Genetic basis of priority effects: insights from nectar yeast
Hartwig, Thomas
2016-01-01
Priority effects, in which the order of species arrival dictates community assembly, can have a major influence on species diversity, but the genetic basis of priority effects remains unknown. Here, we suggest that nitrogen scavenging genes previously considered responsible for starvation avoidance may drive priority effects by causing rapid resource depletion. Using single-molecule sequencing, we de novo assembled the genome of the nectar-colonizing yeast, Metschnikowia reukaufii, across eight scaffolds and complete mitochondrion, with gap-free coverage over gene spaces. We found a high rate of tandem gene duplication in this genome, enriched for nitrogen metabolism and transport. Both high-capacity amino acid importers, GAP1 and PUT4, present as tandem gene arrays, were highly expressed in synthetic nectar and regulated by the availability and quality of amino acids. In experiments with competitive nectar yeast, Candida rancensis, amino acid addition alleviated suppression of C. rancensis by early arrival of M. reukaufii, corroborating that amino acid scavenging may contribute to priority effects. Because niche pre-emption via rapid resource depletion may underlie priority effects in a broad range of microbial, plant and animal communities, nutrient scavenging genes like the ones we considered here may be broadly relevant to understanding priority effects. PMID:27708148
Weeks, R; Adams, V M
2018-02-01
For conservation science to effectively inform management, research must focus on creating the scientific knowledge required to solve conservation problems. We identified research questions that, if answered, would increase the effectiveness of conservation and natural resource management practice and policy in Oceania's small-island developing states. We asked conservation professionals from academia, governmental, and nongovernmental organizations across the region to propose such questions and then identify which were of high priority in an online survey. We compared the high-priority questions with research questions identified globally and for other regions. Of 270 questions proposed by respondents, 38 were considered high priority, including: What are the highest priority areas for conservation in the face of increasing resource demand and climate change? How should marine protected areas be networked to account for connectivity and climate change? What are the most effective fisheries management policies that contribute to sustainable coral reef fisheries? High-priority questions related to the particular challenges of undertaking conservation on small-island developing states and the need for a research agenda that is responsive to the sociocultural context of Oceania. Research priorities for Oceania relative to elsewhere were broadly similar but differed in specific issues relevant to particular conservation contexts. These differences emphasize the importance of involving local practitioners in the identification of research priorities. Priorities were reasonably well aligned among sectoral groups. Only a few questions were widely considered answered, which may indicate a smaller-than-expected knowledge-action gap. We believe these questions can be used to strengthen research collaborations between scientists and practitioners working to further conservation and natural resource management in this region. © 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.
Jaramillo, Alejandra; Welch, Vivian A; Ueffing, Erin; Gruen, Russell L; Bragge, Peter; Lyddiatt, Anne; Tugwell, Peter
2013-05-01
To identify high-priority research questions for osteoarthritis systematic reviews with consideration of health equity and the social determinants of health (SDH). We consulted with experts and conducted a literature search to identify a priority-setting method that could be adapted to address the health equity and SDH. We selected the Global Evidence Mapping priority-setting method, and through consultations and consensus, we adapted the method to meet our objectives. This involves developing an evidence map of the existing systematic reviews on osteoarthritis; conducting one face-to-face workshop with patients and another one with clinicians, researchers, and patients; and conducting an online survey of patients to rank the top 10 research questions. We piloted the adapted method with the Cochrane Musculoskeletal Review Group to set research priorities for osteoarthritis. Our focus was on systematic reviews: we identified 34 high-priority research questions for osteoarthritis systematic reviews. Prevention and self-management interventions, mainly diet and exercise, are top priorities for osteoarthritis systematic reviews. Evaluation against our predefined objectives showed that this method did prioritize SDH (50% of the research questions considered SDH). There were marked gaps: no high-priority topics were identified for access to care until patients had advanced disease-lifestyle changes once the disease was diagnosed. This method was felt feasible if conducted annually. We confirmed the utility of an adapted priority-setting method that is feasible and considers SDH. Further testing of this method is needed to assess whether considerations of health equity are prioritized and involve disadvantaged groups of the population. Copyright © 2013 Elsevier Inc. All rights reserved.
Global priorities for conservation across multiple dimensions of mammalian diversity
Graham, Catherine H.; Costa, Gabriel C.; Hedges, S. Blair; Penone, Caterina; Radeloff, Volker C.; Rondinini, Carlo; Davidson, Ana D.
2017-01-01
Conservation priorities that are based on species distribution, endemism, and vulnerability may underrepresent biologically unique species as well as their functional roles and evolutionary histories. To ensure that priorities are biologically comprehensive, multiple dimensions of diversity must be considered. Further, understanding how the different dimensions relate to one another spatially is important for conservation prioritization, but the relationship remains poorly understood. Here, we use spatial conservation planning to (i) identify and compare priority regions for global mammal conservation across three key dimensions of biodiversity—taxonomic, phylogenetic, and traits—and (ii) determine the overlap of these regions with the locations of threatened species and existing protected areas. We show that priority areas for mammal conservation exhibit low overlap across the three dimensions, highlighting the need for an integrative approach for biodiversity conservation. Additionally, currently protected areas poorly represent the three dimensions of mammalian biodiversity. We identify areas of high conservation priority among and across the dimensions that should receive special attention for expanding the global protected area network. These high-priority areas, combined with areas of high priority for other taxonomic groups and with social, economic, and political considerations, provide a biological foundation for future conservation planning efforts. PMID:28674013
Global priorities for conservation across multiple dimensions of mammalian diversity.
Brum, Fernanda T; Graham, Catherine H; Costa, Gabriel C; Hedges, S Blair; Penone, Caterina; Radeloff, Volker C; Rondinini, Carlo; Loyola, Rafael; Davidson, Ana D
2017-07-18
Conservation priorities that are based on species distribution, endemism, and vulnerability may underrepresent biologically unique species as well as their functional roles and evolutionary histories. To ensure that priorities are biologically comprehensive, multiple dimensions of diversity must be considered. Further, understanding how the different dimensions relate to one another spatially is important for conservation prioritization, but the relationship remains poorly understood. Here, we use spatial conservation planning to ( i ) identify and compare priority regions for global mammal conservation across three key dimensions of biodiversity-taxonomic, phylogenetic, and traits-and ( ii ) determine the overlap of these regions with the locations of threatened species and existing protected areas. We show that priority areas for mammal conservation exhibit low overlap across the three dimensions, highlighting the need for an integrative approach for biodiversity conservation. Additionally, currently protected areas poorly represent the three dimensions of mammalian biodiversity. We identify areas of high conservation priority among and across the dimensions that should receive special attention for expanding the global protected area network. These high-priority areas, combined with areas of high priority for other taxonomic groups and with social, economic, and political considerations, provide a biological foundation for future conservation planning efforts.
Integrating economic costs and biological traits into global conservation priorities for carnivores.
Loyola, Rafael Dias; Oliveira-Santos, Luiz Gustavo Rodrigues; Almeida-Neto, Mário; Nogueira, Denise Martins; Kubota, Umberto; Diniz-Filho, José Alexandre Felizola; Lewinsohn, Thomas Michael
2009-08-27
Prioritization schemes usually highlight species-rich areas, where many species are at imminent risk of extinction. To be ecologically relevant these schemes should also include species biological traits into area-setting methods. Furthermore, in a world of limited funds for conservation, conservation action is constrained by land acquisition costs. Hence, including economic costs into conservation priorities can substantially improve their conservation cost-effectiveness. We examined four global conservation scenarios for carnivores based on the joint mapping of economic costs and species biological traits. These scenarios identify the most cost-effective priority sets of ecoregions, indicating best investment opportunities for safeguarding every carnivore species, and also establish priority sets that can maximize species representation in areas harboring highly vulnerable species. We compared these results with a scenario that minimizes the total number of ecoregions required for conserving all species, irrespective of other factors. We found that cost-effective conservation investments should focus on 41 ecoregions highlighted in the scenario that consider simultaneously both ecoregion vulnerability and economic costs of land acquisition. Ecoregions included in priority sets under these criteria should yield best returns of investments since they harbor species with high extinction risk and have lower mean land cost. Our study highlights ecoregions of particular importance for the conservation of the world's carnivores defining global conservation priorities in analyses that encompass socioeconomic and life-history factors. We consider the identification of a comprehensive priority-set of areas as a first step towards an in-situ biodiversity maintenance strategy.
Economical ground data delivery
NASA Technical Reports Server (NTRS)
Markley, Richard W.; Byrne, Russell H.; Bromberg, Daniel E.
1994-01-01
Data delivery in the Deep Space Network (DSN) involves transmission of a small amount of constant, high-priority traffic and a large amount of bursty, low priority data. The bursty traffic may be initially buffered and then metered back slowly as bandwidth becomes available. Today both types of data are transmitted over dedicated leased circuits. The authors investigated the potential of saving money by designing a hybrid communications architecture that uses leased circuits for high-priority network communications and dial-up circuits for low-priority traffic. Such an architecture may significantly reduce costs and provide an emergency backup. The architecture presented here may also be applied to any ground station-to-customer network within the range of a common carrier. The authors compare estimated costs for various scenarios and suggest security safeguards that should be considered.
Integrating Economic Costs and Biological Traits into Global Conservation Priorities for Carnivores
Loyola, Rafael Dias; Oliveira-Santos, Luiz Gustavo Rodrigues; Almeida-Neto, Mário; Nogueira, Denise Martins; Kubota, Umberto; Diniz-Filho, José Alexandre Felizola; Lewinsohn, Thomas Michael
2009-01-01
Background Prioritization schemes usually highlight species-rich areas, where many species are at imminent risk of extinction. To be ecologically relevant these schemes should also include species biological traits into area-setting methods. Furthermore, in a world of limited funds for conservation, conservation action is constrained by land acquisition costs. Hence, including economic costs into conservation priorities can substantially improve their conservation cost-effectiveness. Methodology/Principal Findings We examined four global conservation scenarios for carnivores based on the joint mapping of economic costs and species biological traits. These scenarios identify the most cost-effective priority sets of ecoregions, indicating best investment opportunities for safeguarding every carnivore species, and also establish priority sets that can maximize species representation in areas harboring highly vulnerable species. We compared these results with a scenario that minimizes the total number of ecoregions required for conserving all species, irrespective of other factors. We found that cost-effective conservation investments should focus on 41 ecoregions highlighted in the scenario that consider simultaneously both ecoregion vulnerability and economic costs of land acquisition. Ecoregions included in priority sets under these criteria should yield best returns of investments since they harbor species with high extinction risk and have lower mean land cost. Conclusions/Significance Our study highlights ecoregions of particular importance for the conservation of the world's carnivores defining global conservation priorities in analyses that encompass socioeconomic and life-history factors. We consider the identification of a comprehensive priority-set of areas as a first step towards an in-situ biodiversity maintenance strategy. PMID:19710911
Strecker, A.L.; Olden, J.D.; Whittier, Joanna B.; Paukert, C.P.
2011-01-01
To date, the predominant use of systematic conservation planning has been to evaluate and conserve areas of high terrestrial biodiversity. Although studies in freshwater ecosystems have received recent attention, research has rarely considered the potential tradeoffs between protecting different dimensions of biodiversity and the ecological processes that maintain diversity. We provide the first systematic prioritization for freshwaters (focusing on the highly threatened and globally distinct fish fauna of the Lower Colorado River Basin, USA) simultaneously considering scenarios of: taxonomic, functional, and phylogenetic diversity;contemporary threats to biodiversity (including interactions with nonnative species);and future climate change and human population growth. There was 75% congruence between areas of highest conservation priority for different aspects of biodiversity, suggesting that conservation efforts can concurrently achieve strong complementarity among all types of diversity. However, sizable fractions of the landscape were incongruent across conservation priorities for different diversity scenarios, underscoring the importance of considering multiple dimensions of biodiversity and highlighting catchments that contribute disproportionately to taxonomic, functional, and phylogenetic diversity in the region. Regions of projected human population growth were not concordant with conservation priorities;however, higher human population abundance will likely have indirect effects on native biodiversity by increasing demand for water. This will come in direct conflict with projected reductions in precipitation and warmer temperatures, which have substantial overlap with regions of high contemporary diversity. Native and endemic fishes in arid ecosystems are critically endangered by both current and future threats, but our results highlight the use of systematic conservation planning for the optimal allocation of limited resources that incorporates multiple and complementary conservation values describing taxonomic, functional, and phylogenetic diversity. ??2011 by the Ecological Society of America.
Strecker, Angela L.; Olden, Julian D.; Whittier, Joanna B.; Paukert, Craig P.
2011-01-01
To date, the predominant use of systematic conservation planning has been to evaluate and conserve areas of high terrestrial biodiversity. Although studies in freshwater ecosystems have received recent attention, research has rarely considered the potential trade-offs between protecting different dimensions of biodiversity and the ecological processes that maintain diversity. We provide the first systematic prioritization for freshwaters (focusing on the highly threatened and globally distinct fish fauna of the Lower Colorado River Basin, USA) simultaneously considering scenarios of: taxonomic, functional, and phylogenetic diversity; contemporary threats to biodiversity (including interactions with nonnative species); and future climate change and human population growth. There was 75% congruence between areas of highest conservation priority for different aspects of biodiversity, suggesting that conservation efforts can concurrently achieve strong complementarity among all types of diversity. However, sizable fractions of the landscape were incongruent across conservation priorities for different diversity scenarios, underscoring the importance of considering multiple dimensions of biodiversity and highlighting catchments that contribute disproportionately to taxonomic, functional, and phylogenetic diversity in the region. Regions of projected human population growth were not concordant with conservation priorities; however, higher human population abundance will likely have indirect effects on native biodiversity by increasing demand for water. This will come in direct conflict with projected reductions in precipitation and warmer temperatures, which have substantial overlap with regions of high contemporary diversity. Native and endemic fishes in arid ecosystems are critically endangered by both current and future threats, but our results highlight the use of systematic conservation planning for the optimal allocation of limited resources that incorporates multiple and complementary conservation values describing taxonomic, functional, and phylogenetic diversity.
Casalegno, Stefano; Bennie, Jonathan J; Inger, Richard; Gaston, Kevin J
2014-01-01
Although the importance of addressing ecosystem service benefits in regional land use planning and decision-making is evident, substantial practical challenges remain. In particular, methods to identify priority areas for the provision of key ecosystem services and other environmental services (benefits from the environment not directly linked to the function of ecosystems) need to be developed. Priority areas are locations which provide disproportionally high benefits from one or more service. Here we map a set of ecosystem and environmental services and delineate priority areas according to different scenarios. Each scenario is produced by a set of weightings allocated to different services and corresponds to different landscape management strategies which decision makers could undertake. Using the county of Cornwall, U.K., as a case study, we processed gridded maps of key ecosystem services and environmental services, including renewable energy production and urban development. We explored their spatial distribution patterns and their spatial covariance and spatial stationarity within the region. Finally we applied a complementarity-based priority ranking algorithm (zonation) using different weighting schemes. Our conclusions are that (i) there are two main patterns of service distribution in this region, clustered services (including agriculture, carbon stocks, urban development and plant production) and dispersed services (including cultural services, energy production and floods mitigation); (ii) more than half of the services are spatially correlated and there is high non-stationarity in the spatial covariance between services; and (iii) it is important to consider both ecosystem services and other environmental services in identifying priority areas. Different weighting schemes provoke drastic changes in the delineation of priority areas and therefore decision making processes need to carefully consider the relative values attributed to different services.
Casalegno, Stefano; Bennie, Jonathan J.; Inger, Richard; Gaston, Kevin J.
2014-01-01
Although the importance of addressing ecosystem service benefits in regional land use planning and decision-making is evident, substantial practical challenges remain. In particular, methods to identify priority areas for the provision of key ecosystem services and other environmental services (benefits from the environment not directly linked to the function of ecosystems) need to be developed. Priority areas are locations which provide disproportionally high benefits from one or more service. Here we map a set of ecosystem and environmental services and delineate priority areas according to different scenarios. Each scenario is produced by a set of weightings allocated to different services and corresponds to different landscape management strategies which decision makers could undertake. Using the county of Cornwall, U.K., as a case study, we processed gridded maps of key ecosystem services and environmental services, including renewable energy production and urban development. We explored their spatial distribution patterns and their spatial covariance and spatial stationarity within the region. Finally we applied a complementarity-based priority ranking algorithm (zonation) using different weighting schemes. Our conclusions are that (i) there are two main patterns of service distribution in this region, clustered services (including agriculture, carbon stocks, urban development and plant production) and dispersed services (including cultural services, energy production and floods mitigation); (ii) more than half of the services are spatially correlated and there is high non-stationarity in the spatial covariance between services; and (iii) it is important to consider both ecosystem services and other environmental services in identifying priority areas. Different weighting schemes provoke drastic changes in the delineation of priority areas and therefore decision making processes need to carefully consider the relative values attributed to different services. PMID:25250775
Scanlan, Justin Newton; Meredith, Pamela J; Haracz, Kirsti; Ennals, Priscilla; Pépin, Geneviève; Webster, Jayne S; Arblaster, Karen; Wright, Shelley
2017-12-01
Occupational therapy programs must prepare graduates for work in mental health. However, this area of practice is complex and rapidly changing. This study explored the alignment between educational priorities identified by occupational therapists practising in mental health and level of coverage of these topics in occupational therapy programs in Australia and New Zealand. Surveys were distributed to heads of all occupational therapy programs across Australia and New Zealand. The survey included educational priorities identified by occupational therapists in mental health from a previous study. Respondents were requested to identify the level of coverage given to each of these priorities within their curriculum. These data were analysed to determine a ranking of educational topics in terms of level of coverage in university programs. Responses were received for 19 programs from 16 universities. Thirty-four topics were given 'High-level coverage' in university programs, and these were compared against the 29 topics classified as 'Essential priorities' by clinicians. Twenty topics were included in both the 'Essential priorities' and 'High-level coverage' categories. Topics considered to be 'Essential priorities' by clinicians which were not given 'High-level coverage' in university programs included the following: mental health fieldwork experiences; risk assessment and management; professional self-care resilience and sensory approaches. While there appears to be overall good alignment between mental health curricula and priorities identified by practising occupational therapists, there are some discrepancies. These discrepancies are described and establish a strong foundation for further discussion between clinicians, academics and university administration to support curriculum review and revision. © 2017 Occupational Therapy Australia.
ERIC Educational Resources Information Center
McNair, Ellen L.
2017-01-01
The creation and identification of high-yield practices for empowering students to think, wonder, and own their learning is a high priority for school librarians who value instructional leadership. Future-ready librarians are working to create flexible learning environments in which their students design solutions, consider possibilities, and…
NASA Astrophysics Data System (ADS)
Souza Silva, Marconi; Martins, Rogério Parentoni; Ferreira, Rodrigo Lopes
2015-02-01
Cave environments are characterized by possessing specialized fauna living in high environmental stability with limited food conditions. These fauna are highly vulnerable to impacts, because this condition can frequently be easily altered. Moreover, environmental determinants of the biodiversity patterns of caves remain poorly understood and protected. Therefore, the main goal of this work is to propose a cave conservation priority index (CCPi) for a rapid assessment for troglobiotic and troglophile protection. Furthermore, the troglobiotic diversity, distribution and threats have been mapped in the Brazilian Atlantic forest. To propose the CCPi, the human impacts and richness of troglobiotic and troglophile species of 100 caves were associated. Data related to troglomorphic/troglobiotic fauna from another 200 caves were used to map the troglobiotic diversity and distribution. The CCPi reveals extremely high conservation priority for 15 % of the caves, high for 36 % and average for 46 % of the caves. Fourteen caves with extremely high priorities should have urgent conservation and management actions. The geographical distribution of the 221 known troglobiotic/troglomorphic species allowed us to select 19 karst areas that need conservation actions. Seven areas were considered to have urgent priority for conservation actions. The two richest areas correspond to the "iron quadrangle" with iron ore caves (67 spp.) and the "Açungui limestone group" (56 spp.). Both areas have several caves and are important aquifers. The use of the CCPi can prevent future losses because it helps assessors to select caves with priorities for conservation which should receive emergency attention in relation to protection, management and conservation actions.
Durán, América P.; Duffy, James P.; Gaston, Kevin J.
2014-01-01
Agroecosystems have traditionally been considered incompatible with biological conservation goals, and often been excluded from spatial conservation prioritization strategies. The consequences for the representativeness of identified priority areas have been little explored. Here, we evaluate these for biodiversity and carbon storage representation when agricultural land areas are excluded from a spatial prioritization strategy for South America. Comparing different prioritization approaches, we also assess how the spatial overlap of priority areas changes. The exclusion of agricultural lands was detrimental to biodiversity representation, indicating that priority areas for agricultural production overlap with areas of relatively high occurrence of species. By contrast, exclusion of agricultural lands benefits representation of carbon storage within priority areas, as lands of high value for agriculture and carbon storage overlap little. When agricultural lands were included and equally weighted with biodiversity and carbon storage, a balanced representation resulted. Our findings suggest that with appropriate management, South American agroecosystems can significantly contribute to biodiversity conservation. PMID:25143040
Setting Priorities for Diabetic Retinopathy Clinical Research and Identifying Evidence Gaps.
Le, Jimmy T; Hutfless, Susan; Li, Tianjing; Bressler, Neil M; Heyward, James; Bittner, Ava K; Glassman, Adam; Dickersin, Kay
2017-01-01
Prioritizing comparative effectiveness research may contribute to obtaining answers that clinicians perceive they need and may minimize research that could be considered wasteful. Our objective was to identify evidence gaps and set priorities for new systematic reviews and randomized controlled trials for managing diabetic retinopathy (DR), including diabetic macular edema (DME). Cross-sectional study. Diabetic Retinopathy Clinical Research Network (DRCR.net) investigators. We provided recommendations from the American Academy of Ophthalmology's 2012 Preferred Practice Patterns for Diabetic Retinopathy as 91 answerable clinical research questions about intervention effectiveness to 410 DRCR.net investigators to rate each question's importance from 0 (not important) to 10 (very important) using a 2-round Delphi survey and to suggest additional questions. We considered questions as high priority if at least 75% of respondents to both rounds assigned an importance rating of 5 or more in round 2. We also extracted outcome measures relevant to DR and asked respondents to identify those that must be measured in all studies. We mapped Cochrane reviews published up to March 2016 to high-priority clinical research questions. Ranking of importance of each clinical question. Thirty-two individuals completed rounds 1 and 2 and suggested 15 questions. Among the final list of 106 clinical research questions, 22 questions met our definition of high priority: 9 of 22 concerned the effectiveness of anti-VEGF therapy, and 13 of 22 focused on how often patients should be followed up (re-examination) and treatment effectiveness in patients with specific characteristics (e.g., DME). Outcomes that 75% or more of respondents marked as "must be measured in all studies" included visual acuity and visual loss, death of participants, and intraocular pressure. Only 1 prioritized question was associated with conclusive evidence from a Cochrane systematic review. A limited response rate among DRCR.net members identified 22 comparative effectiveness research questions as high priority for the management of DR, including DME, but few were associated with Cochrane reviews. These results support the need of systematic reviews and randomized controlled trials to address evidence gaps.
Development and Application of a Taiwan Domestic Generalized Water Supply Model
NASA Astrophysics Data System (ADS)
Ho, C. C.; Chang, L. C.
2016-12-01
Water allocation in Taiwan is more complicated than other countries because high river turbidity caused by rainstorm, reservoir management governed by different organization and conjunctive use of inter-basin reservoirs and dams. Those properties cause water resource planners need make extra effort on developing customized model to simulate the impact of water supply strategies on water resources. Hence, the study develops a Generalized Water Supply Model (GWSM) to analysis Multi-reservoirs water allocation in Taiwan for advancing the planning process. The model has following functions: (1) considering reservoirs operating rule curve. (2) considering the rule of multi-reservoir operation. Such as setting supply priority of different reservoirs or using "index balance" rule. (3) considering optimal hydroelectric power operation. (4) estimating the impact of high river turbidity on water supply. (5) considering the supply priority of different water use. (6) considering irrigation supply under special constraint. Such as the maximum irrigation supply is subject to natural inflow without reservoir storage. (7) considering two-way conduit transport. (8) considering environmental flow reservation. Conjunctive use Taan and Dajia Rivers was selected to demonstrate the ability of GWSM. The results also can be provided to different authorities to realize the impact of different strategies and that is good for negotiation and reaching a consensus.
Brownlie, T S; Weir, A M; Tarbotton, I; Morton, J M; Heuer, C; McDougall, S
2011-01-01
To examine attitudes, priorities, and constraints pertaining to herd reproductive management perceived by farmers managing seasonal-calving, pasture-based dairy herds in four regions of New Zealand, and to explore how these varied with demographic and biophysical factors. Key decision makers (KDM) on 133 dairy herds in four dairy regions (Waikato, Taranaki, and north and south Canterbury) were interviewed between May and July 2009. They were asked to provide demographic and biophysical data about the farm, and to rate their attitude in relation to their own personality traits, management issues and priorities, and likely constraints affecting reproductive performance in their herds. Associations between demographic factors and attitudes, priorities and constraints were analysed using univariable and multivariable proportional-odds regression models. Farms in the regions studied in the South Island were larger, had larger herds and more staff than farms in the regions studied in the North Island. The farms in the South Island were more likely to be owned by a corporation, managed by younger people or people who had more education, and the herds were more likely to be fed a higher percentage of supplementary feed. The majority of KDM rated the current genetics, milksolids performance and reproductive performance of their herds as high or very high, and >70% believed that the reproductive performance had remained the same or improved over the preceding 3 years. Despite this, improving reproductive performance was the most highly rated priority for the next 3 years. The constraints considered most likely to have affected reproductive performance in the last 2 years were anoestrous cows, protracted calving periods, and low body condition scores; those considered least likely were artificial breeding and heat detection. Of the variables examined related to attitudes, priorities and likely constraints, there were significant differences between region for 10/40, and with age and occupation of the KDM for 24/40 and 5/40, respectively (p<0.05). The majority of KDM reported the current reproductive performance of their herds to be high or very high, yet rated improving reproductive performance as a very high priority for the next 3 years. Mismatch between perceived and actual performance may result in reduced uptake of extension programmes designed to improve performance, and accurate benchmarking may help increase uptake and engagement. Further work is needed to determine whether the attitudes and perceptions about performance of farmers affect the likelihood of changes in their management behaviour which translate to measurable change in the actual reproductive performance of their herds. The variation in attitude, priorities and perceived constraints among age groups and region indicates that design of extension programmes may need to vary with these demographics.
A data fusion-based methodology for optimal redesign of groundwater monitoring networks
NASA Astrophysics Data System (ADS)
Hosseini, Marjan; Kerachian, Reza
2017-09-01
In this paper, a new data fusion-based methodology is presented for spatio-temporal (S-T) redesigning of Groundwater Level Monitoring Networks (GLMNs). The kriged maps of three different criteria (i.e. marginal entropy of water table levels, estimation error variances of mean values of water table levels, and estimation values of long-term changes in water level) are combined for determining monitoring sub-areas of high and low priorities in order to consider different spatial patterns for each sub-area. The best spatial sampling scheme is selected by applying a new method, in which a regular hexagonal gridding pattern and the Thiessen polygon approach are respectively utilized in sub-areas of high and low monitoring priorities. An Artificial Neural Network (ANN) and a S-T kriging models are used to simulate water level fluctuations. To improve the accuracy of the predictions, results of the ANN and S-T kriging models are combined using a data fusion technique. The concept of Value of Information (VOI) is utilized to determine two stations with maximum information values in both sub-areas with high and low monitoring priorities. The observed groundwater level data of these two stations are considered for the power of trend detection, estimating periodic fluctuations and mean values of the stationary components, which are used for determining non-uniform sampling frequencies for sub-areas. The proposed methodology is applied to the Dehgolan plain in northwestern Iran. The results show that a new sampling configuration with 35 and 7 monitoring stations and sampling intervals of 20 and 32 days, respectively in sub-areas with high and low monitoring priorities, leads to a more efficient monitoring network than the existing one containing 52 monitoring stations and monthly temporal sampling.
How do employees prioritise when they schedule their own shifts?
Nabe-Nielsen, Kirsten; Lund, Henrik; Ajslev, Jeppe Z; Hansen, Åse Marie; Albertsen, Karen; Hvid, Helge; Garde, Anne Helene
2013-01-01
We investigated how employees prioritised when they scheduled their own shifts and whether priorities depended on age, gender, educational level, cohabitation and health status. We used cross-sectional questionnaire data from the follow-up survey of an intervention study investigating the effect of self-scheduling (n = 317). Intervention group participants were asked about their priorities when scheduling their own shifts succeeded by 17 items covering family/private life, economy, job content, health and sleep. At least half of the participants reported that they were giving high priority to their family life, having consecutive time off, leisure-time activities, rest between shifts, sleep, regularity of their everyday life, health and that the work schedule balanced. Thus, employees consider both their own and the workplace's needs when they have the opportunity to schedule their own shifts. Age, gender, cohabitation and health status were all significantly associated with at least one of these priorities. Intervention studies report limited health effects of self-scheduling. Therefore, we investigated to what extent employees prioritise their health and recuperation when scheduling their own shifts. We found that employees not only consider both their health and family but also the workplace's needs when they schedule their own shifts.
Compact, Deep-Penetrating Geothermal Heat Flow Instrumentation for Lunar Landers
NASA Technical Reports Server (NTRS)
Nagihara, S.; Zacny, K.; Hedlund, M.; Taylor, P. T.
2012-01-01
Geothermal heat flow is obtained as a product of the two separate measurements of geothermal gradient in, and thermal conductivity of, the vertical soi/rock/regolith interval penetrated by the instrument. Heat flow measurements are a high priority for the geophysical network missions to the Moon recommended by the latest Decadal Survey [I] and previously the International Lunar Network [2]. The two lunar-landing missions planned later this decade by JAXA [3] and ESA [4] also consider geothermal measurements a priority.
Holmes, George; Scholfield, Katherine; Brockington, Dan
2012-08-01
In recent decades, various conservation organizations have developed models to prioritize locations for conservation. Through a survey of the spending patterns of 281 conservation nongovernmental organizations (NGOs), we examined the relation between 2 such models and spatial patterns of spending by conservation NGOs in 44 countries in sub-Saharan Africa. We tested whether, at the country level, the proportion of a country designated as a conservation priority was correlated with where NGOs spent money. For one model (the combination of Conservation International's hotspots and High Biodiversity Wilderness Areas, which are areas of high endemism with high or low levels of vegetation loss respectively), there was no relation between the proportion of a country designated as a priority and levels of NGO spending, including by the NGO associated with the model. In the second model (Global 200), the proportion of a country designated as a priority and the amount of money spent by NGOs were significantly and positively related. Less money was spent in countries in northern and western sub-Saharan Africa than countries in southern and eastern Africa, relative to the proportion of the country designated as a conservation priority. We suggest that on the basis of our results some NGOs consider increasing their spending on the areas designated as of conservation priority which are currently relatively underfunded, although there are economic, political, cultural, historical, biological, and practical reasons why current spending patterns may not align with priority sites. ©2012 Society for Conservation Biology.
The High School Economics Text: An Examination of Priorities and Needs.
ERIC Educational Resources Information Center
Radner, Barbara
1990-01-01
Analyzes high school economics textbooks through an examination of the questions that textbooks traditionally address about economic production: What, how much, and how will something be produced, and who gets the product? Considers teachers' relationships to economic textbooks and courses. Concludes that textbooks should be more relevant to…
Setting stroke research priorities: The consumer perspective.
Sangvatanakul, Pukkaporn; Hillege, Sharon; Lalor, Erin; Levi, Christopher; Hill, Kelvin; Middleton, Sandy
2010-12-01
To test a method of engaging consumers in research priority-setting using a quantitative approach and to determine consumer views on stroke research priorities for clinical practice recommendations with lower levels of evidence (Level III and Level IV) and expert consensus opinion as published in the Australian stroke clinical practice guidelines. Survey Urban community Eighteen stroke survivors (n = 12) and carers (n = 6) who were members of the "Working Aged Group - Stroke" (WAGS) consumer support group. Phase I: Participants were asked whether recommendations were "worth" researching ("yes" or "no"); and, if researched, what potential impact they likely would have on patient outcomes. Phase II: Participants were asked to rank recommendations rated by more than 75% of participants in Phase I as "worth" researching and "highly likely" or "likely" to generate research with a significant effect on patient outcomes (n = 13) in order of priority for future stroke research. All recommendations were rated by at least half (n = 9, 50%) of participants as "worth" researching. The majority (67% to 100%) rated all recommendations as "highly likely" or "likely" that research would have a significant effect on patient outcomes. Thirteen out of 20 recommendations were ranked for their research priorities. Recommendations under the topic heading Getting to hospital were ranked highest and Organization of care and Living with stroke were ranked as a lower priority for research. This study provided an example of how to involve consumers in research priority setting successfully using a quantitative approach. Stroke research priorities from the consumer perspective were different from those of health professionals, as published in the literature; thus, consumer opinion should be considered when setting research priorities. Copyright © 2010 Society for Vascular Nursing, Inc. Published by Mosby, Inc. All rights reserved.
Governance factors in the identification of global conservation priorities for mammals
Eklund, Johanna; Arponen, Anni; Visconti, Piero; Cabeza, Mar
2011-01-01
Global conservation priorities have often been identified based on the combination of species richness and threat information. With the development of the field of systematic conservation planning, more attention has been given to conservation costs. This leads to prioritizing developing countries, where costs are generally low and biodiversity is high. But many of these countries have poor governance, which may result in ineffective conservation or in larger costs than initially expected. We explore how the consideration of governance affects the selection of global conservation priorities for the world's mammals in a complementarity-based conservation prioritization. We use data on Control of Corruption (Worldwide Governance Indicators project) as an indicator of governance effectiveness, and gross domestic product per capita as an indicator of cost. We show that, while core areas with high levels of endemism are always selected as important regardless of governance and cost values, there are clear regional differences in selected sites when biodiversity, cost or governance are taken into account separately. Overall, the analysis supports the concentration of conservation efforts in most of the regions generally considered of high priority, but stresses the need for different conservation approaches in different continents owing to spatial patterns of governance and economic development. PMID:21844045
Governance factors in the identification of global conservation priorities for mammals.
Eklund, Johanna; Arponen, Anni; Visconti, Piero; Cabeza, Mar
2011-09-27
Global conservation priorities have often been identified based on the combination of species richness and threat information. With the development of the field of systematic conservation planning, more attention has been given to conservation costs. This leads to prioritizing developing countries, where costs are generally low and biodiversity is high. But many of these countries have poor governance, which may result in ineffective conservation or in larger costs than initially expected. We explore how the consideration of governance affects the selection of global conservation priorities for the world's mammals in a complementarity-based conservation prioritization. We use data on Control of Corruption (Worldwide Governance Indicators project) as an indicator of governance effectiveness, and gross domestic product per capita as an indicator of cost. We show that, while core areas with high levels of endemism are always selected as important regardless of governance and cost values, there are clear regional differences in selected sites when biodiversity, cost or governance are taken into account separately. Overall, the analysis supports the concentration of conservation efforts in most of the regions generally considered of high priority, but stresses the need for different conservation approaches in different continents owing to spatial patterns of governance and economic development.
Ecosystem Services Modeling as a Tool for Defining Priority Areas for Conservation.
Duarte, Gabriela Teixeira; Ribeiro, Milton Cezar; Paglia, Adriano Pereira
2016-01-01
Conservationists often have difficulty obtaining financial and social support for protected areas that do not demonstrate their benefits for society. Therefore, ecosystem services have gained importance in conservation science in the last decade, as these services provide further justification for appropriate management and conservation of natural systems. We used InVEST software and a set of GIS procedures to quantify, spatialize and evaluated the overlap between ecosystem services-carbon stock and sediment retention-and a biodiversity proxy-habitat quality. In addition, we proposed a method that serves as an initial approach of a priority areas selection process. The method considers the synergism between ecosystem services and biodiversity conservation. Our study region is the Iron Quadrangle, an important Brazilian mining province and a conservation priority area located in the interface of two biodiversity hotspots, the Cerrado and Atlantic Forest biomes. The resultant priority area for the maintenance of the highest values of ecosystem services and habitat quality was about 13% of the study area. Among those priority areas, 30% are already within established strictly protected areas, and 12% are in sustainable use protected areas. Following the transparent and highly replicable method we proposed in this study, conservation planners can better determine which areas fulfill multiple goals and can locate the trade-offs in the landscape. We also gave a step towards the improvement of the habitat quality model with a topography parameter. In areas of very rugged topography, we have to consider geomorfometric barriers for anthropogenic impacts and for species movement and we must think beyond the linear distances. Moreover, we used a model that considers the tree mortality caused by edge effects in the estimation of carbon stock. We found low spatial congruence among the modeled services, mostly because of the pattern of sediment retention distribution.
Ecosystem Services Modeling as a Tool for Defining Priority Areas for Conservation
Duarte, Gabriela Teixeira; Ribeiro, Milton Cezar; Paglia, Adriano Pereira
2016-01-01
Conservationists often have difficulty obtaining financial and social support for protected areas that do not demonstrate their benefits for society. Therefore, ecosystem services have gained importance in conservation science in the last decade, as these services provide further justification for appropriate management and conservation of natural systems. We used InVEST software and a set of GIS procedures to quantify, spatialize and evaluated the overlap between ecosystem services—carbon stock and sediment retention—and a biodiversity proxy–habitat quality. In addition, we proposed a method that serves as an initial approach of a priority areas selection process. The method considers the synergism between ecosystem services and biodiversity conservation. Our study region is the Iron Quadrangle, an important Brazilian mining province and a conservation priority area located in the interface of two biodiversity hotspots, the Cerrado and Atlantic Forest biomes. The resultant priority area for the maintenance of the highest values of ecosystem services and habitat quality was about 13% of the study area. Among those priority areas, 30% are already within established strictly protected areas, and 12% are in sustainable use protected areas. Following the transparent and highly replicable method we proposed in this study, conservation planners can better determine which areas fulfill multiple goals and can locate the trade-offs in the landscape. We also gave a step towards the improvement of the habitat quality model with a topography parameter. In areas of very rugged topography, we have to consider geomorfometric barriers for anthropogenic impacts and for species movement and we must think beyond the linear distances. Moreover, we used a model that considers the tree mortality caused by edge effects in the estimation of carbon stock. We found low spatial congruence among the modeled services, mostly because of the pattern of sediment retention distribution. PMID:27145031
Priority Setting in Government: Beyond the Magic Bullet.
ERIC Educational Resources Information Center
Bosin, Morris Robert
1992-01-01
Priority setting is examined from the perspective of planning practitioners operating in a major federal regulatory agency. Causes of ambivalence in setting priorities are considered, and ways to reduce ambivalence are suggested. Three models are proposed for setting priorities in the public sector. (SLD)
Durán, América P; Duffy, James P; Gaston, Kevin J
2014-10-07
Agroecosystems have traditionally been considered incompatible with biological conservation goals, and often been excluded from spatial conservation prioritization strategies. The consequences for the representativeness of identified priority areas have been little explored. Here, we evaluate these for biodiversity and carbon storage representation when agricultural land areas are excluded from a spatial prioritization strategy for South America. Comparing different prioritization approaches, we also assess how the spatial overlap of priority areas changes. The exclusion of agricultural lands was detrimental to biodiversity representation, indicating that priority areas for agricultural production overlap with areas of relatively high occurrence of species. By contrast, exclusion of agricultural lands benefits representation of carbon storage within priority areas, as lands of high value for agriculture and carbon storage overlap little. When agricultural lands were included and equally weighted with biodiversity and carbon storage, a balanced representation resulted. Our findings suggest that with appropriate management, South American agroecosystems can significantly contribute to biodiversity conservation. © 2014 The Author(s) Published by the Royal Society. All rights reserved.
Environmental control technology (ECT) for geothermal processes
DOE Office of Scientific and Technical Information (OSTI.GOV)
Katz, G.
1982-01-01
The objectives of the environmental control technology (ECT) program are to develop research priorities, research new and alternative technologies and to improve economics and performance of ECT systems. The Interagency Geothermal Coordinating Council, Environmental Control Panel developed priorities and obtained industry input during 1980. H/sub 2/S controls, injection monitoring, solid waste characterization and control and subsidence were reviewed as high priority while noise controls were considered low priority. Since geothermal technology is still developing there is a need to continue researching new and alternative ECT. Often ECT systems must be designed for site specific applications and need modification for usemore » of other sites. Most of the US geothermal experience is found at the Geysers, California where H/sub 2/S abatement is required. Various systems have been tested with mixed results. The bottom line is that the economics and performance of H/sub 2/S abatement systems are less than desirable.« less
Wu, Ruidong; Long, Yongcheng; Malanson, George P; Garber, Paul A; Zhang, Shuang; Li, Diqiang; Zhao, Peng; Wang, Longzhu; Duo, Hairui
2014-01-01
By addressing several key features overlooked in previous studies, i.e. human disturbance, integration of ecosystem- and species-level conservation features, and principles of complementarity and representativeness, we present the first national-scale systematic conservation planning for China to determine the optimized spatial priorities for biodiversity conservation. We compiled a spatial database on the distributions of ecosystem- and species-level conservation features, and modeled a human disturbance index (HDI) by aggregating information using several socioeconomic proxies. We ran Marxan with two scenarios (HDI-ignored and HDI-considered) to investigate the effects of human disturbance, and explored the geographic patterns of the optimized spatial conservation priorities. Compared to when HDI was ignored, the HDI-considered scenario resulted in (1) a marked reduction (∼9%) in the total HDI score and a slight increase (∼7%) in the total area of the portfolio of priority units, (2) a significant increase (∼43%) in the total irreplaceable area and (3) more irreplaceable units being identified in almost all environmental zones and highly-disturbed provinces. Thus the inclusion of human disturbance is essential for cost-effective priority-setting. Attention should be targeted to the areas that are characterized as moderately-disturbed, <2,000 m in altitude, and/or intermediately- to extremely-rugged in terrain to identify potentially important regions for implementing cost-effective conservation. We delineated 23 primary large-scale priority areas that are significant for conserving China's biodiversity, but those isolated priority units in disturbed regions are in more urgent need of conservation actions so as to prevent immediate and severe biodiversity loss. This study presents a spatially optimized national-scale portfolio of conservation priorities--effectively representing the overall biodiversity of China while minimizing conflicts with economic development. Our results offer critical insights for current conservation and strategic land-use planning in China. The approach is transferable and easy to implement by end-users, and applicable for national- and local-scale systematic conservation prioritization practices.
Wu, Ruidong; Long, Yongcheng; Malanson, George P.; Garber, Paul A.; Zhang, Shuang; Li, Diqiang; Zhao, Peng; Wang, Longzhu; Duo, Hairui
2014-01-01
By addressing several key features overlooked in previous studies, i.e. human disturbance, integration of ecosystem- and species-level conservation features, and principles of complementarity and representativeness, we present the first national-scale systematic conservation planning for China to determine the optimized spatial priorities for biodiversity conservation. We compiled a spatial database on the distributions of ecosystem- and species-level conservation features, and modeled a human disturbance index (HDI) by aggregating information using several socioeconomic proxies. We ran Marxan with two scenarios (HDI-ignored and HDI-considered) to investigate the effects of human disturbance, and explored the geographic patterns of the optimized spatial conservation priorities. Compared to when HDI was ignored, the HDI-considered scenario resulted in (1) a marked reduction (∼9%) in the total HDI score and a slight increase (∼7%) in the total area of the portfolio of priority units, (2) a significant increase (∼43%) in the total irreplaceable area and (3) more irreplaceable units being identified in almost all environmental zones and highly-disturbed provinces. Thus the inclusion of human disturbance is essential for cost-effective priority-setting. Attention should be targeted to the areas that are characterized as moderately-disturbed, <2,000 m in altitude, and/or intermediately- to extremely-rugged in terrain to identify potentially important regions for implementing cost-effective conservation. We delineated 23 primary large-scale priority areas that are significant for conserving China's biodiversity, but those isolated priority units in disturbed regions are in more urgent need of conservation actions so as to prevent immediate and severe biodiversity loss. This study presents a spatially optimized national-scale portfolio of conservation priorities – effectively representing the overall biodiversity of China while minimizing conflicts with economic development. Our results offer critical insights for current conservation and strategic land-use planning in China. The approach is transferable and easy to implement by end-users, and applicable for national- and local-scale systematic conservation prioritization practices. PMID:25072933
ERIC Educational Resources Information Center
Black, Susan
2001-01-01
Of all art forms, dance is experienced least and considered low-priority. Art educators and the NAEP's arts education framework view dance as essential for every child's complete development. The National Dance Association has set high standards. Baltimore and South Bronx programs are profiled. (MLH)
Code of Federal Regulations, 2013 CFR
2013-10-01
... does not meet one of the Corporation's priorities if the State commission adequately explains why the State is not able to carry out a program that meets one of the Corporation's priorities, and why the program meets one of the State's priorities. (b) A State may apply priorities different than those of the...
Ethical Challenges in the Provision of Dialysis in Resource-Constrained Environments.
Luyckx, Valerie A; Miljeteig, Ingrid; Ejigu, Addisu M; Moosa, M Rafique
2017-05-01
The number of patients requiring dialysis by 2030 is projected to double worldwide, with the largest increase expected in low- and middle-income countries (LMICs). Dialysis is seldom considered a high priority by health care funders, consequently, few LMICs develop policies regarding dialysis allocation. Dialysis facilities may exist, but access remains highly inequitable in LMICs. High out-of-pocket payments make dialysis unsustainable and plunge many families into poverty. Patients, families, and clinicians suffer significant emotional and moral distress from daily life-and-death decisions imposed by dialysis. The health system's obligation to provide financial risk protection is an important component of global and national strategies to achieve universal health coverage. An ethical imperative therefore exists to develop transparent dialysis priority-setting guidelines to facilitate public understanding and acceptance of the realistic limits within the health system, and facilitate fair allocation of scarce resources. In this article, we present ethical challenges faced by patients, families, clinicians, and policy makers where dialysis is not universally accessible and discuss the potential ethical consequences of various dialysis allocation strategies. Finally, we suggest an ethical framework for use in policy development for priority setting of dialysis care. The accountability for reasonableness framework is proposed as a procedurally fair decision-making, priority-setting process. Copyright © 2017 Elsevier Inc. All rights reserved.
Palliative care, public health and justice: setting priorities in resource poor countries.
Blinderman, Craig
2009-12-01
Many countries have not considered palliative care a public health problem. With limited resources, disease-oriented therapies and prevention measures take priority. In this paper, I intend to describe the moral framework for considering palliative care as a public health priority in resource-poor countries. A distributive theory of justice for health care should consider integrative palliative care as morally required as it contributes to improving normal functioning and preserving opportunities for the individual. For patients requiring terminal care, we are guided less by principles of justice and more by the duty to relieve suffering and society's commitment to protecting the professional's obligation to uphold principles of beneficence, compassion and non-abandonment. A fair deliberation process is necessary to allow these strong moral commitments to serve as reasons when setting priorities in resource poor countries.
You Are What You Write: Improving the Quality of Your Written Communication
ERIC Educational Resources Information Center
Robertson, Rachel
2012-01-01
Good and plentiful communication often lands high on the list of priorities for families participating in child care programs. Conversely, poor and scarce communication often lands high on the list of reasons parents leave a particular child care program. There are many types of communication to consider when meeting families' needs. While in most…
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-19
.... Priorities: This competition includes five absolute priorities and one competitive preference priority. In... priorities. Under 34 CFR 75.105(c)(3), we consider only applications that meet: (a) one or more of the... purposes of accountability under Title I and Title III of the ESEA; (4) Can be used, as appropriate, as one...
Braid, Andrew C R; Nielsen, Scott E
2015-01-01
As the influence of human activities on natural systems continues to expand, there is a growing need to prioritize not only pristine sites for protection, but also degraded sites for restoration. We present an approach for simultaneously prioritizing sites for protection and restoration that considers landscape patterns for a threatened population of grizzly bears (Ursus arctos) in southwestern Alberta, Canada. We considered tradeoffs between bottom-up (food resource supply) and top-down (mortality risk from roads) factors affecting seasonal habitat quality for bears. Simulated annealing was used to prioritize source-like sites (high habitat productivity, low mortality risk) for protection, as well as sink-like sites (high habitat productivity, high mortality risk) for restoration. Priority source-like habitats identified key conservation areas where future developments should be limited, whereas priority sink-like habitats identified key areas for mitigating road-related mortality risk with access management. Systematic conservation planning methods can be used to complement traditional habitat-based methods for individual focal species by identifying habitats where conservation actions (both protection and restoration) have the highest potential utility.
Against proportional shortfall as a priority-setting principle.
Altmann, Samuel
2018-05-01
As the demand for healthcare rises, so does the need for priority setting in healthcare. In this paper, I consider a prominent priority-setting principle: proportional shortfall. My purpose is to argue that proportional shortfall, as a principle, should not be adopted. My key criticism is that proportional shortfall fails to consider past health.Proportional shortfall is justified as it supposedly balances concern for prospective health while still accounting for lifetime health, even though past health is deemed irrelevant. Accounting for this lifetime perspective means that the principle may indirectly consider past health by accounting for how far an individual is from achieving a complete, healthy life. I argue that proportional shortfall does not account for this lifetime perspective as it fails to incorporate the fair innings argument as originally claimed, undermining its purported justification.I go on to demonstrate that the case for ignoring past health is weak, and argue that past health is at least sometimes relevant for priority-setting decisions. Specifically, when an individual's past health has a direct impact on current or future health, and when one individual has enjoyed significantly more healthy life years than another.Finally, I demonstrate that by ignoring past illnesses, even those entirely unrelated to their current illness, proportional shortfall can lead to instances of double jeopardy, a highly problematic implication. These arguments give us reason to reject proportional shortfall. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
ZBB--a new skill for the financial manager.
Thompson, G B; Pyhrr, P A
1979-03-01
Zero-based budgeting (ZBB) is a management decision-making tool currently gaining wide acceptance. ZBB is a budgeting approach which is useful for planning, controlling and coordinating financial and human resources. It involves the re-evaluation of all budgeted activities in terms of priorities established by the management. The traditional process of incremental budgeting differs from ZBB in that only the planned changes are evaluated in the former. In incremental budgeting, the base budget is considered authorized and required little attention. The ZBB process focuses on the whol budget. This is accomplished by: (1) identifying decision units; (2) evaluating each decision unit in terms of performance, costs, benefits, and alternate means of accomplishiing the objectives; (3) ranking the decision packages; and (4) preparing a budget for the highest priority decision packages. The effect of the ZBB approach is that new high priority programs may be funded by eliminating or reducing existing lower-priority programs. ZBB is viewed as a logical process which can combine many of the elements of good management.
Wavelength assignment algorithm considering the state of neighborhood links for OBS networks
NASA Astrophysics Data System (ADS)
Tanaka, Yu; Hirota, Yusuke; Tode, Hideki; Murakami, Koso
2005-10-01
Recently, Optical WDM technology is introduced into backbone networks. On the other hand, as the future optical switching scheme, Optical Burst Switching (OBS) systems become a realistic solution. OBS systems do not consider buffering in intermediate nodes. Thus, it is an important issue to avoid overlapping wavelength reservation between partially interfered paths. To solve this problem, so far, the wavelength assignment scheme which has priority management tables has been proposed. This method achieves the reduction of burst blocking probability. However, this priority management table requires huge memory space. In this paper, we propose a wavelength assignment algorithm that reduces both the number of priority management tables and burst blocking probability. To reduce priority management tables, we allocate and manage them for each link. To reduce burst blocking probability, our method announces information about the change of their priorities to intermediate nodes. We evaluate its performance in terms of the burst blocking probability and the reduction rate of priority management tables.
Opinions of patients and the public regarding NHS priorities.
Baker, A D; Bassran, A; Paterson-Brown, S
2001-10-01
The purpose of this study was to ascertain the views of patients and the public on NHS priorities. Data were gathered by interview questionnaire throughout Edinburgh city centre, and within various departments of one large teaching hospital. Of the 1502 responses, 462 were from within the hospital and 1040 were from city centre locations. 1497 (99.7%) were in favour of treating emergencies, and 1467 (97.7%) life threatening conditions as a priority. 1315 (88%) agreed that treatable conditions that seriously affect quality of life should also be considered a priority and 1127 (75%) were in favour of treating patients with incurable terminal disease regardless of cost. In order to provide these services 584 (39%) considered it acceptable to make patients with less serious conditions wait longer. Of the 918 (61%) who considered it not acceptable to wait longer 812 (88%) would be prepared to pay more in tax to provide this. The General Public do support the treatment of emergency and life threatening conditions as an absolute priority. The majority also support the prioritization of conditions which are treatable and seriously affect quality of life. If in establishing these priorities waiting times for other conditions are likely to rise, the public would generally accept increased taxation or some form of fee for service.
34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?
Code of Federal Regulations, 2010 CFR
2010-07-01
... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for... DISABILITIES How Does the Secretary Make a Grant? § 376.30 What priorities are considered for support by the... result directly in competitive or supported employment for youths with disabilities within the labor...
Issues and consequences of using nutrition to modulate the avian immune response
USDA-ARS?s Scientific Manuscript database
Combatting antimicrobial resistant bacteria is a high priority for both public health and agriculture in the United States and globally. Antibiotic use in animals and humans is considered a major risk factor in the development of antibiotic resistant bacteria in animals, humans, and the environment...
Seismic evaluation of I-24 bridges and embankments in Western Kentucky : summary report.
DOT National Transportation Integrated Search
2006-09-01
I-24 is considered as one of the high priority and emergency routes in the region. Hence, it is essential that I-24 remains functional and operational after an earthquake event. The objective of this study is to perform seismic evaluation and risk as...
Potential economic impacts of water-use changes in southwest Kansas
USDA-ARS?s Scientific Manuscript database
This research considers three policy scenarios aimed at reducing groundwater consumption in three high priority subareas of southwest Kansas. The three policy scenarios include: (1) a Status Quo scenario where there is no change in water-use policy, (2) an Immediate Conversion to Dryland scenario wh...
Momentum has been growing in Toxicology to assess the utility of high-throughput screening (HTS) assays in the determination of chemical testing priorities. However, in vitro potencies determined in these assays do not consider in vivo bioavailability, clearance or exposure estim...
Analysis of mobile source air toxics (MSATs)–Near-Road VOC and carbonyl concentrations
Exposures to mobile source air toxics (MSATs) have been associated with numerous adverse health effects. While thousands of air toxic compounds are emitted from mobile sources, a subset of compounds are considered high priority due to their significant contribution to cancer and...
Ridruejo, Ezequiel; Mendizabal, Manuel; Silva, Marcelo O
2018-04-01
Hepatitis C virus infection (HCV) is highly prevalent in patients with chronic kidney disease (CKD) and kidney transplant recipients. Little information exists on treatment in patients with CKD stages 2 to 3, where CKD progression might be slowed by HCV treatment. These patients are not considered a high priority for HCV treatment in most international guidelines. Although some recently published guidelines propose universal treatment, others are still recommending it only in high priority groups. In this review, we evaluate current evidence of HCV infection impact on CKD progression, on cardiovascular and metabolic risk, and the benefits of HCV infection treatment to improve cardiovascular and metabolic outcomes. We made special focus on the benefits of HCV infection treatment in patients with stages 2 to 3 CKD to avoid CKD progression. © 2018 International Society for Hemodialysis.
NASA Astrophysics Data System (ADS)
Ribeiro, F.; Roberts, D. A.; Davis, F. W.; Antunes Daldegan, G.; Nackoney, J.; Hess, L. L.
2016-12-01
The Brazilian savanna, Cerrado, is the second largest biome over South America and the most floristically diverse savanna in the world. This biome is considered a conservation hotspot in respect to its biodiversity importance and rapid transformation of its landscape. The Cerrado's natural vegetation has been severely transformed by agriculture and pasture activities. Currently it is the main agricultural frontier in Brazil and one of the most threatened Brazilian biomes. This scenario results in environmental impacts such as ecosystems fragmentation as well as losses in connectivity, biodiversity and gene flow, changes in the microclimate and energy, carbon and nutrients cycles, among others. The Priority Areas for Conservation is a governmental program from Brazil that identifies areas with high conservation priority. One of this program's recommendation is a natural vegetation map including their major ecosystem classes. This study aims to generate more precise information for the Cerrado's vegetation. The main objective of this study is to identify which ecosystems are being prioritized and/or threatened by land use, refining information for further protection. In order to test methods, the priority area for conservation Chapada da Contagem was selected as the study site. This area is ranked as "extremely high priority" by the government and is located in the Federal District and Goias State, Brazil. Satellites with finer spatial resolution may improve the classification of the Cerrado's vegetation. Remote sensing methods and two criteria were tested using RapidEye 3A imagery (5m spatial resolution) collected in 2014 in order to classify the Cerrado's major land cover types of this area, as well as its land use. One criterion considers the Cerrado's major terrestrial ecosystems, which are divided into forest, savanna and grassland. The other involves scaling it down to the major physiognomic groups of each ecosystem. Other sources of environmental dataset such as soil type and slope were incorporated into this test as they are correlated with the ecosystems and physiognomies presence. A Decision Tree was used to map the land cover and land use types present in the region and demonstrated to have an effective result due to the map's high accuracy and incorporation of environmental dataset.
NASA Astrophysics Data System (ADS)
Kiran Kumar, Kalla; Nagaraju, Dega; Gayathri, S.; Narayanan, S.
2017-05-01
Priority Sequencing Rules provide the guidance for the order in which the jobs are to be processed at a workstation. The application of different priority rules in job shop scheduling gives different order of scheduling. More experimentation needs to be conducted before a final choice is made to know the best priority sequencing rule. Hence, a comprehensive method of selecting the right choice is essential in managerial decision making perspective. This paper considers seven different priority sequencing rules in job shop scheduling. For evaluation and selection of the best priority sequencing rule, a set of eight criteria are considered. The aim of this work is to demonstrate the methodology of evaluating and selecting the best priority sequencing rule by using hybrid multi criteria decision making technique (MCDM), i.e., analytical hierarchy process (AHP) with technique for order preference by similarity to ideal solution (TOPSIS). The criteria weights are calculated by using AHP whereas the relative closeness values of all priority sequencing rules are computed based on TOPSIS with the help of data acquired from the shop floor of a manufacturing firm. Finally, from the findings of this work, the priority sequencing rules are ranked from most important to least important. The comprehensive methodology presented in this paper is very much essential for the management of a workstation to choose the best priority sequencing rule among the available alternatives for processing the jobs with maximum benefit.
Priority arbitration mechanism
Garmire, Derrick L [Kingston, NY; Herring, Jay R [Poughkeepsie, NY; Stunkel, Craig B [Bethel, CT
2007-03-06
A method is provided for selecting a data source for transmission on one of several logical (virtual) lanes embodied in a single physical connection. Lanes are assigned to either a high priority class or to a low priority class. One of six conditions is employed to determine when re-arbitration of lane priorities is desired. When this occurs a next source for transmission is selected based on a the specification of the maximum number of high priority packets that can be sent after a lower priority transmission has been interrupted. Alternatively, a next source for transmission is selected based on a the specification of the maximum number of high priority packets that can be sent while a lower priority packet is waiting. If initialized correctly, the arbiter keeps all of the packets of a high priority packet contiguous, while allowing lower priority packets to be interrupted by the higher priority packets, but not to the point of starvation of the lower priority packets.
Spinal cord injury pressure ulcer treatment: an experience-based approach.
Sunn, Gabriel
2014-08-01
Pressure ulcers continue to impact the lives of spinal cord injury patients severely. Pressure ulcers must be accurately staged according to National Pressure Ulcer Advisory recommendations before treatment design. The first priority in treatment of pressure ulcers is offloading. Intact skin ulcers may be treated with noncontact nonthermal low-frequency ultrasound. Superficial pressure ulcers may be treated with a combination of collagenase and foam dressings. Deeper pressure ulcers warrant negative-pressure wound therapy dressings along with biologic adjuncts to fill in wound depth. Discovery and treatment of osteomyelitis is a high priority when initially evaluating pressure ulcers. Surgical intervention must always be considered. Published by Elsevier Inc.
Communicating in context: a priority for gene therapy researchers.
Robillard, Julie M
2015-03-01
History shows that public opinion of emerging biotechnologies has the potential to impact the research process through mechanisms such as funding and advocacy. It is critical, therefore, to consider public attitudes towards modern biotechnology such as gene therapy and more specifically towards the ethics of gene therapy, alongside advances in basic and clinical research. Research conducted through social media recently assessed how online users view the ethics of gene therapy and showed that while acceptability is high, significant ethical concerns remain. To address these concerns, the development of effective and evidence-based communication strategies that engage a wide range of stakeholders should be a priority for researchers.
Cortés, O; Martinez, A M; Cañon, J; Sevane, N; Gama, L T; Ginja, C; Landi, V; Zaragoza, P; Carolino, N; Vicente, A; Sponenberg, P; Delgado, J V
2016-07-01
Criollo pig breeds are descendants from pigs brought to the American continent starting with Columbus second trip in 1493. Pigs currently play a key role in social economy and community cultural identity in Latin America. The aim of this study was to establish conservation priorities among a comprehensive group of Criollo pig breeds based on a set of 24 microsatellite markers and using different criteria. Spain and Portugal pig breeds, wild boar populations of different European geographic origins and commercial pig breeds were included in the analysis as potential genetic influences in the development of Criollo pig breeds. Different methods, differing in the weight given to within- and between-breed genetic variability, were used in order to estimate the contribution of each breed to global genetic diversity. As expected, the partial contribution to total heterozygosity gave high priority to Criollo pig breeds, whereas Weitzman procedures prioritized Iberian Peninsula breeds. With the combined within- and between-breed approaches, different conservation priorities were achieved. The Core Set methodologies highly prioritized Criollo pig breeds (Cr. Boliviano, Cr. Pacifico, Cr. Cubano and Cr. Guadalupe). However, weighing the between- and within-breed components with FST and 1-FST, respectively, resulted in higher contributions of Iberian breeds. In spite of the different conservation priorities according to the methodology used, other factors in addition to genetic information also need to be considered in conservation programmes, such as the economic, cultural or historical value of the breeds involved.
Cortés, O; Martinez, A M; Cañon, J; Sevane, N; Gama, L T; Ginja, C; Landi, V; Zaragoza, P; Carolino, N; Vicente, A; Sponenberg, P; Delgado, J V
2016-01-01
Criollo pig breeds are descendants from pigs brought to the American continent starting with Columbus second trip in 1493. Pigs currently play a key role in social economy and community cultural identity in Latin America. The aim of this study was to establish conservation priorities among a comprehensive group of Criollo pig breeds based on a set of 24 microsatellite markers and using different criteria. Spain and Portugal pig breeds, wild boar populations of different European geographic origins and commercial pig breeds were included in the analysis as potential genetic influences in the development of Criollo pig breeds. Different methods, differing in the weight given to within- and between-breed genetic variability, were used in order to estimate the contribution of each breed to global genetic diversity. As expected, the partial contribution to total heterozygosity gave high priority to Criollo pig breeds, whereas Weitzman procedures prioritized Iberian Peninsula breeds. With the combined within- and between-breed approaches, different conservation priorities were achieved. The Core Set methodologies highly prioritized Criollo pig breeds (Cr. Boliviano, Cr. Pacifico, Cr. Cubano and Cr. Guadalupe). However, weighing the between- and within-breed components with FST and 1-FST, respectively, resulted in higher contributions of Iberian breeds. In spite of the different conservation priorities according to the methodology used, other factors in addition to genetic information also need to be considered in conservation programmes, such as the economic, cultural or historical value of the breeds involved. PMID:27025169
2013-01-01
South Africa, the country with the largest HIV epidemic worldwide, has been scaling up treatment since 2003 and is rapidly expanding its eligibility criteria. The HIV treatment programme has achieved significant results, and had 1.8 million people on treatment per 2011. Despite these achievements, it is now facing major concerns regarding (i) efficiency: alternative treatment policies may save more lives for the same budget; (ii) equity: there are large inequalities in who receives treatment; (iii) feasibility: still only 52% of the eligible population receives treatment. Hence, decisions on the design of the present HIV treatment programme in South Africa can be considered suboptimal. We argue there are two fundamental reasons to this. First, while there is a rapidly growing evidence-base to guide priority setting decisions on HIV treatment, its included studies typically consider only one criterion at a time and thus fail to capture the broad range of values that stakeholders have. Second, priority setting on HIV treatment is a highly political process but it seems no adequate participatory processes are in place to incorporate stakeholders’ views and evidences of all sorts. We propose an alternative approach that provides a better evidence base and outlines a fair policy process to improve priority setting in HIV treatment. The approach integrates two increasingly important frameworks on health care priority setting: accountability for reasonableness (A4R) to foster procedural fairness, and multi-criteria decision analysis (MCDA) to construct an evidence-base on the feasibility, efficiency, and equity of programme options including trade-offs. The approach provides programmatic guidance on the choice of treatment strategies at various decisions levels based on a sound conceptual framework, and holds large potential to improve HIV priority setting in South Africa. PMID:24107435
ERIC Educational Resources Information Center
DeFigio, Nicholas; Hughes, Sean
Increasingly, principals are being viewed as instructional leaders, professional educators active in initiating and planning teacher development programs. While most principals consider instructional leadership a high priority, they spend much of their time solving routine problems and confronting minor crises. Immediate, short-term responses take…
Relational Resources of a University as a Source of Education Quality Assurance
ERIC Educational Resources Information Center
Bagdasaryan, Irina; Vasilyeva, Zoya; Almabekova, Olga
2015-01-01
This paper considers high quality educational services provided by a university being the highest priority and assumes relational resources as valuable sources that can facilitate and enhance quality assurance. Each university with a unique resource base is connected with a variety of entities--other universities, non-profit and for-profit…
42 CFR 494.110 - Condition: Quality assessment and performance improvement.
Code of Federal Regulations, 2010 CFR
2010-10-01
... time. (c) Standard: Prioritizing improvement activities. The dialysis facility must set priorities for performance improvement, considering prevalence and severity of identified problems and giving priority to...
