggest for the first time that younger and older adults do not always utilize similar timing strategies, and as a result, can produce differential timing biases under the exact same environmental conditions. These timing biases, in turn, play a vital role in how efficiently both younger and older adults perform a later TBPM task that requires them to utilize their earlier time estimate. PMID:27336325

Distributed intelligence for supervisory control

NASA Technical Reports Server (NTRS)

Wolfe, W. J.; Raney, S. D.

1987-01-01

Supervisory control systems must deal with various types of intelligence distributed throughout the layers of control. Typical layers are real-time servo control, off-line planning and reasoning subsystems and finally, the human operator. Design methodologies must account for the fact that the majority of the intelligence will reside with the human operator. Hierarchical decompositions and feedback loops as conceptual building blocks that provide a common ground for man-machine interaction are discussed. Examples of types of parallelism and parallel implementation on several classes of computer architecture are also discussed.

Review of the Increased Participation of the Commanders-in-Chief (CINCS) in the Planning, Programing, and Budgeting System (PPBS)

DTIC Science & Technology

1988-06-01

NOVEMBER 1984, SUBJECT: ENHANCEMENT OF THE CINCS ROLE IN PPBS......152 APPENDIX C: EXTRACTS FROM THE GOLDWATER-NICHOLS ACT RELATING TO THE CINCS...18 The law refers to combatant commands and later combatant commanders who are more commonly referred to as CINCs or Commanders-in-Chief. 19 Boldin ...Appendix D for extracts from the Goldwater-Nichols Act .-- and other documents relating to the CINCs.) For the first time, and because of the Act

Loneliness: a concept analysis.

PubMed

Bekhet, Abir K; Zauszniewski, Jaclene A; Nakhla, Wagdy E

2008-01-01

Loneliness is a universal human experience recognized since the dawn of time, yet it is unique for every individual. Loneliness can lead to both depression and low self-esteem. This article explicates the concept of loneliness through the examination of its conceptual definition and uses, defining attributes, related concepts, and empirical referents. Literature review using hand search and database were used as sources of information. Because loneliness is commonly encountered in nursing situations, the information provided will serve as a framework for assessment, planning, intervention, and evaluation of clients.

Strange Horizons: Teaching Usual and Unusual Atmospheric Effects using APOD

NASA Astrophysics Data System (ADS)

Wilson, Teresa

2015-01-01

Unusual Sun and moonsets are not only photogenic -- they are educational. Images appearing on the Astronomy Picture of the Day (APOD) that demonstrate dramatic examples of the green flash, the Moon illusion, Fata Morgana, and the Etruscan vase effect are discussed in terms of how they demonstrate atmospheric refraction, chromatic aberration, and temperature inversions. A lesson plan is given for undergraduate classrooms as well as estimates of how each effect might alter the perceived time of a common sunset.

Women in the US Army: A Quiet Revolution in Military Affairs

DTIC Science & Technology

2007-05-24

Marines, Army Rangers , Navy Special Warfare teams, and other military forces to invade Grenada. The planning time used for this operation was “very...all Away with the horizons too. The sun is beyond them— The moon and stars do not touch them. I seek new galaxies — But only as oases for respite...commonly acknowledged that Ranger School has a lasting effect on its graduates. It is not uncommon for male Soldiers to reflect on their Ranger School

Safe and Healthy Birth: The Importance of Data

PubMed Central

Romano, Amy M.

2010-01-01

In this column, the author reprises recent selections from the Lamaze International research blog, Science & Sensibility. Each selection discusses the mismatch between data commonly collected at the time of birth and the data needed to measure optimal care for physiologic birth. Selections include the importance of documenting duration of skin-to-skin contact after birth, the role of qualitative research in improving care in the second stage of labor, and pitfalls of meta-analyzing data on the safety of planned home birth. PMID:21886420

The Role of Public-Sector Family Planning Programs in Meeting the Demand for Contraception in Sub-Saharan Africa.

PubMed

Bongaarts, John; Hardee, Karen

2017-06-01

Commonly used indicators of contraceptive behavior in a population-modern contraceptive prevalence (mCPR), unmet need for contraception, demand for contraception and demand satisfied-are not well-suited for evaluating the progress made by government family planning programs in helping women and men achieve their reproductive goals. Trends in these measures in 26 Sub-Saharan African countries between 1990 and 2014 were examined. Trends in a proposed new indicator, the public-sector family planning program impact score (PFPI), and its relationship to mCPR and the family planning effort score were also assessed. Case studies were used to review public family planning program development and implementation in four countries (Nigeria, Ethiopia, Rwanda and Kenya). The four commonly used indicators capture the extent to which women use family planning and to which demand is satisfied, but shed no direct light on the role of family planning programs. PFPI provides evidence that can be used to hold governments accountable for meeting the demand for family planning, and was closely related to policy developments in the four case-study countries. PFPI provides a useful addition to the indicators currently used to assess progress in reproductive health and family planning programs.

Methods for planning a statistical POD study

NASA Astrophysics Data System (ADS)

Koh, Y.-M.; Meeker, W. Q.

2013-01-01

The most common question asked of a statistician is "How large should my sample be?" In NDE applications, the most common questions asked of a statistician are "How many specimens do I need and what should be the distribution of flaw sizes?" Although some useful general guidelines exist (e.g. in MIK-HDBK-1823) it is possible to use statistical tools to provide more definitive guidelines and to allow comparison among different proposed study plans. One can assess the performance of a proposed POD study plan by obtaining computable expressions for estimation precision. This allows for a quick and easy assessment of tradeoffs and comparison of various alternative plans. We use a signal-response dataset obtained from MIK-HDBK-1823 to illustrate the ideas.

Development of Secondary Route Bridge Design Plan Guides

DOT National Transportation Integrated Search

2018-03-03

The objective of this study is to develop a set of bridge plan guides for low-volume traffic roads. The purpose of the plans is to facilitate construction of new structures suitable for local agencies. The designs are to specifically address common l...

Peer Review of Radiotherapy Planning: Quantifying Outcomes and a Proposal for Prospective Data Collection.

PubMed

Mackenzie, J; Graham, G; Olivotto, I A

2016-12-01

The Canadian Partnership for Quality Radiotherapy quality assurance guidelines recommend that radiation oncologist peer review of curative radiotherapy plans takes place ideally before the first fraction of treatment is delivered. This study documented and evaluated the outcomes of weekly, disease site-specific, radiotherapy peer review, quality assurance rounds at the Tom Baker Cancer Centre in Calgary, Canada with a view to making recommendations about the optimal timing and documentation of peer review during the radiotherapy planning processes. Outcomes of each case reviewed at (i) breast, (ii) head and neck (including thyroid and cutaneous cases) and (iii) lung team quality assurance rounds from 6 January to 5 May 2015 were recorded prospectively. Each radiotherapy plan was assigned an outcome: A for plans with no suggested changes; B for satisfactory, but where issues were raised to consider for future patients; or C when a change was recommended before the first or next fraction. The B outcomes were further subdivided into B1 for a case-specific concern and B2 for a policy gap. Plans were assessed after contour definition and before the plan was formulated (post-contouring reviews) and/or assessed when the plan was complete (post-planning reviews). 209 radiotherapy plans prescribed by 20 radiation oncologists were peer reviewed at 43 quality assurance meetings. 93% were curative-intent and 7% were palliative. 83% of plans were reviewed before delivery of the first treatment fraction. There were a total of 257 case reviews: 60 at the post-contouring stage, 197 at the post-planning stage, including 46 patients reviewed at both time points. Overall rates of A, B1, B2 and C outcomes were 78%, 9%, 4% and 9%, respectively. The most common reason for a B or C outcome was related to target volume definition. Only 56% of C outcomes at the post-planning stage would have been detected at the post-contouring stage. Results varied between tumour site groups. 9% of radiotherapy plans reviewed had changes suggested before delivery to the patient. Review at the post-planning stage after plan completion was necessary to detect all suggested changes, but for head and neck cases, all C outcomes could have been detected at the post-contouring stage. More widespread implementation of radiotherapy peer review in the UK is recommended. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Community wildfire protection planning in the American West: homogeneity within diversity?

Treesearch

Jesse Abrams; Max Nielsen-Pincus; Travis Paveglio; Cassandra Moseley

2016-01-01

As large wildfires have become common across the American West, federal policies such as the Healthy Forests Restoration Act have empowered local communities to plan for their own wildfire protection. Here, we present an analysis of 113 community wildfire protection plans from 10 western states where large fires have recently occurred. These plans contain wide...

Creating a University for the 21st Century: Strategic Plan

ERIC Educational Resources Information Center

North Dakota University System, 2005

2005-01-01

This document presents the strategic plan of the North Dakota University System, revised in November 2005, to develop a common vision and clear set of expectations for higher education in North Dakota. The strategic plan for the University System is directly linked to the Roundtable on Higher Education plan. This document presents the ten sections…

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

Brouillette, Greg A.

These are slides for various presentations on C41SR and urban disasters disasters response and recovery tools. These are all mainly charts and images of disaster response and recovery tools. Slides included have headings such as the following: vignette of a disaster response, situational awareness and common operating picture available to EOC, plume modeling capability, Program ASPECT Chemical Response Products, EPA ASPECT - Hurricane RITA Response 9/25/2005, Angel Fire Imagery, incident commander's view/police chief's view/ EMS' view, common situational awareness and collaborative planning, exercise, training capability, systems diagram, Austere Challenge 06 Sim/C4 Requirements, common situational awareness and collaborative planning, exercise, trainingmore » environment, common situational awareness, real world, crisis response, and consequence management.« less

Continuous Flow in Labour-Intensive Manufacturing Process

NASA Astrophysics Data System (ADS)

Pacheco Eng., Jhonny; Carbajal MSc., Eduardo; Stoll-Ing., Cesar, Dr.

2017-06-01

A continuous-flow manufacturing represents the peak of standard production, and usually it means high production in a strict line production. Furthermore, low-tech industry demands high labour-intensive, in this context the efficient of the line production is tied at the job shop organization. Labour-intensive manufacturing processes are a common characteristic for developing countries. This research aims to propose a methodology for production planning in order to fulfilment a variable monthly production quota. The main idea is to use a clock as orchestra director in order to synchronize the rate time (takt time) of customer demand with the manufacturing time. In this way, the study is able to propose a stark reduction of stock in process, over-processing, and unnecessary variability.

Succession Planning for Library Instruction

ERIC Educational Resources Information Center

Sobel, Karen; Drewry, Josiah

2015-01-01

Detailed succession planning helps libraries pass information from one employee to the next. This is crucial in preparing for hiring, turnover, retirements, training of graduate teaching assistants in academic libraries, and other common situations. The authors of this article discuss succession planning for instruction programs in academic…

Ten common estate planning mistakes to avoid.

PubMed

Harper, M E

2000-01-01

While most Americans are aware of the importance of estate planning, many fail to make the proper arrangements for their heirs. Problems can arise from a number of mistake, such as underestimating assets, relying solely on a will, or not planning for estate tax payments.

17 CFR 229.402 - (Item 402) Executive compensation.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., concise and understandable disclosure of all plan and non-plan compensation awarded to, earned by, or paid... stock units, phantom stock, phantom stock units, common stock equivalent units or any similar..., registrants may omit information regarding group life, health, hospitalization, or medical reimbursement plans...

17 CFR 229.402 - (Item 402) Executive compensation.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., concise and understandable disclosure of all plan and non-plan compensation awarded to, earned by, or paid... stock units, phantom stock, phantom stock units, common stock equivalent units or any similar..., registrants may omit information regarding group life, health, hospitalization, or medical reimbursement plans...

Java RMI Software Technology for the Payload Planning System of the International Space Station

NASA Technical Reports Server (NTRS)

Bryant, Barrett R.

1999-01-01

The Payload Planning System is for experiment planning on the International Space Station. The planning process has a number of different aspects which need to be stored in a database which is then used to generate reports on the planning process in a variety of formats. This process is currently structured as a 3-tier client/server software architecture comprised of a Java applet at the front end, a Java server in the middle, and an Oracle database in the third tier. This system presently uses CGI, the Common Gateway Interface, to communicate between the user-interface and server tiers and Active Data Objects (ADO) to communicate between the server and database tiers. This project investigated other methods and tools for performing the communications between the three tiers of the current system so that both the system performance and software development time could be improved. We specifically found that for the hardware and software platforms that PPS is required to run on, the best solution is to use Java Remote Method Invocation (RMI) for communication between the client and server and SQLJ (Structured Query Language for Java) for server interaction with the database. Prototype implementations showed that RMI combined with SQLJ significantly improved performance and also greatly facilitated construction of the communication software.

[The Health Plan for Catalonia: an instrument to transform the health system].

PubMed

Constante i Beitia, Carles

2015-11-01

The Department of Health of the Generalitat in Catalonia periodically draws up the Health Plan, which is the strategic document that brings together the reference framework for initiatives concerning public health in terms of the Catalan health administration. The 2011-2015 version of the Health Plan incorporates key care and system governance-related elements, which, in conjunction with health goals, make up the complete picture of what the health system in Catalonia should look like until 2015. The Plan was drawn up at a time when the environmental conditions were extremely particular, given the major economic crisis that began in 2007. This has meant that the system has been forced to address public health problems using a significant reduction in the economic resources available, while aiming to maintain the level of care provided, both quantitatively and qualitatively, and preserve the sustainability of the system whose defining traits are its universality, equity and the wide range of services on offer. The Health Plan focuses on three areas of action, 9 major courses of action and 32 strategic projects designed to respond to new social needs: addressing the most common health issues, comprehensive care for chronic patients and organizational modernization. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Characteristic Risk Factors Associated with Planned versus Impulsive Suicide Attempters.

PubMed

Kim, Jaeha; Lee, Kang-Sook; Kim, Dai Jin; Hong, Seung-Chul; Choi, Kyoung Ho; Oh, Youngmin; Wang, Sheng-Min; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

2015-12-31

The present study aimed to investigate predictors for planned suicide attempters. This study included 1,003 patients who attempted suicide and visited emergency department. They were divided into two groups, planned suicide attempters (SAs; n=133 [13.3%]) and impulsive SAs (n=870, [86.7%]), and the demographic variables, clinical characteristics, factors related to suicide, and psychiatric resources of the groups were compared. Major depressive disorder and substance use disorders were more common among planned SAs than among impulsive SAs. Additionally, the planned SAs were older, more likely to be divorced, separated or widowed, and more likely to have comorbid medical illnesses, severe depression, higher suicidality, and self-blaming tendencies than the impulsive SAs. Financial problems and physical illnesses were more common in planned SAs but interpersonal conflicts were more frequent in impulsive SAs. Planned SAs had fewer previous suicide attempts but these were more serious suicide attempts. The presence of the hope to die, a written will, and suicidal ideation of a repetitive, intense, and continuous nature were predictive of planned SAs. The present findings demonstrated that planned SAs had more severe psychopathology and medical illnesses than impulsive SAs. Therefore, screening for depression, substance use disorders, and suicidal plans among old and medically ill patients may be important for preventing suicide attempts.

Strategic planning for post-disaster temporary housing.

PubMed

Johnson, Cassidy

2007-12-01

Temporary housing programmes suffer from excessively high cost, late delivery, poor location, improper unit designs and other inherent issues. These issues can be attributed in part to a prevalence of ad hoc tactical planning, rather than pre-disaster strategic planning, for reconstruction undertaken by governments and non-governmental organisations (NGOs) in the chaotic post-disaster environment. An analysis of the process and outcomes from six case studies of temporary housing programmes after disasters in Turkey and Colombia in 1999, Japan in 1995, Greece in 1986, Mexico in 1985, and Italy in 1976 yields information about the extent to which strategic planning is employed in temporary housing programmes, as well as common issues in temporary housing. Based on an understanding of these common issues, this paper proposes a framework for strategic planning for temporary housing that identifies organisational designs and available resources for temporary housing before the disaster, but allows modifications to fit the specific post-disaster situation.

Reliability of an interactive computer program for advance care planning.

PubMed

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

2012-06-01

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

Reliability of an Interactive Computer Program for Advance Care Planning

PubMed Central

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

2012-01-01

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

Reasoning on the Self-Organizing Incremental Associative Memory for Online Robot Path Planning

NASA Astrophysics Data System (ADS)

Kawewong, Aram; Honda, Yutaro; Tsuboyama, Manabu; Hasegawa, Osamu

Robot path-planning is one of the important issues in robotic navigation. This paper presents a novel robot path-planning approach based on the associative memory using Self-Organizing Incremental Neural Networks (SOINN). By the proposed method, an environment is first autonomously divided into a set of path-fragments by junctions. Each fragment is represented by a sequence of preliminarily generated common patterns (CPs). In an online manner, a robot regards the current path as the associative path-fragments, each connected by junctions. The reasoning technique is additionally proposed for decision making at each junction to speed up the exploration time. Distinct from other methods, our method does not ignore the important information about the regions between junctions (path-fragments). The resultant number of path-fragments is also less than other method. Evaluation is done via Webots physical 3D-simulated and real robot experiments, where only distance sensors are available. Results show that our method can represent the environment effectively; it enables the robot to solve the goal-oriented navigation problem in only one episode, which is actually less than that necessary for most of the Reinforcement Learning (RL) based methods. The running time is proved finite and scales well with the environment. The resultant number of path-fragments matches well to the environment.

Behavioral Health Services in the Changing Landscape of Private Health Plans.

PubMed

Horgan, Constance M; Stewart, Maureen T; Reif, Sharon; Garnick, Deborah W; Hodgkin, Dominic; Merrick, Elizabeth L; Quinn, Amity E

2016-06-01

Health plans play a key role in facilitating improvements in population health and may engage in activities that have an impact on access, cost, and quality of behavioral health care. Although behavioral health care is becoming more integrated with general medical care, its delivery system has unique aspects. The study examined how health plans deliver and manage behavioral health care in the context of the Affordable Care Act (ACA) and the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). This is a critical time to examine how health plans manage behavioral health care. A nationally representative survey of private health plans (weighted N=8,431 products; 89% response rate) was conducted in 2010 during the first year of MHPAEA, when plans were subject to the law but before final regulations, and just before the ACA went into effect. The survey addressed behavioral health coverage, cost-sharing, contracting arrangements, medical home innovations, support for technology, and financial incentives to improve behavioral health care. Coverage for inpatient and outpatient behavioral health services was stable between 2003 and 2010. In 2010, health plans were more likely than in 2003 to manage behavioral health care through internal arrangements and to contract for other services. Medical home initiatives were common and almost always included behavioral health, but financial incentives did not. Some plans facilitated providers' use of technology to improve care delivery, but this was not the norm. Health plans are key to mainstreaming and supporting delivery of high-quality behavioral health services. Since 2003, plans have made changes to support delivery of behavioral health services in the context of a rapidly changing environment.

Developing Legacy: Health Planning in the Host City of Porto Alegre for the 2014 Football World Cup.

PubMed

Witt, Regina Rigatto; Kotlhar, Mauro Kruter; Mesquita, Marilise Oliveira; Lima, Maria Alice Dias da Silva; Marin, Sandra Mara; Day, Carolina Baltar; Bandeira, Andrea Goncalves; Hutton, Alison

2015-12-01

To describe the process adopted to identify, classify, and evaluate legacy of health care planning in the host city of Porto Alegre for the Football World Cup 2014. There is an emerging interest in the need to demonstrate a sustainable health legacy from mass gatherings investments. Leaving a public health legacy for future host cities and countries is now an important part of planning for these events. The Ministry of Sports initiated and coordinated the development of projects in the host cities to identify actions, projects, and constructions to be developed to prepare for the World Cup. In Porto Alegre, a common structure was developed by the coordinating team to instruct legacy identification, classification, and evaluation. This structure was based on international documentary analysis (including official reports, policy documents, and web-based resources) and direct communication with recognized experts in the field. Sixteen total legacies were identified for health surveillance (5) and health services (11). They were classified according to the strategic area, organizations involved, dimension, typology, planned or unplanned, tangible or intangible, territorial coverage, and situation prior to the World Cup. Possible impacts were then assessed as positive, negative, and potentiating, and mitigating actions were indicated. The project allowed the identification, classification, and development of health legacy, including risk analysis, surveillance, mitigation measures, and provision of emergency medical care. Although the project intended the development of indicators to measure the identified legacies, evaluation was not possible at the time of publication due to time.

Future career plans of a cohort of senior doctors working in the National Health Service.

PubMed

Taylor, Kathryn; Lambert, Trevor; Goldacre, Michael

2008-04-01

To report on the future career plans of senior doctors working in the NHS. Postal questionnaires. All doctors who qualified in 1977 from all UK medical schools. Future plans and whether participants had any unmet needs for advice on how to put their future plans into effect. 25% definitely intended to continue with their current employment on the same basis until they retired; 75% hoped for change. A reduction in working hours was the most commonly desired change; but a substantial percentage also wanted changes in job content. 50% of respondents intended definitely (17%) or probably (33%) to work in the NHS to their normal retirement age; and 37% definitely (20%) or probably (17%) intended to retire early. 48% had made plans, in addition to the standard pension, to facilitate early retirement. The main factors given for considering early retirement were family reasons and wanting more time for leisure, a desire to maintain good health, excessive pressure of work, and disillusionment with NHS changes. A reduction in workload would be the greatest inducement to stay. 31% of respondents reported that they had unmet needs for advice about their future plans. Of these, about half were needs for advice about planning for retirement. Many senior NHS doctors would like to reduce their working hours. Less than a quarter definitely intend to work in the NHS to normal retirement age. Even for senior doctors, advice on career development is needed.

Wavefront correction with Kalman filtering for the WFIRST-AFTA coronagraph instrument

NASA Astrophysics Data System (ADS)

Riggs, A. J. Eldorado; Kasdin, N. Jeremy; Groff, Tyler D.

2015-09-01

The only way to characterize most exoplanets spectrally is via direct imaging. For example, the Coronagraph Instrument (CGI) on the proposed Wide-Field Infrared Survey Telescope-Astrophysics Focused Telescope Assets (WFIRST-AFTA) mission plans to image and characterize several cool gas giants around nearby stars. The integration time on these faint exoplanets will be many hours to days. A crucial assumption for mission planning is that the time required to dig a dark hole (a region of high star-to-planet contrast) with deformable mirrors is small compared to science integration time. The science camera must be used as the wavefront sensor to avoid non-common path aberrations, but this approach can be quite time intensive. Several estimation images are required to build an estimate of the starlight electric field before it can be partially corrected, and this process is repeated iteratively until high contrast is reached. Here we present simulated results of batch process and recursive wavefront estimation schemes. In particular, we test a Kalman filter and an iterative extended Kalman filter (IEKF) to reduce the total exposure time and improve the robustness of wavefront correction for the WFIRST-AFTA CGI. An IEKF or other nonlinear filter also allows recursive, real-time estimation of sources incoherent with the star, such as exoplanets and disks, and may therefore reduce detection uncertainty.

WOMEN’S EMPOWERMENT AND FAMILY PLANNING: A REVIEW OF THE LITERATURE

PubMed Central

PRATA, NDOLA; FRASER, ASHLEY; HUCHKO, MEGAN J.; GIPSON, JESSICA D.; WITHERS, MELLISSA; LEWIS, SHAYNA; CIARALDI, ERICA J.; UPADHYAY, USHMA D.

2017-01-01

Summary This paper reviews the literature examining the relationship between women’s empowerment and contraceptive use, unmet need for contraception and related family planning topics in developing countries. Searches were conducted using PubMed, Popline and Web of Science search engines in May 2013 to examine literature published between January 1990 and December 2012. Among the 46 articles included in the review, the majority were conducted in South Asia (n = 24). Household decision-making (n = 21) and mobility (n = 17) were the most commonly examined domains of women’s empowerment. Findings show that the relationship between empowerment and family planning is complex, with mixed positive and null associations. Consistently positive associations between empowerment and family planning outcomes were found for most family planning outcomes but those investigations represented fewer than two-fifths of the analyses. Current use of contraception was the most commonly studied family planning outcome, examined in more than half the analyses, but reviewed articles showed inconsistent findings. This review provides the first critical synthesis of the literature and assesses existing evidence between women’s empowerment and family planning use. PMID:28069078

MO-G-BRE-02: A Survey of IMRT QA Practices for More Than 800 Institutions

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

Pulliam, K; Kerns, J; Howell, R

Purpose: A wide range of techniques and measurement devices are employed for IMRT QA, causing a large variation of accepted action limits and potential follow up for failing plans. Such procedures are not well established or accepted in the medical physics community. To achieve the goal of proving insight into current IMRT QA practices, we created an electronic IMRT QA survey. The survey was open to a variety of the most common QA devices and assessed the type of comparison to measurement, action limits, delivery methods, and clinical action for failing QA plans. Methods: We conducted an online survey throughmore » the Radiological Physics Center's (RPC) annual survey with the goal of ascertaining elements of routine patient-specific IMRT QA. A total of 874 institutions responded to the survey. The questions ranged from asking for action limits, dosimeter type(s) used, delivery techniques, and actions taken when a plan fails IMRT QA. Results: The most common (52%) planar gamma criteria was 3%/3 mm with a 95% of pixels passing criteria. The most common QA device were diode arrays (48%). The most common first response to a plan failing QA was to re-measure at the same point the point dose (89%), second was to re-measure at a new point (13%), and third was to analyze the plan in relative instead of absolute mode (10%) (Does not add to 100% as not all institutions placed a response for each QA follow-up option). Some institutions, however, claimed that they had never observed a plan failure. Conclusion: The survey provided insights into the way the community currently performs IMRT QA. This information will help in the push to standardize action limits among dosimeters.« less

The Paris Declaration in practice: challenges of health sector aid coordination at the district level in Zambia

PubMed Central

Sundewall, Jesper; Forsberg, Birger C; Jönsson, Kristina; Chansa, Collins; Tomson, Göran

2009-01-01

Background The increasing resources available for and number of partners providing health sector aid have stimulated innovations, notably, the Paris Declaration on Aid Effectiveness, which aim to improve aid coordination. In this, one of the first studies to analyse implementation of aid coordination below national level, the aim was to investigate the effect of the Paris Declaration on coordination of health sector aid at the district level in Zambia. Methods The study was carried out in three districts of Zambia. Data were collected via interviews with health centre staff, district managers and officials from the Ministry of Health, and from district action plans, financial reports and accounts, and health centre ledger cards. Four indicators of coordination related to external-partner activity, common arrangements used by external partners and predictability of funding were analysed and assessed in relation to the 2010 targets set by the Paris Declaration. Findings While the activity of external partners at the district level has increased, funding and activities provided by these partners are often not included in local plans. HIV/AIDS support show better integration in planning and implementation at the district level than other support. Regarding common arrangements used for fund disbursement, the share of resources provided as programme-based support is not increasing. The predictability of funds coming from outside the government financing mechanism is low. Conclusion Greater efforts to integrate partners in district level planning and implementation are needed. External partners must improve the predictability of their support and be more proactive in informing the districts about their intended contributions. With the deadline for achieving the targets set by the Paris Declaration fast approaching, it is time for the signatories to accelerate its implementation. PMID:19505300

Defense Health Care: Applying Key Management Practices Should Help Achieve Efficiencies within the Military Health System

DTIC Science & Technology

2012-04-01

5. Realign the TRICARE Management Activity and establish a Joint Military Health Service Directorate to consolidate shared services and common...Directorate to consolidate shared services and common functions Realign TRICARE Management Activity and establish a TRICARE Health Plan Agency to...Uniformed Services University of the Health Sciences, (2) TRICARE health plan, (3) Health Management Support, and (4) Shared Services division

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

Belley, M; Schmidt, M; Knutson, N

Purpose: Physics second-checks for external beam radiation therapy are performed, in-part, to verify that the machine parameters in the Record-and-Verify (R&V) system that will ultimately be sent to the LINAC exactly match the values initially calculated by the Treatment Planning System (TPS). While performing the second-check, a large portion of the physicists’ time is spent navigating and arranging display windows to locate and compare the relevant numerical values (MLC position, collimator rotation, field size, MU, etc.). Here, we describe the development of a software tool that guides the physicist by aggregating and succinctly displaying machine parameter data relevant to themore » physics second-check process. Methods: A data retrieval software tool was developed using Python to aggregate data and generate a list of machine parameters that are commonly verified during the physics second-check process. This software tool imported values from (i) the TPS RT Plan DICOM file and (ii) the MOSAIQ (R&V) Structured Query Language (SQL) database. The machine parameters aggregated for this study included: MLC positions, X&Y jaw positions, collimator rotation, gantry rotation, MU, dose rate, wedges and accessories, cumulative dose, energy, machine name, couch angle, and more. Results: A GUI interface was developed to generate a side-by-side display of the aggregated machine parameter values for each field, and presented to the physicist for direct visual comparison. This software tool was tested for 3D conformal, static IMRT, sliding window IMRT, and VMAT treatment plans. Conclusion: This software tool facilitated the data collection process needed in order for the physicist to conduct a second-check, thus yielding an optimized second-check workflow that was both more user friendly and time-efficient. Utilizing this software tool, the physicist was able to spend less time searching through the TPS PDF plan document and the R&V system and focus the second-check efforts on assessing the patient-specific plan-quality.« less

Real-time Data Access From Remote Observatories

NASA Astrophysics Data System (ADS)

Detrick, D. L.; Lutz, L. F.; Etter, J. E.; Rosenberg, T. J.; Weatherwax, A. T.

2006-12-01

Real-time access to solar-terrestrial data is becoming increasingly important, not only because it is now possible to acquire and access data rapidly via the internet, but also because of the need for timely publication of real-time data for analysis and modeling efforts. Currently, engineering-scaled summary data are available routinely on a daily basis from many observatories, but only when the observatories have continuous, or at least daily network access. Increasingly, the upgrading of remote data acquisition hardware makes it possible to provide data in real-time, and it is becoming normal to expect timely access to data products. The NSF- supported PENGUIn/AGO constellation of autonomous Antarctic research observatories has provided real-time data since December, 2002, when Iridium satellite modems were installed at three sites. The Iridium telecommunications links are maintained continuously, transferring data between the remote observatories and a U.S.-based data acquisition site. The time-limiting factor with this scenario is now the delay in completing a data record before transmission, which can be as short as minutes depending on the sampling rate. The single-channel data throughput of the current systems is 20-MB/day (megabytes per day), but planned installations will be capable of operating with multiple modem channels. The data records are currently posted immediately to a web site accessible by anonymous FTP client software, for use by the instruments' principal investigators, and survey plots of selected signals are published daily. The web publication facilities are being upgraded, in order to allow other interested researchers rapid access to engineering-scaled data products, in several common formats, as well as providing interactive plotting capabilities. The web site will provide access to data from other collaborating observatories (including South Pole and McMurdo Stations), as well as ancillary data accessible from public sites (e.g., Kp, AE, Dst). The site will be accessible via common HTML interface protocols, enabling access to the data products by browsers or other compatible application software. We describe details of the hardware and software components of the Iridium telecommunications linkage, as well as details of the current and planned web publication capabilities.

WE-A-BRD-01: MR Imaging for Treatment Planning: What Every Physicist Should Know

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

McGee, K.

2015-06-15

Ever since its introduction as a diagnostic imaging modality over 30 years ago, the radiation therapy community has acknowledged the utility of MR imaging as a tool for not only improved visualization of the target volume but also for demarcation of adjacent organs at risk. However, the adaptation of MR imaging in radiation oncology has, until recently been slow due in large part to the inability to image radiation therapy patients in their treatment position. With the introduction of so-called wide bore high field MR scanners, multi element flexible receive only RF coils, high performance imaging gradients and a rangemore » of volumetric imaging sequences it is now possible to obtain both high resolution and high signal-to-noise ratio images of in-treatment radiation therapy patients within clinically feasible imaging times. As a Result, there is renewed interest in the use of MR imaging for radiation oncology treatment planning that is being translated into physical siting and integration of these systems into radiation oncology departments. As MR imaging expands into the radiation oncology domain there is a significant and unmet need for radiation therapy physicists to become educated regarding the strengths, limitations and technical challenges associated with MR imaging. The purpose of this presentation is to address this need by providing an educational overview of the techniques and challenges associated with MR imaging of patients for radiation therapy treatment planning. As such this presentation will: 1) describe the fundamental differences between imaging of patients for diagnostic and therapeutic purposes (i.e. radiation therapy planning), 2) describe most commonly used imaging sequences and contrasts for identification of disease for radiation planning, 3) identify the most common sources of image distortion and techniques to reduce their effect on spatial fidelity of the MR data, 4) describe the effects of motion and methods to quantify/correct it, and 5) identify emergent techniques for performing MR only treatment simulation. Upon completion attendees will have a working understanding of the basic methodologies associated with MR imaging in radiation oncology, the unique technical challenges imposed by MR imaging in the treatment position and techniques to address these. Learning Objectives: 1. Understand the differences between MR imaging for diagnostic imaging and for radiation therapy planning. 2. Identify the most common sources of distortion and artifacts and simple methods to correct them. 3. Understand the challenges with MR imaging in the therapy treatment position and appropriate techniques to address them.« less

An effectiveness monitoring program for the northwest forest plan: new approaches to common monitoring problems

Treesearch

Craig Palmer; Barry Mulder; Barry Noon

2000-01-01

The Northwest Forest Plan is a large-scale ecosystem management plan for federal lands in the Pacific Northwest of the United States. An effectiveness monitoring program has been developed to determine the extent to which the goals and objectives of this Plan are being achieved. Priority resources identified for ecological monitoring include late-successional and old-...

COSPAR/PRBEM international working group activities report

NASA Astrophysics Data System (ADS)

Bourdarie, S.; Blake, B.; Cao, J. B.; Friedel, R.; Miyoshi, Y.; Panasyuk, M.; Underwood, C.

It is now clear to everybody that the current standard AE8 AP8 model for ionising particle specification in the radiation belts must be updated But such an objective is quite difficult to reach just as a reminder to develop AE8 AP8 model in the seventies was 10 persons full time for ten years It is clear that world-wide efforts must be combined because not any individual group has the human resource to perform these new models by themselves Under COSPAR umbrella an international group of expert well distributed around the world has been created to set up a common framework for everybody involved in this field Planned activities of the international group of experts are to - Define users needs - Provide guidelines for standard file format for ionising measurements - Set up guidelines to process in-situ data on a common basis - Decide in which form the new models will have to be - Centralise all progress done world-wide to advise the community - Try to organise world-wide activities as a project to ensure complementarities and more efficiencies between all efforts done Activities of this working group since its creation will be reported as well as future plans

Contraceptive Methods Accessed in Volta Region, Ghana, 2009-2014.

