Using Simulation to Determine a Strategy for Positively Tracking a Cruise Missile by CMMCA

DTIC Science & Technology

1990-03-01

ANPOS/SS(6),ATC/SS(7),ATAS/ SS(8),ABANGLE/SS(9),CBANGLE/DD(1),CEVEL/ DD(2),CNVEL/DD(3),CTCC/DD(4),AEVEL/ DD(5), ANVEL /DD(6),ATCC RECORD,TNOW,MINUTES,20...ABANGLE),(SS(9),CBANGLE), & (DD(1),CEVEL),(DD(2),CNVEL).(DD(3),CTCC), & (DD(4),AEVEL),(DD(5), ANVEL ),(DD(6).ATCC) GOTO(l,2,3,4,5,6) ,I 1IF (XX(14) *EQ. 1...ABANGLE),(SS(9),CBANGLE), & (DD(l),CEVEL),(DD(2),CNVEL),(DD(3),CTCG), & (DD(4),AEVEL),(DD(5), ANVEL ),CDD(6),ATCC) REAL COSD EXTERNAL COSD REAL SIND

Spacecraft Radiator Freeze Protection Using a Regenerative Heat Exchanger with Bypass Setpoint Temperature Control

NASA Technical Reports Server (NTRS)

Ungar, Eugene K.

2008-01-01

Spacecraft radiators are sized for their maximum heat load in their warmest thermal environment, but must operate at reduced heat loads and in colder environments. For systems where the radiator environment can be colder than the working fluid freezing temperature, radiator freezing becomes an issue. Radiator freezing has not been a major issue for the Space Shuttle and the International Space Station (ISS) active thermal control systems (ATCSs) because they operate in environments that are warm relative to the freezing point of their external coolants (Freon-21 and ammonia, respectively). For a vehicle that lands at the Lunar South Pole, the design thermal environment is 215K, but the radiator working fluid must also be kept from freezing during the 0 K sink of transit. A radiator bypass flow control design such as those used on the Space Shuttle and ISS requires more than 30% of the design heat load to avoid radiator freezing during transit - even with a very low freezing point working fluid. By changing the traditional ATCS architecture to include a regenerating heat exchanger inboard of the radiator and by using a regenerator bypass flow control valve to maintain system setpoint, the required minimum heat load can be reduced by more than half. This gives the spacecraft much more flexibility in design and operation. The present work describes the regenerator bypass ATCS setpoint control methodology. It includes analytical results comparing the performance of this system to the traditional radiator bypass system. Finally, a summary of the advantages of the regenerator bypass system are presented.

Integration of Specialized Pain Control Services in Palliative Care: A Nationwide Web-based Survey.

PubMed

Page, Nivedita Dilip

2017-01-01

Pain control is an important part of palliative care (PC), and conventional analgesics do not provide adequate pain relief to all patients. Many patients present with complex pain syndromes that require interventional pain control measures usually deployed by pain specialists. There is adequate integration of specialized pain control services with PC elsewhere, but information about the same in our country is lacking. An internet survey was conducted among palliative specialists regarding the need and availability of pain specialists for their patients suffering from complex pain syndromes. Their attitude toward integrating specialized pain control services in their practice was also explored. Majority of palliative physicians came across situations where specialists in pain would control the patients' pain better. There was a poor availability of such services, and when available, the cost was significant. It is heartening to note that though there is poor integration of specialized pain control services with palliation, palliative physicians acknowledge the need for pain specialists and their techniques for providing pain relief for their patients. Effective pain control is needed in palliation, barriers however exist, and there is a need to make pain specialists and interventional techniques more freely available.

Shape Morphing Adaptive Radiator Technology (SMART) Updates to Techport Entry

NASA Technical Reports Server (NTRS)

Erickson, Lisa; Bertagne, Christopher; Hartl, Darren; Witcomb, John; Cognata, Thomas