Novel strategies for sedentary behavior research.
Rosenberg, Dori E; Lee, I-Min; Young, Deborah Rohm; Prohaska, Thomas R; Owen, Neville; Buchner, David M
2015-06-01
This article reports on the "Novel Strategies for Sedentary Behavior Research" session of the Sedentary Behavior: Identifying Research Priorities workshop. The purpose of this session of the workshop were to propose strategies for accomplishing a research agenda in dealing with sedentary behavior and to consider research priorities for people at high risk for excess sedentary behavior. The four major recommendations from this workshop were as follows: 1) To add repeated objective measures of physical activity and sedentary behavior to existing cohort studies and standardize approaches to measurement and analysis. Epidemiologic studies will be the most efficient design for addressing some research questions. 2) To increase research efficiency, consider the advantages of a network of connected research studies and health systems. Advantages include access to existing data in electronic health records. 3) To carefully select a variety of high-risk study populations and preplan collaboration among studies in intervention research. This strategy can efficiently address the breadth of issues in sedentary behavior research. 4) To include comparative effectiveness designs and pure environmental interventions in intervention research. This strategy facilitates and enhances translation of interventions into practice.
Sales, Anne; O'Rourke, Hannah M.; Draper, Kellie; Teare, Gary F.; Maxwell, Colleen
2011-01-01
Purpose: To elicit priority rankings of indicators of quality of care among providers and decision-makers in continuing care in Alberta, Canada. Methods: We used modified nominal group technique to elicit priorities and criteria for prioritization among the quality indicators and resident/client assessment protocols developed by the interRAI consortium for use in long-term care and home care. Results: The top-ranked items from the long-term care assessment data were pressure ulcers, pain and incontinence. The top-ranked items from the home care data were pain, falls and proportion of clients at high risk for residential placement. Participants considered a variety of issues in deciding how to rank the indicators. Implications: This work reflects the beginning of a process to better understand how providers and policy makers can work together to assess priorities for quality improvement within continuing care. PMID:22294992
Explicit criteria for prioritization of cataract surgery
Ma Quintana, José; Escobar, Antonio; Bilbao, Amaia
2006-01-01
Background Consensus techniques have been used previously to create explicit criteria to prioritize cataract extraction; however, the appropriateness of the intervention was not included explicitly in previous studies. We developed a prioritization tool for cataract extraction according to the RAND method. Methods Criteria were developed using a modified Delphi panel judgment process. A panel of 11 ophthalmologists was assembled. Ratings were analyzed regarding the level of agreement among panelists. We studied the effect of all variables on the final panel score using general linear and logistic regression models. Priority scoring systems were developed by means of optimal scaling and general linear models. The explicit criteria developed were summarized by means of regression tree analysis. Results Eight variables were considered to create the indications. Of the 310 indications that the panel evaluated, 22.6% were considered high priority, 52.3% intermediate priority, and 25.2% low priority. Agreement was reached for 31.9% of the indications and disagreement for 0.3%. Logistic regression and general linear models showed that the preoperative visual acuity of the cataractous eye, visual function, and anticipated visual acuity postoperatively were the most influential variables. Alternative and simple scoring systems were obtained by optimal scaling and general linear models where the previous variables were also the most important. The decision tree also shows the importance of the previous variables and the appropriateness of the intervention. Conclusion Our results showed acceptable validity as an evaluation and management tool for prioritizing cataract extraction. It also provides easy algorithms for use in clinical practice. PMID:16512893
Faith, Daniel P
2008-12-01
New species conservation strategies, including the EDGE of Existence (EDGE) program, have expanded threatened species assessments by integrating information about species' phylogenetic distinctiveness. Distinctiveness has been measured through simple scores that assign shared credit among species for evolutionary heritage represented by the deeper phylogenetic branches. A species with a high score combined with a high extinction probability receives high priority for conservation efforts. Simple hypothetical scenarios for phylogenetic trees and extinction probabilities demonstrate how such scoring approaches can provide inefficient priorities for conservation. An existing probabilistic framework derived from the phylogenetic diversity measure (PD) properly captures the idea of shared responsibility for the persistence of evolutionary history. It avoids static scores, takes into account the status of close relatives through their extinction probabilities, and allows for the necessary updating of priorities in light of changes in species threat status. A hypothetical phylogenetic tree illustrates how changes in extinction probabilities of one or more species translate into changes in expected PD. The probabilistic PD framework provided a range of strategies that moved beyond expected PD to better consider worst-case PD losses. In another example, risk aversion gave higher priority to a conservation program that provided a smaller, but less risky, gain in expected PD. The EDGE program could continue to promote a list of top species conservation priorities through application of probabilistic PD and simple estimates of current extinction probability. The list might be a dynamic one, with all the priority scores updated as extinction probabilities change. Results of recent studies suggest that estimation of extinction probabilities derived from the red list criteria linked to changes in species range sizes may provide estimated probabilities for many different species. Probabilistic PD provides a framework for single-species assessment that is well-integrated with a broader measurement of impacts on PD owing to climate change and other factors.
42 CFR 403.732 - Condition of participation: Quality assessment and performance improvement.
Code of Federal Regulations, 2010 CFR
2010-10-01
... performance improvement program. (3) The RNHCI must set priorities for performance improvement, considering... assessment and performance improvement program addresses identified priorities in the RNHCI and are...
[The Danish Debate on Priority Setting in Medicine--An Update].
Pornak, S C; Raspe, H
2015-09-01
In the last years, the Danish debate about priority setting in medicine has gained new strength. This paper shows the main focuses of the current discussion based on a research of Danish primary literature. For the first time since the 1990s the Danish Council of Ethics has been involved with priority setting in medicine in a project running from 2011 to 2013. The Council emphasises the importance of legitimate processes and calls for visible values and criteria. A focus of the debate is how to deal with new expensive drugs. Politicians, physicians, health economists and the Council of Ethics have called for a national institution for priority setting in medicine. They have mainly looked to the Norwegian National Council for Priority Setting in Health Care and the British National Institute for Health and Care Excellence for inspiration. The Danish Government considered establishing a national institute for priority setting, but the plans were not put into practice. In the year 2012 a new national project was launched to create clinical guidelines. Danish doctors welcome the guidelines as a good basis for priority setting. Just like in earlier Danish priority setting debates, a coordinating institution is lacking to bundle the discussion and keep it going. The debate seems to have come to an end once again. The fact that it was seriously considered to establish an institute for priority setting is a new development. It can be expected that the discussion will be resumed in the near future, possibly the idea of an institute for priority setting will be readopted. The general conditions for priority setting in health care have improved. © Georg Thieme Verlag KG Stuttgart · New York.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-18
... M. White Physical Education Program (PEP) provides grants to local educational agencies (LEAs) and... this competition, this priority is an absolute priority. Under 34 CFR 75.105(c)(3), we consider only...(c)(2)(i), we will award an additional 3 points to an application that meets this priority. This...
76 FR 39630 - Applications for New Awards; Promise Neighborhoods Program-Planning Grant Competition
Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-06
... VI of the Civil Rights Act of 1964 (prohibiting discrimination on the basis of race, color, or... priorities; however, the Department will review and award points only for a maximum of two of the competitive... application the priority or the two priorities it wishes the Department to consider for purposes of earning...
Space technology to meet future needs
NASA Technical Reports Server (NTRS)
1987-01-01
Key technologies were identified where contemporary investments might have large payoffs in technological options for the future. The future needs were considered for space transportation, space science, national security, and manned missions. Eight areas were selected as being vital for the national future in space. Findings regarding representative mission and the recommendations concerning high priority technologies are summarized.
2013-01-01
Background Determining the value of livestock breeds is essential to define conservation priorities, manage genetic diversity and allocate funds. Within- and between-breed genetic diversity need to be assessed to preserve the highest intra-specific variability. Information on genetic diversity and risk status is still lacking for many Creole cattle breeds from the Americas, despite their distinct evolutionary trajectories and adaptation to extreme environmental conditions. Methods A comprehensive genetic analysis of 67 Iberoamerican cattle breeds was carried out with 19 FAO-recommended microsatellites to assess conservation priorities. Contributions to global diversity were investigated using alternative methods, with different weights given to the within- and between-breed components of genetic diversity. Information on Iberoamerican plus 15 worldwide cattle breeds was used to investigate the contribution of geographical breed groups to global genetic diversity. Results Overall, Creole cattle breeds showed a high level of genetic diversity with the highest level found in breeds admixed with zebu cattle, which were clearly differentiated from all other breeds. Within-breed kinships revealed seven highly inbred Creole breeds for which measures are needed to avoid further genetic erosion. However, if contribution to heterozygosity was the only criterion considered, some of these breeds had the lowest priority for conservation decisions. The Weitzman approach prioritized highly differentiated breeds, such as Guabalá, Romosinuano, Cr. Patagonico, Siboney and Caracú, while kinship-based methods prioritized mainly zebu-related breeds. With the combined approaches, breed ranking depended on the weights given to the within- and between-breed components of diversity. Overall, the Creole groups of breeds were generally assigned a higher priority for conservation than the European groups of breeds. Conclusions Conservation priorities differed significantly according to the weight given to within- and between-breed genetic diversity. Thus, when establishing conservation programs, it is necessary to also take into account other features. Creole cattle and local isolated breeds retain a high level of genetic diversity. The development of sustainable breeding and crossbreeding programs for Creole breeds, and the added value resulting from their products should be taken into consideration to ensure their long-term survival. PMID:24079454
U.S. Academic Libraries: A Snapshot of Priorities & Perspectives
ERIC Educational Resources Information Center
OCLC Online Computer Library Center, Inc., 2012
2012-01-01
This new report details findings from a study OCLC conducted with libraries in mid-2011 to learn about their priorities, initiatives, thoughts on the future of their service points and the sources they use to keep up with developments in the library field. Most academic library staff: (1) Consider licensed e-collections to be a top priority; (2)…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-30
... priorities and one competitive preference priority. In accordance with 34 CFR 75.105(b)(2)(iv), absolute... priorities. Under 34 CFR 75.105(c)(3) we consider only applications that meet: (a) one or more of the... Title I and Title III of the ESEA; (4) Can be used, as appropriate, as one of multiple measures, to...
Priority Setting for Improvement of Cervical Cancer Prevention in Iran.
Majidi, Azam; Ghiasvand, Reza; Hadji, Maryam; Nahvijou, Azin; Mousavi, Azam-Sadat; Pakgohar, Minoo; Khodakarami, Nahid; Abedini, Mehrandokht; Amouzegar Hashemi, Farnaz; Rahnamaye Farzami, Marjan; Shahsiah, Reza; Sajedinejhad, Sima; Mohagheghi, Mohammad Ali; Nadali, Fatemeh; Rashidian, Arash; Weiderpass, Elisabete; Mogensen, Ole; Zendehdel, Kazem
2015-11-22
Cervical cancer is the fourth most common cancer among women worldwide. Organized cervical screening and vaccination against human papilloma virus (HPV) have been successful interventions for prevention of invasive cervical cancer (ICC). Because of cultural and religious considerations, ICC has low incidence in Iran and many other Muslim countries. There is no organized cervical screening in these countries. Therefore, ICC is usually diagnosed in advanced stages with poor prognosis in these countries. We performed a priority setting exercise and suggested priorities for prevention of ICC in this setting. We invited experts and researchers to a workshop and asked them to list important suggestions for ICC prevention in Iran. After merging similar items and removing the duplicates, we asked the experts to rank the list of suggested items. We used a strategy grid and Go-zone analysis to determine final list of priorities for ICC prevention in Iran. From 26 final items suggested as priorities for prevention of ICC, the most important priorities were developing national guidelines for cervical screening and quality control protocol for patient follow-up and management of precancerous lesions. In addition, we emphasized considering insurance coverage for cervical screening, public awareness, and research priorities, and establishment of a cervical screening registry. A comprehensive approach and implementation of organized cervical screening program is necessary for prevention of ICC in Iran and other low incidence Muslim countries. Because of high cost for vaccination and low incidence of cervical cancer, we do not recommend HPV vaccination for the time being in Iran. © 2016 by Kerman University of Medical Sciences.
Priority Setting for Improvement of Cervical Cancer Prevention in Iran
Majidi, Azam; Ghiasvand, Reza; Hadji, Maryam; Nahvijou, Azin; Mousavi, Azam-Sadat; Pakgohar, Minoo; Khodakarami, Nahid; Abedini, Mehrandokht; Amouzegar Hashemi, Farnaz; Rahnamaye Farzami, Marjan; Shahsiah, Reza; Sajedinejhad, Sima; Mohagheghi, Mohammad Ali; Nadali, Fatemeh; Rashidian, Arash; Weiderpass, Elisabete; Mogensen, Ole; Zendehdel, Kazem
2016-01-01
Background: Cervical cancer is the fourth most common cancer among women worldwide. Organized cervical screening and vaccination against human papilloma virus (HPV) have been successful interventions for prevention of invasive cervical cancer (ICC). Because of cultural and religious considerations, ICC has low incidence in Iran and many other Muslim countries. There is no organized cervical screening in these countries. Therefore, ICC is usually diagnosed in advanced stages with poor prognosis in these countries. We performed a priority setting exercise and suggested priorities for prevention of ICC in this setting. Methods: We invited experts and researchers to a workshop and asked them to list important suggestions for ICC prevention in Iran. After merging similar items and removing the duplicates, we asked the experts to rank the list of suggested items. We used a strategy grid and Go-zone analysis to determine final list of priorities for ICC prevention in Iran. Results: From 26 final items suggested as priorities for prevention of ICC, the most important priorities were developing national guidelines for cervical screening and quality control protocol for patient follow-up and management of precancerous lesions. In addition, we emphasized considering insurance coverage for cervical screening, public awareness, and research priorities, and establishment of a cervical screening registry. Conclusion: A comprehensive approach and implementation of organized cervical screening program is necessary for prevention of ICC in Iran and other low incidence Muslim countries. Because of high cost for vaccination and low incidence of cervical cancer, we do not recommend HPV vaccination for the time being in Iran. PMID:27239863
Aortic rupture complicating a fracture of an ankylosed thoracic spine. A case report.
Savolaine, E R; Ebraheim, N A; Stitgen, S; Jackson, W T
1991-11-01
A 34-year-old man was injured in a motorcycle accident and suffered both aortic rupture and thoracic spinal fracture, complicated by an underlying undetected ankylosing spondylitis. The latter disease can affect the integrity of vascular and spinal structure. Aortography is recommended as a high priority for the patient in an unstable cardiovascular condition requiring a definitive diagnosis. Aortic rupture and thoracic spine fracture may occur from high energy deceleration trauma. Motor vehicle passenger and pedestrian injuries are most commonly involved, although airline accidents and high falls also generate some cases. Mediastinal widening, displacement of esophagus and trachea, apical dissection of blood, and, especially, paravertebral pleural space widening are common to both injuries. Whereas most mediastinal hematomas are nonaortic in origin, a combined injury must be considered because clinical features may also overlap. These include hypotension (hypovolemic or spinal shock), paraplegia, and severe back pain. In light of the high mortality and time constraints associated with aortic rupture, immediate diagnostic resolution is necessary for appropriate management and priority of investigation.
The method of selecting an integrated development territory for the high-rise unique constructions
NASA Astrophysics Data System (ADS)
Sheina, Svetlana; Shevtsova, Elina; Sukhinin, Alexander; Priss, Elena
2018-03-01
On the basis of data provided by the Department of architecture and urban planning of the city of Rostov-on-don, the problem of the choice of the territory for complex development that will be in priority for the construction of high-rise and unique buildings is solved. The objective of the study was the development of a methodology for selection of the area and the implementation of the proposed method on the example of evaluation of four-territories complex development. The developed method along with standard indicators of complex evaluation considers additional indicators that assess the territory from the position of high-rise unique building. The final result of the study is the rankings of the functional priority areas that takes into account the construction of both residential and public and business objects of unique high-rise construction. The use of the developed methodology will allow investors and customers to assess the investment attractiveness of the future unique construction project on the proposed site.
NASA Technical Reports Server (NTRS)
Woo, Simon S.; Cheng, Michael K.
2011-01-01
The original Luby Transform (LT) coding scheme is extended to account for data transmissions where some information symbols in a message block are more important than others. Prioritized LT codes provide unequal error protection (UEP) of data on an erasure channel by modifying the original LT encoder. The prioritized algorithm improves high-priority data protection without penalizing low-priority data recovery. Moreover, low-latency decoding is also obtained for high-priority data due to fast encoding. Prioritized LT codes only require a slight change in the original encoding algorithm, and no changes at all at the decoder. Hence, with a small complexity increase in the LT encoder, an improved UEP and low-decoding latency performance for high-priority data can be achieved. LT encoding partitions a data stream into fixed-sized message blocks each with a constant number of information symbols. To generate a code symbol from the information symbols in a message, the Robust-Soliton probability distribution is first applied in order to determine the number of information symbols to be used to compute the code symbol. Then, the specific information symbols are chosen uniform randomly from the message block. Finally, the selected information symbols are XORed to form the code symbol. The Prioritized LT code construction includes an additional restriction that code symbols formed by a relatively small number of XORed information symbols select some of these information symbols from the pool of high-priority data. Once high-priority data are fully covered, encoding continues with the conventional LT approach where code symbols are generated by selecting information symbols from the entire message block including all different priorities. Therefore, if code symbols derived from high-priority data experience an unusual high number of erasures, Prioritized LT codes can still reliably recover both high- and low-priority data. This hybrid approach decides not only "how to encode" but also "what to encode" to achieve UEP. Another advantage of the priority encoding process is that the majority of high-priority data can be decoded sooner since only a small number of code symbols are required to reconstruct high-priority data. This approach increases the likelihood that high-priority data is decoded first over low-priority data. The Prioritized LT code scheme achieves an improvement in high-priority data decoding performance as well as overall information recovery without penalizing the decoding of low-priority data, assuming high-priority data is no more than half of a message block. The cost is in the additional complexity required in the encoder. If extra computation resource is available at the transmitter, image, voice, and video transmission quality in terrestrial and space communications can benefit from accurate use of redundancy in protecting data with varying priorities.
Atkins, David; Perez-Padilla, Rogelio; Macnee, William; Buist, A Sonia; Cruz, Alvaro A
2012-12-01
Professional societies, like many other organizations around the world, have recognized the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. Priority setting is an essential component of developing clinical practice guidelines informed by the best available research evidence. It ensures that resources and attention are devoted to those areas in which clinical recommendations will provide the greatest benefit to patients, clinicians, and policy makers. This is the second of a series of 14 articles that methodologists and researchers from around the world prepared to advise guideline developers in respiratory and other diseases. This review focuses on priority setting, addressing five key questions. In this review, we addressed the following questions. (1) At which steps of guideline development should priorities be considered? (2) How do we create an initial list of potential topics within the guideline? (3) What criteria should be used to establish priorities? (4) What parties should be involved and what processes should be used to set priorities? (5)What are the potential challenges of setting priorities? We updated an existing review on priority setting, and searched PubMed and other databases of methodological studies for existing systematic reviews and relevant methodological research. We did not conduct systematic reviews ourselves. Our conclusions are based on available evidence, our own experience working with guideline developers, and workshop discussions. Existing literature on priority setting largely applies to identifying priorities for which guidelines to develop rather than setting priorities for recommendations within a guideline. Nonetheless, there is substantial consensus about the general factors that should be considered in setting priorities. These include the burdens and costs of illness, potential impact of a recommendation, identified deficits or weak points in practice, variation or uncertainty in practice, and availability of evidence. The input of a variety of stakeholders is useful in setting priorities, although informal consultation is used more often than formal methods. Processes for setting priorities remains poorly described in most guidelines.
Decision Making on Regional Landfill Site Selection in Hormozgan Province Using Smce
NASA Astrophysics Data System (ADS)
Majedi, A. S.; Kamali, B. M.; Maghsoudi, R.
2015-12-01
Landfill site selection and suitable conditions to bury hazardous wastes are among the most critical issues in modern societies. Taking several factors and limitations into account along with true decision making requires application of different decision techniques. To this end, current paper aims to make decisions about regional landfill site selection in Hormozgan province and utilizes SMCE technique combined with qualitative and quantitative criteria to select the final alternatives. To this respect, we first will describe the existing environmental situation in our study area and set the goals of our study in the framework of SMCE and will analyze the effective factors in regional landfill site selection. Then, methodological procedure of research was conducted using Delphi approach and questionnaires (in order to determine research validity, Chronbach Alpha (0.94) method was used). Spatial multi-criteria analysis model was designed in the form of criteria tree in SMCE using IL WIS software. Prioritization of respective spatial alternatives included: Bandar Abbas city with total 4 spatial alternatives (one zone with 1st priority, one zone with 3rd priority and two zones with 4thpriority) was considered the first priority, Bastak city with total 3 spatial alternatives (one zone with 2nd priority, one zone with 3rdpriorit and one zone with 4th priority) was the second priority and Bandar Abbas, Minab, Jask and Haji Abad cities were considered as the third priority.
Waldau, Susanne; Lindholm, Lars; Wiechel, Anna Helena
2010-08-01
In the Västerbotten County Council in Sweden a priority setting process was undertaken to reallocate existing resources for funding of new methods and activities. Resources were created by limiting low priority services. A procedure for priority setting was constructed and fully tested by engaging the entire organisation. The procedure included priority setting within and between departments and political decision making. Participants' views and experiences were collected as a basis for future improvement of the process. Results indicate that participants appreciated the overall approach and methodology and wished to engage in their improvement. Among the improvement proposals is prolongation of the process in order to improve the knowledge base quality. The procedure for identification of new items for funding also needs to be revised. The priority setting process was considered an overall success because it fulfilled its political goals. Factors considered crucial for success are a wish among managers for an economic strategy that addresses existing internal resource allocation; process management characterized by goal orientation and clear leadership; an elaborate communications strategy integrated early in the process and its management; political unity in support of the procedure, and a strong political commitment throughout the process. Generalizability has already been demonstrated by several health care organisations that performed processes founded on this working model. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
Christian Nurture of Children in the Writings of Horace Bushnell and Ellen G. White
ERIC Educational Resources Information Center
Jankiewicz, Darius; Jankiewicz, Edyta
2016-01-01
Until the 20th century, the spiritual nurture of children was not a high priority for the Christian church. In fact, for most of Christian history, reflection on the nature of children and their faith formation was often considered "beneath" the work of theologians. Two 19th-century American Christian writers, however, stand in sharp…
Stokes, W S; Kulpa-Eddy, J; Brown, K; Srinivas, G; McFarland, R
2012-01-01
Veterinary vaccines contribute to improved animal and human health and welfare by preventing infectious diseases. However, testing necessary to ensure vaccine effectiveness and safety can involve large numbers of animals and significant pain and distress. NICEATM and ICCVAM recently convened an international workshop to review the state of the science of human and veterinary vaccine potency and safety testing, and to identify priority activities to advance new and improved methods that can further reduce, refine and replace animal use. Rabies, Clostridium sp., and Leptospira sp. vaccines were identified as the highest priorities, while tests requiring live viruses and bacteria hazardous to laboratory workers, livestock, pets, and wildlife were also considered high priorities. Priority research, development and validation activities to address critical knowledge and data gaps were identified, including opportunities to apply new science and technology. Enhanced international harmonization and cooperation and closer collaborations between human and veterinary researchers were recommended to expedite progress. Implementation of the workshop recommendations is expected to advance new methods for vaccine testing that will benefit animal welfare and ensure continued and improved protection of human and animal health.
Zhuo, Shaojie; Shen, Guofeng; Zhu, Ying; Du, Wei; Pan, Xuelian; Li, Tongchao; Han, Yang; Li, Bengang; Liu, Junfeng; Cheng, Hefa; Xing, Baoshan; Tao, Shu
2017-05-01
Sixteen U.S. EPA priority polycyclic aromatic hydrocarbons (PAHs) and eleven non-priority isomers including some dibenzopyrenes were analyzed to evaluate health risk attributable to inhalation exposure to ambient PAHs and contributions of the non-priority PAHs in a megacity Nanjing, east China. The annual average mass concentration of the total 16 EPA priority PAHs in air was 51.1 ± 29.8 ng/m 3 , comprising up to 93% of the mass concentration of all 27 PAHs, however, the estimated Incremental Lifetime Cancer Risk (ILCR) due to inhalation exposure would be underestimated by 63% on average if only accounting the 16 EPA priority PAHs. The risk would be underestimated by 13% if only particulate PAHs were considered, though gaseous PAHs made up to about 70% of the total mass concentration. During the last fifteen years, ambient Benzo[a]pyrene decreased significantly in the city which was consistent with the declining trend of PAHs emissions. Source contributions to the estimated ILCR were much different from the contributions for the total mass concentration, calling for the introduce of important source-oriented risk assessments. Emissions from gasoline vehicles contributed to 12% of the total mass concentration of 27 PAHs analyzed, but regarding relative contributions to the overall health risk, gasoline vehicle emissions contributed 45% of the calculated ILCR. Dibenzopyrenes were a group of non-priority isomers largely contributing to the calculated ILCR, and vehicle emissions were probably important sources of these high molecular weight isomers. Ambient dibenzo[a,l]pyrene positively correlated with the priority PAH Benzo[g,h,i]perylene. The study indicates that inclusion of non-priority PAHs could be valuable for both PAH source apportionment and health risk assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.
Jo, Heui-Sug; Kim, Dong Ik; Oh, Moo-Kyung
2015-12-01
By November 2013, a total of 125 clinical practice guidelines (CPGs) have been developed in Korea. However, despite the high burden of diseases and the clinical importance of CPGs, most chronic diseases do not have available CPGs. Merely 83 CPGs are related to chronic diseases, and only 40 guidelines had been developed in the last 5 yr. Considering the rate of the production of new evidence in medicine and the worsening burden from chronic diseases, the need for developing CPGs for more chronic diseases is becoming increasingly pressing. Since 2011, the Korean Academy of Medical Sciences and the Korea Centers for Disease Control and Prevention have been jointly developing CPGs for chronic diseases. However, priorities have to be set and resources need to be allocated within the constraint of a limited funding. This study identifies the chronic diseases that should be prioritized for the development of CPGs in Korea. Through an objective assessment by using the analytic hierarchy process and a subjective assessment with a survey of expert opinion, high priorities were placed on ischemic heart disease, cerebrovascular diseases, Alzheimer's disease and other dementias, osteoarthritis, neck pain, chronic kidney disease, and cirrhosis of the liver.
Prenatal knowledge and informational priorities of pregnant adolescents.
Smith, P B; Levenson, P M; Morrow, J R
1985-01-01
One hundred and forty-six indigent pregnant adolescents (12 to 18 years of age) were asked to complete a questionnaire concerning their prenatal care priorities (Scale I) and their knowledge of correct perinatal behaviors (Scale II). On Scale I, over 75% of teens considered parenting skills, infant care, and diet extremely important. On Scale II correctly answered items focused on the need to avoid substance abuse and smoking during pregnancy, visit the doctor, and eat balanced meals. The mean number of correct answers, however, was only 11.8 out of a total possible scale of 18 items. Less than 50% correctly answered statements about the effects of weight gain and other health behaviors on risk for high blood pressure and toxemia, safety of laxatives during pregnancy, possibility of becoming pregnant again before resuming menstruation, and the safety of various physical activities. Performance on both knowledge and health priority scales showed correct health information was limited to basic concrete facts. Abstract and technical aspects of health care did not appear to be easily assimilated.
2013-01-01
Background In an era of scarce and competing priorities for implementation, choosing what to implement is a key decision point for many behavioural change projects. The values and attitudes of the professionals and managers involved inevitably impact the priority attached to decision options. Reliably capturing such values is challenging. Methods This paper presents an approach for capturing and incorporating professional values into the prioritization of healthcare innovations being considered for adoption. Conjoint Analysis (CA) was used in a single UK Primary Care Trust to measure the priorities of healthcare professionals working with women with postnatal depression. Rating-based CA data was gathered using a questionnaire and then mapped onto 12 interventions being considered as a means of improving the management of postnatal depression. Results The ‘impact on patient care’ and the ‘quality of supporting evidence’ associated with the potential innovations were the most influential in shaping priorities. Professionals were least influenced by whether an innovation was an existing national or local priority, or whether current practice in the Trust was meeting minimum standards. Ranking the 12 innovations by the preferences of potential adopters revealed ‘guided self help’ was the top priority for implementation and ‘screening questions for post natal depression’ the least. When other factors were considered (such as the presence of routine data or planned implementation activity elsewhere in the Trust), the project team chose to combine the eight related treatments and implement these as a single innovation referred to as ‘psychological therapies’. Conclusions Using Conjoint Analysis to prioritise potential innovation implementation options is a feasible means of capturing the utility of stakeholders and thus increasing the chances of an innovation being adopted. There are some practical barriers to overcome such as increasing response rates to conjoint surveys before routine and unevaluated use of this technique should be considered. PMID:23714429
Khazanie, Prateeti; Krumholz, Harlan M; Kiefe, Catarina I; Kressin, Nancy R; Wells, Barbara; Wang, Tracy Y; Peterson, Eric D
2017-07-01
The Centers for Cardiovascular Outcomes Research (CCORs) held a meeting to review how cardiovascular outcomes research had evolved in the decade since the National Heart, Lung, and Blood Institute 2004 working group report and to consider future directions. The conference involved representatives from governmental agencies, outcomes research thought leaders, and public and private healthcare partners. The main purposes of this meeting were to (1) advance collaborative high-yield, high-impact outcomes research; (2) identify priorities and barriers to important cardiovascular outcomes research; and (3) define future needs for the field. This report highlights the key topics covered during the meeting, including an examination of the recent history of outcomes research, an evaluation of the current academic climate, and a vision for the future of cardiovascular outcomes research. © 2017 American Heart Association, Inc.
Criteria for choosing clinically effective glaucoma treatment: A discussion panel consensus
Thygesen, John; Burk, Reinhard; Carassa, Roberto; Crichton, Andrew; Goñi, Francisco Javier; Menage, Mitch; Miglior, Stefano; Montgomery, Donald; Nordmann, John-Philippe; Roberts, Tim; Singh, Kuldev
2007-01-01
Abstract Background: In the clinical management of patients at risk for or diagnosed with primary open-angle glaucoma (POAG), the aim of medical treatment is to reduce intraocular pressure (IOP) and then maintain it over time at a level that preserves both the structure and function of the optic nerve. Objective: The objective of this report was to establish a consensus on the criteria that should be used to determine the characteristics of IOP-lowering medication. Methods: Discussion was held among a panel of 12 physicians considered to be experts in glaucoma to develop a consensus on the criteria used by them to determine the characteristics of the IOP-lowering medication chosen for initial monotherapy and adjunctive treatment of ocular hypertension (OHT) or POAG. Consensus development combined available evidence and the impressions of these physicians regarding the clinical effectiveness of IOP-lowering medication for OHT and POAG. Once the panel identified the criteria, the order of priority and the relative importance of these criteria were then established in the setting of 3 risk categories (low, medium, and high) for a patient to experience significant visual disability from glaucoma over their expected life span. Results: The panel identified 5 criteria to determine the characteristics of IOP-lowering medication for OHT and POAG: IOP-lowering effect, systemic adverse events (AEs), ocular tolerability, compliance/administration, and cost of treatment. IOP-lowering effect was consistently ranked as the highest priority and cost as the lowest. The priority of compliance/administration did not vary by clinical situation. Systemic AEs and ocular tolerability were ranked as higher priorities in initial monotherapy than in adjunctive treatment and ranked lower as the risk for visual disability increased. The priority given to the criteria used to determine clinical effectiveness varied both with the risk for functional vision loss from glaucoma and whether initial monotherapy or adjunctive treatment was being considered. Conclusion: Glaucoma treatment should be assessed with regard to the need not only to lower IOP but also to minimize systemic and ocular AEs, promote patient compliance, and minimize cost. The order of priority and relative importance given to these treatment criteria will vary as part of individualizing patient care. PMID:24683204
Physiotherapy Research Priorities in Switzerland: Views of the Various Stakeholders.
Nast, Irina; Tal, Amir; Schmid, Stefan; Schoeb, Veronika; Rau, Barbara; Barbero, Marco; Kool, Jan
2016-09-01
Research priorities, defined by multiple stakeholders, can proximally facilitate the coordination of research projects and national and international cooperation and distally further improve the quality of physiotherapy practice. The aim of this study was therefore to establish physiotherapy research priorities in Switzerland considering multiple stakeholders' opinions. A mixed methods design was chosen. For a qualitative identification of physiotherapy research topics, 18 focus group discussions and 23 semi-structured interviews/written commentaries were conducted. For the quantitative analysis, 420 participants prioritized research topics using a two-round Delphi questionnaire survey. The following stakeholder groups were surveyed in the German-speaking, French-speaking and Italian-speaking regions of Switzerland: physiotherapy researchers, practitioners and educators, representatives of patient organizations, public health organizations, health insurers, physicians, nurses, occupational therapists and other health professionals, as well as physical educators. The top five overall physiotherapy research priorities identified were as follows: physiotherapy treatment, physiotherapy assessment and diagnosis, prevention, physiotherapist-patient interaction and physiotherapy professional education at the bachelor level. With regard to diagnostic groups, the highest priorities were placed on musculoskeletal disorders, neurology, orthopaedics, geriatrics and ergonomics/occupational health. Consensus was moderate to high, and only few differences between stakeholder groups were revealed. Research directly related to physiotherapy treatment is of highest priority. It should focus on diagnostic groups related to chronicity in anticipation of demographic changes. Multidisciplinary networks for research and practice, alongside sound coordination of research projects, should increase the impact of physiotherapy research. An accurate dissemination of research priorities, defined and supported by multiple stakeholder groups, might strengthen their impact on research and practice. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Midwifery: "at the edge of history".
Dahlen, H
2006-03-01
The paper focuses on possible future pathways in maternity care for midwives and nations to consider. The paper blends personal and professional experiences to outline priority areas facing midwives in the future. It begins by examining maternal mortality and morbidity in the developing world and considering the potential of the ten high priority action messages (1997) in helping to improve the plight of women and children in the future. The paper then examines major issues facing midwives in the developed world including: the way birth is viewed; the medical-midwifery divide; marketing midwifery; and finally the challenge of dealing with fear around birth. The third part of the paper examines a part of society where the two worlds meet and there are issues from both the developed and developing world to consider. The paper focuses on women from culturally and linguistically diverse communities, Aboriginal and Torres Strait Islander women and women birthing in remote and rural areas. By looking at these three worlds separately the paper examines different concerns facing midwives in the future but also draws on common issues that face us all as citizens of this planet and particularly as predominantly women. The paper challenges midwives to be politically active and dare to change the world.
NASA Astrophysics Data System (ADS)
Kim, Hoon; Hyon, Taein; Lee, Yeonwoo
Most of previous works have presented the dynamic spectrum allocation (DSA) gain achieved by utilizing the time or regional variations in traffic demand between multi-network operators (NOs). In this paper, we introduce the functionalities required for the entities related with the spectrum sharing and allocation and propose a spectrum allocation algorithm while considering the long-term priority between NOs, the priority between multiple class services, and the urgent bandwidth request. To take into account the priorities among the NOs and the priorities of multiple class services, a spectrum sharing metric (SSM) is proposed, while a negotiation procedure is proposed to treat the urgent bandwidth request.
Neiger, Brad L; Thackeray, Rosemary; Fagen, Michael C
2011-03-01
Priority setting is an important component of systematic planning in health promotion and also factors into the development of a comprehensive evaluation plan. The basic priority rating (BPR) model was introduced more than 50 years ago and includes criteria that should be considered in any priority setting approach (i.e., use of predetermined criteria, standardized comparisons, and a rubric that controls bias). Although the BPR model has provided basic direction in priority setting, it does not represent the broad array of data currently available to decision makers. Elements in the model also give more weight to the impact of communicable diseases compared with chronic diseases. For these reasons, several modifications are recommended to improve the BPR model and to better assist health promotion practitioners in the priority setting process. The authors also suggest a new name, BPR 2.0, to represent this revised model.
Improving effectiveness of systematic conservation planning with density data.
Veloz, Samuel; Salas, Leonardo; Altman, Bob; Alexander, John; Jongsomjit, Dennis; Elliott, Nathan; Ballard, Grant
2015-08-01
Systematic conservation planning aims to design networks of protected areas that meet conservation goals across large landscapes. The optimal design of these conservation networks is most frequently based on the modeled habitat suitability or probability of occurrence of species, despite evidence that model predictions may not be highly correlated with species density. We hypothesized that conservation networks designed using species density distributions more efficiently conserve populations of all species considered than networks designed using probability of occurrence models. To test this hypothesis, we used the Zonation conservation prioritization algorithm to evaluate conservation network designs based on probability of occurrence versus density models for 26 land bird species in the U.S. Pacific Northwest. We assessed the efficacy of each conservation network based on predicted species densities and predicted species diversity. High-density model Zonation rankings protected more individuals per species when networks protected the highest priority 10-40% of the landscape. Compared with density-based models, the occurrence-based models protected more individuals in the lowest 50% priority areas of the landscape. The 2 approaches conserved species diversity in similar ways: predicted diversity was higher in higher priority locations in both conservation networks. We conclude that both density and probability of occurrence models can be useful for setting conservation priorities but that density-based models are best suited for identifying the highest priority areas. Developing methods to aggregate species count data from unrelated monitoring efforts and making these data widely available through ecoinformatics portals such as the Avian Knowledge Network will enable species count data to be more widely incorporated into systematic conservation planning efforts. © 2015, Society for Conservation Biology.
Patient and public engagement in priority setting: A systematic rapid review of the literature.
Manafò, Elizabeth; Petermann, Lisa; Vandall-Walker, Virginia; Mason-Lai, Ping
2018-01-01
Current research suggests that while patients are becoming more engaged across the health delivery spectrum, this involvement occurs most often at the pre-preparation stage to identify 'high-level' priorities in health ecosystem priority setting, and at the preparation phase for health research. The purpose of this systematic rapid review of the literature is to describe the evidence that does exist in relation to patient and public engagement priority setting in both health ecosystem and health research. HealthStar (via OVID); CINAHL; Proquest Databases; and Scholar's Portal. i) published in English; ii) published within the timeframe of 2007-Current (10 years) unless the report/article was formative in synthesizing key considerations of patient engagement in health ecosystem and health research priority setting; iii) conducted in Canada, the US, Europe, UK, Australia/New Zealand, or Scandinavian countries. i) Is the research valid, sound, and applicable?; ii) what outcomes can we potentially expect if we implement the findings from this research?; iii) will the target population (i.e., health researchers and practitioners) be able to use this research?. A summary of findings from each of the respective processes was synthesized to highlight key information that would support decision-making for researchers when determining the best priority setting process to apply for their specific patient-oriented research. Seventy articles from the UK, US, Canada, Netherlands and Australia were selected for review. Results were organized into two tiers of public and patient engagement in prioritization: Tier 1-Deliberative and Tier 2-Consultative. Highly structured patient and public engagement planning activities include the James Lind Alliance Priority Setting Partnerships (UK), Dialogue Method (Netherlands), Global Evidence Mapping (Australia), and the Deep Inclusion Method/CHoosing All Together (US). The critical study limitations include challenges in comprehensively identifying the patient engagement literature for review, bias in article selection due to the identified scope, missed information due to a more limited use of exhaustive search strategies (e.g., in-depth hand searching), and the heterogeneity of reported study findings. The four public and patient engagement priority setting processes identified were successful in setting priorities that are inclusive and objectively based, specific to the priorities of stakeholders engaged in the process. The processes were robust, strategic and aimed to promote equity in patient voices. Key limitations identified a lack of evaluation data on the success and extent in which patients were engaged. Issues pertaining to feasibility of stakeholder engagement, coordination, communication and limited resources were also considered.
Meeting Kentucky's Transportation needs and priorities : citizens' perceptions and recommendations.
DOT National Transportation Integrated Search
2005-08-01
This study was designed to (1) consider the role of public input in the transportation planning process; (2) obtain citizen perceptions of system needs and develop priorities in the state of Kentucky; and (3) use that experience (and the experiences ...
MacLeod, Tatjana E; Harris, Anthony H; Mahal, Ajay
2016-06-01
The growing focus on patient-centred care has encouraged the inclusion of patient and public input into payer drug reimbursement decisions. Yet, little is known about patient/public priorities for funding high-cost medicines, and how they compare to payer priorities applied in public funding decisions for new cancer drugs. The aim was to identify and compare the funding preferences of cancer patients and the general public against the criteria used by payers making cancer drug funding decisions. A thorough review of the empirical, peer-reviewed English literature was conducted. Information sources were PubMed, EMBASE, MEDLINE, Web of Science, Business Source Complete, and EconLit. Eligible studies (1) assessed the cancer drug funding preferences of patients, the general public or payers, (2) had pre-defined measures of funding preference, and (3) had outcomes with attributes or measures of 'value'. The quality of included studies was evaluated using a health technology assessment-based assessment tool, followed by extraction of general study characteristics and funding preferences, which were categorized using an established WHO-based framework. Twenty-five preference studies were retrieved (11 quantitative, seven qualitative, seven mixed-methods). Most studies were published from 2005 onward, with the oldest dating back to 1997. Two studies evaluated both patient and public perspectives, giving 27 total funding perspectives (41 % payer, 33 % public, 26 % patients). Of 41 identified funding criteria, payers consider the most (35), the general public considers fewer (23), and patients consider the fewest (12). We identify four unique patient criteria: financial protection, access to medical information, autonomy in treatment decision making, and the 'value of hope'. Sixteen countries/jurisdictions were represented. Our results suggest that (1) payers prioritize efficiency (health gains per dollar), while citizens (patients and the general public) prioritize equity (equal access to cancer medicines independent of cost or effectiveness), (2) citizens prioritize few criteria relevant to payers, and (3) citizens prioritize several criteria not considered by payers. This can explain why payer and citizen priorities clash when new cancer medicines are denied public funding.
Bramesfeld, A; Stegbauer, C
2016-10-01
The World Health Organisation has defined health service responsiveness as one of the key-objectives of health systems. Health service responsiveness relates to the ability to respond to service users' legitimate expectations on non-medical issues when coming into contact with the services of a healthcare system. It is defined by the areas showing respect for persons and patient orientation. Health service responsiveness is particularly relevant to mental health services, due to the specific vulnerability of mental health patients but also because it matches what mental health patients consider as good quality of care as well as their priorities when seeking healthcare. As (mental) health service responsiveness applies equally to all concerned services it would be suitable as a universal indicator for the quality of services' performance. However, performance monitoring programs in mental healthcare rarely assess health service performance with respect to meeting patient priorities. This is in part due of patient priorities as an outcome being underrepresented in studies that evaluate service provision. The lack of studies using patient priorities as outcomes transmits into evidence based guidelines and subsequently, into underrepresentation of patient priorities in performance monitoring. Possible ways out of this situation include more intervention studies using patient priorities as outcome, considering evidence from qualitative studies in guideline development and developing performance monitoring programs along the patient pathway and on key-points of relevance for service quality from a patient perspective.
Wallace, Lauren; Kapirir, Lydia
2017-01-01
Background: To date, research on priority-setting for new vaccines has not adequately explored the influence of the global, national and sub-national levels of decision-making or contextual issues such as political pressure and stakeholder influence and power. Using Kapiriri and Martin’s conceptual framework, this paper evaluates priority setting for new vaccines in Uganda at national and sub-national levels, and considers how global priorities can influence country priorities. This study focuses on 2 specific vaccines, the human papilloma virus (HPV) vaccine and the pneumococcal conjugate vaccine (PCV). Methods: This was a qualitative study that involved reviewing relevant Ugandan policy documents and media reports, as well as 54 key informant interviews at the global level and national and sub-national levels in Uganda. Kapiriri and Martin’s conceptual framework was used to evaluate the prioritization process. Results: Priority setting for PCV and HPV was conducted by the Ministry of Health (MoH), which is considered to be a legitimate institution. While respondents described the priority setting process for PCV process as transparent, participatory, and guided by explicit relevant criteria and evidence, the prioritization of HPV was thought to have been less transparent and less participatory. Respondents reported that neither process was based on an explicit priority setting framework nor did it involve adequate representation from the districts (program implementers) or publicity. The priority setting process for both PCV and HPV was negatively affected by the larger political and economic context, which contributed to weak institutional capacity as well as power imbalances between development assistance partners and the MoH. Conclusion: Priority setting in Uganda would be improved by strengthening institutional capacity and leadership and ensuring a transparent and participatory processes in which key stakeholders such as program implementers (the districts) and beneficiaries (the public) are involved. Kapiriri and Martin’s framework has the potential to guide priority setting evaluation efforts, however, evaluation should be built into the priority setting process a priori such that information on priority setting is gathered throughout the implementation cycle. PMID:29172378
What criteria do decision makers in Thailand use to set priorities for vaccine introduction?
Pooripussarakul, Siriporn; Riewpaiboon, Arthorn; Bishai, David; Muangchana, Charung; Tantivess, Sripen
2016-08-02
There is a need to identify rational criteria and set priorities for vaccines. In Thailand, many licensed vaccines are being considering for introduction into the Expanded Program on Immunization; thus, the government has to make decisions about which vaccines should be adopted. This study aimed to set priorities for new vaccines and to facilitate decision analysis. We used a best-worst scaling study for rank-ordering of vaccines. The candidate vaccines were determined by a set of criteria, including burden of disease, target age group, budget impact, side effect, effectiveness, severity of disease, and cost of vaccine. The criteria were identified from a literature review and by in-depth, open-ended interviews with experts. The priority-setting model was conducted among three groups of stakeholders, including policy makers, healthcare professionals and healthcare administrators. The vaccine data were mapped and then calculated for the probability of selection. From the candidate vaccines, the probability of hepatitis B vaccine being selected by all respondents (96.67 %) was ranked first. This was followed, respectively, by pneumococcal conjugate vaccine-13 (95.09 %) and Haemophilus influenzae type b vaccine (90.87 %). The three groups of stakeholders (policy makers, healthcare professionals and healthcare administrators) showed the same ranking trends. Most severe disease, high fever rate and high disease burden showed the highest coefficients for criterion levels being selected by all respondents. This result can be implied that a vaccine which can prevent most severe disease with high disease burden and has low safety has a greater chance of being selected by respondents in this study. The priority setting of vaccines through a multiple-criteria approach could contribute to transparency and accountability in the decision-making process. This is a step forward in the development of an evidence-based approach that meets the need of developing country. The methodology is generalizable but its application to another country would require the criteria as relevant to that country.
NASA Technical Reports Server (NTRS)
Black, D. C. (Editor); Brunk, W. E. (Editor)
1980-01-01
The feasibility and limitations of ground-based techniques for detecting other planetary systems are discussed as well as the level of accuracy at which these limitations would occur and the extent to which they can be overcome by new technology and instrumenation. Workshop conclusions and recommendations are summarized and a proposed high priority program is considered.
ERIC Educational Resources Information Center
Al-Sobhi, Bandar Mohammad Saeed; Preece, Abdul Shakour
2018-01-01
Of the four English language skills, speaking enjoys a superior status. Accordingly, it should be given high priority while teaching. In spite of its importance, teaching English speaking skill to Arab EFL learners has always been an exacting task for Arab teachers of English because it is considered a foreign language, i.e. not widely spoken or…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-21
... methods for potential use in the EPA EDSP. The evaluation indicated that no in vitro ER- or AR-based test... considered a high priority based on the lack of adequately validated test methods and the regulatory and... Limitations of the LUMI-CELL[supreg] ER (BG1Luc ER TA) Test Method, An In Vitro Assay for Identifying Human...
34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?
Code of Federal Regulations, 2012 CFR
2012-07-01
... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...
34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?
Code of Federal Regulations, 2011 CFR
2011-07-01
... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...
34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?
Code of Federal Regulations, 2014 CFR
2014-07-01
... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...
34 CFR 376.30 - What priorities are considered for support by the Secretary under this part?
Code of Federal Regulations, 2013 CFR
2013-07-01
... demonstrate effective Statewide approaches to transitional rehabilitation service delivery for youths with... illness, mental retardation, and learning disability. (d) Transitional rehabilitation services for institutionalized persons. This priority supports projects that demonstrate effective ways to assist youths and...
Mirando, Mark A; Hamernik, Debora L
2006-03-01
The National Research Initiative (NRI) Competitive Grants Program is the U.S. Department of Agriculture's major competitive grants program and is administered by the Cooperative State Research, Education, and Extension Service (CSREES). Since its inception in 1991, the NRI has funded competitive grants in the discipline of animal reproduction. Previously, this program provided funding for a broad range of projects encompassing almost every subdiscipline in reproductive biology of farm animals, including aquatic species important to the aquaculture industry. During fiscal year 2004, the NRI Animal Reproduction Program narrowed the focus of funding priorities to the topics of infertility, basic mechanisms regulating fertility, cryopreservation of gametes, reducing the postpartum interval to conception, and sterilization methods or development of monosex populations. In response to a directive to further narrow the focus of funding priorities for fiscal year 2005 and beyond, CSREES conducted a Stakeholder Workshop on Funding Priorities in Animal Reproduction at the 37th Annual Meeting of the Society for the Study of Reproduction in Vancouver, Canada. More than 75 stakeholder scientists from a cross section of federal, public, and private institutions from across the United States participated in the workshop and provided recommendations to CSREES for future NRI-funding priorities in Animal Reproduction. The recommendations provided by stakeholders included continuing efforts to focus funding priorities into fewer high-impact areas relevant to animal agriculture and aquaculture. Recommendations also included movement back toward subdisciplines of animal reproduction that cut across all applicable species. The three funding priorities that consistently emerged as recommendations from the workshop participants were 1) gonadal function and production of gametes, 2) pituitary-hypothalamic function, and 3) embryo and conceptus development, including interaction between the conceptus and uterus. These funding priorities were considered when preparing the fiscal year 2006 NRI Request for Applications.
Global health priorities – priorities of the wealthy?
Ollila, Eeva
2005-01-01
Health has gained importance on the global agenda. It has become recognized in forums where it was once not addressed. In this article three issues are considered: global health policy actors, global health priorities and the means of addressing the identified health priorities. I argue that the arenas for global health policy-making have shifted from the public spheres towards arenas that include the transnational for-profit sector. Global health policy has become increasingly fragmented and verticalized. Infectious diseases have gained ground as global health priorities, while non-communicable diseases and the broader issues of health systems development have been neglected. Approaches to tackling the health problems are increasingly influenced by trade and industrial interests with the emphasis on technological solutions. PMID:15847685
45 CFR 1620.5 - Annual review.
Code of Federal Regulations, 2011 CFR
2011-10-01
... considered in determining whether the recipient's priorities should be changed: (1) The extent to which the objectives of the recipient's priorities have been accomplished; (2) Changes in the resources of the recipient; (3) Changes in the size, distribution, or needs of the eligible client population; and (4) The...
Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda.
Kapiriri, Lydia; Norheim, Ole Frithjof; Martin, Douglas K
2007-06-01
The objectives of this study were (1) to describe the process of healthcare priority setting in Ontario-Canada, Norway and Uganda at the three levels of decision-making; (2) to evaluate the description using the framework for fair priority setting, accountability for reasonableness; so as to identify lessons of good practices. We carried out case studies involving key informant interviews, with 184 health practitioners and health planners from the macro-level, meso-level and micro-level from Canada-Ontario, Norway and Uganda (selected by virtue of their varying experiences in priority setting). Interviews were audio-recorded, transcribed and analyzed using a modified thematic approach. The descriptions were evaluated against the four conditions of "accountability for reasonableness", relevance, publicity, revisions and enforcement. Areas of adherence to these conditions were identified as lessons of good practices; areas of non-adherence were identified as opportunities for improvement. (i) at the macro-level, in all three countries, cabinet makes most of the macro-level resource allocation decisions and they are influenced by politics, public pressure, and advocacy. Decisions within the ministries of health are based on objective formulae and evidence. International priorities influenced decisions in Uganda. Some priority-setting reasons are publicized through circulars, printed documents and the Internet in Canada and Norway. At the meso-level, hospital priority-setting decisions were made by the hospital managers and were based on national priorities, guidelines, and evidence. Hospital departments that handle emergencies, such as surgery, were prioritized. Some of the reasons are available on the hospital intranet or presented at meetings. Micro-level practitioners considered medical and social worth criteria. These reasons are not publicized. Many practitioners lacked knowledge of the macro- and meso-level priority-setting processes. (ii) Evaluation-relevance: medical evidence and economic criteria were thought to be relevant, but lobbying was thought to be irrelevant. Publicity: all cases lacked clear and effective mechanisms for publicity. REVISIONS: formal mechanisms, following the planning hierarchy, were considered less effective, informal political mechanisms were considered more effective. Canada and Norway had patients' relations officers to deal with patients' dissensions; however, revisions were more difficult in Uganda. Enforcement: leadership for ensuring decision-making fairness was not apparent. The different levels of priority setting in the three countries fulfilled varying conditions of accountability for reasonableness, none satisfied all the four conditions. To improve, decision makers at the three levels in all three cases should engage frontline practitioners, develop more effectively publicized reasons, and develop formal mechanisms for challenging and revising decisions.
Chen, Shu-Ling; Hsieh, Pao-Chun; Chou, Chia-Hui; Tzeng, Ya-Ling
2014-11-25
Many Taiwanese women (43.8%) did not participate in regular cervical screening in 2011. An alternative to cervical screening, self-sampling for human papillomavirus (HPV), has been available at no cost under Taiwan's National Health Insurance since 2010, but the extent and likelihood of HPV self-sampling were unknown. A cross-sectional study was performed to explore determinants of women's likelihood of HPV self-sampling. Data were collected by questionnaire from a convenience sample of 500 women attending hospital gynecologic clinics in central Taiwan from June to October 2012. Data were analyzed by descriptive statistics, chi-square test, and logistic regression. Of 500 respondents, 297 (59.4%) had heard of HPV; of these 297 women, 69 (23%) had self-sampled for HPV. Among the 297 women who had heard of HPV, 234 (78.8%) considered cost a priority for HPV self-sampling. Likelihood of HPV self-sampling was determined by previous Pap testing, high perceived risk of cervical cancer, willingness to self-sample for HPV, high HPV knowledge, and cost as a priority consideration. Outreach efforts to increase the acceptability of self-sampling for HPV testing rates should target women who have had a Pap test, perceive themselves at high risk for cervical cancer, are willing to self-sample for HPV, have a high level of HPV knowledge, and for whom the cost of self-sampling covered by health insurance is a priority.
Incorporating Conservation Zone Effectiveness for Protecting Biodiversity in Marine Planning
Makino, Azusa; Klein, Carissa J.; Beger, Maria; Jupiter, Stacy D.; Possingham, Hugh P.
2013-01-01
Establishing different types of conservation zones is becoming commonplace. However, spatial prioritization methods that can accommodate multiple zones are poorly understood in theory and application. It is typically assumed that management regulations across zones have differential levels of effectiveness (“zone effectiveness”) for biodiversity protection, but the influence of zone effectiveness on achieving conservation targets has not yet been explored. Here, we consider the zone effectiveness of three zones: permanent closure, partial protection, and open, for planning for the protection of five different marine habitats in the Vatu-i-Ra Seascape, Fiji. We explore the impact of differential zone effectiveness on the location and costs of conservation priorities. We assume that permanent closure zones are fully effective at protecting all habitats, open zones do not contribute towards the conservation targets and partial protection zones lie between these two extremes. We use four different estimates for zone effectiveness and three different estimates for zone cost of the partial protection zone. To enhance the practical utility of the approach, we also explore how much of each traditional fishing ground can remain open for fishing while still achieving conservation targets. Our results show that all of the high priority areas for permanent closure zones would not be a high priority when the zone effectiveness of the partial protection zone is equal to that of permanent closure zones. When differential zone effectiveness and costs are considered, the resulting marine protected area network consequently increases in size, with more area allocated to permanent closure zones to meet conservation targets. By distributing the loss of fishing opportunity equitably among local communities, we find that 84–88% of each traditional fishing ground can be left open while still meeting conservation targets. Finally, we summarize the steps for developing marine zoning that accounts for zone effectiveness. PMID:24223870
Demand-based urban forest planning using high-resolution remote sensing and AHP
NASA Astrophysics Data System (ADS)
Kolanuvada, Srinivasa Raju; Mariappan, Muneeswaran; Krishnan, Vani
2016-05-01
Urban forest planning is important for providing better urban ecosystem services and conserve the natural carbon sinks inside the urban area. In this study, a demand based urban forest plan was developed for Chennai city by using Analytical Hierarchy Process (AHP) method. Population density, Tree cover, Air quality index and Carbon stocks are the parameters were considered in this study. Tree cover and Above Ground Biomass (AGB) layers were prepared at a resolution of 1m from airborne LiDAR and aerial photos. The ranks and weights are assigned by the spatial priority using AHP. The results show that, the actual status of the urban forest is not adequate to provide ecosystem services on spatial priority. From this perspective, we prepared a demand based plan for improving the urban ecosystem.
National Adult Student Priorities Report. Research Report, 2011
ERIC Educational Resources Information Center
Noel-Levitz, Inc, 2011
2011-01-01
Serving the needs of adult learners in today's economic environment is becoming a greater priority for colleges and universities. Student satisfaction is considered a core element for higher education institutions serving traditional-age students. More colleges and universities are expanding this assessment activity to adult students as well. As…
A Mathematical Analysis of Air Traffic Priority Rules
NASA Technical Reports Server (NTRS)
Nakawicz, Anthony J.; Munoz, Cesar A.; Maddalon, Jeffrey M.
2012-01-01
This paper analyzes priority rules, such as those in Part 91.113 of the Federal Aviation Regulations. Such rules determine which of two aircraft should maneuver in a given conflict scenario. While the rules in 91.113 are well accepted, other concepts of operation for NextGen, such as self separation, may allow for different priority rules. A mathematical framework is presented that can be used to analyze a general set of priority rules and enables proofs of important properties. Specific properties considered in this paper include safety, effectiveness, and stability. A set of rules is said to be safe if it ensures that it is never the case that both aircraft have priority. They are effective if exactly one aircraft has priority in every situation. Finally, a set of rules is called stable if it produces compatible results even under small changes to input data.
Vulnerability in Determining the Cost of Information System Project to Avoid Loses
NASA Astrophysics Data System (ADS)
Haryono, Kholid; Ikhsani, Zulfa Amalia
2018-03-01
Context: This study discusses the priority of cost required in software development projects. Objectives: To show the costing models, the variables involved, and how practitioners assess and decide the priorities of each variable. To strengthen the information, each variable also confirmed the risk if ignored. Method: The method is done by two approaches. First, systematic literature reviews to find the models and variables used to decide the cost of software development. Second, confirm and take judgments about the level of importance and risk of each variable to the software developer. Result: Obtained about 54 variables that appear on the 10 models discussed. The variables are categorized into 15 groups based on the similarity of meaning. Each group becomes a variable. Confirmation results with practitioners on the level of importance and risk. It shown there are two variables that are considered very important and high risk if ignored. That is duration and effort. Conclusion: The relationship of variable rates between the results of literature studies and confirmation of practitioners contributes to the use of software business actors in considering project cost variables.
Prioritizing pesticide compounds for analytical methods development
Norman, Julia E.; Kuivila, Kathryn; Nowell, Lisa H.
2012-01-01
The U.S. Geological Survey (USGS) has a periodic need to re-evaluate pesticide compounds in terms of priorities for inclusion in monitoring and studies and, thus, must also assess the current analytical capabilities for pesticide detection. To meet this need, a strategy has been developed to prioritize pesticides and degradates for analytical methods development. Screening procedures were developed to separately prioritize pesticide compounds in water and sediment. The procedures evaluate pesticide compounds in existing USGS analytical methods for water and sediment and compounds for which recent agricultural-use information was available. Measured occurrence (detection frequency and concentrations) in water and sediment, predicted concentrations in water and predicted likelihood of occurrence in sediment, potential toxicity to aquatic life or humans, and priorities of other agencies or organizations, regulatory or otherwise, were considered. Several existing strategies for prioritizing chemicals for various purposes were reviewed, including those that identify and prioritize persistent, bioaccumulative, and toxic compounds, and those that determine candidates for future regulation of drinking-water contaminants. The systematic procedures developed and used in this study rely on concepts common to many previously established strategies. The evaluation of pesticide compounds resulted in the classification of compounds into three groups: Tier 1 for high priority compounds, Tier 2 for moderate priority compounds, and Tier 3 for low priority compounds. For water, a total of 247 pesticide compounds were classified as Tier 1 and, thus, are high priority for inclusion in analytical methods for monitoring and studies. Of these, about three-quarters are included in some USGS analytical method; however, many of these compounds are included on research methods that are expensive and for which there are few data on environmental samples. The remaining quarter of Tier 1 compounds are high priority as new analytes. The objective for analytical methods development is to design an integrated analytical strategy that includes as many of the Tier 1 pesticide compounds as possible in a relatively few, cost-effective methods. More than 60 percent of the Tier 1 compounds are high priority because they are anticipated to be present at concentrations approaching levels that could be of concern to human health or aquatic life in surface water or groundwater. An additional 17 percent of Tier 1 compounds were frequently detected in monitoring studies, but either were not measured at levels potentially relevant to humans or aquatic organisms, or do not have benchmarks available with which to compare concentrations. The remaining 21 percent are pesticide degradates that were included because their parent pesticides were in Tier 1. Tier 1 pesticide compounds for water span all major pesticide use groups and a diverse range of chemical classes, with herbicides and their degradates composing half of compounds. Many of the high priority pesticide compounds also are in several national regulatory programs for water, including those that are regulated in drinking water by the U.S. Environmental Protection Agency under the Safe Drinking Water Act and those that are on the latest Contaminant Candidate List. For sediment, a total of 175 pesticide compounds were classified as Tier 1 and, thus, are high priority for inclusion in analytical methods available for monitoring and studies. More than 60 percent of these compounds are included in some USGS analytical method; however, some are spread across several research methods that are expensive to perform, and monitoring data are not extensive for many compounds. The remaining Tier 1 compounds for sediment are high priority as new analytes. The objective for analytical methods development for sediment is to enhance an existing analytical method that currently includes nearly half of the pesticide compounds in Tier 1 by adding as many additional Tier 1 compounds as are analytically compatible. About 35 percent of the Tier 1 compounds for sediment are high priority on the basis of measured occurrence. A total of 74 compounds, or 42 percent, are high priority on the basis of predicted likelihood of occurrence according to physical-chemical properties, and either have potential toxicity to aquatic life, high pesticide useage, or both. The remaining 22 percent of Tier 1 pesticide compounds were either degradates of Tier 1 parent compounds or included for other reasons. As with water, the Tier 1 pesticide compounds for sediment are distributed across the major pesticide-use groups; insecticides and their degradates are the largest fraction, making up 45 percent of Tier 1. In contrast to water, organochlorines, at 17 percent, are the largest chemical class for Tier 1 in sediment, which is to be expected because there is continued widespread detection in sediments of persistent organochlorine pesticides and their degradates at concentrations high enough for potential effects on aquatic life. Compared to water, there are fewer available benchmarks with which to compare contaminant concentrations in sediment, but a total of 19 Tier 1 compounds have at least one sediment benchmark or screening value for aquatic organisms. Of the 175 compounds in Tier 1, 77 percent have high aquatic-life toxicity, as defined for this process. This evaluation of pesticides and degradates resulted in two lists of compounds that are priorities for USGS analytical methods development, one for water and one for sediment. These lists will be used as the basis for redesigning and enhancing USGS analytical capabilities for pesticides in order to capture as many high-priority pesticide compounds as possible using an economically feasible approach.
Byskov, Jens; Bloch, Paul; Blystad, Astrid; Hurtig, Anna-Karin; Fylkesnes, Knut; Kamuzora, Peter; Kombe, Yeri; Kvåle, Gunnar; Marchal, Bruno; Martin, Douglas K; Michelo, Charles; Ndawi, Benedict; Ngulube, Thabale J; Nyamongo, Isaac; Olsen, Oystein E; Onyango-Ouma, Washington; Sandøy, Ingvild F; Shayo, Elizabeth H; Silwamba, Gavin; Songstad, Nils Gunnar; Tuba, Mary
2009-10-24
Despite multiple efforts to strengthen health systems in low and middle income countries, intended sustainable improvements in health outcomes have not been shown. To date most priority setting initiatives in health systems have mainly focused on technical approaches involving information derived from burden of disease statistics, cost effectiveness analysis, and published clinical trials. However, priority setting involves value-laden choices and these technical approaches do not equip decision-makers to address a broader range of relevant values - such as trust, equity, accountability and fairness - that are of concern to other partners and, not least, the populations concerned. A new focus for priority setting is needed.Accountability for Reasonableness (AFR) is an explicit ethical framework for legitimate and fair priority setting that provides guidance for decision-makers who must identify and consider the full range of relevant values. AFR consists of four conditions: i) relevance to the local setting, decided by agreed criteria; ii) publicizing priority-setting decisions and the reasons behind them; iii) the establishment of revisions/appeal mechanisms for challenging and revising decisions; iv) the provision of leadership to ensure that the first three conditions are met.REACT - "REsponse to ACcountable priority setting for Trust in health systems" is an EU-funded five-year intervention study started in 2006, which is testing the application and effects of the AFR approach in one district each in Kenya, Tanzania and Zambia. The objectives of REACT are to describe and evaluate district-level priority setting, to develop and implement improvement strategies guided by AFR and to measure their effect on quality, equity and trust indicators. Effects are monitored within selected disease and programme interventions and services and within human resources and health systems management. Qualitative and quantitative methods are being applied in an action research framework to examine the potential of AFR to support sustainable improvements to health systems performance.This paper reports on the project design and progress and argues that there is a high need for research into legitimate and fair priority setting to improve the knowledge base for achieving sustainable improvements in health outcomes.