PubMed

Wilson, Himiede W; Ameme, Donne K; Ilesanmi, Olayinka Stephen

2017-01-01

In 2016, Volta Region was one of the two regions in Ghana that recorded a high prevalence of teenage pregnancy, accounting for 15.5% of all adolescent pregnancies in the country. This study aimed to determine the prevalence of contraceptive methods accessed by person, place, and time in Volta Region, Ghana, 2009-2014. We carried out a secondary analysis of contraceptive use data derived from the District Health Information Management System (DHIMS) 2 for Volta Region, between 2009 and 2014. We calculated proportions and described trends. Over the five-year period, there were 673,409 (75.0%) acceptors of family planning out of a total 897, 645 males and females of reproductive age. The proportion of family planning acceptors increased gradually from 18% in 2009 to 23% in 2014. Contraceptive methods were most commonly accessed by male and female between 20 and 29 years. The most common methods of contraceptives accessed were injectables among females accounting for about 70% and condoms accounting for over 90% among males. All the districts in Volta Region did not access contraceptives adequately. The Volta Regional Health Directorate should encourage and support research to ascertain factors influencing uptake of contraceptive methods in all the districts.

Women's experiences after Planned Parenthood's exclusion from a family planning program in Texas.

PubMed

Woo, C Junda; Alamgir, Hasanat; Potter, Joseph E

2016-04-01

We assessed the impact on depot medroxyprogesterone continuation when a large care provider was banned from a state-funded family planning program. We used three methods to assess the effect of the ban: (a) In a records review, we compared how many state program participants returned to two Planned Parenthood affiliates for a scheduled dose of depot medroxyprogesterone acetate (DMPA) immediately after the ban; (b) We conducted phone interviews with 224 former Planned Parenthood patients about DMPA use and access to contraception immediately after the ban; (c) We compared current contraceptive method of our interviewees to that of comparable DMPA users in the National Survey of Family Growth 2006-2010 (NSFG). (a) Fewer program clients returned for DMPA at a large urban Planned Parenthood, compared to a remotely located affiliate (14.4%, vs. 64.8%), reflecting different levels of access to alternative providers in the two cities. (b) Among program participants who went elsewhere for the injection, only 56.8% obtained it at no cost and on time. More than one in five women missed a dose because of barriers, most commonly due to difficulty finding a provider. (c) Compared to NSFG participants, our interviewees used less effective methods of contraception, even more than a year after the ban went into effect. Injectable contraception use was disrupted during the rollout of the state-funded family planning program. Women living in a remote area of Texas encountered more barriers. Requiring low-income family planning patients to switch healthcare providers has adverse consequences. Copyright © 2016 Elsevier Inc. All rights reserved.

Women’s experiences after Planned Parenthood’s exclusion from a family planning program in Texas☆

PubMed Central

Woo, C. Junda; Alamgir, Hasanat; Potter, Joseph E.

2016-01-01

Objective We assessed the impact on depot medroxyprogesterone continuation when a large care provider was banned from a state-funded family planning program. Study Design We used three methods to assess the effect of the ban: (a) In a records review, we compared how many state program participants returned to two Planned Parenthood affiliates for a scheduled dose of depot medroxyprogesterone acetate (DMPA) immediately after the ban; (b) We conducted phone interviews with 224 former Planned Parenthood patients about DMPA use and access to contraception immediately after the ban; (c) We compared current contraceptive method of our interviewees to that of comparable DMPA users in the National Survey of Family Growth 2006–2010 (NSFG). Results (a) Fewer program clients returned for DMPA at a large urban Planned Parenthood, compared to a remotely located affiliate (14.4%, vs. 64.8%), reflecting different levels of access to alternative providers in the two cities. (b) Among program participants who went elsewhere for the injection, only 56.8% obtained it at no cost and on time. More than one in five women missed a dose because of barriers, most commonly due to difficulty finding a provider. (c) Compared to NSFG participants, our interviewees used less effective methods of contraception, even more than a year after the ban went into effect. Conclusions Injectable contraception use was disrupted during the rollout of the state-funded family planning program. Women living in a remote area of Texas encountered more barriers. Implications Requiring low-income family planning patients to switch healthcare providers has adverse consequences. PMID:26680757

Ascidians and the plasticity of the chordate developmental program.

PubMed

Lemaire, Patrick; Smith, William C; Nishida, Hiroki

2008-07-22

Little is known about the ancient chordates that gave rise to the first vertebrates, but the descendants of other invertebrate chordates extant at the time still flourish in the ocean. These invertebrates include the cephalochordates and tunicates, whose larvae share with vertebrate embryos a common body plan with a central notochord and a dorsal nerve cord. Tunicates are now thought to be the sister group of vertebrates. However, research based on several species of ascidians, a diverse and wide-spread class of tunicates, revealed that the molecular strategies underlying their development appear to diverge greatly from those found in vertebrates. Furthermore, the adult body plan of most tunicates, which arises following an extensive post-larval metamorphosis, shows little resemblance to the body plan of any other chordate. In this review, we compare the developmental strategies of ascidians and vertebrates and argue that the very divergence of these strategies reveals the surprising level of plasticity of the chordate developmental program and is a rich resource to identify core regulatory mechanisms that are evolutionarily conserved in chordates. Further, we propose that the comparative analysis of the architecture of ascidian and vertebrate gene regulatory networks may provide critical insight into the origin of the chordate body plan.

Patient-specific cardiac phantom for clinical training and preprocedure surgical planning.

PubMed

Laing, Justin; Moore, John; Vassallo, Reid; Bainbridge, Daniel; Drangova, Maria; Peters, Terry

2018-04-01

Minimally invasive mitral valve repair procedures including MitraClip ® are becoming increasingly common. For cases of complex or diseased anatomy, clinicians may benefit from using a patient-specific cardiac phantom for training, surgical planning, and the validation of devices or techniques. An imaging compatible cardiac phantom was developed to simulate a MitraClip ® procedure. The phantom contained a patient-specific cardiac model manufactured using tissue mimicking materials. To evaluate accuracy, the patient-specific model was imaged using computed tomography (CT), segmented, and the resulting point cloud dataset was compared using absolute distance to the original patient data. The result, when comparing the molded model point cloud to the original dataset, resulted in a maximum Euclidean distance error of 7.7 mm, an average error of 0.98 mm, and a standard deviation of 0.91 mm. The phantom was validated using a MitraClip ® device to ensure anatomical features and tools are identifiable under image guidance. Patient-specific cardiac phantoms may allow for surgical complications to be accounted for preoperative planning. The information gained by clinicians involved in planning and performing the procedure should lead to shorter procedural times and better outcomes for patients.

Stronger Together: Use of Storytelling at a Dietetics Conference to Promote Professional Collaboration.

PubMed

Fox, Ann; Gillis, Doris; Anderson, Barb; Lordly, Daphne

2017-03-01

During a Dietitians of Canada conference session (2015), 4 facilitators drew upon "Alice's Adventures in Wonderland" (Alice) to engage participants in discussing the future of dietetic education. The aim was to feature Nova Scotia (NS) collaborative experiences as an example of dietetic education planning that could be implemented elsewhere. Three vignettes from the Alice story were chosen as metaphoric representations of dilemmas and assumptions commonly faced by dietetic educators. Story quotations and facilitator questions related to each vignette-guided discussion. The 3-part story-based arts approach of hearing stories, recognizing stories, and telling stories enabled participants to reflect on their own practice, relate to the challenges of others, and question conventional wisdom. Participants heard the Alice stories, recognized their experiences through the NS examples and had an opportunity to tell their own stories during discussions. Participants identified barriers to and strategies for collaborative planning in their own regions. Evaluation suggests most participants were positively engaged by the storytelling approach. Participants recommended that future offerings allow more time for orientation and for completion of planned activities. Bilingual programming should also be considered. Participants valued the unconventional approach to workshop engagement and planned to implement it in their own workplaces.

MO-B-BRC-00: Prostate HDR Treatment Planning - Considering Different Imaging Modalities

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

NONE

2016-06-15

Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR ismore » U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.« less

Pancreatic cancer planning: Complex conformal vs modulated therapies

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

Chapman, Katherine L.; Witek, Matthew E.; Chen, Hongyu

To compare the roles of intensity-modulated radiation therapy (IMRT) and volumetric- modulated arc therapy (VMAT) therapy as compared to simple and complex 3-dimensional chemoradiotherpy (3DCRT) planning for resectable and borderline resectable pancreatic cancer. In all, 12 patients who received postoperative radiotherapy (8) or neoadjuvant concurrent chemoradiotherapy (4) were evaluated retrospectively. Radiotherapy planning was performed for 4 treatment techniques: simple 4-field box, complex 5-field 3DCRT, 5 to 6-field IMRT, and single-arc VMAT. All volumes were approved by a single observer in accordance with Radiation Therapy Oncology Group (RTOG) Pancreas Contouring Atlas. Plans included tumor/tumor bed and regional lymph nodes to 45more » Gy; with tumor/tumor bed boosted to 50.4 Gy, at least 95% of planning target volume (PTV) received the prescription dose. Dose-volume histograms (DVH) for multiple end points, treatment planning, and delivery time were assessed. Complex 3DCRT, IMRT, and VMAT plans significantly (p < 0.05) decreased mean kidney dose, mean liver dose, liver (V{sub 30}, V{sub 35}), stomach (D{sub 10}%), stomach (V{sub 45}), mean right kidney dose, and right kidney (V{sub 15}) as compared with the simple 4-field plans that are most commonly reported in the literature. IMRT plans resulted in decreased mean liver dose, liver (V{sub 35}), and left kidney (V{sub 15}, V{sub 18}, V{sub 20}). VMAT plans decreased small bowel (D{sub 10}%, D{sub 15}%), small bowel (V{sub 35}, V{sub 45}), stomach (D{sub 10}%, D{sub 15}%), stomach (V{sub 35}, V{sub 45}), mean liver dose, liver (V{sub 35}), left kidney (V{sub 15}, V{sub 18}, V{sub 20}), and right kidney (V{sub 18}, V{sub 20}). VMAT plans significantly decreased small bowel (D{sub 10}%, D{sub 15}%), left kidney (V{sub 20}), and stomach (V{sub 45}) as compared with IMRT plans. Treatment planning and delivery times were most efficient for simple 4-field box and VMAT. Excluding patient setup and imaging, average treatment delivery was within 10 minutes for simple and complex 3DCRT, IMRT, and VMAT treatments. This article shows significant improvements in 3D plan performance with complex planning over the more frequently compared 3- or 4-field simple 3D planning techniques. VMAT plans continue to demonstrate potential for the most organ sparing. However, further studies are required to identify if dosimetric benefits associated with inverse optimized planning can be translated into clinical benefits and if these treatment techniques are value-added therapies for this group of patients with cancer.« less

Potential impact of pharmacist interventions to reduce cost for Medicare Part D beneficiaries.

PubMed

Thatcher, Erin E; Vanwert, Elizabeth M; Erickson, Steven R

2013-06-01

The objective was to determine the impact of simulated pharmacist interventions on out-of-pocket cost, time to coverage gap, and cost per patient to the Medicare Part D program using actual patient cases from an adult general medicine clinic. Medication profiles of 100 randomly selected Medicare-eligible patients from a university-affiliated general internal medicine clinic were reviewed by a pharmacist to identify opportunities to cost-maximize the patients' therapies based on the plan. An online Part-D calculator, Aetna Medicare Rx Essentials, was used as the standard plan to determine medication cost and time to gap. The primary analysis was comparison of the patients' pre-review and post-review out-of-pocket cost, time to coverage gap, and cost to Medicare. A total of 65 patients had at least 1 simulated pharmacist cost intervention. The most common intervention was substituting for a less costly generic, followed by substituting a generic for a brand name. Projected patient cost savings was $476 per year. The average time to coverage gap was increased by 0.7 ±1.2 months. This study illustrates that the pharmacists may be able to reduce cost to some patients as well as to the Medicare Part D program.

Extracurricular Business Planning Competitions: Challenging the Assumptions

ERIC Educational Resources Information Center

Watson, Kayleigh; McGowan, Pauric; Smith, Paul

2014-01-01

Business planning competitions [BPCs] are a commonly offered yet under-examined extracurricular activity. Given the extent of sceptical comment about business planning, this paper offers what the authors believe is a much-needed critical discussion of the assumptions that underpin the provision of such competitions. In doing so it is suggested…

40 CFR 75.53 - Monitoring plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... this part. (c)-(d) [Reserved] (e) Contents of the monitoring plan. Each monitoring plan shall contain..., rounded to the nearest 100 lb/hr); (J) Identification of all units using a common stack; (K) Activation...: (A) Program(s) for which the EDR is submitted; (B) Unit classification; (C) Reporting frequency; (D...

40 CFR 75.53 - Monitoring plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... this part. (c)-(d) [Reserved] (e) Contents of the monitoring plan. Each monitoring plan shall contain..., rounded to the nearest 100 lb/hr); (J) Identification of all units using a common stack; (K) Activation...: (A) Program(s) for which the EDR is submitted; (B) Unit classification; (C) Reporting frequency; (D...

29 CFR 2520.102-2 - Style and format of summary plan description.

Code of Federal Regulations, 2014 CFR

2014-07-01

... plan description shall be written in a manner calculated to be understood by the average plan... to these participants, offering them assistance. The assistance provided need not involve written... assistance provided need not involve written materials, but shall be given in the non-English language common...

29 CFR 2520.102-2 - Style and format of summary plan description.

Code of Federal Regulations, 2012 CFR

2012-07-01

... plan description shall be written in a manner calculated to be understood by the average plan... to these participants, offering them assistance. The assistance provided need not involve written... assistance provided need not involve written materials, but shall be given in the non-English language common...

29 CFR 2520.102-2 - Style and format of summary plan description.

Code of Federal Regulations, 2011 CFR

2011-07-01

... plan description shall be written in a manner calculated to be understood by the average plan... to these participants, offering them assistance. The assistance provided need not involve written... assistance provided need not involve written materials, but shall be given in the non-English language common...

29 CFR 2520.102-2 - Style and format of summary plan description.

Code of Federal Regulations, 2013 CFR

2013-07-01

... plan description shall be written in a manner calculated to be understood by the average plan... to these participants, offering them assistance. The assistance provided need not involve written... assistance provided need not involve written materials, but shall be given in the non-English language common...

Grid Integration Studies: Advancing Clean Energy Planning and Deployment

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

Katz, Jessica; Chernyakhovskiy, Ilya

2016-07-01

Integrating significant variable renewable energy (VRE) into the grid requires an evolution in power system planning and operation. To plan for this evolution, power system stakeholders can undertake grid integration studies. This Greening the Grid document reviews grid integration studies, common elements, questions, and guidance for system planners.

Time evolving multi-city dependencies and robustness tradeoffs for risk-based portfolios of conservation, transfers, and cooperative water supply infrastructure development pathways

NASA Astrophysics Data System (ADS)

Trindade, B. C.; Reed, P. M.; Zeff, H. B.; Characklis, G. W.

2016-12-01

Water scarcity in historically water-rich regions such as the southeastern United States is becoming a more prevalent concern. It has been shown that cooperative short-term planning that relies on conservation and transfers of existing supplies amongst communities can be used by water utilities to mitigate the effects of water scarcity in the near future. However, in the longer term, infrastructure expansion is likely to be necessary to address imbalances between growing water demands and the available supply capacity. This study seeks to better diagnose and avoid candidate modes for system failure. Although it is becoming more common for water utilities to evaluate the robustness of their water supply, defined as the insensitivity of their systems to errors in deeply uncertain projections or assumptions, defining robustness is particularly challenging in multi-stakeholder regional contexts for decisions that encompass short management actions and long-term infrastructure planning. Planning and management decisions are highly interdependent and strongly shape how a region's infrastructure itself evolves. This research advances the concept of system robustness by making it evolve over time rather than static, so that it is applicable to an adaptive system and therefore more suited for use for combined short and long-term planning efforts. The test case for this research is the Research Triangle area of North Carolina, where the cities of Raleigh, Durham, Cary and Chapel Hill are experiencing rapid population growth and increasing concerns over drought. This study is facilitating their engagement in cooperative and robust regional water portfolio planning. The insights from this work have general merit for regions where adjacent municipalities can benefit from improving cooperative infrastructure investments and more efficient resource management strategies.

eConsultations to Infectious Disease Specialists: Questions Asked and Impact on Primary Care Providers' Behavior.

PubMed

Murthy, Ruchi; Rose, Gregory; Liddy, Clare; Afkham, Amir; Keely, Erin

2017-01-01

Since 2010, the Champlain BASE (Building Access to Specialist Advice through eConsultation) has allowed primary care providers (PCPs) to submit clinical questions to specialists through a secure web service. The study objectives are to describe questions asked to Infectious Diseases specialists through eConsultation and assess impact on physician behaviors. eConsults completed through the Champlain BASE service from April 15, 2013 to January 29, 2015 were characterized by the type of question asked and infectious disease content. Usage data and PCP responses to a closeout survey were analyzed to determine eConsult response time, change in referral plans, and change in planned course of action. Of the 224 infectious diseases eConsults, the most common question types were as follows: interpretation of a clinical test 18.0% (41), general management 16.5 % (37), and indications/goals of treating a particular condition 16.5% (37). The most frequently consulted infectious diseases were as follows: tuberculosis 14.3% (32), Lyme disease 14.3% (32), and parasitology 12.9% (29). Within 24 hours, 63% of cases responded to the questions, and 82% of cases took under 15 minutes to complete. In 32% of cases, a face-to-face referral was originally planned by the PCP but was no longer needed. In 8% of cases, the PCP referred the patient despite originally not planning to make a referral. In 55% of cases, the PCP either received new information or changed their course of action. An eConsult service provides PCPs with timely access to infectious disease specialists' advice that often results in a change in plans for a face-to-face referral. © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Adverse Drug Reactions Reported by Healthcare Professionals: Reaction Characteristics and Time to Reporting.

PubMed

Aung, Ar Kar; Tang, Mei Jie; Adler, Nikki Rae; de Menezes, Sara Lee; Goh, Michelle Sue Yen; Tee, Hui Wen; Trubiano, Jason Anthony; Puy, Robert; Zubrinich, Celia Mary; Graudins, Linda Velta

2018-05-07

We describe adverse drug reaction (ADR) reporting characteristics and factors contributing to length of time to report by healthcare professionals. This is a retrospective study of voluntary reports to an Australian healthcare ADR Review Committee over a 2-year period (2015-2016). Descriptive and univariate models were used for outcomes, employing standardized ADR definitions. Hospital pharmacists reported 84.8% of the 555 ADRs: 70.3% were hospital onset reactions, and 71.7% were at least of moderate severity. Immunologically mediated reactions were most commonly reported (409, 73.7%). The median time to submit an ADR report was 3 (interquartile range 1-10) days. Longer median times to reporting were associated with multiple implicated agents and delayed hypersensitivity reactions, especially severe cutaneous adverse reactions. A total of 650 medications were implicated that involved multiple agents in 165/555 (29.7%) reports. Antimicrobials were the most commonly implicated agents. Immunologically mediated reactions were most commonly associated with antimicrobials and radiocontrast agents (P < .0001, odds ratio [OR] 3.6, 95%CI 2.4-5.5, and P = .04, OR 4.2, 95%CI 1.2-18.2, respectively). Opioids and psychoactive medications were more commonly implicated in nonimmunological reported ADRs (P = .0002, OR 3.9, 95%CI 1.9-7.9, and P < .0001, OR 11.4, 95%CI 4.6-27.8, respectively). Due to the predominant reporting of immunologically mediated reactions, a targeted education program is being planned to improve identification and accuracy of ADR reports, with the overall aim of improved management to ensure quality service provision and patient safety. © 2018, The American College of Clinical Pharmacology.

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

Bush, K; Freeman, J; Zavalkovskiy, B

Purpose: Situated 20 miles from 5 major fault lines in California’s Bay Area, Stanford Universityhas a critical need for IT infrastructure planning to handle the high probability devastating earthquakes. Recently, a multi-million dollar project has been underway to overhaul Stanford’s radiation oncology information systems, maximizing planning system performance and providing true disaster recovery abilities. An overview of the project will be given with particular focus on lessons learned throughout the build. Methods: In this implementation, two isolated external datacenters provide geographical redundancy to Stanford’s main campus datacenter. Real-time mirroring is made of all data stored to our serial attached networkmore » (SAN) storage. In each datacenter, hardware/software virtualization was heavily implemented to maximize server efficiency and provide a robust mechanism to seamlessly migrate users in the event of an earthquake. System performance is routinely assessed through the use of virtualized data robots, able to log in to the system at scheduled times, perform routine planning tasks and report timing results to a performance dashboard. A substantial dose calculation framework (608 CPU cores) has been constructed as part of the implementation. Results: Migration to a virtualized server environment with a high performance SAN has resulted in up to a 45% speed up of common treatment planning tasks. Switching to a 608 core DCF has resulted in a 280% speed increase in dose calculations. Server tuning was found to further improved read/write performance by 20%. Disaster recovery tests are carried out quarterly and, although successful, remain time consuming to perform and verify functionality. Conclusion: Achieving true disaster recovery capabilities is possible through server virtualization, support from skilled IT staff and leadership. Substantial performance improvements are also achievable through careful tuning of server resources and disk read/write operations. Developing a streamlined method to comprehensively test failover is a key requirement to the system’s success.« less

Why are you late? Investigating the role of time management in time-based prospective memory.

PubMed

Waldum, Emily R; McDaniel, Mark A

2016-08-01

Time-based prospective memory tasks (TBPM) are those that are to be performed at a specific future time. Contrary to typical laboratory TBPM tasks (e.g., hit the Z key every 5 min), many real-world TBPM tasks require more complex time-management processes. For instance, to attend an appointment on time, one must estimate the duration of the drive to the appointment and then use this estimate to create and execute a secondary TBPM intention (e.g., "I need to start driving by 1:30 to make my 2:00 appointment on time"). Future under- and overestimates of drive time can lead to inefficient TBPM performance with the former lending to missed appointments and the latter to long stints in the waiting room. Despite the common occurrence of complex TBPM tasks in everyday life, to date, no studies have investigated how components of time management, including time estimation, affect behavior in such complex TBPM tasks. Therefore, the current study aimed to investigate timing biases in both older and younger adults and, further, to determine how such biases along with additional time management components including planning and plan fidelity influence complex TBPM performance. Results suggest for the first time that younger and older adults do not always utilize similar timing strategies, and as a result, can produce differential timing biases under the exact same environmental conditions. These timing biases, in turn, play a vital role in how efficiently both younger and older adults perform a later TBPM task that requires them to utilize their earlier time estimate. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

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

Clemente, F; Perez, C

Purpose: Redundant treatment verifications in conformal and intensity-modulated radiation therapy techniques are traditionally performed with single point calculations. New solutions can replace these checks with 3D treatment plan verifications. This work describes a software tool (Mobius3D, Mobius Medical Systems) that uses a GPU-accelerated collapsed cone algorithm to perform 3D independent verifications of TPS calculations. Methods: Mobius3D comes with reference beam models for common linear accelerators. The system uses an independently developed collapsed cone algorithm updated with recent enhancements. 144 isotropically-spaced cones are used for each voxel for calculations. These complex calculations can be sped up by using GPUs. Mobius3D calculatemore » dose using DICOM information coming from TPS (CT, RT Struct, RT Plan RT Dose). DVH-metrics and 3D gamma tests can be used to compare both TPS and secondary calculations. 170 patients treated with all common techniques as 3DCFRT (including wedged), static and dynamic IMRT and VMAT have been successfully verified with this solution. Results: Calculation times are between 3–5 minutes for 3DCFRT treatments and 15–20 for most complex dMLC and VMAT plans. For all PTVs mean dose and 90% coverage differences are (1.12±0.97)% and (0.68±1.19)%, respectively. Mean dose discrepancies for all OARs is (0.64±1.00)%. 3D gamma (global, 3%/3 mm) analysis shows a mean passing rate of (97.8 ± 3.0)% for PTVs and (99.0±3.0)% for OARs. 3D gamma pasing rate for all voxels in CT has a mean value of (98.5±1.6)%. Conclusion: Mobius3D is a powerful tool to verify all modalities of radiation therapy treatments. Dose discrepancies calculated by this system are in good agreement with TPS. The use of reference beam data results in time savings and can be used to avoid the propagation of errors in original beam data into our QA system. GPU calculations permit enhanced collapsed cone calculations with reasonable calculation times.« less

An Analysis of Adverse Events in the Rehabilitation Department: Using the Veterans Affairs Root Cause Analysis System.

PubMed

Hagley, Gregory W; Mills, Peter D; Shiner, Brian; Hemphill, Robin R

2018-04-01

Root cause analyses (RCA) are often completed in health care settings to determine causes of adverse events (AEs). RCAs result in action plans designed to mitigate future patient harm. National reviews of RCA reports have assessed the safety of numerous health care settings and suggested opportunities for improvement. However, few studies have assessed the safety of receiving care from physical therapists, occupational therapists, or speech and language pathology pathologists. The objective of this study was to determine the types of AEs, root causes, and action plans for risk mitigation that exist within the disciplines of rehabilitation medicine. This study is a retrospective, cross-sectional review. A national search of the Veterans Health Administration RCA database was conducted to identify reports describing AEs associated with physical therapy, occupational therapy, or speech and language pathology services between 2009 and May 2016. Twenty-five reports met the inclusion requirements. The reports were classified by the event type, root cause, action plans, and strength of action plans. Delays in care (32.0%) and falls (28.0%) were the most common type of AE. Three AEs resulted in death. RCA teams identified deficits regarding policy and procedures as the most common root cause. Eighty-eight percent of RCA reports included strong or intermediate action plans to mitigate risk. Strong action plans included standardizing emergency terminology and implementing a dedicated line to call for an emergency response. These data are self-reported and only AEs that are scored as a safety assessment code 3 in the system receive a full RCA, so there are likely AEs that were not captured in this study. In addition, the RCA reports are deidentified and so do not include all patient characteristics. As the Veterans Health Administration system services mostly men, the data might not generalize to non-Veterans Health Administration systems with a different patient mix. Care provided by rehabilitation professionals is generally safe, but AEs do occur. Based on this RCA review, the safety of rehabilitation services can be improved by implementing strong practices to mitigate risk to patients. Checklists should be considered to aid timely decision making when initiating an emergency response.

Sustainability and transformation plans: translating the perspectives.

PubMed

Thakrar, Sonali V; Bell, Diane

2017-10-02

Each local health economy has been tasked with producing a sustainability and transformation plan. A health economy is a system that controls and contributes to health-care resource and the effects of health services on its population. This includes commissioners, acute providers, primary care providers, community services, public health and the voluntary sector. Sustainability and transformation plans represent a shift in the way health care is planned for in England. The aim of each sustainability and transformation plan is to deliver care within existing resource limits by improving quality of care, developing new models of care and improving efficiency of care provision. The tight timescales for production of sustainability and transformation plans mean that in most cases there has been limited clinical engagement; as a result many clinicians have limited sight, understanding or ownership of the proposals within sustainability and transformation plans. As sustainability and transformation plans move into the implementation phase, this article explores the role of the clinician in the ongoing design and delivery of the local sustainability and transformation plans. By finding the common ground between the perspectives of the clinician, the commissioner and system leaders, the motivation of clinicians can be aligned with the ambitions of the sustainability and transformation plan. The common goal of a sustainability and transformation plan and the necessary collaboration required to make it successful is discussed. Ultimately, such translation is essential: clinicians are intelligent, adaptive and motivated individuals who must have a lead role in constructing and implementing plans that transform health and social care.

Nurse manager succession planning: a concept analysis.

PubMed

Titzer, Jennifer L; Shirey, Maria R

2013-01-01

The current nursing leadership pipeline is inadequate and demands strategic succession planning methods. This article provides concept clarification regarding nurse manager succession planning. Attributes common to succession planning include organizational commitment and resource allocation, proactive and visionary leadership approach, and a mentoring and coaching environment. Strategic planning, current and future leadership analysis, high-potential identification, and leadership development are succession planning antecedents. Consequences of succession planning are improved leadership and organizational culture continuity, and increased leadership bench strength. Health care has failed to strategically plan for future leadership. Developing a strong nursing leadership pipeline requires deliberate and strategic succession planning. © 2013 Wiley Periodicals, Inc.

The Ozone Widget Framework: towards modularity of C2 human interfaces

NASA Astrophysics Data System (ADS)

Hellar, David Benjamin; Vega, Laurian C.

2012-05-01

The Ozone Widget Framework (OWF) is a common webtop environment for distribution across the enterprise. A key mission driver for OWF is to enable rapid capability delivery by lowering time-to-market with lightweight components. OWF has been released as Government Open Source Software and has been deployed in a variety of C2 net-centric contexts ranging from real-time analytics, cyber-situational awareness, to strategic and operational planning. This paper discusses the current and future evolution of OWF including the availability of the OZONE Marketplace (OMP), useractivity driven metrics, and architecture enhancements for accessibility. Together, OWF is moving towards the rapid delivery of modular human interfaces supporting modern and future command and control contexts.

Physics-based interactive volume manipulation for sharing surgical process.

PubMed

Nakao, Megumi; Minato, Kotaro

2010-05-01

This paper presents a new set of techniques by which surgeons can interactively manipulate patient-specific volumetric models for sharing surgical process. To handle physical interaction between the surgical tools and organs, we propose a simple surface-constraint-based manipulation algorithm to consistently simulate common surgical manipulations such as grasping, holding and retraction. Our computation model is capable of simulating soft-tissue deformation and incision in real time. We also present visualization techniques in order to rapidly visualize time-varying, volumetric information on the deformed image. This paper demonstrates the success of the proposed methods in enabling the simulation of surgical processes, and the ways in which this simulation facilitates preoperative planning and rehearsal.

Improvements of Travel-time Tomography Models from Joint Inversion of Multi-channel and Wide-angle Seismic Data

NASA Astrophysics Data System (ADS)

Begović, Slaven; Ranero, César; Sallarès, Valentí; Meléndez, Adrià; Grevemeyer, Ingo

2016-04-01

Commonly multichannel seismic reflection (MCS) and wide-angle seismic (WAS) data are modeled and interpreted with different approaches. Conventional travel-time tomography models using solely WAS data lack the resolution to define the model properties and, particularly, the geometry of geologic boundaries (reflectors) with the required accuracy, specially in the shallow complex upper geological layers. We plan to mitigate this issue by combining these two different data sets, specifically taking advantage of the high redundancy of multichannel seismic (MCS) data, integrated with wide-angle seismic (WAS) data into a common inversion scheme to obtain higher-resolution velocity models (Vp), decrease Vp uncertainty and improve the geometry of reflectors. To do so, we have adapted the tomo2d and tomo3d joint refraction and reflection travel time tomography codes (Korenaga et al, 2000; Meléndez et al, 2015) to deal with streamer data and MCS acquisition geometries. The scheme results in a joint travel-time tomographic inversion based on integrated travel-time information from refracted and reflected phases from WAS data and reflected identified in the MCS common depth point (CDP) or shot gathers. To illustrate the advantages of a common inversion approach we have compared the modeling results for synthetic data sets using two different travel-time inversion strategies: We have produced seismic velocity models and reflector geometries following typical refraction and reflection travel-time tomographic strategy modeling just WAS data with a typical acquisition geometry (one OBS each 10 km). Second, we performed joint inversion of two types of seismic data sets, integrating two coincident data sets consisting of MCS data collected with a 8 km-long streamer and the WAS data into a common inversion scheme. Our synthetic results of the joint inversion indicate a 5-10 times smaller ray travel-time misfit in the deeper parts of the model, compared to models obtained using just wide-angle seismic data. As expected, there is an important improvement in the definition of the reflector geometry, which in turn, allows to improve the accuracy of the velocity retrieval just above and below the reflector. To test the joint inversion approach with real data, we combined wide-angle (WAS) seismic and coincident multichannel seismic reflection (MCS) data acquired in the northern Chile subduction zone into a common inversion scheme to obtain a higher-resolution information of upper plate and inter-plate boundary.

Radiobiological evaluation of the influence of dwell time modulation restriction in HIPO optimized HDR prostate brachytherapy implants.

PubMed

Mavroidis, Panayiotis; Katsilieri, Zaira; Kefala, Vasiliki; Milickovic, Natasa; Papanikolaou, Nikos; Karabis, Andreas; Zamboglou, Nikolaos; Baltas, Dimos

2010-09-01

One of the issues that a planner is often facing in HDR brachytherapy is the selective existence of high dose volumes around some few dominating dwell positions. If there is no information available about its necessity (e.g. location of a GTV), then it is reasonable to investigate whether this can be avoided. This effect can be eliminated by limiting the free modulation of the dwell times. HIPO, an inverse treatment plan optimization algorithm, offers this option. In treatment plan optimization there are various methods that try to regularize the variation of dose non-uniformity using purely dosimetric measures. However, although these methods can help in finding a good dose distribution they do not provide any information regarding the expected treatment outcome as described by radiobiology based indices. The quality of 12 clinical HDR brachytherapy implants for prostate utilizing HIPO and modulation restriction (MR) has been compared to alternative plans with HIPO and free modulation (without MR). All common dose-volume indices for the prostate and the organs at risk have been considered together with radiobiological measures. The clinical effectiveness of the different dose distributions was investigated by calculating the response probabilities of the tumors and organs-at-risk (OARs) involved in these prostate cancer cases. The radiobiological models used are the Poisson and the relative seriality models. Furthermore, the complication-free tumor control probability, P + and the biologically effective uniform dose ([Formula: see text]) were used for treatment plan evaluation and comparison. Our results demonstrate that HIPO with a modulation restriction value of 0.1-0.2 delivers high quality plans which are practically equivalent to those achieved with free modulation regarding the clinically used dosimetric indices. In the comparison, many of the dosimetric and radiobiological indices showed significantly different results. The modulation restricted clinical plans demonstrated a lower total dwell time by a mean of 1.4% that was proved to be statistically significant ( p = 0.002). The HIPO with MR treatment plans produced a higher P + by 0.5%, which stemmed from a better sparing of the OARs by 1.0%. Both the dosimetric and radiobiological comparison shows that the modulation restricted optimization gives on average similar results with the optimization without modulation restriction in the examined clinical cases. Concluding, based on our results, it appears that the applied dwell time regularization technique is expected to introduce a minor improvement in the effectiveness of the optimized HDR dose distributions.