2017-01-01

The Shape-Morphing Adaptive Radiator Technology (SMART) project builds off the FY16 research effort that developed a flexible composite radiator panel and demonstrated its ability to actuate from SMA's attached to it. The proposed FY17 Shape-Morphing Adaptive Radiator Technology (SMART) project's goal is to 1) develop a practical radiator design with shape memory alloys (SMAs) bonded to the radiator's panel, and 2) build a multi-panel radiator prototype for subsequent system level thermal vacuum tests. The morphing radiator employs SMA materials to passively change its shape to adapt its rate of heat rejection to vehicle requirements. Conceptually, the radiator panel has a naturally closed position (like a cylinder) in a cold environment. Whenever the radiator's temperature gradually rises, SMA's affixed to the face sheet will pull the face sheet open a commensurate amount - increasing the radiators view to space and causing it to reject more heat. In a vehicle, the radiator's variable heat rejection capabilities would reduce the number of additional heat rejection devices in a vehicle's thermal control system. This technology aims to help achieve the required maximum to minimum heat rejection ratio required for manned space vehicles to adopt a lighter, simpler, single loop thermal control architecture (ATCS). Single loop architectures are viewed as an attractive means to reduce mass and complexity over traditional dual-loop solutions. However, fluids generally considered safe enough to flow within crewed cabins (e.g. propylene glycol-water mixtures) have much higher freezing points and viscosities than those used in the external sides of dual loop ATCSs (e.g. Ammonia and HFE7000).

Skill/Knowledge Commonalities in Selected Electronics Specialties.

DTIC Science & Technology

1986-10-01

Maintenance Specialist 241 19 30750 Telecomunications Systems Control Specialist 498 35 30950A Missile Det and Warning Radar Specialistc 18 30 309506... Telecomunications Systems Control Specialist 59 ( 5) 125 (10) 259 (21) :. aNumbers in parenthesis are percentage of total possible (1,257). bBased on principles

78 FR 41993 - Transport Handling Specialists, Inc.-Continuance in Control Exemption-RSL Railroad, LLC

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [Docket No. FD 35726] Transport Handling Specialists, Inc.--Continuance in Control Exemption--RSL Railroad, LLC Transport Handling Specialists, Inc. (THS), has filed a verified notice of exemption (Notice) under 49 CFR 1180.2(d)(2) to continue in...

Air traffic control specialist visual scanning II : task load, visual noise, and intrusions into controlled airspace.

DOT National Transportation Integrated Search

1999-12-01

The Federal Aviation Administration (FAA) started an Air Traffic Control Specialist (ATCS) information-scanning program a number : of years ago. The goal is to learn about how controllers use information displays and develop techniques for reducing a...

Improving cancer patients' pain: the impact of the hospital specialist palliative care team.

PubMed

Jack, B; Hillier, V; Williams, A; Oldham, J

2006-12-01

Pain is reported to occur in the majority of patients with advanced cancer and is one of the main reasons for referral to a hospital specialist palliative care team. Yet despite this, there is a paucity of research into the impact the hospital specialist palliative care team has on pain control in patients. A non-equivalent control group design using a quota sample investigated 100 cancer patients who had been admitted to hospital for symptom control. Fifty patients received specialist hospital palliative care team intervention compared with 50 patients receiving traditional care. Outcome was assessed using the Palliative Care Assessment (PACA) tool on three occasions. There was no difference between the groups on the initial assessment and the results indicated that all cancer patients admitted to hospital had a significant improvement in their pain control. However, the patients who had the additional input of the palliative care team demonstrated a statistically significant greater improvement than the control group (P<0.001). Potential explanations are made for the results including the enhanced knowledge and skills of the hospital specialist palliative care team.

Motivational Profiles and Motivation for Lifelong Learning of Medical Specialists.

PubMed

van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Wilschut, Janneke A; Tjin A Tsoi, Sharon L N M; Croiset, Gerda; Peerdeman, Saskia M

2018-05-22

Medical specialists face the challenge of maintaining their knowledge and skills and continuing professional development, that is, lifelong learning. Motivation may play an integral role in many of the challenges facing the physician workforce today including maintenance of a high performance. The aim of this study was to determine whether medical specialists show different motivational profiles and if these profiles predict differences in motivation for lifelong learning. An online questionnaire was sent to every medical specialist working in five hospitals in the Netherlands. The questionnaire included the validated Multidimensional Work Motivation Scale and the Jefferson Scale of Physician Lifelong Learning together with background questions like age, gender, and type of hospital. Respondents were grouped into different motivational profiles by using a two-step clustering approach. Four motivational profiles were identified: (1) HAMC profile (for High Autonomous and Moderate Controlled motivation), (2) MAMC profile (for Moderate Autonomous and Moderate Controlled motivation), (3) MALC profile (for Moderate Autonomous and Low Controlled motivation), and (4) HALC profile (for High Autonomous and Low Controlled motivation). Most of the female specialists that work in an academic hospital and specialists with a surgical specialty were represented in the HALC profile. Four motivational profiles were found among medical specialists, differing in gender, experience and type of specialization. The profiles are based on the combination of autonomous motivation (AM) and controlled motivation (CM) in the specialists. The profiles that have a high score on autonomous motivation have a positive association with lifelong learning.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Asthma management in a specialist setting: Results of an Italian Respiratory Society survey.