The EPA Schools Chemical Cleanout Campaign (SC3) and How You Can Help
NASA Astrophysics Data System (ADS)
Phifer, Russell W.; Gmurczyk, Marta
2008-08-01
The U.S. Environmental Protection Agency (EPA) has historically not recognized chemical disposal in secondary schools as a priority. Considering that laboratory waste as a whole represents less than 0.1% of all hazardous waste, and secondary schools generate less than 1% of that volume, this makes perfect sense from a regulatory perspective. However, it is becoming increasingly obvious that many secondary schools and their local school districts struggle with chemical management. Chemical disposal is not a financial priority, and as a result unused and unneeded chemicals are frequently kept at schools. Often, that storage place is not well planned, chemicals are not secured, and accidents may occur. In addition, the expertise needed to effectively manage chemicals may not be available within the school system. The scope of this problem is extensive—EPA estimates there are at least 33,000 middle and high schools across the country with unnecessary or mismanaged chemicals, potentially affecting 21 million students nationwide. While there are certainly schools that manage chemicals properly, many schools have aging infrastructures, competing priorities, and a lack of resources available to direct towards chemical management.
Wallace, Lauren; Kapirir, Lydia
2017-04-08
To date, research on priority-setting for new vaccines has not adequately explored the influence of the global, national and sub-national levels of decision-making or contextual issues such as political pressure and stakeholder influence and power. Using Kapiriri and Martin's conceptual framework, this paper evaluates priority setting for new vaccines in Uganda at national and sub-national levels, and considers how global priorities can influence country priorities. This study focuses on 2 specific vaccines, the human papilloma virus (HPV) vaccine and the pneumococcal conjugate vaccine (PCV). This was a qualitative study that involved reviewing relevant Ugandan policy documents and media reports, as well as 54 key informant interviews at the global level and national and sub-national levels in Uganda. Kapiriri and Martin's conceptual framework was used to evaluate the prioritization process. Priority setting for PCV and HPV was conducted by the Ministry of Health (MoH), which is considered to be a legitimate institution. While respondents described the priority setting process for PCV process as transparent, participatory, and guided by explicit relevant criteria and evidence, the prioritization of HPV was thought to have been less transparent and less participatory. Respondents reported that neither process was based on an explicit priority setting framework nor did it involve adequate representation from the districts (program implementers) or publicity. The priority setting process for both PCV and HPV was negatively affected by the larger political and economic context, which contributed to weak institutional capacity as well as power imbalances between development assistance partners and the MoH. Priority setting in Uganda would be improved by strengthening institutional capacity and leadership and ensuring a transparent and participatory processes in which key stakeholders such as program implementers (the districts) and beneficiaries (the public) are involved. Kapiriri and Martin's framework has the potential to guide priority setting evaluation efforts, however, evaluation should be built into the priority setting process a priori such that information on priority setting is gathered throughout the implementation cycle. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
A systematic review of nursing research priorities on health system and services in the Americas.
Garcia, Alessandra Bassalobre; Cassiani, Silvia Helena De Bortoli; Reveiz, Ludovic
2015-03-01
To systematically review literature on priorities in nursing research on health systems and services in the Region of the Americas as a step toward developing a nursing research agenda that will advance the Regional Strategy for Universal Access to Health and Universal Health Coverage. This was a systematic review of the literature available from the following databases: Web of Science, PubMed, LILACS, and Google. Documents considered were published in 2008-2014; in English, Spanish, or Portuguese; and addressed the topic in the Region of the Americas. The documents selected had their priority-setting process evaluated according to the "nine common themes for good practice in health research priorities." A content analysis collected all study questions and topics, and sorted them by category and subcategory. Of 185 full-text articles/documents that were assessed for eligibility, 23 were selected: 12 were from peer-reviewed journals; 6 from nursing publications; 4 from Ministries of Health; and 1 from an international organization. Journal publications had stronger methodological rigor; the majority did not present a clear implementation or evaluation plan. After compiling the 444 documents' study questions and topics, the content analysis resulted in a document with 5 categories and 16 subcategories regarding nursing research priorities on health systems and services. Research priority-setting is a highly important process for health services improvement and resources optimization, but implementation and evaluation plans are rarely included. The resulting document will serve as basis for the development of a new nursing research agenda focused on health systems and services, and shaped to advance universal health coverage and universal access to health.
Patient and public engagement in priority setting: A systematic rapid review of the literature
Vandall-Walker, Virginia; Mason-Lai, Ping
2018-01-01
Background Current research suggests that while patients are becoming more engaged across the health delivery spectrum, this involvement occurs most often at the pre-preparation stage to identify ‘high-level’ priorities in health ecosystem priority setting, and at the preparation phase for health research. Objective The purpose of this systematic rapid review of the literature is to describe the evidence that does exist in relation to patient and public engagement priority setting in both health ecosystem and health research. Data sources HealthStar (via OVID); CINAHL; Proquest Databases; and Scholar’s Portal. Study eligibility criteria i) published in English; ii) published within the timeframe of 2007—Current (10 years) unless the report/article was formative in synthesizing key considerations of patient engagement in health ecosystem and health research priority setting; iii) conducted in Canada, the US, Europe, UK, Australia/New Zealand, or Scandinavian countries. Study appraisal and synthesis i) Is the research valid, sound, and applicable?; ii) what outcomes can we potentially expect if we implement the findings from this research?; iii) will the target population (i.e., health researchers and practitioners) be able to use this research?. A summary of findings from each of the respective processes was synthesized to highlight key information that would support decision-making for researchers when determining the best priority setting process to apply for their specific patient-oriented research. Results Seventy articles from the UK, US, Canada, Netherlands and Australia were selected for review. Results were organized into two tiers of public and patient engagement in prioritization: Tier 1—Deliberative and Tier 2—Consultative. Highly structured patient and public engagement planning activities include the James Lind Alliance Priority Setting Partnerships (UK), Dialogue Method (Netherlands), Global Evidence Mapping (Australia), and the Deep Inclusion Method/CHoosing All Together (US). Limitations The critical study limitations include challenges in comprehensively identifying the patient engagement literature for review, bias in article selection due to the identified scope, missed information due to a more limited use of exhaustive search strategies (e.g., in-depth hand searching), and the heterogeneity of reported study findings. Conclusion The four public and patient engagement priority setting processes identified were successful in setting priorities that are inclusive and objectively based, specific to the priorities of stakeholders engaged in the process. The processes were robust, strategic and aimed to promote equity in patient voices. Key limitations identified a lack of evaluation data on the success and extent in which patients were engaged. Issues pertaining to feasibility of stakeholder engagement, coordination, communication and limited resources were also considered. PMID:29499043
Jin, Meihua; Jung, Ji-Young; Lee, Jung-Ryun
2016-10-12
With the arrival of the era of Internet of Things (IoT), Wi-Fi Direct is becoming an emerging wireless technology that allows one to communicate through a direct connection between the mobile devices anytime, anywhere. In Wi-Fi Direct-based IoT networks, all devices are categorized by group of owner (GO) and client. Since portability is emphasized in Wi-Fi Direct devices, it is essential to control the energy consumption of a device very efficiently. In order to avoid unnecessary power consumed by GO, Wi-Fi Direct standard defines two power-saving methods: Opportunistic and Notice of Absence (NoA) power-saving methods. In this paper, we suggest an algorithm to enhance the energy efficiency of Wi-Fi Direct power-saving, considering the characteristics of multimedia video traffic. Proposed algorithm utilizes the statistical distribution for the size of video frames and adjusts the lengths of awake intervals in a beacon interval dynamically. In addition, considering the inter-dependency among video frames, the proposed algorithm ensures that a video frame having high priority is transmitted with higher probability than other frames having low priority. Simulation results show that the proposed method outperforms the traditional NoA method in terms of average delay and energy efficiency.
Jin, Meihua; Jung, Ji-Young; Lee, Jung-Ryun
2016-01-01
With the arrival of the era of Internet of Things (IoT), Wi-Fi Direct is becoming an emerging wireless technology that allows one to communicate through a direct connection between the mobile devices anytime, anywhere. In Wi-Fi Direct-based IoT networks, all devices are categorized by group of owner (GO) and client. Since portability is emphasized in Wi-Fi Direct devices, it is essential to control the energy consumption of a device very efficiently. In order to avoid unnecessary power consumed by GO, Wi-Fi Direct standard defines two power-saving methods: Opportunistic and Notice of Absence (NoA) power-saving methods. In this paper, we suggest an algorithm to enhance the energy efficiency of Wi-Fi Direct power-saving, considering the characteristics of multimedia video traffic. Proposed algorithm utilizes the statistical distribution for the size of video frames and adjusts the lengths of awake intervals in a beacon interval dynamically. In addition, considering the inter-dependency among video frames, the proposed algorithm ensures that a video frame having high priority is transmitted with higher probability than other frames having low priority. Simulation results show that the proposed method outperforms the traditional NoA method in terms of average delay and energy efficiency. PMID:27754315
Boucaud-Maitre, Denis; Altman, Jean-Jacques
2016-10-01
The Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have both implemented procedures in order to shorten review time for marketing authorizations with potential therapeutic added value, called priority review and accelerated assessment procedure, respectively. The aim of this study is to compare the new molecular entities (NME) assessed in shorter review time by both agencies and to investigate whether granting a shorter review time status subsequently predicts its therapeutic value attributed by a health technology assessment agency, the French Haute Autorité de Santé (HAS). All NME approved by the EMA and the FDA with a therapeutic added value between 2007 and June 30, 2015 were extracted. We assessed the sensibility, the positive predictive value, and the EMA review time. One hundred seventy-eight NME were approved by the FDA and the EMA and a therapeutic value was available for 160 NME. Eighty-eight (55.0 %) NME were on FDA priority review, 24 (15.0 %) on EMA accelerated procedure and 43 (26.9 %) were considered of high clinical added value. The sensibility was 86.0 % for the FDA and 30.2 % for the EMA. The positive predictive value was, respectively, 42.0 and 54.2 %. Twenty-five NME on FDA priority review and of high therapeutic added value were not on EMA accelerated assessment procedure, leading to a supplementary mean EMA review time of 146 days. The EMA was restrictive to grant a shorten review time status for products with therapeutic interest during the study period.
Mason, Helen; Baker, Rachel; Donaldson, Cam
2011-04-01
Health care budgets are finite and decisions must be made about which interventions to provide and, by implication, which will not be provided. The aim of this study was to investigate what features of health care interventions, including the type of health gain, are important to members of the public in England in making priority-setting decisions and to understand why. Q methodology was used with 52 members of the public in north east England. Respondents rank ordered 36 health care interventions from those they would give highest priority to through to those they would give lowest priority to. A form of factor analysis was used to reveal a small number of shared viewpoints. Five factors emerged: 'life saving to maximize the size of the health gain', 'everyone deserves a chance at life', '(potential for) own benefit', 'maximum benefit for (perceived) lowest cost' and 'quality of life and social responsibility'. There were different views about which interventions should be given priority. Respondents considered not only the type of health gain received from an intervention as important, but also the size of the health gain, who received the health gain and an individual's personal responsibility. Aspects other than health gain need to be considered when soliciting the public's views of priorities for health care interventions.
76 FR 17629 - Applications for New Awards; Transition to Teaching Grant Program
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-30
... teachers in high-need schools operated by high-need local educational agencies (LEAs), including charter schools that operate as high-need LEAs. Priorities: This notice contains two competitive preference... Preference Priorities: Competitive Preference Priority 1 is from section 2313(c) of the Elementary and...
Papers on the National Health Guidelines: The Priorities of Section 1502.
ERIC Educational Resources Information Center
Health Resources Administration (DHEW/PHS), Bethesda, MD.
This monograph brings together staff papers relating to the national guidelines for health planning called for by Section 1501 of the National Health Planning and Resources Development Act of 1974 (Public Law 93-641). The papers consider relationships between local plans and programs and ten health policies designated for priority consideration:…
Robert S. Motroni; Daniel A. Airola; Robin K. Ma rose; Nancy D. Tosta
1991-01-01
A geographic information system was used to assess wildlife species richness (number of species) in valley-foothill hardwood habitats throughout California to set priorities for conservation attention. Species richness values were assessed and compared using three methods: one that included all species without considering canopy cover conditions and species preferences...
Setting numerical population objectives for priority landbird species
Kenneth V. Rosenberg; Peter J. Blancher
2005-01-01
Following the example of the North American Waterfowl Management Plan, deriving numerical population estimates and conservation targets for priority landbird species is considered a desirable, if not necessary, element of the Partners in Flight planning process. Methodology for deriving such estimates remains in its infancy, however, and the use of numerical population...
Exploring Health Priorities for Young People Leaving Care
ERIC Educational Resources Information Center
Matthews, Susan; Sykes, Susie
2012-01-01
Care-leavers are considered amongst the most vulnerable and disadvantaged group of young people with worse health outcomes than their peers. However, there is limited evidence to suggest how this can be improved, particularly from the perspective of the young people themselves. The aim of this study was to explore the health priorities of young…
77 FR 23690 - Applications for New Awards; Promise Neighborhoods Program-Planning Grant Competition
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-20
... (prohibiting discrimination on the basis of race, color, or national origin); Section 504 of the Rehabilitation... Department will review and award points only for a maximum of two of the competitive preference priorities... the two priorities it wishes the Department to consider for purposes of earning the competitive...
The Relationship of Leadership Qualities to Wisconsin School Superintendent Hiring Practices
ERIC Educational Resources Information Center
VerDuin, Joel A.
2011-01-01
The purpose of this study was to examine the relationship between school board hiring practices and specific leadership behaviors. The current priority of educational leaders is often spoken of in terms of accountability for student achievement. This study considered the priority of educational improvement, and examined hiring practices using five…
Vision-related research priorities and how to finance them.
McCarty, Catherine A
2012-01-01
A number of organizations have employed a consultative process with the vision community to engage relevant parties in identifying needs and opportunities for vision research. The National Eye Institute in the US and the European Commission are currently undergoing consultation to develop priorities for vision research. Once these priorities have been established, the challenge will be to identify the resources to advance these research agendas. Success rates for Federal funding for research have decreased recently in the USA, UK, and Australia. Researchers should consider various potential funding sources for their research. The universal consideration for funding is that the reason for funding should align with the mission of the funding organization. In addition to Federal research organizations that fund investigator-initiated research, other potential funding sources include nongovernmental organizations, for-profit companies, individual philanthropy, and service organizations. In addition to aligning with organizational funding priorities, researchers need to consider turn-around time and total funds available including whether an organization will cover institutional indirect costs. Websites are useful tools to find information about organizations that fund research, including grant deadlines. Collaboration is encouraged.
Vision-related research priorities and how to finance them
McCarty, Catherine A
2012-01-01
A number of organizations have employed a consultative process with the vision community to engage relevant parties in identifying needs and opportunities for vision research. The National Eye Institute in the US and the European Commission are currently undergoing consultation to develop priorities for vision research. Once these priorities have been established, the challenge will be to identify the resources to advance these research agendas. Success rates for Federal funding for research have decreased recently in the USA, UK, and Australia. Researchers should consider various potential funding sources for their research. The universal consideration for funding is that the reason for funding should align with the mission of the funding organization. In addition to Federal research organizations that fund investigator-initiated research, other potential funding sources include nongovernmental organizations, for-profit companies, individual philanthropy, and service organizations. In addition to aligning with organizational funding priorities, researchers need to consider turn-around time and total funds available including whether an organization will cover institutional indirect costs. Websites are useful tools to find information about organizations that fund research, including grant deadlines. Collaboration is encouraged. PMID:22944760
Development of maintenance composite priority index for buildings in Palestine: A pilot case study
NASA Astrophysics Data System (ADS)
Issa, Amjad; Awad, Riyad
2017-11-01
The current building maintenance practices in Palestine are not based on scientific systematic methods. Most of the municipalities use one criterion to define the maintenance priorities, which is the "worst-first" criterion. Therefore, the current practices in defining buildings maintenance plans are not dealing with the known phases that are generally followed, including those in establishing building inventories, building condition survey, detailed visual inspection, identification of the proper maintenance and rehabilitation measures, and setting priorities. Accordingly, the recent preparation of the Operation and Maintenance (O&M) Manual for Palestinian municipalities is an important step to guide them towards preparing and implementing their O&M priority-based plans, considering scare resources. During the course of preparation of the Manual, the proposed procedures were applied at ten pilot municipalities. This study aims to explore the outcome of the implementation of the 2014/2015 O&M buildings maintenance priorities at these municipalities through the development of maintenance composite priority index (PI). The new proposed priority index is a scientific tool that will identify the priority of maintenance buildings through using a systematic procedure instead of first worst one. To achieve this, analyses of the outcome of a questionnaire designed to collect relevant information from these municipalities was conducted. The maintenance priority index for buildings is calculated considering different indicators among them building status (condition), classification and importance of the building, number of beneficiaries (users), safety aspects (severity level in the building), and people complaints. The main component of the PI is the building condition index (BCI) which forms about 40% of the total weight. The physical inspection, which is the main input for calculating the BCI, is conducted on two levels; the primary level, and the secondary level. The buildings are ranked in descending order based on the PI values for each public building. The buildings that have the highest values of PI take the most priority till the specified asset maintenance budget for the targeted year is achieved. Finally, the results indicate that most of the maintenance works are funded by municipalities own budgets and not by the government.
Multiple Smaller Missions as a Direct Pathway to Mars Sample Return
NASA Technical Reports Server (NTRS)
Niles, P. B.; Draper, D. S.; Evans, C. A.; Gibson, E. K.; Graham, L. D.; Jones, J. H.; Lederer, S. M.; Ming, D.; Seaman, C. H.; Archer, P. D.;
2012-01-01
Recent discoveries by the Mars Exploration Rovers, Mars Express, Mars Odyssey, and Mars Reconnaissance Orbiter spacecraft include multiple, tantalizing astrobiological targets representing both past and present environments on Mars. The most desirable path to Mars Sample Return (MSR) would be to collect and return samples from that site which provides the clearest examples of the variety of rock types considered a high priority for sample return (pristine igneous, sedimentary, and hydrothermal). Here we propose an MSR architecture in which the next steps (potentially launched in 2018) would entail a series of smaller missions, including caching, to multiple landing sites to verify the presence of high priority sample return targets through in situ analyses. This alternative architecture to one flagship-class sample caching mission to a single site would preserve a direct path to MSR as stipulated by the Planetary Decadal Survey, while permitting investigation of diverse deposit types and providing comparison of the site of returned samples to other aqueous environments on early Mars
Engineering Specifications derived from Science Requirements
NASA Technical Reports Server (NTRS)
Stahl, H. Philip; Arnold, William; Bevan, Ryan M.; Smith, W. Scott; Kirk, Charles S.; Postman, Marc
2013-01-01
Advanced Mirror Technology Development (AMTD) is a multi-year effort to systematically mature to TRL-6 the critical technologies needed to produce 4-m or larger flight-qualified UVOIR mirrors by 2018 so that a viable mission can be considered by the 2020 Decadal Review. This technology must enable missions capable of both general astrophysics & ultra-high contrast observations of exoplanets. To accomplish our objective, we use a science-driven systems engineering approach. We mature technologies required to enable the highest priority science AND result in a high-performance low-cost low-risk system.
Sex-related knowledge, attitudes, and behaviors of U.S. medical students.
Frank, Erica; Coughlin, Steven S; Elon, Lisa
2008-08-01
To understand the personal and clinical safe-sex-related knowledge, attitudes, and practices of U.S. medical students. Sixteen medical schools were selected to survey the class of 2003 based on their characteristics similar to the national average. Students were surveyed at freshman orientation, at entrance to wards, and during their senior year. The primary personal outcome was the response to the question, "Are you currently trying to practice safe sex when sexually involved? (no, not applicable/no, not trying/yes, low priority/yes, high priority)." The primary professional outcomes were answers to: 1) "How relevant do you think talking to patients about safe sex will be in your intended practice? (not at all/somewhat/highly)," and 2) "With a typical general medicine patient, how often do you actually talk about safe sex? (never-rarely/sometimes/usually-always)." A total of 2,316 students provided data, and the response rate was 80%. Personally practicing safe-sex habits was a high priority for 75% of the sexually active, single medical students, especially for women, African Americans, and those earlier in their medical education. Among seniors, 41% reported extensive training in discussing safe sex with patients, and 57% were highly confident about conducting such discussions. Overall, 55% of students believed it would be highly relevant to counsel patients about safe sex (59% of freshmen, 62% of those at entry to wards, and 41% of seniors); 73% answered all four true/false questions on human papillomavirus correctly. About half of U.S. medical students believed that counseling their patients about safe sex will not be highly relevant to their practice. These findings should be considered by those trying to interest a new generation of physicians in helping patients have safe-sex practices.
Voigt, Isabel; Wrede, Jennifer; Diederichs-Egidi, Heike; Dierks, Marie-Luise; Junius-Walker, Ulrike
2010-12-01
To ascertain health priorities of older patients and treatment priorities of their general practitioners (GP) on the basis of a geriatric assessment and to determine the agreement between these priorities. The study included a sample of 9 general practitioners in Hannover, Germany, and a stratified sample of 35 patients (2-5 patients per practice, 18 female, average age 77.7 years). Patients were given a geriatric assessment using the Standardized Assessment for Elderly Patients in Primary Care (STEP) to gain an overview of their health and everyday problems. On the basis of these results, patients and their physicians independently rated the importance of each problem disclosed by the assessment. Whereas patients assessed the importance for their everyday lives, physicians assessed the importance for patients' medical care and patients' everyday lives. Each patient had a mean ± standard deviation of 18 ± 9.2 health problems. Thirty five patients disclosed a total of 634 problems; 537 (85%) were rated by patients and physicians. Of these 537 problems, 332 (62%) were rated by patients and 334 (62%) by physicians as important for patients' everyday lives. In addition, 294 (55%) were rated by physicians as important for patients' medical care. Although these proportions of important problems were similar between patients and physicians, there was little overlap in the specific problems that each group considered important. The chance-corrected agreement (Cohen κ) between patients and physicians on the importance of problems for patients' lives was low (κ=0.23). Likewise, patients and physicians disagreed on the problems that physicians considered important for patients' medical care (κ=0.18, P<0.001 for each). The low agreement on health and treatment priorities between patients and physicians necessitates better communication between the two parties to strengthen mutual understanding.
The EEOC charge priority policy and claimants with psychiatric disabilities.
Ullman, M D; Johnsen, M C; Moss, K; Burris, S
2001-05-01
In June 1995 the U.S. Equal Employment Opportunity Commission (EEOC) instituted a new charge priority policy. Under the new policy, charges are classified as one of three priority levels during or immediately after intake. Only charges assigned a high priority receive a full investigation. This paper examines the effect of the charge priority policy on individuals with psychiatric disabilities who filed Americans With Disabilities Act (ADA) charges with the EEOC. Using data extracted from the EEOC's charge data system, the authors analyzed all 66,298 ADA claims prioritized and closed between June 1995 and March 1998. The z test for difference in proportions and the generalized estimating equations procedure were used. The primary outcome measure was the priority assignment received by ADA claimants. Charges that received a high priority assignment were more likely to result in benefits for claimants. Charges filed by claimants with psychiatric disabilities were significantly less likely to be assigned a high priority than charges filed by other claimants. Claimants with psychiatric disabilities were also significantly less likely to benefit from their claims. The strong relationship between being assigned high priority and receiving benefits as a result of filing a charge demonstrates the importance of accurate priority categorization. The finding that people with psychiatric disabilities are less likely than others to benefit from their claims is cause for concern, particularly given the fact that the accuracy of the charge prioritization system has not been validated.
Sanchez, Katherine; Papelard, Agathe; Nguyen, Christelle; Bendeddouche, Imad; Jousse, Marylène; Rannou, François; Revel, Michel; Poiraudeau, Serge
2011-01-01
Objective To assess the sensitivity to change of the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR) in chronic low back pain (CLBP) and shifts in patients' priorities of disabling activities over time. Methods A prospective longitudinal survey of 100 patients (38 males) with CLBP in a tertiary care teaching hospital. Evaluation at baseline and 6 months by the MACTAR, Quebec Back Pain Disability Questionnaire (QUEBEC), Hospital Anxiety and Depression scale (HAD), Fear-Avoidance Beliefs Questionnaire (FABQ), Coping Strategies Questionnaire (CSQ), and pain and handicap visual analogue scales (VASs). Patients' perceived improvement or worsening of condition was assessed at 6 months. Effect size (ES) and Standardized response mean (SRM) and effect size (ES) were used to evaluate sensitivity to change of the MACTAR. Results The MACTAR SRM and ES values (SRM = 0.25; ES = 0.37) were among the highest for the instruments evaluated. For patients considering their condition as improved, the SRM was 0.66 and the ES 1. The 3 disability domains, classified by the International Classification of Functioning, Disability and Health (ICF), most often cited as priorities at baseline remained the most cited at follow-up: mobility (40.9% of patients); community, social and civic life (22.7%); and domestic life (22.4%). At 6 months, 48 patients shifted their priorities, for a decrease in MACTAR SRM and ES values for patients considering their condition improved and an increase in these values for those considering their condition deteriorated. Conclusions Although the MACTAR has similar sensitivity to change as other outcome measures widely used in CLBP, shifts in patient priorities over time are common and influence scores and sensitivity to change. PMID:21629777
Roller, Sarah; Pippins, Raqiyyah
2010-01-01
Over the past decade, the liability risks associated with food and beverage product marketing have increased significantly, particularly with respect to nutrition and health-related product benefit claims. FDA and FTC enforcement priorities appear to have contributed to the increasing liability trends that are associated with these nutrition and health-related claims. This article examines key enforcement and litigation developments involving conventional food and beverage product marketing claims during the first 18 months of President Obama's administration: Part I considers FDA enforcement priorities and recent warning letters; Part II considers FTC enforcement priorities, warning letters, and consent orders; and Part III considers the relationship between FDA and FTC enforcement priorities and recent false advertising cases brought by private parties challenging nutrition and health-related marketing claims for food and beverage products. The article makes recommendations concerning ways in which food and beverage companies can help minimize liability risks associated with health-related marketing claims. In addition, the article suggests that federal policy reforms may be required to counter the perverse chilling effects current food liability trends appear to be having on health-related marketing claims for food and beverage products, and proposes a number of specific reforms that would help encourage the responsible use of well-substantiated marketing claims that can help foster healthy dietary practices. In view of the obesity prevention and other diet-related public health priorities of the Obama administration, the article suggests that this is an opportune time to address the apparent chilling effects increasing food liability risks are having on nutrition and health-related marketing claims for healthy food and beverage products, and potential adverse consequences for public health.
Learning to Love the Motherland: Educating Tibetans in China
ERIC Educational Resources Information Center
Bass, Catriona
2005-01-01
A major goal of education for Tibetans, as for all China's "minority nationalities", has been to encourage patriotism towards China and to foster a sense of nationhood. This paper considers the ways in which this priority has conditioned the schooling of Tibetans since 1950. Although this priority is unchanging, the paper looks at how it…
Metcalfe, Leanne; O’Donoghue, Katriona; Ball, Simon T.; Beale, Angela; Beale, William; Hilton, Rachel; Hodkinson, Keith; Lipkin, Graham W.; Loud, Fiona; Marson, Lorna P.; Morris, Peter J.
2016-01-01
Background It has been suggested that the research priorities of those funding and performing research in transplantation may differ from those of end service users such as patients, carers and healthcare professionals involved in day-to-day care. The Kidney Transplant Priority Setting Partnership (PSP) was established with the aim of involving all stakeholders in prioritising future research in the field. Methods The PSP methodology is as outlined by the James Lind Alliance. An initial survey collected unanswered research questions from patients, carers and clinicians. Duplicate and out-of-scope topics were excluded and the existing literature searched to identify topics answered by current evidence. An interim prioritisation survey asked patients and professionals to score the importance of the remaining questions to create a ranked long-list. These were considered at a final consensus workshop using a modified nominal group technique to agree a final top ten. Results The initial survey identified 497 questions from 183 respondents, covering all aspects of transplantation from assessment through to long-term follow-up. These were grouped into 90 unanswered “indicative” questions. The interim prioritisation survey received 256 responses (34.8% patients/carers, 10.9% donors and 54.3% professionals), resulting in a ranked list of 25 questions that were considered during the final workshop. Participants agreed a top ten priorities for future research that included optimisation of immunosuppression (improved monitoring, choice of regimen, personalisation), prevention of sensitisation and transplanting the sensitised patient, management of antibody-mediated rejection, long-term risks to live donors, methods of organ preservation, induction of tolerance and bioengineering of organs. There was evidence that patient and carer involvement had a significant impact on shaping the final priorities. Conclusions The final list of priorities relates to all stages of the transplant process, including access to transplantation, living donation, organ preservation, post-transplant care and management of the failing transplant. This list of priorities will provide an invaluable resource for researchers and funders to direct future activity. PMID:27776143
Knight, Simon R; Metcalfe, Leanne; O'Donoghue, Katriona; Ball, Simon T; Beale, Angela; Beale, William; Hilton, Rachel; Hodkinson, Keith; Lipkin, Graham W; Loud, Fiona; Marson, Lorna P; Morris, Peter J
2016-01-01
It has been suggested that the research priorities of those funding and performing research in transplantation may differ from those of end service users such as patients, carers and healthcare professionals involved in day-to-day care. The Kidney Transplant Priority Setting Partnership (PSP) was established with the aim of involving all stakeholders in prioritising future research in the field. The PSP methodology is as outlined by the James Lind Alliance. An initial survey collected unanswered research questions from patients, carers and clinicians. Duplicate and out-of-scope topics were excluded and the existing literature searched to identify topics answered by current evidence. An interim prioritisation survey asked patients and professionals to score the importance of the remaining questions to create a ranked long-list. These were considered at a final consensus workshop using a modified nominal group technique to agree a final top ten. The initial survey identified 497 questions from 183 respondents, covering all aspects of transplantation from assessment through to long-term follow-up. These were grouped into 90 unanswered "indicative" questions. The interim prioritisation survey received 256 responses (34.8% patients/carers, 10.9% donors and 54.3% professionals), resulting in a ranked list of 25 questions that were considered during the final workshop. Participants agreed a top ten priorities for future research that included optimisation of immunosuppression (improved monitoring, choice of regimen, personalisation), prevention of sensitisation and transplanting the sensitised patient, management of antibody-mediated rejection, long-term risks to live donors, methods of organ preservation, induction of tolerance and bioengineering of organs. There was evidence that patient and carer involvement had a significant impact on shaping the final priorities. The final list of priorities relates to all stages of the transplant process, including access to transplantation, living donation, organ preservation, post-transplant care and management of the failing transplant. This list of priorities will provide an invaluable resource for researchers and funders to direct future activity.
Communicating laboratory results through a Web site: Patients' priorities and viewpoints.
Sabahi, Azam; Ahmadian, Leila; Mirzaee, Moghademeh
2018-02-28
Patients can access laboratory results using various technologies. The aim of this study was to integrate the laboratory results into the hospital Web site based on patients' viewpoints and priorities and to measure patients' satisfaction. This descriptive-analytical study was conducted in 2015. First, a questionnaire was distributed among 200 patients to assess patients' priorities to receive laboratory results through the Web site. Second, those who agreed (n = 95) to receive their laboratory results through the Web site were identified. Then, the required changes were made to the hospital Web site based on patients' viewpoints and priorities. Third, patients were divided into two groups. The first group received their laboratory results through the Web site on the date had been announced during their visit to the laboratory. The second group was informed by SMS once their results were shown on the Web site. After receiving laboratory results, patients' satisfaction was evaluated. More than half of the participants (n = 53, 55.8%) were highly satisfied with receiving the results electronically. The higher number of people in SMS group (n = 9, 20.9%) reported that they were satisfied with time-saving compared to other group (n = 2, 3.8%) (P = .04). Participants after receiving the results through the Web site considered the functionalities of reprinting (P < .0001) and timeliness (P = .017) more important. Integrating laboratory results into the hospital Web site based on the patients' viewpoints and priorities can improve patient satisfaction and lower the patients' concern regarding confidentiality of their results. © 2018 Wiley Periodicals, Inc.
Research priorities for specialized nursing practice in the United Arab Emirates.
Al-Yateem, N; Al-Tamimi, M; Brenner, M; Altawil, H; Ahmad, A; Brownie, S
2017-08-25
Globally, nurses are undertaking expanded and more specialized roles in healthcare planning and service delivery in response to changing patterns and levels of health service demand. This means the nursing profession is increasingly considered as leaders in health service policy, research and practice. The United Arab Emirates has strengthened nursing governance and practice by establishing a Nursing and Midwifery Council and increasing the activity of nursing specialization, service leadership and research. This study aimed to identify clinically relevant research priorities to facilitate nursing contributions to evidence-based care and strengthening health services in the country. A two-stage Delphi study design was used. The first round involved 783 participants. The second round involved 1116 participants, as more clinical settings were accessed. In total, 58 research priorities across a variety of nursing specialties (paediatrics, emergency care, intensive care, labour and maternity care, operating theatre and long-term care) were identified as highly important. These identified priorities will guide a more informed programme of research in each nursing specialty, with the aim of strengthening the evidence base to improving outcomes for patients and their families in the United Arab Emirates. The findings provide guidance on key areas for nurses to focus research contributions to enhance evidence-based care and strengthen health systems. The identified priorities may also guide researchers in academic institutions to conduct research informed by current, clinically relevant issues. The findings may help inform funders and policymakers to support allocation of funding to research that has potential to contribute to enhancing nursing care in specialist areas. © 2017 International Council of Nurses.
Cornu, Pieter; Phansalkar, Shobha; Seger, Diane L; Cho, Insook; Pontefract, Sarah; Robertson, Alexandra; Bates, David W; Slight, Sarah P
2018-03-01
To investigate whether alert warnings for high-priority and low-priority drug-drug interactions (DDIs) were present in five international electronic health record (EHR) systems, to compare and contrast the severity level assigned to them, and to establish the proportion of alerts that were overridden. We conducted a comparative, retrospective, multinational study using a convenience sample of 5 EHRs from the U.S., U.K., Republic of Korea and Belgium. Of the 15 previously defined, high-priority, class-based DDIs, alert warnings were found to exist for 11 in both the Korean and UK systems, 9 in the Belgian system, and all 15 in the two US systems. The specific combinations that were included in these class-based DDIs varied considerably in number, type and level of severity amongst systems. Alerts were only active for 8.4% (52/619) and 52.4% (111/212) of the specific drug-drug combinations contained in the Belgian and UK systems, respectively. Hard stops (not possible to override) existed in the US and UK systems only. The override rates for high-priority alerts requiring provider action ranged from 56.7% to 83.3%. Of the 33 previously defined low-priority DDIs, active alerts existed only in the US systems, for three class-based DDIs. The majority were non-interruptive. Alert warnings existed for most of the high-priority DDIs in the different EHRs but overriding them was easy in most of the systems. In addition to validating the high- and low-priority DDIs, this study reported a lack of standardization in DDI levels across different international knowledge bases. Copyright © 2017. Published by Elsevier B.V.
NASA Astrophysics Data System (ADS)
Sutrisno, Agung; Gunawan, Indra; Vanany, Iwan
2017-11-01
In spite of being integral part in risk - based quality improvement effort, studies improving quality of selection of corrective action priority using FMEA technique are still limited in literature. If any, none is considering robustness and risk in selecting competing improvement initiatives. This study proposed a theoretical model to select risk - based competing corrective action by considering robustness and risk of competing corrective actions. We incorporated the principle of robust design in counting the preference score among corrective action candidates. Along with considering cost and benefit of competing corrective actions, we also incorporate the risk and robustness of corrective actions. An example is provided to represent the applicability of the proposed model.
McKenzie, Emily; Potestio, Melissa L; Boyd, Jamie M; Niven, Daniel J; Brundin-Mather, Rebecca; Bagshaw, Sean M; Stelfox, Henry T
2017-12-01
Providers have traditionally established priorities for quality improvement; however, patients and their family members have recently become involved in priority setting. Little is known about how to reconcile priorities of different stakeholder groups into a single prioritized list that is actionable for organizations. To describe the decision-making process for establishing consensus used by a diverse panel of stakeholders to reconcile two sets of quality improvement priorities (provider/decision maker priorities n=9; patient/family priorities n=19) into a single prioritized list. We employed a modified Delphi process with a diverse group of panellists to reconcile priorities for improving care of critically ill patients in the intensive care unit (ICU). Proceedings were audio-recorded, transcribed and analysed using qualitative content analysis to explore the decision-making process for establishing consensus. Nine panellists including three providers, three decision makers and three family members of previously critically ill patients. Panellists rated and revised 28 priorities over three rounds of review and reached consensus on the "Top 5" priorities for quality improvement: transition of patient care from ICU to hospital ward; family presence and effective communication; delirium screening and management; early mobilization; and transition of patient care between ICU providers. Four themes were identified as important for establishing consensus: storytelling (sharing personal experiences), amalgamating priorities (negotiating priority scope), considering evaluation criteria and having a priority champion. Our study demonstrates the feasibility of incorporating families of patients into a multistakeholder prioritization exercise. The approach described can be used to guide consensus building and reconcile priorities of diverse stakeholder groups. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.
Research priorities in Italian diabetes nursing care: findings from a Delphi study.
Palese, A; Gentilini, S; Lo Grasso, G; Branca, M T; Chiandetti, R; Mansutti, I
2015-01-01
Defining a set of research priorities for diabetes nursing care in the Italian context. A two-step study design based on a modified Delphi technique was undertaken in 2013. In the first stage of research, five systematic reviews of literature were performed. Among them 865 recommendations in diabetes nursing care emerged, and 217 (25.1%) were categorized at level IV or lower, thus based on a lack of knowledge and therefore a potential research area. Homogeneous recommendations among the 217 emerged and were categorized by two researchers independently: 96 final recommendations were identified and transformed into items embodied into a questionnaire. A Likert scale ranging from 1 (very low) to 5 (very high) was used to collect the consensus regarding priority. For that purpose a sample of 200 nurses was randomly considered. Potential participants were invited to cooperate via email through a letter reporting aims and methods. In the first round 85 nurses participated; in the third and final round, only 13 nurses took part. Participants have identified 14 research priorities categorized into three main areas: 1) education strategies' effectiveness (n=7); 2) models of care delivery and advanced nursing education effectiveness (n=4); and 3) in specific clinical issues (n=3). More research on patient education and on models of care delivery and advanced nursing education should be included in any future Italian agenda.
Failure Mode and Effect Analysis for Delivery of Lung Stereotactic Body Radiation Therapy
DOE Office of Scientific and Technical Information (OSTI.GOV)
Perks, Julian R., E-mail: julian.perks@ucdmc.ucdavis.edu; Stanic, Sinisa; Stern, Robin L.
2012-07-15
Purpose: To improve the quality and safety of our practice of stereotactic body radiation therapy (SBRT), we analyzed the process following the failure mode and effects analysis (FMEA) method. Methods: The FMEA was performed by a multidisciplinary team. For each step in the SBRT delivery process, a potential failure occurrence was derived and three factors were assessed: the probability of each occurrence, the severity if the event occurs, and the probability of detection by the treatment team. A rank of 1 to 10 was assigned to each factor, and then the multiplied ranks yielded the relative risks (risk priority numbers).more » The failure modes with the highest risk priority numbers were then considered to implement process improvement measures. Results: A total of 28 occurrences were derived, of which nine events scored with significantly high risk priority numbers. The risk priority numbers of the highest ranked events ranged from 20 to 80. These included transcription errors of the stereotactic coordinates and machine failures. Conclusion: Several areas of our SBRT delivery were reconsidered in terms of process improvement, and safety measures, including treatment checklists and a surgical time-out, were added for our practice of gantry-based image-guided SBRT. This study serves as a guide for other users of SBRT to perform FMEA of their own practice.« less
Zhang, Bo; Cohen, Joanna E; OʼConnor, Shawn
2014-01-01
Selection of priority groups is important for health interventions. However, no quantitative method has been developed. To develop a quantitative method to support the process of selecting priority groups for public health interventions based on both high risk and population health burden. Secondary data analysis of the 2010 Canadian Community Health Survey. Canadian population. Survey respondents. We identified priority groups for 3 diseases: heart disease, stroke, and chronic lower respiratory diseases. Three measures--prevalence, population counts, and adjusted odds ratios (OR)--were calculated for subpopulations (sociodemographic characteristics and other risk factors). A Priority Group Index (PGI) was calculated by summing the rank scores of these 3 measures. Of the 30 priority groups identified by the PGI (10 for each of the 3 disease outcomes), 7 were identified on the basis of high prevalence only, 5 based on population count only, 3 based on high OR only, and the remainder based on combinations of these. The identified priority groups were all in line with the literature as risk factors for the 3 diseases, such as elderly people for heart disease and stroke and those with low income for chronic lower respiratory diseases. The PGI was thus able to balance both high risk and population burden approaches in selecting priority groups, and thus it would address health inequities as well as disease burden in the overall population. The PGI is a quantitative method to select priority groups for public health interventions; it has the potential to enhance the effective use of limited public resources.
Vulnerability of ecosystems to climate change moderated by habitat intactness.
Eigenbrod, Felix; Gonzalez, Patrick; Dash, Jadunandan; Steyl, Ilse
2015-01-01
The combined effects of climate change and habitat loss represent a major threat to species and ecosystems around the world. Here, we analyse the vulnerability of ecosystems to climate change based on current levels of habitat intactness and vulnerability to biome shifts, using multiple measures of habitat intactness at two spatial scales. We show that the global extent of refugia depends highly on the definition of habitat intactness and spatial scale of the analysis of intactness. Globally, 28% of terrestrial vegetated area can be considered refugia if all natural vegetated land cover is considered. This, however, drops to 17% if only areas that are at least 50% wilderness at a scale of 48×48 km are considered and to 10% if only areas that are at least 50% wilderness at a scale of 4.8×4.8 km are considered. Our results suggest that, in regions where relatively large, intact wilderness areas remain (e.g. Africa, Australia, boreal regions, South America), conservation of the remaining large-scale refugia is the priority. In human-dominated landscapes, (e.g. most of Europe, much of North America and Southeast Asia), focusing on finer scale refugia is a priority because large-scale wilderness refugia simply no longer exist. Action to conserve such refugia is particularly urgent since only 1 to 2% of global terrestrial vegetated area is classified as refugia and at least 50% covered by the global protected area network. © 2014 John Wiley & Sons Ltd.
Clavisi, Ornella; Bragge, Peter; Tavender, Emma; Turner, Tari; Gruen, Russell L
2013-05-01
We present a multistep process for identifying priority research areas in rehabilitation and long-term care of traumatic brain-injured (TBI) patients. In particular, we aimed to (1) identify which stakeholders should be involved; (2) identify what methods are appropriate; (3) examine different criteria for the generation of research priority areas; and (4) test the feasibility of linkage and exchange among researchers, decision makers, and other potential users of the research. Potential research questions were identified and developed using an initial scoping meeting and preliminary literature search, followed by a facilitated mapping workshop and an online survey. Identified research questions were then prioritized against specific criteria (clinical importance, novelty, and controversy). Existing evidence was then mapped to the high-priority questions using usual processes for search, screening, and selection. A broad range of stakeholders were then brought together at a forum to identify priority research themes for future research investment. Using clinical and research leaders, smaller targeted planning workshops prioritized specific research projects for each of the identified themes. Twenty-six specific questions about TBI rehabilitation were generated, 14 of which were high priority. No one method identified all high-priority questions. Methods that relied solely on the views of clinicians and researchers identified fewer high-priority questions compared with methods that used broader stakeholder engagement. Evidence maps of these high-priority questions yielded a number of evidence gaps. Priority questions and evidence maps were then used to inform a research forum, which identified 12 priority themes for future research. Our research demonstrates the value of a multistep and multimethod process involving many different types of stakeholders for prioritizing research to improve the rehabilitation outcomes of people who have suffered TBI. Enhancing stakeholder representation can be augmented using a combination of methods and a process of linkage and exchange. This process can inform decisions about prioritization of research areas. Copyright © 2013 Elsevier Inc. All rights reserved.
7 CFR 4279.155 - Loan priorities.
Code of Federal Regulations, 2010 CFR
2010-01-01
... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... the maximum allowable for a loan of its size (5 points). (5) High impact business investment priorities. The priority score for high impact business investment will be the total score for the following...
The badness of death and priorities in health.
Solberg, Carl Tollef; Gamlund, Espen
2016-04-14
The state of the world is one with scarce medical resources where longevity is not equally distributed. Given such facts, setting priorities in health entails making difficult yet unavoidable decisions about which lives to save. The business of saving lives works on the assumption that longevity is valuable and that an early death is worse than a late death. There is a vast literature on health priorities and badness of death, separately. Surprisingly, there has been little cross-fertilisation between the academic fields of priority setting and badness of death. Our aim is to connect philosophical discussions on the badness of death to contemporary debates in health priorities. Two questions regarding death are especially relevant to health priorities. The first question is why death is bad. Death is clearly bad for others, such as family, friends and society. Many philosophers also argue that death can be bad for those who die. This distinction is important for health priorities, because it concerns our fundamental reasons for saving lives. The second question is, 'When is the worst time to die?' A premature death is commonly considered worse than a late death. Thus, the number of good life years lost seems to matter to the badness of death. Concerning young individuals, some think the death of infants is worse than the death of adolescents, while others have contrary intuitions. Our claim is that to prioritise between age groups, we must consider the question of when it is worst to die. Deprivationism provides a more plausible approach to health priorities than Epicureanism. If Deprivationism is accepted, we will have a firmer basis for claiming that individuals, in addition to having a health loss caused by morbidity, will have a loss of good life years due to mortality. Additionally, Deprivationism highlights the importance of age and values for health priorities. Regarding age, both variants of Deprivationism imply that stillbirths are included in the Global Burden of Disease. Finally, we suggest that the Time-Relative Interest Account may serve as an alternative to the discounting and age weighting previously applied in the Global Burden of Disease.
Methodological Quality of National Guidelines for Pediatric Inpatient Conditions
Hester, Gabrielle; Nelson, Katherine; Mahant, Sanjay; Eresuma, Emily; Keren, Ron; Srivastava, Rajendu
2014-01-01
Background Guidelines help inform standardization of care for quality improvement (QI). The Pediatric Research in Inpatient Settings (PRIS) network published a prioritization list of inpatient conditions with high prevalence, cost, and variation in resource utilization across children’s hospitals. The methodological quality of guidelines for priority conditions is unknown. Objective To rate the methodological quality of national guidelines for 20 priority pediatric inpatient conditions. Design We searched sources including PubMed for national guidelines published 2002–2012. Guidelines specific to one organism, test or treatment, or institution were excluded. Guidelines were rated by two raters using a validated tool (AGREE II) with an overall rating on a 7-point scale (7–highest). Inter-rater reliability was measured with a weighted kappa coefficient. Results 17 guidelines met inclusion criteria for 13 conditions, 7 conditions yielded no relevant national guidelines. The highest methodological quality guidelines were for asthma, tonsillectomy, and bronchiolitis (mean overall rating 7, 6.5 and 6.5 respectively); the lowest were for sickle cell disease (2 guidelines) and dental caries (mean overall rating 4, 3.5, and 3 respectively). The overall weighted kappa was 0.83 (95% confidence interval 0.78–0.87). Conclusions We identified a group of moderate to high methodological quality national guidelines for priority pediatric inpatient conditions. Hospitals should consider these guidelines to inform QI initiatives. PMID:24677729
Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People.
Simopoulos, Artemis P; Bourne, Peter G; Faergeman, Ole
2013-03-01
The Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People is the result of the meeting held at the Rockefeller Foundation Bellagio Center in Lake Como, Italy 30 October-1 November, 2012. The meeting was science-based but policy-oriented. The role and amount of healthy and unhealthy fats, with attention to the relative content of omega-3 and omega-6 fatty acids, sugar, and particularly fructose in foods that may underlie the epidemics of non-communicable diseases (NCDs) worldwide were extensively discussed. The report concludes that sugar consumption, especially in the form of high energy fructose in soft drinks, poses a major and insidious health threat, especially in children, and most diets, although with regional differences, are deficient in omega-3 fatty acids and too high in omega-6 fatty acids. Gene-nutrient interactions in growth and development and in disease prevention are fundamental to health, therefore regional Centers on Genetics, Nutrition and Fitness for Health should be established worldwide. Heads of state and government must elevate, as a matter of urgency, nutrition as a national priority, that access to a healthy diet should be considered a human right and that the lead responsibility for nutrition should be placed in Ministries of Health rather than agriculture so that the health requirements drive agricultural priorities, not vice versa. Nutritional security should be given the same priority as food security.
Bellagio report on healthy agriculture, healthy nutrition, healthy people.
Simopoulos, Artemis P; Bourne, Peter G; Faergeman, Ole
2013-02-05
The Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People is the result of the meeting held at the Rockefeller Foundation Bellagio Center in Lake Como, Italy, 29 October-2 November 2012. The meeting was science-based but policy-oriented. The role and amount of healthy and unhealthy fats, with attention to the relative content of omega-3 and omega-6 fatty acids, sugar, and particularly fructose in foods that may underlie the epidemics of non-communicable diseases (NCD's) worldwide were extensively discussed. The report concludes that sugar consumption, especially in the form of high energy fructose in soft drinks, poses a major and insidious health threat, especially in children, and most diets, although with regional differences, are deficient in omega-3 fatty acids and too high in omega-6 fatty acids. Gene-nutrient interactions in growth and development and in disease prevention are fundamental to health, therefore regional Centers on Genetics, Nutrition and Fitness for Health should be established worldwide. Heads of state and government must elevate, as a matter of urgency, Nutrition as a national priority, that access to a healthy diet should be considered a human right and that the lead responsibility for Nutrition should be placed in Ministries of Health rather than agriculture so that the health requirements drive agricultural priorities, not vice versa. Nutritional security should be given the same priority as food security.
Marine litter from beach-based sources: Case study of an Eastern Mediterranean coastal town.
Portman, Michelle E; Brennan, Ruth E
2017-11-01
Marine litter has been a serious and growing problem for some decades now. Yet, there is still much speculation among researchers, policy makers and planners about how to tackle marine litter from land-based sources. This paper provides insights into approaches for managing marine litter by reporting and analyzing survey results of litter dispersal and makeup from three areas along an Arab-Israeli coastal town in view of other recent studies conducted around the Mediterranean Sea. Based on our results and analysis, we posit that bathing beach activities should be a high priority for waste managers as a point of intervention and beach-goers must be encouraged to take a more active role in keeping beaches clean. Further, plastic fragments on the beach should be targeted as a first priority for prevention (and cleanup) of marine litter with plastic bottle caps being a high priority to be targeted among plastics. More survey research is needed on non-plastic litter composition for which amounts and geographic dispersal in the region vary greatly from place to place along Mediterranean shores. In general, findings of this study lead us to recommend exploring persuasive beach trash can design coupled with greater enforcement for short term waste management intervention while considering the local socio-economic and institutional context further for long-term efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.
Protecting Biodiversity when Money Matters: Maximizing Return on Investment
Underwood, Emma C.; Shaw, M. Rebecca; Wilson, Kerrie A.; Kareiva, Peter; Klausmeyer, Kirk R.; McBride, Marissa F.; Bode, Michael; Morrison, Scott A.; Hoekstra, Jonathan M.; Possingham, Hugh P.
2008-01-01
Background Conventional wisdom identifies biodiversity hotspots as priorities for conservation investment because they capture dense concentrations of species. However, density of species does not necessarily imply conservation ‘efficiency’. Here we explicitly consider conservation efficiency in terms of species protected per dollar invested. Methodology/Principal Findings We apply a dynamic return on investment approach to a global biome and compare it with three alternate priority setting approaches and a random allocation of funding. After twenty years of acquiring habitat, the return on investment approach protects between 32% and 69% more species compared to the other priority setting approaches. To correct for potential inefficiencies of protecting the same species multiple times we account for the complementarity of species, protecting up to three times more distinct vertebrate species than alternate approaches. Conclusions/Significance Incorporating costs in a return on investment framework expands priorities to include areas not traditionally highlighted as priorities based on conventional irreplaceability and vulnerability approaches. PMID:18231601
Master Environmental Plan for Fort Devens, Massachusetts
1992-04-01
sites located in proximity to each other were grouped together. The rationale for the order of priority assigned to the study areas in this section is...following priority categories: 1. High priority for action. All group 1 study areas have known contamination. Group IA includes sites that have ongoing...remedial investigations. Group 1B includes sites that have ongoing site inspections. 2. Moderate to high priority for action. Study areas in groups 3
NASA Astrophysics Data System (ADS)
Vilar, Ciro C.; Joyeux, Jean-Christophe; Spach, Henry L.
2017-09-01
While the number of species is a key indicator of ecological assemblages, spatial conservation priorities solely identified from species richness are not necessarily efficient to protect other important biological assets. Hence, the results of spatial prioritization analysis would be greatly enhanced if richness were used in association to complementary biodiversity measures. In this study, geographic patterns in estuarine fish species rarity (i.e. the average range size in the study area), endemism and richness, were mapped and integrated to identify regions important for biodiversity conservation along the Brazilian coast. Furthermore, we analyzed the effectiveness of the national system of protected areas to represent these regions. Analyses were performed on presence/absence data of 412 fish species in 0.25° latitudinal bands covering the entire Brazilian biogeographical province. Species richness, rarity and endemism patterns differed and strongly reflected biogeographical limits and regions. However, among the existing 154 latitudinal bands, 48 were recognized as conservation priorities by concomitantly harboring high estuarine fish species richness and assemblages of geographically rare species. Priority areas identified for all estuarine fish species largely differed from those identified for Brazilian endemics. Moreover, there was no significant correlation between the different aspects of the fish assemblages considered (i.e. species richness, endemism or rarity), suggesting that designating reserves based on a single variable may lead to large gaps in the overall protection of biodiversity. Our results further revealed that the existing system of protected areas is insufficient for representing the priority bands we identified. This highlights the urgent need for expanding the national network of protected areas to maintain estuarine ecosystems with high conservation value.
76 FR 69246 - Application for New Awards; High School Equivalency Program
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-08
... could include, for example, participation in training on intensive science teaching techniques presented...)). The third priority is an invitational priority for applications that promote science, technology... preference over other applications. These priorities are: Invitational Priority 1--Science, Technology...
Impacts of climate change on prioritizing conservation areas of hydrological ecosystem services
NASA Astrophysics Data System (ADS)
Lien, Wan Yu; Lin, Yu Pin
2015-04-01
Ecosystem services (ESs) including hydrological services play important roles in our daily life and provide a lot of benefits for human beings from ecological systems. The systems and their services may be threatened by climate change from global to local scales. We herein developed a systematic approach to assess the impacts of climate change on the hydrological ecosystem services, such as water yield, nutrient (nitrogen and phosphorous) retention, and soil retention in a watershed in Northern Taiwan. We first used an ecosystem service evaluation model, InVEST, to estimate the amount and spatial patterns of annual and monthly hydrological ecosystem services under historical weather data, and different climate change scenarios based on five GMSs. The monthly and annual spatiotemporal variations of the ESs were analyzed in this study. Finally, the multiple estimated ESs were considered as the protection conservation targets and regarded as the input data of the systematic conservation planning software, Zonation, to systematically prioritize reserve areas of the ESs under the climate change scenarios. The ES estimation results indicated that the increasing rainfall in wet season leads to the higher water yield and results in the higher sediment and nutrient export indirectly. The Zonation successfully fielded conservation priorities of the ESs. The conservation priorities of the ESs significantly varied spatially and monthly under the climate change scenarios. The ESs results also indicated that the areas where ESs values and conservation priorities with low resilience under climate change should be considered as high priority protected area to ensure the hydrological services in future. Our proposed approach is a novel systematic approach which can be applied to assess impacts of climate change on spatiotemporal variations of ESs as well as prioritize protected area of the ESs under various climate change scenarios. Keyword: climate change, ecosystem service, conservation planning, spatial analysis.
ERIC Educational Resources Information Center
Bitchener, John
2016-01-01
The focus of this article is on the written feedback that supervisors say they often give their second language (L2) doctoral students. Little is known about the focus of this feedback and about what supervisors consider as priorities in the early draft writing of dissertation chapters. Given the potentially different priorities and foci of…
U.S. Community College Libraries: A Snapshot of Priorities & Perspectives
ERIC Educational Resources Information Center
OCLC Online Computer Library Center, Inc., 2012
2012-01-01
This new report details findings from a study OCLC conducted with libraries in mid-2011 to learn about their priorities, initiatives, thoughts on the future of their service points and the sources they use to keep up with developments in the library field. Most community college library staff: (1) Consider licensed e-collections and e-books to be…
ERIC Educational Resources Information Center
Fatimah, P. L. Rika; Jemain, A. A.; Ibrahim, K.; Nasir, S. Mohammad; Anuar, M. A. Khairul
2009-01-01
Determining priority importance is a matter of concerns among the organization to improve their performance. One of the important aspects that should be considered by the organization is management of human resources, comprising of members who have their own family life. In this paper, we deliver a new perspective for organization to provide…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-30
... consider only applications that meet one or more of the Statutory Priorities. These priorities are... matching. 3. Other: An application from a consortium of SEAs must designate one SEA as the fiscal agent. IV... more than 45 pages, using the following standards: A ``page'' is 8.5 x 11 , on one side only with 1...
Aljumah, Mohammed; Alroughani, Raed; Alsharoqi, I; Bohlega, Saeed A; Dahdaleh, Maurice; Deleu, Dirk; Esmat, Khaled; Khalifa, Ahmad; Sahraian, Mohammad A; Szólics, Miklós; Altahan, Abdulrahman; Yamout, Bassem I; Rieckmann, Peter; Daif, Abdulkader
2013-01-01
The prevalence of multiple sclerosis (MS) is now considered to be medium-to-high in the Middle East and is rising, particularly among women. While the characteristics of the disease and the response of patients to disease-modifying therapies are generally comparable between the Middle East and other areas, significant barriers to achieving optimal care for MS exist in these developing nations. A group of physicians involved in the management of MS in ten Middle Eastern countries met to consider the future of MS care in the region, using a structured process to reach a consensus. Six key priorities were identified: early diagnosis and management of MS, the provision of multidisciplinary MS centres, patient engagement and better communication with stakeholders, regulatory body education and reimbursement, a commitment to research, and more therapy options with better benefit-to-risk ratios. The experts distilled these priorities into a single vision statement: "Optimization of patient-centred multidisciplinary strategies to improve the quality of life of people with MS." These core principles will contribute to the development of a broader consensus on the future of care for MS in the Middle East.
Which Social Values Are Considered in Iranian Health System?
Rashidian, Arash; Arab, Mohammad; Vaez Mahdavi, Mohammadreza; Ashtarian, Koimars; Mostafavi, Hakimeh
2018-05-01
Health systems have a set of limited resources for meeting the needs of communities. Health priority setting based on criteria and values is inevitable in such situation. This paper aims to identify the social values that are considered in Iranian health system. This qualitative study was conducted in 3 steps including collecting national documents and literature review, interviewing key informants, and a 2 round Delphi. Interviews and documents were analyzed through thematic framework analysis. Statistical guidance was applied for determining consensus cut-off in Delphi technique. Five social values including freedom of choice, equity, solidarity, severity of disease(s), and burden of disease(s) were considered more important than other values in the health priority setting decisions. Moreover, 2 non-value based factors including conflict of interest and lobbying had a high effect on decision making. Most health policy makers decide based on Egalitarian school, but restriction of resources in the country decreases the outcome. Moreover, personal judgments and preferences sometimes affect their decisions. It seems that developing a value-based framework and making it as a national guidance could have affirmative effect on health administers decisions. © 2018 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
NASA Astrophysics Data System (ADS)
Rosli, A. Z.; Reba, M. N. M.; Roslan, N.; Room, M. H. M.
2014-02-01
In order to maintain the stability of natural ecosystems around urban areas, urban forestry will be the best initiative to maintain and control green space in our country. Integration between remote sensing (RS) and geospatial information system (GIS) serves as an effective tool for monitoring environmental changes and planning, managing and developing a sustainable urbanization. This paper aims to assess capability of the integration of RS and GIS to provide information for urban forest potential sites based on qualitative and quantitative by using priority parameter ranking in the new township of Nusajaya. SPOT image was used to provide high spatial accuracy while map of topography, landuse, soils group, hydrology, Digital Elevation Model (DEM) and soil series data were applied to enhance the satellite image in detecting and locating present attributes and features on the ground. Multi-Criteria Decision Making (MCDM) technique provides structural and pair wise quantification and comparison elements and criteria for priority ranking for urban forestry purpose. Slope, soil texture, drainage, spatial area, availability of natural resource, and vicinity of urban area are criteria considered in this study. This study highlighted the priority ranking MCDM is cost effective tool for decision-making in urban forestry planning and landscaping.
25 CFR Appendix A to Subpart C - IRR High Priority Project Scoring Matrix
Code of Federal Regulations, 2011 CFR
2011-04-01
... 25 Indians 1 2011-04-01 2011-04-01 false IRR High Priority Project Scoring Matrix A Appendix A to...—IRR High Priority Project Scoring Matrix Score 10 5 3 1 0 Accident and fatality rate for candidate...,000 or less 250,001-500,000 500,001-750,000 Over 750,000. Geographic isolation No external access to...
25 CFR Appendix A to Subpart C - IRR High Priority Project Scoring Matrix
Code of Federal Regulations, 2013 CFR
2013-04-01
... 25 Indians 1 2013-04-01 2013-04-01 false IRR High Priority Project Scoring Matrix A Appendix A to...—IRR High Priority Project Scoring Matrix Score 10 5 3 1 0 Accident and fatality rate for candidate...,000 or less 250,001-500,000 500,001-750,000 Over 750,000. Geographic isolation No external access to...
25 CFR Appendix A to Subpart C - IRR High Priority Project Scoring Matrix
Code of Federal Regulations, 2014 CFR
2014-04-01
... 25 Indians 1 2014-04-01 2014-04-01 false IRR High Priority Project Scoring Matrix A Appendix A to...—IRR High Priority Project Scoring Matrix Score 10 5 3 1 0 Accident and fatality rate for candidate...,000 or less 250,001-500,000 500,001-750,000 Over 750,000. Geographic isolation No external access to...
25 CFR Appendix A to Subpart C - IRR High Priority Project Scoring Matrix
Code of Federal Regulations, 2012 CFR
2012-04-01
... 25 Indians 1 2012-04-01 2011-04-01 true IRR High Priority Project Scoring Matrix A Appendix A to...—IRR High Priority Project Scoring Matrix Score 10 5 3 1 0 Accident and fatality rate for candidate...,000 or less 250,001-500,000 500,001-750,000 Over 750,000. Geographic isolation No external access to...
Advanced Mirror Technology Development (AMTD) for Very Large Space Telescopes
NASA Technical Reports Server (NTRS)
Stahl, H. Philip
2014-01-01
Advanced Mirror Technology Development (AMTD) is a multi-year effort to systematically mature to TRL-6 the critical technologies needed to produce 4-m or larger flight-qualified UVOIR mirrors by 2018 so that a viable mission can be considered by the 2020 Decadal Review. This technology must enable missions capable of both general astrophysics & ultra-high contrast observations of exoplanets. To accomplish our objective, We use a science-driven systems engineering approach. We mature technologies required to enable the highest priority science AND result in a high-performance low-cost low-risk system.
Promotion of mental health and prevention of mental disorders: priorities for implementation.
Barry, M M; Clarke, A M; Petersen, I
2015-09-28
There is compelling evidence from high-quality studies that mental health promotion and primary prevention interventions can reduce the risk of mental disorders, enhance protective factors for good mental and physical health, and lead to lasting positive effects on a range of social and economic outcomes. This paper reviews the available evidence in order to guide the implementation of mental health promotion and prevention interventions in the Eastern Mediterranean Region. The paper identifies a number of priority areas that can generate clear health and social gains in the population and be implemented and sustained at a reasonable cost. The interventions cover population groups across the lifespan from infancy to adulthood and include actions delivered across different settings and delivery platforms. "Best practices" were identified as interventions for which there is evidence not only of their effectiveness but also of their feasibility within resource constraints. The implications of the findings for capacity development are considered.