Radiobiological evaluation of the influence of dwell time modulation restriction in HIPO optimized HDR prostate brachytherapy implants

PubMed Central

Katsilieri, Zaira; Kefala, Vasiliki; Milickovic, Natasa; Papanikolaou, Nikos; Karabis, Andreas; Zamboglou, Nikolaos; Baltas, Dimos

2010-01-01

Purpose One of the issues that a planner is often facing in HDR brachytherapy is the selective existence of high dose volumes around some few dominating dwell positions. If there is no information available about its necessity (e.g. location of a GTV), then it is reasonable to investigate whether this can be avoided. This effect can be eliminated by limiting the free modulation of the dwell times. HIPO, an inverse treatment plan optimization algorithm, offers this option. In treatment plan optimization there are various methods that try to regularize the variation of dose non-uniformity using purely dosimetric measures. However, although these methods can help in finding a good dose distribution they do not provide any information regarding the expected treatment outcome as described by radiobiology based indices. Material and methods The quality of 12 clinical HDR brachytherapy implants for prostate utilizing HIPO and modulation restriction (MR) has been compared to alternative plans with HIPO and free modulation (without MR). All common dose-volume indices for the prostate and the organs at risk have been considered together with radiobiological measures. The clinical effectiveness of the different dose distributions was investigated by calculating the response probabilities of the tumors and organs-at-risk (OARs) involved in these prostate cancer cases. The radiobiological models used are the Poisson and the relative seriality models. Furthermore, the complication-free tumor control probability, P+ and the biologically effective uniform dose (D¯¯) were used for treatment plan evaluation and comparison. Results Our results demonstrate that HIPO with a modulation restriction value of 0.1-0.2 delivers high quality plans which are practically equivalent to those achieved with free modulation regarding the clinically used dosimetric indices. In the comparison, many of the dosimetric and radiobiological indices showed significantly different results. The modulation restricted clinical plans demonstrated a lower total dwell time by a mean of 1.4% that was proved to be statistically significant (p = 0.002). The HIPO with MR treatment plans produced a higher P+ by 0.5%, which stemmed from a better sparing of the OARs by 1.0%. Conclusions Both the dosimetric and radiobiological comparison shows that the modulation restricted optimization gives on average similar results with the optimization without modulation restriction in the examined clinical cases. Concluding, based on our results, it appears that the applied dwell time regularization technique is expected to introduce a minor improvement in the effectiveness of the optimized HDR dose distributions. PMID:27853473

26 CFR 1.414(c)-1 - Commonly controlled trades or businesses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Commonly controlled trades or businesses. 1.414.... § 1.414(c)-1 Commonly controlled trades or businesses. For purposes of applying the provisions of... 416 (relating to top-heavy plans), all employees of two or more trades or businesses under common...

26 CFR 1.414(c)-1 - Commonly controlled trades or businesses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 5 2014-04-01 2014-04-01 false Commonly controlled trades or businesses. 1.414.... § 1.414(c)-1 Commonly controlled trades or businesses. For purposes of applying the provisions of... 416 (relating to top-heavy plans), all employees of two or more trades or businesses under common...

75 FR 16817 - Meeting for Software Developers on the Technical Specifications for Common Formats for Patient...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

... Software Developers on the Technical Specifications for Common Formats for Patient Safety Data Collection... software developers can provide input on these technical specifications for the Common Formats Version 1.1... specifications, which provide direction to software developers that plan to implement the Common Formats...

Real-Time Interactive Facilities Associated With A 3-D Medical Workstation

NASA Astrophysics Data System (ADS)

Goldwasser, S. M.; Reynolds, R. A.; Talton, D.; Walsh, E.

1986-06-01

Biomedical workstations of the future will incorporate three-dimensional interactive capabilities which provide real-time response to most common operator requests. Such systems will find application in many areas of medicine including clinical diagnosis, surgical and radiation therapy planning, biomedical research based on functional imaging, and medical education. This paper considers the requirements of these future systems in terms of image quality, performance, and the interactive environment, and examines the relationship of workstation capabilities to specific medical applications. We describe a prototype physician's workstation that we have designed and built to meet many of these requirements (using conventional graphics technology in conjunction with a custom real-time 3-D processor), and give an account of the remaining issues and challenges that future designers of such systems will have to address.

Functional Magnetic Resonance Imaging for Preoperative Planning in Brain Tumour Surgery.

PubMed

Lau, Jonathan C; Kosteniuk, Suzanne E; Bihari, Frank; Megyesi, Joseph F

2017-01-01

Functional magnetic resonance imaging (fMRI) is being increasingly used for the preoperative evaluation of patients with brain tumours. The study is a retrospective chart review investigating the use of clinical fMRI from 2002 through 2013 in the preoperative evaluation of brain tumour patients. Baseline demographic and clinical data were collected. The specific fMRI protocols used for each patient were recorded. Sixty patients were identified over the 12-year period. The tumour types most commonly investigated were high-grade glioma (World Health Organization grade III or IV), low-grade glioma (World Health Organization grade II), and meningioma. Most common presenting symptoms were seizures (69.6%), language deficits (23.2%), and headache (19.6%). There was a predominance of left hemispheric lesions investigated with fMRI (76.8% vs 23.2% for right). The most commonly involved lobes were frontal (64.3%), temporal (33.9%), parietal (21.4%), and insular (7.1%). The most common fMRI paradigms were language (83.9%), motor (75.0%), sensory (16.1%), and memory (10.7%). The majority of patients ultimately underwent a craniotomy (75.0%), whereas smaller groups underwent stereotactic biopsy (8.9%) and nonsurgical management (16.1%). Time from request for fMRI to actual fMRI acquisition was 3.1±2.3 weeks. Time from fMRI acquisition to intervention was 4.9±5.5 weeks. We have characterized patient demographics in a retrospective single-surgeon cohort undergoing preoperative clinical fMRI at a Canadian centre. Our experience suggests an acceptable wait time from scan request to scan completion/analysis and from scan to intervention.

Diabetes Diet, Eating, & Physical Activity

MedlinePlus

... for pregnancy if you have diabetes. Meal plan methods Two common ways to help you plan how ... about the method that’s best for you. Plate method The plate method helps you control your portion ...

Behavioral Health Coverage Under the Affordable Care Act: What Can We Learn From Marketplace Products?

PubMed

Stewart, Maureen T; Horgan, Constance M; Hodgkin, Dominic; Creedon, Timothy B; Quinn, Amity; Garito, Lindsay; Reif, Sharon; Garnick, Deborah W

2018-03-01

The 2008 federal parity law and the 2010 Affordable Care Act (ACA) sought to expand access to behavioral health services. There was concern that health plans might discourage enrollment by individuals with behavioral health conditions who tend to be higher cost. This study compared behavioral health benefits available in the group insurance market (nonmarketplace) to those sold through the ACA marketplaces to check for evidence of less generous behavioral health coverage in marketplace plans. Data were from a 2014 nationally representative survey of commercial health plans regarding behavioral health services (80% response rate). The sample included the most common silver marketplace product and, as a comparison, the most common nonmarketplace product of the same type (for example, health maintenance organization or preferred provider organization) from each health plan (N=106 marketplace and nonmarketplace pairs, or 212 products). Marketplace and nonmarketplace products were similar in terms of coverage, prior authorization, and continuing review requirements. Marketplace products were more likely to employ narrow and tiered behavioral health provider networks. Narrow and tiered networks were more common in state than in federal marketplaces. Provider network design is a tool that health plans may use to control cost and possibly discourage enrollment by high-cost users, including those with behavioral health conditions. The ACA was successful in ensuring robust behavioral health coverage in marketplace plans. As the marketplaces evolve or are replaced, these data provide an important baseline to which future systems can be compared.

MO-FG-CAMPUS-TeP2-01: A Graph Form ADMM Algorithm for Constrained Quadratic Radiation Treatment Planning

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

Liu, X; Belcher, AH; Wiersma, R

Purpose: In radiation therapy optimization the constraints can be either hard constraints which must be satisfied or soft constraints which are included but do not need to be satisfied exactly. Currently the voxel dose constraints are viewed as soft constraints and included as a part of the objective function and approximated as an unconstrained problem. However in some treatment planning cases the constraints should be specified as hard constraints and solved by constrained optimization. The goal of this work is to present a computation efficiency graph form alternating direction method of multipliers (ADMM) algorithm for constrained quadratic treatment planning optimizationmore » and compare it with several commonly used algorithms/toolbox. Method: ADMM can be viewed as an attempt to blend the benefits of dual decomposition and augmented Lagrangian methods for constrained optimization. Various proximal operators were first constructed as applicable to quadratic IMRT constrained optimization and the problem was formulated in a graph form of ADMM. A pre-iteration operation for the projection of a point to a graph was also proposed to further accelerate the computation. Result: The graph form ADMM algorithm was tested by the Common Optimization for Radiation Therapy (CORT) dataset including TG119, prostate, liver, and head & neck cases. Both unconstrained and constrained optimization problems were formulated for comparison purposes. All optimizations were solved by LBFGS, IPOPT, Matlab built-in toolbox, CVX (implementing SeDuMi) and Mosek solvers. For unconstrained optimization, it was found that LBFGS performs the best, and it was 3–5 times faster than graph form ADMM. However, for constrained optimization, graph form ADMM was 8 – 100 times faster than the other solvers. Conclusion: A graph form ADMM can be applied to constrained quadratic IMRT optimization. It is more computationally efficient than several other commercial and noncommercial optimizers and it also used significantly less computer memory.« less

Merit Pay Plans for Teachers: Status and Descriptions. ERS Report.

ERIC Educational Resources Information Center

Educational Research Service, Arlington, VA.

This report, an update of the 1978 survey of national merit pay plans for teachers, provides descriptive data on currently operating merit pay plans and state level activities. Outlining current research, the report points out that neither a commonly acceptable definition of merit pay nor a generally acceptable method of determining meritorious…

Plan, Save, Succeed! Financial Literacy Poster/Teaching Guide. Expect the Unexpected with Math[R

ERIC Educational Resources Information Center

Actuarial Foundation, 2013

2013-01-01

"Plan, Save, Succeed!" is a new program aligned with Jumpstart Coalition National Standards in K-12 Personal Finance Education, National Council of Teachers of Mathematics (NCTM) Standards, and Common Core Standards for Mathematical Practice. "Plan, Save, Succeed!" is designed to help students understand key financial literacy topics including…

Scenario Planning at College of Marin.

ERIC Educational Resources Information Center

College of Marin, Kentfield, CA.

This article reviews the scenario planning process implemented at the College of Marin (California). Scenario planning is a creative process in which a group of people who share a common fate develop stories about different ways their future might unfold, and use these stories to make decisions about what path to take. The Global Business Network…

Strategy for development of the Polish electricity sector

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

Dybowski, J.

1995-12-01

This paper represents the strategy for development of the Polish Electricity Sector dealing with specific problems which are common for all of East Central Europe. In 1990 Poland adopted a restructuring program for the entire energy sector. Very ambitious plans were changed several times but still the main direction of change was preserved. The most difficult period of transformation is featured by several contradictions which have to be balanced. Electricity prices should increase in order to cover the modernization and development program but the society is not able to take this burden in such a short time. Furthermore the newmore » environment protection standards force the growth of capital investment program which sooner or later has to be transferred through the electricity prices. New economic mechanisms have to be introduced to the electricity sector to replace the old ones noneffective, centrally planned. This process has to follow slow management changes. Also, introduction of new electricity market is limited by those constraints. However, this process of change would not be possible without parallel governmental initiation like preparation of new energy law and regulatory frames.« less

A production planning model considering uncertain demand using two-stage stochastic programming in a fresh vegetable supply chain context.

PubMed

Mateo, Jordi; Pla, Lluis M; Solsona, Francesc; Pagès, Adela

2016-01-01

Production planning models are achieving more interest for being used in the primary sector of the economy. The proposed model relies on the formulation of a location model representing a set of farms susceptible of being selected by a grocery shop brand to supply local fresh products under seasonal contracts. The main aim is to minimize overall procurement costs and meet future demand. This kind of problem is rather common in fresh vegetable supply chains where producers are located in proximity either to processing plants or retailers. The proposed two-stage stochastic model determines which suppliers should be selected for production contracts to ensure high quality products and minimal time from farm-to-table. Moreover, Lagrangian relaxation and parallel computing algorithms are proposed to solve these instances efficiently in a reasonable computational time. The results obtained show computational gains from our algorithmic proposals in front of the usage of plain CPLEX solver. Furthermore, the results ensure the competitive advantages of using the proposed model by purchase managers in the fresh vegetables industry.

The application of dynamic programming in production planning

NASA Astrophysics Data System (ADS)

Wu, Run

2017-05-01

Nowadays, with the popularity of the computers, various industries and fields are widely applying computer information technology, which brings about huge demand for a variety of application software. In order to develop software meeting various needs with most economical cost and best quality, programmers must design efficient algorithms. A superior algorithm can not only soul up one thing, but also maximize the benefits and generate the smallest overhead. As one of the common algorithms, dynamic programming algorithms are used to solving problems with some sort of optimal properties. When solving problems with a large amount of sub-problems that needs repetitive calculations, the ordinary sub-recursive method requires to consume exponential time, and dynamic programming algorithm can reduce the time complexity of the algorithm to the polynomial level, according to which we can conclude that dynamic programming algorithm is a very efficient compared to other algorithms reducing the computational complexity and enriching the computational results. In this paper, we expound the concept, basic elements, properties, core, solving steps and difficulties of the dynamic programming algorithm besides, establish the dynamic programming model of the production planning problem.

Advanced space system concepts and their orbital support needs (1980 - 2000). Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Bekey, I.; Mayer, H. L.; Wolfe, M. G.

1976-01-01

The likely system concepts which might be representative of NASA and DoD space programs in the 1980-2000 time period were studied along with the programs' likely needs for major space transportation vehicles, orbital support vehicles, and technology developments which could be shared by the military and civilian space establishments in that time period. Such needs could then be used by NASA as an input in determining the nature of its long-range development plan. The approach used was to develop a list of possible space system concepts (initiatives) in parallel with a list of needs based on consideration of the likely environments and goals of the future. The two lists thus obtained represented what could be done, regardless of need; and what should be done, regardless of capability, respectively. A set of development program plans for space application concepts was then assembled, matching needs against capabilities, and the requirements of the space concepts for support vehicles, transportation, and technology were extracted. The process was pursued in parallel for likely military and civilian programs, and the common support needs thus identified.

[Some psychological problems in family planning work].

PubMed

Chen, J

1983-11-29

Psychology has significance in family planning work, because it may promote the scientific nature of family planning work and thus increase its effectiveness. Since people have some common aspects in their psychological process, family planning workers should master some common rules of the people's psychological process in order to understand psychological trends and possible behavior. Through this method, family planning workers may find how to adjust to problems they may encounter in their daily work, such as the worries about a single child being too lonely, spoiled, and hard to handle for the parents, the traditional belief that more children represent good fortune, and more male children may provide security for one's old age. Traditionally, the Chinese people believed that only male children can carry on the family line and that more children will provide a larger labor force, which is beneficial to a family's financial situation. In family planning work, all such incorrect ways of thinking should be corrected and revised. Studies of children's psychology should also be developed so that children may develop a healthy mentality. All these are crucial to the success of family planning work and the promotion of population quality.

Cost-Control Mechanisms in Canadian Private Drug Plans

PubMed Central

Kratzer, Jillian; McGrail, Kimberlyn; Strumpf, Erin; Law, Michael R.

2013-01-01

Approximately 68% of Canadians receive prescription drug coverage through an employer-sponsored private plan. However, we have very limited data on the structure of these plans. This study aims to identify and describe the use of cost-control mechanisms in private drug plans in Canada and describe what private coverage looks like for the average Canadian. Using 2010 data from over 113,000 different private drug plans, provided by Applied Management Consultants, we determined the overall use of key cost-control measures, and the cost-control tools that appear to be gaining currency compared to a report on benefits coverage in 1998. We found that the use of common cost-control measures is relatively low among Canadian private benefits programs. Co-insurance is much more common in private coverage plans than co-payments. Deductibles are uncommon in Canada and, when in place, are very small. The use of annual and lifetime maximums is increasing. Canadian private benefits programs use few cost-control measures to respond to increasing costs, particularly in comparison to their public counterparts. These results suggest there are ample opportunities for greater efficiency in private sector drug coverage plans. PMID:23968672

Organization, appointment planning, and surgery design in the treatment of the older patient.

PubMed

Hoad-Reddick, G

1995-10-01

As the proportion of the elderly in society increases and as more people retain teeth into old age, the type of dental treatment needed for this group will increase in both complexity and quantity. This article describes problems faced by the elderly such as mobility, fear, and medical conditions that may affect dental treatment either by increasing anxiety levels or by affecting duration or timing of appointments. The effects of visual impairment, hearing loss, and common medical conditions on elderly people are considered.

In the United States, a Mother's Plans for Infant Feeding Are Associated with Her Plans for Employment.

PubMed

Mirkovic, Kelsey R; Perrine, Cria G; Scanlon, Kelley S; Grummer-Strawn, Laurence M

2014-08-01

The American Academy of Pediatrics recommends 6 months of exclusive breastfeeding, however, only 16% of US infants meet this recommendation. Shorter exclusive/predominant breastfeeding durations have been observed from women who return to work early and/or full-time. We assessed the relationship between prenatal plans for maternity leave duration and return to full-time/part-time status and plans for exclusive breastfeeding. This study included 2348 prenatally employed women from the Infant Feeding Practices Study II (2005-2007) who planned to return to work in the first year postpartum. Bivariate analysis and logistic regression were used to describe the association of maternity leave duration and return status with plans for infant feeding. Overall, 59.5% of mothers planned to exclusively breastfeed in the first few weeks. Mothers planning to return to work within 6 weeks had 0.60 times the odds (95% confidence interval [CI], 0.46-0.77) and mothers planning to return between 7 and 12 weeks had 0.72 times the odds (95% CI, 0.56-0.92) of planning to exclusively breastfeed compared with mothers who were planning to return after 12 weeks. Prenatal plans to return full-time (≥ 30 hours/week vs part-time) were also associated with lower odds of planning to exclusively breastfeed (adjusted odds ratio = 0.61; 95% CI, 0.51-0.77). Mothers planning to return to work before 12 weeks and/or full-time were less likely to plan to exclusively breastfeed. Longer maternity leave and/or part-time return schedules may increase the proportion of mothers who plan to exclusively breastfeed. © International Lactation Consultant Association 2014.

Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health.

PubMed

Stephenson, Judith; Heslehurst, Nicola; Hall, Jennifer; Schoenaker, Danielle A J M; Hutchinson, Jayne; Cade, Janet E; Poston, Lucilla; Barrett, Geraldine; Crozier, Sarah R; Barker, Mary; Kumaran, Kalyanaraman; Yajnik, Chittaranjan S; Baird, Janis; Mishra, Gita D

2018-05-05

A woman who is healthy at the time of conception is more likely to have a successful pregnancy and a healthy child. We reviewed published evidence and present new data from low-income, middle-income, and high-income countries on the timing and importance of preconception health for subsequent maternal and child health. We describe the extent to which pregnancy is planned, and whether planning is linked to preconception health behaviours. Observational studies show strong links between health before pregnancy and maternal and child health outcomes, with consequences that can extend across generations, but awareness of these links is not widespread. Poor nutrition and obesity are rife among women of reproductive age, and differences between high-income and low-income countries have become less distinct, with typical diets falling far short of nutritional recommendations in both settings and especially among adolescents. Several studies show that micronutrient supplementation starting in pregnancy can correct important maternal nutrient deficiencies, but effects on child health outcomes are disappointing. Other interventions to improve diet during pregnancy have had little effect on maternal and newborn health outcomes. Comparatively few interventions have been made for preconception diet and lifestyle. Improvements in the measurement of pregnancy planning have quantified the degree of pregnancy planning and suggest that it is more common than previously recognised. Planning for pregnancy is associated with a mixed pattern of health behaviours before conception. We propose novel definitions of the preconception period relating to embryo development and actions at individual or population level. A sharper focus on intervention before conception is needed to improve maternal and child health and reduce the growing burden of non-communicable diseases. Alongside continued efforts to reduce smoking, alcohol consumption, and obesity in the population, we call for heightened awareness of preconception health, particularly regarding diet and nutrition. Importantly, health professionals should be alerted to ways of identifying women who are planning a pregnancy. Copyright © 2018 Elsevier Ltd. All rights reserved.

How the contractualist account of preconception negligence undermines prenatal reproductive autonomy.

PubMed

Melanson, Glen

2013-08-01

Suppose a physician advises a woman to delay her planned pregnancy for a few months in order to significantly reduce the likelihood that her baby will suffer with Spina Bifida. If the woman chooses to ignore this advice and conceives soon after, I believe most people would consider it a matter of common sense that the child thus born is a victim of this woman's negligence, even if it is fortunate enough to not be burdened with Spina Bifida. This common sense judgement appeared to have been done in by the fact that the timing of conception can be identity-influencing, and so the child that is born only exists because of its mother's decision to ignore her physician's advice. However, recently, contemporary contractualist theories have been used to make sense of preconception negligence towards persons whose existence is a result of that same negligence. I will briefly discuss this interesting development and then show how this retrieval of the common sense judgement comes at a great cost to prenatal reproductive autonomy.

Common Standards for Career Education Programs

ERIC Educational Resources Information Center

Missouri Department of Elementary and Secondary Education, 2012

2012-01-01

The Office of College and Career Readiness has developed the "Common Standards for Career Education Programs." The six common standards are: (1) Program Management and Planning; (2) Curriculum; (3) Instruction; (4) Professional Development; (5) Career and Technical Student Organizations; and (6) Instructional Facilities and Equipment.…

Geriatric hip fracture management: keys to providing a successful program.

PubMed

Basu, N; Natour, M; Mounasamy, V; Kates, S L

2016-10-01

Hip fractures are a common event in older adults and are associated with significant morbidity, mortality and costs. This review examines the necessary elements required to implement a successful geriatric fracture program and identifies some of the barriers faced when implementing a successful program. The Geriatric Fracture Center (GFC) is a treatment model that standardizes the approach to the geriatric fracture patient. It is based on five principles: surgical fracture management; early operative intervention; medical co-management with geriatricians; patient-centered, standard order sets to employ best practices; and early discharge planning with a focus on early functional rehabilitation. Implementing a geriatric fracture program begins with an assessment of the hospital's data on hip fractures and standard care metrics such as length of stay, complications, time to surgery, readmission rates and costs. Business planning is essential along with the medical planning process. To successfully develop and implement such a program, strong physician leadership is necessary to articulate both a short- and long-term plan for implementation. Good communication is essential-those organizing a geriatric fracture program must be able to implement standardized plans of care working with all members of the healthcare team and must also be able to foster relationships both within the hospital and with other institutions in the community. Finally, a program of continual quality improvement must be undertaken to ensure that performance outcomes are improving patient care.

GPS net­work operations for the International GPS Geodynamics Service

USGS Publications Warehouse

Neilan, Ruth E.

1993-01-01

As GPS technology comes of age in the 1990’s, it is evident that an internationally sponsored GPS tracking system is called for to provide consistent, timely ground tracking data and data products to the geophysical community. The planning group for the International GPS Geodynamics Service (IGS), sponsored by the International Association of Geodesy (IAG), is addressing all elements of the end-to-end tracking system, ranging from data collection to data analysis and distribution of products (Mueller, 1992). Part of the planning process is to formulate how these various elements work together to create the common infrastructure needed to support a wide variety of GPS investigations. A key element for any permanent satellite tracking system is certainly the acquisition segment; the reliability and robustness of the ground network operations directly determine the fates and limitations of final products. The IGS planning group therefore included a committee tasked to develop and establish standards governing data acquisition and site-specific characteristics deemed necessary to ensure the collection of a high quality, continuous data set.

Magnetic resonance imaging for planning intracavitary brachytherapy for the treatment of locally advanced cervical cancer.

PubMed

Oñate Miranda, M; Pinho, D F; Wardak, Z; Albuquerque, K; Pedrosa, I

2016-01-01

Cervical cancer is the third most common gynecological cancer. Its treatment depends on tumor staging at the time of diagnosis, and a combination of chemotherapy and radiotherapy is the treatment of choice in locally advanced cervical cancers. The combined use of external beam radiotherapy and brachytherapy increases survival in these patients. Brachytherapy enables a larger dose of radiation to be delivered to the tumor with less toxicity for neighboring tissues with less toxicity for neighboring tissues compared to the use of external beam radiotherapy alone. For years, brachytherapy was planned exclusively using computed tomography (CT). The recent incorporation of magnetic resonance imaging (MRI) provides essential information about the tumor and neighboring structures making possible to better define the target volumes. Nevertheless, MRI has limitations, some of which can be compensated for by fusing CT and MRI. Fusing the images from the two techniques ensures optimal planning by combining the advantages of each technique. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

Mass-gathering Events: The Public Health Challenge of the Kumbh Mela 2013.

PubMed

Dwivedi, Suresh; Cariappa, Mudera P

2015-12-01

Mass-gathering (MG) events pose challenges to the most adept of public health practitioners in ensuring the health safety of the population. These MGs can be for sporting events, musical festivals, or more commonly, have religious undertones. The Kumbh Mela 2013 at Allahabad, India may have been the largest gathering of humanity in history with nearly 120 million pilgrims having thronged the venue. The scale of the event posed a challenge to the maintenance of public health security and safety. A snapshot of the experience of managing the hygiene and sanitation aspects of this mega event is presented herein, highlighting the importance of proactive public health planning and preparedness. There having been no outbreaks of disease is vindication of the steps undertaken in planning and preparedness, notwithstanding obvious limitations of unsanitary behaviors and traditional beliefs of those attending the festival. The evident flaw on post-event analyses was the failure to cater adequately for environmental mopping-up operations after the festival. Besides, a system of real-time monitoring of disease and morbidity patterns, harnessing low cost technology alternatives, should be planned for at all such future events.

Integrated Budget Office Toolbox

NASA Technical Reports Server (NTRS)

Rushing, Douglas A.; Blakeley, Chris; Chapman, Gerry; Robertson, Bill; Horton, Allison; Besser, Thomas; McCarthy, Debbie

2010-01-01

The Integrated Budget Office Toolbox (IBOT) combines budgeting, resource allocation, organizational funding, and reporting features in an automated, integrated tool that provides data from a single source for Johnson Space Center (JSC) personnel. Using a common interface, concurrent users can utilize the data without compromising its integrity. IBOT tracks planning changes and updates throughout the year using both phasing and POP-related (program-operating-plan-related) budget information for the current year, and up to six years out. Separating lump-sum funds received from HQ (Headquarters) into separate labor, travel, procurement, Center G&A (general & administrative), and servicepool categories, IBOT creates a script that significantly reduces manual input time. IBOT also manages the movement of travel and procurement funds down to the organizational level and, using its integrated funds management feature, helps better track funding at lower levels. Third-party software is used to create integrated reports in IBOT that can be generated for plans, actuals, funds received, and other combinations of data that are currently maintained in the centralized format. Based on Microsoft SQL, IBOT incorporates generic budget processes, is transportable, and is economical to deploy and support.

A Markov model for planning and permitting offshore wind energy: A case study of radio-tracked terns in the Gulf of Maine, USA.

PubMed

Cranmer, Alexana; Smetzer, Jennifer R; Welch, Linda; Baker, Erin

2017-05-15

Quantifying and managing the potential adverse wildlife impacts of offshore wind energy is critical for developing offshore wind energy in a sustainable and timely manner, but poses a significant challenge, particularly for small marine birds that are difficult to monitor. We developed a discrete-time Markov model of seabird movement around a colony site parameterized by automated radio telemetry data from common terns (Sterna hirundo) and Arctic terns (S. paradisaea), and derived impact functions that estimate the probability of collision fatality as a function of the distance and bearing of wind turbines from a colony. Our purpose was to develop and demonstrate a new, flexible tool that can be used for specific management and wind-energy planning applications when adequate data are available, rather than inform wind-energy development at this site. We demonstrate how the tool can be used 1) in marine spatial planning exercises to quantitatively identify setback distances under development scenarios given a risk threshold, 2) to examine the ecological and technical trade-offs of development alternatives to facilitate negotiation between objectives, and 3) in the U.S. National Environmental Policy Act (NEPA) process to estimate collision fatality under alternative scenarios. We discuss model limitations and data needs, and highlight opportunities for future model extension and development. We present a highly flexible tool for wind energy planning that can be easily extended to other central place foragers and data sources, and can be updated and improved as new monitoring data arises. Copyright © 2017 Elsevier Ltd. All rights reserved.

Optimizing highly noncoplanar VMAT trajectories: the NoVo method.

PubMed

Langhans, Marco; Unkelbach, Jan; Bortfeld, Thomas; Craft, David

2018-01-16

We introduce a new method called NoVo (Noncoplanar VMAT Optimization) to produce volumetric modulated arc therapy (VMAT) treatment plans with noncoplanar trajectories. While the use of noncoplanar beam arrangements for intensity modulated radiation therapy (IMRT), and in particular high fraction stereotactic radiosurgery (SRS), is common, noncoplanar beam trajectories for VMAT are less common as the availability of treatment machines handling these is limited. For both IMRT and VMAT, the beam angle selection problem is highly nonconvex in nature, which is why automated beam angle selection procedures have not entered mainstream clinical usage. NoVo determines a noncoplanar VMAT solution (i.e. the simultaneous trajectories of the gantry and the couch) by first computing a [Formula: see text] solution (beams from every possible direction, suitably discretized) and then eliminating beams by examing fluence contributions. Also all beam angles are scored via geometrical considerations only to find out the usefulness of the whole beam space in a very short time. A custom path finding algorithm is applied to find an optimized, continuous trajectory through the most promising beam angles using the calculated score of the beam space. Finally, using this trajectory a VMAT plan is optimized. For three clinical cases, a lung, brain, and liver case, we compare NoVo to the ideal [Formula: see text] solution, nine beam noncoplanar IMRT, coplanar VMAT, and a recently published noncoplanar VMAT algorithm. NoVo comes closest to the [Formula: see text] solution considering the lung case (brain and liver case: second), as well as improving the solution time by using geometrical considerations, followed by a time effective iterative process reducing the [Formula: see text] solution. Compared to a recently published noncoplanar VMAT algorithm, using NoVo the computation time is reduced by a factor of 2-3 (depending on the case). Compared to coplanar VMAT, NoVo reduces the objective function value by 24%, 49% and 6% for the lung, brain and liver cases, respectively.

Optimizing highly noncoplanar VMAT trajectories: the NoVo method

NASA Astrophysics Data System (ADS)

Langhans, Marco; Unkelbach, Jan; Bortfeld, Thomas; Craft, David

2018-01-01

We introduce a new method called NoVo (Noncoplanar VMAT Optimization) to produce volumetric modulated arc therapy (VMAT) treatment plans with noncoplanar trajectories. While the use of noncoplanar beam arrangements for intensity modulated radiation therapy (IMRT), and in particular high fraction stereotactic radiosurgery (SRS), is common, noncoplanar beam trajectories for VMAT are less common as the availability of treatment machines handling these is limited. For both IMRT and VMAT, the beam angle selection problem is highly nonconvex in nature, which is why automated beam angle selection procedures have not entered mainstream clinical usage. NoVo determines a noncoplanar VMAT solution (i.e. the simultaneous trajectories of the gantry and the couch) by first computing a 4π solution (beams from every possible direction, suitably discretized) and then eliminating beams by examing fluence contributions. Also all beam angles are scored via geometrical considerations only to find out the usefulness of the whole beam space in a very short time. A custom path finding algorithm is applied to find an optimized, continuous trajectory through the most promising beam angles using the calculated score of the beam space. Finally, using this trajectory a VMAT plan is optimized. For three clinical cases, a lung, brain, and liver case, we compare NoVo to the ideal 4π solution, nine beam noncoplanar IMRT, coplanar VMAT, and a recently published noncoplanar VMAT algorithm. NoVo comes closest to the 4π solution considering the lung case (brain and liver case: second), as well as improving the solution time by using geometrical considerations, followed by a time effective iterative process reducing the 4π solution. Compared to a recently published noncoplanar VMAT algorithm, using NoVo the computation time is reduced by a factor of 2-3 (depending on the case). Compared to coplanar VMAT, NoVo reduces the objective function value by 24%, 49% and 6% for the lung, brain and liver cases, respectively.

A review of plan library approaches in adaptive radiotherapy of bladder cancer.

PubMed

Collins, Shane D; Leech, Michelle M

2018-05-01

Large variations in the shape and size of the bladder volume are commonly observed in bladder cancer radiotherapy (RT). The clinical target volume (CTV) is therefore frequently inadequately treated and large isotropic margins are inappropriate in terms of dose to organs at risk (OAR); thereby making adaptive radiotherapy (ART) attractive for this tumour site. There are various methods of ART delivery, however, for bladder cancer, plan libraries are frequently used. A review of published studies on plan libraries for bladder cancer using four databases (Pubmed, Science Direct, Embase and Cochrane Library) was conducted. The endpoints selected were accuracy and feasibility of initiation of a plan library strategy into a RT department. Twenty-four articles were included in this review. The majority of studies reported improvement in accuracy with 10 studies showing an improvement in planning target volume (PTV) and CTV coverage with plan libraries, some by up to 24%. Seventeen studies showed a dose reduction to OARs, particularly the small bowel V45Gy, V40Gy, V30Gy and V10Gy, and the rectal V30Gy. However, the occurrence of no suitable plan was reported in six studies, with three studies showing no significant difference between adaptive and non-adaptive strategies in terms of target coverage. In addition, inter-observer variability in plan selection appears to remain problematic. The additional resources, education and technology required for the initiation of plan library selection for bladder cancer may hinder its routine clinical implementation, with eight studies illustrating increased treatment time required. While there is a growing body of evidence in support of plan libraries for bladder RT, many studies differed in their delivery approach. The advent of the clinical use of the MRI-linear accelerator will provide RT departments with the opportunity to consider daily online adaption for bladder cancer as an alternate to plan library approaches.