PubMed

Braido, Fulvio; Baiardini, Ilaria; Alleri, Pietro; Bacci, Elena; Barbetta, Carlo; Bellocchia, Michela; Benfante, Alida; Blasi, Francesco; Bucca, Caterina; Busceti, Maria Teresa; Centanni, Stefano; Colanardi, Maria Cristina; Contoli, Marco; Corsico, Angelo; D'Amato, Maria; Di Marco, Fabiano; Marco, Dottorini; Ferrari, Marta; Florio, Giovanni; Fois, Alessandro Giuseppe; Foschino Barbaro, Maria Pia; Silvia, Garuti; Girbino, Giuseppe; Grosso, Amelia; Latorre, Manuela; Maniscalco, Sara; Mazza, Francesco; Mereu, Carlo; Molinengo, Giorgia; Ora, Josuel; Paggiaro, Pierluigi; Patella, Vincenzo; Pelaia, Girolamo; Pirina, Pietro; Proietto, Alfio; Rogliani, Paola; Santus, Pierachille; Scichilone, Nicola; Simioli, Francesca; Solidoro, Paolo; Terraneo, Silvia; Zuccon, Umberto; Canonica, Giorgio Walter

2017-06-01

Asthma considerably impairs patients' quality of life and increases healthcare costs. Severity, morbidity, and degree of disease control are the major drivers of its clinical and economic impact. National scientific societies are required to monitor the application of international guidelines and to adopt strategies to improve disease control and better allocate resources. to provide a detailed picture of the characteristics of asthma patients and modalities of asthma management by specialists in Italy and to develop recommendations for the daily management of asthma in a specialist setting. A quantitative research program was implemented. Data were collected using an ad hoc questionnaire developed by a group of specialists selected by the Italian Pneumology Society/Italian Respiratory Society. The records of 557 patients were analyzed. In the next few years, specialists are expected to focus their activity patients with more severe disease and will be responsible for selection of patients for personalized biological therapy; however, only 20% of patients attending Italian specialist surgery can be considered severe. In 84.4% of cases, the visit was a follow-up visit requested in 82.2% of cases by the specialist him/herself. The Asthma Control Test is used only in 65% of patients. When available, a significant association has been observed between the test score and asthma control as judged by the physician, although concordance was only moderate (κ = 0.68). Asthma was considered uncontrolled by the specialist managing the case in 29.1% of patients; nevertheless, treatment was not stepped up in uncontrolled or partly controlled patients (modified in only 37.2% of patients). The results of this survey support re-evaluation of asthma management by Italian specialists. More resources should be made available for the initial visit and for more severely ill patients. In addition, more extensive use should be made of validated tools, and available drugs should be used more appropriately. Copyright © 2017 Elsevier Ltd. All rights reserved.

Impact of referral letters on scheduling of hospital appointments: a randomised control trial.

PubMed

Jiwa, Moyez; Meng, Xingqiong; O'Shea, Carolyn; Magin, Parker; Dadich, Ann; Pillai, Vinita