Aeyels, Daan; Seys, Deborah; Sinnaeve, Peter R; Claeys, Marc J; Gevaert, Sofie; Schoors, Danny; Sermeus, Walter; Panella, Massimiliano; Bruyneel, Luk; Vanhaecht, Kris
2018-02-01
A focus on specific priorities increases the success rate of quality improvement efforts for broad and complex-care processes. Importance-performance analysis presents a possible approach to set priorities around which to design and implement effective quality improvement initiatives. Persistent variation in hospital performance makes ST-elevation myocardial infarction care relevant to consider for importance-performance analysis. The purpose of this study was to identify quality improvement priorities in ST-elevation myocardial infarction care. Importance and performance levels of ST-elevation myocardial infarction key interventions were combined in an importance-performance analysis. Content validity indexes on 23 ST-elevation myocardial infarction key interventions of a multidisciplinary RAND Delphi Survey defined importance levels. Structured review of 300 patient records in 15 acute hospitals determined performance levels. The significance of between-hospital variation was determined by a Kruskal-Wallis test. A performance heat-map allowed for hospital-specific priority setting. Seven key interventions were each rated as an overall improvement priority. Priority key interventions related to risk assessment, timely reperfusion by percutaneous coronary intervention and secondary prevention. Between-hospital performance varied significantly for the majority of key interventions. The type and number of priorities varied strongly across hospitals. Guideline adherence in ST-elevation myocardial infarction care is low and improvement priorities vary between hospitals. Importance-performance analysis helps clinicians and management in demarcation of the nature, number and order of improvement priorities. By offering a tailored improvement focus, this methodology makes improvement efforts more specific and achievable.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-29
...' participation in training on intensive science teaching techniques presented by a professionally credentialed...)). The third priority is an invitational priority for applications that promote science, technology... priorities are: Invitational Priority 1--Science, Technology, Engineering and Mathematics (STEM) Education...
A Fair Contention Access Scheme for Low-Priority Traffic in Wireless Body Area Networks
Sajeel, Muhammad; Bashir, Faisal; Asfand-e-yar, Muhammad; Tauqir, Muhammad
2017-01-01
Recently, wireless body area networks (WBANs) have attracted significant consideration in ubiquitous healthcare. A number of medium access control (MAC) protocols, primarily derived from the superframe structure of the IEEE 802.15.4, have been proposed in literature. These MAC protocols aim to provide quality of service (QoS) by prioritizing different traffic types in WBANs. A contention access period (CAP)with high contention in priority-based MAC protocols can result in higher number of collisions and retransmissions. During CAP, traffic classes with higher priority are dominant over low-priority traffic; this has led to starvation of low-priority traffic, thus adversely affecting WBAN throughput, delay, and energy consumption. Hence, this paper proposes a traffic-adaptive priority-based superframe structure that is able to reduce contention in the CAP period, and provides a fair chance for low-priority traffic. Simulation results in ns-3 demonstrate that the proposed MAC protocol, called traffic- adaptive priority-based MAC (TAP-MAC), achieves low energy consumption, high throughput, and low latency compared to the IEEE 802.15.4 standard, and the most recent priority-based MAC protocol, called priority-based MAC protocol (PA-MAC). PMID:28832495
Priority service needs and receipt across the lifespan for individuals with autism spectrum disorder
Lai, Jonathan K. Y.
2017-01-01
Abstract Individuals with Autism Spectrum Disorder (ASD) have a range of health, community, and social support needs across the lifespan that create age‐specific challenges in navigating service sectors. In this study, we set out to identify the priority needs of individuals with ASD across the lifespan, and the factors that predict receiving priority services. Participants included 3,317 individuals with ASD from a Canada‐wide online caregiver survey, stratified into five age groups (preschool, elementary school age, adolescence, emerging adulthood, adulthood). Priority receipt was calculated as a ratio of current services that corresponded to individualized priority need. Age‐stratified Poisson regression analyses were used to identify the sociodemographic, clinical and systemic predictors of priority receipt. Results indicate that the distribution of priority need varied by age, except for social skills programming, which was a high across all groups. The number of high and moderate priority needs diversified with age. Overall, 30% of individuals had none of their priority needs met and priority receipt decreased with age. Systemic factors were most consistently related to priority receipt across the lifespan. Understanding patterns and correlates of priority needs and use that currently exist in different age groups can inform policies to improve service access. Autism Res 2017, 10: 1436–1447. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. PMID:28383156
The $2000 Electric Powertrain Option-1 Program. Final technical report
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
1999-06-01
This report describes the tasks accomplished as part of Northrop Grumman's TRP $2000 Electric Powertrain Option-1 program. Northrop Grumman has strived to achieve technology advances and development considered as high priority to the success of future electric vehicles. Northrop Grumman has achieved the intent of the program by taking several steps toward reducing the cost of the electric vehicle powertrain, demonstrating technologies in the form of hardware and introducing enhancements into production that are consistent with the needs of the market.
Smith, Stephanie L; Shiffman, Jeremy
2016-10-01
This study investigates a puzzle concerning global health priorities-why do comparable issues receive differential levels of attention and resources? It considers maternal and neonatal mortality, two high-burden issues that pertain to groups at risk at birth and whose lives could be saved with effective intrapartum care. Why did maternal survival gain status as a global health priority earlier and to a greater degree than newborn survival? Higher mortality and morbidity burdens among newborns and the cost-effectiveness of interventions would seem to predict that issue's earlier and higher prioritization. Yet maternal survival emerged as a priority two decades earlier and had attracted considerably more attention and resources by the close of the Millennium Development Goals era. This study uses replicative process-tracing case studies to examine the emergence and growth of political priority for these two issues, probing reasons for unexpected variance. The study finds that maternal survival's grounding as a social justice issue spurred growth of a strong and diverse advocacy network and aligned the issue with powerful international norms (e.g. expectations to advance women's rights and the Millennium Development Goals), drawing attention and resources to the issue over three decades. Newborn survival's disadvantage stems from its long status as an issue falling under the umbrellas of maternal and child survival but not fully adopted by these networks, and with limited appeal as a public health issue advanced by a small and technically focused network; network expansion and alignment with child survival norms have improved the issue's status in the past few years. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Rupp, Michael T
2002-01-01
To define programmatic objectives and initial operational priorities for CommuniRes, a university-based education and support service designed to help community pharmacists successfully implement and sustain community pharmacy residency programs (CPRPs). Advisory committee of nationally recognized experts in CPRPs in a small-group planning session. CPRPs are postgraduate clinical training experiences conducted in chain and independent community pharmacies. The nominal group technique (NGT), a structured approach to group planning and decision making, was used to identify and prioritize the needs of CPRPs. Results of the NGT exercise were used as input to a brainstorming session that defined specific CommuniRes services and resources that must be developed to meet high priority needs of CPRPs. Group consensus on the priority needs of CPRPs was determined through rank order voting. The advisory committee identified 20 separate CPRP needs that it believed must be met to ensure that CPRPs will be successful and sustainable. Group voting resulted in the selection of six needs that were considered to be consensus priorities for services and resources provided through CommuniRes: image parity for CPRPs; CPRP marketing materials; attractive postresidency employment opportunities; well-defined goals, objectives, and residency job descriptions; return on investment and sources of ongoing funding for the residency; and opportunities and mechanisms for communicating/networking with other residents and preceptors. The needs-based programmatic priorities defined by the advisory committee are now being implemented through a tripartite program consisting of live training seminars for CPRP preceptors and directors, an Internet site (www.communires.com), and a host of continuing support services available to affiliated CPRP sites. Future programmatic planning will increasingly involve CPRP preceptors, directors, and former residents to determine the ongoing needs of CPRPs.
Dettenkofer, Markus; Humphreys, Hilary; Saenz, Henri; Carlet, Jean; Hanberger, Håkan; Ruef, Christian; Widmer, Andreas; Wolkewitz, Martin; Cookson, Barry
2016-12-01
Prevention and control of healthcare-associated infection (HCAI) are important within and beyond Europe. However, it is unclear which areas are considered important by HCAI prevention and control professionals. This study assesses the priorities in the prevention and control of HCAI as judged by experts in the field. A survey was conducted by the European Society of Clinical Microbiology and Infectious Diseases focussing on seven topics using SurveyMonkey ® . Through a newsletter distributed by email, about 5000 individuals were targeted throughout the world in February and March 2013. Participants were asked to rate the importance of particular topics from one (low importance) to ten (extraordinary importance), and there was no restriction on giving equal importance to more than one topic. A total of 589 experts from 86 countries participated including 462 from Europe (response rate: 11.8 %). Physicians accounted for 60 % of participants, and 57 % had ten or more years' experience in this area. Microbial epidemiology/resistance achieved the highest priority scoring with 8.9, followed by surveillance 8.2, and decolonisation/disinfection/antiseptics with 7.9. Under epidemiology/resistance, highly resistant Gram-negative bacilli scored highest (9.0-9.2). The provision of computerised healthcare information systems for the early detection of outbreaks was accorded the top priority under surveillance. The prevention of surgical site and central line infections ranked highest under the category of specific HCAI and HCAI in certain settings. Differences between regions are described. These findings reflect the concerns of experts in HCAI prevention and control. The results from this survey should inform national and international agencies on future action and research priorities.
Mac Giolla Phadraig, Caoimhin; Nunn, June; Dougall, Alison; O'Neill, Eunan; McLoughlin, Jacinta; Guerin, Suzanne
2014-01-01
This study aimed to generate prioritised goals for oral health services for people with disabilities as a first step in meeting the need for evidence based oral health services for people with disabilities in Ireland. The study used a three round modified e-Delphi method, involving dental service professionals and people with disabilities or their representatives, in Ireland. Three rounds were completed online using SurveyMonkey. Round 1 asked: "List what you think dental services for people with disabilities in Ireland should be like." Items for subsequent rounds were generated from responses to Round 1. Round 2 and Round 3 used 5 point Likert scales to rank these items by priority: from No Priority (1) to Top Priority (5). Consensus was achieved on each item where at least 80% of respondents considered an item either High or Top Priority. A consensus meeting concluded the process. Sixty-one panelists started and 48 completed the survey. The Delphi panel agreed on level of priority for 69 items and generated 16 consensus statements. These statements covered a range of topics such as access to care, availability of information and training, quality of care, dental treatment and cost. A recurrent theme relating to the appropriateness of care to individual need arose across topics suggesting a need to match service delivery according to the individual's needs, wants and expectations rather than the disability type/diagnosis based service which predominates today. This process produced a list of prioritised goals for dental services for people with disabilities. This creates a foundation for building evidence-based service models for people with disabilities in Ireland.
McConkey, R; Collins, S
2010-08-01
Past studies have found that people supported in more individualised housing options tend to have levels of community participation and wider social networks than those in other accommodation options. Yet, the contribution of support staff in facilitating social inclusion has received relatively scant attention. In all 245 staff working in either supported living schemes, or shared residential and group homes, or in day centres completed a written questionnaire in which they rated in terms of priority to their job, 16 tasks that were supportive of social inclusion and a further 16 tasks that related to the care of the person they supported. In addition staff identified those tasks that they considered were not appropriate to their job. Across all three service settings, staff rated more care tasks as having higher priority than they did the social inclusion tasks. However, staff in supported living schemes rated more social inclusion tasks as having high priority than did staff in the other two service settings. Equally the staff who were most inclined to rate social inclusion tasks as not being applicable to their job were those working day centres; female rather than male staff, those in front-line staff rather than senior staff, and those in part-time or relief positions rather than full-time posts. However, within each service settings, there were wide variations in how staff rated the social inclusion tasks. Staff working in more individualised support arrangements tend to give greater priority to promoting social inclusion although this can vary widely both across and within staff teams. Nonetheless, staff gave greater priority to care tasks especially in congregated service settings. Service managers may need to give more emphasis to social inclusion tasks and provide the leadership, training and resources to facilitate support staff to re-assess their priorities.
Stakeholder views on criteria and processes for priority setting in Norway: a qualitative study.
Aidem, Jeremy M
2017-06-01
Since 2013, Norway has engaged in political processes to revise criteria for priority setting. These processes have yielded key efficiency and equity criteria, but excluded potentially relevant social values. This study describes the views of 27 stakeholders in Norway's health system regarding a wider set of priority-setting criteria and procedural characteristics. Between January and February 2016, semi-structured interviews and focus groups were conducted with a purposive sample of policymakers, hospital administrators, practitioners, university students and seniors. Improving health among low-socioeconomic-status groups was considered an important policy objective: some favored giving more priority to diseases affecting socioeconomically disadvantaged groups, and some believed inequalities in health could be more effectively addressed outside the health sector. Age was not widely accepted as an independent criterion, but deemed relevant as an indicator of capacity to benefit, cost-effectiveness and health loss. Cost-effectiveness, severity and health-loss measures were judged relevant to policymaking, but cost-effectiveness and health loss were considered less influential to clinical decision-making. Public engagement was seen as essential yet complicated by media and stakeholder pressures. This study highlights how views on the relevance and implementation of criteria can vary significantly according to the health system level being evaluated. Further, the findings suggest that giving priority to socioeconomically disadvantaged groups and reducing inequalities in health may be relevant preferences not captured in recent policy proposals. Copyright © 2017 Elsevier B.V. All rights reserved.
Smith, Neale; Mitton, Craig; Peacock, Stuart; Cornelissen, Evelyn; MacLeod, Stuart
2009-01-01
Background To date there has been relatively little published about how research priorities are set, and even less about methods by which decision-makers can be engaged in defining a relevant and appropriate research agenda. We report on a recent effort in British Columbia to have researchers and decision-makers jointly establish an agenda for future research into questions of resource allocation. Methods The researchers enlisted decision-maker partners from each of British Columbia's six health authorities. Three forums were held, at which researchers and decision-makers from various levels in the health authorities considered possible research areas related to three key focus areas: (1) generation and use of decision criteria and measurement of 'benefit' against such criteria; (2) identification of so-called 'disinvestment' opportunities; and (3) evaluation of the effectiveness of priority setting procedures. Detailed notes were taken from each forum and synthesized into a set of qualitative themes. Results Forum participants suggested that future research into healthcare priority setting would benefit from studies that were longitudinal, comparative, and/or interdisciplinary. As well, participants identified two broad theme areas in which specific research projects were deemed desirable. First, future research might usefully consider how formal priority setting and resource allocation projects are situated within a larger organizational and political context. Second, additional research efforts should be devoted to better understanding and improving the actual implementation of priority setting frameworks, particularly with respect to issues of change management and the resolution of impediments to action on recommendations for resource allocation. Conclusion We were able to validate the importance of initial areas posed to the group and observed emergence of additional concerns and directions of critical importance to these decision-makers at this time. It is likely that the results are broadly applicable to other healthcare contexts. The implementation of this research agenda in British Columbia will depend upon the ability of the researchers and decision-makers to develop particular projects that fit within the constraints of existing funding opportunities. The process of engagement itself had benefits in terms of connecting decision-makers with their peers and sparking increased interest in the use and refinement of priority setting frameworks. PMID:19754969
A survey of time management and particular tasks undertaken by consultant microbiologists in the UK.
Riordan, Terry; Cartwright, Keith; Cunningham, Richard; Logan, Margaret; Wright, Paul
2007-05-01
Medical microbiology practice encompasses a diverse range of activities. Consultant medical microbiologists (CMMs) attribute widely differing priorities to, and spend differing proportions of time on various components of the job. To obtain a professional consensus on what are high-priority and low-priority activities, and to identify the time spent on low-priority activities. National survey. Many respondents felt that time spent on report authorisation and telephoning of results was excessive, whereas time spent on ward-based work was inadequate. Timesaving could also be achieved through better prioritisation of infection-control activities. CMMs should apportion their time at work focusing on high-priority activities identified through professional consensus.
High resolution tsunami modelling for the evaluation of potential risk areas in Setúbal (Portugal)
NASA Astrophysics Data System (ADS)
Ribeiro, J.; Silva, A.; Leitão, P.
2011-08-01
The use of high resolution hydrodynamic modelling to simulate the potential effects of tsunami events can provide relevant information about the most probable inundation areas. Moreover, the consideration of complementary data such as the type of buildings, location of priority equipment, type of roads, enables mapping of the most vulnerable zones, computing of the expected damage on man-made structures, constrain of the definition of rescue areas and escape routes, adaptation of emergency plans and proper evaluation of the vulnerability associated with different areas and/or equipment. Such an approach was used to evaluate the specific risks associated with a potential occurrence of a tsunami event in the region of Setúbal (Portugal), which was one of the areas most seriously affected by the 1755 tsunami. In order to perform an evaluation of the hazard associated with the occurrence of a similar event, high resolution wave propagation simulations were performed considering different potential earthquake sources with different magnitudes. Based on these simulations, detailed inundation maps associated with the different events were produced. These results were combined with the available information on the vulnerability of the local infrastructures (building types, roads and streets characteristics, priority buildings) in order to impose restrictions in the production of high-scale potential damage maps, escape routes and emergency routes maps.
Diffin, Janet; Spence, Michael; Spencer, Rebecca; Mellor, Peter; Grande, Gunn
2017-02-02
It is important to ensure regional variances are considered when setting future end-of-life research priorities, given the differing demographics and service provision. This project sought to identify end-of-life research priorities within Greater Manchester (United Kingdom). Following an initial scoping exercise, six topics within the 10 national priorities outlined by The Palliative and end-of-life care Priority Setting Partnership were selected for exploration. A workshop involving 32 healthcare professionals and a consultation process with 26 family carers was conducted. Healthcare professionals and carers selected and discussed the topics important to them. The topics selected most frequently by both healthcare professionals and carers were 'Access to 24 hour care', 'Planning end-of-life care in advance' and 'Staff and carer education'. Healthcare professionals also developed research questions for their topics of choice which were refined to incorporate carers' views. These questions are an important starting point for future end-of-life research within Greater Manchester.
Cleary, Susan; Molyneux, Sassy; English, Mike
2017-01-01
Abstract This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. With regard to consequentialist conditions, the hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to proceduralist conditions, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the proceduralist conditions were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonizing these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequentialist (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities, implementation of decisions), and proceduralist (stakeholder engagement and empowerment, transparency, use of evidence, revisions, enforcement, and incorporating community values) conditions. PMID:27679522
Barasa, Edwine W; Cleary, Susan; Molyneux, Sassy; English, Mike
2017-04-01
This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. With regard to consequentialist conditions, the hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to proceduralist conditions, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the proceduralist conditions were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonizing these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequentialist (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities, implementation of decisions), and proceduralist (stakeholder engagement and empowerment, transparency, use of evidence, revisions, enforcement, and incorporating community values) conditions. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
NASA Technical Reports Server (NTRS)
Brower, Robert N.
2004-01-01
This Summary of Research report is a final report which summarizes significant accomplishments achieved during NASA grant NAG 13-00044 entitled Phase IV: Deploying ESE Pilot Information Programs for State and Local Government in the Northeast, the Education Community and the Commercial Sector , for the period of September 27,2000 through September 26,2004. All activities under this grant have been successfully completed. It has been requested by NASA reviewers that the material contained herein also be considered in $iew of NASA s twelve national priority areas. During the grant period, the nature of the Earth Science Enterprise (ESE) Application Program has been significantly amended (two major restructurings). These amendments have been reviewed at several meetings, including a national gathering held in Washington DC. Additional meetings have occurred with NASA officials at headquarters and at IAGT offices as the newly emerging programs have become defined. The work described herein is considered "cross-cutting", meaning that it has relevancy to several of the national priority areas. The time period covered requires that the twelve national priority areas initially articulated by NASA be considered. (Subsequent NASA revision has eliminated "community growth" as a focus area. It is not clear how this area might be treated in the future NASA organizational structure, but it is noted that the work reported herein includes clear potential for application to the previously defined community growth area, as well as most of the other application areas.) As indicated in the accompanying figure, activity reports throughout this report can be "mapped" to the priority areas.
[Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People].
Simopoulos, Artemis P; Bourne, Peter G; Faergeman, Ole
2013-11-01
The Bellagio Report on Healthy Agriculture, Healthy Nutrition, Healthy People is the result of the meeting held at the Rockefeller Foundation Bellagio Center in Lake Como, Italy, 29 October-2 November 2012. The meeting was science-based but policy-oriented. The role and amount of healthy and unhealthy fats, with attention to the relative content of omega-3 and omega-6 fatty acids, sugar, and particularly fructose in foods that may underlie the epidemics of non-communicable diseases (NCD's) worldwide were extensively discussed. The report concludes that sugar consumption, especially in the form of high energy fructose in soft drinks, poses a major and insidious health threat, especially in children, and most diets, although with regional differences, are deficient in omega-3 fatty acids and too high in omega-6 fatty acids. Gene-nutrient interactions in growth and development and in disease prevention are fundamental to health, therefore regional Centers on Genetics, Nutrition and Fitness for Health should be established worldwide. Heads of state and government must elevate, as a matter of urgency, Nutrition as a national priority, that access to a healthy diet should be considered a human right and that the lead responsibility for Nutrition should be placed in Ministries of Health rather than agriculture so that the health requirements drive agricultural priorities, not vice versa. Nutritional security should be given the same priority as food security. Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.
ERIC Educational Resources Information Center
Kimmons, Royce
2017-01-01
This study seeks to evaluate the basic Priority 1 web accessibility of all college and university websites in the US (n = 3141). Utilizing web scraping and automated content analysis, the study establishes that even in the case of high-priority, simple-to-address accessibility requirements, colleges and universities generally fail to make their…
Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-28
... higher priority listing activities. A listing priority of 5 is assigned to species with high magnitude... number for Gunnison sage-grouse as a 2. A listing priority number of 2 is assigned to species with high... that are rich in calcium, phosphorous, and protein to meet the nutritional needs of females during the...
Resource allocation in health care and the role of personal autonomy.
Gandjour, A
2015-03-01
Resource allocation decisions in health care require the consideration of ethical values. Major ethical theories include Amartya Sen's capability approach, Norman Daniels's theory of justice for health, and preference utilitarian theory. This paper argues that while only preference utilitarian theory explicitly considers the impact of an individual's actions on others, all 3 theories agree in terms of providing individual autonomy. Furthermore, it shows that all 3 theories emphasise the role of informed preferences in securing individual autonomy. Still, stressing personal autonomy has limited direct implications for priority setting. 2 priority rules for resource allocation could be identified: 1) to give priority to patients with mental disability (over those with pure physical disability); and 2) to give priority to patients with a large expected loss of autonomy without treatment. © Georg Thieme Verlag KG Stuttgart · New York.
Pronk, Nicolaas P; Baase, Catherine; May, Jeanette; Terry, Paul; Moseley, Karen
2017-11-01
To explore factors that matter to business in making decisions regarding engagement in community health improvement efforts. Using qualitative methods, domains of interest were identified through literature reviews and expert interviews. Relevance of the domains in terms of potential priorities for action was tested through employer and community stakeholder interviews. Factors that employers considered important to sustained community collaboration as a business priority included (1) credibility of the convener, (2) broad representation of the community, (3) strong mission and goals, (4) individual commitment to health, (5) organizational commitment to health, and (6) demonstrated commitment from leadership. Priorities have been identified for engaging business in community health efforts. Implications for research, practice, and policy include the need for measurement, transparency in reporting, and agreement on principles for public-private partnership in this area.
2010-01-01
Mwingi District lies within the Kenyan Arid and Semiarid lands (ASALs) in Eastern Province. Although some ethnobotanical surveys have been undertaken in some arid and semiarid areas of Kenya, limited studies have documented priority medicinal plants as well as local people's awareness of conservation needs of these plants. This study sought to establish the priority traditional medicinal plants used for human, livestock healthcare, and those used for protecting stored grains against pest infestation in Mwingi district. Further, the status of knowledge among the local people on the threat and conservation status of important medicinal species was documented. This study identified 18 species which were regarded as priority traditional medicinal plants for human health. In terms of priority, 8 were classified as moderate, 6 high, while 4 were ranked highest priority species. These four species are Albizia amara (Roxb.) Boiv. (Mimosacaeae), Aloe secundiflora (Engl. (Aloaceae), Acalypha fruticosa Forssk. (Euphorbiaceae) and Salvadora persica L. (Salvadoraceae). In regard to medicinal plants used for ethnoveterinary purposes, eleven species were identified while seven species were reported as being important for obtaining natural products or concoctions used for stored grain preservation especially against weevils. The data obtained revealed that there were new records of priority medicinal plants which had not been documented as priority species in the past. Results on conservation status of these plants showed that more than 80% of the respondents were unaware that wild medicinal plants were declining, and, consequently, few of them have any domesticated species. Some of the species that have been conserved on farm or deliberately allowed to persist when wild habitats are converted into agricultural lands include: Croton megalocarpus Hutch., Aloe secundiflora, Azadirachta indica A. Juss., Warburgia ugandensis Sprague, Ricinus communis L. and Terminalia brownie Fresen. A small proportion of the respondents however, were aware of the threats facing medicnal plants. Some of the plants reported as declining include, Solanum renschii Vatke (Solanaceae), Populus ilicifolia (Engl.) Rouleau (Salicaceae), Strychnos henningsii Gilg (Loganiaceae) and Rumex usambarensis (Dammer) Dammer (Polygonaceae). Considering the low level of understanding of conservation concerns for these species, there is need therefore, to build capacity among the local communities in this area particularly in regard to sustainable use of natural resources, conservation methods as well as domestication processes. PMID:20712897
Parsons, Suzanne; Thomson, Wendy; Cresswell, Katharine; Starling, Bella; McDonagh, Janet E
2017-07-03
The involvement of people of all ages including young people in research is now widely advocated but prioritisation of research topics is still driven largely by professional agendas. Evidence from adult literature has reported a mismatch between a researcher and patient generated list of research topics. There have been no studies to date exploring the priorities of young people with long term conditions other than in SLE. The study aimed to explore the research priorities of young people across the UK with respect to rheumatic conditions. Focus groups were undertaken with young people aged 11-24 years with rheumatic conditions recruited across the UK via members of the Barbara Ansell National Network for Adolescent Rheumatology BANNAR and relevant national charities. Data was analysed using a Framework approach. Participants discussed their beliefs about what should be researched in: Basic Science; Clinical Medicine; Health Services, Psychosocial, and Public Health. They were then invited to prioritize these areas in terms of how much funding they should receive. Thirteen focus groups were held involving 63 participants (18 males: 45 females, mean age 16 years, range 10 to 24) in all four nations of the UK. Young people's research priorities were influenced by whether they felt research would achieve benefits for all or just some patients and long or short term goals. Another influence was whether participants felt that research areas were already well funded. Across all groups, Basic Science was a key priority and participants felt that psychosocial research should be prioritized more. Health Services Research was a lower priority, as the majority of participants were happy with their care. Clinical medicine was not a high priority as young people were happy with their medication or uncomfortable with trying new ones. Finally, for nearly all groups, Public Health was a low priority. Differences were also observed between the two age groups and across the geographically diverse focus groups. Understanding young people's research priorities is important to develop research that is in tune with their needs. The results highlight the importance of considering the whole age range of adolescence and young adulthood as well as geographical diversity. The findings from this work will inform the future research of the Barbara Ansell National Network for Adolescent Rheumatology BANNAR in the UK.
NASA Technical Reports Server (NTRS)
Cabrol, N. A.; Grin, E. A.; McKay, C. P.; Friedmann, I.; Diaz, G. Chong; Demergasso, C.; Kisse, K.; Grigorszky, I.; Friedmann, R. Ocampo; Hock, A.
2003-01-01
The Licancabur volcano (6017 m) hosts the highest and one of the least explored lakes in the world in its summit crater. It is located 22 deg.50 min. South / 67 deg.53 min. West at the boundary of Chile and Bolivia in the High-Andes. In a freezing environment, the lake located in volcano-tectonic environment combines low-oxygen, low atmospheric pressure due to altitude, and high-UV radiation (see table). However, its bottom water temperature remains above 0 C year-round. These conditions make Licancabur a unique analog to Martian paleolakes considered high-priority sites for the search for life on Mars.
Gardner, Karen; Davies, G Powell; Edwards, Karen; McDonald, Julie; Findlay, Terry; Kearns, Rachael; Joshi, Chandni; Harris, Mark
2016-01-01
The aim of this systematic review was to assess evidence of the impact of commissioning on health service use, quality, outcomes and value for money and to consider findings in the Australian context. Systematic searches of the literature identified 444 papers and, after exclusions, 36 were subject to full review. The commissioning cycle (planning, contracting, monitoring) formed a framework for analysis and impacts were assessed at individual, subpopulation and population levels. Little evidence of the effectiveness of commissioning at any level was available and observed impacts were highly context-dependent. There was insufficient evidence to identify a preferred model. Lack of skills and capacity were cited as major barriers to the implementation of commissioning. Successful commissioning requires a clear policy framework of national and regional priorities that define agreed targets for commissioning agencies. Engagement of consumers and providers, especially physicians, was considered to be critically important but is time consuming and has proven difficult to sustain. Adequate information on the cost, volume and quality of healthcare services is critically important for setting priorities, and for contracting and monitoring performance. Lack of information resulted in serious problems. High-quality nationally standardised performance measures and data requirements need to be built into contracts and ongoing monitoring and evaluation. In Australia, there is significant work to be done in areas of policy and governance, funding systems and incentives, patient enrolment or registration, information systems, individual and organisational capacity, community engagement and experience in commissioning.
2008-01-01
Background Adaptive radiation within fishes of the Coregonus lavaretus complex has created numerous morphs, posing significant challenges for taxonomy and conservation priorities. The highly endangered North Sea houting (C. oxyrhynchus; abbreviated NSH) has been considered a separate species from European lake whitefish (C. lavaretus; abbreviated ELW) due to morphological divergence and adaptation to oceanic salinities. However, its evolutionary and taxonomic status is controversial. We analysed microsatellite DNA polymorphism in nine populations from the Jutland Peninsula and the Baltic Sea, representing NSH (three populations, two of which are reintroduced) and ELW (six populations). The objectives were to: 1) analyse postglacial recolonization of whitefish in the region; 2) assess the evolutionary distinctiveness of NSH, and 3) apply several approaches for defining conservation units towards setting conservation priorities for NSH. Results Bayesian cluster analyses of genetic differentiation identified four major groups, corresponding to NSH and three groups of ELW (Western Jutland, Central Jutland, Baltic Sea). Estimates of historical migration rates indicated recolonization in a north-eastern direction, suggesting that all except the Baltic Sea population predominantly represent postglacial recolonization via the ancient Elbe River. Contemporary gene flow has not occurred between NSH and ELW, with a divergence time within the last 4,000 years suggested from coalescence methods. NSH showed interbreeding with ELW when brought into contact by stocking. Thus, reproductive isolation of NSH was not absolute, although possible interbreeding beyond the F1 level could not be resolved. Conclusion Fishes of the C. lavaretus complex in the Jutland Peninsula originate from the same recolonization event. NSH has evolved recently and its species status may be questioned due to incomplete reproductive isolation from ELW, but it was shown to merit consideration as an independent conservation unit. Yet, application of several approaches for defining conservation units generated mixed outcomes regarding its conservation priority. Within the total species complex, it remains one among many recently evolved unique forms. Its uniqueness and high conservation priority is more evident at a local geographical scale, where conservation efforts will also benefit populations of a number of other endangered species. PMID:18471278
Water quality monitoring for high-priority water bodies in the Sonoran Desert network
Terry W. Sprouse; Robert M. Emanuel; Sara A. Strorrer
2005-01-01
This paper describes a network monitoring program for âhigh priorityâ water bodies in the Sonoran Desert Network of the National Park Service. Protocols were developed for monitoring selected waters for ten of the eleven parks in the Network. Park and network staff assisted in identifying potential locations of testing sites, local priorities, and how water quality...
Bus accident analysis of routes with/without bus priority.
Goh, Kelvin Chun Keong; Currie, Graham; Sarvi, Majid; Logan, David
2014-04-01
This paper summarises findings on road safety performance and bus-involved accidents in Melbourne along roads where bus priority measures had been applied. Results from an empirical analysis of the accident types revealed significant reduction in the proportion of accidents involving buses hitting stationary objects and vehicles, which suggests the effect of bus priority in addressing manoeuvrability issues for buses. A mixed-effects negative binomial (MENB) regression and back-propagation neural network (BPNN) modelling of bus accidents considering wider influences on accident rates at a route section level also revealed significant safety benefits when bus priority is provided. Sensitivity analyses done on the BPNN model showed general agreement in the predicted accident frequency between both models. The slightly better performance recorded by the MENB model results suggests merits in adopting a mixed effects modelling approach for accident count prediction in practice given its capability to account for unobserved location and time-specific factors. A major implication of this research is that bus priority in Melbourne's context acts to improve road safety and should be a major consideration for road management agencies when implementing bus priority and road schemes. Copyright © 2013 Elsevier Ltd. All rights reserved.
Enhanced Handover Decision Algorithm in Heterogeneous Wireless Network
Abdullah, Radhwan Mohamed; Zukarnain, Zuriati Ahmad
2017-01-01
Transferring a huge amount of data between different network locations over the network links depends on the network’s traffic capacity and data rate. Traditionally, a mobile device may be moved to achieve the operations of vertical handover, considering only one criterion, that is the Received Signal Strength (RSS). The use of a single criterion may cause service interruption, an unbalanced network load and an inefficient vertical handover. In this paper, we propose an enhanced vertical handover decision algorithm based on multiple criteria in the heterogeneous wireless network. The algorithm consists of three technology interfaces: Long-Term Evolution (LTE), Worldwide interoperability for Microwave Access (WiMAX) and Wireless Local Area Network (WLAN). It also employs three types of vertical handover decision algorithms: equal priority, mobile priority and network priority. The simulation results illustrate that the three types of decision algorithms outperform the traditional network decision algorithm in terms of handover number probability and the handover failure probability. In addition, it is noticed that the network priority handover decision algorithm produces better results compared to the equal priority and the mobile priority handover decision algorithm. Finally, the simulation results are validated by the analytical model. PMID:28708067
Dynamic autonomous routing technology for IP-based satellite ad hoc networks
NASA Astrophysics Data System (ADS)
Wang, Xiaofei; Deng, Jing; Kostas, Theresa; Rajappan, Gowri
2014-06-01
IP-based routing for military LEO/MEO satellite ad hoc networks is very challenging due to network and traffic heterogeneity, network topology and traffic dynamics. In this paper, we describe a traffic priority-aware routing scheme for such networks, namely Dynamic Autonomous Routing Technology (DART) for satellite ad hoc networks. DART has a cross-layer design, and conducts routing and resource reservation concurrently for optimal performance in the fluid but predictable satellite ad hoc networks. DART ensures end-to-end data delivery with QoS assurances by only choosing routing paths that have sufficient resources, supporting different packet priority levels. In order to do so, DART incorporates several resource management and innovative routing mechanisms, which dynamically adapt to best fit the prevailing conditions. In particular, DART integrates a resource reservation mechanism to reserve network bandwidth resources; a proactive routing mechanism to set up non-overlapping spanning trees to segregate high priority traffic flows from lower priority flows so that the high priority flows do not face contention from low priority flows; a reactive routing mechanism to arbitrate resources between various traffic priorities when needed; a predictive routing mechanism to set up routes for scheduled missions and for anticipated topology changes for QoS assurance. We present simulation results showing the performance of DART. We have conducted these simulations using the Iridium constellation and trajectories as well as realistic military communications scenarios. The simulation results demonstrate DART's ability to discriminate between high-priority and low-priority traffic flows and ensure disparate QoS requirements of these traffic flows.
Recommended Priorities for NASA's Gamma Ray Astronomy Program 1999-2013
NASA Technical Reports Server (NTRS)
Carol, Ladd
1999-01-01
The Gamma-Ray Astronomy Program Working Group (GRAPWG) recommends priorities for the NASA Gamma-Ray Astronomy Program. The highest priority science topic is nuclear astrophysics and sites of gamma ray line emission. Other high priority topics are gamma ray bursts, hard x-ray emission from accreting black holes and neutron stars, the Advanced Compton Telescope (ACT), the High-resolution Spectroscopic Imager (HSI), and the Energetic X-ray Imaging Survey Telescope (EXIST). The recommendations include special consideration for technology development, TeV astronomy, the ultra-long duration balloon (ULDB) program, the International Space Station, optical telescope support, and data analysis and theory.
Establishing national priorities for Australian occupational health and safety research.
Smith, Derek R
2010-01-01
This study aimed to identify current and emerging issues relevant to Occupational Health & Safety (OHS) research in Australia, and to formulate strategic research directions and strategies for the future. A national research forum was held which included leading OHS academics, employer and employee representative groups, as well as executives from state (New South Wales) and national (Safe Work Australia) representative bodies. A modified Delphi technique was used for collecting data in three phases. When ranked according to group consensus, the top three priorities for future OHS research in Australia were identified as being psychosocial and soft tissue injury hazards, work/life issues, and the impact of multiple, long-term exposures. Strategies to enhance collaboration despite limited research funding included the need to focus on complementary skills, to make the best use of Safe Work Australia's role (particularly to link with strategic and operational plans), and to foster closer engagement with research communities. While certain research priorities appear to be similar to those of other countries, the current study did identify some unique characteristics within an Australian context. High quality investigations of these issues should now be considered, in conjunction with greater cooperation between governments, regulators, employers and employee groups for the more effective facilitation of applied OHS research in the coming years.
Scheduling revisited workstations in integrated-circuit fabrication
NASA Technical Reports Server (NTRS)
Kline, Paul J.
1992-01-01
The cost of building new semiconductor wafer fabrication factories has grown rapidly, and a state-of-the-art fab may cost 250 million dollars or more. Obtaining an acceptable return on this investment requires high productivity from the fabrication facilities. This paper describes the Photo Dispatcher system which was developed to make machine-loading recommendations on a set of key fab machines. Dispatching policies that generally perform well in job shops (e.g., Shortest Remaining Processing Time) perform poorly for workstations such as photolithography which are visited several times by the same lot of silicon wafers. The Photo Dispatcher evaluates the history of workloads throughout the fab and identifies bottleneck areas. The scheduler then assigns priorities to lots depending on where they are headed after photolithography. These priorities are designed to avoid starving bottleneck workstations and to give preference to lots that are headed to areas where they can be processed with minimal waiting. Other factors considered by the scheduler to establish priorities are the nearness of a lot to the end of its process flow and the time that the lot has already been waiting in queue. Simulations that model the equipment and products in one of Texas Instrument's wafer fabs show the Photo Dispatcher can produce a 10 percent improvement in the time required to fabricate integrated circuits.
NASA Astrophysics Data System (ADS)
Zhao, Wei-hu; Zhao, Jing; Zhao, Shang-hong; Li, Yong-jun; Wang, Xiang; Dong, Yi; Dong, Chen
2013-08-01
Optical satellite communication with the advantages of broadband, large capacity and low power consuming broke the bottleneck of the traditional microwave satellite communication. The formation of the Space-based Information System with the technology of high performance optical inter-satellite communication and the realization of global seamless coverage and mobile terminal accessing are the necessary trend of the development of optical satellite communication. Considering the resources, missions and restraints of Data Relay Satellite Optical Communication System, a model of optical communication resources scheduling is established and a scheduling algorithm based on artificial intelligent optimization is put forwarded. According to the multi-relay-satellite, multi-user-satellite, multi-optical-antenna and multi-mission with several priority weights, the resources are scheduled reasonable by the operation: "Ascertain Current Mission Scheduling Time" and "Refresh Latter Mission Time-Window". The priority weight is considered as the parameter of the fitness function and the scheduling project is optimized by the Genetic Algorithm. The simulation scenarios including 3 relay satellites with 6 optical antennas, 12 user satellites and 30 missions, the simulation result reveals that the algorithm obtain satisfactory results in both efficiency and performance and resources scheduling model and the optimization algorithm are suitable in multi-relay-satellite, multi-user-satellite, and multi-optical-antenna recourses scheduling problem.
NABEIEI, PARISA; AMINI, MITRA; GHANAVATI, SHIRIN; MARHAMATI, SAADAT
2016-01-01
Introduction Research in education is a globally significant issue without a long history. Due to the importance of the issue in Health System Development programs, this study intended to determine research priorities in medical education, considering their details and functions. By determining barriers existing in research in education progress, it is tried to make research priorities more functional by recommending acceptable strategies. Methods This is a qualitative-descriptive study in two descriptive phases. The goal of these phases was to determine research priorities subcategories in medical education by Nominal Group Technique (NGT) and two rounds of Delphi method. Through the first phase, subcategories of research priorities were determined, using Nominal Group Technique under medical education experts’ supervision. Through two rounds of Delphi, a questionnaire was constructed based on the subcategories. Eventually, research priorities were determined based on their highest score (scores more than 7 out of 10). Results In the first phase (NGT), 35 priorities in 5 major fields of medical education were presented. In the second phase, priorities were scored, using Delphi method. Medical Ethics and professionalism gained the highest scores (7.63±1.26) and educational evaluation the lowest (7.28±1.52). In this stage, 7 items were omitted but 2 of them were added again after experts’ revision in the third round of Delphi. Conclusion According to the results of the present study and based on previous studies, it really seems that the fields of “Learning and Teaching Approaches” and “Medical Ethics and Professionalism” were more important. Because of financial and resource limitations in our country and the importance of research priorities, it is recommended to frequently study “research priorities determination program” at universities. PMID:26793723
Rehabilitation priorities for individuals with Prader-Willi Syndrome.
Pituch, Keenan A; Green, Vanessa A; Didden, Robert; Lang, Russell; O'Reilly, Mark F; Lancioni, Giulio E; Whittle, Lisa; Hodis, Flaviu; Sigafoos, Jeff
2010-01-01
To identify rehabilitation priorities that parents have for their children, including their adult-aged children, with Prader-Willi Syndrome (PWS) and to determine the relation between these priorities and the child's levels of adaptive behaviour functioning. Parents involved in organisations related to PWS were invited to complete an online survey. The survey listed 54 skills/behaviours (e.g. toileting, expresses wants and needs and tantrums) representing 10 adaptive functioning domains (e.g. self-care, communication and problem behaviour). Parents rated their child's current level of ability/performance with respect to each skill/behaviour and indicated the extent to which training/treatment was a priority. Fifty-eight surveys were completed during the 4-month data collection period. Parents identified nine high-priority skills/behaviours from five different adaptive functioning domains. For most domains, parent priorities showed a significant linear relation to the children's adaptive behaviour deficits, in that priorities reflected areas where the child had the greatest deficits and the most problematic behaviours. Rehabilitation professionals should focus on the eating issues that arise in PWS and identify the adaptive functioning deficits of these individuals because such deficits are high-priority areas for parents.
Tacconelli, Evelina; Carrara, Elena; Savoldi, Alessia; Harbarth, Stephan; Mendelson, Marc; Monnet, Dominique L; Pulcini, Céline; Kahlmeter, Gunnar; Kluytmans, Jan; Carmeli, Yehuda; Ouellette, Marc; Outterson, Kevin; Patel, Jean; Cavaleri, Marco; Cox, Edward M; Houchens, Chris R; Grayson, M Lindsay; Hansen, Paul; Singh, Nalini; Theuretzbacher, Ursula; Magrini, Nicola
2018-03-01
The spread of antibiotic-resistant bacteria poses a substantial threat to morbidity and mortality worldwide. Due to its large public health and societal implications, multidrug-resistant tuberculosis has been long regarded by WHO as a global priority for investment in new drugs. In 2016, WHO was requested by member states to create a priority list of other antibiotic-resistant bacteria to support research and development of effective drugs. We used a multicriteria decision analysis method to prioritise antibiotic-resistant bacteria; this method involved the identification of relevant criteria to assess priority against which each antibiotic-resistant bacterium was rated. The final priority ranking of the antibiotic-resistant bacteria was established after a preference-based survey was used to obtain expert weighting of criteria. We selected 20 bacterial species with 25 patterns of acquired resistance and ten criteria to assess priority: mortality, health-care burden, community burden, prevalence of resistance, 10-year trend of resistance, transmissibility, preventability in the community setting, preventability in the health-care setting, treatability, and pipeline. We stratified the priority list into three tiers (critical, high, and medium priority), using the 33rd percentile of the bacterium's total scores as the cutoff. Critical-priority bacteria included carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa, and carbapenem-resistant and third-generation cephalosporin-resistant Enterobacteriaceae. The highest ranked Gram-positive bacteria (high priority) were vancomycin-resistant Enterococcus faecium and meticillin-resistant Staphylococcus aureus. Of the bacteria typically responsible for community-acquired infections, clarithromycin-resistant Helicobacter pylori, and fluoroquinolone-resistant Campylobacter spp, Neisseria gonorrhoeae, and Salmonella typhi were included in the high-priority tier. Future development strategies should focus on antibiotics that are active against multidrug-resistant tuberculosis and Gram-negative bacteria. The global strategy should include antibiotic-resistant bacteria responsible for community-acquired infections such as Salmonella spp, Campylobacter spp, N gonorrhoeae, and H pylori. World Health Organization. Copyright © 2018 Elsevier Ltd. All rights reserved.
2014 Decompression Sickness/Extravehicular Activity Risks Standing Review Panel
NASA Technical Reports Server (NTRS)
Steinberg, Susan; Mahon, Richard; Klaus, David; Neuman, Tom; Pilmanis, Andrew; Regis, David
2014-01-01
The 2014 Decompression Sickness (DCS)/Extravehicular Activity (EVA) Risks Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on November 4 - 5, 2014. The SRP reviewed the Research Plans for The Risk of Decompression Sickness and the Risk of Injury and Compromised Performance due to EVA Operations, as well as the Evidence Reports for both of these Risks. The SRP found that the NASA DCS/EVA team did an excellent job of presenting their research plans. The SRP considers it critical that NASA proceeds with the high priority tasks identified in this report (DCS1, DCS3, DCS5). The highest priority is to determine the acceptable DCS and hypoxia risk associated with the planned human exploration beyond low Earth orbit. The risk of DCS is highly dependent upon the pressure within the exploration vehicle. If slightly more hypoxia is permitted then (even with the same percentage of oxygen) the pressure within the exploration vehicle can be lowered thus further mitigating the risk of DCS. The second highest priority is to test and validate the recommended 8.2psi/34% O2 atmosphere. Development of procedures and equipment for human exploration missions are very limited until the results of this testing are completed. The SRP also suggests that DCS7 be separated into two Gaps. Gap DCS7 should deal with DCS treatment while a new Gap should be created to deal with the long-term effects of DCS. The SRP also encourages NASA to increase collaboration with other organizations and pool resources where possible. The current NASA DCS/EVA team has the extensive expertise and a wealth of knowledge in this area. The SRP suggests that increased manpower for this team would be highly productive.
Robillard, Cassandra M; Kerr, Jeremy T
2017-08-01
High costs of land in agricultural regions warrant spatial prioritization approaches to conservation that explicitly consider land prices to produce protected-area networks that accomplish targets efficiently. However, land-use changes in such regions and delays between plan design and implementation may render optimized plans obsolete before implementation occurs. To measure the shelf life of cost-efficient conservation plans, we simulated a land-acquisition and restoration initiative aimed at conserving species at risk in Canada's farmlands. We accounted for observed changes in land-acquisition costs and in agricultural intensity based on censuses of agriculture taken from 1986 to 2011. For each year of data, we mapped costs and areas of conservation priority designated using Marxan. We compared plans to test for changes through time in the arrangement of high-priority sites and in the total cost of each plan. For acquisition costs, we measured the savings from accounting for prices during site selection. Land-acquisition costs and land-use intensity generally rose over time independent of inflation (24-78%), although rates of change were heterogeneous through space and decreased in some areas. Accounting for spatial variation in land price lowered the cost of conservation plans by 1.73-13.9%, decreased the range of costs by 19-82%, and created unique solutions from which to choose. Despite the rise in plan costs over time, the high conservation priority of particular areas remained consistent. Delaying conservation in these critical areas may compromise what optimized conservation plans can achieve. In the case of Canadian farmland, rapid conservation action is cost-effective, even with moderate levels of uncertainty in how to implement restoration goals. © 2016 Society for Conservation Biology.
The View of Nurses toward Prioritizing the Caring Behaviors in Cancer Patients
Valizadeh, Leila; Zamanzadeh, Vahid; Azimzadeh, Roghaieh; Rahmani, Azad
2012-01-01
Introduction: There are many opportunities for nurses to assist improving patient’s ex-perience of cancer. In fact, in every stage of cancer process, nurses can provide the re-quired and necessary cares and supports by representing substantial caring behaviors. Thus, by identifying and understanding the importance of caring behaviors which led to nurse-patient effective interactions, nurses would be able to care better for patients and so to enhance patients’ satisfaction toward nursing services. However, a few studies have ever been done about perception of oncology nurses about prioritization of caring behaviors. Methods: This was a descriptive study done among all the nurses of oncology wards (n = 40) in Shahid-Ghazi-Tabatabaei Hospital of Tabriz in 2009. Data collection performed using Larson’s CARE-Q tool that assessed the importance of caring beha-viors in six subscales as the following: “Monitors and follows through”, “Explains and facilitates”, “Physical and emotional comforts”, “Trusting relationship”, “Anticipates” and “Being accessible”. Results: In this study, the importance of caring behaviors was evaluated in moderate to high level and the priorities of care dimensions were deter-mined. “Monitors and follows through” and “Being accessible” received a high priority and “Anticipates”, “Explains and facilitates”, “Physical and emotional comforts” and “Trusting relationship” were given the low priority by nurses. Conclusion: The difference of caring prioritization by the nurses of this study compared to other studies can be attributed to the influence of cultural background on caring. Considering the high prioritizing of “Monitors and follows through” and “Being accessible”, nursing service officials and planners are recommended to attempt providing prerequisites of these two caring aspects. PMID:25276670
Systems and methods for maintaining multiple objects within a camera field-of-view
Gans, Nicholas R.; Dixon, Warren
2016-03-15
In one embodiment, a system and method for maintaining objects within a camera field of view include identifying constraints to be enforced, each constraint relating to an attribute of the viewed objects, identifying a priority rank for the constraints such that more important constraints have a higher priority that less important constraints, and determining the set of solutions that satisfy the constraints relative to the order of their priority rank such that solutions that satisfy lower ranking constraints are only considered viable if they also satisfy any higher ranking constraints, each solution providing an indication as to how to control the camera to maintain the objects within the camera field of view.
NASA Astrophysics Data System (ADS)
Yuvarani, S.; Saravanarajan, M. C.
2017-11-01
This paper concerned with performance analysis of single server preemptive priority retrial queue with a single vacation where two types of customers are considered and they are called priority customers and ordinary customers. The ordinary customers arrive in batch into the system. The priority customers do not form any queue. After the completion of regular service, the customers may demand re-service for the previous service without joining the orbit or may leave the system. As soon as the system is empty, the server goes for vacation and the regular busy server can be subjected to breakdown. By using the supplementary variable technique, we obtain the steady-state probability generating functions for the system/orbit size. Some important system performance measures and the stochastic decomposition are discussed. Finally, numerical examples are presented to visualize the effect of parameters on system performance measures.
25 CFR 170.205 - What is an IRR High Priority Project (IRRHPP)?
Code of Federal Regulations, 2010 CFR
2010-04-01
... RESERVATION ROADS PROGRAM Indian Reservation Roads Program Funding Irr High Priority Project (irrhpp) § 170... applications. (c) IRRHPP funds cannot be used for transportation planning, research, routine maintenance...
May-Collado, Laura J; Agnarsson, Ingi
2011-01-01
Habitat loss and overexploitation are among the primary factors threatening populations of many mammal species. Recently, aquatic mammals have been highlighted as particularly vulnerable. Here we test (1) if aquatic mammals emerge as more phylogenetically urgent conservation priorities than their terrestrial relatives, and (2) if high priority species are receiving sufficient conservation effort. We also compare results among some phylogenetic conservation methods. A phylogenetic analysis of conservation priorities for all 620 species of Cetartiodactyla and Carnivora, including most aquatic mammals. Conservation priority ranking of aquatic versus terrestrial species is approximately proportional to their diversity. However, nearly all obligated freshwater cetartiodactylans are among the top conservation priority species. Further, ∼74% and 40% of fully aquatic cetartiodactylans and carnivores, respectively, are either threatened or data deficient, more so than their terrestrial relatives. Strikingly, only 3% of all 'high priority' species are thought to be stable. An overwhelming 97% of these species thus either show decreasing population trends (87%) or are insufficiently known (10%). Furthermore, a disproportional number of highly evolutionarily distinct species are experiencing population decline, thus, such species should be closely monitored even if not currently threatened. Comparison among methods reveals that exact species ranking differs considerably among methods, nevertheless, most top priority species consistently rank high under any method. While we here favor one approach, we also suggest that a consensus approach may be useful when methods disagree. These results reinforce prior findings, suggesting there is an urgent need to gather basic conservation data for aquatic mammals, and special conservation focus is needed on those confined to freshwater. That evolutionarily distinct--and thus 'biodiverse'--species are faring relatively poorly is alarming and requires further study. Our results offer a detailed guide to phylogeny-based conservation prioritization for these two orders.
Krause, V L; Britton, W J
1993-09-20
Until recently tuberculosis was considered a well controlled disease, at least in developed countries. In developing countries, more than seven million people are affected by active tuberculosis. This situation is exacerbated by poor infrastructure to support tuberculosis control measures and the interaction between tuberculosis and infection with the human immunodeficiency virus. The three major strategies for controlling tuberculosis remain BCG vaccination in children, appropriate preventive therapy and, most importantly, reducing the sources of infection through case finding and curative treatment. Research and resources to improve on these strategies should be given high priority by the international health community.
Predicting Sepsis Risk Using the "Sniffer" Algorithm in the Electronic Medical Record.
Olenick, Evelyn M; Zimbro, Kathie S; DʼLima, Gabrielle M; Ver Schneider, Patricia; Jones, Danielle
The Sepsis "Sniffer" Algorithm (SSA) has merit as a digital sepsis alert but should be considered an adjunct to versus an alternative for the Nurse Screening Tool (NST), given lower specificity and positive predictive value. The SSA reduced the risk of incorrectly categorizing patients at low risk for sepsis, detected sepsis high risk in half the time, and reduced redundant NST screens by 70% and manual screening hours by 64% to 72%. Preserving nurse hours expended on manual sepsis alerts may translate into time directed toward other patient priorities.
Domitrovich, Celene E.; Bradshaw, Catherine P.; Poduska, Jeanne M.; Hoagwood, Kimberly; Buckley, Jacquelyn A.; Olin, Serene; Romanelli, Lisa Hunter; Leaf, Philip J.; Greenberg, Mark T.; Ialongo, Nicholas S.
2011-01-01
Increased availability of research-supported, school-based prevention programs, coupled with the growing national policy emphasis on use of evidence-based practices, has contributed to a shift in research priorities from efficacy to implementation and dissemination. A critical issue in moving research to practice is ensuring high-quality implementation of both the intervention model and the support system for sustaining it. The paper describes a three-level framework for considering the implementation quality of school-based interventions. Future directions for research on implementation are discussed. PMID:27182282
Software engineering processes for Class D missions
NASA Astrophysics Data System (ADS)
Killough, Ronnie; Rose, Debi
2013-09-01
Software engineering processes are often seen as anathemas; thoughts of CMMI key process areas and NPR 7150.2A compliance matrices can motivate a software developer to consider other career fields. However, with adequate definition, common-sense application, and an appropriate level of built-in flexibility, software engineering processes provide a critical framework in which to conduct a successful software development project. One problem is that current models seem to be built around an underlying assumption of "bigness," and assume that all elements of the process are applicable to all software projects regardless of size and tolerance for risk. This is best illustrated in NASA's NPR 7150.2A in which, aside from some special provisions for manned missions, the software processes are to be applied based solely on the criticality of the software to the mission, completely agnostic of the mission class itself. That is, the processes applicable to a Class A mission (high priority, very low risk tolerance, very high national significance) are precisely the same as those applicable to a Class D mission (low priority, high risk tolerance, low national significance). This paper will propose changes to NPR 7150.2A, taking mission class into consideration, and discuss how some of these changes are being piloted for a current Class D mission—the Cyclone Global Navigation Satellite System (CYGNSS).
Priority design parameters of industrialized optical fiber sensors in civil engineering
NASA Astrophysics Data System (ADS)
Wang, Huaping; Jiang, Lizhong; Xiang, Ping
2018-03-01
Considering the mechanical effects and the different paths for transferring deformation, optical fiber sensors commonly used in civil engineering have been systematically classified. Based on the strain transfer theory, the relationship between the strain transfer coefficient and allowable testing error is established. The proposed relationship is regarded as the optimal control equation to obtain the optimal value of sensors that satisfy the requirement of measurement precision. Furthermore, specific optimization design methods and priority design parameters of the classified sensors are presented. This research indicates that (1) strain transfer theory-based optimization design method is much suitable for the sensor that depends on the interfacial shear stress to transfer the deformation; (2) the priority design parameters are bonded (sensing) length, interfacial bonded strength, elastic modulus and radius of protective layer and thickness of adhesive layer; (3) the optimization design of sensors with two anchor pieces at two ends is independent of strain transfer theory as the strain transfer coefficient can be conveniently calibrated by test, and this kind of sensors has no obvious priority design parameters. Improved calibration test is put forward to enhance the accuracy of the calibration coefficient of end-expanding sensors. By considering the practical state of sensors and the testing accuracy, comprehensive and systematic analyses on optical fiber sensors are provided from the perspective of mechanical actions, which could scientifically instruct the application design and calibration test of industrialized optical fiber sensors.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bekelman, Justin E., E-mail: bekelman@uphs.upenn.edu; Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
Purpose: To present the principles and rationale of the Proton Priority System (PROPS), a priority points framework that assigns higher scores to patients thought to more likely benefit from proton therapy, and the distribution of PROPS scores by patient characteristics Methods and Materials: We performed multivariable logistic regression to evaluate the association between PROPS scores and receipt of proton therapy, adjusted for insurance status, gender, race, geography, and the domains that inform the PROPS score. Results: Among 1529 adult patients considered for proton therapy prioritization during our Center's ramp-up phase of treatment availability, PROPS scores varied by age, diagnosis, site,more » and other PROPS domains. In adjusted analyses, receipt of proton therapy was lower for patients with non-Medicare relative to Medicare health insurance (commercial vs Medicare: adjusted odds ratio [OR] 0.47, 95% confidence interval [CI] 0.34-0.64; managed care vs Medicare: OR 0.40, 95% CI 0.28-0.56; Medicaid vs Medicare: OR 0.24, 95% CI 0.13-0.44). Proton Priority System score and age were not significantly associated with receipt of proton therapy. Conclusions: The Proton Priority System is a rationally designed and transparent system for allocation of proton therapy slots based on the best available evidence and expert opinion. Because the actual allocation of treatment slots depends mostly on insurance status, payers may consider incorporating PROPS, or its underlying principles, into proton therapy coverage policies.« less
Sequential decision tree using the analytic hierarchy process for decision support in rectal cancer.
Suner, Aslı; Çelikoğlu, Can Cengiz; Dicle, Oğuz; Sökmen, Selman
2012-09-01
The aim of the study is to determine the most appropriate method for construction of a sequential decision tree in the management of rectal cancer, using various patient-specific criteria and treatments such as surgery, chemotherapy, and radiotherapy. An analytic hierarchy process (AHP) was used to determine the priorities of variables. Relevant criteria used in two decision steps and their relative priorities were established by a panel of five general surgeons. Data were collected via a web-based application and analyzed using the "Expert Choice" software specifically developed for the AHP. Consistency ratios in the AHP method were calculated for each set of judgments, and the priorities of sub-criteria were determined. A sequential decision tree was constructed for the best treatment decision process, using priorities determined by the AHP method. Consistency ratios in the AHP method were calculated for each decision step, and the judgments were considered consistent. The tumor-related criterion "presence of perforation" (0.331) and the patient-surgeon-related criterion "surgeon's experience" (0.630) had the highest priority in the first decision step. In the second decision step, the tumor-related criterion "the stage of the disease" (0.230) and the patient-surgeon-related criterion "surgeon's experience" (0.281) were the paramount criteria. The results showed some variation in the ranking of criteria between the decision steps. In the second decision step, for instance, the tumor-related criterion "presence of perforation" was just the fifth. The consistency of decision support systems largely depends on the quality of the underlying decision tree. When several choices and variables have to be considered in a decision, it is very important to determine priorities. The AHP method seems to be effective for this purpose. The decision algorithm developed by this method is more realistic and will improve the quality of the decision tree. Copyright © 2012 Elsevier B.V. All rights reserved.
36 CFR 230.4 - State program administration.
Code of Federal Regulations, 2010 CFR
2010-07-01
... and set priorities for achieving the goals and objectives identified for the State for each year. (2... planting, maintenance, and improvement, and other high priority practices within the State that will result... appropriate Service Representative; (9) Guidelines for establishing annual priorities for the approval of...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hall, David R; Bartholomew, David B; Moon, Justin
2009-09-08
An apparatus for fixing computational latency within a deterministic region on a network comprises a network interface modem, a high priority module and at least one deterministic peripheral device. The network interface modem is in communication with the network. The high priority module is in communication with the network interface modem. The at least one deterministic peripheral device is connected to the high priority module. The high priority module comprises a packet assembler/disassembler, and hardware for performing at least one operation. Also disclosed is an apparatus for executing at least one instruction on a downhole device within a deterministic region,more » the apparatus comprising a control device, a downhole network, and a downhole device. The control device is near the surface of a downhole tool string. The downhole network is integrated into the tool string. The downhole device is in communication with the downhole network.« less
Nagler, Rebekah H; Viswanath, Kasisomayajula
2013-04-01
Article 13 of the Framework Convention on Tobacco Control (FCTC) calls for a comprehensive ban on tobacco advertising, promotion, and sponsorship (TAPS), and Article 16 calls for prohibition of tobacco sales to and by minors. Although these mandates are based on sound science, many countries have found provision implementation to be rife with challenges. This paper reviews the history of tobacco marketing and minor access restrictions in high-, middle-, and low-income countries, identifying past challenges and successes. We consider current challenges to FCTC implementation, how these barriers can be addressed, and what research is necessary to support such efforts. Specifically, we identify implementation and research priorities for FCTC Articles 13 and 16. Although a solid evidence base underpins the FCTC's call for TAPS bans and minor access restrictions, we know substantially less about how best to implement these restrictions. Drawing on the regulatory experiences of high-, middle-, and low-income countries, we discern several implementation and research priorities, which are organized into 4 categories: policy enactment and enforcement, human capital expertise, the effects of FCTC marketing and youth access policies, and knowledge exchange and transfer among signatories. Future research should provide detailed case studies on implementation successes and failures, as well as insights into how knowledge of successful restrictions can be translated into tobacco control policy and practice and shared among different stakeholders. Tobacco marketing surveillance, sales-to-minors compliance checks, enforcement and evaluation of restriction policies, and capacity building and knowledge transfer are likely to prove central to effective implementation.
2014-08-14
The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Assistive Technology Alternative Financing Program administered by the Rehabilitation Services Administration (RSA). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. This priority is designed to ensure that the Department funds high-quality assistive technology (AT) alternative financing programs (AFPs) that meet rigorous standards in order to enable individuals with disabilities to access and acquire assistive technology devices and services necessary to achieve education, community living, and employment goals.
Kaplan, Giora; Baron-Epel, Orna
2015-01-01
Many stakeholders have little or no confidence in the ability of the public to express their opinions on health policy issues. The claim often arises that lay people prioritize according to their own personal experiences and may lack the broad perspective necessary to understand the needs of the population at large. In order to test this claim empirically, this study compares the public's priorities regarding personal insurance to their priorities regarding allocation of national health resources. Thus, the study should shed light on the extent to which the public's priorities at the national level are a reflection of their priorities at the personal level. A telephone survey was conducted with a representative sample of the Israeli adult population aged 18 and over (n = 1,225). The public's priorities were assessed by asking interviewees to assume that they were the Minister of Health and from this point of view allocate an additional budget among various health areas. Their priorities at the personal level were assessed by asking interviewees to choose preferred items for inclusion in their personal supplementary health insurance. Over half of the respondents (54%) expressed different personal and national priorities. In multivariable logistic analysis, "population group" was the only variable found to be statistically significant; Jews were 1.8 times more likely than Arabs to give a similar response to both questions. Income level was of borderline significance. At least half of the population was able to differentiate between their personal needs and national policy needs. We do not advocate a decision-making process based on polls or referendums. However, we believe that people should be allowed to express their priorities regarding national policy issues, and that decision-makers should consider these as one of the factors used to determine policy decisions.
Mather, Mara; Clewett, David; Sakaki, Michiko; Harley, Carolyn W
2016-01-01
Emotional arousal enhances perception and memory of high-priority information but impairs processing of other information. Here, we propose that, under arousal, local glutamate levels signal the current strength of a representation and interact with norepinephrine (NE) to enhance high priority representations and out-compete or suppress lower priority representations. In our "glutamate amplifies noradrenergic effects" (GANE) model, high glutamate at the site of prioritized representations increases local NE release from the locus coeruleus (LC) to generate "NE hotspots." At these NE hotspots, local glutamate and NE release are mutually enhancing and amplify activation of prioritized representations. In contrast, arousal-induced LC activity inhibits less active representations via two mechanisms: 1) Where there are hotspots, lateral inhibition is amplified; 2) Where no hotspots emerge, NE levels are only high enough to activate low-threshold inhibitory adrenoreceptors. Thus, LC activation promotes a few hotspots of excitation in the context of widespread suppression, enhancing high priority representations while suppressing the rest. Hotspots also help synchronize oscillations across neural ensembles transmitting high-priority information. Furthermore, brain structures that detect stimulus priority interact with phasic NE release to preferentially route such information through large-scale functional brain networks. A surge of NE before, during, or after encoding enhances synaptic plasticity at NE hotspots, triggering local protein synthesis processes that enhance selective memory consolidation. Together, these noradrenergic mechanisms promote selective attention and memory under arousal. GANE not only reconciles apparently contradictory findings in the emotion-cognition literature but also extends previous influential theories of LC neuromodulation by proposing specific mechanisms for how LC-NE activity increases neural gain.