Predicted versus executed surgical orthognathic treatment.

PubMed

Falter, B; Schepers, S; Vrielinck, L; Lambrichts, I; Politis, C

2013-10-01

This study aimed to analyse combined surgical-orthodontic treatment plans, compare them with the actual surgery performed, and define factors resulting in changes of the original plan during orthodontic pre-surgical preparation. The clinical files of 312 orthognathic surgery patients, operated between January 2008 and December 2010, were retrospectively reviewed. Of these 312 patients, 129 had a bimaxillary operation. One hundred sixty patients had osteotomy of the lower jaw only and 23 had osteotomy of the upper jaw only. Factors analysed in the study include Angle Class malocclusion, patient sex, and age. Lip-to-incisor relationship, overjet, overbite and midline deviations of the upper and lower jaw were recorded. Effects of surgical assisted rapid palatal expansion (SARPE) on the eventual surgery were also investigated. Reasons for changing the original treatment plan at the time of the finished pre-surgical-orthodontic alignment were analysed. The original treatment plan was changed in 42 of the 312 patients (13.5%). Changes occurred generally in case of a larger interval between set-up of the first treatment plan and the eventual operation (average 22.4 versus 16.4 months for patients with changed versus unchanged treatment plan, respectively). All Class I patients had surgery performed as planned. Class III patients had a significantly higher rate of altered treatment plan (27.3%) than Class II patients (7.6%). More men (52.4%) saw their treatment plan changed, although there were more women than men in the study population (59.6 versus 40.4%). One in seven patients (13.5%) had a different operation than was planned at the start of treatment. Class III patients with small overjet and overbite commonly have a treatment plan for a monomaxillary operation that, after decompensation, needs to be adapted to a bimaxillary operation. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Nurse manager job satisfaction and intent to leave

PubMed Central

Warshawsky, Nora E.; Havens, Donna S.

2015-01-01

Background The nurse manager role is critical to staff nurse retention and often the portal to senior nursing leadership, yet little is known about nurse managers' job satisfaction and career plans. The purpose of this study was to describe nurse managers' job satisfaction and intent to leave. Methods An electronic survey was used to collect data from 291 nurse managers working in U.S. hospitals. Findings Seventy percent were satisfied or very satisfied with their jobs and 68% were either likely or very likely to recommend nursing management as a career choice. Seventy-two percent of these nurse managers were also planning to leave their positions in the next five years. The four most common reasons reported for intent to leave included burnout, career change, retirement, and promotion. Burnout was the most common reason cited by the entire sample but the fourth most common reason for leaving cited by those nurse managers who were planning to leave and also satisfied or very satisfied with their positions. Conclusions Recommendations for nursing leaders include evaluating the workload of nurse managers, providing career counseling, and developing succession plans. Additional research is needed to understand the determinants and consequences of nurse manager job satisfaction, intent to leave, and turnover. PMID:24689156

Waking the Sleeping Giant at Pearl Harbor: A Case for Intelligence and Operations Fusion

DTIC Science & Technology

2013-05-23

York: Random House Inc., 2002), 7. 9Allan R. Millet and Peter Maslowski, For the Common Defense A Military History of the United States of America...the complexity of a major war.”40 37Keegan, Intelligence in War, 188-89. 38Ball, Of Responsible Command, 189; Allan R. Millet & Peter Maslowski...65Gole, The Road to Rainbow, 114; Miller, War Plan Orange, 270; Millet and Maslowski, For the Common Defense, 418; Ross, U.S. War Plans 1938-1945, 55

The Washington State Technology Plan for the K-12 Common School System. Sections 701-703, Chapter 336, Laws of 1993 (Engrossed Substitute House Bill 1209) as Amended by Chapter 245, Laws of 1994. Report to the Legislature.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia.

This final report for the Washington State Technology Plan for K-12 Common Schools provides a vision, long-term framework, and recommendations for implementation. Following an executive summary and a list of committee members, the first section of the report discusses technology in K-12 schools of tomorrow, including legislative charge, vision,…

Implications of Current and Proposed Funding Plans for Oklahoma Common Schools. Research Report P-748.

ERIC Educational Resources Information Center

Lowrance, Danny; Tweeten, Luther

Utilizing data from the 1973-1974 school year, the study analyzed and compared the educational funding system presently used by Oklahoma with other school funding plans on the basis of economic efficiency and social equity. Funding plans used for comparison included Flat Grants, Minimum Foundation, Percentage Equalizing, Guaranteed Tax Base, Full…

Square Peg for a Square Hole: A Standards- and Repertoire-Based Curriculum Model

ERIC Educational Resources Information Center

Standerfer, Stephanie L.; Hunter, Lisa R.

2010-01-01

For decades, music teachers have shared the dread of writing formal lesson plans, yet most know that planning yields better instruction. Why does this disconnect continue? The common argument that music teachers make is that teaching music is fundamentally different from teaching other subjects. Lesson plans are written to pacify supervisors and…

The Changing Role of Planning Units in Universities: Renewing Our Approach and Future Directions

ERIC Educational Resources Information Center

Shah, Mahsood; Aumann, Tom

2012-01-01

The past decade has witnessed significant change in the role and responsibilities of planning units within Australian universities. The main change has been a broadening of the role from routine data analysis to a comprehensive set of responsibilities that commonly include: strategic planning, coordination of internal and external reviews, quality…

"Putting Music On": Everyday Leisure Activities, Choice-Making and Person-Centred Planning in a Supported Living Scheme

ERIC Educational Resources Information Center

Hassan, Nedim

2017-01-01

Background: Person-centred planning, which commonly becomes formalised within services for people with learning disabilities through an Essential Lifestyle Plan (ELP), was intended to help place the choices of individuals at the forefront of service provision. However, beyond UK government policy rhetoric, scholars have raised issues regarding the…

Planned Giving Administration: The Business Officer's Guide [with DVD

ERIC Educational Resources Information Center

Brostrom, Forrest C.

2005-01-01

Some people associate planned giving with fancy trusts and exotic tax plans. The truth is far simpler and more profound. This book provides a comprehensive review of the subject, from the relative simplicity of outright gifts and bequests to the more complex workings of pooled income funds and retained life estates. The author lends a common sense…

Pandemic Planning: Are Universities Really Prepared?

ERIC Educational Resources Information Center

Pokrywka, Francis J.

2016-01-01

Planning for a pandemic influenza outbreak at a college or university cannot be done in a vacuum. Like any emergency plan, it needs to be a coordinated effort by a dedicated and unselfish group of individuals at the university pulling together a multitude of people and resources focused on a common goal. There is an ongoing struggle among…

Linking the Teacher Appraisal Process to the School Improvement Plan

ERIC Educational Resources Information Center

Reddekopp, Therese

2007-01-01

If a school improvement plan includes input from all stakeholders and focuses on data-driven processes that are linked to teacher appraisal, it can be powerful in leading the school toward the common mission of achieving student success. Linking the school improvement plan to the teacher appraisal process creates a system whereby all individuals…

Helical tomotherapy with dynamic running-start-stop delivery compared to conventional tomotherapy delivery

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

Rong, Yi, E-mail: yi.rong@osumc.edu; Chen, Yu; Lu, Weiguo

Purpose: Despite superior target dose uniformity, helical tomotherapy{sup ®} (HT) may involve a trade-off between longitudinal dose conformity and beam-on time (BOT), due to the limitation of only three available jaw sizes with the conventional HT (1.0, 2.5, and 5.0 cm). The recently introduced dynamic running-start-stop (RSS) delivery allows smaller jaw opening at the superior and inferior ends of the target when a sharp penumbra is needed. This study compared the dosimetric performance of RSS delivery with the fixed jaw HT delivery. Methods: Twenty patient cases were selected and deidentified prior to treatment planning, including 16 common clinical cases (brain,more » head and neck (HN), lung, and prostate) and four special cases of whole brain with hippocampus avoidance (WBHA) that require a high degree of dose modulation. HT plans were generated for common clinical cases using the fixed 2.5 cm jaw width (HT2.5) and WBHA cases using 1.0 cm (HT1.0). The jaw widths for RSS were preset with a larger size (RSS5.0 vs HT2.5 and RSS2.5 vs HT1.0). Both delivery techniques were planned based on identical contours, prescriptions, and planning objectives. Dose indices for targets and critical organs were compared using dose-volume histograms, BOT, and monitor units. Results: The average BOT was reduced from 4.8 min with HT2.5 to 2.5 min with RSS5.0. Target dose homogeneity with RSS5.0 was shown comparable to HT2.5 for common clinical sites. Superior normal tissue sparing was observed in RSS5.0 for optic nerves and optic chiasm in brain and HN cases. RSS5.0 demonstrated improved dose sparing for cord and esophagus in lung cases, as well as penile bulb in prostate cases. The mean body dose was comparable for both techniques. For the WBHA cases, the target homogeneity was significantly degraded in RSS2.5 without distinct dose sparing for hippocampus, compared to HT1.0. Conclusions: Compared to the fixed jaw HT delivery, RSS combined with a larger jaw width provides faster treatment delivery and improved cranial-caudal target dose conformity. The target coverage achieved by RSS with a large jaw width is comparable to the fixed jaw HT delivery for common cancer sites, but may deteriorate for cases where complex geometry is present in the middle part of the target.« less

HIV/AIDS National Strategic Plans of Sub-Saharan African countries: an analysis for gender equality and sex-disaggregated HIV targets

PubMed Central

Sherwood, Jennifer; Sharp, Alana; Cooper, Bergen; Roose-Snyder, Beirne; Blumenthal, Susan

2017-01-01

Abstract National Strategic Plans (NSPs) for HIV/AIDS are country planning documents that set priorities for programmes and services, including a set of targets to quantify progress toward national and international goals. The inclusion of sex-disaggregated targets and targets to combat gender inequality is important given the high disease burden among young women and adolescent girls in Sub-Saharan Africa, yet no comprehensive gender-focused analysis of NSP targets has been performed. This analysis quantitatively evaluates national HIV targets, included in NSPs from eighteen Sub-Saharan African countries, for sex-disaggregation. Additionally, NSP targets aimed at reducing gender-based inequality in health outcomes are compiled and inductively coded to report common themes. On average, in the eighteen countries included in this analysis, 31% of NSP targets include sex-disaggregation (range 0–92%). Three countries disaggregated a majority (>50%) of their targets by sex. Sex-disaggregation in data reporting was more common for targets related to the early phases of the HIV care continuum: 83% of countries included any sex-disaggregated targets for HIV prevention, 56% for testing and linkage to care, 22% for improving antiretroviral treatment coverage, and 11% for retention in treatment. The most common target to reduce gender inequality was to prevent gender-based violence (present in 50% of countries). Other commonly incorporated target areas related to improving women’s access to family planning, human and legal rights, and decision-making power. The inclusion of sex-disaggregated targets in national planning is vital to ensure that programmes make progress for all population groups. Improving the availability and quality of indicators to measure gender inequality, as well as evaluating programme outcomes by sex, is critical to tracking this progress. This analysis reveals an urgent need to set specific and separate targets for men and women in order to achieve an equitable and effective HIV response and align government planning with international priorities for gender equality. PMID:28973358

South Florida freight advanced traveler information system.

DOT National Transportation Integrated Search

2013-10-01

This Demonstration Plan has been prepared to provide guidance and a common definition to all parties of the testing program that will be conducted for the South Florida FRATIS Demonstration Project. More specifically, this document provides: Plan...

Reading your own lips: common-coding theory and visual speech perception.

PubMed

Tye-Murray, Nancy; Spehar, Brent P; Myerson, Joel; Hale, Sandra; Sommers, Mitchell S

2013-02-01

Common-coding theory posits that (1) perceiving an action activates the same representations of motor plans that are activated by actually performing that action, and (2) because of individual differences in the ways that actions are performed, observing recordings of one's own previous behavior activates motor plans to an even greater degree than does observing someone else's behavior. We hypothesized that if observing oneself activates motor plans to a greater degree than does observing others, and if these activated plans contribute to perception, then people should be able to lipread silent video clips of their own previous utterances more accurately than they can lipread video clips of other talkers. As predicted, two groups of participants were able to lipread video clips of themselves, recorded more than two weeks earlier, significantly more accurately than video clips of others. These results suggest that visual input activates speech motor activity that links to word representations in the mental lexicon.

Socioeconomic inequalities in dental health services in Sao Paulo, Brazil, 2003-2008.

PubMed

Monteiro, Camila Nascimento; Beenackers, Mariëlle A; Goldbaum, Moisés; de Azevedo Barros, Marilisa Berti; Gianini, Reinaldo José; Cesar, Chester Luiz Galvão; Mackenbach, Johan P

2016-12-07

Access to, and use of, dental health services in Brazil have improved since 2003. The increase of private health care plans and the implementation of the "Smiling Brazil" Program, the largest public oral health care program in the world, could have influenced this increase in access. However, we do not yet know if inequalities in the use of dental health services persist after the improvement in access. The aims of this study are to analyze socioeconomic differences for dental health service use between 2003 and 2008 in São Paulo and to examine changes in these associations since the implementation of the Smiling Brazil program in 2003. Data was obtained via two household health surveys (ISA-Capital 2003 and ISA-Capital 2008) which investigated living conditions, lifestyle, health status and use of health care services. Logistic regression was used to analyze associations between socioeconomic factors and dental services use. Additionally, trends from 2003 to 2008 regarding socioeconomic characteristics and dental health service use were explored. Overall, dental health service use increased between 2003 and 2008 and was at both time points more common among those who had higher income, better education, better housing conditions, private health care plans and were Caucasian. Inequalities in use of dental health care did not decrease over time. Among the reasons for not seeking dental care, not having teeth and financial difficulty were more common in lower socioeconomic groups, while thinking it was unnecessary was more common in higher socioeconomic groups. The Brazilian oral health policy is still in a period of expansion and seems to have contributed slightly to increased dental health service use, but has not influenced socioeconomic inequalities in the use of these services. Acquiring deeper knowledge about inequalities in dental health service use will contribute to better understanding of potential barriers to reducing them.

76 FR 52441 - Summary of Benefits and Coverage and the Uniform Glossary

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

... facts label that includes examples to illustrate common benefits scenarios (including pregnancy and... plan or coverage for common benefits scenarios, including pregnancy and serious or chronic medical...

Outcomes of a NASA Workshop to Develop a Portfolio of Low Latency Datasets for Time-Sensitive Applications

NASA Technical Reports Server (NTRS)

Davies, Diane K.; Brown, Molly E.; Green, David S.; Michael, Karen A.; Murray, John J.; Justice, Christopher O.; Soja, Amber J.

2016-01-01

It is widely accepted that time-sensitive remote sensing data serve the needs of decision makers in the applications communities and yet to date, a comprehensive portfolio of NASA low latency datasets has not been available. This paper will describe the NASA low latency, or Near-Real Time (NRT), portfolio, how it was developed and plans to make it available online through a portal that leverages the existing EOSDIS capabilities such as the Earthdata Search Client (https:search.earthdata.nasa.gov), the Common Metadata Repository (CMR) and the Global Imagery Browse Service (GIBS). This paper will report on the outcomes of a NASA Workshop to Develop a Portfolio of Low Latency Datasets for Time-Sensitive Applications (27-29 September 2016 at NASA Langley Research Center, Hampton VA). The paper will also summarize findings and recommendations from the meeting outlining perceived shortfalls and opportunities for low latency research and application science.

Update on sideline and event preparation for management of sudden cardiac arrest in athletes.

PubMed

Harmon, Kimberly G; Drezner, Jonathan A

2007-06-01

Sudden death in athletes occurs approximately once every 3 days in the United States. Each school or venue should have an emergency action plan that is coordinated with local emergency medical services (EMS). Access to early defibrillation to treat sudden cardiac arrest (SCA) is critical. If EMS response times are greater than 3 to 5 minutes from collapse to first shock, an on-site automated external defibrillator (AED) should be available. Delays in recognition of SCA in athletes occur commonly. Any collapsed and unresponsive athlete should be considered to be in cardiac arrest and an AED should be applied for rhythm analysis as soon as possible. Cardiopulmonary resuscitation should be provided while waiting for an AED and interruptions in chest compressions should be minimized. Rehearsal of the emergency action plan with potential first responders is essential to ensuring an efficient response to SCA in athletics.

Beyond the PhD: Putting the Right Tools in Your Research Toolbox

PubMed Central

Downs, Charles A.; Morrison, Helena W.

2013-01-01

Postdoctoral training is vital to a successful career for nurse researchers with a biological or biobehavioral focus. Such training provides structured time to devote to gaining substantive knowledge, expanding one’s biological-methods repertoire, and writing grants. However, for unknown reasons, relatively few nurses pursue postdoctoral training. A few plausible explanations include a near critical shortage of nursing faculty coupled with an aging population in need of health care, a lack of available mentoring for predoctoral students to pursue postdoctoral training, and the difficulty of navigating the process of finding and choosing the right match for a postdoctoral experience. The purposes of this article are to provide a rationale for choosing postdoctoral training, review common fellowship opportunities, and discuss the process of finding and choosing the right match for postdoctoral training. The authors provide two prospective plans for postdoctoral training and include a plan for staying on track during the postdoctoral experience. PMID:20026452

Beyond the PhD: putting the right tools in your research toolbox.

PubMed

Downs, Charles A; Morrison, Helena W

2011-01-01

Postdoctoral training is vital to a successful career for nurse researchers with a biological or biobehavioral focus. Such training provides structured time to devote to gaining substantive knowledge, expanding one's biological-methods repertoire, and writing grants. However, for unknown reasons, relatively few nurses pursue postdoctoral training. A few plausible explanations include a near critical shortage of nursing faculty coupled with an aging population in need of health care, a lack of available mentoring for predoctoral students to pursue postdoctoral training, and the difficulty of navigating the process of finding and choosing the right match for a postdoctoral experience. The purposes of this article are to provide a rationale for choosing postdoctoral training, review common fellowship opportunities, and discuss the process of finding and choosing the right match for postdoctoral training. The authors provide two prospective plans for postdoctoral training and include a plan for staying on track during the postdoctoral experience.

The Italian VLBI Network: First Results and Future Perspectives

NASA Astrophysics Data System (ADS)

Stagni, Matteo; Negusini, Monia; Bianco, Giuseppe; Sarti, Pierguido

2016-12-01

A first 24-hour Italian VLBI geodetic experiment, involving the Medicina, Noto, and Matera antennas, shaped as an IVS standard EUROPE, was successfully performed. In 2014, starting from the correlator output, a geodetic database was created and a typical solution of a small network was achieved, here presented. From this promising result we have planned new observations in 2016, involving the three Italian geodetic antennas. This could be the beginning of a possible routine activity, creating a data set that can be combined with GNSS observations to contribute to the National Geodetic Reference Datum. Particular care should be taken in the scheduling of the new experiments in order to optimize the number of usable observations. These observations can be used to study and plan future experiments in which the time and frequency standards can be given by an optical fiber link, thus having a common clock at different VLBI stations.

Challenges Facing Early Phase Trials Sponsored by the National Cancer Institute: An Analysis of Corrective Action Plans to Improve Accrual

PubMed Central

Massett, Holly A.; Mishkin, Grace; Rubinstein, Larry; Ivy, S. Percy; Denicoff, Andrea; Godwin, Elizabeth; DiPiazza, Kate; Bolognese, Jennifer; Zwiebel, James A.; Abrams, Jeffrey S.

2016-01-01

Accruing patients in a timely manner represents a significant challenge to early phase cancer clinical trials. The NCI Cancer Therapy Evaluation Program analyzed 19 months of corrective action plans (CAPs) received for slow-accruing Phase 1 and 2 trials to identify slow accrual reasons, evaluate whether proposed corrective actions matched these reasons, and assess the CAP impact on trial accrual, duration, and likelihood of meeting primary scientific objectives. Of the 135 CAPs analyzed, 69 were for Phase 1 trials and 66 for Phase 2 trials. Primary reasons cited for slow accrual were safety/toxicity (Phase 1: 48%), design/protocol concerns (Phase 1: 42%, Phase 2: 33%), and eligibility criteria (Phase 1: 41%, Phase 2: 35%). The most commonly proposed corrective actions were adding institutions (Phase 1: 43%, Phase 2: 85%) and amending the trial to change eligibility or design (Phase 1: 55%, Phase 2: 44%). Only 40% of CAPs provided proposed corrective actions that matched the reasons given for slow accrual. Seventy percent of trials were closed to accrual at time of analysis (Phase 1=48; Phase 2=46). Of these, 67% of Phase 1 and 70% of Phase 2 trials met their primary objectives, but they were active three times longer than projected. Among closed trials, 24% had an accrual rate increase associated with a greater likelihood of meeting their primary scientific objectives. Ultimately, trials receiving CAPs saw improved accrual rates. Future trials may benefit from implementing CAPs early in trial lifecycles, but it may be more beneficial to invest in earlier accrual planning. PMID:27401246

Childhood Immunizations: First-Time Expectant Mothers' Knowledge, Beliefs, Intentions, and Behaviors.

PubMed

Weiner, Judith L; Fisher, Allison M; Nowak, Glen J; Basket, Michelle M; Gellin, Bruce G

2015-12-01

This study focused on how first-time mothers decide or intend to decide with respect to the recommended childhood immunization schedule. This was the baseline survey of a larger longitudinal survey. Data were collected between June and September 2014 from 200 first-time mothers in their second trimester of pregnancy to examine vaccine-related knowledge, perceptions, intentions, and information-seeking behavior. Data were analyzed between January and June 2015. Seventy-five percent planned to have their child receive all the vaccinations consistent with the recommended childhood immunization schedule. Although participants expressed interest in childhood vaccine information, most had not received information directly from a primary care provider. One third reported receiving such information from their obstetrician/gynecologist but only about half of those were "very satisfied" with the information they received. About 70% indicated they were not familiar with the recommended vaccination schedule and number of routinely recommended vaccines. Familiarity with common vaccine education messages varied widely. Women who indicated they were planning to delay one or more recommended vaccinations were most likely to rely on Internet searches for childhood vaccine information. Overall, respondents had relatively positive beliefs and perceptions regarding childhood vaccines, which were associated with intentions to get their newborn vaccinated as recommended. However, most who were planning to delay recommended vaccinations or were undecided relied primarily on socially available sources of vaccine information, rather than information provided by a healthcare professional. Improved access to vaccine information from healthcare professionals could foster better vaccine-related knowledge and favorably impact vaccination decisions. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Planned flooding and Colorado River riparian trade-offs downstream from Glen Canyon Dam, Arizona

USGS Publications Warehouse

Stevens, Lawrence E.; Ayers, T.J.; Bennett, J.B.; Christensen, K.; Kearsley, M.J.C.; Meretsky, V.J.; Phillips, A. M.; Parnell, R.A.; Spence, J.; Sogge, M.K.; Springer, A.E.; Wegner, D.L.

2001-01-01

Regulated river restoration through planned flooding involves trade-offs between aquatic and terrestrial components, between relict pre-dam and novel post-dam resources and processes, and between management of individual resources and ecosystem characteristics. We review the terrestrial (wetland and riparian) impacts of a 1274 m3/s test flood conducted by the U.S. Bureau of Reclamation in March/April 1996, which was designed to improve understanding of sediment transport and management downstream from Glen Canyon Dam in the Colorado River ecosystem. The test flood successfully restored sandbars throughout the river corridor and was timed to prevent direct impacts to species of concern. A total of 1275 endangered Kanab ambersnail (Oxyloma haydeni kanabensis) were translocated above the flood zone at Vaseys Paradise spring, and an estimated 10.7% of the total snail habitat and 7.7% of the total snail population were lost to the flood. The test flood scoured channel margin wetlands, including potential foraging habitats of endangered Southwestern Willow Flycatcher (Empidonax traillii extimus). It also buried ground-covering riparian vegetation under >1 m of fine sand but only slightly altered woody sandbar vegetation and some return-current channel marshes. Pre-flood control efforts and appropriate flood timing limited recruitment of four common nonnative perennial plant species. Slight impacts on ethnobotanical resources were detected >430 km downstream, but those plant assemblages recovered rapidly. Careful design of planned flood hydrograph shape and seasonal timing is required to mitigate terrestrial impacts during efforts to restore essential fluvial geomorphic and aquatic habitats in regulated river ecosystems.

MO-F-CAMPUS-T-05: SQL Database Queries to Determine Treatment Planning Resource Usage

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

Fox, C; Gladstone, D

2015-06-15

Purpose: A radiation oncology clinic’s treatment capacity is traditionally thought to be limited by the number of machines in the clinic. As the number of fractions per course decrease and the number of adaptive plans increase, the question of how many treatment plans a clinic can plan becomes increasingly important. This work seeks to lay the ground work for assessing treatment planning resource usage. Methods: Care path templates were created using the Aria 11 care path interface. Care path tasks included key steps in the treatment planning process from the completion of CT simulation through the first radiation treatment. SQLmore » Server Management Studio was used to run SQL queries to extract task completion time stamps along with care path template information and diagnosis codes from the Aria database. 6 months of planning cycles were evaluated. Elapsed time was evaluated in terms of work hours within Monday – Friday, 7am to 5pm. Results: For the 195 validated treatment planning cycles, the average time for planning and MD review was 22.8 hours. Of those cases 33 were categorized as urgent. The average planning time for urgent plans was 5 hours. A strong correlation between diagnosis code and range of elapsed planning time was as well as between elapsed time and select diagnosis codes was observed. It was also observed that tasks were more likely to be completed on the date due than the time that they were due. Follow-up confirmed that most users did not look at the due time. Conclusion: Evaluation of elapsed planning time and other tasks suggest that care paths should be adjusted to allow for different contouring and planning times for certain diagnosis codes and urgent cases. Additional clinic training around task due times vs dates or a structuring of care paths around due dates is also needed.« less

Regional landslide-hazard assessment for Seattle, Washington, USA

USGS Publications Warehouse

Baum, R.L.; Coe, J.A.; Godt, J.W.; Harp, E.L.; Reid, M.E.; Savage, W.Z.; Schulz, W.H.; Brien, D.L.; Chleborad, A.F.; McKenna, J.P.; Michael, J.A.

2005-01-01

Landslides are a widespread, frequent, and costly hazard in Seattle and the Puget Sound area of Washington State, USA. Shallow earth slides triggered by heavy rainfall are the most common type of landslide in the area; many transform into debris flows and cause significant property damage or disrupt transportation. Large rotational and translational slides, though less common, also cause serious property damage. The hundreds of landslides that occurred during the winters of 1995-96 and 1996-97 stimulated renewed interest by Puget Sound communities in identifying landslide-prone areas and taking actions to reduce future landslide losses. Informal partnerships between the U.S. Geological Survey (USGS), the City of Seattle, and private consultants are focusing on the problem of identifying and mapping areas of landslide hazard as well as characterizing temporal aspects of the hazard. We have developed GIS-based methods to map the probability of landslide occurrence as well as empirical rainfall thresholds and physically based methods to forecast times of landslide occurrence. Our methods for mapping landslide hazard zones began with field studies and physically based models to assess relative slope stability, including the effects of material properties, seasonal groundwater levels, and rainfall infiltration. We have analyzed the correlation between historic landslide occurrence and relative slope stability to map the degree of landslide hazard. The City of Seattle is using results of the USGS studies in storm preparedness planning for emergency access and response, planning for development or redevelopment of hillsides, and municipal facility planning and prioritization. Methods we have developed could be applied elsewhere to suit local needs and available data.

Multiparametric MRI of Prostate Cancer: An Update on State-of-the-Art Techniques and Their Performance in Detecting and Localizing Prostate Cancer

PubMed Central

Hegde, John V.; Mulkern, Robert V.; Panych, Lawrence P.; Fennessy, Fiona M.; Fedorov, Andriy; Maier, Stephan E.; Tempany, Clare M.C.

2013-01-01

Magnetic resonance (MR) examinations of men with prostate cancer are most commonly performed for detecting, characterizing, and staging the extent of disease to best determine diagnostic or treatment strategies, which range from biopsy guidance to active surveillance to radical prostatectomy. Given both the exam's importance to individual treatment plans and the time constraints present for its operation at most institutions, it is essential to perform the study effectively and efficiently. This article reviews the most commonly employed modern techniques for prostate cancer MR examinations, exploring the relevant signal characteristics from the different methods discussed and relating them to intrinsic prostate tissue properties. Also, a review of recent articles using these methods to enhance clinical interpretation and assess clinical performance is provided. PMID:23606141

Ergonomics in the electronic library.

PubMed Central

Thibodeau, P L; Melamut, S J

1995-01-01

New technologies are changing the face of information services and how those services are delivered. Libraries spend a great deal of time planning the hardware and software implementations of electronic information services, but the human factors are often overlooked. Computers and electronic tools have changed the nature of many librarians' daily work, creating new problems, including stress, fatigue, and cumulative trauma disorders. Ergonomic issues need to be considered when designing or redesigning facilities for electronic resources and services. Libraries can prevent some of the common problems that appear in the digital workplace by paying attention to basic ergonomic issues when designing workstations and work areas. Proper monitor placement, lighting, workstation setup, and seating prevent many of the common occupational problems associated with computers. Staff training will further reduce the likelihood of ergonomic problems in the electronic workplace. PMID:7581189

Characteristics of health plans that treat psychiatric patients.

PubMed

Zarin, D A; West, J C; Pincus, H A; Tanielian, T L

1999-01-01

Nationally representative data regarding the organizational, financial, and procedural features of health plans in which psychiatric patients receive treatment indicate that fewer privately insured, Medicaid, and Medicare managed care enrollees receive care from a psychiatrist than is true for "nonmanaged" enrollees. Financial considerations were reported to adversely affect treatment for one-third of all patients. Although utilization management techniques and financial/resource constraints commonly applied to patients in both managed and nonmanaged plans, performance-based incentives were rare in nonmanaged plans. The traditional health plan categories provide limited information to identify salient plan characteristics and guide policy decisions regarding the provision of care.

Development and refinement of computer-assisted planning and execution system for use in face-jaw-teeth transplantation to improve skeletal and dento-occlusal outcomes.

PubMed

Hashemi, Sepehr; Armand, Mehran; Gordon, Chad R

2016-10-01

To describe the development and refinement of the computer-assisted planning and execution (CAPE) system for use in face-jaw-teeth transplants (FJTTs). Although successful, some maxillofacial transplants result in suboptimal hybrid occlusion and may require subsequent surgical orthognathic revisions. Unfortunately, the use of traditional dental casts and splints pose several compromising shortcomings in the context of FJTT and hybrid occlusion. Computer-assisted surgery may overcome these challenges. Therefore, the use of computer-assisted orthognathic techniques and functional planning may prevent the need for such revisions and improve facial-skeletal outcomes. A comprehensive CAPE system for use in FJTT was developed through a multicenter collaboration and refined using plastic models, live miniature swine surgery, and human cadaver models. The system marries preoperative surgical planning and intraoperative execution by allowing on-table navigation of the donor fragment relative to recipient cranium, and real-time reporting of patient's cephalometric measurements relative to a desired dental-skeletal outcome. FJTTs using live-animal and cadaveric models demonstrate the CAPE system to be accurate in navigation and beneficial in improving hybrid occlusion and other craniofacial outcomes. Future refinement of the CAPE system includes integration of more commonly performed orthognathic/maxillofacial procedures.

Problem in application carrying capacity approach for land allocation assessment in Indonesian municipal spatial planning: A case of Kutai Kartanegara Regency

NASA Astrophysics Data System (ADS)

Wijaya, I. N. S.; Rahadi, B.; Lusiana, N.; Maulidina, I.

2017-06-01

Urbanization in many countries, such as Indonesia, is commonly appeared as a dynamic population of developed areas. It is followed with reducing rural uses of land for improving urban land uses such as housing, industry, infrastructure, etc. in response to the growth of population. One may not be sufficiently considered by the urban planners and the decision makers, urbanization also means escalation of natural resources consumption that should be supported by the natural capacity of the area. In this situation, balancing approach as carrying capacity calculation in spatial planning is needed for sustainability. Indonesian Spatial Planning Law 26/2007 has already expressed about the balance approach in the system. Moreover, it strictly regulates the assessment and the permission system in controlling land development, especially for the conversion. However, the reductions over the rural uses of land, especially agriculture, are continuously occurred. Concerning the planning approach, this paper aims to disclose common insufficiency of carrying capacity considerations in Indonesian spatial planning practice. This paper describes common calculation weaknesses in projecting area for the urban development by recalculating the actual gap between supply and demand of agriculture land areas. Here, municipal spatial plan of Kutai Kartanegara Regency is utilized as single sample case to discuss. As the result, the recalculation shows that: 1) there are serious deficit status of agriculture land areas in order to fulfil the demanded agriculture production for the existed population, 2) some calculation of agriculture production may be miss-interpreted because of insufficient explanation toward the productivity of each agriculture commodity.

Simulating recurrent event data with hazard functions defined on a total time scale.

PubMed

Jahn-Eimermacher, Antje; Ingel, Katharina; Ozga, Ann-Kathrin; Preussler, Stella; Binder, Harald

2015-03-08

In medical studies with recurrent event data a total time scale perspective is often needed to adequately reflect disease mechanisms. This means that the hazard process is defined on the time since some starting point, e.g. the beginning of some disease, in contrast to a gap time scale where the hazard process restarts after each event. While techniques such as the Andersen-Gill model have been developed for analyzing data from a total time perspective, techniques for the simulation of such data, e.g. for sample size planning, have not been investigated so far. We have derived a simulation algorithm covering the Andersen-Gill model that can be used for sample size planning in clinical trials as well as the investigation of modeling techniques. Specifically, we allow for fixed and/or random covariates and an arbitrary hazard function defined on a total time scale. Furthermore we take into account that individuals may be temporarily insusceptible to a recurrent incidence of the event. The methods are based on conditional distributions of the inter-event times conditional on the total time of the preceeding event or study start. Closed form solutions are provided for common distributions. The derived methods have been implemented in a readily accessible R script. The proposed techniques are illustrated by planning the sample size for a clinical trial with complex recurrent event data. The required sample size is shown to be affected not only by censoring and intra-patient correlation, but also by the presence of risk-free intervals. This demonstrates the need for a simulation algorithm that particularly allows for complex study designs where no analytical sample size formulas might exist. The derived simulation algorithm is seen to be useful for the simulation of recurrent event data that follow an Andersen-Gill model. Next to the use of a total time scale, it allows for intra-patient correlation and risk-free intervals as are often observed in clinical trial data. Its application therefore allows the simulation of data that closely resemble real settings and thus can improve the use of simulation studies for designing and analysing studies.

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

PubMed Central

Molyneux, Sassy; Goodman, Catherine

2015-01-01

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

An unusual foreign body in the upper aerodigestive tract: esophageal obstruction due to bran impaction.

PubMed

Losacco, T; Cagiano, R; Luperto, P; Bera, I; Santacroce, L

2009-01-01

Foreign bodies of the upper aerodigestive tract are common problems encountered by the otolaryngologist and general surgeons. While the diagnosis seems straightforward, it is sometimes delayed until after serious complications have occurred. The treatment of choice is endoscopic retrieval under general anesthesia. The procedure should be preceded by the completion of appropriate studies (radiographic and other specifically indicated for the patient) planned and performed by the endoscopy team. Time invested in preparation and planning will usually yield a speedy recovery of the patient. Bran is a natural fiber that undergoes considerable expansion and thickening when hydrated. Due to this property, it has been used in "weight loss" tablets that in the stomach undergo expansion and are expected to cause early satiety. These tablets are usually marketed as over-the-counter (OTC) diet products by a number of pharmaceutical manufacturers. These supplements consisting primarily of dietary fibers, so common and inoffensive-seeming, rarely may have severe side effects, such a sudden esophageal obstruction. We report a case of a bran dietary product impacted in the cervical esophagus in a 45 year old woman, presenting as an emergency complaining of retrosternal discomfort and difficult to swallow or drink. The technique for removal of such object that is also reported.

Multicriteria plan optimization in the hands of physicians: a pilot study in prostate cancer and brain tumors.

PubMed

Müller, Birgit S; Shih, Helen A; Efstathiou, Jason A; Bortfeld, Thomas; Craft, David

2017-11-06

The purpose of this study was to demonstrate the feasibility of physician driven planning in intensity modulated radiotherapy (IMRT) with a multicriteria optimization (MCO) treatment planning system and template based plan optimization. Exploiting the full planning potential of MCO navigation, this alternative planning approach intends to improve planning efficiency and individual plan quality. Planning was retrospectively performed on 12 brain tumor and 10 post-prostatectomy prostate patients previously treated with MCO-IMRT. For each patient, physicians were provided with a template-based generated Pareto surface of optimal plans to navigate, using the beam angles from the original clinical plans. We compared physician generated plans to clinically delivered plans (created by dosimetrists) in terms of dosimetric differences, physician preferences and planning times. Plan qualities were similar, however physician generated and clinical plans differed in the prioritization of clinical goals. Physician derived prostate plans showed significantly better sparing of the high dose rectum and bladder regions (p(D1) < 0.05; D1: dose received by 1% of the corresponding structure). Physicians' brain tumor plans indicated higher doses for targets and brainstem (p(D1) < 0.05). Within blinded plan comparisons physicians preferred the clinical plans more often (brain: 6:3 out of 12, prostate: 2:6 out of 10) (not statistically significant). While times of physician involvement were comparable for prostate planning, the new workflow reduced the average involved time for brain cases by 30%. Planner times were reduced for all cases. Subjective benefits, such as a better understanding of planning situations, were observed by clinicians through the insight into plan optimization and experiencing dosimetric trade-offs. We introduce physician driven planning with MCO for brain and prostate tumors as a feasible planning workflow. The proposed approach standardizes the planning process by utilizing site specific templates and integrates physicians more tightly into treatment planning. Physicians' navigated plan qualities were comparable to the clinical plans. Given the reduction of planning time of the planner and the equal or lower planning time of physicians, this approach has the potential to improve departmental efficiencies.

Legal Challenges and Pitfalls for Start-up Companies - 48 Common Questions and Answers.

PubMed

Staehelin, Matthias

2014-12-01

Transforming a business idea into reality requires a legal implementation plan. The following 48 questions and answers address key issues that typically arise in start-up situations. Early planning can help avoid costly mistakes.

Planning for Fiscal Risk Management Demands of Retirees.

ERIC Educational Resources Information Center

Wood, R. Craig

1981-01-01

Assesses the common practice of allowing retiring employees to continue receiving group insurance benefits and suggests that before agreeing to this arrangement, administrators should consider the situation carefully and plan for the potential long-range consequences. (Author/WD)

AQUATIC STRESSORS: FRAMEWORK AND IMPLEMENTATION PLAN FOR EFFECTS RESEARCH

EPA Science Inventory

This document describes the framework and research implementation plans for ecological effects research on aquatic stressors within the National Health and Environmental Effects Laboratory. The context for the research identified within the framework is the common management goal...

Space science and applications: Strategic plan 1991

NASA Technical Reports Server (NTRS)

1991-01-01

The Office of Space Science and Applications (OSSA) 1991 Strategic Plan reflects a transitional year in which we respond to changes and focus on carrying out a vital space science program and strengthening our research base to reap the benefits of current and future missions. The Plan is built on interrelated, complementary strategies for the core space science program, for Mission to Planet Earth, and for Mission from Planet Earth. Each strategy has its own unique themes and mission priorities, but they share a common set of principles and a common goal - leadership through the achievement of excellence. Discussed here is the National Space Policy; an overview of OSSA activities, goals, and objectives; and the implications of the OSSA space science and applications strategy.

Building a New Model of Care for Rapid Breast Radiotherapy Treatment Planning: Evaluation of the Advanced Practice Radiation Therapist in Cavity Delineation.

PubMed

Lee, G; Dinniwell, R; Liu, F F; Fyles, A; Han, K; Conrad, T; Levin, W; Marshall, A; Purdie, T G; Koch, C A

2016-12-01

Breast radiotherapy treatment is commonly managed by a multidisciplinary team to ensure optimal delivery of care. We sought a new model of care whereby a clinical specialist radiation therapist (CSRT) delineates the cavity target for whole breast radiotherapy treatment planning and the radiation oncologist validates the contour during final plan review. This study evaluated the radiation oncologist's acceptance of these contours and identified characteristics of cavities suitable for CSRT-directed contouring. Following specialised breast oncology education and training by the radiation oncologist, the CSRT prospectively delineated cavities in 30 tangential breast radiotherapy cases and consulted the radiation oncologist in 'complex' cases but directed 'non-complex' cases for treatment planning. Changes to CSRT contours were evaluated using the conformity index. Breast density, time since surgery and cavity location, size and visualisation score [CVS: range 1 (no visible cavity) to 5 (homogenous cavity)] were captured. Of the 30 CSRT delineated cavities contours, the CSRT directed 20 (66.7%) cases for planning without radiation oncology review; 19 were accepted (without changes) by the radiation oncologist upon final plan review and one was changed by the radiation oncologist (conformity index = 0.93) for boost treatment and did not affect the tangential treatment plan. Ten (33.3%) cases, all CVS ≤ 3, were reviewed with the radiation oncologist before planning (conformity index = 0.88 ± 0.12). CVS was inversely correlated with breast density and cavity size (P < 0.01). The CSRT delineated cavities appropriate for clinical radiotherapy treatment planning in women with well-visualised cavities, whereas 'complex' cases with dense breast parenchyma, CVS ≤ 3, and/or cases needing boost radiotherapy treatment required review with the radiation oncologist before planning. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Online Aerial Terrain Mapping for Ground Robot Navigation

PubMed Central

Peterson, John; Chaudhry, Haseeb; Abdelatty, Karim; Bird, John; Kochersberger, Kevin

2018-01-01

This work presents a collaborative unmanned aerial and ground vehicle system which utilizes the aerial vehicle’s overhead view to inform the ground vehicle’s path planning in real time. The aerial vehicle acquires imagery which is assembled into a orthomosaic and then classified. These terrain classes are used to estimate relative navigation costs for the ground vehicle so energy-efficient paths may be generated and then executed. The two vehicles are registered in a common coordinate frame using a real-time kinematic global positioning system (RTK GPS) and all image processing is performed onboard the unmanned aerial vehicle, which minimizes the data exchanged between the vehicles. This paper describes the architecture of the system and quantifies the registration errors between the vehicles. PMID:29461496

Time studies in A&E departments--a useful tool for management.

PubMed

Aharonson-Daniel, L; Fung, H; Hedley, A J

1996-01-01

A time and motion study was conducted in an accident and emergency (A&E) department in a Hong Kong Government hospital in order to suggest solutions for severe queuing problems found in A&E. The study provided useful information about the patterns of arrival and service; the throughput; and the factors that influence the length of the queue at the A&E department. Plans for building a computerized simulation model were dropped as new intelligence generated by the study enabled problem solving using simple statistical analysis and common sense. Demonstrates some potential benefits for management in applying operations research methods in busy clinical working environments. The implementation of the recommendations made by this study successfully eliminated queues in A&E.

Online Aerial Terrain Mapping for Ground Robot Navigation.

PubMed

Peterson, John; Chaudhry, Haseeb; Abdelatty, Karim; Bird, John; Kochersberger, Kevin

2018-02-20

This work presents a collaborative unmanned aerial and ground vehicle system which utilizes the aerial vehicle's overhead view to inform the ground vehicle's path planning in real time. The aerial vehicle acquires imagery which is assembled into a orthomosaic and then classified. These terrain classes are used to estimate relative navigation costs for the ground vehicle so energy-efficient paths may be generated and then executed. The two vehicles are registered in a common coordinate frame using a real-time kinematic global positioning system (RTK GPS) and all image processing is performed onboard the unmanned aerial vehicle, which minimizes the data exchanged between the vehicles. This paper describes the architecture of the system and quantifies the registration errors between the vehicles.

Using principles from emergency management to improve emergency response plans for research animals.

PubMed

Vogelweid, Catherine M

2013-10-01

Animal research regulatory agencies have issued updated requirements for emergency response planning by regulated research institutions. A thorough emergency response plan is an essential component of an institution's animal care and use program, but developing an effective plan can be a daunting task. The author provides basic information drawn from the field of emergency management about best practices for developing emergency response plans. Planners should use the basic principles of emergency management to develop a common-sense approach to managing emergencies in their facilities.

Improve Performance of Data Warehouse by Query Cache

NASA Astrophysics Data System (ADS)

Gour, Vishal; Sarangdevot, S. S.; Sharma, Anand; Choudhary, Vinod

2010-11-01

The primary goal of data warehouse is to free the information locked up in the operational database so that decision makers and business analyst can make queries, analysis and planning regardless of the data changes in operational database. As the number of queries is large, therefore, in certain cases there is reasonable probability that same query submitted by the one or multiple users at different times. Each time when query is executed, all the data of warehouse is analyzed to generate the result of that query. In this paper we will study how using query cache improves performance of Data Warehouse and try to find the common problems faced. These kinds of problems are faced by Data Warehouse administrators which are minimizes response time and improves the efficiency of query in data warehouse overall, particularly when data warehouse is updated at regular interval.

Review and Analysis of the Colombian Foreign Language Bilingualism Policies and Plans

ERIC Educational Resources Information Center

Gómez Sará, Mary Mily

2017-01-01

This article reviews the background of the foreign language bilingualism in Colombia, as well as the Colombian bilingualism plans and the policy launched between 2004 and 2016. Then, these plans and policy are analyzed taking into account the most common criticisms from the academic community. In this sense, aspects such as the lack of continuity,…

Interactive experimenters' planning procedures and mission control

NASA Technical Reports Server (NTRS)

Desjardins, R. L.

1973-01-01

The computerized mission control and planning system routinely generates a 24-hour schedule in one hour of operator time by including time dimensions into experimental planning procedures. Planning is validated interactively as it is being generated segment by segment in the frame of specific event times. The planner simply points a light pen at the time mark of interest on the time line for entering specific event times into the schedule.

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

PubMed

Tsofa, Benjamin; Molyneux, Sassy; Goodman, Catherine

2016-07-01

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

Survey of image-guided radiotherapy use in Australia.

PubMed

Batumalai, Vikneswary; Holloway, Lois Charlotte; Kumar, Shivani; Dundas, Kylie; Jameson, Michael Geoffrey; Vinod, Shalini Kavita; Delaney, Geoff P

2017-06-01

This study aimed to evaluate the current use of imaging technologies for planning and delivery of radiotherapy (RT) in Australia. An online survey was emailed to all Australian RT centres in August 2015. The survey inquired about imaging practices during planning and treatment delivery processes. Participants were asked about the types of image-guided RT (IGRT) technologies and the disease sites they were used for, reasons for implementation, frequency of imaging and future plans for IGRT use in their department. The survey was completed by 71% of Australian RT centres. All respondents had access to computed tomography (CT) simulators and regularly co-registered the following scans to the RT: diagnostic CT (50%), diagnostic magnetic resonance imaging (MRI) (95%), planning MRI (34%), planning positron emission tomography (PET) (26%) and diagnostic PET (97%) to aid in tumour delineation. The main reason for in-room IGRT implementation was the use of highly conformal techniques, while the most common reason for under-utilisation was lack of equipment capability. The most commonly used IGRT modalities were kilovoltage (kV) cone-beam CT (CBCT) (97%), kV electronic portal image (EPI) (89%) and megavoltage (MV) EPI (75%). Overall, participants planned to increase IGRT use in planning (33%) and treatment delivery (36%). IGRT is widely used among Australian RT centres. On the basis of future plans of respondents, the installation of new imaging modalities is expected to increase for both planning and treatment. © 2016 The Royal Australian and New Zealand College of Radiologists.

Development of Virtual Airspace Simulation Technology - Real-Time (VAST-RT) Capability 2 and Experimental Plans

NASA Technical Reports Server (NTRS)

Lehmer, R.; Ingram, C.; Jovic, S.; Alderete, J.; Brown, D.; Carpenter, D.; LaForce, S.; Panda, R.; Walker, J.; Chaplin, P.;

The Use of Categorized Time-Trend Reporting of Radiation Oncology Incidents: A Proactive Analytical Approach to Improving Quality and Safety Over Time

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

Arnold, Anthony, E-mail: anthony.arnold@sesiahs.health.nsw.gov.a; Delaney, Geoff P.; Cassapi, Lynette

Purpose: Radiotherapy is a common treatment for cancer patients. Although incidence of error is low, errors can be severe or affect significant numbers of patients. In addition, errors will often not manifest until long periods after treatment. This study describes the development of an incident reporting tool that allows categorical analysis and time trend reporting, covering first 3 years of use. Methods and Materials: A radiotherapy-specific incident analysis system was established. Staff members were encouraged to report actual errors and near-miss events detected at prescription, simulation, planning, or treatment phases of radiotherapy delivery. Trend reporting was reviewed monthly. Results: Reportsmore » were analyzed for the first 3 years of operation (May 2004-2007). A total of 688 reports was received during the study period. The actual error rate was 0.2% per treatment episode. During the study period, the actual error rates reduced significantly from 1% per year to 0.3% per year (p < 0.001), as did the total event report rates (p < 0.0001). There were 3.5 times as many near misses reported compared with actual errors. Conclusions: This system has allowed real-time analysis of events within a radiation oncology department to a reduced error rate through focus on learning and prevention from the near-miss reports. Plans are underway to develop this reporting tool for Australia and New Zealand.« less

7 CFR 1207.308 - Handler.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Definitions § 1207.308 Handler. Handler means any person (except a common or contract carrier of potatoes owned by another person) who handles potatoes, including a...

A Comprehensive Planning Model

ERIC Educational Resources Information Center

Temkin, Sanford

1972-01-01

Combines elements of the problem solving approach inherent in methods of applied economics and operations research and the structural-functional analysis common in social science modeling to develop an approach for economic planning and resource allocation for schools and other public sector organizations. (Author)

7 CFR 1207.308 - Handler.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Definitions § 1207.308 Handler. Handler means any person (except a common or contract carrier of potatoes owned by another person) who handles potatoes, including a...

7 CFR 1207.308 - Handler.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Definitions § 1207.308 Handler. Handler means any person (except a common or contract carrier of potatoes owned by another person) who handles potatoes, including a...

7 CFR 1207.308 - Handler.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Definitions § 1207.308 Handler. Handler means any person (except a common or contract carrier of potatoes owned by another person) who handles potatoes, including a...

7 CFR 1207.308 - Handler.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Definitions § 1207.308 Handler. Handler means any person (except a common or contract carrier of potatoes owned by another person) who handles potatoes, including a...

Monte Carlo simulations in radiotherapy dosimetry.

PubMed

Andreo, Pedro

2018-06-27

The use of the Monte Carlo (MC) method in radiotherapy dosimetry has increased almost exponentially in the last decades. Its widespread use in the field has converted this computer simulation technique in a common tool for reference and treatment planning dosimetry calculations. This work reviews the different MC calculations made on dosimetric quantities, like stopping-power ratios and perturbation correction factors required for reference ionization chamber dosimetry, as well as the fully realistic MC simulations currently available on clinical accelerators, detectors and patient treatment planning. Issues are raised that include the necessity for consistency in the data throughout the entire dosimetry chain in reference dosimetry, and how Bragg-Gray theory breaks down for small photon fields. Both aspects are less critical for MC treatment planning applications, but there are important constraints like tissue characterization and its patient-to-patient variability, which together with the conversion between dose-to-water and dose-to-tissue, are analysed in detail. Although these constraints are common to all methods and algorithms used in different types of treatment planning systems, they make uncertainties involved in MC treatment planning to still remain "uncertain".

Discrepancies Between Planned and Actual Operating Room Turnaround Times at a Large Rural Hospital in Germany

PubMed Central

Morgenegg, Regula; Heinze, Franziska; Wieferich, Katharina; Schiffer, Ralf; Stueber, Frank; Luedi, Markus M.; Doll, Dietrich

2017-01-01

Objectives While several factors have been shown to influence operating room (OR) turnaround times, few comparisons of planned and actual OR turnaround times have been performed. This study aimed to compare planned and actual OR turnaround times at a large rural hospital in Northern Germany. Methods This retrospective study examined the OR turnaround data of 875 elective surgery cases scheduled at the Marienhospital, Vechta, Germany, between July and October 2014. The frequency distributions of planned and actual OR turnaround times were compared and correlations between turnaround times and various factors were established, including the time of day of the procedure, patient age and the planned duration of the surgery. Results There was a significant difference between mean planned and actual OR turnaround times (0.32 versus 0.64 hours; P <0.001). In addition, significant correlations were noted between actual OR turnaround times and the time of day of the surgery, patient age, actual duration of the procedure and staffing changes affecting the surgeon or the medical specialty of the surgery (P <0.001 each). The quotient of actual/planned OR turnaround times ranged from 1.733–3.000. Conclusion Significant discrepancies between planned and actual OR turnaround times were noted during the study period. Such findings may be potentially used in future studies to establish a tool to improve OR planning, measure OR management performance and enable benchmarking. PMID:29372083

Comparison of dietary habits and plans for dietary changes in black and white women seeking bariatric surgery.

PubMed

McLean, Kendall L; Moore, Carolyn E; Miketinas, Derek C; Champagne, Catherine M

2018-01-01

Achieving weight loss after bariatric surgery depends on the individual's ability to sustain lifestyle changes involving dietary modifications. Presurgical dietary assessment is critical to evaluate usual dietary habits and identify the need for intervention before surgery. The objective of this study was to identify usual dietary habits of black and white women seeking bariatric surgery and to examine potential differences between these ethnic groups. An additional aim was to describe participants' plans to change dietary behaviors after surgery. This study examined data from an observational study sponsored by a benefits management group in Louisiana. In this cross-sectional study, a presurgical dietary assessment interview questionnaire collected information on dietary habits. Participants (n = 200) were adult women being screened for bariatric surgery; 54% were white, and 46% were black. Descriptive statistics were calculated and differences between groups were tested using 2-way analysis of the variance. Participants reported consuming fast food 2.9 ± 2.6 times per week, fried foods 2.1 ± 1.8 times per week, and desserts 3.4 ± 3.2 times per week. Blacks reported more frequent consumption of fast food (P<.01), sugar-sweetened sodas (P<.05), and sugar-sweetened tea (P<.01) compared with whites. Plans for changing dietary behaviors after surgery were similar between ethnic groups. Findings indicated that frequent consumption of fast foods, fried foods, desserts, and sugar-sweetened beverages was common among women seeking bariatric surgery. Blacks tended to consume these foods and beverages more often than whites. Current dietary habits and future plans to change dietary behaviors should be addressed before surgery for success. Follow-up studies investigating the assessment instrument's ability to predict dietary adherence and weight loss after surgery are warranted. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Image calibration and registration in cone-beam computed tomogram for measuring the accuracy of computer-aided implant surgery

NASA Astrophysics Data System (ADS)

Lam, Walter Y. H.; Ngan, Henry Y. T.; Wat, Peter Y. P.; Luk, Henry W. K.; Goto, Tazuko K.; Pow, Edmond H. N.

2015-02-01

Medical radiography is the use of radiation to "see through" a human body without breaching its integrity (surface). With computed tomography (CT)/cone beam computed tomography (CBCT), three-dimensional (3D) imaging can be produced. These imagings not only facilitate disease diagnosis but also enable computer-aided surgical planning/navigation. In dentistry, the common method for transfer of the virtual surgical planning to the patient (reality) is the use of surgical stent either with a preloaded planning (static) like a channel or a real time surgical navigation (dynamic) after registration with fiducial markers (RF). This paper describes using the corner of a cube as a radiopaque fiducial marker on an acrylic (plastic) stent, this RF allows robust calibration and registration of Cartesian (x, y, z)- coordinates for linking up the patient (reality) and the imaging (virtuality) and hence the surgical planning can be transferred in either static or dynamic way. The accuracy of computer-aided implant surgery was measured with reference to coordinates. In our preliminary model surgery, a dental implant was planned virtually and placed with preloaded surgical guide. The deviation of the placed implant apex from the planning was x=+0.56mm [more right], y=- 0.05mm [deeper], z=-0.26mm [more lingual]) which was within clinically 2mm safety range. For comparison with the virtual planning, the physically placed implant was CT/CBCT scanned and errors may be introduced. The difference of the actual implant apex to the virtual apex was x=0.00mm, y=+0.21mm [shallower], z=-1.35mm [more lingual] and this should be brought in mind when interpret the results.

The Impact of Consumer-Directed Health Plans and Patient Socioeconomic Status on Physician Recommendations for Colorectal Cancer Screening

PubMed Central

Mallya, Giridhar; Polsky, Daniel

2008-01-01

Background Consumer-directed health plans are increasingly common, yet little is known about their impact on physician decision-making and preventive service use. Objective To determine how patients’ deductible levels and socioeconomic status may affect primary care physicians’ recommendations for colorectal cancer screening. Design, Setting, and Participants Screening recommendations were elicited using hypothetical vignettes from a national sample of 1,500 primary care physicians. Physicians were randomized to one of four vignettes describing a patient with either low or high socioeconomic status (SES) and either low- or high-deductible plan. Bivariate and multivariate analyses were used to examine how recommendations varied as a function of SES and deductible. Outcome Measures Rates of recommendation for home fecal occult blood testing, sigmoidoscopy, colonoscopy, and inappropriate screening, defined as no screening or office-based fecal occult blood testing. Results A total of 528 (49%) eligible physicians responded. Overall, 7.2% of physicians recommended inappropriate screening; 3.2% of patients with high SES in low-deductible plans received inappropriate screening recommendations and 11.4% of patients with low SES in high-deductible plans for an adjusted odds ratio of 0.22 (0.05–0.89). The odds of a colonoscopy recommendation were over ten times higher (AOR 11.46, 5.26–24.94) for patients with high SES in low-deductible plans compared to patients with low SES in high-deductible plans. Funds in medical savings accounts eliminated differences in inappropriate screening recommendations. Conclusions Patient SES and deductible-level affect physician recommendations for preventive care. Coverage of preventive services and funds in medical savings accounts may help to mitigate the impact of high-deductibles and SES on inappropriate recommendations. PMID:18629590

"If I have only two children and they die… who will take care of me?" -a qualitative study exploring knowledge, attitudes and practices about family planning among Mozambican female and male adults.

PubMed

Capurchande, Rehana; Coene, Gily; Roelens, Kristien; Meulemans, Herman

2017-08-22

By focusing upon family planning counselling services, the Mozambican government has significantly enhanced the general health of female and male clients. However, little is known about the experiences of family planning by female and male adults. This article focuses on knowledge, attitudes and practices regarding contraceptive methods and fertility intentions. An in-depth qualitative study of female and male clients was conducted in two settings in Maputo province - Ndlavela and Boane. A total of sixteen in-depth interviews, four informal conversations, and observations were equally divided between both study sites. The analysis followed a constructionist approach. Three steps were considered in the analysis: examining commonalities, differences and relationships. Although there was a high level of family planning knowledge, there were discrepancies in clients' everyday practices. Male and female clients are confronted with a variety of expectations concerning fertility intentions and family size, and are under pressure in numerous ways. Social pressures include traditional expectations and meanings connected to having children, as well as religious factors. Short interaction time between clients and health workers is a problem. Additionally, imposed contraceptive methods, and typically brief conversations about birth control between couples only adds to the burden. Because family planning is largely viewed as a woman's concern, most clients have never attended counselling sessions with their partners. Attitudes towards responsibility for contraceptive use and risk-taking are strongly gendered. Female and male clients have differing expectations about contraceptive use and fertility intentions. They participate differently in family planning programs leading to their inconsistent and ambivalent practices as well as vague perceptions of risk-taking. Therefore, policymakers must address the reasons behind ambivalence and inconsistency regarding contraceptives and family planning.

Poster - Thurs Eve-09: Evaluation of a commercial 2D ion-chamber array for intensity modulated radiation therapy dose measurements.

PubMed

Mei, X; Bracken, G; Kerr, A

2008-07-01

Experimental verification of calculated dose from a treatment planning system is often essential for quality assurance (QA) of intensity modulated radiation therapy (IMRT). Film dosimetry and single ion chamber measurements are commonly used for IMRT QA. Film dosimetry has very good spatial resolution, but is labor intensive and absolute dose is not reliable. Ion chamber measurements are still required for absolute dose after measurements using films. Dosimeters based on 2D detector arrays that can measure 2D dose in real-time are gaining wider use. These devices provide a much easier and reliable tool for IMRT QA. We report the evaluation of a commercial 2D ion chamber array, including its basic performance characteristics, such as linearity, reproducibility and uniformity of relative ion chamber sensitivities, and comparisons between measured 2D dose and calculated dose with a commercial treatment planning system. Our analysis shows this matrix has excellent linearity and reproducibility, but relative sensitivities are tilted such that the +Y region is over sensitive, while the -Y region is under sensitive. Despite this behavior, our results show good agreement between measured 2D dose profiles and Eclipse planned data for IMRT test plans and a few verification plans for clinical breast field-in-field plans. The gamma values (3% or 3 mm distance-to-agreement) are all less than 1 except for one or two pixels at the field edge This device provides a fast and reliable stand-alone dosimeter for IMRT QA. © 2008 American Association of Physicists in Medicine.

The Common Core State Standards Initiative: an Overview

ERIC Educational Resources Information Center

Watt, Michael G.

2011-01-01

The purpose of this study was to evaluate decision making in the Common Core State Standards Initiative as the change process moved from research, development and diffusion activities to adoption of the Common Core State Standards by the states. A decision-oriented evaluation model was used to describe the four stages of planning, structuring,…

Investigating the Effects of Planning Time on the Complexity of L2 Argumentative Writing

ERIC Educational Resources Information Center

Tabari, Mahmoud Abdi

2017-01-01

Much research has investigated the role of planning time in second language writing; however, the results show that there are inconsistent findings about the effects of planning time conditions on the complexity of the EFL learners' textual output. The current study attempted to consider the differential effects of planning time conditions in…

Effects on health of volunteers deployed during a disaster.

PubMed

Swygard, Heidi; Stafford, Renae E

2009-09-01

Little is known about the risks, hazards, and health outcomes for health care personnel and volunteers working in disaster relief. We sought to characterize risks and outcomes in volunteers deployed to provide relief for victims of Hurricane Katrina. We performed a longitudinal e-mail survey that assessed preventive measures taken before and during deployment, exposures to hazards while deployed, and health outcomes at 1, 3, and 6 months postdeployment. Overall response rate was 36.1 per cent and one-third of those who responded did so for all three surveys. Exposures to different types of hazards changed over time with exposures to contaminated water being common. Despite predeployment and on-site education, use of preventive measures such as vaccination, appropriate clothing, hydration, sunscreen, and insect repellant was variable. Few injuries were sustained. Insect bites were common despite the use of insect repellants. Skin lesions, diarrhea, and other gastrointestinal complaints occurred most commonly early on during or after deployment. Psychological complaints were common at 3 and 6 months. In conclusion, identification of at risk volunteer cohorts with longitudinal surveillance is critical for future disaster planning to provide training for volunteers and workers and to allow for deployment of appropriate resources pre, during, and postdeployment.

Practice Patterns Analysis of Ocular Proton Therapy Centers: The International OPTIC Survey.

PubMed

Hrbacek, Jan; Mishra, Kavita K; Kacperek, Andrzej; Dendale, Remi; Nauraye, Catherine; Auger, Michel; Herault, Joel; Daftari, Inder K; Trofimov, Alexei V; Shih, Helen A; Chen, Yen-Lin E; Denker, Andrea; Heufelder, Jens; Horwacik, Tomasz; Swakoń, Jan; Hoehr, Cornelia; Duzenli, Cheryl; Pica, Alessia; Goudjil, Farid; Mazal, Alejandro; Thariat, Juliette; Weber, Damien C

2016-05-01

To assess the planning, treatment, and follow-up strategies worldwide in dedicated proton therapy ocular programs. Ten centers from 7 countries completed a questionnaire survey with 109 queries on the eye treatment planning system (TPS), hardware/software equipment, image acquisition/registration, patient positioning, eye surveillance, beam delivery, quality assurance (QA), clinical management, and workflow. Worldwide, 28,891 eye patients were treated with protons at the 10 centers as of the end of 2014. Most centers treated a vast number of ocular patients (1729 to 6369). Three centers treated fewer than 200 ocular patients. Most commonly, the centers treated uveal melanoma (UM) and other primary ocular malignancies, benign ocular tumors, conjunctival lesions, choroidal metastases, and retinoblastomas. The UM dose fractionation was generally within a standard range, whereas dosing for other ocular conditions was not standardized. The majority (80%) of centers used in common a specific ocular TPS. Variability existed in imaging registration, with magnetic resonance imaging (MRI) rarely being used in routine planning (20%). Increased patient to full-time equivalent ratios were observed by higher accruing centers (P=.0161). Generally, ophthalmologists followed up the post-radiation therapy patients, though in 40% of centers radiation oncologists also followed up the patients. Seven centers had a prospective outcomes database. All centers used a cyclotron to accelerate protons with dedicated horizontal beam lines only. QA checks (range, modulation) varied substantially across centers. The first worldwide multi-institutional ophthalmic proton therapy survey of the clinical and technical approach shows areas of substantial overlap and areas of progress needed to achieve sustainable and systematic management. Future international efforts include research and development for imaging and planning software upgrades, increased use of MRI, development of clinical protocols, systematic patient-centered data acquisition, and publishing guidelines on QA, staffing, treatment, and follow-up parameters by dedicated ocular programs to ensure the highest level of care for ocular patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Use of Survivorship Care Plans and Analysis of Patient-Reported Outcomes in Multinational Patients With Lung Cancer.

PubMed

Berman, Abigail T; DeCesaris, Cristina M; Simone, Charles B; Vachani, Carolyn; DiLullo, Gloria; Hampshire, Margaret K; Metz, James; Hill-Kayser, Christine

2016-05-01

Lung cancer is the leading cause of cancer death and is a significant source of morbidity. Patient-reported outcomes (PROs) have been shown to be prognostic for survival. We have analyzed emerging patterns of longitudinal PROs collected in the development of survivorship care plans (SCPs). OncoLife and the LIVESTRONG Care Plans are Internet-based programs designed to generate unique SCPs. We selected SCPs from patients identifying as survivors of primary lung cancer. Patient-reported demographics and treatment and toxicity data were examined. Effects were categorized by the physiologic system that they affected. Six hundred eighty-nine plans were created for users self-identifying as survivors of primary lung cancer. Average time from diagnosis to reporting was 1.68 years (range, 0 to 24 years). Most were white (85.9%), well educated (61.1% "some college" or higher), and lived in the United States (90.7%). Patients underwent chemotherapy (75.8%), radiotherapy (54.7%), and surgery (54.4%). Neurocognitive symptoms (eg, fatigue, cognitive changes) were the most common (48.8%), especially among those receiving chemotherapy, followed by musculoskeletal/dermatologic symptoms (14.1%) and thoracic symptoms (13.5%). Only 11.2% were initially offered an SCP. Of those offered SCPs, 54.5% were offered by their health care provider, and most often were at a non-university-based cancer center (66.2%). For patients with lung cancer worldwide, it is feasible to obtain PROs and to create SCPs through an Internet-based program. As patients with lung cancer achieve improved survival, further attention should be paid to PROs. Surprisingly, neurocognitive symptoms seem to be the most common issues and therefore the most important to address. Increased effort should be made to provide SCPs, particularly in urban and university cancer center settings. Copyright © 2016 by American Society of Clinical Oncology.