NASA Astrophysics Data System (ADS)
Gan, Luping; Li, Yan-Feng; Zhu, Shun-Peng; Yang, Yuan-Jian; Huang, Hong-Zhong
2014-06-01
Failure mode, effects and criticality analysis (FMECA) and Fault tree analysis (FTA) are powerful tools to evaluate reliability of systems. Although single failure mode issue can be efficiently addressed by traditional FMECA, multiple failure modes and component correlations in complex systems cannot be effectively evaluated. In addition, correlated variables and parameters are often assumed to be precisely known in quantitative analysis. In fact, due to the lack of information, epistemic uncertainty commonly exists in engineering design. To solve these problems, the advantages of FMECA, FTA, fuzzy theory, and Copula theory are integrated into a unified hybrid method called fuzzy probability weighted geometric mean (FPWGM) risk priority number (RPN) method. The epistemic uncertainty of risk variables and parameters are characterized by fuzzy number to obtain fuzzy weighted geometric mean (FWGM) RPN for single failure mode. Multiple failure modes are connected using minimum cut sets (MCS), and Boolean logic is used to combine fuzzy risk priority number (FRPN) of each MCS. Moreover, Copula theory is applied to analyze the correlation of multiple failure modes in order to derive the failure probabilities of each MCS. Compared to the case where dependency among multiple failure modes is not considered, the Copula modeling approach eliminates the error of reliability analysis. Furthermore, for purpose of quantitative analysis, probabilities importance weight from failure probabilities are assigned to FWGM RPN to reassess the risk priority, which generalize the definition of probability weight and FRPN, resulting in a more accurate estimation than that of the traditional models. Finally, a basic fatigue analysis case drawn from turbine and compressor blades in aeroengine is used to demonstrate the effectiveness and robustness of the presented method. The result provides some important insights on fatigue reliability analysis and risk priority assessment of structural system under failure correlations.
Bourbakis, N G
1997-01-01
This paper presents a generic traffic priority language, called KYKLOFORTA, used by autonomous robots for collision-free navigation in a dynamic unknown or known navigation space. In a previous work by X. Grossmman (1988), a set of traffic control rules was developed for the navigation of the robots on the lines of a two-dimensional (2-D) grid and a control center coordinated and synchronized their movements. In this work, the robots are considered autonomous: they are moving anywhere and in any direction inside the free space, and there is no need of a central control to coordinate and synchronize them. The requirements for each robot are i) visual perception, ii) range sensors, and iii) the ability of each robot to detect other moving objects in the same free navigation space, define the other objects perceived size, their velocity and their directions. Based on these assumptions, a traffic priority language is needed for each robot, making it able to decide during the navigation and avoid possible collision with other moving objects. The traffic priority language proposed here is based on a set of primitive traffic priority alphabet and rules which compose pattern of corridors for the application of the traffic priority rules.
Plint, Amy C; Stang, Antonia S; Calder, Lisa A
2015-01-01
Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for improving patient safety (five priorities). This study established expert, consensus-based research priorities for patient safety in emergency medicine. This framework could be used by researchers and health-care funders and represents an essential guiding step towards enhancing quality of care and patient safety in the ED.
Rieger, Marc Oliver; Wang, Mei
2008-01-01
Comments on the article by E. Brandstätter, G. Gigerenzer, and R. Hertwig. The authors discuss the priority heuristic, a recent model for decisions under risk. They reanalyze the experimental validity of this approach and discuss how these results compare with cumulative prospect theory, the currently most established model in behavioral economics. They also discuss how general models for decisions under risk based on a heuristic approach can be understood mathematically to gain some insight in their limitations. They finally consider whether the priority heuristic model can lead to some understanding of the decision process of individuals or whether it is better seen as an as-if model. (c) 2008 APA, all rights reserved
How to save the national priorities list from the D.C. Circuit -- and itself
DOE Office of Scientific and Technical Information (OSTI.GOV)
Applegate, J.S.
1993-12-31
This article considers the National Priorities List (NPL) and its fate at the hands of the U.S. Court of Appeals for the District of Columbia Circuit. This author describes how the statutory structure of CERCLA, its bureaucratic implementation, and its juducual mistreatment have combined to focus enormous resources on the decisionmaking steps along the way, instead of the actual clean-up. This has contributed to the embarrassingly unproductive system whose reauthorization is now before Congress. 123 refs.
Using evaluation theory in priority setting and resource allocation.
Smith, Neale; Mitton, Craig; Cornelissen, Evelyn; Gibson, Jennifer; Peacock, Stuart
2012-01-01
Public sector interest in methods for priority setting and program or policy evaluation has grown considerably over the last several decades, given increased expectations for accountable and efficient use of resources and emphasis on evidence-based decision making as a component of good management practice. While there has been some occasional effort to conduct evaluation of priority setting projects, the literatures around priority setting and evaluation have largely evolved separately. In this paper, the aim is to bring them together. The contention is that evaluation theory is a means by which evaluators reflect upon what it is they are doing when they do evaluation work. Theories help to organize thinking, sort out relevant from irrelevant information, provide transparent grounds for particular implementation choices, and can help resolve problematic issues which may arise in the conduct of an evaluation project. A detailed review of three major branches of evaluation theory--methods, utilization, and valuing--identifies how such theories can guide the development of efforts to evaluate priority setting and resource allocation initiatives. Evaluation theories differ in terms of their guiding question, anticipated setting or context, evaluation foci, perspective from which benefits are calculated, and typical methods endorsed. Choosing a particular theoretical approach will structure the way in which any priority setting process is evaluated. The paper suggests that explicitly considering evaluation theory makes key aspects of the evaluation process more visible to all stakeholders, and can assist in the design of effective evaluation of priority setting processes; this should iteratively serve to improve the understanding of priority setting practices themselves.
Hart, Ailsa L; Lomer, Miranda; Verjee, Azmina; Kemp, Karen; Faiz, Omar; Daly, Ann; Solomon, Julie; McLaughlin, John
2017-02-01
Many uncertainties remain regarding optimal therapies and strategies for the treatment of inflammatory bowel disease. Setting research priorities addressing therapies requires a partnership between health care professionals, patients and organisations supporting patients. We aimed to use the structure of the James Lind Alliance Priority Setting Partnership, which has been used in other disease areas, to identify and prioritise unanswered questions about treatments for inflammatory bowel disease. The James Lind Priority Setting Partnership uses methods agreed and adopted in other disease areas to work with patients and clinicians: to identify uncertainties about treatments; to agree by consensus a prioritised list of uncertainties for research; then to translate these uncertainties into research questions which are amenable to hypothesis testing; and finally to take results to research commissioning bodies to be considered for funding. A total of 1636 uncertainties were collected in the initial survey from 531 respondents, which included 22% health care professionals and 78% patients and carers. Using the rigorously applied processes of the priority setting partnership, this list was distilled down to the top 10 research priorities for inflammatory bowel disease. The top priorities were: identifying treatment strategies to optimise efficacy, safety and cost-effectiveness; and stratifying patients with regard to their disease course and treatment response. Diet and symptom control [pain, incontinence and fatigue] were also topics which were prioritised. A partnership involving multidisciplinary clinicians, patients and organisations supporting patients has identified the top 10 research priorities in the treatment of patients with inflammatory bowel disease. © European Crohn’s and Colitis Organisation 2016.
Scanlan, Justin Newton; Pépin, Geneviève; Haracz, Kirsti; Ennals, Priscilla; Webster, Jayne S; Meredith, Pamela J; Batten, Rachel; Bowman, Siann; Bonassi, Marianne; Bruce, Rosie
2015-10-01
The effective preparation of occupational therapy students for mental health practice is critical to facilitate positive consumer outcomes, underpin optimal practice and support new graduates' professional identity. This project was established to determine a set of 'educational priorities' for occupational therapy students to prepare them for current (and future) entry-level practice in mental health, from the perspective of mental health occupational therapists in Australia and New Zealand. The study included two phases. In Phase One, participants identified what they considered to be important educational priorities for occupational therapy students to prepare them for practice in mental health. For Phase Two, an 'expert panel' was assembled to review and rank these using a Policy Delphi approach. Eighty-five participants provided educational priorities in Phase One. These were grouped into a total of 149 educational themes. In Phase Two, the expert panel (consisting of 37 occupational therapists from diverse locations and practice settings) prioritised these themes across three Delphi rounds. A final priority list was generated dividing educational themes into three prioritised categories: 29 'Essential', 25 'Important' and 44 'Optional' priorities. Highest-ranked priorities were: clinical reasoning, client-centred practice, therapeutic use of self, functional implications of mental illness, therapeutic use of occupation and mental health fieldwork experience. The priority list developed as part of this project provides additional information to support the review of occupational therapy curricula across Australia and New Zealand to ensure that new graduates are optimally prepared for mental health practice. © 2015 Occupational Therapy Australia.
Global research priorities for interpersonal violence prevention: a modified Delphi study.
Mikton, Christopher R; Tanaka, Masako; Tomlinson, Mark; Streiner, David L; Tonmyr, Lil; Lee, Bandy X; Fisher, Jane; Hegadoren, Kathy; Pim, Joam Evans; Wang, Shr-Jie Sharlenna; MacMillan, Harriet L
2017-01-01
To establish global research priorities for interpersonal violence prevention using a systematic approach. Research priorities were identified in a three-round process involving two surveys. In round 1, 95 global experts in violence prevention proposed research questions to be ranked in round 2. Questions were collated and organized according to the four-step public health approach to violence prevention. In round 2, 280 international experts ranked the importance of research in the four steps, and the various substeps, of the public health approach. In round 3, 131 international experts ranked the importance of detailed research questions on the public health step awarded the highest priority in round 2. In round 2, "developing, implementing and evaluating interventions" was the step of the public health approach awarded the highest priority for four of the six types of violence considered (i.e. child maltreatment, intimate partner violence, armed violence and sexual violence) but not for youth violence or elder abuse. In contrast, "scaling up interventions and evaluating their cost-effectiveness" was ranked lowest for all types of violence. In round 3, research into "developing, implementing and evaluating interventions" that addressed parenting or laws to regulate the use of firearms was awarded the highest priority. The key limitations of the study were response and attrition rates among survey respondents. However, these rates were in line with similar priority-setting exercises. These findings suggest it is premature to scale up violence prevention interventions. Developing and evaluating smaller-scale interventions should be the funding priority.
Global research priorities for interpersonal violence prevention: a modified Delphi study
Tanaka, Masako; Tomlinson, Mark; Streiner, David L; Tonmyr, Lil; Lee, Bandy X; Fisher, Jane; Hegadoren, Kathy; Pim, Joam Evans; Wang, Shr-Jie Sharlenna; MacMillan, Harriet L
2017-01-01
Abstract Objective To establish global research priorities for interpersonal violence prevention using a systematic approach. Methods Research priorities were identified in a three-round process involving two surveys. In round 1, 95 global experts in violence prevention proposed research questions to be ranked in round 2. Questions were collated and organized according to the four-step public health approach to violence prevention. In round 2, 280 international experts ranked the importance of research in the four steps, and the various substeps, of the public health approach. In round 3, 131 international experts ranked the importance of detailed research questions on the public health step awarded the highest priority in round 2. Findings In round 2, “developing, implementing and evaluating interventions” was the step of the public health approach awarded the highest priority for four of the six types of violence considered (i.e. child maltreatment, intimate partner violence, armed violence and sexual violence) but not for youth violence or elder abuse. In contrast, “scaling up interventions and evaluating their cost–effectiveness” was ranked lowest for all types of violence. In round 3, research into “developing, implementing and evaluating interventions” that addressed parenting or laws to regulate the use of firearms was awarded the highest priority. The key limitations of the study were response and attrition rates among survey respondents. However, these rates were in line with similar priority-setting exercises. Conclusion These findings suggest it is premature to scale up violence prevention interventions. Developing and evaluating smaller-scale interventions should be the funding priority. PMID:28053363
Sherfy, Mark; Anteau, Michael J.; Shaffer, Terry; Sovada, Marsha; Stucker, Jennifer
2011-01-01
Supporting recovery of federally listed interior least tern (Sternula antillarum athalassos; tern) and piping plover (Charadrius melodus; plover) populations is a desirable goal in management of the Missouri River ecosystem. Many tools are implemented in support of this goal, including habitat management, annual monitoring, directed research, and threat mitigation. Similarly, many types of data can be used to make management decisions, evaluate system responses, and prioritize research and monitoring. The ecological importance of Missouri River recovery and the conservation status of terns and plovers place a premium on efficient and effective resource use. Efficiency is improved when a single data source informs multiple high-priority decisions, whereas effectiveness is improved when decisions are informed by reliable knowledge. Seldom will a single study design be optimal for addressing all data needs, making prioritization of needs essential. Data collection motivated by well-articulated objectives and priorities has many advantages over studies in which questions and priorities are determined retrospectively. Research and monitoring for terns and plovers have generated a wealth of data that can be interpreted in a variety of ways. The validity and strength of conclusions from analyses of these data is dependent on compatibility between the study design and the question being asked. We consider issues related to collection and interpretation of biological data, and discuss their utility for enhancing the role of science in management of Missouri River terns and plovers. A team of USGS scientists at Northern Prairie Wildlife Research Center has been conducting tern and plover research on the Missouri River since 2005. The team has had many discussions about the importance of setting objectives, identifying priorities, and obtaining reliable information to answer pertinent questions about tern and plover management on this river system. The objectives of this presentation are to summarize those conversations and to share insights about concepts that could contribute to rigorous science support for management of this river system.
Grepperud, Sverre; Holman, Per Arne; Wangen, Knut Reidar
2014-12-14
Clinicians at Norwegian community mental health centres assess referrals from general practitioners and classify them into three priority groups (high priority, low priority, and refusal) according to need where need is defined by three prioritization criteria (severity, effect, and cost-effectiveness). In this study, we seek to operationalize the three criteria and analyze to what extent they have an effect on clinical-level priority setting after controlling for clinician characteristics and organisational factors. Twenty anonymous referrals were rated by 42 admission team members employed at 14 community mental health centres in the South-East Health Region of Norway. Intra-class correlation coefficients were calculated and logistic regressions were performed. Variation in clinicians' assessments of the three criteria was highest for effect and cost-effectiveness. An ordered logistic regression model showed that all three criteria for prioritization, three clinician characteristics (education, being a manager or not, and "guideline awareness"), and the centres themselves (fixed effects), explained priority decisions. The relative importance of the explanatory factors, however, depended on the priority decision studied. For the classification of all admitted patients into high- and low-priority groups, all clinician characteristics became insignificant. For the classification of patients, into those admitted and non-admitted, one criterion (effect) and "being a manager or not" became insignificant, while profession ("being a psychiatrist") became significant. Our findings suggest that variation in priority decisions can be reduced by: (i) reducing the disagreement in clinicians' assessments of cost-effectiveness and effect, and (ii) restricting priority decisions to clinicians with a similar background (education, being a manager or not, and "guideline awareness").
Advanced In-Space Propulsion: "Exploring the Solar System"
NASA Technical Reports Server (NTRS)
Johnson, Les
2003-01-01
This viewgraph presentation reviews a number of advanced propulsion technologies for interplanetary spacecraft. The objective of the In Space Propulsion Technology Projects Office is to develop in-space propulsion technologies that can enable and/or benefit near and mid-term NASA science missions by significantly reducing cost, mass, and/or travel times. The technologies profiled are divided into several categories: High Priority (aerocapture, next generation ion propulsion, solar sails); Medium Priority (advanced chemical propulsion, solar electric propulsion, Hall thrusters); Low Priority (solar thermal propulsion); and High Payoff/High Risk (1 g/sq m solar sails, momentum exchange tethers, and plasma sails).
RACOON: a multiuser QoS design for mobile wireless body area networks.
Cheng, Shihheng; Huang, Chingyao; Tu, Chun Chen
2011-10-01
In this study, Random Contention-based Resource Allocation (RACOON) medium access control (MAC) protocol is proposed to support the quality of service (QoS) for multi-user mobile wireless body area networks (WBANs). Different from existing QoS designs that focus on a single WBAN, a multiuser WBAN QoS should further consider both inter-WBAN interference and inter-WBAN priorities. Similar problems have been studied in both overlapped wireless local area networks (WLANs) and Bluetooth piconets that need QoS supports. However, these solutions are designed for non-medical transmissions that do not consider any priority scheme for medical applications. Most importantly, these studies focus on only static or low mobility networks. Network mobility of WBANs will introduce unnecessary inter-network collisions and energy waste, which are not considered by these solutions. The proposed multiuser-QoS protocol, RACOON, simultaneously satisfies the inter WBAN QoS requirements and overcomes the performance degradation caused by WBAN mobility. Simulation results verify that RACOON provides better latency and energy control, as compared with WBAN QoS protocols without considering the inter-WBAN requirements.
Strategic workload management and decision biases in aviation
NASA Technical Reports Server (NTRS)
Raby, Mireille; Wickens, Christopher D.
1994-01-01
Thirty pilots flew three simulated landing approaches under conditions of low, medium, and high workload. Workload conditions were created by varying time pressure and external communications requirements. Our interest was in how the pilots strategically managed or adapted to the increasing workload. We independently assessed the pilot's ranking of the priority of different discrete tasks during the approach and landing. Pilots were found to sacrifice some aspects of primary flight control as workload increased. For discrete tasks, increasing workload increased the amount of time in performing the high priority tasks, decreased the time in performing those of lowest priority, and did not affect duration of performance episodes or optimality of scheduling of tasks of any priority level. Individual differences analysis revealed that high-performing subjects scheduled discrete tasks earlier in the flight and shifted more often between different activities.
Implementation of and Ada real-time executive: A case study
NASA Technical Reports Server (NTRS)
Laird, James D.; Burton, Bruce A.; Koppes, Mary R.
1986-01-01
Current Ada language implementations and runtime environments are immature, unproven and are a key risk area for real-time embedded computer system (ECS). A test-case environment is provided in which the concerns of the real-time, ECS community are addressed. A priority driven executive is selected to be implemented in the Ada programming language. The model selected is representative of real-time executives tailored for embedded systems used missile, spacecraft, and avionics applications. An Ada-based design methodology is utilized, and two designs are considered. The first of these designs requires the use of vendor supplied runtime and tasking support. An alternative high-level design is also considered for an implementation requiring no vendor supplied runtime or tasking support. The former approach is carried through to implementation.
Current Challenges for Healthcare Services and the Opportunities Created by the Marketing Abilities
Purcărea, T; Purcărea, LV; Raţiu, M
2008-01-01
Life is changing dramatically, market position as part of life is becoming more and more important, and marketing, considered a key cultural architect of nowadays that involves voluntary relation exchanges between the communicating partners, is placing the patient in the center of most adequate action towards the medical future which represents his life quality. We think that the moment has come to resort to marketing as a new method to identify innovation opportunities in healthcare services' delivery, considering that the high quality of healthcare services, answering to demands of healthcare systems' consumers, represents a well recognized priority for the European citizens. Consequently, the model of ‘healthcare business’ has to rely on the value for patient by creating competition concerning the results at medical condition level. PMID:20108474
Landing Site Selection for Mars Sample Return
NASA Astrophysics Data System (ADS)
Farmer, J. D.
2002-05-01
"Follow the water" remains a guiding theme in the Mars exploration program. This is because information about the early volatile and climate history of Mars, habitability for past or present life and the potential for human exploration all require a knowledge of the distribution of water in all its forms and how water reservoirs have changed over time.ÿ Over the next four launch opportunities (through 2009), implementation of this broad goal will achieved using a combination of infrared spectral mapping of mineralogy from orbit and on the ground (to identify ancient surface water systems), and radar sounding from orbit to locate reservoirs of modern subsurface water. High spatial and spectral resolution mineralogical mapping from orbit is considered essential for locating the highest priority sites for in situ surface exploration and sample return. This work is now underway with THEMIS, a mid-IR instrument onboard the Odyssey spacecraft and presently mapping Mars at a spatial resolution of ~100 m/pixel. In 2005 the Mars Reconnaissance Orbiter (MRO) will carry a hyperspectral, near IR instrument capable of mapping targeted areas at a spatial resolution of <50 m/pixel. The 2001 and 2005 orbital missions will be interleaved with surface investigations in 2003 which will place twin "Mars Exploration Rovers" (MER's A and B) at two high priority sites to gather in situ information about surface mineralogy and petrology. The synergistic use of orbital reconnaissance and landed in situ science during the next three launch opportunities will yield important new information about the hydrological history of Mars that will provide a basis for targeting a second rover mission, the Mars Smart Lander (MSL), to a high priority site in 2009. The MSL rover will be a large, mobile platform of prolonged mission capability, that will conduct a variety of surface and shallow subsurface experiments to explore for aqueous minerals and organic materials preserved in aqueous sedimentary materials. In combination, these broadly-based investigations comprise an essential prelude for the targeting of sites for a first sample return from Mars sometime after 2011. In this talk, I will also review some of the high priority sites that have been identified as potential targets for the 2003 MER landers and beyond based on what we have learned about Mars since Viking.
Fitzpatrick, Una; Murray, Tomás E; Paxton, Robert J; Brown, Mark J F
2007-10-01
A World Conservation Union (IUCN) regional red list is an objective assessment of regional extinction risk and is not the same as a list of conservation priority species. Recent research reveals the widespread, but incorrect, assumption that IUCN Red List categories represent a hierarchical list of priorities for conservation action. We developed a simple eight-step priority-setting process and applied it to the conservation of bees in Ireland. Our model is based on the national red list but also considers the global significance of the national population; the conservation status at global, continental, and regional levels; key biological, economic, and societal factors; and is compatible with existing conservation agreements and legislation. Throughout Ireland, almost one-third of the bee fauna is threatened (30 of 100 species), but our methodology resulted in a reduced list of only 17 priority species. We did not use the priority species list to broadly categorize species to the conservation action required; instead, we indicated the individual action required for all threatened, near-threatened, and data-deficient species on the national red list based on the IUCN's conservation-actions template file. Priority species lists will strongly influence prioritization of conservation actions at national levels, but action should not be exclusive to listed species. In addition, all species on this list will not necessarily require immediate action. Our method is transparent, reproducible, and readily applicable to other taxa and regions.
Research priorities in medical education: A national study.
Tootoonchi, Mina; Yamani, Nikoo; Changiz, Tahereh; Yousefy, Alireza
2012-01-01
One preliminary step to strengthen medical education research would be determining the research priorities. The aim of this study was to determine the research priorities of medical education in Iran in 2007-2008. This descriptive study was carried out in two phases. Phase one was performed in 3 stages and used Delphi technique among academic staffs of Isfahan University of Medical Sciences. The three stages included a brainstorming workshop for 140 faculty members and educational experts resulting in a list of research priorities, then, in the second and third stages 99 and 76 questionnaires were distributed among faculty members. In the second phase, the final questionnaires were mailed to educational research center managers of universities type I, II and III, and were distributed among 311 academic members and educational experts to rate the items on a numerical scale ranging from 1 to 10. The most important research priorities included faculty members' development methods, faculty members' motives, satisfaction and welfare, criteria and procedures of faculty members' promotion, teaching methods and learning techniques, job descriptions and professional skills of graduates, quality management in education, second language, clinical education, science production in medicine, faculty evaluation and information technology. This study shows the medial education research priorities in national level and in different types of medical universities in Iran. It is recommended that faculty members and research administrators consider the needs and requirements of education and plan the researches in education according to these priorities.
Research priorities in medical education: A national study
Tootoonchi, Mina; Yamani, Nikoo; Changiz, Tahereh; Yousefy, Alireza
2012-01-01
BACKGROUND: One preliminary step to strengthen medical education research would be determining the research priorities. The aim of this study was to determine the research priorities of medical education in Iran in 2007-2008. METHODS: This descriptive study was carried out in two phases. Phase one was performed in 3 stages and used Delphi technique among academic staffs of Isfahan University of Medical Sciences. The three stages included a brainstorming workshop for 140 faculty members and educational experts resulting in a list of research priorities, then, in the second and third stages 99 and 76 questionnaires were distributed among faculty members. In the second phase, the final questionnaires were mailed to educational research center managers of universities type I, II and III, and were distributed among 311 academic members and educational experts to rate the items on a numerical scale ranging from 1 to 10. RESULTS: The most important research priorities included faculty members’ development methods, faculty members’ motives, satisfaction and welfare, criteria and procedures of faculty members’ promotion, teaching methods and learning techniques, job descriptions and professional skills of graduates, quality management in education, second language, clinical education, science production in medicine, faculty evaluation and information technology. CONCLUSIONS: This study shows the medial education research priorities in national level and in different types of medical universities in Iran. It is recommended that faculty members and research administrators consider the needs and requirements of education and plan the researches in education according to these priorities. PMID:23248661
Arora, Narendra K; Swaminathan, Soumya; Mohapatra, Archisman; Gopalan, Hema S; Katoch, Vishwa M; Bhan, Maharaj K; Rasaily, Reeta; Shekhar, Chander; Thavaraj, Vasantha; Roy, Malabika; Das, Manoja K; Wazny, Kerri; Kumar, Rakesh; Khera, Ajay; Bhatla, Neerja; Jain, Vanita; Laxmaiah, Avula; Nair, M K C; Paul, Vinod K; Ramachandran, Prema; Ramji, Siddharth; Vaidya, Umesh; Verma, I C; Shah, Dheeraj; Bahl, Rajiv; Qazi, Shamim; Rudan, Igor; Black, Robert E
2017-05-01
In India, research prioritization in Maternal, Newborn, and Child Health and Nutrition (MNCHN) themes has traditionally involved only a handful of experts mostly from major cities. The Indian Council of Medical Research (ICMR)-INCLEN collaboration undertook a nationwide exercise engaging faculty from 256 institutions to identify top research priorities in the MNCHN themes for 2016-2025. The Child Health and Nutrition Research Initiative method of priority setting was adapted. The context of the exercise was defined by a National Steering Group (NSG) and guided by four Thematic Research Subcommittees. Research ideas were pooled from 498 experts located in different parts of India, iteratively consolidated into research options, scored by 893 experts against five pre-defined criteria (answerability, relevance, equity, investment and innovation) and weighed by a larger reference group. Ranked lists of priorities were generated for each of the four themes at national and three subnational (regional) levels [Empowered Action Group & North-Eastern States, Southern and Western States, & Northern States (including West Bengal)]. Research priorities differed between regions and from overall national priorities. Delivery domain of research which included implementation research constituted about 70 per cent of the top ten research options under all four themes. The results were endorsed in the NSG meeting. There was unanimity that the research priorities should be considered by different governmental and non-governmental agencies for investment with prioritization on implementation research and issues cutting across themes.
Arora, Narendra K.; Swaminathan, Soumya; Mohapatra, Archisman; Gopalan, Hema S.; Katoch, Vishwa M.; Bhan, Maharaj K.; Rasaily, Reeta; Shekhar, Chander; Thavaraj, Vasantha; Roy, Malabika; Das, Manoja K.; Wazny, Kerri; Kumar, Rakesh; Khera, Ajay; Bhatla, Neerja; Jain, Vanita; Laxmaiah, Avula; Nair, M.K.C.; Paul, Vinod K.; Ramachandran, Prema; Ramji, Siddharth; Vaidya, Umesh; Verma, I.C.; Shah, Dheeraj; Bahl, Rajiv; Qazi, Shamim; Rudan, Igor; Black, Robert E.
2017-01-01
In India, research prioritization in Maternal, Newborn, and Child Health and Nutrition (MNCHN) themes has traditionally involved only a handful of experts mostly from major cities. The Indian Council of Medical Research (ICMR)-INCLEN collaboration undertook a nationwide exercise engaging faculty from 256 institutions to identify top research priorities in the MNCHN themes for 2016-2025. The Child Health and Nutrition Research Initiative method of priority setting was adapted. The context of the exercise was defined by a National Steering Group (NSG) and guided by four Thematic Research Subcommittees. Research ideas were pooled from 498 experts located in different parts of India, iteratively consolidated into research options, scored by 893 experts against five pre-defined criteria (answerability, relevance, equity, investment and innovation) and weighed by a larger reference group. Ranked lists of priorities were generated for each of the four themes at national and three subnational (regional) levels [Empowered Action Group & North-Eastern States, Southern and Western States, & Northern States (including West Bengal)]. Research priorities differed between regions and from overall national priorities. Delivery domain of research which included implementation research constituted about 70 per cent of the top ten research options under all four themes. The results were endorsed in the NSG meeting. There was unanimity that the research priorities should be considered by different governmental and non-governmental agencies for investment with prioritization on implementation research and issues cutting across themes. PMID:28948951
Priority Techniques for High Occupancy Vehicles : State-of-the-Art Overview
DOT National Transportation Integrated Search
1975-11-01
The report, part of a series of publications based on research and development efforts is a concise state-of-the-art overview of priority techniques for high occupancy vehicles (buses, carpools, and vanpools). The report identifies and summarizes sel...
2016-08-01
ARMY TRAINING Efforts to Adjust Training Requirements Should Consider the Use of Virtual Training Devices Report...Requirements Should Consider the Use of Virtual Training Devices What GAO Found In 2010, the Army began modifying its training priorities and goals to...until fiscal year 2017. The Army has taken some steps to improve the integration of virtual training devices into operational training, but gaps in
Chung, Kuo-Piao; Chen, Li-Ju; Chang, Yao-Jen; Chang, Yun-Jau; Lai, Mei-Shu
2013-02-01
To prioritize performance measures for colorectal cancer care to facilitate the implementation of a pay-for-performance (PFP) system. Questionnaires survey. Medical hospitals in Taiwan. Sixty-six medical doctors from 5 November 2009 to 10 December 2009. Analytic hierarchy process (AHP) technique. Main outcome measure(s) Performance measures (two pre-treatment, six treatment related and three monitoring related) were used. Forty-eight doctors responded and returned questionnaires (response rate 72.7%) with surgeons and physicians contributing equally. The most important measure was the proportion of colorectal patients who had pre-operative examinations that included chest X-ray and abdominal ultrasound, computed tomography or MRI (global priority: 0.144), followed by the proportion of stages I-III colorectal cancer patients who had undergone a wide surgical resection documented as 'negative margin' (global priority: 0.133) and the proportion of colorectal cancer patients who had undergone surgery with a pathology report that included information on tumor size and node differentiation (global priority: 0.116). Most participants considered that the best interval for the renewal indicators was 3-5 years (43.75%) followed by 5-10 years (27.08%). To design a PFP program, the AHP method is a useful technique to prioritize performance measures, especially in a highly specialized domain such as colorectal cancer care.
Proportional fair scheduling algorithm based on traffic in satellite communication system
NASA Astrophysics Data System (ADS)
Pan, Cheng-Sheng; Sui, Shi-Long; Liu, Chun-ling; Shi, Yu-Xin
2018-02-01
In the satellite communication network system, in order to solve the problem of low system capacity and user fairness in multi-user access to satellite communication network in the downlink, combined with the characteristics of user data service, an algorithm study on throughput capacity and user fairness scheduling is proposed - Proportional Fairness Algorithm Based on Traffic(B-PF). The algorithm is improved on the basis of the proportional fairness algorithm in the wireless communication system, taking into account the user channel condition and caching traffic information. The user outgoing traffic is considered as the adjustment factor of the scheduling priority and presents the concept of traffic satisfaction. Firstly,the algorithm calculates the priority of the user according to the scheduling algorithm and dispatches the users with the highest priority. Secondly, when a scheduled user is the business satisfied user, the system dispatches the next priority user. The simulation results show that compared with the PF algorithm, B-PF can improve the system throughput, the business satisfaction and fairness.
Adapting Technological Interventions to Meet the Needs of Priority Populations.
Linke, Sarah E; Larsen, Britta A; Marquez, Becky; Mendoza-Vasconez, Andrea; Marcus, Bess H
2016-01-01
Cardiovascular diseases (CVD) comprise the leading cause of mortality worldwide, accounting for 3 in 10 deaths. Individuals with certain risk factors, including tobacco use, obesity, low levels of physical activity, type 2 diabetes mellitus, racial/ethnic minority status and low socioeconomic status, experience higher rates of CVD and are, therefore, considered priority populations. Technological devices such as computers and smartphones are now routinely utilized in research studies aiming to prevent CVD and its risk factors, and they are also rampant in the public and private health sectors. Traditional health behavior interventions targeting these risk factors have been adapted for technology-based approaches. This review provides an overview of technology-based interventions conducted in these priority populations as well as the challenges and gaps to be addressed in future research. Researchers currently possess tremendous opportunities to engage in technology-based implementation and dissemination science to help spread evidence-based programs focusing on CVD risk factors in these and other priority populations. Copyright © 2016 Elsevier Inc. All rights reserved.
Ethics education: a priority for general practitioners in occupational medicine.
Alavi, S Shohreh; Makarem, Jalil; Mehrdad, Ramin
2015-01-01
General practitioners (GPs) who work in occupational medicine (OM) should be trained continuously. However, it seems that ethical issues have been neglected. This cross-sectional study aimed to determine educational priorities for GPs working in OM. A total of 410 GPs who participated in OM seminars were asked to answer a number of questions related to items that they usually come across in their work. The respondents were given scores on 15 items, which pertained to their frequency of experience in OM, their felt needs regarding education in the field, and their knowledge and skills. Ethical issues were the most frequently utilised item and the area in which the felt need for education was the greatest. The knowledge of and skills in ethical issues and matters were the poorest. Ethical principles and confidentiality had the highest calculated educational priority scores. It is necessary to consider ethical issues as an educational priority for GPs working in the field of OM.
Fundamentals of Gas Turbine combustion
NASA Technical Reports Server (NTRS)
Gerstein, M.
1979-01-01
Combustion problems and research recommendations are discussed in the areas of atomization and vaporization, combustion chemistry, combustion dynamics, and combustion modelling. The recommendations considered of highest priority in these areas are presented.
7 CFR 1410.12 - Emergency Forestry Program.
Code of Federal Regulations, 2010 CFR
2010-01-01
..., may be considered for priority purposes. These include but are not limited to soil erosion prevention, water quality improvement, wildlife habitat restoration, and mitigation of economic loss. (h) In return...
7 CFR 1410.12 - Emergency Forestry Program.
Code of Federal Regulations, 2011 CFR
2011-01-01
..., may be considered for priority purposes. These include but are not limited to soil erosion prevention, water quality improvement, wildlife habitat restoration, and mitigation of economic loss. (h) In return...
Interactions between visual working memory representations.
Bae, Gi-Yeul; Luck, Steven J
2017-11-01
We investigated whether the representations of different objects are maintained independently in working memory or interact with each other. Observers were shown two sequentially presented orientations and required to reproduce each orientation after a delay. The sequential presentation minimized perceptual interactions so that we could isolate interactions between memory representations per se. We found that similar orientations were repelled from each other whereas dissimilar orientations were attracted to each other. In addition, when one of the items was given greater attentional priority by means of a cue, the representation of the high-priority item was not influenced very much by the orientation of the low-priority item, but the representation of the low-priority item was strongly influenced by the orientation of the high-priority item. This indicates that attention modulates the interactions between working memory representations. In addition, errors in the reported orientations of the two objects were positively correlated under some conditions, suggesting that representations of distinct objects may become grouped together in memory. Together, these results demonstrate that working-memory representations are not independent but instead interact with each other in a manner that depends on attentional priority.
Saura, Santiago; Rondinini, Carlo
2016-01-01
One of the biggest challenges in large-scale conservation is quantifying connectivity at broad geographic scales and for a large set of species. Because connectivity analyses can be computationally intensive, and the planning process quite complex when multiple taxa are involved, assessing connectivity at large spatial extents for many species turns to be often intractable. Such limitation results in that conducted assessments are often partial by focusing on a few key species only, or are generic by considering a range of dispersal distances and a fixed set of areas to connect that are not directly linked to the actual spatial distribution or mobility of particular species. By using a graph theory framework, here we propose an approach to reduce computational effort and effectively consider large assemblages of species in obtaining multi-species connectivity priorities. We demonstrate the potential of the approach by identifying defragmentation priorities in the Italian road network focusing on medium and large terrestrial mammals. We show that by combining probabilistic species graphs prior to conducting the network analysis (i) it is possible to analyse connectivity once for all species simultaneously, obtaining conservation or restoration priorities that apply for the entire species assemblage; and that (ii) those priorities are well aligned with the ones that would be obtained by aggregating the results of separate connectivity analysis for each of the individual species. This approach offers great opportunities to extend connectivity assessments to large assemblages of species and broad geographic scales. PMID:27768718
Application of economic principles in healthcare priority setting.
Bate, Angela; Mitton, Craig
2006-06-01
In healthcare, resources are often insufficient to meet all claims on them. In this respect, resources are considered scarce and have to be managed by prioritizing between competing claims. Economics as a discipline explicitly addresses this reality by acknowledging resource scarcity. However, the extent to which economics actually influences such prioritizing decisions in healthcare is unclear. The purpose of this paper is to review the use of economics in priority setting decision making. We outline the key principles of economics as they apply to priority setting and review the methods reported in the literature with respect to these. We find that these methods, even economic methods (e.g., those typically used in conducting economic evaluations such as cost-effectiveness analyses) do not tend to explicitly incorporate economic principles. We argue therefore that these methods, when applied to the context of priority setting, are not sufficient and that what is required is a broader framework that can incorporate the output from economic methods yet also be pragmatically applicable. We then go on to present an alternative approach - namely program budgeting and marginal analysis. Finally, we put forward our case for using program budgeting and marginal analysis in priority setting practice and set out some future research challenges.
Xie, Hualin; Kung, Chih-Chun; Zhang, Yanting; Li, Xiubin
2012-01-01
Ecological land is like the “liver” of a city and is very useful to public health. Ecological land change is a spatially dynamic non-linear process under the interaction between natural and anthropogenic factors at different scales. In this study, by setting up natural development scenario, object orientation scenario and ecosystem priority scenario, a Cellular Automation (CA) model has been established to simulate the evolution pattern of ecological land in Beijing in the year 2020. Under the natural development scenario, most of ecological land will be replaced by construction land and crop land. But under the scenarios of object orientation and ecosystem priority, the ecological land area will increase, especially under the scenario of ecosystem priority. When considering the factors such as total area of ecological land, loss of key ecological land and spatial patterns of land use, the scenarios from priority to inferiority are ecosystem priority, object orientation and natural development, so future land management policies in Beijing should be focused on conversion of cropland to forest, wetland protection and prohibition of exploitation of natural protection zones, water source areas and forest parks to maintain the safety of the regional ecosystem. PMID:23066410
Xie, Hualin; Kung, Chih-Chun; Zhang, Yanting; Li, Xiubin
2012-08-01
Ecological land is like the "liver" of a city and is very useful to public health. Ecological land change is a spatially dynamic non-linear process under the interaction between natural and anthropogenic factors at different scales. In this study, by setting up natural development scenario, object orientation scenario and ecosystem priority scenario, a Cellular Automation (CA) model has been established to simulate the evolution pattern of ecological land in Beijing in the year 2020. Under the natural development scenario, most of ecological land will be replaced by construction land and crop land. But under the scenarios of object orientation and ecosystem priority, the ecological land area will increase, especially under the scenario of ecosystem priority. When considering the factors such as total area of ecological land, loss of key ecological land and spatial patterns of land use, the scenarios from priority to inferiority are ecosystem priority, object orientation and natural development, so future land management policies in Beijing should be focused on conversion of cropland to forest, wetland protection and prohibition of exploitation of natural protection zones, water source areas and forest parks to maintain the safety of the regional ecosystem.
Prioritization and willingness to pay for bariatric surgery: the patient perspective
Gill, Richdeep S.; Majumdar, Sumit R.; Wang, Xiaoming; Tuepah, Rebecca; Klarenbach, Scott W.; Birch, Daniel W.; Karmali, Shahzeer; Sharma, Arya M.; Padwal, Raj S.
2014-01-01
Background Access to publicly funded bariatric surgery is limited, potential candidates face lengthy waits, and no universally accepted prioritization criteria exist. We examined patients’ perspectives regarding prioritization for surgery. Methods We surveyed consecutively recruited patients awaiting bariatric surgery about 9 hypothetical scenarios describing patients waiting for surgery. Respondents were asked to rank the priority of these hypothetical patients on the wait list relative to their own. Scenarios examined variations in age, clinical severity, functional impairment, social dependence and socioeconomic status. Willingness to pay for faster access was assessed using a 5-point ordinal scale and analyzed using multivariable logistic regression. Results The 99 respondents had mean age of 44.7 ± 9.9 years, 76% were women, and the mean body mass index was 47.3 ± SD 7.6. The mean wait for surgery was 34.4 ± 9.4 months. Respondents assigned similar priority to hypothetical patients with characteristics identical to theirs (p = 0.22) and higher priority (greater urgency) to those exhibiting greater clinical severity (p < 0.001) and functional impairment (p = 0.003). Lower priority was assigned to patients at the extremes of age (p = 0.006), on social assistance (p < 0.001) and of high socioeconomic status (p < 0.001). Most (85%) respondents disagreed with payment to expedite access, although participants earning more than $80 000/year were less likely to disagree. Conclusion Most patients waiting for bariatric surgery consider greater clinical severity and functional impairments related to obesity to be important prioritization indicators and disagreed with paying for faster access. These findings may help inform future efforts to develop acceptable prioritization strategies for publicly funded bariatric surgery. PMID:24461224
Ecosystem Services and Opportunity Costs Shift Spatial Priorities for Conserving Forest Biodiversity
Schröter, Matthias; Rusch, Graciela M.; Barton, David N.; Blumentrath, Stefan; Nordén, Björn
2014-01-01
Inclusion of spatially explicit information on ecosystem services in conservation planning is a fairly new practice. This study analyses how the incorporation of ecosystem services as conservation features can affect conservation of forest biodiversity and how different opportunity cost constraints can change spatial priorities for conservation. We created spatially explicit cost-effective conservation scenarios for 59 forest biodiversity features and five ecosystem services in the county of Telemark (Norway) with the help of the heuristic optimisation planning software, Marxan with Zones. We combined a mix of conservation instruments where forestry is either completely (non-use zone) or partially restricted (partial use zone). Opportunity costs were measured in terms of foregone timber harvest, an important provisioning service in Telemark. Including a number of ecosystem services shifted priority conservation sites compared to a case where only biodiversity was considered, and increased the area of both the partial (+36.2%) and the non-use zone (+3.2%). Furthermore, opportunity costs increased (+6.6%), which suggests that ecosystem services may not be a side-benefit of biodiversity conservation in this area. Opportunity cost levels were systematically changed to analyse their effect on spatial conservation priorities. Conservation of biodiversity and ecosystem services trades off against timber harvest. Currently designated nature reserves and landscape protection areas achieve a very low proportion (9.1%) of the conservation targets we set in our scenario, which illustrates the high importance given to timber production at present. A trade-off curve indicated that large marginal increases in conservation target achievement are possible when the budget for conservation is increased. Forty percent of the maximum hypothetical opportunity costs would yield an average conservation target achievement of 79%. PMID:25393951
Schröter, Matthias; Rusch, Graciela M; Barton, David N; Blumentrath, Stefan; Nordén, Björn
2014-01-01
Inclusion of spatially explicit information on ecosystem services in conservation planning is a fairly new practice. This study analyses how the incorporation of ecosystem services as conservation features can affect conservation of forest biodiversity and how different opportunity cost constraints can change spatial priorities for conservation. We created spatially explicit cost-effective conservation scenarios for 59 forest biodiversity features and five ecosystem services in the county of Telemark (Norway) with the help of the heuristic optimisation planning software, Marxan with Zones. We combined a mix of conservation instruments where forestry is either completely (non-use zone) or partially restricted (partial use zone). Opportunity costs were measured in terms of foregone timber harvest, an important provisioning service in Telemark. Including a number of ecosystem services shifted priority conservation sites compared to a case where only biodiversity was considered, and increased the area of both the partial (+36.2%) and the non-use zone (+3.2%). Furthermore, opportunity costs increased (+6.6%), which suggests that ecosystem services may not be a side-benefit of biodiversity conservation in this area. Opportunity cost levels were systematically changed to analyse their effect on spatial conservation priorities. Conservation of biodiversity and ecosystem services trades off against timber harvest. Currently designated nature reserves and landscape protection areas achieve a very low proportion (9.1%) of the conservation targets we set in our scenario, which illustrates the high importance given to timber production at present. A trade-off curve indicated that large marginal increases in conservation target achievement are possible when the budget for conservation is increased. Forty percent of the maximum hypothetical opportunity costs would yield an average conservation target achievement of 79%.
van der Veer, Sabine N; Jager, Kitty J; Visserman, Ella; Beekman, Robert J; Boeschoten, Els W; de Keizer, Nicolette F; Heuveling, Lara; Stronks, Karien; Arah, Onyebuchi A
2012-08-01
Patient experience is an established indicator of quality of care. Validated tools that measure both experiences and priorities are lacking for chronic dialysis care, hampering identification of negative experiences that patients actually rate important. We developed two Consumer Quality (CQ) index questionnaires, one for in-centre haemodialysis (CHD) and the other for peritoneal dialysis and home haemodialysis (PHHD) care. The instruments were validated using exploratory factor analyses, reliability analysis of identified scales and assessing the association between reliable scales and global ratings. We investigated opportunities for improvement by combining suboptimal experience with patient priority. Sixteen dialysis centres participated in our study. The pilot CQ index for CHD care consisted of 71 questions. Based on data of 592 respondents, we identified 42 core experience items in 10 scales with Cronbach's α ranging from 0.38 to 0.88; five were reliable (α ≥ 0.70). The instrument identified information on centres' fire procedures as the aspect of care exhibiting the biggest opportunity for improvement. The pilot CQ index PHHD comprised 56 questions. The response of 248 patients yielded 31 core experience items in nine scales with Cronbach's α ranging between 0.53 and 0.85; six were reliable. Information on kidney transplantation during pre-dialysis showed most room for improvement. However, for both types of care, opportunities for improvement were mostly limited. The CQ index reliably and validly captures dialysis patient experience. Overall, most care aspects showed limited room for improvement, mainly because patients participating in our study rated their experience to be optimal. To evaluate items with high priority, but with which relatively few patients have experience, more qualitative instruments should be considered.
Use of consensus development to establish national research priorities in critical care
Vella, Keryn; Goldfrad, Caroline; Rowan, Kathy; Bion, Julian; Black, Nick
2000-01-01
Objectives To test the feasibility of using a nominal group technique to establish clinical and health services research priorities in critical care and to test the representativeness of the group's views. Design Generation of topics by means of a national survey; a nominal group technique to establish the level of consensus; a survey to test the representativeness of the results. Setting United Kingdom and Republic of Ireland. Subjects Nominal group composed of 10 doctors (8 consultants, 2 trainees) and 2 nurses. Main outcome measure Level of support (median) and level of agreement (mean absolute deviation from the median) derived from a 9 point Likert scale. Results Of the 325 intensive care units approached, 187 (58%) responded, providing about 1000 suggestions for research. Of the 106 most frequently suggested topics considered by the nominal group, 37 attracted strong support, 48 moderate support and 21 weak support. There was more agreement after the group had met—overall mean of the mean absolute deviations from the median fell from 1.41 to 1.26. The group's views represented the views of the wider community of critical care staff (r=0.73, P<0.01). There was no significant difference in the views of staff from teaching or from non-teaching hospitals. Of the 37 topics that attracted the strongest support, 24 were concerned with organisational aspects of critical care and only 13 with technology assessment or clinical research. Conclusions A nominal group technique is feasible and reliable for determining research priorities among clinicians. This approach is more democratic and transparent than the traditional methods used by research funding bodies. The results suggest that clinicians perceive research into the best ways of delivering and organising services as a high priority. PMID:10753149
Prioritization and willingness to pay for bariatric surgery: the patient perspective.
Gill, Richdeep S; Majumdar, Sumit R; Wang, Xiaoming; Tuepah, Rebecca; Klarenbach, Scott W; Birch, Daniel W; Karmali, Shahzeer; Sharma, Arya M; Padwal, Raj S
2014-02-01
Access to publicly funded bariatric surgery is limited, potential candidates face lengthy waits, and no universally accepted prioritization criteria exist. We examined patients' perspectives regarding prioritization for surgery. We surveyed consecutively recruited patients awaiting bariatric surgery about 9 hypothetical scenarios describing patients waiting for surgery. Respondents were asked to rank the priority of these hypothetical patients on the wait list relative to their own. Scenarios examined variations in age, clinical severity, functional impairment, social dependence and socioeconomic status. Willingness to pay for faster access was assessed using a 5-point ordinal scale and analyzed using multivariable logistic regression. The 99 respondents had mean age of 44.7 ± 9.9 years, 76% were women, and the mean body mass index was 47.3 ± SD 7.6. The mean wait for surgery was 34.4 ± 9.4 months. Respondents assigned similar priority to hypothetical patients with characteristics identical to theirs (p = 0.22) and higher priority (greater urgency) to those exhibiting greater clinical severity (p < 0.001) and functional impairment (p = 0.003). Lower priority was assigned to patients at the extremes of age (p = 0.006), on social assistance (p < 0.001) and of high socioeconomic status (p < 0.001). Most (85%) respondents disagreed with payment to expedite access, although participants earning more than $80 000/year were less likely to disagree. Most patients waiting for bariatric surgery consider greater clinical severity and functional impairments related to obesity to be important prioritization indicators and disagreed with paying for faster access. These findings may help inform future efforts to develop acceptable prioritization strategies for publicly funded bariatric surgery.
Application of remote sensing to state and regional problems. [mississippi
NASA Technical Reports Server (NTRS)
Miller, W. F.; Powers, J. S.; Clark, J. R.; Solomon, J. L.; Williams, S. G. (Principal Investigator)
1981-01-01
The methods and procedures used, accomplishments, current status, and future plans are discussed for each of the following applications of LANDSAT in Mississippi: (1) land use planning in Lowndes County; (2) strip mine inventory and reclamation; (3) white-tailed deer habitat evaluation; (4) remote sensing data analysis support systems; (5) discrimination of unique forest habitats in potential lignite areas; (6) changes in gravel operations; and (7) determining freshwater wetlands for inventory and monitoring. The documentation of all existing software and the integration of the image analysis and data base software into a single package are now considered very high priority items.
Consumers' reports on the health effects of direct-to-consumer drug advertising.
Weissman, Joel S; Blumenthal, David; Silk, Alvin J; Zapert, Kinga; Newman, Michael; Leitman, Robert
2003-01-01
We conducted a national telephone survey about health care experiences associated with direct-to-consumer advertising (DTCA) of prescription drugs. Among the 35 percent of our sample who had a physician visit during which DTCA was discussed, 25 percent received a new diagnosis, of which 43 percent were considered high priority according to authoritative sources. More than half also reported actions taken by their physician other than prescribing the advertised drug. Despite concerns about DTCA's negative consequences, we found no differences in health effects between patients who took advertised drugs and those who took other prescription drugs.
NASA Astrophysics Data System (ADS)
Spierling, Ulrike; Szilas, Nicolas
Authoring is still considered a bottleneck in successful Interactive Storytelling and Drama. The claim for intuitive authoring tools is high, especially for tools that allow storytellers and artists to define dynamic content that can be run with an AI-based story engine. We explored two concrete authoring processes in depth, using various Interactive Storytelling prototypes, and have provided feedback from the practical steps. The result is a presentation of general issues in authoring Interactive Storytelling, rather than of particular problems with a specific system that could be overcome by 'simply' designing the right interface. Priorities for future developments are also outlined.
[Atrial fibrillation in elderly].
Arquizan, Caroline
2012-11-01
Atrial fibrilation (AF) is frequent and a strong risk factor for ischemic stroke in elderly. Ischemic stroke in patients with AF are more severe. Vitamine K antagonist therapy is highly effective for stroke prevention but is associated with hemorrhagic risk. The new oral anticoagulants (direct thrombin inhibitor [dabigatran], and direct factor Xa inhibitors [rivaroxaban and apixaban]) have all shown non inferiority or superiority, with better safety, considering the risk of intracranial haemorrhage. On this basis, it is justified to give them in priority in the vast majority of patients with AF, the choice of the drug and the dose is individual.
5 CFR 330.201 - Establishment and maintenance of RPL.
Code of Federal Regulations, 2010 CFR
2010-01-01
... RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Reemployment Priority List (RPL) § 330.201 Establishment and... registrants before considering internal candidates. (b) Each agency is required to establish and maintain a...
Land Use in the CERCLA Remedy Selection Process
This directive presents additional information for considering land use in making remedy selection decisions under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) at National Priorities List (NPL) sites.
The mycetoma knowledge gap: identification of research priorities.
van de Sande, Wendy W J; Maghoub, El Sheikh; Fahal, Ahmed H; Goodfellow, Michael; Welsh, Oliverio; Zijlstra, Ed
2014-03-01
Mycetoma is a tropical disease which is caused by a taxonomically diverse range of actinomycetes (actinomycetoma) and fungi (eumycetoma). The disease was only recently listed by the World Health Organization (WHO) as a neglected tropical disease (NTD). This recognition is the direct result of a meeting held in Geneva on February 1, 2013, in which experts on the disease from around the world met to identify the key research priorities needed to combat mycetoma. The areas that need to be addressed are highlighted here. The initial priority is to establish the incidence and prevalence of the disease in regions where mycetoma is endemic, prior to determining the primary reservoirs of the predominant causal agents and their mode of transmission to susceptible individuals in order to establish novel interventions that will reduce the impact of the disease on individuals, families, and communities. Critically, economical, reliable, and effective methods are required to achieve early diagnosis of infections and consequential improved therapeutic outcomes. Molecular techniques and serological assays were considered the most promising in the development of novel diagnostic tools to be used in endemic settings. Improved strategies for treating eumycetoma and actinomycetoma are also considered.
Space Shuttle food galley design concept
NASA Technical Reports Server (NTRS)
Heidelbaugh, N. D.; Smith, M. C.; Fischer, R.; Cooper, B.
1974-01-01
A food galley has been designed for the crew compartment of the NASA Space Shuttle Orbiter. The rationale for the definition of this design was based upon assignment of priorities to each functional element of the total food system. Principle priority categories were assigned in the following order: food quality, nutrition, food packaging, menu acceptance, meal preparation efficiency, total system weight, total system volume, and total power requirements. Hence, the galley was designed using an 'inside-out' approach which first considered the food and related biological functions and subsequently proceeded 'outward' from the food to encompass supporting hardware. The resulting galley is an optimal design incorporating appropriate priorities for trade-offs between biological and engineering constraints. This design approach is offered as a model for the design of life support systems.
Operating room scheduling using hybrid clustering priority rule and genetic algorithm
NASA Astrophysics Data System (ADS)
Santoso, Linda Wahyuni; Sinawan, Aisyah Ashrinawati; Wijaya, Andi Rahadiyan; Sudiarso, Andi; Masruroh, Nur Aini; Herliansyah, Muhammad Kusumawan
2017-11-01
Operating room is a bottleneck resource in most hospitals so that operating room scheduling system will influence the whole performance of the hospitals. This research develops a mathematical model of operating room scheduling for elective patients which considers patient priority with limit number of surgeons, operating rooms, and nurse team. Clustering analysis was conducted to the data of surgery durations using hierarchical and non-hierarchical methods. The priority rule of each resulting cluster was determined using Shortest Processing Time method. Genetic Algorithm was used to generate daily operating room schedule which resulted in the lowest values of patient waiting time and nurse overtime. The computational results show that this proposed model reduced patient waiting time by approximately 32.22% and nurse overtime by approximately 32.74% when compared to actual schedule.
Future hadron colliders: From physics perspectives to technology R&D
NASA Astrophysics Data System (ADS)
Barletta, William; Battaglia, Marco; Klute, Markus; Mangano, Michelangelo; Prestemon, Soren; Rossi, Lucio; Skands, Peter
2014-11-01
High energy hadron colliders have been instrumental to discoveries in particle physics at the energy frontier and their role as discovery machines will remain unchallenged for the foreseeable future. The full exploitation of the LHC is now the highest priority of the energy frontier collider program. This includes the high luminosity LHC project which is made possible by a successful technology-readiness program for Nb3Sn superconductor and magnet engineering based on long-term high-field magnet R&D programs. These programs open the path towards collisions with luminosity of 5×1034 cm-2 s-1 and represents the foundation to consider future proton colliders of higher energies. This paper discusses physics requirements, experimental conditions, technological aspects and design challenges for the development towards proton colliders of increasing energy and luminosity.
Childs, Nicola; Robinson, Lisa; Chowdhury, Sonya; Ogden, Clare; Newton, Julia L
2015-01-01
Myalgic encephalitis (M.E.) is a common condition, the cause of which is not known and there are no treatments available. In this study the national patient support group Action for M.E. sought the opinions of their members via an online survey as to what they felt should be future priorities for M.E. Respondents were asked what they considered first, second and third research priorities to be from a list of 13 pre-defined options. Individuals were invited to provide additional free text comments about Action for M.E.'s research priorities in general. Of the 1144 respondents: 822 had M.E.; 94 were a supporting a member of Action for M.E. ; 66 were carers for someone with M.E.; 26 were professionals with an interest in M.E.; 136 had a family member or colleague with M.E. Individuals selected more than one category as applicable. The top five research priorities identified were: disease processes to achieve a better understanding of the causes of M.E.; more effective treatments; faster and more accurate diagnosis; clinical course of M.E.; outcomes and natural history; and severely affected patients. Least popular priorities were: sleep; economic research towards identifying the cost of ME; and psychological aspects. Much of the free text comments emphasised the importance of funding biomedical research into disease processes to achieve a better understanding of the causes of M.E. Three themes were identified in relation to this topic: accurate diagnosis and awareness; risk factors and causes; drug development and curative therapies. In conclusion; individuals affected by M.E. have clear views regarding priorities for research investment. These have informed Action for M.E.'s ongoing research strategy and ultimately will inform national and international research priorities.
Unconventional missile concepts from consideration of varied mission requirements
NASA Technical Reports Server (NTRS)
Spearman, M. L.
1984-01-01
Missile concepts for volumetric efficiency, minimum carriage constraints, and aerodynamic performance to achieve mission requirements. The mission requirements considered include air to surface roles such as defense suppression or antishipping where payload and range may have priority over high maneuver capability, and air to air and surface to air roles paying attention to good maneuvering capability. The concepts are intended to provide for ease of storage or carriage. The concepts include monoplanes with highly swept, thick delta wings, highly swept delta wings mounted either high or low on a semicircular body, some ring wing and semiring wing arrangements, parasol wing, and elliptical lifting bodies. The missile configurations indicate possible approaches toward resolving problems of carriage and storage while retaining good volumetric and aerodynamic efficiency. The configurations can accomplish a variety of possible missions with relatively simple vehicle shapes.
Market segmentation using perceived constraints
Jinhee Jun; Gerard Kyle; Andrew Mowen
2008-01-01
We examined the practical utility of segmenting potential visitors to Cleveland Metroparks using their constraint profiles. Our analysis identified three segments based on their scores on the dimensions of constraints: Other priorities--visitors who scored the highest on 'other priorities' dimension; Highly Constrained--visitors who scored relatively high on...
Cornelissen, Evelyn; Mitton, Craig; Davidson, Alan; Reid, Colin; Hole, Rachelle; Visockas, Anne-Marie; Smith, Neale
2014-08-01
Techniques to manage scarce healthcare resources continue to evolve in response to changing, growing and competing demands. Yet there is no standard definition in the priority setting literature of what might constitute the desired impact or success of resource management activities. In this 2006-09 study, using action research methodology, we determined the impact of implementing a formal priority setting model, Program Budgeting and Marginal Analysis (PBMA), in a Canadian health authority. Qualitative data were collected through post year-1 (n = 12) and year-2 (n = 9) participant interviews, meeting observation and document review. Interviews were analyzed using a constant comparison technique to identify major themes. Impact can be defined as effects at three levels: system, group, and individual. System-level impact can be seen in the actual selection of priorities and resource re-allocation. In this case, participants prioritized a list of $760,000 worth of investment proposals and $38,000 of disinvestment proposals; however, there was no clear evidence as to whether financial resources were reallocated as a result. Group and individual impacts, less frequently reported in the literature, included changes in priority setting knowledge, attitudes and practice. PBMA impacts at these three levels were found to be interrelated. This work argues in favor of attempts to expand the definition of priority setting success by including both desired system-level outcomes like resource re-allocation and individual or group level impacts like changes to priority setting knowledge, attitudes and practice. These latter impacts are worth pursuing as they appear to be intrinsic to successful system-wide priority setting. A broader definition of PBMA impact may also suggest conceptualizing PBMA as both a priority setting approach and as a tool to develop individual and group priority setting knowledge and practice. These results should be of interest to researchers and decision makers using or considering a formal priority setting approach to manage scarce healthcare resources. Copyright © 2014 Elsevier Ltd. All rights reserved.
2014-07-28
The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Research Fellowships Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, this notice announces a priority for a Distinguished Residential Disability and Rehabilitation Policy Fellowship. We take this action to focus attention on an area of national need. We intend the priority to build research capacity by providing support to highly qualified, experienced researchers, including those who are individuals with disabilities, to conduct policy research in the areas of disability and rehabilitation.
The Big Rocks: Priority Management for Principals
ERIC Educational Resources Information Center
Marshall, Kim
2008-01-01
How can a dedicated principal work really, really hard but fail to get significant gains in student achievement? The answer is obvious: by spending too much time on the wrong things and not enough on the right things. The principal's number-one priority is zeroing in on the highest-priority activities for bringing all students to high levels of…
Khoury, Colin K.; Heider, Bettina; Castañeda-Álvarez, Nora P.; Achicanoy, Harold A.; Sosa, Chrystian C.; Miller, Richard E.; Scotland, Robert W.; Wood, John R. I.; Rossel, Genoveva; Eserman, Lauren A.; Jarret, Robert L.; Yencho, G. C.; Bernau, Vivian; Juarez, Henry; Sotelo, Steven; de Haan, Stef; Struik, Paul C.
2015-01-01
Crop wild relatives of sweetpotato [Ipomoea batatas (L.) Lam., I. series Batatas] have the potential to contribute to breeding objectives for this important root crop. Uncertainty in regard to species boundaries and their phylogenetic relationships, the limited availability of germplasm with which to perform crosses, and the difficulty of introgression of genes from wild species has constrained their utilization. Here, we compile geographic occurrence data on relevant sweetpotato wild relatives and produce potential distribution models for the species. We then assess the comprehensiveness of ex situ germplasm collections, contextualize these results with research and breeding priorities, and use ecogeographic information to identify species with the potential to contribute desirable agronomic traits. The fourteen species that are considered the closest wild relatives of sweetpotato generally occur from the central United States to Argentina, with richness concentrated in Mesoamerica and in the extreme Southeastern United States. Currently designated species differ among themselves and in comparison to the crop in their adaptations to temperature, precipitation, and edaphic characteristics and most species also show considerable intraspecific variation. With 79% of species identified as high priority for further collecting, we find that these crop genetic resources are highly under-represented in ex situ conservation systems and thus their availability to breeders and researchers is inadequate. We prioritize taxa and specific geographic locations for further collecting in order to improve the completeness of germplasm collections. In concert with enhanced conservation of sweetpotato wild relatives, further taxonomic research, characterization and evaluation of germplasm, and improving the techniques to overcome barriers to introgression with wild species are needed in order to mobilize these genetic resources for crop breeding. PMID:25954286
2013-01-01
Introduction: Article 13 of the Framework Convention on Tobacco Control (FCTC) calls for a comprehensive ban on tobacco advertising, promotion, and sponsorship (TAPS), and Article 16 calls for prohibition of tobacco sales to and by minors. Although these mandates are based on sound science, many countries have found provision implementation to be rife with challenges. Objective: This paper reviews the history of tobacco marketing and minor access restrictions in high-, middle-, and low-income countries, identifying past challenges and successes. We consider current challenges to FCTC implementation, how these barriers can be addressed, and what research is necessary to support such efforts. Specifically, we identify implementation and research priorities for FCTC Articles 13 and 16. Discussion: Although a solid evidence base underpins the FCTC’s call for TAPS bans and minor access restrictions, we know substantially less about how best to implement these restrictions. Drawing on the regulatory experiences of high-, middle-, and low-income countries, we discern several implementation and research priorities, which are organized into 4 categories: policy enactment and enforcement, human capital expertise, the effects of FCTC marketing and youth access policies, and knowledge exchange and transfer among signatories. Future research should provide detailed case studies on implementation successes and failures, as well as insights into how knowledge of successful restrictions can be translated into tobacco control policy and practice and shared among different stakeholders. Conclusion: Tobacco marketing surveillance, sales-to-minors compliance checks, enforcement and evaluation of restriction policies, and capacity building and knowledge transfer are likely to prove central to effective implementation. PMID:23291641
Khoury, Colin K; Heider, Bettina; Castañeda-Álvarez, Nora P; Achicanoy, Harold A; Sosa, Chrystian C; Miller, Richard E; Scotland, Robert W; Wood, John R I; Rossel, Genoveva; Eserman, Lauren A; Jarret, Robert L; Yencho, G C; Bernau, Vivian; Juarez, Henry; Sotelo, Steven; de Haan, Stef; Struik, Paul C
2015-01-01
Crop wild relatives of sweetpotato [Ipomoea batatas (L.) Lam., I. series Batatas] have the potential to contribute to breeding objectives for this important root crop. Uncertainty in regard to species boundaries and their phylogenetic relationships, the limited availability of germplasm with which to perform crosses, and the difficulty of introgression of genes from wild species has constrained their utilization. Here, we compile geographic occurrence data on relevant sweetpotato wild relatives and produce potential distribution models for the species. We then assess the comprehensiveness of ex situ germplasm collections, contextualize these results with research and breeding priorities, and use ecogeographic information to identify species with the potential to contribute desirable agronomic traits. The fourteen species that are considered the closest wild relatives of sweetpotato generally occur from the central United States to Argentina, with richness concentrated in Mesoamerica and in the extreme Southeastern United States. Currently designated species differ among themselves and in comparison to the crop in their adaptations to temperature, precipitation, and edaphic characteristics and most species also show considerable intraspecific variation. With 79% of species identified as high priority for further collecting, we find that these crop genetic resources are highly under-represented in ex situ conservation systems and thus their availability to breeders and researchers is inadequate. We prioritize taxa and specific geographic locations for further collecting in order to improve the completeness of germplasm collections. In concert with enhanced conservation of sweetpotato wild relatives, further taxonomic research, characterization and evaluation of germplasm, and improving the techniques to overcome barriers to introgression with wild species are needed in order to mobilize these genetic resources for crop breeding.