Practice Patterns Analysis of Ocular Proton Therapy Centers: The International OPTIC Survey

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

Hrbacek, Jan, E-mail: Jan.hrbacek@psi.ch; Mishra, Kavita K.; Kacperek, Andrzej

Purpose: To assess the planning, treatment, and follow-up strategies worldwide in dedicated proton therapy ocular programs. Methods and Materials: Ten centers from 7 countries completed a questionnaire survey with 109 queries on the eye treatment planning system (TPS), hardware/software equipment, image acquisition/registration, patient positioning, eye surveillance, beam delivery, quality assurance (QA), clinical management, and workflow. Results: Worldwide, 28,891 eye patients were treated with protons at the 10 centers as of the end of 2014. Most centers treated a vast number of ocular patients (1729 to 6369). Three centers treated fewer than 200 ocular patients. Most commonly, the centers treated uvealmore » melanoma (UM) and other primary ocular malignancies, benign ocular tumors, conjunctival lesions, choroidal metastases, and retinoblastomas. The UM dose fractionation was generally within a standard range, whereas dosing for other ocular conditions was not standardized. The majority (80%) of centers used in common a specific ocular TPS. Variability existed in imaging registration, with magnetic resonance imaging (MRI) rarely being used in routine planning (20%). Increased patient to full-time equivalent ratios were observed by higher accruing centers (P=.0161). Generally, ophthalmologists followed up the post–radiation therapy patients, though in 40% of centers radiation oncologists also followed up the patients. Seven centers had a prospective outcomes database. All centers used a cyclotron to accelerate protons with dedicated horizontal beam lines only. QA checks (range, modulation) varied substantially across centers. Conclusions: The first worldwide multi-institutional ophthalmic proton therapy survey of the clinical and technical approach shows areas of substantial overlap and areas of progress needed to achieve sustainable and systematic management. Future international efforts include research and development for imaging and planning software upgrades, increased use of MRI, development of clinical protocols, systematic patient-centered data acquisition, and publishing guidelines on QA, staffing, treatment, and follow-up parameters by dedicated ocular programs to ensure the highest level of care for ocular patients.« less

Formula one night race in Singapore: a 4-year analysis of a planned mass gathering.

PubMed

Ho, Weng Hoe; Koenig, Kristi L; Quek, Lit Sin

2014-10-01

Every mass gathering presents its unique characteristics that influence medical resource utilization. Medical planning for mass gatherings involves both use of predictive models and analysis of data from similar past events. This study aimed to describe the medical presentations and the unique challenges influencing medical planning at the Formula One Singtel Singapore Grand Prix, the inaugural Formula One night race. Patient presentation characteristics, rates of patient presentation, and transportation to hospitals in association with attendance and heat index were evaluated over a 4-year period from 2009 through 2012. This will facilitate medical planning for similar events. A database containing patient presentations from the 3-day Singapore Grand Prix in 2009, 2010, 2011, and 2012 was analyzed. Patient presentations were categorized by time of day and presenting complaints. Patient presentation rates (PPRs) were analyzed to determine correlation with attendance numbers and heat index. The average annual attendance at the Singapore Grand Prix was 81,992 from 2009 through 2012. The average PPR was 2.17 (SD=0.63)/1,000 attendees. The average transport to hospital rate (TTHR) was 0.033 (SD=0.026)/1,000 attendees. While medical coverage was provided at the circuit park between 2:00 pm to 1:00 am daily, most attendees presented from 5:00 pm to 10:00 pm. The most common presenting complaints included: musculoskeletal conditions (59%) and heat related illnesses (19%). There was no correlation between attendance numbers and PPR and the heat index and PPR. Musculoskeletal conditions and heat-related illnesses were the most common presenting complaints at the Singapore Grand Prix from 2009-2012. The lack of correlation between heat index and PPR is a new finding compared with prior studies. This could be due to the minimal heat variation that occurred during the night event. Further study is required to refine models that can be used in specialized events.

Knowledge for Healthcare: the future of health librarianship.

PubMed

Bryant, Sue Lacey; Stewart, David; Goswami, Louise

2015-09-01

Many people are still not receiving the right care. It is imperative for health care librarians to come together around a common vision to achieve Knowledge for Healthcare so that the right knowledge and evidence is used at the right time in the right place. The authors describe five workstreams within a modernisation programme: Service Transformation, Workforce Planning and Development, Quality and Impact, Resource Discovery and Optimising Investment. Communications, engagement and partnership working are central to success. The development framework sets out principles on which to base decisions, and design criteria for transforming services. © 2015 Health Libraries Group.

Corridors Increase Plant Species Richness at Large Scales

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

Damschen, Ellen I.; Haddad, Nick M.; Orrock,John L.

2006-09-01

Habitat fragmentation is one of the largest threats to biodiversity. Landscape corridors, which are hypothesized to reduce the negative consequences of fragmentation, have become common features of ecological management plans worldwide. Despite their popularity, there is little evidence documenting the effectiveness of corridors in preserving biodiversity at large scales. Using a large-scale replicated experiment, we showed that habitat patches connected by corridors retain more native plant species than do isolated patches, that this difference increases over time, and that corridors do not promote invasion by exotic species. Our results support the use of corridors in biodiversity conservation.

Acute Sheehan's syndrome presenting as central diabetes insipidus.

PubMed

Robalo, Raquel; Pedroso, Célia; Agapito, Ana; Borges, Augusta

2012-11-06

Sheehan's syndrome occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage. Improvements in obstetrical care have significantly reduced its incidence in developed countries, but postpartum pituitary infarction remains a common cause of hypopituitarism in developing countries. We report a case of severe postpartum haemorrhage followed by headache, central diabetes insipidus and failure to lactate, which prompted us to investigate and identify both anterior and posterior pituitary deficiency compatible with Sheehan's syndrome. A timely diagnosis allowed us to implement an adequate treatment and follow-up plan, which are known to improve clinical status and patient outcome.

Corridors increase plant species richness at large scales.

PubMed

Damschen, Ellen I; Haddad, Nick M; Orrock, John L; Tewksbury, Joshua J; Levey, Douglas J

2006-09-01

Habitat fragmentation is one of the largest threats to biodiversity. Landscape corridors, which are hypothesized to reduce the negative consequences of fragmentation, have become common features of ecological management plans worldwide. Despite their popularity, there is little evidence documenting the effectiveness of corridors in preserving biodiversity at large scales. Using a large-scale replicated experiment, we showed that habitat patches connected by corridors retain more native plant species than do isolated patches, that this difference increases over time, and that corridors do not promote invasion by exotic species. Our results support the use of corridors in biodiversity conservation.

On the Interconnection of Incompatible Solid Finite Element Meshes Using Multipoint Constraints

NASA Technical Reports Server (NTRS)

Fox, G. L.

1985-01-01

Incompatible meshes, i.e., meshes that physically must have a common boundary, but do not necessarily have coincident grid points, can arise in the course of a finite element analysis. For example, two substructures may have been developed at different times for different purposes and it becomes necessary to interconnect the two models. A technique that uses only multipoint constraints, i.e., MPC cards (or MPCS cards in substructuring), is presented. Since the method uses only MPC's, the procedure may apply at any stage in an analysis; no prior planning or special data is necessary.

Centrifugation and the Manhattan Project

NASA Astrophysics Data System (ADS)

Reed, Cameron

2009-05-01

A study of U. S. Army Manhattan Engineer District documents reveals that consideration of centrifugation as a means of uranium enrichment during World War II was considerably more extensive than is commonly appreciated. By the time the centrifuge project was abandoned in early 1944 a full-scale prototype unit had been fabricated and tested at near-production speeds, enrichments of close to theoretically-expected levels had been demonstrated with pilot-plant units, and plans for production plants had been developed. This paper will review the history of this little-known aspect of the Project and examine the circumstances of how it came to be discontinued.

Centrifugation and the Manhattan Project

NASA Astrophysics Data System (ADS)

Reed, Cameron

2009-04-01

A study of U. S. Army Manhattan Engineer District documents reveals that consideration of centrifugation as a means of uranium enrichment during World War II was considerably more extensive than is commonly appreciated. By the time the centrifuge project was abandoned in early 1944 a full-scale prototype unit had been fabricated and tested at near-production speeds, enrichments of close to theoretically-expected levels had been demonstrated with pilot-plant units, and plans for production plants had been developed. This paper will review the history of this little-known aspect of the Project and examine the circumstances of how it came to be discontinued.

How to hold an effective meeting.

PubMed

Koshy, Kiron; Liu, Alison; Whitehurst, Katharine; Gundogan, Buket; Al Omran, Yasser

2017-06-01

Meetings are a common occurrence in academic and medical life. However, most of these meetings will be under-productive and inefficient uses of time. In this article, we provide valuable tips on how best to plan a meeting and get the most out of the people in attendance. This includes how to assess whether a meeting is necessary and what form this meeting should take. In addition to this, guidance is divided into before, during, and after the meeting. This guide will provide structure to your meetings and improve the output you and your team gain from them.

Subject Matter Expert Evaluation of Multi-Flight Common Route Advisories

NASA Technical Reports Server (NTRS)

Bilimoria, Karl; Hayashi, Miwa; Sheth, Kapil S.

2017-01-01

Traffic flow management seeks to balance the demand for National Airspace System (NAS) flight resources, such as airspace and airports, with the available supply. When forecasted weather blocks nominal air traffic routes, traffic managers must re-route affected flights for weather avoidance. Depending on the nature and scope of the weather, traffic managers may use pre-coordinated re-routes such as Playbook Routes or Coded Departure Routes, or may design ad hoc local re-routes. The routes of affected flights are modified accordingly. These weather avoidance routes will, of course, be less efficient than the nominal routes due to increased flight time and fuel burn. In current traffic management operations, the transition into a weather avoidance re-routing initiative is typically implemented more aggressively than the transition out of that initiative after the weather has dissipated or moved away. For example, strategic large-scale Playbook re-routes are sometimes left in place (as initially implemented) for many hours before being lifted entirely when the weather dissipates. There is an opportunity to periodically modify the re-routing plan as weather evolves, thereby attenuating its adverse impact on flight time and fuel consumption; this is called delay recovery. Multi-Flight Common Routes (MFCR) is a NASA-developed operational concept and associated decision support tool for delay recovery, designed to assist traffic managers to efficiently update weather avoidance traffic routes after the original re-routes have become stale due to subsequent evolution of the convective weather system. MFCR groups multiple flights to reduce the number of advisories that the traffic manager needs to evaluate, and also merges these flights on a common route segment to provide an orderly flow of re-routed traffic. The advisory is presented to the appropriate traffic manager who evaluates it and has the option to modify it using MFCRs graphical user interface. If the traffic manager finds the advisory to be operationally appropriate, he or she would coordinate with the Area Supervisor(s) of the sectors that currently control the flights in the advisory. When the traffic manager accepts the MFCR advisory via the user interface, the corresponding flight plan amendments would be sent to the displays of the appropriate sector controllers, using the Airborne Re-Routing (ABRR) capability which is scheduled for nationwide operation in 2017. The sector controllers would then offer this time-saving route modification to the pilots of the affected flights via datalink (or voice), and implement the corresponding flight plan amendment if the pilots accept it. MFCR is implemented as an application in the software environment of the Future Air traffic management Concepts Evaluation Tool (FACET). This paper focuses on an initial subject matter expert (SME) evaluation of MFCR. The evaluation covers MFCRs operational concept, algorithm, and user interface.

45 CFR 1176.5 - Annual plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ENDOWMENT FOR THE HUMANITIES PART-TIME CAREER EMPLOYMENT § 1176.5 Annual plan. (a) An agencywide plan for promoting part-time employment opportunities will be developed annually. This plan will establish annual... administering personnel ceilings, part-time career employees shall be counted against ceiling authorizations as...

Advanced space program studies. Overall executive summary

NASA Technical Reports Server (NTRS)

Wolfe, M. G.

1977-01-01

NASA and DoD requirements and planning data were used in multidiscipline advanced planning investigations of space operations and associated elements (including man), identification of potential low cost approaches, vehicle design, cost synthesis techniques, technology forecasting and opportunities for DoD technology transfer, and the development near-, mid-, and far-term space initiatives and development plans with emphasis on domestic and military commonality. An overview of objectives and results are presented for the following studies: advanced space planning and conceptual analysis, shuttle users, technology assessment and new opportunities, standardization and program practice, integrated STS operations planning, solid spinning upper stage, and integrated planning support functions.

Reasoning with inaccurate spatial knowledge. [for Planetary Rover

NASA Technical Reports Server (NTRS)

Doshi, Rajkumar S.; White, James E.; Lam, Raymond; Atkinson, David J.

1988-01-01

This paper describes work in progress on spatial planning for a semiautonomous mobile robot vehicle. The overall objective is to design a semiautonomous rover to plan routes in unknown, natural terrains. The approach to spatial planning involves deduction of common-sense spatial knowledge using geographical information, natural terrain representations, and assimilation of new and possibly conflicting terrain information. This report describes the ongoing research and implementation.

The Virginia Plan for Higher Education: Annual Report for 2016 to the General Assembly of Virginia

ERIC Educational Resources Information Center

State Council of Higher Education for Virginia, 2017

2017-01-01

The Virginia Plan for Higher Education is designed to identify trends that the Commonwealth must address if it is to prosper and succeed. Through input by higher education partners, The Virginia Plan is intended to help guide a vision for Virginia's future through a common framework. This framework is built on the premise that all partners in…

26 CFR 1.1042-1T - Questions and answers relating to the sales of stock to employee stock ownership plans or certain...

Code of Federal Regulations, 2010 CFR

2010-04-01

... stock to employee stock ownership plans or certain cooperatives (temporary). 1.1042-1T Section 1.1042-1T...) INCOME TAXES Common Nontaxable Exchanges § 1.1042-1T Questions and answers relating to the sales of stock to employee stock ownership plans or certain cooperatives (temporary). Q-1: What does section 1042...

Progress Made on a Plan To Integrate Planning, Budgeting, Assessment and Quality Principles To Achieve Institutional Improvement. First Year Report. AIR 1996 Annual Forum Paper.

ERIC Educational Resources Information Center

Griffith, Susan R.; And Others

This paper describes first year implementation efforts of Southwest Texas (SWT) State University to develop a system to integrate planning, budgeting, assessment, and quality to improve the delivery of education and other services to all the institution's customers. The document addresses the common situation when an organization already has…

An economic and life cycle analysis of regional land use and transportation plans.

DOT National Transportation Integrated Search

2012-06-01

Travel and emissions models are commonly applied to evaluate the change in passenger and commercial travel and associated greenhouse gas (GHG) emissions from land use and transportation plans. Analyses conducted by the Sacramento Area Council of Gove...

Validating commercial remote sensing and spatial information (CRS&SI) technologies for streamlining environmental and planning processes in transportation projects.

DOT National Transportation Integrated Search

2010-03-01

Transportation corridor-planning processes are well understood, and consensus exists among practitioners : about common practices for stages and tasks included in traditional EIS approaches. However, traditional approaches do : not typically employ f...

Dimensions of Professional Virtue.

ERIC Educational Resources Information Center

Sergiovanni, Thomas J.

1995-01-01

Exhorts 1994 University of San Diego graduates to invest their talents in serving the common good, whatever their chosen professions. Professionals have the capacity for welcoming complexity, acquiring information without being overwhelmed by it, planning without being controlled by their plans, discovering relationships, and creating meaning from…

Higher Education Trends (1997-1999): Administration. ERIC-HE Trends.

ERIC Educational Resources Information Center

Kezar, Adrianna J.

Several themes are prevalent in the literature on college administration. Motivating staff, planning, conflict management, ethics, power and influence, communication, strategy and decision making, vision, and financial issues are consistently discussed. However, common administrative processes such as planning, morale, and administrative climate…

Relative efficacy of cash versus vouchers in engaging opioid substitution treatment clients in survey-based research.

PubMed

Topp, Libby; Islam, M Mofizul; Day, Carolyn Ann

2013-04-01

Concerns that cash payments to people who inject drugs (PWID) to reimburse research participation will facilitate illicit drug purchases have led some ethical authorities to mandate department store/supermarket vouchers as research reimbursement. To examine the relative efficacy of the two forms of reimbursement in engaging PWID in research, clients of two public opioid substitution therapy clinics were invited to participate in a 20-30 min, anonymous and confidential interview about alcohol consumption on two separate occasions, 4 months apart. Under the crossover design, at Time 1, clients of Clinic 1 were offered $A20 cash as reimbursement, while clients of Clinic 2 were offered an $A20 voucher; at Time 2, the form of reimbursement was reversed. Using clinic records to determine the denominator (number of clients dosed), we found that compared with clients offered a voucher, a significantly higher proportion of clients who were offered cash participated in the survey (58% (139/241) vs 74% (186/252); χ(2)=14.27; p=0.0002). At first participation, respondents most commonly reported planning to purchase food/drinks/groceries (68%), cigarettes (21%) and transport/fuel (11%) with their payments, with those reimbursed in cash more likely to report planning to fund transport/fuel (19% vs 1%; p<.01) and less likely to report planning to purchase food/drinks/groceries (62% vs 76%; p=0.02). Just three out of 155 cash participants reported planning to purchase illicit drugs with their payment. Results demonstrate that modest cash payments enhanced recruitment of this group, an important consideration given the challenges of delineating the parameters of a population defined by illegal activity, seemingly without promoting excessive additional drug use.

Family Planning Practices, Programmes and Policies in India Including Implants and Injectables with a Special Focus on Jharkhand, India: A Brief Review

PubMed Central

Dehury, Ranjit Kumar

2015-01-01

The National Family Health Survey (NFHS)-3 clearly delineates that the usage of contraceptive practices has increased considerably but is more inclined toward terminal methods of contraception especially the female sterilization. The fact is also evident from various studies carried out from time to time in different Indian states. Given the context we carried out a short review to understand the family planning practices, programs and policies in India including implants and injectable contraceptives with a special focus on the state of Jharkhand. We found that among the reversible methods IUCD (intra uterine contraceptive devices), OC (oral contraceptive) pills and condoms are the most commonly used methods. In this review, in addition to national picture, we specially focused on the state of Jharkhand owing to its very gloomy picture of family planning practices as per NFHS -3 reports. The current usage of any methods of contraception in Jharkhand is only 35.7% out of which terminal methods especially female sterilization accounts to 23.4% and male sterilization being only 0.4%. Similar picture is also reflected in the conventional methods such as; IUCD-0.6%, oral pill -3.8% and condom-2.7%. Compared to the national figure the unmet need for family planning in Jharkhand is also relatively high for the conventional reversible methods than that of terminal methods which is 11.9 and 11.3 respectively. Injectable contraceptives are available only through private or social marketing channels, because of which their use is limited. The studies carried out in different Indian states show improvement in contraceptive prevalence but the same needs further improvement. PMID:26674943

Family Planning Practices, Programmes and Policies in India Including Implants and Injectables with a Special Focus on Jharkhand, India: A Brief Review.

PubMed

Samal, Janmejaya; Dehury, Ranjit Kumar

2015-11-01

The National Family Health Survey (NFHS)-3 clearly delineates that the usage of contraceptive practices has increased considerably but is more inclined toward terminal methods of contraception especially the female sterilization. The fact is also evident from various studies carried out from time to time in different Indian states. Given the context we carried out a short review to understand the family planning practices, programs and policies in India including implants and injectable contraceptives with a special focus on the state of Jharkhand. We found that among the reversible methods IUCD (intra uterine contraceptive devices), OC (oral contraceptive) pills and condoms are the most commonly used methods. In this review, in addition to national picture, we specially focused on the state of Jharkhand owing to its very gloomy picture of family planning practices as per NFHS -3 reports. The current usage of any methods of contraception in Jharkhand is only 35.7% out of which terminal methods especially female sterilization accounts to 23.4% and male sterilization being only 0.4%. Similar picture is also reflected in the conventional methods such as; IUCD-0.6%, oral pill -3.8% and condom-2.7%. Compared to the national figure the unmet need for family planning in Jharkhand is also relatively high for the conventional reversible methods than that of terminal methods which is 11.9 and 11.3 respectively. Injectable contraceptives are available only through private or social marketing channels, because of which their use is limited. The studies carried out in different Indian states show improvement in contraceptive prevalence but the same needs further improvement.

SU-F-BRB-14: Dosimetric Effects at Air- Tissue Boundary Due to Magnetic Field in MR-Guided IMRT/VMAT Delivery for Head and Neck Cancer

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

Prior, P; Chen, X; Schultz, C

Purpose: The advent of the MR-Linac enables real-time and high soft tissue contrast image guidance in radiation therapy (RT) delivery. Potential hot-spots at air-tissue interfaces, such as the sphenoid sinus, in RT for head and neck cancer (HNC), could potentially occur due to the electron return effect (ERE). In this study, we investigate the dosimetric effects of ERE on the dose distribution at air-tissues interfaces in HNC IMRT treatment planning. Methods: IMRT plans were generated based on planning CT’s acquired for HNC cases (nasopharynx, base of skull and paranasal sinus) using a research planning system (Monaco, v5.09.06, Elekta) employing Montemore » Carlo dose calculations with or without the presence of a transverse magnetic field (TMF). The dose in the air cavity was calculated in a 1 & 2 mm thick tissue layer, while the dose to the skin was calculated in a 1, 3 and 5 mm thick tissue layer. The maximum dose received in 1 cc volume, D1cc, were collected at different TMF strengths. Plan qualities generated with or without TMF or with increasing TMF were compared in terms of commonly-used dose-volume parameters (DVPs). Results: Variations in DVPs between plans with and without a TMF present were found to be within 5% of the planning CT. The presence of a TMF results in <5% changes in sinus air tissue interface. The largest skin dose differences with and without TMF were found within 1 mm of the skin surface Conclusion: The presence of a TMF results in practically insignificant changes in HNC IMRT plan quality, except for skin dose. Planning optimization with skin DV constraints could reduce the skin doses. This research was partially supported by Elekta Inc. (Crowley, U.K.)« less

The Mental Health Parity and Addiction Equity Act (MHPAEA) Evaluation Study: Impact on Quantitative Treatment Limits.

PubMed

Thalmayer, Amber Gayle; Friedman, Sarah A; Azocar, Francisca; Harwood, Jessica M; Ettner, Susan L

2017-05-01

The Mental Health Parity and Addiction Equity Act (MHPAEA) significantly changed regulations governing behavioral health benefits for large, commercially insured employers. Pre-MHPAEA, many plans covered only a specific number of behavioral health treatment days or visits; post-MHPAEA, such quantitative treatment limits (QTLs) were allowed only if they were "at parity" with medical-surgical limits. This study assessed MHPAEA's effect on the prevalence of behavioral health QTLs. Analyses used 2008-2013 specialty behavioral health benefit design data for Optum large-group plans, both carve-outs (N=2,257 plan-years, corresponding to 1,527 plans and 40 employers) and carve-ins (N=11,644 plan-years, 3,569 plans, and 340 employers). Descriptive statistics were calculated for limits existing at parity implementation, distinguished by accumulation period (annual or lifetime), level of care (inpatient, intermediate, or outpatient), unit (days, visits, or courses), condition, and network level. Proportions of plans using specific limits during the preparity (2008-2009), transition (2010), and postparity (2011-2013) periods were compared with Fisher's exact tests. Preparity, the most common QTLs were annual visit or day limits. Accounting for overlap in limit types, 89% of regular carve-out plans, 90% of in-network-only carve-outs, and 77% of carve-in plans limited outpatient visits; 66% of regular carve-out plans, 74% of in-network-only carve-outs, and 73% of carve-ins limited inpatient or intermediate days. Postparity, QTLs almost entirely disappeared (p<.001). Before MHPAEA, QTLs were common. Postimplementation, virtually all plans dropped such limits, suggesting that MHPAEA was effective at eliminating QTLs. However, increasing access to behavioral health care will mean going beyond such QTL changes and looking at other areas of benefit management.

Partnering With Community-Dwelling Individuals With Diabetes for Health Behavior Change Using Action Plans: An Innovation in Health Professionals Education and Practice.

PubMed

Barry Hultquist, Teresa; Brown, Sara Goomis; Geske, Jenenne; Kaiser, Katherine Laux; Waibel-Rycek, Denise

2015-11-01

Health care practitioners support or hinder an individual's attempts to self-manage health behavior. Practitioners must understand an individual's health needs and goals to effectively partner for behavior change. Self-management support (SMS) promote efforts toward positive health behavior change. Practitioners need training to provide effective SMS, beginning with their formal education. The purpose of this educational practice project was to integrate an evidence-based intervention (SMS using action plans) into a nursing curriculum. Three sequential steps included (1) providing foundational SMS education, (2) SMS application with students' personal action plans, and (3) implementing SMS with community-dwelling individuals with diabetes. Students (n = 130) partnered with participants (n = 85), developing short- (n = 240) and long-term (n = 99) action plans during home visits. The average baseline Diabetes Empowerment Scale score measuring participant's perceived psychosocial diabetes management self-efficacy was 4.3 (1-5 scale, SD = 0.51, n = 83). Most common short-term actions related to physical activity (n = 100, 42%) and healthy eating (n = 61, 25%). Average participant confidence level was 7.7 (SD = 1.9, 0-10 scale). Short-term goal evaluation (n = 209) revealed 66% (n = 137) were met more than 50% of the time. Both participants (99%) and students (99%) expressed satisfaction with home visit and action plan experiences. This teaching-learning experience is replicable and applicable to any professional health care student. © 2015 Society for Public Health Education.

Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia.

PubMed

Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Khu, Naw Htee; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan

2013-10-01

To describe predictors of contraceptive method discontinuation and switching behaviours among HIV-positive couples receiving couples' voluntary HIV counselling and testing services in Lusaka, Zambia. Couples were randomized in a factorial design to two-family planning educational intervention videos, received comprehensive family planning services and were assessed every 3 months for contraceptive initiation, discontinuation and switching. We modelled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long-acting reversible contraceptive (LARC) methods, and that fertility goal based, LARC-focused family planning be offered as an integral part of HIV prevention services.

A deterministic aggregate production planning model considering quality of products

NASA Astrophysics Data System (ADS)

Madadi, Najmeh; Yew Wong, Kuan

2013-06-01

Aggregate Production Planning (APP) is a medium-term planning which is concerned with the lowest-cost method of production planning to meet customers' requirements and to satisfy fluctuating demand over a planning time horizon. APP problem has been studied widely since it was introduced and formulated in 1950s. However, in several conducted studies in the APP area, most of the researchers have concentrated on some common objectives such as minimization of cost, fluctuation in the number of workers, and inventory level. Specifically, maintaining quality at the desirable level as an objective while minimizing cost has not been considered in previous studies. In this study, an attempt has been made to develop a multi-objective mixed integer linear programming model that serves those companies aiming to incur the minimum level of operational cost while maintaining quality at an acceptable level. In order to obtain the solution to the multi-objective model, the Fuzzy Goal Programming approach and max-min operator of Bellman-Zadeh were applied to the model. At the final step, IBM ILOG CPLEX Optimization Studio software was used to obtain the experimental results based on the data collected from an automotive parts manufacturing company. The results show that incorporating quality in the model imposes some costs, however a trade-off should be done between the cost resulting from producing products with higher quality and the cost that the firm may incur due to customer dissatisfaction and sale losses.

Data Management Plan and Functional System Design for the Information Management System of the Clinch River Remedial Investigation and Waste Area Grouping 6

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

Ball, T.; Brandt, C.; Calfee, J.

1994-03-01

The Data Management Plan and Functional System Design supports the Clinch River Remedial Investigation (CRRI) and Waste Area Grouping (WAG) 6 Environmental Monitoring Program. The objective of the Data Management Plan and Functional System Design is to provide organization, integrity, security, traceability, and consistency of the data generated during the CRRI and WAG 6 projects. Proper organization will ensure that the data are consistent with the procedures and requirements of the projects. The Information Management Groups (IMGs) for these two programs face similar challenges and share many common objectives. By teaming together, the IMGs have expedited the development and implementationmore » of a common information management strategy that benefits each program.« less

One common way - The strategic and methodological influence on environmental planning across Europe

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

Jiricka, Alexandra, E-mail: alexandra.jiricka@boku.ac.a; Proebstl, Ulrike, E-mail: ulrike.proebstl@boku.ac.a

In the last decades the European Union exerted influence on precautionary environmental planning by the establishment of several Directives. The most relevant were the Habitat-Directive, the EIA-Directive, the SEA-Directive and the Water Framework Directive. Comparing these EU policies in the area of environmental precaution it becomes obvious that there is a lot of common ground. Thus, the conclusion seems likely that the European Union, in doing so, has intended to establish general planning concepts through introducing several methodological steps indicated by the regulations. The goal of this article is firstly to point out, which are the common planning principles, convertedmore » by methodological elements and secondly examine the consideration of these planning concepts by the implementation and application in the member states. In this context it is analysed whether the connections and divergences between the directives lead to significant differences in the implementation process. To this aim the directives are shortly introduced and significant steps of the processes regulated by them are outlined. In the second steps the national legal implementation in the Alpine states and its consequences for the practical application are discussed. The results show a heterogeneous application of the EU principles. Within the comparative view on the four directives influence and causalities between the national implementation and the practical application were identified, which can be simplified as four types. Since a coherent strategic and methodological concept for improving environmental precaution planning from part of the EU is noticeable, more unity and comparability within the implementation is desirable, particularly in areas with comparable habitats such as the alpine space. Beyond this the trade-off between the directives poses an important task for the future.« less

Occurrence of oral health problems and planned measures in dependent older people in nursing care.

PubMed

Rantzow, Veronica; Andersson, Pia; Lindmark, Ulrika

2018-06-26

The aim of the study was to describe oral health problems and planned measures in older people receiving nursing care. Poor oral health conditions have a negative impact on the quality of life of older people. Therefore, oral care is an important task in daily nursing activities. Data were obtained from the web-based Swedish national quality register Senior Alert. Data regarding oral health status and planned measures in individuals ≥65 years from one county in Sweden between July 2014 and June 2015 were included. The Revised Oral Assessment Guide - the Jönköping (ROAG-J), was used routinely by nursing staff in nursing care facilities to measure oral health status. Oral assessments were made on 2567 individuals (65.7% women). The most common oral health problem was related to "Teeth" (43.0%), which indicates deficient oral hygiene and/or broken teeth. At least one measure was planned in all the participants. The most common planned measures were "Moistening of the mouth" (16.6%), followed by "Brushing - assistance or complete help" (13.5%). Oral health problems were common, and planned measures did not seem to be sufficient to address the identified problems. The results indicate that greater priority should be given to the oral health care of older people in nursing care. The study highlights the importance of not only identifying oral health problems but also having knowledge and strategies for oral health care. Collaboration is needed to support nurses in caring for the oral health care of older people in nursing homes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Climate and ET: Does Plant Water Requirements Increase during Droughts?

NASA Astrophysics Data System (ADS)

Fipps, G.

2015-12-01

Municipalities, engineering consultants and State agencies use reference evapotranspiration (ETo) data (directly and indirectly) for long-term water planning, for designing hydraulic structures, and for establishing regulatory guidance and conservation programs intended to reduce water waste. The use ETo data for agricultural and landscape irrigation scheduling is becoming more common in Texas as ETo-based controllers and automation technologies become more affordable. Until recently, most ETo data has been available as monthly values averaged over many years. Today, automated weather stations and irrigation controllers equipped with specialized instrumentation allow for real-time ETo measurements. With the expected rise in global warming and increased frequency of extreme climate variability in the coming decades, conservation and efficient use of water resources is essential and must make use of the most accurate and representative data available. 2011 marked the driest year on record in the State of Texas. Compounding the lack of rainfall was record heat during the Summer of 2011. An analysis of real time ETo (reference evapotranspiration) data in Texas found that ET was 30 to 50% higher than historic averages during the 2011 Summer. The implications are quite serious, as most current water planning and drought contingency plans do not take into consideration increases in ET during such periods, and irrigation planning and capacity sizing are based on historic averages of consumptive use. This paper examines the relationship between ET and climate during this extreme climatic event. While the solar radiation was near normal levels, temperature and wind was much higher and dew points much lower than norms. The variability and statistical difference between average monthly ETo data and daily, monthly and seasonal ETo measurements (from 2006 to 2014) for selected weather stations of the Texas ET Network. This study will also examine the suitability of using average ETo rates for use in regional water planning and in irrigation scheduling.

The dilemma of parotid gland and pharyngeal constrictor muscles preservation—Is daily online image guidance required? A dosimetric analysis

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

Duffy, Olivia; Forde, Elizabeth; Leech, Michelle, E-mail: leechm@tcd.ie

With margin reduction common in head and neck radiotherapy, it is critical that the dosimetric effects of setup deviations are quantified. With past studies focusing on the quantification of positional and volumetric changes of organs at risk (OARs), this study aimed to measure the dose delivered to these the parotid gland (PG) and pharyngeal constrictor muscles (PCMs) using cone beam computed tomography (CBCT). Furthermore, this investigation sought to establish a potential time trend of change in dose delivered to target volumes secondary to ascertaining the need for daily image guidance (IG) to reduce the dose burden to these important OARs.more » Intensity modulated radiotherapy (IMRT) plans for 5 locally advanced head and neck patients' plans were created and mapped to weekly CBCTs. Each plan was recalculated without heterogeneity correction allowing for dosimetric comparison. Dosimetric endpoints recorded to assess the effect of positional variation were as per ICRU 83 and included D{sub 95} and D{sub 98} for the target volumes, mean dose (MD) and V{sub 30} {sub Gy} for the PGs, and V{sub 50} {sub Gy} and MD for the PCMs. Results were deemed statistically significant if p < 0.05. No significant time trends were established for these OARs. A significant decrease in V{sub 50} {sub Gy} was observed for all PCMs (p < 0.001) on all CBCTs relative to the original plan. Regarding target volumes, a highly significant decrease in MD (MD = 20 Gy, CI: −20.310 to −19.820) in D{sub 98} of the high-dose planning target volume (PTV [70 Gy]; PTVD{sub 98%} = 70 Gy) for case 3 was found (p ≤ 0.001). A nonpredictable, yet significant dosimetric effect was found. A clinically acceptable balance must be achieved between OAR dosimetry and target coverage as can be achieved by frequent IG.« less

Evaluation of the Trajectory Operations Applications Software Task (TOAST)

NASA Technical Reports Server (NTRS)

Perkins, Sharon; Martin, Andrea; Bavinger, Bill

1990-01-01

The Trajectory Operations Applications Software Task (TOAST) is a software development project under the auspices of the Mission Operations Directorate. Its purpose is to provide trajectory operation pre-mission and real-time support for the Space Shuttle program. As an Application Manager, TOAST provides an isolation layer between the underlying Unix operating system and the series of user programs. It provides two main services: a common interface to operating system functions with semantics appropriate for C or FORTRAN, and a structured input and output package that can be utilized by user application programs. In order to evaluate TOAST as an Application Manager, the task was to assess current and planned capabilities, compare capabilities to functions available in commercially-available off the shelf (COTS) and Flight Analysis Design System (FADS) users for TOAST implementation. As a result of the investigation, it was found that the current version of TOAST is well implemented and meets the needs of the real-time users. The plans for migrating TOAST to the X Window System are essentially sound; the Executive will port with minor changes, while Menu Handler will require a total rewrite. A series of recommendations for future TOAST directions are included.