Dauner, Ana L L; Dias, Thais H; Ishii, Fernanda K; Libardoni, Bruno G; Parizzi, Rafael A; Martins, César C
2018-06-23
The concentration, distribution, and ecological risk of hydrocarbons, as well as bulk parameters, were determined in surface sediments of the Babitonga Bay, a subtropical human-impacted estuary in South Atlantic. Total aliphatic and polycyclic aromatic hydrocarbons (PAHs) ranged between 0.8 and 201.2 μg g -1 and from 8.7 to 5489 ng g -1 , respectively. Saguaçú Lagoon, the region near the ferry boat and the vicinity of São Francisco harbour (SFH), presented high hydrocarbon concentrations. Despite the low accumulation trend in this region, the SFH and city may act as a punctual hydrocarbon source. The inner portion of the estuary had the finest sediment grains and the highest concentrations of carbon, nitrogen, and sulphur, indicating its importance as a depositional and cumulative area. The occurrence of unresolved complex mixture suggested chronic oil contamination. Petrogenic (based on the high percentage of alkylated PAHs) and pyrolytic (according to the diagnostic ratios of PAH isomer pairs) sources were confirmed. Ecological risk assessment was evaluated by the risk quotient (RQ). All samples had at least one priority PAH present at above the negligible concentration, including naphthalene, which was observed in all samples. Only the sites near the ferry boat and at the Saguaçú Lagoon contained compounds with concentrations above their maximum permissible concentrations, while all other sampling sites are classified as "Low-risk." The spatial distribution of RQs coincides with PAHs distribution, indicating that the regions near SFH, ferry-boat, and the Saguaçú Lagoon should be considered to be priority areas when making environmental monitoring policies. Copyright © 2018 Elsevier Ltd. All rights reserved.
NASA Astrophysics Data System (ADS)
Ramos Bendana, Zayra Sherlly
Tropical forests are of high conservation priority world-wide due their high value for harboring biodiversity and providing ecosystem services from the local to global scale. Financial resources for conservation are scarce. This challenges practitioners to design conservation networks encompassing spatial synergies between biodiversity and ecosystem services. Furthermore, conservation networks need to be robust to climate change impacts and the unpredictability of biodiversity response to these impacts. Methodologies for selecting locations that can help achieve multiple conservation objectives and can be easily integrated in current conservation practices are urgently needed. The first chapter of this study was focused on exploring the effect of integrating into conservation assessments two climate adaptation approaches based on environmental heterogeneity, as well as the effect of the selection of planning unit size on resultant conservation networks. With Costa Rica as planning region, our results showed that protecting the representation of the geophysical diversity resulted in conservation networks with over 25% more internal environmental heterogeneity, but more fragmented. Incorporating cross-environmental connectivity, on the other hand, resulted in low increases in environmental heterogeneity. Increasing the planning unit size reduced the effect of emphasizing connectivity between environmentally different locations. These results highlight the importance of testing environmental-heterogeneity-based approaches in each context due the specific characteristics of planning regions prior integrating them into formal conservation assessments. The second chapter focused on exploring synergies between biodiversity and carbon storage priorities, when integrating environmental-heterogeneity-based climate adaptation approaches. Results revealed very low synergies between targeting the representation of regional biodiversity and areas of high carbon content. However, spreading out across the country the selection of carbon priority areas by adding stratification improved the synergies with biodiversity priorities, and revealed locations that could be considered priorities for carbon storage in the distribution range of Dry Tropical Forests; one of the most threatened tropical ecosystem. The extent of gains for co-benefits between carbon-related ES and biodiversity conservation will depend in part on how priority areas are selected for implementing strategies, such as PES and REDD, and will determine the location and amount of tropical forest to be conserved. As indicated by the recent development of the spatial data used in Chapter 2, improving spatial datasets for supporting ES targeting is critical in tropical dry forests. As a result, we developed new phenological approaches to map tropical dry forest type using multitemporal Landsat 8 Operational Land Imager data. The major gains in mapping accuracy realized by the multitemporal analysis bodes well for the future of landscape level ES planning in tropical dry forest. Finally, the promising progress in the detection of functional traits through remote sensing offers further opportunities to improve on the quality of the inputs for the mapping of ES, a topic covered in Chapter 4.
Malik, Mohammad Imran; Bhat, M Sultan
2014-12-01
The Himalayan watersheds are susceptible to various forms of degradation due to their sensitive and fragile ecological disposition coupled with increasing anthropogenic disturbances. Owing to the paucity of appropriate technology and financial resources, the prioritization of watersheds has become an inevitable process for effective planning and management of natural resources. Lidder catchment constitutes a segment of the western Himalayas with an area of 1,159.38 km(2). The study is based on integrated analysis of remote sensing, geographic information system, field study, and socioeconomic data. Multicriteria evaluation of geophysical, land-use and land-cover (LULC) change, and socioeconomic indicators is carried out to prioritize watersheds for natural resource conservation and management. Knowledge-based weights and ranks are normalized, and weighted linear combination technique is adopted to determine final priority value. The watersheds are classified into four priority zones (very high priority, high priority, medium priority, and low priority) on the basis of quartiles of the priority value, thus indicating their ecological status in terms of degradation caused by anthropogenic disturbances. The correlation between priority ranks of individual indicators and integrated indicators is drawn. The results reveal that socioeconomic indicators are the most important drivers of LULC change and environmental degradation in the catchment. Moreover, the magnitude and intensity of anthropogenic impact is not uniform in different watersheds of Lidder catchment. Therefore, any conservation and management strategy must be formulated on the basis of watershed prioritization.
NASA Astrophysics Data System (ADS)
Malik, Mohammad Imran; Bhat, M. Sultan
2014-12-01
The Himalayan watersheds are susceptible to various forms of degradation due to their sensitive and fragile ecological disposition coupled with increasing anthropogenic disturbances. Owing to the paucity of appropriate technology and financial resources, the prioritization of watersheds has become an inevitable process for effective planning and management of natural resources. Lidder catchment constitutes a segment of the western Himalayas with an area of 1,159.38 km2. The study is based on integrated analysis of remote sensing, geographic information system, field study, and socioeconomic data. Multicriteria evaluation of geophysical, land-use and land-cover (LULC) change, and socioeconomic indicators is carried out to prioritize watersheds for natural resource conservation and management. Knowledge-based weights and ranks are normalized, and weighted linear combination technique is adopted to determine final priority value. The watersheds are classified into four priority zones (very high priority, high priority, medium priority, and low priority) on the basis of quartiles of the priority value, thus indicating their ecological status in terms of degradation caused by anthropogenic disturbances. The correlation between priority ranks of individual indicators and integrated indicators is drawn. The results reveal that socioeconomic indicators are the most important drivers of LULC change and environmental degradation in the catchment. Moreover, the magnitude and intensity of anthropogenic impact is not uniform in different watersheds of Lidder catchment. Therefore, any conservation and management strategy must be formulated on the basis of watershed prioritization.
Maluka, Stephen Oswald
2011-01-01
Health care systems are faced with the challenge of resource scarcity and have insufficient resources to respond to all health problems and target groups simultaneously. Hence, priority setting is an inevitable aspect of every health system. However, priority setting is complex and difficult because the process is frequently influenced by political, institutional and managerial factors that are not considered by conventional priority-setting tools. In a five-year EU-supported project, which started in 2006, ways of strengthening fairness and accountability in priority setting in district health management were studied. This review is based on a PhD thesis that aimed to analyse health care organisation and management systems, and explore the potential and challenges of implementing Accountability for Reasonableness (A4R) approach to priority setting in Tanzania. A qualitative case study in Mbarali district formed the basis of exploring the sociopolitical and institutional contexts within which health care decision making takes place. The study also explores how the A4R intervention was shaped, enabled and constrained by the contexts. Key informant interviews were conducted. Relevant documents were also gathered and group priority-setting processes in the district were observed. The study revealed that, despite the obvious national rhetoric on decentralisation, actual practice in the district involved little community participation. The assumption that devolution to local government promotes transparency, accountability and community participation, is far from reality. The study also found that while the A4R approach was perceived to be helpful in strengthening transparency, accountability and stakeholder engagement, integrating the innovation into the district health system was challenging. This study underscores the idea that greater involvement and accountability among local actors may increase the legitimacy and fairness of priority-setting decisions. A broader and more detailed analysis of health system elements, and socio-cultural context is imperative in fostering sustainability. Additionally, the study stresses the need to deal with power asymmetries among various actors in priority-setting contexts. PMID:22072991
Oncken, Cheryl A; Dietz, Patricia M; Tong, Van T; Belizán, José M; Tolosa, Jorge E; Berghella, Vincenzo; Goldenberg, Robert L; Lando, Harry A; Samet, Jonathan M; Bloch, Michele H
2010-01-01
Although the prevalence of tobacco use is decreasing in many high-income countries, it is increasing in many low- and middle-income countries. The health and economic burden of increasing tobacco use and dependence is predictable and will have devastating effects in countries with limited resources, particularly for vulnerable populations such as pregnant women. We sought to review effective tobacco prevention and intervention strategies for decreasing tobacco use and secondhand smoke exposure before and during pregnancy in high-, middle-, and low-income countries. We reviewed several types of interventions, including population-level efforts (increasing tobacco prices, implementing tobacco control policies), community interventions, clinical interventions, and pharmacological treatments. A second purpose of this report is to present findings of an international expert working group that was convened to review the evidence and to establish research priorities in the following areas: (a) preventing the uptake and reducing tobacco use among girls and women of reproductive age; and (b) reducing tobacco use and secondhand smoke exposure among pregnant women. The working group considered the evidence on existing interventions in terms of burden of disease, intervention impact, intervention costs, feasibility of integration into existing services, uniqueness of the contribution, and overall feasibility. Finally, we present the working group's recommendations for intervention research priorities.
Commercial Lighting Solutions Webtool Peer Review Report, Office Solutions
DOE Office of Scientific and Technical Information (OSTI.GOV)
Beeson, Tracy A.; Jones, Carol C.
2010-02-01
The Commercial Lighting Solutions (CLS) project directly supports the U.S. Department of Energy’s Commercial Building Energy Alliance efforts to design high performance buildings. CLS creates energy efficient best practice lighting designs for widespread use, and they are made available to users via an interactive webtool that both educates and guides the end user through the application of the Lighting Solutions. This report summarizes the peer review of the CLS webtool for offices. The methodology for the peer review process included data collection (stakeholder input), analysis of the comments, and organization of the input into categories for prioritization of the commentsmore » against a set of criteria. Based on this process, recommendations were developed for the release of version 2.0 of the webtool at the Lightfair conference in Las Vegas in May 2010. The report provides a list of the top ten most significant and relevant improvements that will be made within the webtool for version 2.0 as well as appendices containing the comments and short-term priorities in additional detail. Peer review comments that are considered high priority by the reviewers and the CLS team but cannot be completed for Version 2.0 are listed as long-term recommendations.« less
Abarca, Katia; Valenzuela, M Teresa; Vergara, Rodrigo; Luchsinger, Vivian; Muñoz, Alma; Jiménez de la J, Jorge; Ripoll, Erna; O'Ryan, Miguel
2008-11-01
This article briefly reviews the epidemiology of human papillomavirus (HPV) infection and associated diseases globally and in Chile, and the scientific information of the licensed HPV vaccines: Gardasil and Cervari. Considering the available information, the Advisory Committee on Immunizations of the Chilean Society of Infectious Diseases recommends vaccination of teenage girls, ideally before initiating sexual activity, i.e., approximately at the age of 12 to 13 years and vaccination of women of any age if they have not started sexual activity. If women are vaccinated after initiating sexual activity, they should be informed of the lower efficacy of immunization if HPV infection has occurred. Education on responsible sexuality and sexually transmitted diseases should be maintained as a priority. Vaccination should be highly considered for inclusion in the National Immunization Program.
Validation of nursing management diagnoses.
Morrison, R S
1995-01-01
Nursing management diagnosis based on nursing and management science, merges "nursing diagnosis" and "organizational diagnosis". Nursing management diagnosis is a judgment about nursing organizational problems. The diagnoses provide a basis for nurse manager interventions to achieve outcomes for which a nurse manager is accountable. A nursing organizational problem is a discrepancy between what should be happening and what is actually happening that prevents the goals of nursing from being accomplished. The purpose of this study was to validate 73 nursing management diagnoses identified previously in 1992: 71 of the 72 diagnoses were considered valid by at least 70% of 136 participants. Diagnoses considered to have high priority for future research and development were identified by summing the mean scores for perceived frequency of occurrence and level of disruption. Further development of nursing management diagnoses and testing of their effectiveness in enhancing decision making is recommended.
Fradcourt, B; Peyrin, C; Baciu, M; Campagne, A
2013-10-01
Previous studies performed on visual processing of emotional stimuli have revealed preference for a specific type of visual spatial frequencies (high spatial frequency, HSF; low spatial frequency, LSF) according to task demands. The majority of studies used a face and focused on the appraisal of the emotional state of others. The present behavioral study investigates the relative role of spatial frequencies on processing emotional natural scenes during two explicit cognitive appraisal tasks, one emotional, based on the self-emotional experience and one motivational, based on the tendency to action. Our results suggest that HSF information was the most relevant to rapidly identify the self-emotional experience (unpleasant, pleasant, and neutral) while LSF was required to rapidly identify the tendency to action (avoidance, approach, and no action). The tendency to action based on LSF analysis showed a priority for unpleasant stimuli whereas the identification of emotional experience based on HSF analysis showed a priority for pleasant stimuli. The present study confirms the interest of considering both emotional and motivational characteristics of visual stimuli. Copyright © 2013 Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Jaafar, Hazriq Izzuan; Latif, Norfaneysa Abd; Kassim, Anuar Mohamed; Abidin, Amar Faiz Zainal; Hussien, Sharifah Yuslinda Syed; Aras, Mohd Shahrieel Mohd
2015-05-01
Advanced manufacturing technology made Gantry Crane System (GCS) is one of the suitable heavy machinery transporters and frequently employed in handling with huge materials. The interconnection of trolley movement and payload oscillation has a technical impact which needs to be considered. Once the trolley moves to the desired position with high speed, this will induce undesirable's payload oscillation. This frequent unavoidable load swing causes an efficiency drop, load damages and even accidents. In this paper, a new control strategy of Firefly Algorithm (FA) will be developed to obtain five optimal controller parameters (PID and PD) via Priority-based Fitness Scheme (PFS). Combinations of these five parameters are utilized for controlling trolley movement and minimizing the angle of payload oscillation. This PFS is prioritized based on steady-state error (SSE), overshoot (OS) and settling time (Ts) according to the needs and circumstances. Lagrange equation will be chosen for modeling and simulation will be conducted by using related software. Simulation results show that the proposed control strategy is efficient to control the trolley movement to the desired position and minimize the angle of payload oscillation.
ERIC Educational Resources Information Center
Petrina, Neysa; Carter, Mark; Stephenson, Jennifer
2015-01-01
Parental perceptions of the importance of friendship development in comparison to other outcome priorities are examined in this research. Parents of children with high functioning autism between the age of 5-10?years (N?=?74) were asked to rate and rank the importance of the following six outcome priorities: friendship, social skills, physical and…
Crist, Michele R.; Knick, Steven T.; Hanser, Steven E.
2017-01-01
The delineation of priority areas in western North America for managing Greater Sage-Grouse (Centrocercus urophasianus) represents a broad-scale experiment in conservation biology. The strategy of limiting spatial disturbance and focusing conservation actions within delineated areas may benefit the greatest proportion of Greater Sage-Grouse. However, land use under normal restrictions outside priority areas potentially limits dispersal and gene flow, which can isolate priority areas and lead to spatially disjunct populations. We used graph theory, representing priority areas as spatially distributed nodes interconnected by movement corridors, to understand the capacity of priority areas to function as connected networks in the Bi-State, Central, and Washington regions of the Greater Sage-Grouse range. The Bi-State and Central networks were highly centralized; the dominant pathways and shortest linkages primarily connected a small number of large and centrally located priority areas. These priority areas are likely strongholds for Greater Sage-Grouse populations and might also function as refugia and sources. Priority areas in the Central network were more connected than those in the Bi-State and Washington networks. Almost 90% of the priority areas in the Central network had ≥2 pathways to other priority areas when movement through the landscape was set at an upper threshold (effective resistance, ER12). At a lower threshold (ER4), 83 of 123 priority areas in the Central network were clustered in 9 interconnected subgroups. The current conservation strategy has risks; 45 of 61 priority areas in the Bi-State network, 68 of 123 in the Central network, and all 4 priority areas in the Washington network had ≤1 connection to another priority area at the lower ER4threshold. Priority areas with few linkages also averaged greater environmental resistance to movement along connecting pathways. Without maintaining corridors to larger priority areas or a clustered group, isolation of small priority areas could lead to regional loss of Greater Sage-Grouse
The importance of TVET and its contribution to sustainable development
NASA Astrophysics Data System (ADS)
Paryono
2017-09-01
Technical and Vocational Education and Training (TVET) has been gaining its popularity and considered as the driving force for sustainable development. TVET is also considered highly in strategic and operational priorities of the G20, the Organisation for Economic Co-operation and Development (OECD), and of multilateral organizations such as the International Labour Organization (ILO), UNESCO, ASEAN, and SEAMEO. As reflected in Shanghai Consensus, TVET systems need sustained transformation and revitalization if TVET is to realize its enormous potential to impact development. This paper will elaborate relevant policies considered as major drivers for promoting TVET at global, regional, and national levels. The paper also shares TVET initiatives in response the policies, especially in meeting the labour market demands in the 21st century. Lastly, the paper highlights TVET contribution to sustainable development, particularly on the sustainable environmental development, including green jobs. The integration of sustainable development into TVET curriculum, learning contents, and also school policies and practices are important indicators to consider. The paper was based secondary data and documents from the meetings and also reports.
29 CFR 1990.132 - Factors to be considered.
Code of Federal Regulations, 2014 CFR
2014-07-01
... inform the public on the development of priorities. It is not intended to create any legal rights with... humans, animals or both; (4) The extent to which regulatory action could reduce not only risks of...
29 CFR 1990.132 - Factors to be considered.
Code of Federal Regulations, 2012 CFR
2012-07-01
... inform the public on the development of priorities. It is not intended to create any legal rights with... humans, animals or both; (4) The extent to which regulatory action could reduce not only risks of...
29 CFR 1990.132 - Factors to be considered.
Code of Federal Regulations, 2013 CFR
2013-07-01
... inform the public on the development of priorities. It is not intended to create any legal rights with... humans, animals or both; (4) The extent to which regulatory action could reduce not only risks of...
Federal budget process: An overview
NASA Astrophysics Data System (ADS)
Frizzell, Virgil A., Jr.
Much geophysical research funding originates from the federal government, and many who obtain federal funding consider the executive branch to be its source. In fact, the federal budget results from a complex ballet between the executive and legislative branches. Because it is both little understood and essential to our work, this report will review the fundamentals of the three-year budgetary process.The Constitution assigns the power of the purse to the Congress. Before the 1920s, executive branch agencies and departments submitted their own separate budgets to Congress, and deliberate planning and priority setting was minimal. In 1921 Congress empowered the president to submit an executive branch budget reflecting his priorities for the next fiscal year. Following this protocol, former President Reagan submitted his budget for Fiscal Year 1990 in January, and President Bush outlined his FY'90 priorities in February.
Photon and vector meson exchanges in the production of light meson pairs and elementary atoms
NASA Astrophysics Data System (ADS)
Gevorkyan, S. R.; Kuraev, E. A.; Volkov, M. K.
2013-01-01
The production of pseudoscalar and scalar meson pairs ππ, ηη, η‧η‧, σσ as well as bound states in high energy γγ collisions are considered. The exchange by a vector particle in the binary process γ + γ → ha + hb with hadronic states ha, hb in fragmentation regions of the initial particle leads to nondecreasing cross sections with increasing energy, that is a priority of peripheral kinematics. Unlike the photon exchange the vector meson exchange needs a reggeization leading to fall with energy growth. Nevertheless, due to the peripheral kinematics beyond very forward production angles the vector meson exchanges dominate over all possible exchanges. The proposed approach allows one to express the matrix elements of the considered processes through impacting factors, which can be calculated in perturbation models like chiral perturbation theory (ChPT) or the Nambu-Jona-Lasinio (NJL) model. In particular cases the impact factors can be determined from relevant γγ sub-processes or the vector meson radiative decay width. The pionium atom production in the collisions of high energy electrons and pions with protons is considered and the relevant cross sections have been estimated.
2013-01-01
Background The objective of this study was to examine the potential environmental risk of tailings resulted after precious and base metal ores processing, stored in seven impoundments located in the Aries river basin, Romania. The tailings were characterized by mineralogical and elemental composition, contamination indices, acid rock drainage generation potential and water leachability of hazardous/priority hazardous metals and ions. Multivariate statistical methods were used for data interpretation. Results Tailings were found to be highly contaminated with several hazardous/priority hazardous metals (As, Cu, Cd, Pb), and pose potential contamination risk for soil, sediments, surface and groundwater. Two out of the seven studied impoundments does not satisfy the criteria required for inert wastes, shows acid rock drainage potential and thus can contaminate the surface and groundwater. Three impoundments were found to be highly contaminated with As, Pb and Cd, two with As and other two with Cu. The tailings impoundments were grouped based on the enrichment factor, geoaccumulation index, contamination factor and contamination degree of 7 hazardous/priority hazardous metals (As, Cd, Cr, Cu, Ni, Pb, Zn) considered typical for the studied tailings. Principal component analysis showed that 47% of the elemental variability was attributable to alkaline silicate rocks, 31% to acidic S-containing minerals, 12% to carbonate minerals and 5% to biogenic elements. Leachability of metals and ions was ascribed in proportion of 61% to silicates, 11% to acidic minerals and 6% to the organic matter. A variability of 18% was attributed to leachability of biogenic elements (Na, K, Cl-, NO3-) with no potential environmental risk. Pattern recognition by agglomerative hierarchical clustering emphasized the grouping of impoundments in agreement with their contamination degree and acid rock drainage generation potential. Conclusions Tailings stored in the studied impoundments were found to be contaminated with some hazardous/ priority hazardous metals, fluoride and sulphate and thus presents different contamination risk for the environment. A long term monitoring program of these tailings impoundments and the expansion of the ecologization measures in the area is required. PMID:23311708
High-Priority Directions of Modernization of University Education in Innovational Society
ERIC Educational Resources Information Center
Sergeev, Nikolai
2017-01-01
Purpose: The purpose of this paper is to verify the offered hypothesis and to determine high-priority directions of modernization of university education in an innovational society by the example of modern Russia. Design/methodology/approach: During the empirical study of connection between university education and innovational development of…
25 CFR Appendix A to Subpart C - IRR High Priority Project Scoring Matrix
Code of Federal Regulations, 2010 CFR
2010-04-01
...—IRR High Priority Project Scoring Matrix Score 10 5 3 1 0 Accident and fatality rate for candidate route 1 Severe X Moderate Minimal No accidents. Years since last IRR construction project completed... elements Addresses 1 element. 1 National Highway Traffic Safety Board standards. 2 Total funds requested...
Obligations to High Priority Target Groups: Philosophical Implications.
ERIC Educational Resources Information Center
Christmas, June Jackson
Community mental health center services must be most plentiful where the need is greatest and must be appropriate and available to meet these needs. The first high priority group, according to statistics on juvenile delinquency, and narcotics, is the black inner city. Socio-psychiatric services, numerous enough in quantity to begin to meet needs…
Restoring High Priority Habitats for Birds: Aspen and Pine in the Interior West
Rex Sallabanks; Nils D. Christoffersen; Whitney W. Weatherford; Ralph Anderson
2005-01-01
This paper describes a long-term habitat restoration project in the Blue Mountains ecoregion, northeast Oregon, that we initiated in May 2000. We focused our restoration activities on two habitats previously identified as being high priority for birds: quaking aspen (Populus tremuloides) and ponderosa pine (Pinus ponderosa). In...
Ephedrine QoS: An Antidote to Slow, Congested, Bufferless NoCs
Fang, Juan; Yao, Zhicheng; Sui, Xiufeng; Bao, Yungang
2014-01-01
Datacenters consolidate diverse applications to improve utilization. However when multiple applications are colocated on such platforms, contention for shared resources like networks-on-chip (NoCs) can degrade the performance of latency-critical online services (high-priority applications). Recently proposed bufferless NoCs (Nychis et al.) have the advantages of requiring less area and power, but they pose challenges in quality-of-service (QoS) support, which usually relies on buffer-based virtual channels (VCs). We propose QBLESS, a QoS-aware bufferless NoC scheme for datacenters. QBLESS consists of two components: a routing mechanism (QBLESS-R) that can substantially reduce flit deflection for high-priority applications and a congestion-control mechanism (QBLESS-CC) that guarantees performance for high-priority applications and improves overall system throughput. We use trace-driven simulation to model a 64-core system, finding that, when compared to BLESS, a previous state-of-the-art bufferless NoC design, QBLESS, improves performance of high-priority applications by an average of 33.2% and reduces network-hops by an average of 42.8%. PMID:25250386
49 CFR 350.329 - How may a State or local agency qualify for High Priority or Border Activity Funds?
Code of Federal Regulations, 2010 CFR
2010-10-01
... 49 Transportation 5 2010-10-01 2010-10-01 false How may a State or local agency qualify for High... How may a State or local agency qualify for High Priority or Border Activity Funds? (a) States must... with the State lead MCSAP agency to ensure the proposal is consistent with State and national CMV...
49 CFR 350.329 - How may a State or local agency qualify for High Priority or Border Activity Funds?
Code of Federal Regulations, 2011 CFR
2011-10-01
... 49 Transportation 5 2011-10-01 2011-10-01 false How may a State or local agency qualify for High... How may a State or local agency qualify for High Priority or Border Activity Funds? (a) States must... with the State lead MCSAP agency to ensure the proposal is consistent with State and national CMV...
MEPAG Recommendations for a 2018 Mars Sample Return Caching Lander - Sample Types, Number, and Sizes
NASA Technical Reports Server (NTRS)
Allen, Carlton C.
2011-01-01
The return to Earth of geological and atmospheric samples from the surface of Mars is among the highest priority objectives of planetary science. The MEPAG Mars Sample Return (MSR) End-to-End International Science Analysis Group (MEPAG E2E-iSAG) was chartered to propose scientific objectives and priorities for returned sample science, and to map out the implications of these priorities, including for the proposed joint ESA-NASA 2018 mission that would be tasked with the crucial job of collecting and caching the samples. The E2E-iSAG identified four overarching scientific aims that relate to understanding: (A) the potential for life and its pre-biotic context, (B) the geologic processes that have affected the martian surface, (C) planetary evolution of Mars and its atmosphere, (D) potential for future human exploration. The types of samples deemed most likely to achieve the science objectives are, in priority order: (1A). Subaqueous or hydrothermal sediments (1B). Hydrothermally altered rocks or low temperature fluid-altered rocks (equal priority) (2). Unaltered igneous rocks (3). Regolith, including airfall dust (4). Present-day atmosphere and samples of sedimentary-igneous rocks containing ancient trapped atmosphere Collection of geologically well-characterized sample suites would add considerable value to interpretations of all collected rocks. To achieve this, the total number of rock samples should be about 30-40. In order to evaluate the size of individual samples required to meet the science objectives, the E2E-iSAG reviewed the analytical methods that would likely be applied to the returned samples by preliminary examination teams, for planetary protection (i.e., life detection, biohazard assessment) and, after distribution, by individual investigators. It was concluded that sample size should be sufficient to perform all high-priority analyses in triplicate. In keeping with long-established curatorial practice of extraterrestrial material, at least 40% by mass of each sample should be preserved to support future scientific investigations. Samples of 15-16 grams are considered optimal. The total mass of returned rocks, soils, blanks and standards should be approximately 500 grams. Atmospheric gas samples should be the equivalent of 50 cubic cm at 20 times Mars ambient atmospheric pressure.
Remotely Sensed Data Informs Red List Evaluations and Conservation Priorities in Southeast Asia.
Li, Binbin V; Hughes, Alice C; Jenkins, Clinton N; Ocampo-Peñuela, Natalia; Pimm, Stuart L
2016-01-01
The IUCN Red List has assessed the global distributions of the majority of the world's amphibians, birds and mammals. Yet these assessments lack explicit reference to widely available, remotely-sensed data that can sensibly inform a species' risk of extinction. Our first goal is to add additional quantitative data to the existing standardised process that IUCN employs. Secondly, we ask: do our results suggest species of concern-those at considerably greater risk than hitherto appreciated? Thirdly, these assessments are not only important on a species-by-species basis. By combining distributions of species of concern, we map conservation priorities. We ask to what degree these areas are currently protected and how might knowledge from remote sensing modify the priorities? Finally, we develop a quick and simple method to identify and modify the priority setting in a landscape where natural habitats are disappearing rapidly and so where conventional species' assessments might be too slow to respond. Tropical, mainland Southeast Asia is under exceptional threat, yet relatively poorly known. Here, additional quantitative measures may be particularly helpful. This region contains over 122, 183, and 214 endemic mammals, birds, and amphibians, respectively, of which the IUCN considers 37, 21, and 37 threatened. When corrected for the amount of remaining natural habitats within the known elevation preferences of species, the average sizes of species ranges shrink to <40% of their published ranges. Some 79 mammal, 49 bird, and 184 amphibian ranges are <20,000km2-an area at which IUCN considers most other species to be threatened. Moreover, these species are not better protected by the existing network of protected areas than are species that IUCN accepts as threatened. Simply, there appear to be considerably more species at risk than hitherto appreciated. Furthermore, incorporating remote sensing data showing where habitat loss is prevalent changes the locations of conservation priorities.
Burden of Disease Study and Priority Setting in Korea: an Ethical Perspective
2016-01-01
When thinking about priority setting in access to healthcare resources, decision-making requires that cost-effectiveness is balanced against medical ethics. The burden of disease has emerged as an important approach to the assessment of health needs for political decision-making. However, the disability adjusted life years approach hides conceptual and methodological issues regarding the claims and value of disabled people. In this article, we discuss ethical issues that are raised as a consequence of the introduction of evidence-based health policy, such as economic evidence, in establishing resource allocation priorities. In terms of ethical values in health priority setting in Korea, there is no reliable rationale for the judgment used in decision-making as well as for setting separate and distinct priorities for different government bodies. An important question, therefore, is which ethical values guiding the practice of decision-making should be reconciled with the economic evidence found in Korean healthcare. The health technology assessment core model from the European network for Health Technology Assessment (EUnetHTA) project is a good example of incorporating ethical values into decision-making. We suggest that a fair distribution of scarce healthcare resources in South Korea can be achieved by considering the ethical aspects of healthcare. PMID:27775247
Whitty, Jennifer A; Littlejohns, Peter
2015-02-01
To describe the role of social values in priority setting related to health technology assessment processes and decision-making in Australia. The processes and decision criteria of the Pharmaceutical and Medical Benefits Advisory Committees are described based on literature and policy sources, and analysed using a framework for identifying social values in priority-setting. Transparency and accountability of processes are apparent. Participation balances inclusiveness and effectiveness of decision-making, but presents an opportunity to enhance priority setting processes. Clinical and cost-effectiveness are important content considerations. Social values related to justice/equity are considered, without quantification of criteria weights for equity relative to other factors. HTA processes support solidarity through subsidising approved technologies for all Australians, whilst retaining autonomy by permitting non-subsidised technologies to be accessed privately, leading to possible tension between the values of solidarity, autonomy and equity. Priority setting related to health technology subsidy incorporates a range of inter-related social values in the processes and content of decision-making. Participation in decision-making could arguably be improved if a patient and public engagement policy were to be formulated alongside more widespread changes across processes to assess social values using approaches such as the Citizens' Jury. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Girschik, Jennifer; Miller, Laura Jean; Addiscott, Tony; Daube, Mike; Katris, Paul; Ransom, David; Slevin, Terry; Threlfall, Tim; Weeramanthri, Tarun Stephen
2017-01-01
Cancer will continue to be a leading cause of ill health and death unless we can capitalize on the potential for 30-40% of these cancers to be prevented. In this light, cancer prevention represents an enormous opportunity for public health, potentially saving much of the pain, anguish, and cost associated with treating cancer. However, there is a challenge for governments, and the wider community, in prioritizing cancer prevention activities, especially given increasing financial constraints. This paper describes a method for identifying cancer prevention priorities. This method synthesizes detailed cancer statistics, expert opinion, and the published literature for the priority setting process. The process contains four steps: assessing the impact of cancer types; identifying cancers with the greatest impact; considering opportunities for prevention; and combining information on impact and preventability. The strength of our approach is that it is straightforward, transparent and reproducible for other settings. Applying this method in Western Australia produced a priority list of seven adult cancers which were identified as having not only the biggest impact on the community but also the best opportunities for prevention. Work conducted in an additional project phase went on to present data on these priority cancers to a public consultation and develop an agenda for action in cancer prevention.
Precision in Setting Cancer Prevention Priorities: Synthesis of Data, Literature, and Expert Opinion
Girschik, Jennifer; Miller, Laura Jean; Addiscott, Tony; Daube, Mike; Katris, Paul; Ransom, David; Slevin, Terry; Threlfall, Tim; Weeramanthri, Tarun Stephen
2017-01-01
Cancer will continue to be a leading cause of ill health and death unless we can capitalize on the potential for 30–40% of these cancers to be prevented. In this light, cancer prevention represents an enormous opportunity for public health, potentially saving much of the pain, anguish, and cost associated with treating cancer. However, there is a challenge for governments, and the wider community, in prioritizing cancer prevention activities, especially given increasing financial constraints. This paper describes a method for identifying cancer prevention priorities. This method synthesizes detailed cancer statistics, expert opinion, and the published literature for the priority setting process. The process contains four steps: assessing the impact of cancer types; identifying cancers with the greatest impact; considering opportunities for prevention; and combining information on impact and preventability. The strength of our approach is that it is straightforward, transparent and reproducible for other settings. Applying this method in Western Australia produced a priority list of seven adult cancers which were identified as having not only the biggest impact on the community but also the best opportunities for prevention. Work conducted in an additional project phase went on to present data on these priority cancers to a public consultation and develop an agenda for action in cancer prevention. PMID:28634579
Crist, Michele R.; Knick, Steven T.; Hanser, Steven E.
2015-09-08
The network of areas delineated in 11 Western States for prioritizing management of greater sage-grouse (Centrocercus urophasianus) represents a grand experiment in conservation biology and reserve design. We used centrality metrics from social network theory to gain insights into how this priority area network might function. The network was highly centralized. Twenty of 188 priority areas accounted for 80 percent of the total centrality scores. These priority areas, characterized by large size and a central location in the range-wide distribution, are strongholds for greater sage-grouse populations and also might function as sources. Mid-ranking priority areas may serve as stepping stones because of their location between large central and smaller peripheral priority areas. The current network design and conservation strategy has risks. The contribution of almost one-half (n = 93) of the priority areas combined for less than 1 percent of the cumulative centrality scores for the network. These priority areas individually are likely too small to support viable sage-grouse populations within their boundary. Without habitat corridors to connect small priority areas either to larger priority areas or as a clustered group within the network, their isolation could lead to loss of sage-grouse within these regions of the network.
Fast simulation of packet loss rates in a shared buffer communications switch
NASA Technical Reports Server (NTRS)
Chang, Cheng-Shang; Heidelberger, Philip; Shahabuddin, Perwez
1993-01-01
This paper describes an efficient technique for estimating, via simulation, the probability of buffer overflows in a queueing model that arises in the analysis of ATM (Asynchronous Transfer Mode) communication switches. There are multiple streams of (autocorrelated) traffic feeding the switch that has a buffer of finite capacity. Each stream is designated as either being of high or low priority. When the queue length reaches a certain threshold, only high priority packets are admitted to the switch's buffer. The problem is to estimate the loss rate of high priority packets. An asymptotically optimal importance sampling approach is developed for this rare event simulation problem. In this approach, the importance sampling is done in two distinct phases. In the first phase, an importance sampling change of measure is used to bring the queue length up to the threshold at which low priority packets get rejected. In the second phase, a different importance sampling change of measure is used to move the queue length from the threshold to the buffer capacity.
May-Collado, Laura J.; Agnarsson, Ingi
2011-01-01
Background Habitat loss and overexploitation are among the primary factors threatening populations of many mammal species. Recently, aquatic mammals have been highlighted as particularly vulnerable. Here we test (1) if aquatic mammals emerge as more phylogenetically urgent conservation priorities than their terrestrial relatives, and (2) if high priority species are receiving sufficient conservation effort. We also compare results among some phylogenetic conservation methods. Methodology/Principal Findings A phylogenetic analysis of conservation priorities for all 620 species of Cetartiodactyla and Carnivora, including most aquatic mammals. Conservation priority ranking of aquatic versus terrestrial species is approximately proportional to their diversity. However, nearly all obligated freshwater cetartiodactylans are among the top conservation priority species. Further, ∼74% and 40% of fully aquatic cetartiodactylans and carnivores, respectively, are either threatened or data deficient, more so than their terrestrial relatives. Strikingly, only 3% of all ‘high priority’ species are thought to be stable. An overwhelming 97% of these species thus either show decreasing population trends (87%) or are insufficiently known (10%). Furthermore, a disproportional number of highly evolutionarily distinct species are experiencing population decline, thus, such species should be closely monitored even if not currently threatened. Comparison among methods reveals that exact species ranking differs considerably among methods, nevertheless, most top priority species consistently rank high under any method. While we here favor one approach, we also suggest that a consensus approach may be useful when methods disagree. Conclusions/Significance These results reinforce prior findings, suggesting there is an urgent need to gather basic conservation data for aquatic mammals, and special conservation focus is needed on those confined to freshwater. That evolutionarily distinct—and thus ‘biodiverse’—species are faring relatively poorly is alarming and requires further study. Our results offer a detailed guide to phylogeny-based conservation prioritization for these two orders. PMID:21799899
SU-E-T-551: Monitor Unit Optimization in Stereotactic Body Radiation Therapy for Stage I Lung Cancer
DOE Office of Scientific and Technical Information (OSTI.GOV)
Huang, B-T; Lu, J-Y
2015-06-15
Purpose: The study aims to reduce the monitor units (MUs) in the stereotactic body radiation therapy (SBRT) treatment for lung cancer by adjusting the optimizing parameters. Methods: Fourteen patients suffered from stage I Non-Small Cell Lung Cancer (NSCLC) were enrolled. Three groups of parameters were adjusted to investigate their effects on MU numbers and organs at risk (OARs) sparing: (1) the upper objective of planning target volume (UOPTV); (2) strength setting in the MU constraining objective; (3) max MU setting in the MU constraining objective. Results: We found that the parameters in the optimizer influenced the MU numbers in amore » priority, strength and max MU dependent manner. MU numbers showed a decreasing trend with the UOPTV increasing. MU numbers with low, medium and high priority for the UOPTV were 428±54, 312±48 and 258±31 MU/Gy, respectively. High priority for UOPTV also spared the heart, cord and lung while maintaining comparable PTV coverage than the low and medium priority group. It was observed that MU numbers tended to decrease with the strength increasing and max MU setting decreasing. With maximum strength, the MU numbers reached its minimum while maintaining comparable or improved dose to the normal tissues. It was also found that the MU numbers continued to decline at 85% and 75% max MU setting but no longer to decrease at 50% and 25%. Combined with high priority for UOPTV and MU constraining objectives, the MU numbers can be decreased as low as 223±26 MU/Gy. Conclusion:: The priority of UOPTV, MU constraining objective in the optimizer impact on the MU numbers in SBRT treatment for lung cancer. Giving high priority to the UOPTV, setting the strength to maximum value and the max MU to 50% in the MU objective achieves the lowest MU numbers while maintaining comparable or improved OAR sparing.« less
Veach, Victoria; Moilanen, Atte; Di Minin, Enrico
2017-01-01
Including threats in spatial conservation prioritization helps identify areas for conservation actions where biodiversity is at imminent risk of extinction. At the global level, an important limitation when identifying spatial priorities for conservation actions is the lack of information on the spatial distribution of threats. Here, we identify spatial conservation priorities under three prominent threats to biodiversity (residential and commercial development, agricultural expansion, and forest loss), which are primary drivers of habitat loss and threaten the persistence of the highest number of species in the International Union for the Conservation of Nature (IUCN) Red List, and for which spatial data is available. We first explore how global priority areas for the conservation of vertebrate (mammals, birds, and amphibians) species coded in the Red List as vulnerable to each threat differ spatially. We then identify spatial conservation priorities for all species vulnerable to all threats. Finally, we identify the potentially most threatened areas by overlapping the identified priority areas for conservation with maps for each threat. We repeat the same with four other well-known global conservation priority area schemes, namely Key Biodiversity Areas, Biodiversity Hotspots, the global Protected Area Network, and Wilderness Areas. We find that residential and commercial development directly threatens only about 4% of the global top 17% priority areas for species vulnerable under this threat. However, 50% of the high priority areas for species vulnerable to forest loss overlap with areas that have already experienced some forest loss. Agricultural expansion overlapped with ~20% of high priority areas. Biodiversity Hotspots had the greatest proportion of their total area under direct threat from all threats, while expansion of low intensity agriculture was found to pose an imminent threat to Wilderness Areas under future agricultural expansion. Our results identify areas where limited resources should be allocated to mitigate risks to vertebrate species from habitat loss.
Moilanen, Atte; Di Minin, Enrico
2017-01-01
Including threats in spatial conservation prioritization helps identify areas for conservation actions where biodiversity is at imminent risk of extinction. At the global level, an important limitation when identifying spatial priorities for conservation actions is the lack of information on the spatial distribution of threats. Here, we identify spatial conservation priorities under three prominent threats to biodiversity (residential and commercial development, agricultural expansion, and forest loss), which are primary drivers of habitat loss and threaten the persistence of the highest number of species in the International Union for the Conservation of Nature (IUCN) Red List, and for which spatial data is available. We first explore how global priority areas for the conservation of vertebrate (mammals, birds, and amphibians) species coded in the Red List as vulnerable to each threat differ spatially. We then identify spatial conservation priorities for all species vulnerable to all threats. Finally, we identify the potentially most threatened areas by overlapping the identified priority areas for conservation with maps for each threat. We repeat the same with four other well-known global conservation priority area schemes, namely Key Biodiversity Areas, Biodiversity Hotspots, the global Protected Area Network, and Wilderness Areas. We find that residential and commercial development directly threatens only about 4% of the global top 17% priority areas for species vulnerable under this threat. However, 50% of the high priority areas for species vulnerable to forest loss overlap with areas that have already experienced some forest loss. Agricultural expansion overlapped with ~20% of high priority areas. Biodiversity Hotspots had the greatest proportion of their total area under direct threat from all threats, while expansion of low intensity agriculture was found to pose an imminent threat to Wilderness Areas under future agricultural expansion. Our results identify areas where limited resources should be allocated to mitigate risks to vertebrate species from habitat loss. PMID:29182662
Bernhard, M.C.; Evans, M.B.; Kent, S.T.; Johnson, E.; Threadgill, S.L.; Tyson, S.; Becker, S.M.; Gohlke, J.M.
2013-01-01
Objectives Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members’ concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities defined the term environment, their perceptions of environmental exposures as affecting their health, specific priorities in their communities, and differences in urban versus rural populations. Study design A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities. Methods A total of eight focus groups were conducted: four in rural and four in urban communities. Topics included defining the term environment, how the environment may affect health, and environmental priorities within their communities, using both open discussion and a predefined list. Data were analysed both qualitatively and quantitatively to identify patterns and trends. Results There were important areas of overlap in priorities between urban and rural communities; both emphasized the importance of the social environment and shared a concern over air pollution from industrial sources. In contrast, for urban focus groups, abandoned houses and their social and physical sequelae were a high priority while concerns about adequate sewer and water services and road maintenance were high priorities in rural communities. Conclusions This study was able to identify environmental health priorities in urban versus rural minority communities. In contrast to some previous risk perception research, the results of this study suggest prioritization of tangible, known risks in everyday life instead of rare, disaster-related events, even in communities that have recently experienced devastating damage from tornadoes. The findings can help inform future efforts to study, understand and effectively address environmental issues, and are particularly relevant to developing effective community-based strategies in vulnerable populations. PMID:24239281
Research priorities in mental health occupational therapy: A study of clinician perspectives.
Hitch, Danielle; Lhuede, Kate
2015-10-01
The evidence to support mental health occupational therapy has proliferated in the early years of this century, but this growth has tended to be organic rather than targeted. Previous efforts to identify research priorities in this area of practice are either out dated, or encompass discrete areas of practice. The aim of this study was to identify priority areas for research in mental health occupational therapy from clinician's perspectives. A Policy Delphi method was used to enable occupational therapists to define and differentiate their perspectives on research priorities. Forty-two occupational therapists took part in the first two rounds of this method, with 69% (n = 29) going on to complete the third and final round of data collection. A Likert scale was used to rate the importance of each priority, and descriptive quantitative analysis undertaken to identify those most consistently identified as being highly important. Four research priorities were identified as being highly important in this study: (i) working in an occupationally focussed way; (ii) consumer experience of therapy groups; (iii) identifying factors which increase consumer engagement in occupation; and (iv) engaging patients on the inpatient unit in meaningful and positive occupation. Two of the priority areas are already the subject of substantial evidence bases, but there has been far less research into consumer experiences of groups and occupational engagement in acute settings. Collaboration between research teams and greater consumer inclusion are recommended for the future. This study provides an updated indication of research priorities for mental health occupational therapy in Australia. © 2015 Occupational Therapy Australia.
Two-dimensional priority-based dynamic resource allocation algorithm for QoS in WDM/TDM PON networks
NASA Astrophysics Data System (ADS)
Sun, Yixin; Liu, Bo; Zhang, Lijia; Xin, Xiangjun; Zhang, Qi; Rao, Lan
2018-01-01
Wavelength division multiplexing/time division multiplexing (WDM/TDM) passive optical networks (PON) is being viewed as a promising solution for delivering multiple services and applications. The hybrid WDM / TDM PON uses the wavelength and bandwidth allocation strategy to control the distribution of the wavelength channels in the uplink direction, so that it can ensure the high bandwidth requirements of multiple Optical Network Units (ONUs) while improving the wavelength resource utilization. Through the investigation of the presented dynamic bandwidth allocation algorithms, these algorithms can't satisfy the requirements of different levels of service very well while adapting to the structural characteristics of mixed WDM / TDM PON system. This paper introduces a novel wavelength and bandwidth allocation algorithm to efficiently utilize the bandwidth and support QoS (Quality of Service) guarantees in WDM/TDM PON. Two priority based polling subcycles are introduced in order to increase system efficiency and improve system performance. The fixed priority polling subcycle and dynamic priority polling subcycle follow different principles to implement wavelength and bandwidth allocation according to the priority of different levels of service. A simulation was conducted to study the performance of the priority based polling in dynamic resource allocation algorithm in WDM/TDM PON. The results show that the performance of delay-sensitive services is greatly improved without degrading QoS guarantees for other services. Compared with the traditional dynamic bandwidth allocation algorithms, this algorithm can meet bandwidth needs of different priority traffic class, achieve low loss rate performance, and ensure real-time of high priority traffic class in terms of overall traffic on the network.
Potential High Priority Subaerial Environments for Mars Sample Return
NASA Astrophysics Data System (ADS)
iMOST Team; Bishop, J. L.; Horgan, B.; Benning, L. G.; Carrier, B. L.; Hausrath, E. M.; Altieri, F.; Amelin, Y.; Ammannito, E.; Anand, M.; Beaty, D. W.; Borg, L. E.; Boucher, D.; Brucato, J. R.; Busemann, H.; Campbell, K. A.; Czaja, A. D.; Debaille, V.; Des Marais, D. J.; Dixon, M.; Ehlmann, B. L.; Farmer, J. D.; Fernandez-Remolar, D. C.; Fogarty, J.; Glavin, D. P.; Goreva, Y. S.; Grady, M. M.; Hallis, L. J.; Harrington, A. D.; Herd, C. D. K.; Humayun, M.; Kleine, T.; Kleinhenz, J.; Mangold, N.; Mackelprang, R.; Mayhew, L. E.; McCubbin, F. M.; Mccoy, J. T.; McLennan, S. M.; McSween, H. Y.; Moser, D. E.; Moynier, F.; Mustard, J. F.; Niles, P. B.; Ori, G. G.; Raulin, F.; Rettberg, P.; Rucker, M. A.; Schmitz, N.; Sefton-Nash, E.; Sephton, M. A.; Shaheen, R.; Shuster, D. L.; Siljestrom, S.; Smith, C. L.; Spry, J. A.; Steele, A.; Swindle, T. D.; ten Kate, I. L.; Tosca, N. J.; Usui, T.; Van Kranendonk, M. J.; Wadhwa, M.; Weiss, B. P.; Werner, S. C.; Westall, F.; Wheeler, R. M.; Zipfel, J.; Zorzano, M. P.
2018-04-01
The highest priority subaerial environments for Mars Sample Return include subaerial weathering (paleosols, periglacial/glacial, and rock coatings/rinds), wetlands (mineral precipitates, redox environments, and salt ponds), or cold spring settings.
32 CFR 245.21 - ESCAT air traffic priority list.
Code of Federal Regulations, 2013 CFR
2013-07-01
... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...
32 CFR 245.21 - ESCAT air traffic priority list.
Code of Federal Regulations, 2010 CFR
2010-07-01
... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...
32 CFR 245.21 - ESCAT air traffic priority list.
Code of Federal Regulations, 2014 CFR
2014-07-01
... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...
32 CFR 245.21 - ESCAT air traffic priority list.
Code of Federal Regulations, 2011 CFR
2011-07-01
... aircraft post-maintenance test flights. (7) Federal aircraft post maintenance check flights in support of... identified as high threat targets. (c) Priority Three. (1) Forces being deployed or performing pre-deployment...
Setting high-impact clinical research priorities for the Society for Vascular Surgery.
Kraiss, Larry W; Conte, Michael S; Geary, Randolph L; Kibbe, Melina; Ozaki, C Keith
2013-02-01
With the overall goal of enhancing the effectiveness and efficiency of vascular care, the Society for Vascular Surgery (SVS) recently completed a process by which it identified its top clinical research priorities to address critical gaps in knowledge guiding practitioners in prevention and treatment of vascular disease. After a survey of the SVS membership, a panel of SVS committee members and opinion leaders considered 53 distinct research questions through a structured process that resulted in identification of nine clinical issues that were felt to merit immediate attention by vascular investigators and external funding agencies. These are, in order of priority: (1) define optimal management of asymptomatic carotid stenosis, (2) compare the effectiveness of medical vs invasive treatment (open or endovascular) of vasculogenic claudication, (3) compare effectiveness of open vs endovascular infrainguinal revascularization as initial treatment of critical limb ischemia, (4) develop and compare the effectiveness of clinical strategies to reduce cardiovascular and other perioperative complications (eg, wound) after vascular intervention, (5) compare the effectiveness of strategies to enhance arteriovenous fistula maturation and durability, (6) develop best practices for management of chronic venous ulcer, (7) define optimal adjunctive medical therapy to enhance the success of lower extremity revascularization, (8) identify and evaluate medical therapy to prevent abdominal aortic aneurysm growth, and (9) evaluate ultrasound vs computed tomographic angiography surveillance after endovascular aneurysm repair. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Gratacós, Jordi; Luelmo, Jesús; Rodríguez, Jesús; Notario, Jaume; Marco, Teresa Navío; de la Cueva, Pablo; Busquets, Manel Pujol; Font, Mercè García; Joven, Beatriz; Rivera, Raquel; Vega, Jose Luis Alvarez; Álvarez, Antonio Javier Chaves; Parera, Ricardo Sánchez; Carrascosa, Jose Carlos Ruiz; Martínez, Fernando José Rodríguez; Sánchez, José Pardo; Olmos, Carlos Feced; Pujol, Conrad; Galindez, Eva; Barrio, Silvia Pérez; Arana, Ana Urruticoechea; Hergueta, Mercedes; Coto, Pablo; Queiro, Rubén
2018-06-01
To define and give priority to standards of care and quality indicators of multidisciplinary care for patients with psoriatic arthritis (PsA). A systematic literature review on PsA standards of care and quality indicators was performed. An expert panel of rheumatologists and dermatologists who provide multidisciplinary care was established. In a consensus meeting group, the experts discussed and developed the standards of care and quality indicators and graded their priority, agreement and also the feasibility (only for quality indicators) following qualitative methodology and a Delphi process. Afterwards, these results were discussed with 2 focus groups, 1 with patients, another with health managers. A descriptive analysis is presented. We obtained 25 standards of care (9 of structure, 9 of process, 7 of results) and 24 quality indicators (2 of structure, 5 of process, 17 of results). Standards of care include relevant aspects in the multidisciplinary care of PsA patients like an appropriate physical infrastructure and technical equipment, the access to nursing care, labs and imaging techniques, other health professionals and treatments, or the development of care plans. Regarding quality indicators, the definition of multidisciplinary care model objectives and referral criteria, the establishment of responsibilities and coordination among professionals and the active evaluation of patients and data collection were given a high priority. Patients considered all of them as important. This set of standards of care and quality indicators for the multidisciplinary care of patients with PsA should help improve quality of care in these patients.
Considerations for an Obesity Policy Research Agenda
McKinnon, Robin A.; Orleans, C. Tracy; Kumanyika, Shiriki K.; Haire-Joshu, Debra; Krebs-Smith, Susan M.; Finkelstein, Eric A.; Brownell, Kelly D.; Thompson, Joseph W.; Ballard-Barbash, Rachel
2010-01-01
The rise in obesity levels in the U.S. in the past several decades has been dramatic, with serious implications for public health and the economy. Experiences in tobacco control and other public health initiatives have shown that public policy may be a powerful tool to effect structural change to alter population-level behavior. In 2007, the National Cancer Institute convened a meeting to discuss priorities for a research agenda to inform obesity policy. Issues considered were how to define obesity policy research, key challenges and key partners in formulating/implementing an obesity policy research agenda, criteria by which to set research priorities, and specific research needs and questions. Themes that emerged were: (1) the embryonic nature of obesity policy research, (2) the need to study “natural experiments” resulting from policy-based efforts to address the obesity epidemic, (3) the importance of research focused beyond individual-level behavior change, (4) the need for economic research across several relevant policy areas, and (5) the overall urgency of taking action in the policy arena. Moving forward, timely evaluation of natural experiments is of especially high priority. A variety of policies intended to promote healthy weight in children and adults are being implemented in communities and at the state and national levels. Although some of these policies are supported by the findings of intervention research, additional research is needed to evaluate the implementation and quantify the impact of new policies designed to address obesity. PMID:19211215
Practical Tips for Working as an Expedition Doctor on High-Altitude Expeditions.
Brants, Anne; Metcalfe, Tracee
2017-09-01
Brants, Anne, and Tracee Metcalfe. Practical tips for working as an expedition doctor on high-altitude expeditions. High Alt Med Biol. 18:193-198, 2017.-With the explosion of adventure travel over the past decade, there has been a concurrent increase in mountaineering expeditions to extreme elevations, including many of the 8000-m peaks. This trend has created an increased demand for qualified expedition doctors to provide specialized medical advice and care to climbers and expedition staff. This review is intended to help physicians prepare for work on such expeditions. The authors rely heavily on their own experience and discuss the types of work available on high-altitude expeditions; how to identify a safe and reputable guiding company; personal and medical preparation; priorities in selecting or building an appropriate medical kit; and medical conditions commonly encountered on expeditions. The review concludes by considering ethical dilemmas and other difficult issues unique to this work.
46 CFR 148.01-9 - Filing of special petition for special permit.
Code of Federal Regulations, 2010 CFR
2010-10-01
... permits, and any other supporting information. (4) The chemical name, common name, hazard classification...) Unless there is a good reason for priority treatment, each proposal is considered in the order in which...
Work, Aging, and Risks to Family Life: The Case of Australia.
Biggs, Simon; Carr, Ashley; Haapala, Irja
2015-09-01
The relationship between work and family is considered with an emphasis on policy solutions. Australian policy is a case example in the context of international trends. A mismatch between policy initiatives and familial and personal priorities constitutes a new social risk associated with demographic and sociocultural development. Contemporary trends, both nationally and internationally, evidence solutions to the “problem of demographic aging” by adopting a form of economic instrumentalism. This restricts legitimate age identities to those associated with work and work-related activity. When applied to family life, such a focus runs the risk of reducing policy interest in intergenerational engagement to unpaid care roles, while personal development and age-related life priorities are ignored. The need for cultural adaptation to population aging is becoming accepted in policy debate and is considered here as an effective response to the personal, social, and economic risks of population aging and associated impacts on family life.
Otolaryngology residents' objectives in entering the workforce.
Kay, David J; Lucente, Frank E
2002-10-01
To determine the priorities of current otolaryngologists-in-training in considering their first employment opportunities. Twenty-one-item survey measuring the importance of various first job issues, with all items scored on a five-point Likert-type ordinal scale. The resident membership of the American Academy of Otolaryngology-Head and Neck Surgery was anonymously surveyed by means of mail-in questionnaires. Results were stratified by years of training. Responses from 242 of 1174 mail-in surveys (21% response rate) exhibited a wide distribution of responses for all 21 questions. The availability of free time to spend with one's family was regarded by more than half of the respondents to have the highest overall importance. As years of training increased, priorities shifted toward geographic location, away from issues such as the on-call schedules. The availability of research time and resources received the overall lowest priority, with more than half of the respondents ranking it as only somewhat important or lower. Otolaryngologists-in-training feel strongest about the availability of free time to spend with their families as they finish formal training and consider employment opportunities. By acknowledging the concerns of graduating residents, including the ability to pursue their primary interests when they start working, we can better adapt conditions to create a more comfortable and stable entry into the workforce.
Peña, Adolfo; Estrada, Carlos A; Soniat, Debbie; Taylor, Benjamin; Burton, Michael
2012-01-01
Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions. To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients. Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT). One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center. Nurses, resident physicians, patient care technicians, and unit clerks. Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?" Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes. Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers. Copyright © 2011 Society of Hospital Medicine.
Decision Making and Priority Setting: The Evolving Path Towards Universal Health Coverage.
Paolucci, Francesco; Redekop, Ken; Fouda, Ayman; Fiorentini, Gianluca
2017-12-01
Health technology assessment (HTA) is widely viewed as an essential component in good universal health coverage (UHC) decision-making in any country. Various HTA tools and metrics have been developed and refined over the years, including systematic literature reviews (Cochrane), economic modelling, and cost-effectiveness ratios and acceptability curves. However, while the cost-effectiveness ratio is faithfully reported in most full economic evaluations, it is viewed by many as an insufficient basis for reimbursement decisions. Emotional debates about the reimbursement of cancer drugs, orphan drugs, and end-of-life treatments have revealed fundamental disagreements about what should and should not be considered in reimbursement decisions. Part of this disagreement seems related to the equity-efficiency tradeoff, which reflects fundamental differences in priorities. All in all, it is clear that countries aiming to improve UHC policies will have to go beyond the capacity building needed to utilize the available HTA toolbox. Multi-criteria decision analysis (MCDA) offers a more comprehensive tool for reimbursement decisions where different weights of different factors/attributes can give policymakers important insights to consider. Sooner or later, every country will have to develop their own way to carefully combine the results of those tools with their own priorities. In the end, all policymaking is based on a mix of facts and values.
Sheppard, Lisa; Senior, Jane; Park, Chae Hee; Mockenhaupt, Robin; Bazzarre, Terry; Chodzko-Zajko, Wojtek
2003-01-01
On May 1, 2001, a coalition of national organizations released a major planning document designed to develop a national strategy for the promotion of physically active lifestyles among the mid-life and older adult population. The National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older was developed with input from 46 organizations with expertise in health, medicine, social and behavioral sciences, epidemiology, gerontology/geriatrics, clinical science, public policy, marketing, medical systems, community organization, and environmental issues. The Blueprint notes that, despite a wealth of evidence about the benefits of physical activity for mid-life and older persons, there has been little success in convincing age 50+ Americans to adopt physically active lifestyles. The Blueprint identifies barriers in the areas of research, home and community programs, medical systems, public policy and advocacy, and marketing and communications. In addition to identifying barriers, the Blueprint proposes a number of concrete strategies that could be employed in order to overcome the barriers to physical activity in society at large. This report summarizes the outcome of the National Blueprint Consensus Conference that was held in October 2002. In this conference, representatives of more than 50 national organizations convened in Washington, D.C. with the goal of identifying high priority and high feasibility strategies which would advance the National Blueprint and which could be initiated within the next 12 to 24 months. Participants in the consensus conference were assigned to one of five breakout groups: home and community, marketing, medical systems, public policy, and research. Each breakout group was charged with identifying the three highest priority strategies within their area for effectively increasing physical activity levels in the mid-life and older adult population. In addition to the 15 strategies identified by the breakout groups, three "cross-cutting" strategies were added which were considered to be broad-based in scope and which applied to more than one of the breakout themes. A national organization was identified to take the lead in planning and implementing each strategy. A summary of the 18 strategies and lead organizations is presented. The National Blueprint Consensus Conference has identified an ambitious agenda of strategies and tactics that will need to be implemented in order to overcome societal barriers to physical activity among the mid-life and older adult population. More than 50 national organizations have expressed a commitment to work towards the implementation of the Blueprint agenda. Eighteen priority strategies have been identified in the areas of home and community, marketing, medical systems, public policy, and research. The organizations charged with the task of implementing the high priority strategies will use professional networks and established delivery channels and communication systems to translate this plan into action. PMID:24688279
Sheppard, Lisa; Senior, Jane; Park, Chae Hee; Mockenhaupt, Robin; Bazzarre, Terry; Chodzko-Zajko, Wojtek
2003-12-01
On May 1, 2001, a coalition of national organizations released a major planning document designed to develop a national strategy for the promotion of physically active lifestyles among the mid-life and older adult population. The National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older was developed with input from 46 organizations with expertise in health, medicine, social and behavioral sciences, epidemiology, gerontology/geriatrics, clinical science, public policy, marketing, medical systems, community organization, and environmental issues. The Blueprint notes that, despite a wealth of evidence about the benefits of physical activity for mid-life and older persons, there has been little success in convincing age 50+ Americans to adopt physically active lifestyles. The Blueprint identifies barriers in the areas of research, home and community programs, medical systems, public policy and advocacy, and marketing and communications. In addition to identifying barriers, the Blueprint proposes a number of concrete strategies that could be employed in order to overcome the barriers to physical activity in society at large. This report summarizes the outcome of the National Blueprint Consensus Conference that was held in October 2002. In this conference, representatives of more than 50 national organizations convened in Washington, D.C. with the goal of identifying high priority and high feasibility strategies which would advance the National Blueprint and which could be initiated within the next 12 to 24 months. Participants in the consensus conference were assigned to one of five breakout groups: home and community, marketing, medical systems, public policy, and research. Each breakout group was charged with identifying the three highest priority strategies within their area for effectively increasing physical activity levels in the mid-life and older adult population. In addition to the 15 strategies identified by the breakout groups, three "cross-cutting" strategies were added which were considered to be broad-based in scope and which applied to more than one of the breakout themes. A national organization was identified to take the lead in planning and implementing each strategy. A summary of the 18 strategies and lead organizations is presented. The National Blueprint Consensus Conference has identified an ambitious agenda of strategies and tactics that will need to be implemented in order to overcome societal barriers to physical activity among the mid-life and older adult population. More than 50 national organizations have expressed a commitment to work towards the implementation of the Blueprint agenda. Eighteen priority strategies have been identified in the areas of home and community, marketing, medical systems, public policy, and research. The organizations charged with the task of implementing the high priority strategies will use professional networks and established delivery channels and communication systems to translate this plan into action.
Septic arthritis due to Cellulosimicrobium cellulans.
Magro-Checa, César; Chaves-Chaparro, Lara; Parra-Ruiz, Jorge; Peña-Monje, Alejandro; Rosales-Alexander, José Luis; Salvatierra, Juan; Raya, Enrique
2011-12-01
Cellulosimicrobium cellulans has been reported as a rare cause of human pathogenesis. Infections mainly occur in immunocompromised patients and very often are associated with a foreign body. We report the first case of septic arthritis caused by C. cellulans in an immunocompetent patient. Our patient suffered a penetrating palm tree thorn injury to his left knee 8 weeks before admission. Although no foreign objects were found, they were suspected because previous reports suggest a frequent association with this microorganism, and open debridament was performed. Removal of foreign bodies related to this organism must be considered a high-priority treatment in these patients to achieve a complete recovery.
Boev, B V; Lobanov, A V; Khudobin, V V
2008-01-01
Features of louse-borne typhus in Russia in the middle of 20th century are considered. Study of the infection source, blood serum in patient after epidemic louse-borne typhus (ELBT) and agent (louse) was performed on territory with high morbidity of pediculosis and ELBT in the years of 2nd world war. New materials of seroimmunological examinations are represented. Priority data of lice morphology based on morphometrical data of lice, collected in Russia and world collection in Berlin are shown. Methods of ELBT prediction are given, special attention is paid to development of mathematic prognostic models based on new technologies.
Intervention complexity--a conceptual framework to inform priority-setting in health.
Gericke, Christian A.; Kurowski, Christoph; Ranson, M. Kent; Mills, Anne
2005-01-01
Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals. PMID:15868020
Intervention complexity--a conceptual framework to inform priority-setting in health.
Gericke, Christian A; Kurowski, Christoph; Ranson, M Kent; Mills, Anne
2005-04-01
Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals.
40 CFR Appendix E to Part 300 - Oil Spill Response
Code of Federal Regulations, 2010 CFR
2010-07-01
..., other waters of the high seas subject to the NCP, and the land surface or land substrata, ground waters... response equipment; and a district response advisory team. Contiguous zone means the zone of the high seas... of the discharge. 2.2Priorities. (a) Safety of human life must be given the highest priority during...
State Strategies to Improve Low-Performing Schools: California's High Priority School Grants Program
ERIC Educational Resources Information Center
Timar, Thomas; Rodriguez, Gloria; Simon, Virginia Adams; Ferrario, Kim; Kim, Kris
2006-01-01
Central to California's school accountability system are programs to engage low-performing schools in improvement efforts. One of these is the High Priority Schools Program (HPSGP), created by Assembly Bill 961 (Chapter 747, "Statutes of 2001") to provide funds to the lowest performing schools in the state. To be eligible for funding,…
Brian W. Smith; Dean Demarest; Ed. Laurent
2010-01-01
The Appalachian Mountains Joint Venture (AMJV) is a self-directed, nonregulatory bird conservation partnership with the mission of restoring and sustaining native bird populations and their habitats throughout Appalachia. In 2008, the AMJV formed an ad hoc "high-elevation" technical working group to identify and address conservation priorities of bird species...
Few Americans Receive All High-Priority, Appropriate Clinical Preventive Services.
Borsky, Amanda; Zhan, Chunliu; Miller, Therese; Ngo-Metzger, Quyen; Bierman, Arlene S; Meyers, David
2018-06-01
As of 2015, only 8 percent of US adults ages thirty-five and older had received all of the high-priority, appropriate clinical preventive services recommended for them. Nearly 5 percent of adults did not receive any such services. Further delivery system-level efforts are needed to increase the use of preventive services.
Exploring end of life priorities in Saudi males: usefulness of Q-methodology.
Hammami, Muhammad M; Al Gaai, Eman; Hammami, Safa; Attala, Sahar
2015-11-26
Quality end-of-life care depends on understanding patients' end-of-life choices. Individuals and cultures may hold end-of-life priorities at different hierarchy. Forced ranking rather than independent rating, and by-person factor analysis rather than averaging may reveal otherwise masked typologies. We explored Saudi males' forced-ranked, end-of-life priorities and dis-priorities. Respondents (n = 120) rank-ordered 47 opinion statements on end-of-life care following a 9-category symmetrical distribution. Statements' scores were analyzed by averaging analysis and factor analysis (Q-methodology). Respondents' mean age was 32.1 years (range, 18-65); 52% reported average religiosity, 88 and 83% ≥ very good health and life-quality, respectively, and 100% ≥ high school education. Averaging analysis revealed that the extreme five end-of-life priorities were to, be at peace with God, be able to say the statement of faith, maintain dignity, resolve conflicts, and have religious death rituals respected, respectively. The extreme five dis-priorities were to, die in the hospital, not receive intensive care if in coma, die at peak of life, be informed about impending death by family/friends rather than doctor, and keep medical status confidential from family/friends, respectively. Q-methodology classified 67% of respondents into five highly transcendent opinion types. Type-I (rituals-averse, family-caring, monitoring-coping, life-quality-concerned) and Type-V (rituals-apt, family-centered, neutral-coping, life-quantity-concerned) reported the lowest and highest religiosity, respectively. Type-II (rituals-apt, family-dependent, monitoring-coping, life-quantity-concerned) and Type-III (rituals-silent, self/family-neutral, avoidance-coping, life-quality & quantity-concerned) reported the best and worst life-quality, respectively. Type-I respondents were the oldest with the lowest general health, in contrast to Type-IV (rituals-apt, self-centered, monitoring-coping, life-quality/quantity-neutral). Of the extreme 14 priorities/dis-priorities for the five types, 29, 14, 14, 50, and 36%, respectively, were not among the extreme 20 priorities/dis-priorities identified by averaging analysis for the entire cohort. 1) Transcendence was the extreme end-of-life priority, and dying in the hospital was the extreme dis-priority. 2) Quality of life was conceptualized differently with less emphasize on its physiological aspects. 3) Disclosure of terminal illness to family/close friends was preferred as long it is through the patient. 4) Q-methodology identified five types of constellations of end-of-life priorities and dis-priorities that may be related to respondents' demographics and are partially masked by averaging analysis.
Perry, D C; Wright, J G; Cooke, S; Roposch, A; Gaston, M S; Nicolaou, N; Theologis, T
2018-05-01
Aims High-quality clinical research in children's orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children's orthopaedics. Methods A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children's Orthopaedic Surgery. The survey was conducted amongst orthopaedic surgeons treating children in the United Kingdom and Ireland. Results A total of 86 clinicians contributed to both rounds of the Delphi process, scoring priorities from one (low priority) to five (high priority). Elective topics were ranked higher than those relating to trauma, with the top ten elective research questions scoring higher than the top question for trauma. Ten elective, and five trauma research priorities were identified, with the three highest ranked questions relating to the treatment of slipped capital femoral epiphysis (mean score 4.6/ 5), Perthes' disease (4.5) and bone infection (4.5). Conclusion This consensus-based research agenda will guide surgeons, academics and funders to improve the evidence in children's orthopaedic surgery and encourage the development of multicentre clinical trials. Cite this article: Bone Joint J 2018;100-B:680-4.
Binge Eating among Women Veterans in Primary Care: Comorbidities and Treatment Priorities.
Rosenbaum, Diane L; Kimerling, Rachel; Pomernacki, Alyssa; Goldstein, Karen M; Yano, Elizabeth M; Sadler, Anne G; Carney, Diane; Bastian, Lori A; Bean-Mayberry, Bevanne A; Frayne, Susan M
2016-01-01
Little is known about the clinical profile and treatment priorities of women with binge eating disorder (BED), a diagnosis new to the fifth edition of Diagnostic and Statistical Manual of Mental Disorders. We identified comorbidities and patients' treatment priorities, because these may inform implementation of clinical services. Data were collected from women veteran primary care patients. Analyses compared those who screened positive for BED (BED+), and those without any binge eating symptoms (BED-). Frequencies of comorbid medical and psychological disorders were high in the BED+ group. The BED+ group's self-identified most common treatment priorities were mood concerns (72.2%), weight loss (66.7%), and body image/food issues (50%). Among those with obesity, a greater proportion of the BED+ group indicated body image/food issues was their top treatment priority (12.9% vs. 2.8%; p < .01), suggesting that these patients may be more apt to seek treatment beyond weight management for their problematic eating patterns. Women primary care patients with BED demonstrate high medical and psychological complexity; their subjective treatment priorities often match objective needs. These findings may inform the development of targeted BED screening practices for women with obesity in primary care settings, and the eventual adoption of patient-centered BED treatment resources. Published by Elsevier Inc.
Biodiversity hotspots house most undiscovered plant species.
Joppa, Lucas N; Roberts, David L; Myers, Norman; Pimm, Stuart L
2011-08-09
For most organisms, the number of described species considerably underestimates how many exist. This is itself a problem and causes secondary complications given present high rates of species extinction. Known numbers of flowering plants form the basis of biodiversity "hotspots"--places where high levels of endemism and habitat loss coincide to produce high extinction rates. How different would conservation priorities be if the catalog were complete? Approximately 15% more species of flowering plant are likely still undiscovered. They are almost certainly rare, and depending on where they live, suffer high risks of extinction from habitat loss and global climate disruption. By using a model that incorporates taxonomic effort over time, regions predicted to contain large numbers of undiscovered species are already conservation priorities. Our results leave global conservation priorities more or less intact, but suggest considerably higher levels of species imperilment than previously acknowledged.
Evolution of ebola virus disease from exotic infection to global health priority, Liberia, mid-2014.
Arwady, M Allison; Bawo, Luke; Hunter, Jennifer C; Massaquoi, Moses; Matanock, Almea; Dahn, Bernice; Ayscue, Patrick; Nyenswah, Tolbert; Forrester, Joseph D; Hensley, Lisa E; Monroe, Benjamin; Schoepp, Randal J; Chen, Tai-Ho; Schaecher, Kurt E; George, Thomas; Rouse, Edward; Schafer, Ilana J; Pillai, Satish K; De Cock, Kevin M
2015-04-01
Over the span of a few weeks during July and August 2014, events in West Africa changed perceptions of Ebola virus disease (EVD) from an exotic tropical disease to a priority for global health security. We describe observations during that time of a field team from the Centers for Disease Control and Prevention and personnel of the Liberian Ministry of Health and Social Welfare. We outline the early epidemiology of EVD within Liberia, including the practical limitations on surveillance and the effect on the country's health care system, such as infections among health care workers. During this time, priorities included strengthening EVD surveillance; establishing safe settings for EVD patient care (and considering alternative isolation and care models when Ebola Treatment Units were overwhelmed); improving infection control practices; establishing an incident management system; and working with Liberian airport authorities to implement EVD screening of departing passengers.
Evolution of Ebola Virus Disease from Exotic Infection to Global Health Priority, Liberia, Mid-2014
Bawo, Luke; Hunter, Jennifer C.; Massaquoi, Moses; Matanock, Almea; Dahn, Bernice; Ayscue, Patrick; Nyenswah, Tolbert; Forrester, Joseph D.; Hensley, Lisa E.; Monroe, Benjamin; Schoepp, Randal J.; Chen, Tai-Ho; Schaecher, Kurt E.; George, Thomas; Rouse, Edward; Schafer, Ilana J.; Pillai, Satish K.; De Cock, Kevin M.
2015-01-01
Over the span of a few weeks during July and August 2014, events in West Africa changed perceptions of Ebola virus disease (EVD) from an exotic tropical disease to a priority for global health security. We describe observations during that time of a field team from the Centers for Disease Control and Prevention and personnel of the Liberian Ministry of Health and Social Welfare. We outline the early epidemiology of EVD within Liberia, including the practical limitations on surveillance and the effect on the country’s health care system, such as infections among health care workers. During this time, priorities included strengthening EVD surveillance; establishing safe settings for EVD patient care (and considering alternative isolation and care models when Ebola Treatment Units were overwhelmed); improving infection control practices; establishing an incident management system; and working with Liberian airport authorities to implement EVD screening of departing passengers. PMID:25811176
Berry, Andrew B.L.; Lim, Catherine; Hartzler, Andrea L.; Hirsch, Tad; Ludman, Evette; Wagner, Edward H.; Ralston, James D.
2017-01-01
Patients with multiple chronic conditions often face competing demands for care, and they often do not agree with physicians on priorities for care. Patients ’ values shape their healthcare priorities, but existing methods for eliciting values do not necessarily meet patients ’ care planning needs. We developed a patient-centered values framework based on a field study with patients and caregivers. In this paper we report on a survey to evaluate how the framework generalizes beyond field study participants, and how well the framework supports values elicitation. We found that respondents frame values in a way that is consistent with the framework, and that domains of the framework can be used to elicit a breadth of potential values individuals with MCC express. These findings demonstrate how a patient-centered perspective on values can expand on the domains considered in values clarification methods andfacilitate patient-provider communication in establishing shared care priorities. PMID:29854107
Berry, Andrew B L; Lim, Catherine; Hartzler, Andrea L; Hirsch, Tad; Ludman, Evette; Wagner, Edward H; Ralston, James D
2017-01-01
Patients with multiple chronic conditions often face competing demands for care, and they often do not agree with physicians on priorities for care. Patients ' values shape their healthcare priorities, but existing methods for eliciting values do not necessarily meet patients ' care planning needs. We developed a patient-centered values framework based on a field study with patients and caregivers. In this paper we report on a survey to evaluate how the framework generalizes beyond field study participants, and how well the framework supports values elicitation. We found that respondents frame values in a way that is consistent with the framework, and that domains of the framework can be used to elicit a breadth of potential values individuals with MCC express. These findings demonstrate how a patient-centered perspective on values can expand on the domains considered in values clarification methods andfacilitate patient-provider communication in establishing shared care priorities.
Classification of factors of development of transport infrastructure in the region
NASA Astrophysics Data System (ADS)
Karpovich, Oleg; Shlafman, Alexander
2017-10-01
The formation of a unified strategy for the development of the transport infrastructure of the region is considered to be the basic direction of the developing the whole territory The article is devoted to determining priorities in the implementation of programs of redevelopment of the regional plants. The submission suggested authors the characteristics of a grouping of theoretical and practical approaches to spatial reorganization of production. The result of this research, the specific recommendations on the application of redevelopment for the development of industrial areas. The organization of economic relations within the eastern regions of the Russian Federation, as well as the implementation of economic activities involving the transit and processing of a multitude of material and intangible flows on their territory, is a priority task of the state policy of smoothing the development of the regions of the country. To solve these macroeconomic problems, the transport infrastructure of the region has a priority.
Future Research Priorities for Morbidity Control of Lymphedema.
Narahari, S R; Aggithaya, Madhur Guruprasad; Moffatt, Christine; Ryan, T J; Keeley, Vaughan; Vijaya, B; Rajendran, P; Karalam, S B; Rajagopala, S; Kumar, N K; Bose, K S; Sushma, K V
2017-01-01
Innovation in the treatment of lower extremity lymphedema has received low priority from the governments and pharmaceutical industry. Advancing lymphedema is irreversible and initiates fibrosis in the dermis, reactive changes in the epidermis and subcutis. Most medical treatments offered for lymphedema are either too demanding with a less than satisfactory response or patients have low concordance due to complex schedules. A priority setting partnership (PSP) was established to decide on the future priorities in lymphedema research. A table of abstracts following a literature search was published in workshop website. Stake holders were requested to upload their priorities. Their questions were listed, randomized, and sent to lymphologists for ranking. High ranked ten research priorities, obtained through median score, were presented in final prioritization work shop attended by invited stake holders. A free medical camp was organized during workshop to understand patients' priorities. One hundred research priorities were selected from priorities uploaded to website. Ten priorities were short listed through a peer review process involving 12 lymphologists, for final discussion. They were related to simplification of integrative treatment for lymphedema, cellular changes in lymphedema and mechanisms of its reversal, eliminating bacterial entry lesions to reduce cellulitis episodes, exploring evidence for therapies in traditional medicine, improving patient concordance to compression therapy, epidemiology of lymphatic filariasis (LF), and economic benefit of integrative treatments of lymphedema. A robust research priority setting process, organized as described in James Lind Alliance guidebook, identified seven priority areas to achieve effective morbidity control of lymphedema including LF. All stake holders including Department of Health Research, Government of India, participated in the PSP.
Future Research Priorities for Morbidity Control of Lymphedema
Narahari, S R; Aggithaya, Madhur Guruprasad; Moffatt, Christine; Ryan, T J; Keeley, Vaughan; Vijaya, B; Rajendran, P; Karalam, S B; Rajagopala, S; Kumar, N K; Bose, K S; Sushma, K V
2017-01-01
Background: Innovation in the treatment of lower extremity lymphedema has received low priority from the governments and pharmaceutical industry. Advancing lymphedema is irreversible and initiates fibrosis in the dermis, reactive changes in the epidermis and subcutis. Most medical treatments offered for lymphedema are either too demanding with a less than satisfactory response or patients have low concordance due to complex schedules. A priority setting partnership (PSP) was established to decide on the future priorities in lymphedema research. Methods: A table of abstracts following a literature search was published in workshop website. Stake holders were requested to upload their priorities. Their questions were listed, randomized, and sent to lymphologists for ranking. High ranked ten research priorities, obtained through median score, were presented in final prioritization work shop attended by invited stake holders. A free medical camp was organized during workshop to understand patients’ priorities. Results: One hundred research priorities were selected from priorities uploaded to website. Ten priorities were short listed through a peer review process involving 12 lymphologists, for final discussion. They were related to simplification of integrative treatment for lymphedema, cellular changes in lymphedema and mechanisms of its reversal, eliminating bacterial entry lesions to reduce cellulitis episodes, exploring evidence for therapies in traditional medicine, improving patient concordance to compression therapy, epidemiology of lymphatic filariasis (LF), and economic benefit of integrative treatments of lymphedema. Conclusion: A robust research priority setting process, organized as described in James Lind Alliance guidebook, identified seven priority areas to achieve effective morbidity control of lymphedema including LF. All stake holders including Department of Health Research, Government of India, participated in the PSP. PMID:28216723
Tallis, Heather; Cole, Aaron; Schill, Steven; Martin, Erik; Heiner, Michael; Paiz, Marie-Claire; Aldous, Allison; Apse, Colin; Nickel, Barry
2017-01-01
Rapidly developing countries contain both the bulk of intact natural areas and biodiversity, and the greatest untapped natural resource stocks, placing them at the forefront of “green” economic development opportunities. However, most lack scientific tools to create development plans that account for biodiversity and ecosystem services, diminishing the real potential to be sustainable. Existing methods focus on biodiversity and carbon priority areas across large geographies (e.g., countries, states/provinces), leaving out essential services associated with water supplies, among others. These hydrologic ecosystem services (HES) are especially absent from methods applied at large geographies and in data-limited contexts. Here, we present a novel, spatially explicit, and relatively simple methodology to identify countrywide HES priority areas. We applied our methodology to the Gabonese Republic, a country undergoing a major economic transformation under a governmental commitment to balance conservation and development goals. We present the first national-scale maps of HES priority areas across Gabon for erosion control, nutrient retention, and groundwater recharge. Priority sub-watersheds covered 44% of the country’s extent. Only 3% of the country was identified as a priority area for all HES simultaneously, highlighting the need to conserve different areas for each different hydrologic service. While spatial tradeoffs occur amongst HES, we identified synergies with two other conservation values, given that 66% of HES priority areas intersect regions of above average area-weighted (by sub-watersheds) total forest carbon stocks and 38% intersect with terrestrial national parks. Considering implications for development, we identified HES priority areas overlapping current or proposed major roads, forestry concessions, and active mining concessions, highlighting the need for proactive planning for avoidance areas and compensatory offsets to mitigate potential conflicts. Collectively, our results provide insight into strategies to protect HES as part of Gabon’s development strategy, while providing a replicable methodology for application to new scales, geographies, and policy contexts. PMID:28594870
Top 40 Priorities for Science to Inform US Conservation and Management Policy
We present a list of America's "Top 40" high-priority questions that, if answered, would help inform some of the most important current and future decisions about resource management in the United States
DOT National Transportation Integrated Search
2011-01-01
Developing computer models of land use and : integrated transportation-land use are high : priorities for Florida transportation planners. : Land use information is fundamental to siting : roadways, signaling, setting maintenance : priorities, routin...
Yek, Sze Huei; Willliams, Stephen E; Burwell, Chris J.; Robson, Simon K.A.; Crozier, Ross H.
2009-01-01
This study aims to identify a set of areas with high biodiversity value over a small spatial scale within the Australian Wet Tropics. We identified sites of high biodiversity value across an altitudinal gradient of ground dwelling ant communities using three measures of biodiversity. The three measures considered were estimated species richness, complementarity between sites and evolutionary history. The latter measure was derived using the systematic nomenclature of the ants to infer a surrogate phylogeny. The goal of conservation assessments could then be achieved by choosing the most diverse site combinations. This approach was found to be valuable for identifying the most diverse site combinations across an altitudinal gradient that could ensure the preservation of terrestrial ground dwelling invertebrates in the Australian Wet Tropics. PMID:19613441
Do People Taking Flu Vaccines Need Them the Most?
Gu, Qian; Sood, Neeraj
2011-01-01
Background A well targeted flu vaccine strategy can ensure that vaccines go to those who are at the highest risk of getting infected if unvaccinated. However, prior research has not explicitly examined the association between the risk of flu infection and vaccination rates. Purpose This study examines the relationship between the risk of flu infection and the probability of getting vaccinated. Methods Nationally representative data from the US and multivariate regression models were used to estimate what individual characteristics are associated with (1) the risk of flu infection when unvaccinated and (2) flu vaccination rates. These results were used to estimate the correlation between the probability of infection and the probability of getting vaccinated. Separate analyses were performed for the general population and the high priority population that is at increased risk of flu related complications. Results We find that the high priority population was more likely to get vaccinated compared to the general population. However, within both the high priority and general populations the risk of flu infection when unvaccinated was negatively correlated with vaccination rates (r = −0.067, p<0.01). This negative association between the risk of infection when unvaccinated and the probability of vaccination was stronger for the high priority population (r = −0.361, p<0.01). Conclusions There is a poor match between those who get flu vaccines and those who have a high risk of flu infection within both the high priority and general populations. Targeting vaccination to people with low socioeconomic status, people who are engaged in unhealthy behaviors, working people, and families with kids will likely improve effectiveness of flu vaccine policy. PMID:22164202
Defining priorities for improving end-of-life care in Canada
Heyland, Daren K.; Cook, Deborah J.; Rocker, Graeme M.; Dodek, Peter M.; Kutsogiannis, Demetrios J.; Skrobik, Yoanna; Jiang, Xuran; Day, Andrew G.; Cohen, S. Robin
2010-01-01
Background High-quality end-of-life care should be the right of every Canadian. The objective of this study was to identify aspects of end-of-life care that are high in priority as targets for improvement using feedback elicited from patients and their families. Methods We conducted a multicentre, cross-sectional survey involving patients with advanced, life-limiting illnesses and their family caregivers. We administered the Canadian Health Care Evaluation Project (CANHELP) questionnaire along with a global rating question to measure satisfaction with end-of-life care. We derived the relative importance of individual questions on the CANHELP questionnaire from their association with a global rating of satisfaction, as determined using Pearson correlation coefficients. To determine high-priority issues, we identified questions that had scores indicating high importance and low satisfaction. Results We approached 471 patients and 255 family members, of whom 363 patients and 193 family members participated, with response rates of 77% for patients and 76% for families. From the perspective of patients, high-priority areas needing improvement were related to feelings of peace, to assessment and treatment of emotional problems, to physician availability and to satisfaction that the physician took a personal interest in them, communicated clearly and consistently, and listened. From the perspective of family members, similar areas were identified as high in priority, along with the additional areas of timely information about the patient’s condition and discussions with the doctor about final location of care and use of end-of-life technology. Interpretation End-of-life care in Canada may be improved for patients and their families by providing better psychological and spiritual support, better planning of care and enhanced relationships with physicians, especially in aspects related to communication and decision-making. PMID:20921249
ERIC Educational Resources Information Center
Blustein, Carly L.; Carter, Erik W.; McMillan, Elise D.
2016-01-01
The expectations of parents can shape the post-school pathways of young people with intellectual and developmental disabilities (IDD). Yet little is known about how parents view the employment prospects and priorities of their sons and daughters after high school. We examined expectations, preferences, and concerns of 1,065 parents of children and…
Job Priorities on Peregrine | High-Performance Computing | NREL
allocation when run with qos=high. Requesting a Node Reservation If you are doing work that requires real scheduler more efficiently plan resources for larger jobs. When projects reach their allocation limit, jobs associated with those projects will run at very low priority, which will ensure that these jobs run only when
High Priority Research Needs for Gestational Diabetes Mellitus
Robinson, Karen A.; Saldanha, Ian J.; Wilson, Lisa M.; Nicholson, Wanda K.
2012-01-01
Abstract Objective Identification of unanswered research questions about the management of gestational diabetes mellitus (GDM) is necessary to focus future research endeavors. We developed a process for elucidating the highest priority research questions on GDM. Methods Using a systematic review on GDM as a starting point, we developed an eight-step process: (1) identification of research gaps, (2) feedback from the review's authors, (3) translation of gaps into researchable questions using population, intervention, comparators, outcomes, setting (PICOS) framework, (4) local institutions' stakeholders' refinement of research questions, (5) national stakeholders' use of Delphi method to develop consensus on the importance of research questions, (6) prioritization of outcomes, (7) conceptual framework, and (8) evaluation. Results We identified 15 high priority research questions for GDM. The research questions focused on medication management of GDM (e.g., various oral agents vs. insulin), delivery management for women with GDM (e.g., induction vs. expectant management), and identification of risk factors for, prevention of, and screening for type 2 diabetes in women with prior GDM. Stakeholders rated the development of chronic diseases in offspring, cesarean delivery, and birth trauma as high priority outcomes to measure in future studies. Conclusions We developed an eight-step process using a multidisciplinary group of stakeholders to identify 15 research questions of high clinical importance. Researchers, policymakers, and funders can use this list to direct research efforts and resources to the highest priority areas to improve care for women with GDM. PMID:22747422
Fuess, Lucas T; Rodrigues, Isabella J; Garcia, Marcelo L
2017-09-19
This paper reports the characterization of the polluting potential of sugarcane vinasse, the main wastewater from ethanol production. Compositional data from vinasse samples collected from sugarcane biorefineries were used to predict negative effects on the soil, water resources and crops potentially associated with fertirrigation, the primary final destination of vinasse in Brazil. High risks of soil salinization were associated with the land disposal of vinasse, as evidenced by the high levels of total dissolved solids (TDS; >4,000 mg L -1 ) and electrical conductivity (>6.7 dS m -1 ). The high TDS levels coupled with the high biodegradable organic content of vinasse (>14 g L -1 ) also favor organic overloading events, leading to local anaerobiosis conditions. Conversely, soil sodification should not be observed in areas fertirrigated with sugarcane vinasse, given the low Na concentrations (<66 mg L -1 ) relative to Mg (>145.1 mg L -1 ) and Ca (>458.4 mg L -1 ) levels. Priority pollutants (Cu, Cr, Ni, Pb and Zn) and phytotoxic elements (Al and Fe) were also found in the analyzed samples; however, relevant environmental impacts should not be associated with these particular constituents. Overall, the relatively simple methodology used herein could efficiently replace massive field data collection to provide a basic understanding of the fate of vinasse in the environment in order to highlight the priority points to be considered in the management of this effluent. In summary, the prompt implementation of treatment plants in distilleries, in addition to a continuous and broad compositional characterization of vinasse, is essential to guarantee its adequate reuse.
Vimal, Ruppert; Pluvinet, Pascal; Sacca, Céline; Mazagol, Pierre-Olivier; Etlicher, Bernard; Thompson, John D
2012-03-01
In this study, we developed a multi-criteria assessment of spatial variability of the vulnerability of three different biodiversity descriptors: sites of high conservation interest by virtue of the presence of rare or remarkable species, extensive areas of high ecological integrity, and landscape diversity in grid cells across an entire region. We assessed vulnerability in relation to (a) direct threats in and around sites to a distance of 2 km associated with intensive agriculture, building and road infrastructure and (b) indirect effects of human population density on a wider scale (50 km). The different combinations of biodiversity and threat indicators allowed us to set differential priorities for biodiversity conservation and assess their spatial variation. For example, with this method we identified sites and grid cells which combined high biodiversity with either high threat values or low threat values for the three different biodiversity indicators. In these two classes the priorities for conservation planning will be different, reduce threat values in the former and restrain any increase in the latter. We also identified low priority sites (low biodiversity with either high or low threats). This procedure thus allows for the integration of a spatial ranking of vulnerability into priority setting for regional conservation planning. Copyright © 2011 Elsevier Ltd. All rights reserved.
Big data privacy protection model based on multi-level trusted system
NASA Astrophysics Data System (ADS)
Zhang, Nan; Liu, Zehua; Han, Hongfeng
2018-05-01
This paper introduces and inherit the multi-level trusted system model that solves the Trojan virus by encrypting the privacy of user data, and achieve the principle: "not to read the high priority hierarchy, not to write the hierarchy with low priority". Thus ensuring that the low-priority data privacy leak does not affect the disclosure of high-priority data privacy. This paper inherits the multi-level trustworthy system model of Trojan horse and divides seven different risk levels. The priority level 1˜7 represent the low to high value of user data privacy, and realize seven kinds of encryption with different execution efficiency Algorithm, the higher the priority, the greater the value of user data privacy, at the expense of efficiency under the premise of choosing a more encrypted encryption algorithm to ensure data security. For enterprises, the price point is determined by the unit equipment users to decide the length of time. The higher the risk sub-group algorithm, the longer the encryption time. The model assumes that users prefer the lower priority encryption algorithm to ensure efficiency. This paper proposes a privacy cost model for each of the seven risk subgroups. Among them, the higher the privacy cost, the higher the priority of the risk sub-group, the higher the price the user needs to pay to ensure the privacy of the data. Furthermore, by introducing the existing pricing model of economics and the human traffic model proposed by this paper and fluctuating with the market demand, this paper improves the price of unit products when the market demand is low. On the other hand, when the market demand increases, the profit of the enterprise will be guaranteed under the guidance of the government by reducing the price per unit of product. Then, this paper introduces the dynamic factors of consumers' mood and age to optimize. At the same time, seven algorithms are selected from symmetric and asymmetric encryption algorithms to define the enterprise costs at different levels. Therefore, the proposed model solves the continuous influence caused by cascading events and ensures that the disclosure of low-level data privacy of users does not affect the high-level data privacy, thus greatly improving the safety of the private information of user.
Priorities for family building among patients and partners seeking treatment for infertility.
Duthie, Elizabeth A; Cooper, Alexandra; Davis, Joseph B; Sandlow, Jay; Schoyer, Katherine D; Strawn, Estil; Flynn, Kathryn E
2017-04-05
Infertility treatment decisions require people to balance multiple priorities. Within couples, partners must also negotiate priorities with one another. In this study, we assessed the family-building priorities of couples prior to their first consultations with a reproductive specialist. Participants were couples who had upcoming first consultations with a reproductive specialist (N = 59 couples (59 women; 59 men)). Prior to the consultation, couples separately completed the Family-Building Priorities Tool, which tasked them with ranking from least to most important 10 factors associated with family building. We describe the highest (top three) and lowest (bottom three) priorities, the alignment of priorities within couples, and test for differences in prioritization between men and women within couples (Wilcoxon signed rank test). Maintaining a close and satisfying relationship with one's partner was ranked as a high priority by majorities of men and women, and in 25% of couples, both partners ranked this factor as their most important priority for family building. Majorities of men and women also ranked building a family in a way that does not make infertility obvious to others as a low priority, and in 27% of couples, both partners ranked this factor as the least important priority for family building. There were also differences within couples that involved either men or women ranking a particular goal more highly than their partners. More women ranked two factors higher than did their partners: 1) that I become a parent one way or another (p = 0.015) and 2) that I have a child in the next year or two (p < 0.001), whereas more men ranked 4 factors higher than their partners: 1) that our child has [woman's] genes (p = 0.025), 2) that our child has [man's] genes (p < 0.001), 3) that I maintain a close relationship with my partner (p = 0.034), and 4) that I avoid side effects from treatment (p < 0.001). Clinicians who support patients in assessing available family-building paths should be aware that: (1) patients balance multiple priorities as a part of, or beside, becoming a parent; and (2) patients and their partners may not be aligned in their prioritization of achieving parenthood. For infertility patients who are in relationships, clinicians should encourage the active participation of both partners as well as frank discussions about each partner's priorities for building their family.
Electric cars. Advantages and disadvantages
NASA Astrophysics Data System (ADS)
Gelmanova, Z. S.; Zhabalova, G. G.; Sivyakova, G. A.; Lelikova, O. N.; Onishchenko, O. N.; Smailova, A. A.; Kamarova, S. N.
2018-05-01
The article considers the positive and negative aspects of the use of electric vehicles. A rough calculation of the energy efficiency and average cost per month was made. Also priorities to avoid the existing problems in the market of electric vehicles were set.
Microorganisms are priority stressors to receiving water bodies. Practitioners often consider structural stormwater management practices as effective tools to mitigate stormwater-carried bacteria before reaching receiving waters. The performance of these controls for microbial ...
Problem area descriptions : motor vehicle crashes - data analysis and IVI program analysis
DOT National Transportation Integrated Search
In general, the IVI program focuses on the more significant safety problem categories as : indicated by statistical analyses of crash data. However, other factors were considered in setting : program priorities and schedules. For some problem areas, ...
ASSESSMENT OF COLD-CLIMATE ENVIRONMENTAL RESEARCH PRIORITIES
Since its inception, the U.S. Environmental Protection Agency has maintained a research program in Alaska to address environmental problems unique to cold climates. The wide range of natural resource developments now being considered pose an equally wide range of possible environ...
Identifying spatial priorities for protecting ecosystem services
Luck, Gary W
2012-01-01
Priorities for protecting ecosystem services must be identified to ensure future human well-being. Approaches to broad-scale spatial prioritization of ecosystem services are becoming increasingly popular and are a vital precursor to identifying locations where further detailed analyses of the management of ecosystem services is required (e.g., examining trade-offs among management actions). Prioritization approaches often examine the spatial congruence between priorities for protecting ecosystem services and priorities for protecting biodiversity; therefore, the spatial prioritization method used is crucial because it will influence the alignment of service protection and conservation goals. While spatial prioritization of ecosystem services and prioritization for conservation share similarities, such as the need to document threats and costs, the former differs substantially from the latter owing to the requirement to measure the following components: supply of services; availability of human-derived alternatives to service provision; capacity to meet beneficiary demand; and site dependency in and scale of service delivery. We review studies that identify broad-scale spatial priorities for managing ecosystem services and demonstrate that researchers have used different approaches and included various measures for identifying priorities, and most studies do not consider all of the components listed above. We describe a conceptual framework for integrating each of these components into spatial prioritization of ecosystem services and illustrate our approach using a worked example for water provision. A fuller characterization of the biophysical and social context for ecosystem services that we call for should improve future prioritization and the identification of locations where ecosystem-service management is especially important or cost effective. PMID:24555017
Farrell, Marie; Wallis, Nancy C; Evans, Marci Tyler
2007-01-01
American universities and nursing faculties, caught between the imperatives of community demand and university financial constraints, need to analyze their communities of interests' shared priorities for nursing education. This replication study's objective was to compare the priorities and attitudes of two nursing programs' communities of interest using appreciative inquiry (AI). The researchers used AI to conduct a qualitative, comparative analysis of data from two nursing programs. They used one-on-one and focus group interviews to examine stakeholders' views of the best of the nursing program's past, their vision and approaches to realizing the vision, and their roles in contributing to the vision they created. The researchers analyzed the qualitative data using a standardized codebook and content analysis. Respondents' priorities for both academic programs were similar, with the western respondents emphasizing nursing's contribution to quality care and the southern respondents emphasizing its leadership and commitment to diversity. Both identified the role of legislators and the community in partnering with nursing to secure funds for expansion. Both programs' respondents viewed nursing as a major part of the university and considered their role as supporters of the university's academic and financial goals. The two nursing programs appeared to harness external and internal support in their respective communities. While some priorities differed between the two nursing programs, respondents were aware of the ripple effect of decreased funding for nursing education on the delivery of nursing services to the community. Differences among the undergraduate and graduate students, which reflect a nursing program's student mix, underscore the priorities that nursing programs must emphasize.
Setting priorities for research in medical nutrition education: an international approach.
Ball, Lauren; Barnes, Katelyn; Laur, Celia; Crowley, Jennifer; Ray, Sumantra
2016-12-14
To identify the research priorities for medical nutrition education worldwide. A 5-step stakeholder engagement process based on methodological guidelines for identifying research priorities in health. 277 individuals were identified as representatives for 30 different stakeholder organisations across 86 countries. The stakeholder organisations represented the views of medical educators, medical students, doctors, patients and researchers in medical education. Each stakeholder representative was asked to provide up to three research questions that should be deemed as a priority for medical nutrition education. Research questions were critically appraised for answerability, sustainability, effectiveness, potential for translation and potential to impact on disease burden. A blinded scoring system was used to rank the appraised questions, with higher scores indicating higher priority (range of scores possible 36-108). 37 submissions were received, of which 25 were unique research questions. Submitted questions received a range of scores from 62 to 106 points. The highest scoring questions focused on (1) increasing the confidence of medical students and doctors in providing nutrition care to patients, (2) clarifying the essential nutrition skills doctors should acquire, (3) understanding the effectiveness of doctors at influencing dietary behaviours and (4) improving medical students' attitudes towards the importance of nutrition. These research questions can be used to ensure future projects in medical nutrition education directly align with the needs and preferences of research stakeholders. Funders should consider these priorities in their commissioning of research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Becker, Richard A; Friedman, Katie Paul; Simon, Ted W; Marty, M Sue; Patlewicz, Grace; Rowlands, J Craig
2015-04-01
Rapid high throughput in vitro screening (HTS) assays are now available for characterizing dose-responses in assays that have been selected for their sensitivity in detecting estrogen-related endpoints. For example, EPA's ToxCast™ program recently released endocrine assay results for more than 1800 substances and the interagency Tox21 consortium is in the process of releasing data for approximately 10,000 chemicals. But such activity measurements alone fall short for the purposes of priority setting or screening because the relevant exposure context is not considered. Here, we extend the method of exposure:activity profiling by calculating the exposure:activity ratios (EARs) using human exposure estimates and AC50 values for a range of chemicals tested in a suite of seven estrogenic assays in ToxCast™ and Tox21. To provide additional context, relative estrogenic exposure:activity quotients (REEAQ) were derived by comparing chemical-specific EARs to the EAR of the ubiquitous dietary phytoestrogen, genistein (GEN). Although the activity of a substance in HTS-endocrine assays is not a measure of health hazard or risk, understanding how such a dose compares to human exposures provides a valuable additional metric that can be used in decision-making; substances with small EARs and REEAQs would indicate low priority for further endocrine screening or testing. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
African stakeholders' views of research options to improve nutritional status in sub-Saharan Africa.
Holdsworth, Michelle; Kruger, Annamarie; Nago, Eunice; Lachat, Carl; Mamiro, Peter; Smit, Karlien; Garimoi-Orach, Chris; Kameli, Yves; Roberfroid, Dominique; Kolsteren, Patrick
2015-09-01
Setting research priorities for improving nutrition in Africa is currently ad hoc and there is a need to shift the status quo in the light of slow progress in reducing malnutrition. This study explored African stakeholders' views on research priorities in the context of environmental and socio-demographic changes that will impact on nutritional status in Africa in the coming years. Using Multi-Criteria Mapping, quantitative and qualitative data were gathered from 91 stakeholders representing 6 stakeholder groups (health professionals, food Industry, government, civil society, academics and research funders) in Benin, Mozambique, South Africa, Tanzania, Togo and Uganda. Stakeholders appraised six research options (ecological nutrition, nutritional epidemiology, community nutrition interventions, behavioural nutrition, clinical nutrition and molecular nutrition) for how well they could address malnutrition in Africa. Impact (28.3%), research efficacy (23.6%) and social acceptability (22.4%) were the criteria chosen the most to evaluate the performance of research options. Research on the effectiveness of community interventions was seen as a priority by stakeholders because they were perceived as likely to have an impact relatively quickly, were inexpensive and cost-effective, involved communities and provided direct evidence of what works. Behavioural nutrition research was also highly appraised. Many stakeholders, particularly academics and government were optimistic about the value of ecological nutrition research (the impact of environmental change on nutritional status). Research funders did not share this enthusiasm. Molecular nutrition was least preferred, considered expensive, slow to have an impact and requiring infrastructure. South Africa ranked clinical and molecular nutrition the highest of all countries. Research funders should redirect research funds in Africa towards the priorities identified by giving precedence to develop the evidence for effective community nutrition interventions. Expanding research funding in behavioural and ecological nutrition was also valued and require multi-disciplinary collaborations between nutritionists, social scientists, agricultural and climate change scientists. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.
7 CFR 4279.155 - Loan priorities.
Code of Federal Regulations, 2011 CFR
2011-01-01
... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...
7 CFR 4279.155 - Loan priorities.
Code of Federal Regulations, 2013 CFR
2013-01-01
... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...
7 CFR 4279.155 - Loan priorities.
Code of Federal Regulations, 2012 CFR
2012-01-01
... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...
7 CFR 4279.155 - Loan priorities.
Code of Federal Regulations, 2014 CFR
2014-01-01
... natural resource value-added product (2 points). (iii) Occupations. The priority score for occupations... natural disaster or experiencing fundamental structural changes in its economic base (5 points). (iv... for the following: (A) Business that offers high value, specialized products and services that command...
Raymond, Christopher M; Brown, Gregory
2011-10-01
This study presents a method for assessing conservation opportunity on private land based on landholders' socio-economic, behavioral, and farm characteristics. These characteristics include age, gender, education, level of off-farm income, farm size, proportion of remnant native vegetation on-farm, and ecological value of native vegetation on-farm. A sample of landholders who own greater than 2 ha of land in the South Australian Murray-Darling Basin region were sent a mail-based survey about their values and preferences for environmental management (N = 659, 52% response). Cross-tabulations and ANOVA statistical analysis techniques were used to compare the socio-economic attributes across three landholder classes: disengaged, moderately engaged, and highly engaged in native vegetation planting. Results indicate that highly engaged landholders were more likely to be female, formally educated, hobby farmers who managed small parcels of land and have high off-farm incomes, whereas disengaged landholders held significantly stronger farming connections (more farming experience, family have lived on the farm for more generations). Spatial analysis revealed area-specific differences in conservation opportunity and conservation priority. In some areas, properties of high ecological value were managed by highly engaged landholders, but nearby properties of high value were managed by moderately engaged or disengaged landholders. Environmental managers therefore cannot assume areas of high conservation priority will be areas of high conservation opportunity. At the regional scale, the potential for revegetation seems most promising within the moderately engaged landholder group considering the vast amount of land managed by this group in areas of high ecological value, particularly within the less represented Mallee and Coorong and Rangelands sub-regions. We suggest that incentive schemes which purchase conservation need to be targeted at disengaged landholders; mentoring schemes led by commercial farmers highly engaged in native vegetation planting should be directed at moderately engaged landholders, and; awards programs which acknowledge conservation successes should be targeted at highly engaged landholders. Copyright © 2011 Elsevier Ltd. All rights reserved.
A matter of priorities? Exploring the persistent gender pay gap in hospital medicine.
Weaver, A Charlotta; Wetterneck, Tosha B; Whelan, Chad T; Hinami, Keiki
2015-08-01
Gender earnings disparities among physicians exist even after considering differences in specialty, part-time status, and practice type. Little is known about the role of job satisfaction priorities on earnings differences. To examine gender differences in work characteristics and job satisfaction priorities, and their relationship with gender earnings disparities among hospitalists. Observational cross-sectional survey study. US hospitalists in 2010. Self-reported income, work characteristics, and priorities among job satisfaction domains. On average, women compared to men hospitalists were younger, less likely to be leaders, worked fewer full-time equivalents, worked more nights, reported fewer daily billable encounters, more were pediatricians, worked in university settings, worked in the Western United States, and were divorced. More hospitalists of both genders prioritized optimal workload among the satisfaction domains. However, substantial pay ranked second in prevalence by men and fourth by women. Women hospitalists earned $14,581 less than their male peers in an analysis adjusting for these differences. The gender earnings gap persists among hospitalists. A portion of the disparity is explained by the fewer women hospitalists compared to men who prioritize pay. © 2015 Society of Hospital Medicine.
Hallberg, Ulrika; Klingberg, Gunilla
2007-10-01
Our knowledge of how people with disabilities look upon oral health and dental care is limited. The aim of this study was thus to explore how the people with disabilities experience the encounter with dental health care. With a focus on dental care and oral health, qualitative interviews with 16 informants with cognitive and/or physical disabilities were analysed in accordance with the qualitative method of grounded theory. A core category identified and labeled "giving low priority to oral health care" was found to be related to four other categories: "being afraid of losing control", "having difficulties complying with instructions", "having a desire for continuity", and "wishing to be just like everyone else". The results show that oral health and dental care are important, but are not considered a priority by the people with disabilities. General health issues have much higher priority but do not include oral health, which consequently can affect oral health negatively. Of several factors identified that could be improved to make dental visits more pleasant for patients are enhancing a sense of control in the patient and improving continuity.
A task scheduler framework for self-powered wireless sensors.
Nordman, Mikael M
2003-10-01
The cost and inconvenience of cabling is a factor limiting widespread use of intelligent sensors. Recent developments in short-range, low-power radio seem to provide an opening to this problem, making development of wireless sensors feasible. However, for these sensors the energy availability is a main concern. The common solution is either to use a battery or to harvest ambient energy. The benefit of harvested ambient energy is that the energy feeder can be considered as lasting a lifetime, thus it saves the user from concerns related to energy management. The problem is, however, the unpredictability and unsteady behavior of ambient energy sources. This becomes a main concern for sensors that run multiple tasks at different priorities. This paper proposes a new scheduler framework that enables the reliable assignment of task priorities and scheduling in sensors powered by ambient energy. The framework being based on environment parameters, virtual queues, and a state machine with transition conditions, dynamically manages task execution according to priorities. The framework is assessed in a test system powered by a solar panel. The results show the functionality of the framework and how task execution reliably is handled without violating the priority scheme that has been assigned to it.
NASA Astrophysics Data System (ADS)
Yang, Feiling; Hu, Jinming; Wu, Ruidong
2016-08-01
Suitable surrogates are critical for identifying optimal priority conservation areas (PCAs) to protect regional biodiversity. This study explored the efficiency of using endangered plants and animals as surrogates for identifying PCAs at the county level in Yunnan, southwest China. We ran the Dobson algorithm under three surrogate scenarios at 75% and 100% conservation levels and identified four types of PCAs. Assessment of the protection efficiencies of the four types of PCAs showed that endangered plants had higher surrogacy values than endangered animals but that the two were not substitutable; coupled endangered plants and animals as surrogates yielded a higher surrogacy value than endangered plants or animals as surrogates; the plant-animal priority areas (PAPAs) was the optimal among the four types of PCAs for conserving both endangered plants and animals in Yunnan. PAPAs could well represent overall species diversity distribution patterns and overlap with critical biogeographical regions in Yunnan. Fourteen priority units in PAPAs should be urgently considered as optimizing Yunnan’s protected area system. The spatial pattern of PAPAs at the 100% conservation level could be conceptualized into three connected conservation belts, providing a valuable reference for optimizing the layout of the in situ protected area system in Yunnan.
Priority setting and evidence based purchasing.
Frith, L
1999-01-01
The purpose of this paper is to consider the role that values play in priority setting through the use of EBP. It is important to be clear about the role of values at all levels of the decision making process. At one level, society as a whole has to make decisions about the kind of health provision that it wants. As is generally accepted, these priority setting questions cannot be answered by medical science alone but involve important judgements of value. However, as I hope to show values come into priority setting questions at another level, one not often explicitly recognised in much of the literature: that of the very definition of the effectiveness of treatments. This has important consequences for patient care. If we do not recognise that the effectiveness of a treatment involve subjective elements--a patient's own assessment of the value of the treatment--then this could lead to the belief that we can purchase one treatment that is the most effective for all patients. This might result in a detrimental reduction in the range of options that a patient is given with some patients not receiving the treatment that is most effective for them.
NASA Astrophysics Data System (ADS)
Ribeiro, F.; Roberts, D. A.; Hess, L. L.; Davis, F. W.; Caylor, K. K.; Nackoney, J.; Antunes Daldegan, G.
2017-12-01
Savannas are heterogeneous landscapes consisting of highly mixed land cover types that lack clear distinct boundaries. The Brazilian Cerrado is a Neotropical savanna considered a biodiversity hotspot for conservation due to its biodiversity richness and rapid transformation of its landscape by crop and pasture activities. The Cerrado is one of the most threatened Brazilian biomes and only 2.2% of its original extent is strictly protected. Accurate mapping and monitoring of its ecosystems and adjacent land use are important to select areas for conservation and to improve our understanding of the dynamics in this biome. Land cover mapping of savannas is difficult due to spectral similarity between land cover types resulting from similar vegetation structure, floristically similar components, generalization of land cover classes, and heterogeneity usually expressed as small patch sizes within the natural landscape. These factors are the major contributor to misclassification and low map accuracies among remote sensing studies in savannas. Specific challenges to map the Cerrado's land cover types are related to the spectral similarity between classes of land use and natural vegetation, such as natural grassland vs. cultivated pasture, and forest ecosystem vs. crops. This study seeks to classify and evaluate the land cover patterns across an area ranked as having extremely high priority for future conservation in the Cerrado. The main objective of this study is to identify the representativeness of each vegetation type across the landscape using high to moderate spatial resolution imagery using an automated scheme. A combination of pixel-based and object-based approaches were tested using RapidEye 3A imagery (5m spatial resolution) to classify the Cerrado's major land cover types. The random forest classifier was used to map the major ecosystems present across the area, and demonstrated to have an effective result with 68% of overall accuracy. Post-classification modification was performed to refine information to the major physiognomic groups of each ecosystem type. In this step, we used segmentation in eCognition, considering the random forest classification as input as well as other environmental layers (e.g. slope, soil types), which improved the overall classification to 75%.
Data Analyses and Modelling for Risk Based Monitoring of Mycotoxins in Animal Feed
van der Fels-Klerx, H.J. (Ine); Adamse, Paulien; Punt, Ans; van Asselt, Esther D.
2018-01-01
Following legislation, European Member States should have multi-annual control programs for contaminants, such as for mycotoxins, in feed and food. These programs need to be risk based implying the checks are regular and proportional to the estimated risk for animal and human health. This study aimed to prioritize feed products in the Netherlands for deoxynivalenol and aflatoxin B1 monitoring. Historical mycotoxin monitoring results from the period 2007–2016 were combined with data from other sources. Based on occurrence, groundnuts had high priority for aflatoxin B1 monitoring; some feed materials (maize and maize products and several oil seed products) and complete/complementary feed excluding dairy cattle and young animals had medium priority; and all other animal feeds and feed materials had low priority. For deoxynivalenol, maize by-products had a high priority, complete and complementary feed for pigs had a medium priority and all other feed and feed materials a low priority. Also including health consequence estimations showed that feed materials that ranked highest for aflatoxin B1 included sunflower seed and palmkernel expeller/extracts and maize. For deoxynivalenol, maize products were ranked highest, followed by various small grain cereals (products); all other feed materials were of lower concern. Results of this study have proven to be useful in setting up the annual risk based control program for mycotoxins in animal feed and feed materials. PMID:29373559
Do different stakeholder groups share mental health research priorities? A four-arm Delphi study.
Owens, Christabel; Ley, Ann; Aitken, Peter
2008-12-01
Despite considerable investment in research priority setting within diverse fields of healthcare, little is known about the extent to which different stakeholder groups share research priorities. Conflicting priorities may jeopardize stakeholder engagement in research. To identify the research priorities of different stakeholder groups within mental health care and examine the extent and nature of agreement between them. Using a Delphi technique, we conducted parallel consultation processes within four different stakeholder groups. Each group process consisted of three rounds. The study was carried out within a mental health and learning disabilities trust in southern England. Participants were recruited from the following groups: mental health service users (34), informal carers (26), mental health practitioners (35) and service managers (23). There were striking differences between the four groups in respect of their ability and willingness to make priority decisions. These differences notwithstanding, there was considerable overlap in respect of their research interests. All groups identified and attached high importance to issues relating to the promotion of independence, self-esteem and recovery. The quality of in-patient care, the place of psychological therapies and the relationship between physical and mental health also emerged across the board. The confluence of four different stakeholder groups around a number of clear themes is highly encouraging, providing a framework within which to construct a research agenda and suggesting that mental health research can be built on solid partnerships.
Sánchez-García, Neus; Raga, Juan Antonio; Montero, Francisco E
2014-08-29
The sharpsnout seabream Diplodus puntazzo is of interest in Mediterranean fish farming. Disease is an important problem because parasites can spread quickly in culture conditions and fish often develop high parasite burdens. Here we assess the risk that documented parasites pose to the sustainability of D. puntazzo farming. This study specifically considers metazoan and protist parasites recorded from wild and farmed D. puntazzo in scientific literature. Risk assessment studies involve the identification, characterization and qualitative quantification of the risk in question (parasitoses in this case) and the probability of establishment. We considered the parasite species which may be difficult to manage as a priority for research into potential management strategies. Those parasites which could be transmitted from cultures of gilthead seabream (Sparus aurata) were also included in this study. Four groups of parasites represented a risk to D. puntazzo farming, ranging from moderate to high: Ciliophora, Myxozoa, Monogenea and Copepoda. Three parasite species were considered high risk to D. puntazzo cultures: Amyloodinium sp., Cryptocaryon sp. and Enteromyxum leei. These species were responsible for high mortalities in cultures of these and other fish species. In addition Sparicotyle chrysophrii, Caligus ligusticus and Gnathia vorax entail a moderate risk to D. puntazzo Mediterranean farms. No important episodes have been related to caligids and isopods in Mediterranean sparids, nevertheless they should be properly managed to prevent future problems. Copyright © 2014 Elsevier B.V. All rights reserved.
Rehm, Roberta S.; Fuentes-Afflick, Elena; Fisher, Lucille T.; Chesla, Catherine A.
2014-01-01
Families undertake extensive planning during transition to adulthood so youth with concomitant special health care needs and developmental disabilities will have a long-term high quality of life. Findings from an interpretive field study involving 64 youth and their parents indicated that the meaning of adulthood was functioning as independently as possible with appropriate supports. Parental priorities included protecting health, assuring safety and security in multiple realms, finding meaningful activities after high school, and establishing supportive social relationships. These priorities demonstrated the need to broaden usual health care transition goals that focus on finding adult providers and optimizing self-management. PMID:22869218
Physics in perspective: Recommendations and program emphases
NASA Technical Reports Server (NTRS)
1972-01-01
Exerpted material from Physics in Perspective, Vol. 1, is presented on recommendations, priorities, and program emphases. The major recommendations are addressed to the Federal Government and support agencies, the physics community, and the educational community, including precollege, undergraduate, and graduate sectors. Approaches to the questions involved in establishing scientific priorities are discussed, and an approach is evolved which is based on the jury rating application of certain criteria to the program elements of a subfield. The question of national support level for the physics enterprise is also considered, and contingency alternatives are suggested such that whatever the level of available support, it may be used with maximum effectiveness.
Implications of Public Opinion for Space Program Planning, 1980 - 2000
NASA Technical Reports Server (NTRS)
Overholt, W.; Wiener, A. J.; Yokelson, D.
1975-01-01
The effect of public opinion on future space programs is discussed in terms of direct support, apathy, or opposition, and concern about the tax burden, budgetary pressures, and national priorities. Factors considered include: the salience and visibility of NASA as compared with other issues, the sources of general pressure on the federal budget which could affect NASA, the public's opinions regarding the size and priority of NASA'S budget, the degree to which the executive can exercise leverage over NASA's budget through influencing or disregarding public opinion, the effects of linkages to other issues on space programs, and the public's general attitudes toward the progress of science.
Turner, Sandra; Eriksen, Jesper G; Trotter, Theresa; Verfaillie, Christine; Benstead, Kim; Giuliani, Meredith; Poortmans, Philip; Holt, Tanya; Brennan, Sean; Pötter, Richard
2015-10-01
Representatives from countries and regions world-wide who have implemented modern competency-based radiation- or clinical oncology curricula for training medical specialists, met to determine the feasibility and value of an ongoing international collaboration. In this forum, educational leaders from the ESTRO School, encompassing many European countries adopting the ESTRO Core Curriculum, and clinician educators from Canada, Denmark, the United Kingdom, Australia and New Zealand considered the training and educational arrangements within their jurisdictions, identifying similarities and challenges between programs. Common areas of educational interest and need were defined, which included development of new competency statements and assessment tools, and the application of the latter. The group concluded that such an international cooperation, which might expand to include others with similar goals, would provide a valuable vehicle to ensure training program currency, through sharing of resources and expertise, and enhance high quality radiation oncology education. Potential projects for the Global Radiation Oncology Collaboration in Education (GRaCE) were agreed upon, as was a strategy designed to maintain momentum. This paper describes the rationale for establishing this collaboration, presents a comparative view of training in the jurisdictions represented, and reports early goals and priorities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Zagonel, Vittorina; Franciosi, Vittorio; Brunello, Antonella; Biasco, Guido; Broglia, Chiara; Cattaneo, Daniela; Cavanna, Luigi; Corsi, Domenico; Farina, Gabriella; Fioretto, Luisa; Gamucci, Teresa; Lanzetta, Gaetano; Magarotto, Roberto; Maltoni, Marco; Marchetti, Paolo; Massa, Elena; Mastromauro, Cataldo; Melotti, Barbara; Meriggi, Fausto; Nacci, Angelo; Pavese, Ida; Piva, Erico; Quirino, Michela; Roselli, Mario; Sacco, Cosimo; Tonini, Giuseppe; Trentin, Leonardo; Ucci, Giovanni; Labianca, Roberto; Gori, Stefania; Pinto, Carmine; Cascinu, Stefano
2017-01-21
One of the priorities of personalized medicine regards the role of early integration of palliative care with cancer-directed treatments, called simultaneous care. This article, written by the Italian Association of Medical Oncology (AIOM) Simultaneous and Continuous Care Task Force, represents the position of Italian medical oncologists about simultaneous care, and is the result of a 2-step project: a Web-based survey among medical oncologists and a consensus conference. We present the opinion of more than 600 oncologists who helped formulate these recommendations. This document covers 4 main aspects of simultaneous care: 1) ethical, cultural, and relational aspects of cancer and implications for patient communication; 2) training of medical oncologists in palliative medicine; 3) research on the integration between cancer treatments and palliative care; and 4) organizational and management models for the realization of simultaneous care. The resulting recommendations highlight the role of skills and competence in palliative care along with implementation of adequate organizational models to accomplish simultaneous care, which is considered a high priority of AIOM in order to grant the best quality of life for cancer patients and their families.
Distribution, congruence, and hotspots of higher plants in China
Zhao, Lina; Li, Jinya; Liu, Huiyuan; Qin, Haining
2016-01-01
Identifying biodiversity hotspots has become a central issue in setting up priority protection areas, especially as financial resources for biological diversity conservation are limited. Taking China’s Higher Plants Red List (CHPRL), including Bryophytes, Ferns, Gymnosperms, Angiosperms, as the data source, we analyzed the geographic patterns of species richness, endemism, and endangerment via data processing at a fine grid-scale with an average edge length of 30 km based on three aspects of richness information: species richness, endemic species richness, and threatened species richness. We sought to test the accuracy of hotspots used in identifying conservation priorities with regard to higher plants. Next, we tested the congruence of the three aspects and made a comparison of the similarities and differences between the hotspots described in this paper and those in previous studies. We found that over 90% of threatened species in China are concentrated. While a high spatial congruence is observed among the three measures, there is a low congruence between two different sets of hotspots. Our results suggest that biodiversity information should be considered when identifying biological hotspots. Other factors, such as scales, should be included as well to develop biodiversity conservation plans in accordance with the region’s specific conditions. PMID:26750244
Distribution, congruence, and hotspots of higher plants in China.
Zhao, Lina; Li, Jinya; Liu, Huiyuan; Qin, Haining
2016-01-11
Identifying biodiversity hotspots has become a central issue in setting up priority protection areas, especially as financial resources for biological diversity conservation are limited. Taking China's Higher Plants Red List (CHPRL), including Bryophytes, Ferns, Gymnosperms, Angiosperms, as the data source, we analyzed the geographic patterns of species richness, endemism, and endangerment via data processing at a fine grid-scale with an average edge length of 30 km based on three aspects of richness information: species richness, endemic species richness, and threatened species richness. We sought to test the accuracy of hotspots used in identifying conservation priorities with regard to higher plants. Next, we tested the congruence of the three aspects and made a comparison of the similarities and differences between the hotspots described in this paper and those in previous studies. We found that over 90% of threatened species in China are concentrated. While a high spatial congruence is observed among the three measures, there is a low congruence between two different sets of hotspots. Our results suggest that biodiversity information should be considered when identifying biological hotspots. Other factors, such as scales, should be included as well to develop biodiversity conservation plans in accordance with the region's specific conditions.
Internal Uses of the RLG Conspectus.
ERIC Educational Resources Information Center
Ferguson, Anthony W.; And Others
1987-01-01
Considers 10 areas of internal operations in which the Research Libraries Group/North American Collection Inventory Project (RLF/NCIP) Conspectus can be used as a management aid: collection priorities, collection management, space utilization, preservation programs, staffing allocations, material fund requests, accreditation, materials selection,…
7 CFR 1415.5 - Land eligibility.
Code of Federal Regulations, 2010 CFR
2010-01-01
... State Technical Committee, determines that it is compatible with grazing uses and related conservation values, and— (i) Could provide habitat for animal or plant populations of significant ecological value if... conservation priorities. (c) Incidental lands, in conjunction with eligible land, may also be considered for...
7 CFR 1415.5 - Land eligibility.
Code of Federal Regulations, 2014 CFR
2014-01-01
... State Technical Committee, determines that it is compatible with grazing uses and related conservation values, and (i) Could provide habitat for animal or plant populations of significant ecological value if... conservation priorities. (c) Incidental lands, in conjunction with eligible land, may also be considered for...
7 CFR 1415.5 - Land eligibility.
Code of Federal Regulations, 2012 CFR
2012-01-01
... State Technical Committee, determines that it is compatible with grazing uses and related conservation values, and (i) Could provide habitat for animal or plant populations of significant ecological value if... conservation priorities. (c) Incidental lands, in conjunction with eligible land, may also be considered for...
7 CFR 1415.5 - Land eligibility.
Code of Federal Regulations, 2013 CFR
2013-01-01
... State Technical Committee, determines that it is compatible with grazing uses and related conservation values, and (i) Could provide habitat for animal or plant populations of significant ecological value if... conservation priorities. (c) Incidental lands, in conjunction with eligible land, may also be considered for...
7 CFR 1415.5 - Land eligibility.
Code of Federal Regulations, 2011 CFR
2011-01-01
... State Technical Committee, determines that it is compatible with grazing uses and related conservation values, and (i) Could provide habitat for animal or plant populations of significant ecological value if... conservation priorities. (c) Incidental lands, in conjunction with eligible land, may also be considered for...
Benefits and challenges of using LCA to advance sustainable wasteand materials management
MSW management can be complex and involve many unit processes that can vary based on needs of urban, rural, and suburbia to safely manage waste and to optimize energy and resource recovery while considering local infrastructure and priorities.
Assessment of shrimp farming impact on groundwater quality using analytical hierarchy process
NASA Astrophysics Data System (ADS)
Anggie, Bernadietta; Subiyanto, Arief, Ulfah Mediaty; Djuniadi
2018-03-01
Improved shrimp farming affects the groundwater quality conditions. Assessment of shrimp farming impact on groundwater quality conventionally has less accuracy. This paper presents the implementation of Analytical Hierarchy Process (AHP) method for assessing shrimp farming impact on groundwater quality. The data used is the impact data of shrimp farming in one of the regions in Indonesia from 2006-2016. Criteria used in this study were 8 criteria and divided into 49 sub-criteria. The weighting by AHP performed to determine the importance level of criteria and sub-criteria. Final priority class of shrimp farming impact were obtained from the calculation of criteria's and sub-criteria's weights. The validation was done by comparing priority class of shrimp farming impact and water quality conditions. The result show that 50% of the total area was moderate priority class, 37% was low priority class and 13% was high priority class. From the validation result impact assessment for shrimp farming has been high accuracy to the groundwater quality conditions. This study shows that assessment based on AHP has a higher accuracy to shrimp farming impact and can be used as the basic fisheries planning to deal with impacts that have been generated.
Design and analysis issues of integrated control systems for high-speed civil transports
NASA Technical Reports Server (NTRS)
Mccarty, Craig A.; Feather, John B.; Dykman, John R.; Page, Mark A.; Hodgkinson, John
1992-01-01
A study was conducted to identify, rank, and define development plans for the critical guidance and control design and analysis issues as related to economically viable and environmentally acceptable high-speed civil transport. The issues were identified in a multistep process. First, pertinent literature on supersonic cruise aircraft was reviewed, and experts were consulted to establish the fundamental characteristics and problems inherent to supersonic cruise aircraft. Next, the advanced technologies and strategies being pursued for the high-speed civil transport were considered to determine any additional unique control problems the transport may have. Finally, existing technologies and methods were examined to determine their capabilities for the design and analysis of high-speed civil transport control systems and to identify the shortcomings and issues. Three priority levels - mandatory, highly beneficial, and desirable - were established. Within each of these levels, the issues were further ranked. Technology development plans for each issue were defined. Each plan contains a task breakdown and schedule.