An improved genetic algorithm for multidimensional optimization of precedence-constrained production planning and scheduling

NASA Astrophysics Data System (ADS)

Dao, Son Duy; Abhary, Kazem; Marian, Romeo

2017-06-01

Integration of production planning and scheduling is a class of problems commonly found in manufacturing industry. This class of problems associated with precedence constraint has been previously modeled and optimized by the authors, in which, it requires a multidimensional optimization at the same time: what to make, how many to make, where to make and the order to make. It is a combinatorial, NP-hard problem, for which no polynomial time algorithm is known to produce an optimal result on a random graph. In this paper, the further development of Genetic Algorithm (GA) for this integrated optimization is presented. Because of the dynamic nature of the problem, the size of its solution is variable. To deal with this variability and find an optimal solution to the problem, GA with new features in chromosome encoding, crossover, mutation, selection as well as algorithm structure is developed herein. With the proposed structure, the proposed GA is able to "learn" from its experience. Robustness of the proposed GA is demonstrated by a complex numerical example in which performance of the proposed GA is compared with those of three commercial optimization solvers.

Large Unmanned Aircraft System Operations in the National Airspace System - the NASA 2007 Western States Fire Missions

NASA Technical Reports Server (NTRS)

Buoni, Gregory P.; Howell, Kathleen M.

2008-01-01

The National Aeronautics and Space Administration (NASA) Dryden Flight Research Center (DFRC) Ikhana (ee-kah-nah) project executed the 2007 Western States Fire Missions over several of the western United States using an MQ-9 unmanned aircraft system (UAS) in partnership with the NASA Ames Research Center, the United States Forest Service, and the National Interagency Fire Center. The missions were intended to supply infrared imagery of wildfires to firefighters on the ground within 10 minutes of data acquisition. For each of the eight missions, the NASA DFRC notified the Federal Aviation Administration (FAA) of specific flight plans within three or fewer days of the flight. The FAA Certificate of Waiver or Authorization (commonly referred to as a COA ) process was used to obtain access to the United States National Airspace System. Significant time and resources were necessary to develop the COA application, perform mission planning, and define and approve emergency landing sites. Unique aspects of flying unmanned aircraft created challenges to mission operations. Close coordination with FAA headquarters and air traffic control resulted in safe and successful missions that assisted firefighters by providing near-real-time imagery of selected wildfires.

An interval-parameter mixed integer multi-objective programming for environment-oriented evacuation management

NASA Astrophysics Data System (ADS)

Wu, C. Z.; Huang, G. H.; Yan, X. P.; Cai, Y. P.; Li, Y. P.

2010-05-01

Large crowds are increasingly common at political, social, economic, cultural and sports events in urban areas. This has led to attention on the management of evacuations under such situations. In this study, we optimise an approximation method for vehicle allocation and route planning in case of an evacuation. This method, based on an interval-parameter multi-objective optimisation model, has potential for use in a flexible decision support system for evacuation management. The modeling solutions are obtained by sequentially solving two sub-models corresponding to lower- and upper-bounds for the desired objective function value. The interval solutions are feasible and stable in the given decision space, and this may reduce the negative effects of uncertainty, thereby improving decision makers' estimates under different conditions. The resulting model can be used for a systematic analysis of the complex relationships among evacuation time, cost and environmental considerations. The results of a case study used to validate the proposed model show that the model does generate useful solutions for planning evacuation management and practices. Furthermore, these results are useful for evacuation planners, not only in making vehicle allocation decisions but also for providing insight into the tradeoffs among evacuation time, environmental considerations and economic objectives.

Automated construction of an intraoperative high-dose-rate treatment plan library for the Varian brachytherapy treatment planning system.

PubMed

Deufel, Christopher L; Furutani, Keith M; Dahl, Robert A; Haddock, Michael G

2016-01-01

The ability to create treatment plans for intraoperative high-dose-rate (IOHDR) brachytherapy is limited by lack of imaging and time constraints. An automated method for creation of a library of high-dose-rate brachytherapy plans that can be used with standard planar applicators in the intraoperative setting is highly desirable. Nonnegative least squares algebraic methods were used to identify dwell time values for flat, rectangular planar applicators. The planar applicators ranged in length and width from 2 cm to 25 cm. Plans were optimized to deliver an absorbed dose of 10 Gy to three different depths from the patient surface: 0 cm, 0.5 cm, and 1.0 cm. Software was written to calculate the optimized dwell times and insert dwell times and positions into a .XML plan template that can be imported into the Varian brachytherapy treatment planning system. The user may import the .XML template into the treatment planning system in the intraoperative setting to match the patient applicator size and prescribed treatment depth. A total of 1587 library plans were created for IOHDR brachytherapy. Median plan generation time was approximately 1 minute per plan. Plan dose was typically 100% ± 1% (mean, standard deviation) of the prescribed dose over the entire length and width of the applicator. Plan uniformity was best for prescription depths of 0 cm and 0.5 cm from the patient surface. An IOHDR plan library may be created using automated methods. Thousands of plan templates may be optimized and prepared in a few hours to accommodate different applicator sizes and treatment depths and reduce treatment planning time. The automated method also enforces dwell time symmetry for symmetrical applicator geometries, which simplifies quality assurance. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

SU-F-T-435: Helical Tomotherapy for Craniospinal Irradiation: What We Have Learned from a Multi-Institutional Study

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

Du, D; Kaprealian, T; Low, D

Purpose: To report cranio-spinal irradiation (CSI) planning experience, compare dosimetric quality and delivery efficiency with Tomotherapy from different institutions, and to investigate effect of planning parameters on plan quality and treatment time. Methods: Clinical helical tomotherapy IMRT plans for thirty-nine CSI cases from three academic institutions were retrospectively evaluated. The planning parameters: field width (FW), pitch, modulation factor (MF), and achieved dosimetric endpoints were cross-compared. A fraction-dose-delivery-timing index (FDTI), defined as treatment time per fraction dose per PTV length, was utilized to evaluate plan delivery efficiency. A lower FDTI indicates higher delivery efficiency. We studied the correlation between planning quality,more » treatment time and planning parameters by grouping the plans under specific planning parameters. Additionally, we created new plans using 5cm jaw for a subset of plans that used 2.5cm jaw to exam if treatment efficiency can be improved without sacrificing plan quality. Results: There were significant dosimetric differences for organ at risks (OARs) among different institutions (A,B,C). Using the lowest average MF (1.9±0.4) and 5cm field width, C had the highest lung, heart, kidney, liver mean doses and maximum doses for lens. Using the same field width of 5cm, but higher MF (2.6±0.6), B had lower doses to the OARs in the thorax and abdomen area. Most of A’s plans were planned with 2.5cm jaw, the plans yielded better PTV coverage, higher OAR doses and slightly shorter FDTI compared to institution B. The replanned 5cm jaw plans achieved comparable PTV coverage and OARs sparing, while saving up to 44.7% treatment time. Conclusion: Plan quality and delivery efficiency could vary significantly in CSI planning on Tomotheapy due to choice of different planning parameters. CSI plans using a 5cm jaw, with proper selection of pitch and MF, can achieve comparable/ better plan quality with shorter delivery time compared to 2.5cm jaw plans.« less

Information Sharing and Collaboration Business Plan

DTIC Science & Technology

2006-03-30

for information sharing The proposed environment will need a common definition of terms and dictionaries of competing terms where common definitions...a lexicon, a monolingual on-line handbook, and a thesaurus and ontology of abbreviations, acronyms, and terminology. (ISCO 2005, 18

Generic extravehicular (EVA) and telerobot task primitives for analysis, design, and integration. Version 1.0: Reference compilation for the EVA and telerobotics communities

NASA Technical Reports Server (NTRS)

Smith, Jeffrey H.; Drews, Michael

1990-01-01

The results are described of an effort to establish commonality and standardization of generic crew extravehicular (crew-EVA) and telerobotic task analysis primitives used for the study of spaceborne operations. Although direct crew-EVA plans are the most visible output of spaceborne operations, significant ongoing efforts by a wide variety of projects and organizations also require tools for estimation of crew-EVA and telerobotic times. Task analysis tools provide estimates for input to technical and cost tradeoff studies. A workshop was convened to identify the issues and needs to establish a common language and syntax for task analysis primitives. In addition, the importance of such a syntax was shown to have precedence over the level to which such a syntax is applied. The syntax, lists of crew-EVA and telerobotic primitives, and the data base in diskette form are presented.

Department of Defense picture archiving and communication system acceptance testing: results and identification of problem components.

PubMed

Allison, Scott A; Sweet, Clifford F; Beall, Douglas P; Lewis, Thomas E; Monroe, Thomas

2005-09-01

The PACS implementation process is complicated requiring a tremendous amount of time, resources, and planning. The Department of Defense (DOD) has significant experience in developing and refining PACS acceptance testing (AT) protocols that assure contract compliance, clinical safety, and functionality. The DOD's AT experience under the initial Medical Diagnostic Imaging Support System contract led to the current Digital Imaging Network-Picture Archiving and Communications Systems (DIN-PACS) contract AT protocol. To identify the most common system and component deficiencies under the current DIN-PACS AT protocol, 14 tri-service sites were evaluated during 1998-2000. Sixteen system deficiency citations with 154 separate types of limitations were noted with problems involving the workstation, interfaces, and the Radiology Information System comprising more than 50% of the citations. Larger PACS deployments were associated with a higher number of deficiencies. The most commonly cited systems deficiencies were among the most expensive components of the PACS.

Integrating Shared Mobility into Multimodal Transportation Planning: Improving Regional Performance to Meet Public Goals

DOT National Transportation Integrated Search

2018-02-01

New shared mobility services have become increasingly common and important modes of travel in U.S. cities, but transportation planning practices are only beginning to adapt in response. This white paper provides a framework and examples to assist tra...

7 CFR 1710.408 - Quality assurance plan.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE GENERAL AND PRE-LOAN POLICIES AND PROCEDURES COMMON TO ELECTRIC LOANS AND GUARANTEES Energy... accordance with quality assurance plans meeting standards designed to achieve the purposes of this subpart... pump) the new system must be designed and installed by certified and insured professionals acceptable...

47 CFR 27.1162 - Administration of the Cost-Sharing Plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Administration of the Cost-Sharing Plan. 27.1162 Section 27.1162 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020 MHz, and...

47 CFR 27.1188 - Dispute resolution under the Cost-Sharing Plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Dispute resolution under the Cost-Sharing Plan. 27.1188 Section 27.1188 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020...

47 CFR 27.1178 - Administration of the Cost-Sharing Plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Administration of the Cost-Sharing Plan. 27.1178 Section 27.1178 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020 MHz, and...

47 CFR 27.1172 - Dispute Resolution Under the Cost-Sharing Plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Dispute Resolution Under the Cost-Sharing Plan. 27.1172 Section 27.1172 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020...

47 CFR 27.1182 - Reimbursement under the Cost-Sharing Plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Reimbursement under the Cost-Sharing Plan. 27.1182 Section 27.1182 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES 1710-1755 MHz, 2110-2155 MHz, 2000-2020 MHz, and...

A Common Foundation of Information and Analytical Capability for AFSPC Decision Making

DTIC Science & Technology

2005-06-23

System Strategic Master Plan MAPs/MSP CRRAAF TASK FORCE CONOPS MUA Task Weights Engagement Analysis ASIIS Optimization ACEIT COST Analysis...Engangement Architecture Analysis Architecture MUA AFSPC POM S&T Planning Military Utility Analysis ACEIT COST Analysis Joint Capab Integ Develop System

School Gardens: Situating Students within a Global Context

ERIC Educational Resources Information Center

Wolsey, Thomas DeVere; Lapp, Diane

2014-01-01

School-based gardens are increasingly common. The benefits to students reflect principles of global education by modeling sustainability through responsible ecological planning and service to the community, the environment, and humanity. The authors propose a pedagogical framework for planning school gardens and related experiences that…

17 CFR 229.402 - (Item 402) Executive compensation.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., concise and understandable disclosure of all plan and non-plan compensation awarded to, earned by, or paid... stock units, phantom stock, phantom stock units, common stock equivalent units or any similar... to one person. Registrants may omit information regarding group life, health, hospitalization, or...

17 CFR 229.402 - (Item 402) Executive compensation.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., concise and understandable disclosure of all plan and non-plan compensation awarded to, earned by, or paid... stock units, phantom stock, phantom stock units, common stock equivalent units or any similar... to one person. Registrants may omit information regarding group life, health, hospitalization, or...

An economic and life cycle analysis of regional land use and transportation plans [research brief].

DOT National Transportation Integrated Search

2012-06-01

Travel and emissions models are commonly applied to evaluate the change in passenger and commercial travel and associated greenhouse gas (GHG) emissions from land use and transportation plans. Analyses conducted by the Sacramento Area Council of Gove...

47 CFR 24.251 - Dispute resolution under the Cost-Sharing Plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Dispute resolution under the Cost-Sharing Plan. 24.251 Section 24.251 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the...

47 CFR 24.251 - Dispute resolution under the Cost-Sharing Plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Dispute resolution under the Cost-Sharing Plan. 24.251 Section 24.251 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the...

47 CFR 24.241 - Administration of the Cost-Sharing Plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Administration of the Cost-Sharing Plan. 24.241 Section 24.241 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the 1850-1990...

47 CFR 24.241 - Administration of the Cost-Sharing Plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Administration of the Cost-Sharing Plan. 24.241 Section 24.241 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the 1850-1990...

47 CFR 24.251 - Dispute resolution under the Cost-Sharing Plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Dispute resolution under the Cost-Sharing Plan. 24.251 Section 24.251 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the...

47 CFR 24.241 - Administration of the Cost-Sharing Plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Administration of the Cost-Sharing Plan. 24.241 Section 24.241 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the 1850-1990...

47 CFR 24.241 - Administration of the Cost-Sharing Plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Administration of the Cost-Sharing Plan. 24.241 Section 24.241 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the 1850-1990...

47 CFR 24.251 - Dispute resolution under the Cost-Sharing Plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Dispute resolution under the Cost-Sharing Plan. 24.251 Section 24.251 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PERSONAL COMMUNICATIONS SERVICES Broadband PCS Policies Governing Microwave Relocation from the...

Technical and Occupational Shops.

ERIC Educational Resources Information Center

Ontario Dept. of Education, Toronto. School Planning and Building Research Section.

This booklet presents suggested plans and specifications for and discusses facilities common to technical and occupational shops. Drawings, room plans, and text illustrate specifications for drafting rooms, a welding shop, an automechanics shop, an auto body shop, and a high school greenhouse. Also included are facility designs for agricultural…

Experts, Public to Weigh in on Common Tests

ERIC Educational Resources Information Center

McNeil, Michele

2009-01-01

As 48 states charge ahead with plans to adopt common academic standards, the U.S. Department of Education will enlist experts and the public to help design a $350 million competition for the next step: the development of common tests. In coming weeks, top Education Department officials will travel to Atlanta, Boston, and Denver for a series of…

75 FR 57310 - American Capital, Ltd.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-20

... markets for the common stock, the Fair Market Value will be determined in good faith by the Board, but in.... Under the Plan, a maximum of 750,000 shares of applicant's common stock, in the aggregate, may be issued to Non-employee Directors and options to purchase 93,750 shares of applicant's common stock may be...

Preschool Literacy and the Common Core: A Professional Development Model

ERIC Educational Resources Information Center

Wake, Donna G.; Benson, Tammy Rachelle

2016-01-01

Many states have adopted the Common Core Standards for literacy and math and have begun enacting these standards in school curriculum. In states where these standards have been adopted, professional educators working in K-12 contexts have been working to create transition plans from existing state-based standards to the Common Core standards. A…

3D Printing in Liver Surgery: A Systematic Review.

PubMed

Witowski, Jan Sylwester; Coles-Black, Jasamine; Zuzak, Tomasz Zbigniew; Pędziwiatr, Michał; Chuen, Jason; Major, Piotr; Budzyński, Andrzej

2017-12-01

Rapid growth of three-dimensional (3D) printing in recent years has led to new applications of this technology across all medical fields. This review article presents a broad range of examples on how 3D printing is facilitating liver surgery, including models for preoperative planning, education, and simulation. We have performed an extensive search of the medical databases Ovid/MEDLINE and PubMed/EMBASE and screened articles fitting the scope of review, following previously established exclusion criteria. Articles deemed suitable were analyzed and data on the 3D-printed models-including both technical properties and desirable application-and their impact on clinical proceedings were extracted. Fourteen articles, presenting unique utilizations of 3D models, were found suitable for data analysis. A great majority of articles (93%) discussed models used for preoperative planning and intraoperative guidance. PolyJet was the most common (43%) and, at the same time, most expensive 3D printing technology used in the development process. Many authors of reviewed articles reported that models were accurate (71%) and allowed them to understand patient's complex anatomy and its spatial relationships. Although the technology is still in its early stages, presented models are considered useful in preoperative planning and patient and student education. There are multiple factors limiting the use of 3D printing in everyday healthcare, the most important being high costs and the time-consuming process of development. Promising early results need to be verified in larger randomized trials, which will provide more statistically significant results.

How did we make the Interdisciplinary Generalist Curriculum Project work? School-level efforts to facilitate success.

PubMed

Matson, C; Davis, A; Steinkohl, D C; Blavo, C

2001-04-01

This article examines how the schools funded by the Interdisciplinary Generalist Curriculum (IGC) Project handled the process of planning and implementing their proposals; incorporated the IGC requirements as templates for changes in educational programs and organizational infrastructures; and identified key educational and management issues that emerged over time. How collaboration flourished at each IGC school was the central functional ingredient for successful implementation. Shared power and support from the dean were essential for success. The need for excellent channels of communication among all constituencies in the process of curricular change cannot be overemphasized. The most common approach was the addition of the new interdisciplinary clinical curriculum to the existing, usually discipline-based, curriculum, with attempts to establish integrative horizontal connections among concurrent courses in years one and two. The integration, sequencing, and correlating of basic science and clinical material occupied much of the IGC course directors' time in the early stages. Several approaches were used to help ensure a beneficial initial clinical experience for medical students, while accepting that a uniform experience for all students was not attainable or necessary. Encouraging active learning on the part of students was a goal of IGC schools' planning in and of itself. The splash of establishing interdisciplinary communication structures and greater melding of disciplinary cultures that occurred at and among the IGC schools appeared to lead to ripple effects that were recognized within the first year of planning and early implementation.

Impact of a value-based insurance design for back pain on health plan member satisfaction and its implications for patient outcomes.

PubMed

Maeng, Daniel D; Fisher, Dorothy Y; Graboski, Anthony; Allison, Peiling L; Rodriguez, Jennifer M; Starr, Alison E; Tomcavage, Janet F; Davis, Duane E

2015-06-01

Back pain is one of the most common reasons for seeking care, and physical therapy (PT) can be an effective treatment option. However, PT coverage for back pain varies widely among private health plans, usually requiring high cost sharing, thereby potentially leading to member dissatisfaction and worse outcomes. In this study, a quasi-experimental design was used to estimate the impact of a new value-based insurance design for back pain-related PT on selected Consumer Assessment of Healthcare Providers and Systems survey items. Under this design, eligible members receive a bundle of 5 PT sessions for a 1-time co-payment; if deemed necessary, the bundle is renewable for 1 additional co-payment. The results indicate that the proportion of members reporting the highest satisfaction rating was higher by about 6 to 10 percentage points among those who received the PT bundle. The data also indicate that those PT bundle members who reported the highest satisfaction rating had improvements in their functional status scores that were roughly 3 to 4 times higher than those who reported a lower satisfaction rating. These findings suggest that providing a value-based insurance design for back pain-related PT can potentially improve health plan members' care experiences and their overall satisfaction. Further study is needed to determine its impact on back pain-related medical care utilization and cost of care.

Accounting for system dynamics in reserve design.

PubMed

Leroux, Shawn J; Schmiegelow, Fiona K A; Cumming, Steve G; Lessard, Robert B; Nagy, John

2007-10-01

Systematic conservation plans have only recently considered the dynamic nature of ecosystems. Methods have been developed to incorporate climate change, population dynamics, and uncertainty in reserve design, but few studies have examined how to account for natural disturbance. Considering natural disturbance in reserve design may be especially important for the world's remaining intact areas, which still experience active natural disturbance regimes. We developed a spatially explicit, dynamic simulation model, CONSERV, which simulates patch dynamics and fire, and used it to evaluate the efficacy of hypothetical reserve networks in northern Canada. We designed six networks based on conventional reserve design methods, with different conservation targets for woodland caribou habitat, high-quality wetlands, vegetation, water bodies, and relative connectedness. We input the six reserve networks into CONSERV and tracked the ability of each to maintain initial conservation targets through time under an active natural disturbance regime. None of the reserve networks maintained all initial targets, and some over-represented certain features, suggesting that both effectiveness and efficiency of reserve design could be improved through use of spatially explicit dynamic simulation during the planning process. Spatial simulation models of landscape dynamics are commonly used in natural resource management, but we provide the first illustration of their potential use for reserve design. Spatial simulation models could be used iteratively to evaluate competing reserve designs and select targets that have a higher likelihood of being maintained through time. Such models could be combined with dynamic planning techniques to develop a general theory for reserve design in an uncertain world.

Planning and Second Language Development in Task-Based Synchronous Computer-Mediated Communication

ERIC Educational Resources Information Center

Hsu, Hsiu-Chen

2012-01-01

This dissertation explored the effect of two planning conditions (the multiple planning condition with rehearsal and online planning time, and the single planning condition with online planning time only) on L2 production complexity and accuracy and the subsequent development of these two linguistic areas in the context of written synchronous…

The Role of Social Support and Self-efficacy for Planning Fruit and Vegetable Intake.

PubMed

Zhou, Guangyu; Gan, Yiqun; Hamilton, Kyra; Schwarzer, Ralf

2017-02-01

The aim of the current study was to examine the joint effect of self-efficacy, action planning, and received social support on fruit and vegetable intake. The study used a longitudinal design with 3 waves of data collection. Major university campus in Beijing, China. Young adults (n = 286). Age, gender, body mass index, dietary self-efficacy, and baseline behavior were measured at time 1. Two weeks after time 1, received social support and action planning were assessed (time 2); 4 weeks after time 1, subsequent fruit and vegetable consumption was measured (time 3). In a path analysis, action planning at time 2 was specified as a mediator between self-efficacy at time 1 and fruit and vegetable intake at time 3, controlling for age, gender, body mass index, and baseline behavior. In addition, in a conditional process analysis, received social support at time 2 was specified as a moderator of the self-efficacy-planning relationship. Action planning mediated between self-efficacy and subsequent dietary behavior, and received social support moderated between self-efficacy and planning supporting a compensation effect. Action planning served as a proximal predictor of fruit and vegetable intake, and planning one's consumption was facilitated by dietary self-efficacy. Through the identification of social cognitive factors influencing dietary planning, interventions can target self-efficacy and received social support to test the efficacy of these mechanisms in increasing individuals' ability to ensure they consume adequate amounts of fruits and vegetables. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

"If at first you don't succeed": using failure to improve teaching.

PubMed

Pinsky, L E; Irby, D M

1997-11-01

The authors surveyed a group of distinguished clinical teachers regarding episodes of failure that had subsequently led to improvements in their teaching. Specifically, they examined how these teachers had used reflection on failed approaches as a tool for experiential learning. The respondents believed that failures were as important as successes in learning to be a good teacher. Using qualitative content analysis of the respondents' comments, the authors identified eight common types of failure associated with each of the three phases of teaching: planning, teaching, and reflection. Common failures associated with the planning stage were misjudging learners, lack of preparation, presenting too much content, lack of purpose, and difficulties with audiovisuals. The primary failure associated with actual teaching was inflexibly using a single teaching method. In the reflection phase, respondents said they most often realized that they had made one of two common errors: selecting the wrong teaching strategy or incorrectly implementing a sound strategy. For each identified failure, the respondents made recommendations for improvement. The deliberative process that had guided planning, teaching, and reflecting had helped all of them transform past failures into successes.

Challenges Facing Early Phase Trials Sponsored by the National Cancer Institute: An Analysis of Corrective Action Plans to Improve Accrual.

PubMed

Massett, Holly A; Mishkin, Grace; Rubinstein, Larry; Ivy, S Percy; Denicoff, Andrea; Godwin, Elizabeth; DiPiazza, Kate; Bolognese, Jennifer; Zwiebel, James A; Abrams, Jeffrey S

2016-11-15

Accruing patients in a timely manner represents a significant challenge to early phase cancer clinical trials. The NCI Cancer Therapy Evaluation Program analyzed 19 months of corrective action plans (CAP) received for slow-accruing phase I and II trials to identify slow accrual reasons, evaluate whether proposed corrective actions matched these reasons, and assess the CAP impact on trial accrual, duration, and likelihood of meeting primary scientific objectives. Of the 135 CAPs analyzed, 69 were for phase I trials and 66 for phase II trials. Primary reasons cited for slow accrual were safety/toxicity (phase I: 48%), design/protocol concerns (phase I: 42%, phase II: 33%), and eligibility criteria (phase I: 41%, phase II: 35%). The most commonly proposed corrective actions were adding institutions (phase I: 43%, phase II: 85%) and amending the trial to change eligibility or design (phase I: 55%, phase II: 44%). Only 40% of CAPs provided proposed corrective actions that matched the reasons given for slow accrual. Seventy percent of trials were closed to accrual at time of analysis (phase I = 48; phase II = 46). Of these, 67% of phase I and 70% of phase II trials met their primary objectives, but they were active three times longer than projected. Among closed trials, 24% had an accrual rate increase associated with a greater likelihood of meeting their primary scientific objectives. Ultimately, trials receiving CAPs saw improved accrual rates. Future trials may benefit from implementing CAPs early in trial life cycles, but it may be more beneficial to invest in earlier accrual planning. Clin Cancer Res; 22(22); 5408-16. ©2016 AACRSee related commentary by Mileham and Kim, p. 5397. ©2016 American Association for Cancer Research.

Determinants of intention to work abroad of college and specialist nursing graduates in Serbia.

PubMed

Santric-Milicevic, M; Matejic, B; Terzic-Supic, Z; Vasic, V; Babic, U; Vukovic, V

2015-04-01

In a country with a poor economy and limited job opportunities, the outmigration of students is not commonly perceived as a problem but rather is perceived as a solution to the high unemployment facing young health professionals. Study objectives were to identify the prevalence of intention to work abroad of nursing graduates to point to the predictors of intention to work abroad and predictors of having a firm plan to work in a foreign country. Descriptive study, a survey. College and specialist nursing schools, Serbia. 719 nursing graduates from the 2012/2013 school year. Voluntarily completed a questionnaire that was designed with regard to similar surveys administered in EU-candidate countries during the pre-accession period. Data were analysed with descriptive and multivariate regression analyses. Almost 70% (501) of respondents indicated an intention to work abroad. Of the nurses, 13% already had established a firm plan to work abroad. Single graduates and those with a friend or relative living abroad were more likely to consider working abroad than were their counterparts (odds ratios were 2.3 and 1.7, respectively). The likelihood of considering working abroad decreased by 29% when the individuals' financial situation was improved. Factors associated with having a firm plan were previous professional experience in a foreign country, having someone abroad and financial improvement (5.4 times, 4.8 times and 2 times greater likelihood, respectively). The high prevalence of intention to work abroad suggests the need to place the issue of the out-migration of nursing graduates on the policy agenda. College and specialty nursing graduates and health technicians are prepared to work abroad in search of a better quality of life, better working conditions and higher salaries. Copyright © 2015 Elsevier Ltd. All rights reserved.

Childhood immunizations: First-time expectant mothers' knowledge, beliefs, intentions, and behaviors.

PubMed

Weiner, Judith L; Fisher, Allison M; Nowak, Glen J; Basket, Michelle M; Gellin, Bruce G

2015-11-27

This study focused on how first-time mothers decide or intend to decide with respect to the recommended childhood immunization schedule. This was the baseline survey of a larger longitudinal survey. Data were collected between June and September 2014 from 200 first-time mothers in their second trimester of pregnancy to examine vaccine-related knowledge, perceptions, intentions, and information-seeking behavior. Data were analyzed between January and June 2015. Seventy-five percent planned to have their child receive all the vaccinations consistent with the recommended childhood immunization schedule. Although participants expressed interest in childhood vaccine information, most had not received information directly from a primary care provider. One third reported receiving such information from their obstetrician/gynecologist but only about half of those were "very satisfied" with the information they received. About 70% indicated they were not familiar with the recommended vaccination schedule and number of routinely recommended vaccines. Familiarity with common vaccine education messages varied widely. Women who indicated they were planning to delay one or more recommended vaccinations were most likely to rely on Internet searches for childhood vaccine information. Overall, respondents had relatively positive beliefs and perceptions regarding childhood vaccines, which were associated with intentions to get their newborn vaccinated as recommended. However, most who were planning to delay recommended vaccinations or were undecided relied primarily on socially available sources of vaccine information, rather than information provided by a healthcare professional. Improved access to vaccine information from healthcare professionals could foster better vaccine-related knowledge and favorably impact vaccination decisions. Copyright © 2015 American Journal of Preventive Medicine and Elsevier Ltd. Published by Elsevier Ltd.. All rights reserved.

High-Dose-Rate Interstitial Brachytherapy as Monotherapy for Clinically Localized Prostate Cancer: Treatment Evolution and Mature Results

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

Zamboglou, Nikolaos; Tselis, Nikolaos, E-mail: ntselis@hotmail.com; Baltas, Dimos

2013-03-01

Purpose: To report the clinical outcome of high-dose-rate (HDR) interstitial (IRT) brachytherapy (BRT) as sole treatment (monotherapy) for clinically localized prostate cancer. Methods and Materials: Between January 2002 and December 2009, 718 consecutive patients with clinically localized prostate cancer were treated with transrectal ultrasound (TRUS)-guided HDR monotherapy. Three treatment protocols were applied; 141 patients received 38.0 Gy using one implant in 4 fractions of 9.5 Gy with computed tomography-based treatment planning; 351 patients received 38.0 Gy in 4 fractions of 9.5 Gy, using 2 implants (2 weeks apart) and intraoperative TRUS real-time treatment planning; and 226 patients received 34.5 Gy,more » using 3 single-fraction implants of 11.5 Gy (3 weeks apart) and intraoperative TRUS real-time treatment planning. Biochemical failure was defined according to the Phoenix consensus, and toxicity was evaluated using Common Toxicity Criteria for Adverse Events version 3. Results: The median follow-up time was 52.8 months. The 36-, 60-, and 96-month biochemical control and metastasis-free survival rates for the entire cohort were 97%, 94%, and 90% and 99%, 98%, and 97%, respectively. Toxicity was scored per event, with 5.4% acute grade 3 genitourinary and 0.2% acute grade 3 gastrointestinal toxicity. Late grade 3 genitourinary and gastrointestinal toxicities were 3.5% and 1.6%, respectively. Two patients developed grade 4 incontinence. No other instance of grade 4 or greater acute or late toxicity was reported. Conclusion: Our results confirm IRT-HDR-BRT is safe and effective as monotherapy for clinically localized prostate cancer.« less

SU-F-T-99: Data Visualization From a Treatment Planning Tracking System for Radiation Oncology

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

Cline, K; Kabat, C; Li, Y

2016-06-15

Purpose: A treatment planning process tracker database with input forms and a TV-viewable display webpage was developed and implemented in our clinic to collect time data points throughout the process. Tracking plan times is important because it directly affects the patient quality of care. Simply, the longer a patient waits after their initial simulation CT for treatment to begin, the more time the cancer has to progress. The tracker helps to drive workflow through the clinic, while the data collected can be used to understand and manage the process to find and eliminate inefficiencies. Methods: The overall process steps trackedmore » are CT-simulation, mark patient, draw normal contours, draw target volumes, create plan, and review/approve plan. Time stamps for task completion were extracted and used to generate a set of clinic metrics, among which include average time for each step in the process split apart by type of treatment, average time to completion for plans started in a given week, and individual overall completion time per plan. Results: Trends have been tracked for fourteen weeks of clinical data (196 plans). On average, drawing normal contours and target volumes is taking 2–5 times as long as creating the plan itself. This is potentially an issue because it could mean the process is taking too long initially, and it could be forcing the planning step to be done in a short amount of time. We also saw from our graphs that there appears to be no clear trend on the average amount of time per plan week-to-week. Conclusion: A tracker of this type has the potential to provide insight into how time is utilized in our clinic. By equipping our dosimetrists, radiation oncologists, and physicists with individualized metric sets, the tracker can help provide visibility and drive workflow. Funded in part by CPRIT (RP140105).« less

Preparing for pandemic influenza.

PubMed

Rebmann, Terri

2008-01-01

Influenza is a highly contagious, acute febrile respiratory illness that results in global morbidity and mortality annually. Avian influenza (H5N1) has the potential to cause a pandemic. Avian influenza's epidemiology and clinical description, including common signs/symptoms, transmission, vaccination, and treatment, are presented. Recommended isolation practices for labor and delivery, and proper procedures for identifying and managing infected patients are provided. Potential maternal and newborn outcomes related to influenza and avian influenza are discussed. Pandemic planning issues are outlined, including hospital surge capacity, medical equipment and staffing availability, and the need for altered standards of care. Communities need to designate sites (whether in hospital or in alternative care centers) for labor and delivery services as part of their disaster plan. Pregnant women and newborns are vulnerable groups during routine times and are expected to be disproportionately affected during a pandemic in terms of morbidity and mortality. Therefore, it is essential that hospitals and communities take steps to protect these vulnerable groups as part of the disaster planning process. It is not known whether or when a pandemic will occur, but perinatal and neonatal nurses should become familiar with avian influenza's clinical description and proper infection control procedures to halt potential disease spread.

Role of health insurance in financing vaccinations for children and adolescents in the United States.