NASA Technical Reports Server (NTRS)
Strom, Stephen; Sargent, Wallace L. W.; Wolff, Sidney; Ahearn, Michael F.; Angel, J. Roger; Beckwith, Steven V. W.; Carney, Bruce W.; Conti, Peter S.; Edwards, Suzan; Grasdalen, Gary
1991-01-01
Optical/infrared (O/IR) astronomy in the 1990's is reviewed. The following subject areas are included: research environment; science opportunities; technical development of the 1980's and opportunities for the 1990's; and ground-based O/IR astronomy outside the U.S. Recommendations are presented for: (1) large scale programs (Priority 1: a coordinated program for large O/IR telescopes); (2) medium scale programs (Priority 1: a coordinated program for high angular resolution; Priority 2: a new generation of 4-m class telescopes); (3) small scale programs (Priority 1: near-IR and optical all-sky surveys; Priority 2: a National Astrometric Facility); and (4) infrastructure issues (develop, purchase, and distribute optical CCDs and infrared arrays; a program to support large optics technology; a new generation of large filled aperture telescopes; a program to archive and disseminate astronomical databases; and a program for training new instrumentalists)
49 CFR 350.329 - How may a State or local agency qualify for High Priority Funds?
Code of Federal Regulations, 2014 CFR
2014-10-01
... ensure the proposal is consistent with State and national CMV safety program priorities. (3) Certify that... sanctions for violations of CMV and driver laws and regulations that are consistent with those of the State...
49 CFR 350.329 - How may a State or local agency qualify for High Priority Funds?
Code of Federal Regulations, 2013 CFR
2013-10-01
... ensure the proposal is consistent with State and national CMV safety program priorities. (3) Certify that... sanctions for violations of CMV and driver laws and regulations that are consistent with those of the State...
49 CFR 350.329 - How may a State or local agency qualify for High Priority Funds?
Code of Federal Regulations, 2012 CFR
2012-10-01
... ensure the proposal is consistent with State and national CMV safety program priorities. (3) Certify that... sanctions for violations of CMV and driver laws and regulations that are consistent with those of the State...
de Oliveira, Guilherme; Lima-Ribeiro, Matheus Souza; Terribile, Levi Carina; Dobrovolski, Ricardo; Telles, Mariana Pires de Campos; Diniz-Filho, José Alexandre Felizola
2015-06-01
REMISE OF THE STUDY: Wild edible plants (WEPs) have an important cultural and economic role in human population worldwide. Human impacts are quickly converting natural habitats in agricultural, cattle ranch, and urbanized lands, putting native species on peril of risk of extinction, including some WEPs. Moreover, global climate changes also can pose another threat to species persistency. Here, we established conservation priorities for the Cerrado, a neotropical region in South America with high levels of plant endemism and vulnerability, aiming to assure long-term persistency of 16 most important WEPs. We evaluated these conservation priorities using a conservation biogeography framework using ecological patterns and process at a biogeographical scale to deal with species conservation features. We built ecological niche models for 16 WEPs from Cerrado in the neotropics using climate models for preindustrial, past (Last Glacial Maximum) and future (year 2080) time periods to establish climatically stable areas through time, finding refugias for these WEPs. We used a spatial prioritization algorithm based on the spatial pattern of irreplaceability across the neotropics, aiming to ensure the persistence of at least 25% of range size in climatically stable areas for each WEP, using agricultural models as constraints. The Southeast Cerrado was the most biotically stable and irreplaceable region for the WEPs compared with other areas across the neotropics. Our findings strongly suggest that the Southeast Cerrado should be considered a conservation priority, with new protected areas to be sustainably managed and restored, to guarantee the supply of cultural and ecosystem services provided from the Cerrado's WEPs. © 2015 Botanical Society of America, Inc.
Hazards of solid waste management: bioethical problems, principles, and priorities
Maxey, Margaret N.
1978-01-01
The putative hazards of solid waste management cannot be evaluated without placing the problem within a cultural climate of crisis where some persons consider such by-products of “high, hard technology” to have raised unresolved moral and ethical issues. In order to assist scientific and technical efforts to protect public health and safety, a bioethical perspective requires us to examine three controversial aspects of policy-making about public safety. Failure to recognize the qualitative difference between two cognitive activities—risk-measurements (objective, scientific probabilities) and safety-judgments (subjective, shifting value priorities)—has had three unfortunate consequences. Sophisticated methods of risk analysis have been applied in a piecemeal, haphazard, ad hoc fashion within traditional institutions with the false expectation that incremental risk-reducing programs automatically ensure public health and safety. Ethical priorities require, first and foremost, a whole new field of data arranged for comparable risk-analyses. Critics of cost/risk/benefit quantifications attack the absurdity of “putting a price on human life” but have not been confronted with its threefold ethical justification. The widening discrepancy in risk-perceptions and loss of mutual confidence between scientific experts and ordinary citizens has placed a burden of social responsibility on members of the scientific and technical community to engage in more effective public education through the political process, notwithstanding advocates of a nonscientific adversary process. The urgency of effective public education has been demonstrated by the extent to which we have lost our historically balanced judgment about the alleged environmental hazards posed by advanced technology. PMID:738238
Modeling of workflow-engaged networks on radiology transfers across a metro network.
Camorlinga, Sergio; Schofield, Bruce
2006-04-01
Radiology metro networks bear the challenging proposition of interconnecting several hospitals in a region to provide a comprehensive diagnostic imaging service. Consequences of a poorly designed and implemented metro network could cause delays or no access at all when health care providers try to retrieve medical cases across the network. This could translate into limited diagnostic services to patients, resulting in negative impacts to the patients' medical treatment. A workflow-engaged network (WEN) is a new network paradigm. A WEN appreciates radiology workflows and priorities in using the network. A WEN greatly improves the network performance by guaranteeing that critical image transfers experience minimal delay. It adjusts network settings to ensure the application's requirements are met. This means that high-priority image transfers will have guaranteed and known delay times, whereas lower-priority traffic will have increased delays. This paper introduces a modeling to understand the benefits that WEN brings to a radiology metro network. The modeling uses actual data patterns and flows found in a hospital metro region. The workflows considered are based on the Integrating the Healthcare Enterprise profiles. This modeling has been applied to metropolitan workflows of a health region. The modeling helps identify the kind of metro network that supports data patterns and flows in a metro area. The results of the modeling show that a 155-Mb/s metropolitan area network (MAN) with WEN operates virtually equal to a normal 622-Mb/s MAN without WEN, with potential cost savings for leased line services measured in the millions of dollars per year.
NASA Astrophysics Data System (ADS)
Mach, K. J.; Field, C. B.
2017-12-01
Over decades, assessment by the Intergovernmental Panel on Climate Change and many others has bolstered understanding of the climate problem: unequivocal warming, pervasive impacts, and serious risks from continued high emissions of heat-trapping gases. Societies are increasingly responding with early actions to decarbonize energy systems and prepare for impacts. This emerging era of climate solutions creates a need for new approaches to assessment that emphasize learning from ongoing real-world experiences and that help close the gap between aspirations and the pace of progress. Against this backdrop, the presentation will take stock of recent advances and challenges in assessment, especially drawing from analysis of climate change assessment. Four assessment priorities will be considered: (1) integrating diverse evidence including quantitative and qualitative results, (2) applying rigorous expert judgment in evaluating knowledge and uncertainties, (3) exploring widely ranging futures and their connections to ongoing choices and actions, and (4) incorporating interactions among experts and decision-makers in assessment processes. Across these assessment priorities, the presentation will critique both opportunities and pitfalls, outlining possibilities for future experimentation, innovation, and learning. It will evaluate, in particular, lessons from risk-based approaches; strategies for transparently acknowledging persistent uncertainties and contested priorities; ways to minimize biases and foster creativity in expert judgments; scenario-based assessment of surprises, deep uncertainties, and decision-making implications; and opportunities for broadening the conception of expertise and engaging different decision-makers and stakeholders. Overall, these approaches can advance assessment products and processes as a basis for sustained dialogue supporting decision-making.
Closing the gap in travel medicine: reframing research questions for a new era.
Chen, Lin H; Leder, Karin; Wilson, Mary E
2017-07-01
Travel medicine needs are changing. New patterns of travel, including greater travel by individuals from emerging economies with different values in costs, risks and benefits, must be considered. This review aims to (1) highlight selected studies that have been published that address previously identified gaps in knowledge; (2) propose possible ways to consider questions regarding travel medicine practice for travelers from emerging economies, underscoring priorities for research focusing on these important populations; (3) highlight potential deficiencies in relevance of current international guidelines as they pertain to travelers from emerging economies; (4) frame research questions for travelers from emerging economies and (5) consider roles for ISTM in closing the gap. We reviewed past travel medicine research priorities published in 2010 to identify publications that responded to some research questions posed. We also reviewed CDC and WHO recommendations and assessed their applicability to travelers from emerging economies. Recent publications have responded to some research questions, but gaps remain and new questions have emerged. Re-framing of several key research questions is needed for travelers from emerging economies. A new challenge looms for traditional travel medicine fields to identify and attend to knowledge and guideline gaps, particularly to rethink questions regarding travel medicine to make them relevant for travelers from emerging economies. The International Society of Travel Medicine is well positioned to assist emerging economies assess their resources and needs, formulate research priorities and tailor the development of travel medicine into a framework aligned to their requirements. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com
Cartier, Yuri; Creatore, Maria I; Hoffman, Steven J; Potvin, Louise
2018-06-22
Priority-driven funding streams for population and public health are an important part of the health research landscape and contribute to orienting future scholarship in the field. While research priorities are often made public through targeted calls for research, less is known about how research funding organisations arrive at said priorities. Our objective was to explore how public health research funding organisations develop priorities for strategic extramural research funding programmes. Content analysis of published academic and grey literature and key informant interviews for five public and private funders of public health research in the United Kingdom, Australia, the United States and France were performed. We found important distinctions in how funding organisations processed potential research priorities through four non-sequential phases, namely idea generation, idea analysis, idea socialisation and idea selection. Funders generally involved the public health research community and public health decision-makers in idea generation and socialisation, but other groups of stakeholders (e.g. the public, advocacy organisations) were not as frequently included. Priority-setting for strategic funding programmes in public health research involves consultation mainly with researchers in the early phase of the process. There is an opportunity for greater breadth of participation and more transparency in priority-setting mechanisms for strategic funding programmes in population and public health research.
Noradrenergic Mechanisms of Arousal’s Bidirectional Effects on Episodic Memory
Clewett, David; Sakaki, Michiko; Nielsen, Shawn; Petzinger, Giselle; Mather, Mara
2016-01-01
Arousal’s selective effects on cognition go beyond the simple enhancement of emotional stimuli, sometimes enhancing and other times impairing processing of proximal neutral information. Past work shows that arousal impairs encoding of subsequent neutral stimuli regardless of their top-down priority via the engagement of β-adrenoreceptors. In contrast, retrograde amnesia induced by emotional arousal can flip to enhancement when preceding neutral items are prioritized in top-down attention. Whether β-adrenoreceptors also contribute to this retrograde memory enhancement of goal-relevant neutral stimuli is unclear. In this pharmacological study, we administered 40mg of propranolol or 40mg of placebo to healthy young adults to examine whether emotional arousal’s bidirectional effects on declarative memory relies on β-adrenoreceptor activation. Following pill intake, participants completed an emotional oddball task in which they were asked to prioritize a neutral object appearing just before an emotional or neutral oddball image within a sequence of 7 neutral objects. Under placebo, emotional oddballs impaired memory for lower priority oddball+1 objects but had no effect on memory for high priority oddball−1 objects. Propranolol blocked this anterograde amnesic effect of arousal. Emotional oddballs also enhanced selective memory trade-offs significantly more in the placebo than drug condition, such that high priority oddball−1 objects were more likely to be remembered at the cost of their corresponding lower priority oddball+1 objects under arousal. Lastly, those who recalled more high priority oddball−1 objects preceding an emotional versus neutral oddball image showed greater increases in salivary alpha-amylase, a biomarker of noradrenergic system activation, across the task. Together these findings suggest that different noradrenergic mechanisms contribute to the anterograde and retrograde mnemonic effects of arousal on proximal neutral memoranda. PMID:27815214
Noradrenergic mechanisms of arousal's bidirectional effects on episodic memory.
Clewett, David; Sakaki, Michiko; Nielsen, Shawn; Petzinger, Giselle; Mather, Mara
2017-01-01
Arousal's selective effects on cognition go beyond the simple enhancement of emotional stimuli, sometimes enhancing and other times impairing processing of proximal neutral information. Past work shows that arousal impairs encoding of subsequent neutral stimuli regardless of their top-down priority via the engagement of β-adrenoreceptors. In contrast, retrograde amnesia induced by emotional arousal can flip to enhancement when preceding neutral items are prioritized in top-down attention. Whether β-adrenoreceptors also contribute to this retrograde memory enhancement of goal-relevant neutral stimuli is unclear. In this pharmacological study, we administered 40mg of propranolol or 40mg of placebo to healthy young adults to examine whether emotional arousal's bidirectional effects on declarative memory relies on β-adrenoreceptor activation. Following pill intake, participants completed an emotional oddball task in which they were asked to prioritize a neutral object appearing just before an emotional or neutral oddball image within a sequence of 7 neutral objects. Under placebo, emotional oddballs impaired memory for lower priority oddball+1 objects but had no effect on memory for high priority oddball-1 objects. Propranolol blocked this anterograde amnesic effect of arousal. Emotional oddballs also enhanced selective memory trade-offs significantly more in the placebo than drug condition, such that high priority oddball-1 objects were more likely to be remembered at the cost of their corresponding lower priority oddball+1 objects under arousal. Lastly, those who recalled more high priority oddball-1 objects preceding an emotional versus neutral oddball image showed greater increases in salivary alpha-amylase, a biomarker of noradrenergic system activation, across the task. Together these findings suggest that different noradrenergic mechanisms contribute to the anterograde and retrograde mnemonic effects of arousal on proximal neutral memoranda. Copyright © 2016 Elsevier Inc. All rights reserved.
Thermodynamic aspects of cluster crystallization in cryoprotective solutions.
Osetsky, A I
2011-01-01
Crystallization of the solutions with quite a high intermolecular interaction of the components is analyzed. For the first time there has been considered the phenomenon of cluster crystallization of these solutions, enabling the reduction of total energy of intermolecular bonds, broken down during crystallization of the components has been discussed. A special priority is given to the cluster crystallization of aqueous solutions of cryoprotective substances close to vitrification temperature. Within this temperature range the mechanism of cluster crystallization is especially effective due to a sharp reduction of sizes of critical ice nucleation centers and diffusion mobility of molecules. This should be taken into account when designing the cryopreservation protocols for biological systems.
Contemporary Role of Radiotherapy in the Management of Primary Penile Tumors and Metastatic Disease.
Crook, Juanita
2016-11-01
Squamous cell cancer of the penis is a radiocurable malignancy all too often managed solely by partial or total penectomy. Effective management of the primary tumor while preserving penile morphology and function is a priority. External radiotherapy and brachytherapy have a role to play in the definitive management of the primary tumor. Surgical nodal staging remains a cornerstone of management because it is the strongest predictor of survival, and inguinal status determines pelvic management. Postoperative radiotherapy of the regional nodes for high-risk pathology is indicated. Chemoradiotherapy should be considered as neoadjuvant treatment for unresectable nodes or as definitive management. Copyright © 2016 Elsevier Inc. All rights reserved.
More, Simon J; McKenzie, Ken; O'Flaherty, Joe; Doherty, Michael L; Cromie, Andrew R; Magan, Mike J
2010-07-01
Agriculture is a very important contributor to the Irish economy. In Ireland, national animal health services have been a government, rather than an industry, responsibility. In 2009, Animal Health Ireland (AHI) was established to provide a partnership approach to national leadership of non-regulatory animal health issues (those not subject to national and/or EU regulation). The objectives of this study were to elicit opinion from experts and farmers about non-regulatory animal health issues facing Irish livestock industries, including prioritisation of animal health issues and identification of opportunities to maximise the effective use of AHI resources. The study was conducted with experts using Policy Delphi methodology over three rounds, and with farmers using a priority identification survey. Non-regulatory bovine diseases/conditions were prioritised by both experts and farmers based on impact and international competitiveness. For each high-priority disease/condition, experts were asked to provide an assessment based on cost, impact, international perception, impediment to international market access and current resource usage effectiveness. Further information was also sought from experts about resource allocation preferences, methods to improve education and coordination, and innovative measures to improve prevention and management. There was close agreement between responses from experts and dairy farmers: each gave highest priority to 3 diseases with a biosecurity risk (subsequently termed 'biosecure diseases') (bovine viral diarrhoea [BVD], infectious bovine rhinotracheitis [IBR], paratuberculosis) and 4 diseases/conditions generally without a biosecurity risk ('non-biosecure diseases/conditions') (fertility, udder health/milk quality, lameness, calf health). Beef farmers also prioritised parasitic conditions and weanling pneumonia. The adverse impact of biosecure diseases is currently considered relatively minor by experts, but would increase substantially in time. There are already substantial costs to farms and agribusiness from non-biosecure diseases/conditions. Experts preferred an equal allocation of resources between these biosecure and non-biosecure diseases/conditions, with emphasis on adopting/adapting international models, education and awareness-raising. The results from this study provide robust insights about non-regulatory animal health priorities in Ireland, as perceived by experts and farmers, using methodologies that are both transparent and inclusive. They have already been extremely influential in shaping national policy, as a foundation for interdisciplinary (and multi-agency) cooperation, as a contribution to efforts to encourage stakeholder responsibility-taking, and to ongoing development of postgraduate and undergraduate veterinary education in Ireland. Copyright (c) 2010. Published by Elsevier B.V.
Bas, Esra
2014-07-01
In this paper, an integrated methodology for Quality Function Deployment (QFD) and a 0-1 knapsack model is proposed for occupational safety and health as a systems thinking approach. The House of Quality (HoQ) in QFD methodology is a systematic tool to consider the inter-relationships between two factors. In this paper, three HoQs are used to consider the interrelationships between tasks and hazards, hazards and events, and events and preventive/protective measures. The final priority weights of events are defined by considering their project-specific preliminary weights, probability of occurrence, and effects on the victim and the company. The priority weights of the preventive/protective measures obtained in the last HoQ are fed into a 0-1 knapsack model for the investment decision. Then, the selected preventive/protective measures can be adapted to the task design. The proposed step-by-step methodology can be applied to any stage of a project to design the workplace for occupational safety and health, and continuous improvement for safety is endorsed by the closed loop characteristic of the integrated methodology. Copyright © 2013 Elsevier Ltd. All rights reserved.
Occupational health research priorities in Malaysia: a Delphi study
Sadhra, S; Beach, J; Aw, T; Sheikh-Ahmed, K
2001-01-01
OBJECTIVES—As part of a consultancy project on occupational health, the Delphi method was used to identify research priorities in occupational health in Malaysia. METHODS—Participation was sought from government ministries, industry, and professional organisations, and university departments with an interest in occupational and public health. Two rounds of questionnaires resulted in a final list of priorities, with noticeable differences between participants depending on whether they worked in industry or were from government organisations. RESULTS—The participation rate of 71% (55 of 78) was obtained for the first questionnaire and 76% (72 of 95) for the second questionnaire. The participants identified occupational health problems for specific groups and industries as the top research priority area (ranked as top priority by 25% of participants). Ministry of Health participants placed emphasis on healthcare workers (52% ranking it as top priority), whereas those from industry identified construction and plantation workers as groups, which should be accorded the highest priority. Evaluation of research and services was given a low priority. CONCLUSIONS—The priorities for occupational health determined with the Delphi approach showed differences between Malaysia, a developing country, and findings from similar European studies. This may be expected, as differences exist in stages of economic development, types of industries, occupational activities, and cultural attitudes to occupational health and safety. Chemical poisonings and workplace accidents were accorded a high priority. By contrast with findings from western countries, workplace psychosocial problems and musculoskeletal injuries were deemed less important. There also seemed to be greater emphasis on adopting interventions for identified problems based on experience in other countries rather than the need to evaluate local occupational health provisions. Keywords: occupational health; research priorities; Malaysia PMID:11404445
OCCURRENCE OF A NEW GENERATION OF DISINFECTION BY-PRODUCTS
A survey of disinfection by-product (DBP) occurrence in the United States was conducted at 12 drinking water treatment plants. In addition to currently regulated DBPs, more than 50 DBPs that rated a high priority for potential toxicity were studied. These priority DBPs included...
Current Status of Multidisciplinary Care in Psoriatic Arthritis in Spain: NEXUS 2.0 Project.
Queiro, Rubén; Coto, Pablo; Joven, Beatriz; Rivera, Raquel; Navío Marco, Teresa; de la Cueva, Pablo; Alvarez Vega, Jose Luis; Narváez Moreno, Basilio; Rodriguez Martínez, Fernando José; Pardo Sánchez, José; Feced Olmos, Carlos; Pujol, Conrad; Rodríguez, Jesús; Notario, Jaume; Pujol Busquets, Manel; García Font, Mercè; Galindez, Eva; Pérez Barrio, Silvia; Urruticoechea-Arana, Ana; Hergueta, Merce; López Montilla, M Dolores; Vélez García-Nieto, Antonio; Maceiras, Francisco; Rodríguez Pazos, Laura; Rubio Romero, Esteban; Rodríguez Fernandez Freire, Lourdes; Luelmo, Jesús; Gratacós, Jordi
2018-02-26
1) To analyze the implementation of multidisciplinary care models in psoriatic arthritis (PsA) patients, 2) To define minimum and excellent standards of care. A survey was sent to clinicians who already performed multidisciplinary care or were in the process of undertaking it, asking: 1) Type of multidisciplinary care model implemented; 2) Degree, priority and feasibility of the implementation of quality standards in the structure, process and result for care. In 6 regional meetings the results of the survey were presented and discussed, and the ultimate priority of quality standards for care was defined. At a nominal meeting group, 11 experts (rheumatologists and dermatologists) analyzed the results of the survey and the regional meetings. With this information, they defined which standards of care are currently considered as minimum and which are excellent. The simultaneous and parallel models of multidisciplinary care are those most widely implemented, but the implementation of quality standards is highly variable. In terms of structure it ranges from 22% to 74%, in those related to process from 17% to 54% and in the results from 2% to 28%. Of the 25 original quality standards for care, 9 were considered only minimum, 4 were excellent and 12 defined criteria for minimum level and others for excellence. The definition of minimum and excellent quality standards for care will help achieve the goal of multidisciplinary care for patients with PAs, which is the best healthcare possible. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.
Arnett, Kelly; Sudore, Rebecca L; Nowels, David; Feng, Cindy X; Levy, Cari R; Lum, Hillary D
2017-12-01
Interprofessional health care team members consider advance care planning (ACP) to be important, yet gaps remain in systematic clinical routines to support ACP. A clearer understanding of the interprofessional team members' perspectives on ACP clinical routines in diverse settings is needed. One hundred eighteen health care team members from community-based clinics, long-term care facilities, academic clinics, federally qualified health centers, and hospitals participated in a 35-question, cross-sectional online survey to assess clinical routines, workflow processes, and policies relating to ACP. Respondents were 53% physicians, 18% advanced practice nurses, 11% nurses, and 18% other interprofessional team members including administrators, chaplains, social workers, and others. Regarding clinical routines, respondents reported that several interprofessional team members play a role in facilitating ACP (ie, physician, social worker, nurse, others). Most (62%) settings did not have, or did not know of, policies related to ACP documentation. Only 14% of settings had a patient education program. Two-thirds of the respondents said that addressing ACP is a high priority and 85% felt that nonphysicians could have ACP conversations with appropriate training. The clinical resources needed to improve clinical routines included training for providers and staff, dedicated staff to facilitate ACP, and availability of patient/family educational materials. Although interprofessional health care team members consider ACP a priority and several team members may be involved, clinical settings lack systematic clinical routines to support ACP. Patient educational materials, interprofessional team training, and policies to support ACP clinical workflows that do not rely solely on physicians could improve ACP across diverse clinical settings.
Schachter, Michael E; Romann, Alexandra; Djurdev, Ognjenka; Levin, Adeera; Beaulieu, Monica
2013-08-29
Early referral and management of high-risk chronic kidney disease may prevent or delay the need for dialysis. Automatic eGFR reporting has increased demand for out-patient nephrology consultations and in some cases, prolonged queues. In Canada, a national task force suggested the development of waiting time targets, which has not been done for nephrology. We sought to describe waiting time for outpatient nephrology consultations in British Columbia (BC). Data collection occurred in 2 phases: 1) Baseline Description (Jan 18-28, 2010) and 2) Post Waiting Time Benchmark-Introduction (Jan 16-27, 2012). Waiting time was defined as the interval from receipt of referral letters to assessment. Using a modified Delphi process, Nephrologists and Family Physicians (FP) developed waiting time targets for commonly referred conditions through meetings and surveys. Rules were developed to weigh-in nephrologists', FPs', and patients' perspectives in order to generate waiting time benchmarks. Targets consider comorbidities, eGFR, BP and albuminuria. Referred conditions were assigned a priority score between 1-4. BC nephrologists were encouraged to centrally triage referrals to see the first available nephrologist. Waiting time benchmarks were simultaneously introduced to guide patient scheduling. A post-intervention waiting time evaluation was then repeated. In 2010 and 2012, 43/52 (83%) and 46/57 (81%) of BC nephrologists participated. Waiting time decreased from 98(IQR44,157) to 64(IQR21,120) days from 2010 to 2012 (p = <.001), despite no change in referral eGFR, demographics, nor number of office hrs/wk. Waiting time improved most for high priority patients. An integrated, Provincial initiative to measure wait times, develop waiting benchmarks, and engage physicians in active waiting time management associated with improved access to nephrologists in BC. Improvements in waiting time was most marked for the highest priority patients, which suggests that benchmarks had an influence on triaging behavior. Further research is needed to determine whether this effect is sustainable.
NASA Astrophysics Data System (ADS)
Moreira da Silva, Manuela; Carvalho, Pedro; Paquete, Rita; Nuno Duarte, Duarte; Chícharo, Luís
2013-04-01
In the last years the European Union has decided to specifically include nickel, cadmium, plumb and TBT in its list of priority substances in water. Trace metals pose a significant threat to organisms because above threshold availability, act as enzyme inhibitors resulting in adverse ecological effects to sediment-associated biota (e.g. macrophytes, benthos, demersal fish) and to higher-biota (e.g. pelagic fish and aquatic birds). Since 2003 International Maritime Organization called for a ban of the application of tributyltin-based paints. Wide distribution, high hydrophobicity, and persistence of organotin compounds have raised concern about their bioaccumulation, their potential biomagnification in the food webs, and their adverse effects to human health and environment, particularly most recent reviews focuses on possible endocrine disrupting effects of OT's (Galloway, 2006; Nakanishi, 2007; Takahashi et al., 1999; Veltman et al., 2006). Saltmarshes are highly heterogeneous environments that have been suffered pressures by the increasing urbanization and industrialization in the adjacent areas. Saltmarsh sediments integrate inputs of contaminants, like metals and organotin compounds and may act as long-term sources of contaminants. At the Ria Formosa saltmarsh several activities were responsible for long-term contaminants, some of them considered priority substances. This work aims to provide information about the present levels and temporal evolution in the last decades of metals (Mn, Zn, Cu, Cr, Ni, Pb, Mo, Cd and Ag, in addition to Fe and Al) and butyltins (TBT, DBT and MBT) in saltmarsh sediments at south of Portugal. Metals were analysed by atomic absorption spectrometry-AAS. Butyltins were determined, after derivatization, by solid phase micro extraction combined with gas chromatography with mass spectrometry (MS/MS). Results showed that legislation was an effective instrument for the decreasing of contamination levels, to sustainable values to ecosystem functioning and human health protection. Keywords: Saltmarshes; Metals; Butyltins; Toxicity; Legislation; Temporal evolution;
Dungey, Sheena; Glew, Simon; Heyes, Barbara; Macleod, John; Tate, A Rosemary
2016-09-01
Electronic healthcare records provide information about patient care over time which not only affords the opportunity to improve patient care directly through effective monitoring and identification of care requirements but also offers a unique platform for both clinical and service-model research essential to the longer-term development of the health service. The quality of the recorded data can, however, be variable and can compromise the validity of data use both for primary and secondary purposes. In order to explore the challenges and benefits of and approaches to recording high quality primary care electronic records, a Clinical Practice Research Datalink (CPRD) sponsored workshop was held at the Society of Academic Primary Care (SAPC) conference in 2014 with the aim of engaging GPs and other data users. The workshop was held as a structured discussion, led by an expert panel and focused around three questions: (1) What are the data quality priorities for clinicians and researchers? How do these priorities differ or overlap? (2) What challenges might GPs face in provision of good data quality both for treating their patients and for research? Do these aims conflict? (3) What tools (such as data metrics and visualisations or software components) could assist the GP in improving data quality and patient management and could this tie in with analytical processes occurring at the research stage? The discussion highlighted both overlap and differences in the perceived data quality priorities and challenges for different user groups. Five key areas of focus were agreed upon and recommendations determined for moving forward in improving quality. The importance of good high quality electronic healthcare records has been set forth along with the need for a practical user-considered and collaborative approach to its improvement.
78 FR 25710 - Applications for New Awards; Strengthening Institutions Program (SIP)
Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-02
... priority in this notice: Carefully matched comparison group design means a type of quasi- experimental... notice). More specifically, it is a design in which project participants are matched with non... group study. When designing their study, applicants should consider participant characteristics relevant...
Families and Professionals as Collaborators in Assessment.
ERIC Educational Resources Information Center
Crais, Elizabeth R.
1993-01-01
This paper considers issues affecting collaboration of professionals and family members in assessing children with special needs. Issues include process versus outcome, the balance of power between families and professionals, choices available to families, sequencing of services, formal versus informal assessment, family concerns and priorities,…
Addressing Priorities for Elementary School Mathematics
ERIC Educational Resources Information Center
Venenciano, Linda; Dougherty, Barbara
2014-01-01
Findings from international assessments present an opportunity to reconsider mathematics education across the grades. If concepts taught in elementary grades lay the foundation for continued study, then children's introduction to school mathematics deserves particular attention. We consider Davydov's theory (1966), which sequences…
Understand and Advocate for Communities First
ERIC Educational Resources Information Center
Khalifa, Muhammad; Arnold, Noelle Witherspoon; Newcomb, Whitney
2015-01-01
Culturally responsive parent-school relationships require educators to consider the cultural practices and understandings of families as a necessary condition of greater academic achievement. The establishment of healthy parent-school relationships is a complex and dynamic process. A school-community overlap, with a priority given to community…
34 CFR 388.22 - What priorities does the Secretary consider in making an award?
Code of Federal Regulations, 2011 CFR
2011-07-01
... education methods, such as interactive audio, video, computer technologies, or existing telecommunications... training materials and practices. The proposed project demonstrates an effective plan to develop and... programs by other State vocational rehabilitation units. (2) Distance education. The proposed project...
34 CFR 388.22 - What priorities does the Secretary consider in making an award?
Code of Federal Regulations, 2010 CFR
2010-07-01
... education methods, such as interactive audio, video, computer technologies, or existing telecommunications... training materials and practices. The proposed project demonstrates an effective plan to develop and... programs by other State vocational rehabilitation units. (2) Distance education. The proposed project...
States Trend toward Performance Funding
ERIC Educational Resources Information Center
Hermes, Jim
2012-01-01
As college completion becomes a priority, more state legislatures are challenging community colleges to demonstrate progress by tying funding measures to institutional performance. Tom Harnisch, a policy analyst with the American Association of State Colleges and Universities, reports that 17 states are currently implementing or considering the…
Solid Waste Reduction--A Hands-on Study.
ERIC Educational Resources Information Center
Wiessinger, Diane
1991-01-01
This lesson plan uses grocery shopping to demonstrate the importance of source reduction in the handling of solid waste problems. Students consider different priorities in shopping (convenience, packaging, and waste reduction) and draw conclusions about the relationship between packaging techniques and solid waste problems. (MCO)
Tertiary Education in the Noughties: The Student Perspective
ERIC Educational Resources Information Center
White, Naomi Rosh
2006-01-01
The psychodynamics of learning and teaching at a time of changing funding arrangements and priorities are explored and discussed through students' accounts of their experience of university. The contextual, organizational and socio-political characteristics implicated in these psychodynamic processes are considered. Among the psychodynamic issues…
34 CFR 388.22 - What priorities does the Secretary consider in making an award?
Code of Federal Regulations, 2014 CFR
2014-07-01
... education methods, such as interactive audio, video, computer technologies, or existing telecommunications... training materials and practices. The proposed project demonstrates an effective plan to develop and... programs by other State vocational rehabilitation units. (2) Distance education. The proposed project...
34 CFR 388.22 - What priorities does the Secretary consider in making an award?
Code of Federal Regulations, 2013 CFR
2013-07-01
... education methods, such as interactive audio, video, computer technologies, or existing telecommunications... training materials and practices. The proposed project demonstrates an effective plan to develop and... programs by other State vocational rehabilitation units. (2) Distance education. The proposed project...
34 CFR 388.22 - What priorities does the Secretary consider in making an award?
Code of Federal Regulations, 2012 CFR
2012-07-01
... education methods, such as interactive audio, video, computer technologies, or existing telecommunications... training materials and practices. The proposed project demonstrates an effective plan to develop and... programs by other State vocational rehabilitation units. (2) Distance education. The proposed project...
ERIC Educational Resources Information Center
Hossler, Don
2006-01-01
The hidden dimensions of leadership and of the costs associated with the implementation of new information systems should be carefully considered. They can help determine the short- and long-term success of new systems.
Guida-Johnson, Bárbara; Zuleta, Gustavo A
2017-09-01
In the present context of global change and search for sustainability, we detected a gap between restoration and society: local communities are usually only considered as threats or disturbances when planning for restoration. To bridge this gap, we propose a landscape design framework for planning riparian rehabilitation in an urban-rural gradient. A spatial multi-criteria analysis was used to assess the priority of riversides by considering two rehabilitation objectives simultaneously-socio-environmental and ecological-and two sets of criteria were designed according to these objectives. The assessment made it possible to identify 17 priority sites for riparian rehabilitation that were associated with different conditions along the gradient. The double goal setting enabled a dual consideration of citizens, both as beneficiaries and potential impacts to rehabilitation, and the criteria selected incorporated the multi-dimensional nature of the environment. This approach can potentially be adapted and implemented in any other anthropic-natural interface throughout the world.
New activity pattern in human interactive dynamics
NASA Astrophysics Data System (ADS)
Formentin, Marco; Lovison, Alberto; Maritan, Amos; Zanzotto, Giovanni
2015-09-01
We investigate the response function of human agents as demonstrated by written correspondence, uncovering a new pattern for how the reactive dynamics of individuals is distributed across the set of each agent’s contacts. In long-term empirical data on email, we find that the set of response times considered separately for the messages to each different correspondent of a given writer, generate a family of heavy-tailed distributions, which have largely the same features for all agents, and whose characteristic times grow exponentially with the rank of each correspondent. We furthermore show that this new behavioral pattern emerges robustly by considering weighted moving averages of the priority-conditioned response-time probabilities generated by a basic prioritization model. Our findings clarify how the range of priorities in the inputs from one’s environment underpin and shape the dynamics of agents embedded in a net of reactive relations. These newly revealed activity patterns might be universal, being present in other general interactive environments, and constrain future models of communication and interaction networks, affecting their architecture and evolution.
New preemptive scheduling for OBS networks considering cascaded wavelength conversion
NASA Astrophysics Data System (ADS)
Gao, Xingbo; Bassiouni, Mostafa A.; Li, Guifang
2009-05-01
In this paper we introduce a new preemptive scheduling technique for next generation optical burst-switched networks considering the impact of cascaded wavelength conversions. It has been shown that when optical bursts are transmitted all optically from source to destination, each wavelength conversion performed along the lightpath may cause certain signal-to-noise deterioration. If the distortion of the signal quality becomes significant enough, the receiver would not be able to recover the original data. Accordingly, subject to this practical impediment, we improve a recently proposed fair channel scheduling algorithm to deal with the fairness problem and aim at burst loss reduction simultaneously in optical burst switching. In our scheme, the dynamic priority associated with each burst is based on a constraint threshold and the number of already conducted wavelength conversions among other factors for this burst. When contention occurs, a new arriving superior burst may preempt another scheduled one according to their priorities. Extensive simulation results have shown that the proposed scheme further improves fairness and achieves burst loss reduction as well.
Occupational health research priorities in Malaysia: a Delphi study.
Sadhra, S; Beach, J R; Aw, T C; Sheikh-Ahmed, K
2001-07-01
As part of a consultancy project on occupational health, the Delphi method was used to identify research priorities in occupational health in Malaysia. Participation was sought from government ministries, industry, and professional organisations, and university departments with an interest in occupational and public health. Two rounds of questionnaires resulted in a final list of priorities, with noticeable differences between participants depending on whether they worked in industry or were from government organisations. The participation rate of 71% (55 of 78) was obtained for the first questionnaire and 76% (72 of 95) for the second questionnaire. The participants identified occupational health problems for specific groups and industries as the top research priority area (ranked as top priority by 25% of participants). Ministry of Health participants placed emphasis on healthcare workers (52% ranking it as top priority), whereas those from industry identified construction and plantation workers as groups, which should be accorded the highest priority. Evaluation of research and services was given a low priority. The priorities for occupational health determined with the Delphi approach showed differences between Malaysia, a developing country, and findings from similar European studies. This may be expected, as differences exist in stages of economic development, types of industries, occupational activities, and cultural attitudes to occupational health and safety. Chemical poisonings and workplace accidents were accorded a high priority. By contrast with findings from western countries, workplace psychosocial problems and musculoskeletal injuries were deemed less important. There also seemed to be greater emphasis on adopting interventions for identified problems based on experience in other countries rather than the need to evaluate local occupational health provisions.
Stokley, Shannon; Cullen, Karen A; Kennedy, Allison; Bardenheier, Barbara H
2008-02-22
While many Complementary/Alternative Medicine (CAM) practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged > or = 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. Data from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever), and > or = 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics. Overall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value < 0.001) and pneumococcal (40% vs 33%; p-value < 0.001) vaccines but were not significantly different for hepatitis B (60% vs 56%; p-value = 0.36). Among non-priority adults, recent CAM users had significantly higher unadjusted and adjusted vaccination coverage levels compared to non-CAM users for all three vaccines (p-values < 0.001). Vaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue monitoring CAM use and its possible influence on receipt of immunizations among adults. Since adult vaccination coverage levels remain below Healthy People 2010 goals, it may be beneficial to work with CAM practitioners to promote adult vaccines as preventive services in keeping with their commitment to maintaining good health.
Alqahtani, Saad; Seoane-Vazquez, Enrique; Rodriguez-Monguio, Rosa; Eguale, Tewodros
2015-07-01
The US Food and Drug Administration (FDA) priority review process applies to a drug that is considered a significant improvement over the available alternatives. The European Medicines Agency (EMA) accelerated approval applies to a product that is of major public health interest. This study assessed differences in the characteristics of priority review new molecular entities and new therapeutic biologic products approved by the FDA and the EMA. This study includes regulatory information on drug applications, approvals, indications, and orphan designations of all priority review drugs approved by the FDA and the EMA in the period 1999-2011. Descriptive statistics, t-tests, and chi-squared and Wilcoxon tests were performed. Overall, 100 FDA priority review new molecular entities and new therapeutic biologics were approved by both agencies; 87.0% of the products were first approved by the FDA. The average FDA review time (9.2 ± 8.4 months) was significantly lower than the EMA average review time (14.6 ± 4.0 months) (p < 0.0001). The FDA and the EMA granted orphan designation to 43.0% and 33.0%, respectively, of the applications. There were differences in the administration route (1.0% of all products), dosage (8.0%), strength (23%), posology (51.0%), indications (30.0%), restrictions of use (52.0%), limitations of use (19.0%), and outcomes limitations (28.0%) approved by both regulatory agencies. Significant differences exist in the characteristics of the priority review drugs approved by the FDA and the EMA. Harmonization of the US and European regulatory frameworks may facilitate timely approval of pharmaceutical products. Copyright © 2015 John Wiley & Sons, Ltd.
The trials methodological research agenda: results from a priority setting exercise.
Tudur Smith, Catrin; Hickey, Helen; Clarke, Mike; Blazeby, Jane; Williamson, Paula
2014-01-23
Research into the methods used in the design, conduct, analysis, and reporting of clinical trials is essential to ensure that effective methods are available and that clinical decisions made using results from trials are based on the best available evidence, which is reliable and robust. An on-line Delphi survey of 48 UK Clinical Research Collaboration registered Clinical Trials Units (CTUs) was undertaken. During round one, CTU Directors were asked to identify important topics that require methodological research. During round two, their opinion about the level of importance of each topic was recorded, and during round three, they were asked to review the group's average opinion and revise their previous opinion if appropriate. Direct reminders were sent to maximise the number of responses at each round. Results are summarised using descriptive methods. Forty one (85%) CTU Directors responded to at least one round of the Delphi process: 25 (52%) responded in round one, 32 (67%) responded in round two, 24 (50%) responded in round three. There were only 12 (25%) who responded to all three rounds and 18 (38%) who responded to both rounds two and three. Consensus was achieved amongst CTU Directors that the top three priorities for trials methodological research were 'Research into methods to boost recruitment in trials' (considered the highest priority), 'Methods to minimise attrition' and 'Choosing appropriate outcomes to measure'. Fifty other topics were included in the list of priorities and consensus was reached that two topics, 'Radiotherapy study designs' and 'Low carbon trials', were not priorities. This priority setting exercise has identified the research topics felt to be most important to the key stakeholder group of Directors of UKCRC registered CTUs. The use of robust methodology to identify these priorities will help ensure that this work informs the trials methodological research agenda, with a focus on topics that will have most impact and relevance.
A comparison of two emergency medical dispatch protocols with respect to accuracy.
Torlén, Klara; Kurland, Lisa; Castrén, Maaret; Olanders, Knut; Bohm, Katarina
2017-12-29
Emergency medical dispatching should be as accurate as possible in order to ensure patient safety and optimize the use of ambulance resources. This study aimed to compare the accuracy, measured as priority level, between two Swedish dispatch protocols - the three-graded priority protocol Medical Index and a newly developed prototype, the four-graded priority protocol, RETTS-A. A simulation study was carried out at the Emergency Medical Communication Centre (EMCC) in Stockholm, Sweden, between October and March 2016. Fifty-three voluntary telecommunicators working at SOS Alarm were recruited nationally. Each telecommunicator handled 26 emergency medical calls, simulated by experienced standard patients. Manuscripts for the scenarios were based on recorded real-life calls, representing the six most common complaints. A cross-over design with 13 + 13 calls was used. Priority level and medical condition for each scenario was set through expert consensus and used as gold standard in the study. A total of 1293 calls were included in the analysis. For priority level, n = 349 (54.0%) of the calls were assessed correctly with Medical Index and n = 309 (48.0%) with RETTS-A (p = 0.012). Sensitivity for the highest priority level was 82.6% (95% confidence interval: 76.6-87.3%) in the Medical Index and 54.0% (44.3-63.4%) in RETTS-A. Overtriage was 37.9% (34.2-41.7%) in the Medical Index and 28.6% (25.2-32.2%) in RETTS-A. The corresponding proportion of undertriage was 6.3% (4.7-8.5%) and 23.4% (20.3-26.9%) respectively. In this simulation study we demonstrate that Medical Index had a higher accuracy for priority level and less undertriage than the new prototype RETTS-A. The overall accuracy of both protocols is to be considered as low. Overtriage challenges resource utilization while undertriage threatens patient safety. The results suggest that in order to improve patient safety both protocols need revisions in order to guarantee safe emergency medical dispatching.
The trials methodological research agenda: results from a priority setting exercise
2014-01-01
Background Research into the methods used in the design, conduct, analysis, and reporting of clinical trials is essential to ensure that effective methods are available and that clinical decisions made using results from trials are based on the best available evidence, which is reliable and robust. Methods An on-line Delphi survey of 48 UK Clinical Research Collaboration registered Clinical Trials Units (CTUs) was undertaken. During round one, CTU Directors were asked to identify important topics that require methodological research. During round two, their opinion about the level of importance of each topic was recorded, and during round three, they were asked to review the group’s average opinion and revise their previous opinion if appropriate. Direct reminders were sent to maximise the number of responses at each round. Results are summarised using descriptive methods. Results Forty one (85%) CTU Directors responded to at least one round of the Delphi process: 25 (52%) responded in round one, 32 (67%) responded in round two, 24 (50%) responded in round three. There were only 12 (25%) who responded to all three rounds and 18 (38%) who responded to both rounds two and three. Consensus was achieved amongst CTU Directors that the top three priorities for trials methodological research were ‘Research into methods to boost recruitment in trials’ (considered the highest priority), ‘Methods to minimise attrition’ and ‘Choosing appropriate outcomes to measure’. Fifty other topics were included in the list of priorities and consensus was reached that two topics, ‘Radiotherapy study designs’ and ‘Low carbon trials’, were not priorities. Conclusions This priority setting exercise has identified the research topics felt to be most important to the key stakeholder group of Directors of UKCRC registered CTUs. The use of robust methodology to identify these priorities will help ensure that this work informs the trials methodological research agenda, with a focus on topics that will have most impact and relevance. PMID:24456928
Afnan-Holmes, Hoviyeh; Magoma, Moke; John, Theopista; Levira, Francis; Msemo, Georgina; Armstrong, Corinne E; Martínez-Álvarez, Melisa; Kerber, Kate; Kihinga, Clement; Makuwani, Ahmad; Rusibamayila, Neema; Hussein, Asia; Lawn, Joy E
2015-07-01
Tanzania is on track to meet Millennium Development Goal (MDG) 4 for child survival, but is making insufficient progress for newborn survival and maternal health (MDG 5) and family planning. To understand this mixed progress and to identify priorities for the post-2015 era, Tanzania was selected as a Countdown to 2015 case study. We analysed progress made in Tanzania between 1990 and 2014 in maternal, newborn, and child mortality, and unmet need for family planning, in which we used a health systems evaluation framework to assess coverage and equity of interventions along the continuum of care, health systems, policies and investments, while also considering contextual change (eg, economic and educational). We had five objectives, which assessed each level of the health systems evaluation framework. We used the Lives Saved Tool (LiST) and did multiple linear regression analyses to explain the reduction in child mortality in Tanzania. We analysed the reasons for the slower changes in maternal and newborn survival and family planning, to inform priorities to end preventable maternal, newborn, and child deaths by 2030. In the past two decades, Tanzania's population has doubled in size, necessitating a doubling of health and social services to maintain coverage. Total health-care financing also doubled, with donor funding for child health and HIV/AIDS more than tripling. Trends along the continuum of care varied, with preventive child health services reaching high coverage (≥85%) and equity (socioeconomic status difference 13-14%), but lower coverage and wider inequities for child curative services (71% coverage, socioeconomic status difference 36%), facility delivery (52% coverage, socioeconomic status difference 56%), and family planning (46% coverage, socioeconomic status difference 22%). The LiST analysis suggested that around 39% of child mortality reduction was linked to increases in coverage of interventions, especially of immunisation and insecticide-treated bednets. Economic growth was also associated with reductions in child mortality. Child health programmes focused on selected high-impact interventions at lower levels of the health system (eg, the community and dispensary levels). Despite its high priority, implementation of maternal health care has been intermittent. Newborn survival has gained attention only since 2005, but high-impact interventions are already being implemented. Family planning had consistent policies but only recent reinvestment in implementation. Mixed progress in reproductive, maternal, newborn, and child health in Tanzania indicates a complex interplay of political prioritisation, health financing, and consistent implementation. Post-2015 priorities for Tanzania should focus on the unmet need for family planning, especially in the Western and Lake regions; addressing gaps for coverage and quality of care at birth, especially in rural areas; and continuation of progress for child health. Government of Canada, Foreign Affairs, Trade, and Development; US Fund for UNICEF; and the Bill & Melinda Gates Foundation. Copyright © 2015 Afnan-Holmes et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.
Identifying appropriate protected areas for endangered fern species under climate change.
Wang, Chun-Jing; Wan, Ji-Zhong; Zhang, Zhi-Xiang; Zhang, Gang-Min
2016-01-01
The management of protected areas (PAs) is widely used in the conservation of endangered plant species under climate change. However, studies that have identified appropriate PAs for endangered fern species are rare. To address this gap, we must develop a workflow to plan appropriate PAs for endangered fern species that will be further impacted by climate change. Here, we used endangered fern species in China as a case study, and we applied conservation planning software coupled with endangered fern species distribution data and distribution modeling to plan conservation areas with high priority protection needs under climate change. We identified appropriate PAs for endangered fern species under climate change based on the IUCN protected area categories (from Ia to VI) and planned additional PAs for endangered fern species. The high priority regions for protecting the endangered fern species were distributed throughout southern China. With decreasing temperature seasonality, the priority ranking of all endangered fern species is projected to increase in existing PAs. Accordingly, we need to establish conservation areas with low climate vulnerability in existing PAs and expand the conservation areas for endangered fern species in the high priority conservation regions.
NASA Astrophysics Data System (ADS)
Tone, Tetsuya; Kohara, Kazuhiro
We have investigated ways to reduce congestion in a theme park with multi-agents. We constructed a theme park model called Digital Park 1.0 with twenty-three attractions similar in form to Tokyo Disney Sea. We consider not only congestion information (number of vistors standing in line at each attraction) but also the advantage of a priority boarding pass, like Fast Pass which is used at Tokyo Disney Sea. The congestion-information-usage ratio, which reflects the ratio of visitors who behave according to congestion information, was changed from 0% to 100% in both models, with and without priority boarding pass. The “mean stay time of visitors" is a measure of satisfaction. The smaller mean stay time, the larger degree of satisfaction. Here, a short stay time means a short wait time. The resluts of each simulation are averaged over ten trials. The main results are as follows. (1) When congestion-information-usage ratio increased, the mean stay time decreases. When 20% of visitors behaved according to congestion information, the mean stay time was reduced by 30%. (2) A priority boarding pass reduced congestion, and mean stay time was reduced by 15%. (3) When visitors used congestion information and a priority boarding pass, mean stay time was further reduced. When the congestion-information-usage ratio was 20%, mean stay time was reduced by 35%. (4) When congestion-information-usage ratio was over 50%, the congestion reduction effects reached saturation.
[Priorities for health policy and systems research focused on human resources in health].
Reveiz, Ludovic; Chapman, Evelina; Flórez, Carlos E Pinzón; Torres, Rubén
2013-11-01
Identify priorities for health policy and systems research related to human resources in Latin America and Caribbean countries. An online survey was designed based on a search in PubMed, Cochrane Library, and LILACS that contributed previously prioritized research questions. Respondents, mainly researchers and decision-makers, were identified through various sources. The first round, directed at researchers, aimed at refining and adding research questions and prioritizing questions that researchers regarded as relevant or very relevant. The second round was directed at researchers and decision-makers. A question was considered a priority when 50% (or more) of respondents described it as "relevant" or "very relevant." The first round included 20 questions on human resources and 33/66 researchers responded. Questions suggested by the researchers were added, resulting in 26 questions for the second round, which were sent to 121 researchers and decision-makers. Respondent representation by country was uniform in both rounds. In the second round, 14/26 (54%) questions were described as very relevant. Priority issues related to regulation of the market, integration of education and health care needs, and distribution of human resources. The response rate was 50% in the first round (33/66), and 34% in the second round (41/121). The results of this exercise provide a starting point for mobilization of resources for health policy and systems research. Identification of health systems research priorities is an effective and efficient strategy for reorienting political, financial, management, and social organization efforts for attaining universal health coverage.
Mondini, Renata Petzhold; Menegolla, Ivone Andreatta; Silva, Eduardo Viegas da
2017-10-01
This paper aimed to identify the priority Health Regions of Rio Grande do Sul (RS) to implement Health Surveillance strengthening actions. This is a descriptive study with data from time series of 11 (eleven) Health Surveillance indicators of the Ministry of Health's 2016 Guidelines, Objectives, Targets and Indicators Journal agreed by the Bipartite Interagency Committee/RS. The selected indicators are synthesized to produce a Composite Health Surveillance Assessment Indicator (ICAVES) for each of the 30 Health Regions of the state, creating values ranging from zero (worst) to 1 (best), using the Human Development Index (HDI) construction calculation method. The lowest rates of the composite indicator are found in the Health Regions "20-Rota da Produção" and "19-Região do Botucaraí". These two Health Regions are priorities for the strengthening of collective Health Surveillance actions and the management of health risks and diseases, considering horizontal equity as guideline of the Unified Health System.
NASA Astrophysics Data System (ADS)
Guojun, He; Lin, Guo; Zhicheng, Yu; Xiaojun, Zhu; Lei, Wang; Zhiqiang, Zhao
2017-03-01
In order to reduce the stochastic volatility of supply and demand, and maintain the electric power system's stability after large scale stochastic renewable energy sources connected to grid, the development and consumption should be promoted by marketing means. Bilateral contract transaction model of large users' direct power purchase conforms to the actual situation of our country. Trading pattern of large users' direct power purchase is analyzed in this paper, characteristics of each power generation are summed up, and centralized matching mode is mainly introduced. Through the establishment of power generation enterprises' priority evaluation index system and the analysis of power generation enterprises' priority based on fuzzy clustering, the sorting method of power generation enterprises' priority in trading patterns of large users' direct power purchase is put forward. Suggestions for trading mechanism of large users' direct power purchase are offered by this method, which is good for expand the promotion of large users' direct power purchase further.
Applying a global justice lens to health systems research ethics: an initial exploration.
Pratt, Bridget; Hyder, Adnan A
2015-03-01
Recent scholarship has considered what, if anything, rich people owe to poor people to achieve justice in global health and the implications of this for international research. Yet this work has primarily focused on international clinical research. Health systems research is increasingly being performed in low and middle income countries and is essential to reducing global health disparities. This paper provides an initial description of the ethical issues related to priority setting, capacity-building, and the provision of post-study benefits that arise during the conduct of such research. It presents a selection of issues discussed in the health systems research literature and argues that they constitute ethical concerns based on their being inconsistent with a particular theory of global justice (the health capability paradigm). Issues identified include the fact that priority setting for health systems research at the global level is often not driven by national priorities and that capacity-building efforts frequently utilize one-size-fits-all approaches.
Gorlick, Marissa A; Worthy, Darrell A; Knopik, Valerie S; McGeary, John E; Beevers, Christopher G; Maddox, W Todd
2015-03-01
Humans with seven or more repeats in exon III of the DRD4 gene (long DRD4 carriers) sometimes demonstrate impaired attention, as seen in attention-deficit hyperactivity disorder, and at other times demonstrate heightened attention, as seen in addictive behavior. Although the clinical effects of DRD4 are the focus of much work, this gene may not necessarily serve as a "risk" gene for attentional deficits, but as a plasticity gene where attention is heightened for priority items in the environment and impaired for minor items. Here we examine the role of DRD4 in two tasks that benefit from selective attention to high-priority information. We examine a category learning task where performance is supported by focusing on features and updating verbal rules. Here, selective attention to the most salient features is associated with good performance. In addition, we examine the Operation Span (OSPAN) task, a working memory capacity task that relies on selective attention to update and maintain items in memory while also performing a secondary task. Long DRD4 carriers show superior performance relative to short DRD4 homozygotes (six or less tandem repeats) in both the category learning and OSPAN tasks. These results suggest that DRD4 may serve as a "plasticity" gene where individuals with the long allele show heightened selective attention to high-priority items in the environment, which can be beneficial in the appropriate context.
Gorlick, Marissa A.; Worthy, Darrell A.; Knopik, Valerie S.; McGeary, John E.; Beevers, Christopher G.; Maddox, W. Todd
2014-01-01
Humans with 7 or more repeats in exon III of the DRD4 gene (long DRD4 carriers) sometimes demonstrate impaired attention, as seen in ADHD, and at other times demonstrate heightened attention, as seen in addictive behavior. Though the clinical effects of DRD4 are the focus of much work, this gene may not necessarily serve as a ‘risk’ gene for attentional deficits, but as a plasticity gene where attention is heightened for priority items in the environment and impaired for minor items. Here we examine the role of DRD4 in two tasks that benefit from selective attention to high-priority information. We examine a category learning task where performance is supported by focusing on features and updating verbal rules. Here selective attention to the most salient features is associated with good performance. In addition, we examine the Operation Span Task (OSPAN), a working memory capacity task that relies on selective attention to update and maintain items in memory while also performing a secondary task. Long DRD4 carriers show superior performance relative to short DRD4 homozygotes (six or less tandem repeats) in both the category learning and OSPAN tasks. These results suggest that DRD4 may serve as a ‘plasticity’ gene where individuals with the long allele show heightened selective attention to high-priority items in the environment, which can be beneficial in the appropriate context. PMID:25244120
Typology of end-of-life priorities in Saudi females: averaging analysis and Q-methodology.
Hammami, Muhammad M; Hammami, Safa; Amer, Hala A; Khodr, Nesrine A
2016-01-01
Understanding culture-and sex-related end-of-life preferences is essential to provide quality end-of-life care. We have previously explored end-of-life choices in Saudi males and found important culture-related differences and that Q-methodology is useful in identifying intraculture, opinion-based groups. Here, we explore Saudi females' end-of-life choices. A volunteer sample of 68 females rank-ordered 47 opinion statements on end-of-life issues into a nine-category symmetrical distribution. The ranking scores of the statements were analyzed by averaging analysis and Q-methodology. The mean age of the females in the sample was 30.3 years (range, 19-55 years). Among them, 51% reported average religiosity, 78% reported very good health, 79% reported very good life quality, and 100% reported high-school education or more. The extreme five overall priorities were to be able to say the statement of faith, be at peace with God, die without having the body exposed, maintain dignity, and resolve all conflicts. The extreme five overall dis-priorities were to die in the hospital, die well dressed, be informed about impending death by family/friends rather than doctor, die at peak of life, and not know if one has a fatal illness. Q-methodology identified five opinion-based groups with qualitatively different characteristics: "physical and emotional privacy concerned, family caring" (younger, lower religiosity), "whole person" (higher religiosity), "pain and informational privacy concerned" (lower life quality), "decisional privacy concerned" (older, higher life quality), and "life quantity concerned, family dependent" (high life quality, low life satisfaction). Out of the extreme 14 priorities/dis-priorities for each group, 21%-50% were not represented among the extreme 20 priorities/dis-priorities for the entire sample. Consistent with the previously reported findings in Saudi males, transcendence and dying in the hospital were the extreme end-of-life priority and dis-priority, respectively, in Saudi females. Body modesty was a major overall concern; however, concerns about pain, various types of privacy, and life quantity were variably emphasized by the five opinion-based groups but masked by averaging analysis.
Typology of end-of-life priorities in Saudi females: averaging analysis and Q-methodology
Hammami, Muhammad M; Hammami, Safa; Amer, Hala A; Khodr, Nesrine A
2016-01-01
Background Understanding culture-and sex-related end-of-life preferences is essential to provide quality end-of-life care. We have previously explored end-of-life choices in Saudi males and found important culture-related differences and that Q-methodology is useful in identifying intraculture, opinion-based groups. Here, we explore Saudi females’ end-of-life choices. Methods A volunteer sample of 68 females rank-ordered 47 opinion statements on end-of-life issues into a nine-category symmetrical distribution. The ranking scores of the statements were analyzed by averaging analysis and Q-methodology. Results The mean age of the females in the sample was 30.3 years (range, 19–55 years). Among them, 51% reported average religiosity, 78% reported very good health, 79% reported very good life quality, and 100% reported high-school education or more. The extreme five overall priorities were to be able to say the statement of faith, be at peace with God, die without having the body exposed, maintain dignity, and resolve all conflicts. The extreme five overall dis-priorities were to die in the hospital, die well dressed, be informed about impending death by family/friends rather than doctor, die at peak of life, and not know if one has a fatal illness. Q-methodology identified five opinion-based groups with qualitatively different characteristics: “physical and emotional privacy concerned, family caring” (younger, lower religiosity), “whole person” (higher religiosity), “pain and informational privacy concerned” (lower life quality), “decisional privacy concerned” (older, higher life quality), and “life quantity concerned, family dependent” (high life quality, low life satisfaction). Out of the extreme 14 priorities/dis-priorities for each group, 21%–50% were not represented among the extreme 20 priorities/dis-priorities for the entire sample. Conclusion Consistent with the previously reported findings in Saudi males, transcendence and dying in the hospital were the extreme end-of-life priority and dis-priority, respectively, in Saudi females. Body modesty was a major overall concern; however, concerns about pain, various types of privacy, and life quantity were variably emphasized by the five opinion-based groups but masked by averaging analysis. PMID:27274205
Sanches, Sandra; Martins, Mónica; Silva, Ana F; Galinha, Claudia F; Santos, Maria A; Pereira, Inês A C; Crespo, Maria Teresa Barreto
2017-02-01
The treatment of large volumes of wastewater during oil refining is presently a challenge. Bioremediation has been considered an eco-friendly approach for the removal of polycyclic aromatic hydrocarbons (PAHs), which are one of the most hazardous groups of organic micropollutants. However, it is crucial to identify native PAH-removing microorganisms for the development of an effective bioremediation process. This study reports the high potential of an anaerobic microbial consortium enriched from a petrochemical refinery wastewater to remove two priority PAHs-acenaphthene and phenanthrene. Seventy-seven percent of acenaphthene was removed within 17 h, whereas phenanthrene was no longer detected after 15 h. Bioremoval rates were extremely high (0.086 and 0.156 h -1 for acenaphthene and phenanthrene, respectively). The characterization of the microbial communities by next-generation sequencing and fluorescence in situ hybridization showed that the PAH-removing consortium was mainly composed by bacteria affiliated to Diaphorobacter and Paracoccus genera, independently of the PAH tested. Moreover, besides biodegradation, biosorption was a relevant mechanism involved in the removal of both PAHs, which is an important finding since biosorption is less expensive than biodegradation and can be carried out with dead biomass. Although biodegradation is the most commonly reported biological mechanism for PAH removal, this study demonstrated that biosorption by this microbial community may be extremely efficient for their removal. Given the outstanding ability of this microbial consortium to quickly remove the compounds addressed, it could be further applied for the bioremediation of PAHs in refinery wastewaters and other contaminated environments.
Communicating Ecological Indicators to Decision Makers and the Public
A. Schiller; Carolyn Hunsaker; M.A. Kane; A.K. Wolfe; V.H. Dale; G.W. Suter; C.S. Russell; G. Pion; N.H. Jensen; V.C. Konar
2001-01-01
Ecological assessments and monitoring programs often rely on indicators to evaluate environmental conditions. Such indicators are frequently developed by scientists, expressed in technical language, and target aspects of the environment that scientists consider useful. Yet setting environmental policy priorities and making environmental decisions requires both...
Gamification in Blackboard Learn
ERIC Educational Resources Information Center
Machajewski, Szymon
2017-01-01
Gamification is an important movement in business management, but also in higher education. Projects like the GradeCraft LMS, funded at $1.8 million dollars at U of M, demonstrate that designing student experience in learning is a top priority for major educational institutions. Considering enrollment limitations and changes in population…
Prevalence of osteoporosis and low bone mass among Puerto Rican older adults
USDA-ARS?s Scientific Manuscript database
Historically, osteoporosis has not been considered a public health priority for the Hispanic population. However, recent data indicate that Mexican Americans are at increased risk for this chronic condition. Although it is well established that there is heterogeneity in social, lifestyle, and health...
DOT National Transportation Integrated Search
2012-07-01
A study was conducted to identify/verify weather factors important to the conduct of aviation activities and : that would be important to consider in systems intended to operate within the NextGen environment. The : study reviewed weather-information...
Biogeographical Analysis of Chemical Co-Occurrence Data to Identify Priorities for Mixtures Research
A challenge with multiple chemical risk assessment is the need to consider the joint behavior of chemicals in mixtures. To address this need, pharmacologists and toxicologists have developed methods over the years to evaluate and test chemical interaction. In practice, however, t...
The Changing Purposes of University Libraries
ERIC Educational Resources Information Center
Evans, G. R.
2013-01-01
This article explores recent developments in national policy for academic libraries. It considers the shift from traditional to managerial academic librarianship; the move to "social space" and multi-use systems; changes in the balance between meeting teaching and research needs and in public funding priorities; the difficulty of making…
Code of Federal Regulations, 2012 CFR
2012-10-01
... HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS NATIONAL LIBRARY OF MEDICINE GRANTS Establishment of Regional Medical Libraries § 59a.15 Awards. (a) General. The Secretary, with the advice of the... medical library. The Secretary, in determining the priority assigned an applicant, must consider: (1) The...
Code of Federal Regulations, 2014 CFR
2014-10-01
... HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS NATIONAL LIBRARY OF MEDICINE GRANTS Establishment of Regional Medical Libraries § 59a.15 Awards. (a) General. The Secretary, with the advice of the... medical library. The Secretary, in determining the priority assigned an applicant, must consider: (1) The...
Code of Federal Regulations, 2013 CFR
2013-10-01
... HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS NATIONAL LIBRARY OF MEDICINE GRANTS Establishment of Regional Medical Libraries § 59a.15 Awards. (a) General. The Secretary, with the advice of the... medical library. The Secretary, in determining the priority assigned an applicant, must consider: (1) The...
Code of Federal Regulations, 2010 CFR
2010-10-01
... HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS NATIONAL LIBRARY OF MEDICINE GRANTS Establishment of Regional Medical Libraries § 59a.15 Awards. (a) General. The Secretary, with the advice of the... medical library. The Secretary, in determining the priority assigned an applicant, must consider: (1) The...