PubMed

Shen, Angela K; Hunsaker, John; Gazmararian, Julie A; Lindley, Megan C; Birkhead, Guthrie S

2009-12-01

The goal was to elicit perspectives of selected health insurance plan medical or quality improvement directors regarding factors related to coverage and reimbursement and perceptions of financing as a barrier to child and adolescent immunization. Medical or quality improvement directors from 20 plans selected by America's Health Insurance Plans were invited to complete an online survey in July 2007. Respondents who agreed to follow-up interviews were invited to participate in telephone interviews conducted by Centers for Disease Control and Prevention staff members in August 2007. Fifteen plans (representing >67 million enrollees) responded to the online survey. All respondents covered all Advisory Committee on Immunization Practices-recommended child and adolescent vaccines in all or most products. Advisory Committee on Immunization Practices recommendations were the most commonly cited criteria for coverage decisions (86.7%) and coverage modifications (100%). Factors affecting reimbursement that were cited most often were manufacturer's vaccine price (80%) and physician feedback (53.3%). In follow-up interviews with 10 self-selected respondents, manufacturer's price (7 of 10 plans) and physician feedback (4 of 10 plans) were identified as the most-important factors affecting reimbursement. Respondents said that reimbursement delays were most commonly attributable to providers' claim submission errors or patient ineligibility. Some respondents thought that vaccine financing was a barrier (4 of 10 plans) or somewhat a barrier (2 of 10 plans) to providing immunizations; others (4 of 10 plans) did not. Although these data suggest that health insurance coverage for recommended vaccines is high, coverage is not universal across all products offered.

HIV/AIDS National Strategic Plans of Sub-Saharan African countries: an analysis for gender equality and sex-disaggregated HIV targets.

PubMed

Sherwood, Jennifer; Sharp, Alana; Cooper, Bergen; Roose-Snyder, Beirne; Blumenthal, Susan

2017-12-01

National Strategic Plans (NSPs) for HIV/AIDS are country planning documents that set priorities for programmes and services, including a set of targets to quantify progress toward national and international goals. The inclusion of sex-disaggregated targets and targets to combat gender inequality is important given the high disease burden among young women and adolescent girls in Sub-Saharan Africa, yet no comprehensive gender-focused analysis of NSP targets has been performed. This analysis quantitatively evaluates national HIV targets, included in NSPs from eighteen Sub-Saharan African countries, for sex-disaggregation. Additionally, NSP targets aimed at reducing gender-based inequality in health outcomes are compiled and inductively coded to report common themes. On average, in the eighteen countries included in this analysis, 31% of NSP targets include sex-disaggregation (range 0-92%). Three countries disaggregated a majority (>50%) of their targets by sex. Sex-disaggregation in data reporting was more common for targets related to the early phases of the HIV care continuum: 83% of countries included any sex-disaggregated targets for HIV prevention, 56% for testing and linkage to care, 22% for improving antiretroviral treatment coverage, and 11% for retention in treatment. The most common target to reduce gender inequality was to prevent gender-based violence (present in 50% of countries). Other commonly incorporated target areas related to improving women's access to family planning, human and legal rights, and decision-making power. The inclusion of sex-disaggregated targets in national planning is vital to ensure that programmes make progress for all population groups. Improving the availability and quality of indicators to measure gender inequality, as well as evaluating programme outcomes by sex, is critical to tracking this progress. This analysis reveals an urgent need to set specific and separate targets for men and women in order to achieve an equitable and effective HIV response and align government planning with international priorities for gender equality. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

JPRS Report, West Europe.

DTIC Science & Technology

1987-06-29

Congress But LSW Feud Continues (DAGENS NYHETER, various dates) 54 Applauds USSR, Attacks SDP, by Ake Ekdahl 54 Plan for Collective Leadership, by...national economy. National economy, however, requires planning based on the consideration of the commom good. The state must have the ability to guide the...regulation and planning as their counterparts to protect the common weal. It has been said of the many meanings of socialism that "the state has to be

CINRG: Infrastructure for Clinical Trials in Duchenne Dystrophy

DTIC Science & Technology

2013-09-01

research centers sharing a common goal of improving the quality of life of neuromuscular disease patients by cooperative planning , implementation, analysis...discrepancies were noted surrounding the regulatory binder, consent process and data records. The site personnel have a scheduled plan with the CINRG CC...missing long term follow-up visits). The project manager also reviewed the study records to date while onsite. A high priority plan was developed with the

SARA: A Mobile App to Engage Users in Health Data Collection

PubMed Central

Rabbi, Mashfiqui; Philyaw-Kotov, Meredith; Lee, Jinseok; Mansour, Anthony; Dent, Laura; Wang, Xiaolei; Cunningham, Rebecca; Bonar, Erin; Nahum-Shani, Inbal; Klasnja, Predrag; Walton, Maureen; Murphy, Susan

2017-01-01

Despite the recent progress in sensor technologies, many relevant health data can be only captured with manual input (e.g., food intake, stress appraisal, subjective emotion, substance use). A common problem of manual logging is that users often disengage within a short time because of high burden. In this work, we propose SARA, a novel app to engage users with ongoing tracking using timely rewards thereby reinforcing users for data input. SARA is developed for adolescents and emerging adults at risk for substance abuse. The rewards in SARA are designed to be developmentally and culturally appropriate to the target demographic and are theoretically grounded in the behavioral science literature. In this paper, we describe SARA and its rewards to increase data collection. We also briefly discuss future plans to evaluate SARA and develop just in time adaptive interventions for engagement and behavior change. PMID:29503985

Investigating diffusion with technology

NASA Astrophysics Data System (ADS)

Miller, Jon S.; Windelborn, Augden F.

2013-07-01

The activities described here allow students to explore the concept of diffusion with the use of common equipment such as computers, webcams and analysis software. The procedure includes taking a series of digital pictures of a container of water with a webcam as a dye slowly diffuses. At known time points, measurements of the pixel densities (darkness) of the digital pictures are recorded and then plotted on a graph. The resulting graph of darkness versus time allows students to see the results of diffusion of the dye over time. Through modification of the basic lesson plan, students are able to investigate the influence of a variety of variables on diffusion. Furthermore, students are able to expand the boundaries of their thinking by formulating hypotheses and testing their hypotheses through experimentation. As a result, students acquire a relevant science experience through taking measurements, organizing data into tables, analysing data and drawing conclusions.

Health impact assessment of urban waterway decisions.

PubMed

Korfmacher, Katrina Smith; Aviles, Katia; Cummings, B J; Daniell, William; Erdmann, Jared; Garrison, Valerie

2014-12-25

Health impact assessments (HIA) promote the consideration of health in a wide range of public decisions. Although each HIA is different, common pathways, evidence bases, and strategies for community engagement tend to emerge in certain sectors, such as urban redevelopment, natural resource extraction, or transportation planning. To date, a limited number of HIAs have been conducted on decisions affecting water resources and waterfronts. This review presents four recent HIAs of water-related decisions in the United States and Puerto Rico. Although the four cases are topically and geographically diverse, several common themes emerged from the consideration of health in water-related decisions. Water resource decisions are characterized by multiple competing uses, inter-institutional and inter-jurisdictional complexity, scientific uncertainty, long time scales for environmental change, diverse cultural and historical human values, and tradeoffs between private use and public access. These four case studies reveal challenges and opportunities of examining waterfront decisions through a "health lens". This review analyzes these cases, common themes, and lessons learned for the future practice of HIA in the waterfront zone and beyond.

Health Impact Assessment of Urban Waterway Decisions

PubMed Central

Korfmacher, Katrina Smith; Aviles, Katia; Cummings, B.J.; Daniell, William; Erdmann, Jared; Garrison, Valerie

2014-01-01

Health impact assessments (HIA) promote the consideration of health in a wide range of public decisions. Although each HIA is different, common pathways, evidence bases, and strategies for community engagement tend to emerge in certain sectors, such as urban redevelopment, natural resource extraction, or transportation planning. To date, a limited number of HIAs have been conducted on decisions affecting water resources and waterfronts. This review presents four recent HIAs of water-related decisions in the United States and Puerto Rico. Although the four cases are topically and geographically diverse, several common themes emerged from the consideration of health in water-related decisions. Water resource decisions are characterized by multiple competing uses, inter-institutional and inter-jurisdictional complexity, scientific uncertainty, long time scales for environmental change, diverse cultural and historical human values, and tradeoffs between private use and public access. These four case studies reveal challenges and opportunities of examining waterfront decisions through a “health lens”. This review analyzes these cases, common themes, and lessons learned for the future practice of HIA in the waterfront zone and beyond. PMID:25547399

The Kaiser Permanente shoulder arthroplasty registry: results from 6,336 primary shoulder arthroplasties.

PubMed

Dillon, Mark T; Ake, Christopher F; Burke, Mary F; Singh, Anshuman; Yian, Edward H; Paxton, Elizabeth W; Navarro, Ronald A

2015-06-01

Shoulder arthroplasty is being performed in the United States with increasing frequency. We describe the medium-term findings from a large integrated healthcare system shoulder arthroplasty registry. Shoulder arthroplasty cases registered between January 2005 and June 2013 were included for analysis. The registry included patient characteristics, surgical information, implant data, attrition, and patient outcomes such as surgical site infections, venous thromboembolism, and revision procedures. During the study period, 6,336 primary cases were registered. Median follow-up time for all primaries was 3.3 years; 461 cases were lost to follow-up by ending of health plan membership. Primary cases were predominantly female (56%) and white (81%), with an average age of 70 years. The most common reason for surgery was osteoarthritis in 60% of cases, followed by acute fracture (17%) and rotator cuff tear arthropathy (15%). In elective shoulder arthroplasty procedures, 200 all-cause revisions (4%) were reported, with glenoid wear being the most common reason. Most arthroplasties were elective procedures: over half performed for osteoarthritis. Glenoid wear was the most common reason for revision of primary shoulder arthroplasty in elective cases.

Center-TRACON Automation System (CTAS) En Route Trajectory Predictor Requirements and Capabilities

NASA Technical Reports Server (NTRS)

Vivona, Robert; Cate, Karen Tung

2013-01-01

This requirements framework document is designed to support the capture of requirements and capabilities for state-of-the-art trajectory predictors (TPs). This framework has been developed to assist TP experts in capturing a clear, consistent, and cross-comparable set of requirements and capabilities. The goal is to capture capabilities (types of trajectories that can be built), functional requirements (including inputs and outputs), non-functional requirements (including prediction accuracy and computational performance), approaches for constraint relaxation, and input uncertainties. The sections of this framework are based on the Common Trajectory Predictor structure developed by the FAA/Eurocontrol Cooperative R&D Action Plan 16 Committee on Common Trajectory Prediction. It is assumed that the reader is familiar with the Common TP Structure.1 This initial draft is intended as a first cut capture of the En Route TS Capabilities and Requirements. As such, it contains many annotations indicating possible logic errors in the CTAS code or in the description provided. It is intended to work out the details of the annotations with NASA and to update this document at a later time.

Commercial insurance vs community-based health plans: time for a policy option with clinical emphasis to address the cost spiral.

PubMed

Amundson, Bruce

2005-01-01

The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship between various clinical strategies and reductions in utilization and costs. This article describes the organization of health services, including integration of delivery and financing systems, at the community level as a model that effectively addresses the critical structural flaws that have frustrated control of costs. Community-based health plans (CHPs) have been developed and have demonstrated viability. The key elements of CHPs are a legal organizational structure, a full provider network, advanced care-management systems, and the ability to assume financial risk. Common misconceptions regarding obstacles to CHP development are the complexity of the undertaking, difficulty assuming the insurance function, and insured pools that are too small to be viable. The characteristics of successful CHPs and 2 case studies are described, including the types of advanced care-management systems that have resulted in strong financial performance. The demonstrated ability of CHPs to establish financial viability with small numbers of enrollees challenges the common assumption that there is a fixed relationship between health plan enrollment size and financial performance. Organizing the health system at the community/regional level provides an attractive alternative model in the health-reform debate. There is an opportunity for clinical systems and state and federal leaders to support the development of community-based integrated delivery and financing system models that, among other advantages, have significant potential to modulate the pernicious cost spiral.

Self-rating of daily time management in children: psychometric properties of the Time-S.

PubMed

Sköld, Annika; Janeslätt, Gunnel Kristina

2017-05-01

Impaired ability to manage time has been shown in several diagnoses common in childhood. Impaired ability involves activities and participation domain (daily time management, DTM) and body function and structure domain (time-processing ability, TPA). DTM needs to be evaluated from an individual's own perspective. To date, there has been a lack of self-rating instruments for children that focus on DTM. The aim of this study is to describe psychometric properties of Time-S when used in children aged 10-17 years with a diagnosis of ADHD, Autism, CP or mild ID. Further, to test whether TPA correlates with self-rated DTM. Eighty-three children aged 10-17 years participated in the study. Rasch analysis was used to assess psychometric properties. Correlation analysis was performed between Time-S and a measure of TPA. The 21 items of the Time-S questionnaire fit into a unitary construct measuring self-perceived daily management of an individual's time. A non-significant, small correlation was found between TPA and DTM. The results indicate good psychometric properties for the questionnaire. The questionnaire is potentially useful in intervention planning and evaluation.

Temporal and Resource Reasoning for Planning, Scheduling and Execution in Autonomous Agents

NASA Technical Reports Server (NTRS)

Muscettola, Nicola; Hunsberger, Luke; Tsamardinos, Ioannis

2005-01-01

This viewgraph slide tutorial reviews methods for planning and scheduling events. The presentation reviews several methods and uses several examples of scheduling events for the successful and timely completion of the overall plan. Using constraint based models the presentation reviews planning with time, time representations in problem solving and resource reasoning.

Evaluation of a commercial automatic treatment planning system for liver stereotactic body radiation therapy treatments.

PubMed

Gallio, Elena; Giglioli, Francesca Romana; Girardi, Andrea; Guarneri, Alessia; Ricardi, Umberto; Ropolo, Roberto; Ragona, Riccardo; Fiandra, Christian

2018-02-01

Automated treatment planning is a new frontier in radiotherapy. The Auto-Planning module of the Pinnacle 3 treatment planning system (TPS) was evaluated for liver stereotactic body radiation therapy treatments. Ten cases were included in the study. Six plans were generated for each case by four medical physics experts. The first two planned with Pinnacle TPS, both with manual module (MP) and Auto-Planning one (AP). The other two physicists generated two plans with Monaco TPS (VM). Treatment plan comparisons were then carried on the various dosimetric parameters of target and organs at risk, monitor units, number of segments, plan complexity metrics and human resource planning time. The user dependency of Auto-Planning was also tested and the plans were evaluated by a trained physician. Statistically significant differences (Anova test) were observed for spinal cord doses, plan average beam irregularity, number of segments, monitor units and human planning time. The Fisher-Hayter test applied to these parameters showed significant statistical differences between AP e MP for spinal cord doses and human planning time; between MP and VM for monitor units, number of segments and plan irregularity; for all those between AP and VM. The two plans created by different planners with AP were similar to each other. The plans created with Auto-Planning were comparable to the manually generated plans. The time saved in planning enables the planner to commit more resources to more complex cases. The independence of the planner enables to standardize plan quality. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

From vision to reality: strategic agility in complex times.

PubMed

Soule, Barbara M

2002-04-01

Health care is experiencing turbulent times. Change has become the constant. Complexity and sometimes chaos are common characteristics. Within this context, infection control professionals strive to maintain their practices, achieve excellence, and plan for the future. As demands shift and expectations increase, professionals in infection surveillance, prevention, and control (ISPC) programs must develop strategic agility. This article describes the rationale for strategic thinking and action set within a framework of 6 thought-provoking questions. It also describes a number of techniques to use for thinking strategically, such as designing visions, becoming entrepreneurial, and engaging in creative and futuristic exercises to evaluate possibilities for program direction. These techniques can guide individual professionals or ISPC programs in strategic decision-making that will increase the ability to survive and succeed in the future.

Less common upper limb mononeuropathies.

PubMed

Williams, Faren H; Kumiga, Bryan

2013-05-01

This article will focus on the less commonly injured nerves of the upper extremity. These nerves may be involved when trauma results in fractures, dislocations, or swelling with resultant nerve compression. Tumors and ganglions can also compress nerves, causing pain and, over time, demyelination or axon degeneration with weakness. Other mechanisms for upper limb nerve injury include participation in high-level sports, that is, those that generate torque about the arm and shoulder, abnormal stresses about the joints and muscles, or muscle hypertrophy, which may result in nerve injury. The goals of this review are to discuss the clinical presentation and possible causes of upper extremity nerve entrapments and to formulate an electrodiagnostic plan for evaluation. Descriptions of the appropriate nerve conduction studies or needle electromyographic protocols are included for specific nerves. The purpose of the electrodiagnostic examination is to evaluate the degree of nerve injury, axon loss over time, and later, evidence for reinnervation to assist with prognostication. The latter has implications for management of the neuropathy, including the type of exercises and therapy that may be indicated to help maintain the stability and motion of the involved joint(s) and promote strengthening over time as the nerve regenerates. Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

12 CFR 225.8 - Capital planning.

Code of Federal Regulations, 2013 CFR

2013-01-01

... instrument, a payment of common or preferred stock dividends, a payment that may be temporarily or... stock repurchases; the strategies for addressing potential capital shortfalls; and the internal...-common elements of tier 1 capital, including perpetual preferred stock and related surplus, minority...

47 CFR 22.857 - Channel plan for commercial aviation air-ground systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Channel plan for commercial aviation air-ground systems. 22.857 Section 22.857 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service Commercial Aviation Air-Ground...

A Layman's Guide to Understanding TSA Compliance.

ERIC Educational Resources Information Center

Alioto, Nicholas C. A.; Simandl, Robert J.

1998-01-01

Since school district business offices are ill-equipped to administer tax shelter annuity (TSA) plans, the result has been inadequate legal compliance and significant financial exposure. This article explains the rules governing TSA planning (testing limitations), examines common pitfalls for districts conducting audits, and outlines steps for…

47 CFR 27.1188 - Dispute resolution under the Cost-Sharing Plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Dispute resolution under the Cost-Sharing Plan. 27.1188 Section 27.1188 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON... support to demonstrate that their calculation is reasonable and made in good faith. Specifically, these...

47 CFR 27.1188 - Dispute resolution under the Cost-Sharing Plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Dispute resolution under the Cost-Sharing Plan. 27.1188 Section 27.1188 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON... support to demonstrate that their calculation is reasonable and made in good faith. Specifically, these...

47 CFR 27.1172 - Dispute Resolution Under the Cost-Sharing Plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Dispute Resolution Under the Cost-Sharing Plan. 27.1172 Section 27.1172 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON... provide evidentiary support to demonstrate that their calculation is reasonable and made in good faith...

47 CFR 27.1172 - Dispute Resolution Under the Cost-Sharing Plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Dispute Resolution Under the Cost-Sharing Plan. 27.1172 Section 27.1172 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON... provide evidentiary support to demonstrate that their calculation is reasonable and made in good faith...

Working Together To Improve Middle School Student Achievement.

ERIC Educational Resources Information Center

Hatch, Holly; Hytten, Kathy

1997-01-01

Involving stakeholders in school-district assessment and planning provides a common learning experience that results in numerous organizational and professional growth benefits. This paper describes one district's experiences with a middle-grades reform audit, examining the rationale, procedures, and application of the audit and planning process…

A currency for offsetting energy development impacts: horse-trading sage-grouse on the open market.

PubMed

Doherty, Kevin E; Naugle, David E; Evans, Jeffrey S

2010-04-28

Biodiversity offsets provide a mechanism to compensate for unavoidable damages from new energy development as the U.S. increases its domestic production. Proponents argue that offsets provide a partial solution for funding conservation while opponents contend the practice is flawed because offsets are negotiated without the science necessary to backup resulting decisions. Missing in negotiations is a biologically-based currency for estimating sufficiency of offsets and a framework for applying proceeds to maximize conservation benefits. Here we quantify a common currency for offsets for greater sage-grouse (Centrocercus urophasianus) by estimating number of impacted birds at 4 levels of development commonly permitted. Impacts were indiscernible at 1-12 wells per 32.2 km(2). Above this threshold lek losses were 2-5 times greater inside than outside of development and bird abundance at remaining leks declined by -32 to -77%. Findings reiterated the importance of time-lags as evidenced by greater impacts 4 years after initial development. Clustering well locations enabled a few small leks to remain active inside of developments. Documented impacts relative to development intensity can be used to forecast biological trade-offs of newly proposed or ongoing developments, and when drilling is approved, anticipated bird declines form the biological currency for negotiating offsets. Monetary costs for offsets will be determined by true conservation cost to mitigate risks such as sagebrush tillage to other populations of equal or greater number. If this information is blended with landscape level conservation planning, the mitigation hierarchy can be improved by steering planned developments away from conservation priorities, ensuring compensatory mitigation projects deliver a higher return for conservation that equate to an equal number of birds in the highest priority areas, provide on-site mitigation recommendations, and provide a biologically based cost for mitigating unavoidable impacts.

Focused process improvement events: sustainability of impact on process and performance in an academic radiology department.

PubMed

Rosenkrantz, Andrew B; Lawson, Kirk; Ally, Rosina; Chen, David; Donno, Frank; Rittberg, Steven; Rodriguez, Joan; Recht, Michael P

2015-01-01

To evaluate sustainability of impact of rapid, focused process improvement (PI) events on process and performance within an academic radiology department. Our department conducted PI during 2011 and 2012 in CT, MRI, ultrasound, breast imaging, and research billing. PI entailed participation by all stakeholders, facilitation by the department chair, collection of baseline data, meetings during several weeks, definition of performance metrics, creation of an improvement plan, and prompt implementation. We explore common themes among PI events regarding initial impact and durability of changes. We also assess performance in each area pre-PI, immediately post-PI, and at the time of the current study. All PI events achieved an immediate improvement in performance metrics, often entailing both examination volumes and on-time performance. IT-based solutions, process standardization, and redefinition of staff responsibilities were often central in these changes, and participants consistently expressed improved internal leadership and problem-solving ability. Major environmental changes commonly occurred after PI, including a natural disaster with equipment loss, a change in location or services offered, and new enterprise-wide electronic medical record system incorporating new billing and radiology informatics systems, requiring flexibility in the PI implementation plan. Only one PI team conducted regular post-PI follow-up meetings. Sustained improvement was frequently, but not universally, observed: in the long-term following initial PI, measures of examination volume showed continued progressive improvements, whereas measures of operational efficiency remained stable or occasionally declined. Focused PI is generally effective in achieving performance improvement, although a changing environment influences the sustainability of impact. Thus, continued process evaluation and ongoing workflow modifications are warranted. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

In the jungle of time: the concept of identity as a way out.

PubMed

Zhou, Bin; Pöppel, Ernst; Bao, Yan

2014-01-01

WHAT COULD BE A UNIFYING PRINCIPLE FOR THE MANIFOLD OF TEMPORAL EXPERIENCES: the simultaneity or temporal order of events, the subjective present, the duration of experiences, or the impression of a continuity of time? Furthermore, we time travel to the past visiting in imagination previous experiences in episodic memory, and we also time travel to the future anticipating actions or plans. For such time traveling we divide time into three domains: past, present, and future. What could be an escape out of this "jungle of time" characterized by many different perceptual and conceptual phenomena? The key concept we want to propose is "identity" which is derived from homeostasis as a fundamental biological principle. Within this conceptual frame two modes of identity are distinguished: individual or self-identity required because of homeostatic demands, and object-related identity necessary for the reliability and efficiency of neuro-cognitive processing. With this concept of self- and object-identity, the different temporal experiences can be conceptualized within a common frame. Thus, we propose a fundamental biological principle to conceptually unify temporal phenomena on the psychological level.

Remote sensing as a source of data for outdoor recreation planning

NASA Technical Reports Server (NTRS)

Reed, W. E.; Goodell, H. G.; Emmitt, G. D.

1972-01-01

Specific data needs for outdoor recreation planning and the ability of tested remote sensors to provide sources for these data are examined. Data needs, remote sensor capabilities, availability of imagery, and advantages and problems of incorporating remote sensing data sources into ongoing planning data collection programs are discussed in detail. Examples of the use of imagery to derive data for a range of common planning analyses are provided. A selected bibliography indicates specific uses of data in planning, basic background materials on remote sensing technology, and sources of information on environmental information systems expected to use remote sensing to provide new environmental data of use in outdoor recreation planning.

The evolutionary origin of the vertebrate body plan: the problem of head segmentation.

PubMed

Onai, Takayuki; Irie, Naoki; Kuratani, Shigeru

2014-01-01

The basic body plan of vertebrates, as typified by the complex head structure, evolved from the last common ancestor approximately 530 Mya. In this review, we present a brief overview of historical discussions to disentangle the various concepts and arguments regarding the evolutionary development of the vertebrate body plan. We then explain the historical transition of the arguments about the vertebrate body plan from merely epistemological comparative morphology to comparative embryology as a scientific treatment on this topic. Finally, we review the current progress of molecular evidence regarding the basic vertebrate body plan, focusing on the link between the basic vertebrate body plan and the evolutionarily conserved developmental stages (phylotypic stages).

The requirements and feasibility of business planning in the office of space and terrestrial applications

NASA Technical Reports Server (NTRS)

Greenberg, J. S.; Miller, B. P.

1979-01-01

The feasibility of applying strategic business planning techniques which are developed and used in the private sector to the planning of certain projects within the NASA Office of Space and Terrestrial Applications was assessed. The methods of strategic business planning that are currently in use in the private sector are examined. The typical contents of a private sector strategic business plan and the techniques commonly used to develop the contents of the plan are described, along with modifications needed to apply these concepts to public sector projects. The current long-range planning process in the Office of Space and Terrestrial Applications is reviewed and program initiatives that might be candidates for the use of strategic business planning techniques are identified. In order to more fully illustrate the information requirements of a strategic business plan for a NASA program, a sample business plan is prepared for a hypothetical Operational Earth Resources Satellite program.

Ultrasound imaging of the nose in septorhinoplasty patients.

PubMed

Stenner, Markus; Rudack, Claudia

2015-10-01

Detailed preoperative planning based on available clinical information is an essential component of determining septorhinoplasty outcome. In addition to rhinoscopy and airway measurements, preoperative photographs are the only image modalities that are regularly used in septorhinoplasty patients and contribute to the preoperative planning of the surgery. The aim of this study was to evaluate the use of high-resolution ultrasonography in septorhinoplasty patients before surgery and during follow-up. We examined 35 patients before and after open septorhinoplasty using 12- and 15-MHz B-mode, linear array transducer ultrasound in noncontact mode. The patients presented with a variety of different functional and aesthetic problems, and all underwent septorhinoplasty for septal modification, and tip and dorsum refinement. The mean follow-up time for ultrasound after surgery was 4.5 weeks. Soft tissue, cartilaginous, and bony structures of the nose could be well-visualised. In the untreated nose, functional and aesthetic characteristics as well as preoperative anatomy relevant for the planning of the surgery could be documented. Surgical modifications of the treated nose postoperatively, that is, osteotomies, inserted spreader grafts, diced cartilage in fascia, and tip sutures could be visualized and followed. Ultrasonography of the nose with a high-frequency transducer may be a helpful tool during preoperative planning and postoperative follow-up in septorhinoplasty patients and might be a reasonable completion to the common photographic and functional diagnostic.

Reptile Critical Care and Common Emergencies.

PubMed

Music, Meera Kumar; Strunk, Anneliese

2016-05-01

Reptile emergencies are an important part of exotic animal critical care, both true emergencies and those perceived as emergencies by owners. The most common presentations for reptile emergencies are addressed here, with information on differential diagnoses, helpful diagnostics, and approach to treatment. In many cases, reptile emergencies are actually acute presentations originating from a chronic problem, and the treatment plan must include both clinical treatment and addressing husbandry and dietary deficiencies at home. Accurate owner expectations must be set in order to have owner compliance to long-term treatment plans. Copyright © 2016 Elsevier Inc. All rights reserved.

Noncoplanar VMAT for nasopharyngeal tumors: Plan quality versus treatment time.

PubMed

Wild, Esther; Bangert, Mark; Nill, Simeon; Oelfke, Uwe

2015-05-01

The authors investigated the potential of optimized noncoplanar irradiation trajectories for volumetric modulated arc therapy (VMAT) treatments of nasopharyngeal patients and studied the trade-off between treatment plan quality and delivery time in radiation therapy. For three nasopharyngeal patients, the authors generated treatment plans for nine different delivery scenarios using dedicated optimization methods. They compared these scenarios according to dose characteristics, number of beam directions, and estimated delivery times. In particular, the authors generated the following treatment plans: (1) a 4π plan, which is a not sequenced, fluence optimized plan that uses beam directions from approximately 1400 noncoplanar directions and marks a theoretical upper limit of the treatment plan quality, (2) a coplanar 2π plan with 72 coplanar beam directions as pendant to the noncoplanar 4π plan, (3) a coplanar VMAT plan, (4) a coplanar step and shoot (SnS) plan, (5) a beam angle optimized (BAO) coplanar SnS IMRT plan, (6) a noncoplanar BAO SnS plan, (7) a VMAT plan with rotated treatment couch, (8) a noncoplanar VMAT plan with an optimized great circle around the patient, and (9) a noncoplanar BAO VMAT plan with an arbitrary trajectory around the patient. VMAT using optimized noncoplanar irradiation trajectories reduced the mean and maximum doses in organs at risk compared to coplanar VMAT plans by 19% on average while the target coverage remains constant. A coplanar BAO SnS plan was superior to coplanar SnS or VMAT; however, noncoplanar plans like a noncoplanar BAO SnS plan or noncoplanar VMAT yielded a better plan quality than the best coplanar 2π plan. The treatment plan quality of VMAT plans depended on the length of the trajectory. The delivery times of noncoplanar VMAT plans were estimated to be 6.5 min in average; 1.6 min longer than a coplanar plan but on average 2.8 min faster than a noncoplanar SnS plan with comparable treatment plan quality. The authors' study reconfirms the dosimetric benefits of noncoplanar irradiation of nasopharyngeal tumors. Both SnS using optimized noncoplanar beam ensembles and VMAT using an optimized, arbitrary, noncoplanar trajectory enabled dose reductions in organs at risk compared to coplanar SnS and VMAT. Using great circles or simple couch rotations to implement noncoplanar VMAT, however, was not sufficient to yield meaningful improvements in treatment plan quality. The authors estimate that noncoplanar VMAT using arbitrary optimized irradiation trajectories comes at an increased delivery time compared to coplanar VMAT yet at a decreased delivery time compared to noncoplanar SnS IMRT.

Causes and Timing of Unplanned Early Readmission After Neurosurgery.

PubMed

Taylor, Blake E S; Youngerman, Brett E; Goldstein, Hannah; Kabat, Daniel H; Appelboom, Geoffrey; Gold, William E; Connolly, Edward Sander

2016-09-01

Reducing the rate of 30-day hospital readmission has become a priority in healthcare quality improvement policy, with a focus on better characterizing the reasons for unplanned readmission. In neurosurgery, however, peer-reviewed analyses describing the patterns of readmission have been limited in their number and generalizability. To determine the incidence, timing, and causes of 30-day readmission after neurosurgical procedures. We conducted a retrospective longitudinal study from 2009 to 2012 using the Statewide Planning And Research Cooperative System, which collects patient-level details for all admissions and discharges within New York. We identified patients readmitted within 30 days of initial discharge. The rate of, reasons for, and time to readmission were determined overall and within 4 subgroups: craniotomies, cranial surgery without craniotomy, spine, and neuroendovascular procedures. There were 163 743 index admissions, of whom 14 791 (9.03%) were readmitted. The most common reasons for unplanned readmission were infection (29.52%) and medical complications (19.22%). Median time to readmission was 11 days, with hemorrhagic strokes and seizures occurring earlier, and medical complications and infections occurring later. Readmission rates were highest among patients undergoing cerebrospinal fluid shunt revision and malignant tumor resection (15.57%-22.60%). Spinal decompressions, however, accounted for the largest volume of readmissions (33.13%). Many readmissions may be preventable and occur at predictable time intervals. The causes and timing of readmission vary significantly across neurosurgical subgroups. Future studies should focus on detecting specific complications in select cohorts at predefined time points, which may allow for interventions to lower costs and reduce patient morbidity. CSF, cerebrospinal fluidIQR, interquartile rangeSPARCS, Statewide Planning And Research Cooperative System.

[Why would doctors from Debrecen go abroad? Results of a questionnaire].

PubMed

Szekanecz, Zoltán; Tóth, Zoltán; Hamar, Attila; Lánczi, Levente

2017-09-01

Numerous beliefs have arisen in relation to the emigration of doctors. First of all, in most cases emigration has been attributed to, almost exclusively, low salaries. There are a number of non-financial issues that could possibly be more easily addressed. In order to get closer to these issues, we sent out a 37-item questionnaire to doctors, who originally graduated from the University of Debrecen. Altogether 82 of them sent back the questionnaire. The mean age at the time of emigration was 32 years. The most popular destination was the United States, however, many colleagues left for the US to do research, as well as clinical practice. Among the European countries, the most popular ones were Sweden, Germany, United Kingdom, Switzerland and Norway. The five most popular clinical specialties were general practice, internal medicine, anesthesiology/intensive care, laboratory/pathology and surgery. With respect to the planned duration of working abroad, at the time of emigration one-fourth of our colleagues planned very short (<2 years) stay. When we asked them now, 38% plans much longer, even indefinite stay. The most common reasons of emigration were also assessed. The most common one was the lack of career track, followed by low salary, quality of life, family issues and adventurousness. Interestingly, burnout and "gratuities" were at the end of the list. A mean 1.3 million HUF per month would make our colleagues satisfied but they think that a mean 486.000 HUF would be realistic and would keep most doctors within the country. As far as university education is concerned, our colleagues agreed that the basic medical knowledge of Hungarian doctors is excellent, but their practical skills are much worse. Although returning to Hungary would be unrealistic by most colleagues, low salaries are definitely not the most important or exclusive reason for leaving the country. These issues are rather complex, there are numerous non-financial issues, which could be addressed much easier by expressing a positive attitude. Orv Hetil. 2017; 158(37): 1458-1468.

Quality planning in Construction Project

NASA Astrophysics Data System (ADS)

Othman, I.; Shafiq, Nasir; Nuruddin, M. F.

2017-12-01

The purpose of this paper is to investigate deeper on the factors that contribute to the effectiveness of quality planning, identifying the common problems encountered in quality planning, practices and ways for improvements in quality planning for construction projects. This paper involves data collected from construction company representatives across Malaysia that are obtained through semi-structured interviews as well as questionnaire distributions. Results shows that design of experiments (average index: 4.61), inspection (average index: 4.45) and quality audit as well as other methods (average index: 4.26) rank first, second and third most important factors respectively.