2014-07-01

Communication is essential for triage, but intervention trials to improve it are scarce. Referral Writer (RW), a referral letter software program, enables documentation of clinical data and extracts relevant patient details from clinical software. To evaluate whether specialists are more confident about scheduling appointments when they receive more information in referral letters. Single-blind, parallel-groups, controlled design with a 1:1 randomisation. Australian GPs watched video vignettes virtually. GPs wrote referral letters after watching vignettes of patients with cancer symptoms. Letter content was scored against a benchmark. The proportions of referral letters triagable by a specialist with confidence, and in which the specialist was confident the patient had potentially life-limiting pathology were determined. Categorical outcomes were tested with χ(2) and continuous outcomes with t-tests. A random-effects logistic model assessed the influence of group randomisation (RW versus control), GP demographics, clinical specialty, and specialist referral assessor on specialist confidence in the information provided. The intervention (RW) group referred more patients and scored significantly higher on information relayed (mean difference 21.6 [95% confidence intervals {CI} = 20.1 to 23.2]). There was no difference in the proportion of letters for which specialists were confident they had sufficient information for appointment scheduling (RW 77.7% versus control 80.6%, P = 0.16). In the logistic model, limited agreement among specialists contributed substantially to the observed differences in appointment scheduling (P = 35% [95% CI 16% to 59%]). In isolation, referral letter templates are unlikely to improve the scheduling of specialist appointments, even when more information is relayed. © British Journal of General Practice 2014.

Human factors for air traffic control specialists : a user's manual for your brain

DOT National Transportation Integrated Search

1999-11-01

This document presents the findings of human factors research and other information useful to air traffic control specialists in a succinct and easy-to-read format. Topics include: controller-pilot voice communications, memory, fatigue and the effect...

Human factors for air traffic control specialists: a user's manual for your brain.

DOT National Transportation Integrated Search

1999-11-01

This document presents the findings of human factors research and other information useful to air traffic control specialists in a succinct and easy-to-read format. Topics include: controller-pilot voice communications, memory, fatigue, and the effec...

Toward the development of a new selection battery for air traffic control specialists.

DOT National Transportation Integrated Search

1979-09-01

In an effort to update and refine the selection battery for air traffic controllers, five experimental tests measuring aptitudes and skills considered important in air traffic work were administered to newly selected Air Traffic Control Specialist (A...

Manpower Requirements for Air Traffic Control and Flight Service Specialists in Indiana.

ERIC Educational Resources Information Center

Purdue Univ., Lafayette, IN. Office of Manpower Studies.

As of January 1, 1968 the Federal Aviation Administration (FAA) of the United States Department of Transportation employed 6,963 controllers in airport towers, 7,617 controllers in Air Route Traffic Control Centers, and 4,459 flight service specialists at airport locations. Projected needs are as follows: (1) Controllers in airport towers:…

Evaluation of an alternative method for hiring air traffic control specialists with prior military experience.

DOT National Transportation Integrated Search

1992-01-01

This study was conducted to assess an FAA program to hire former military air traffic control specialists to enter ATC field training directly without first attending the Academy screening program. Selection of military controllers was based on meeti...

Air traffic control specialist performance measurement database.

DOT National Transportation Integrated Search

1999-06-01

The Air Traffic Control Specialist (ATCS) Performance Measurement Database is a compilation of performance measures and : measurement techniques that researchers have used. It may be applicable to other human factor research related to air traffic co...

Childhood Attention-Deficit/Hyperactivity Disorder Prescribing by Prescriber Type and Specialty in Oregon Medicaid.

PubMed

Klein, Tracy A; Panther, Shannon; Woo, Teri; Odom-Maryon, Tamara; Daratha, Kenn

2016-08-01

This study compares nurse practitioner (NP) and physician (MD/DO) prescribing patterns for treatment of children with an attention-deficit/hyperactivity disorder (ADHD)-related diagnosis covered by Oregon Medicaid from 2012 to 2013. This study is a limited data set review of Oregon pharmacy claims for youth aged 3-18 at time of prescription fill, who were continuously enrolled for at least 10 months of the index year. Claims with selected ICD-9 codes (n = 197,364) were further defined by 30-day prescriptions and prescription drug events (PDE) linked to each prescriber type of interest. Descriptive statistical analysis of variables included prescriber type (NP vs. physician) and specialty (generalist vs. specialist), child age, and controlled versus noncontrolled drug type. A total of 82,754 complete 30-day prescriptions for 10,753 children from 1785 unique prescribers (78 NP specialists; 303 NP generalists; 162 physician specialists; and 1242 physician generalist prescribers) and 16,669 PDE were analyzed. Physicians prescribed more than 81% of all ADHD medications, and physician generalists prescribed nearly 60% of all prescriptions. Sixty-four percent of 30-day supply prescriptions (n = 52,678) were controlled substances. Generalists, both NPs and physician prescribers, prescribed controlled medications more often than specialists. Physician specialists consistently prescribed controlled substances for all age groups, while NP specialists prescribed more controlled substances as child age increased. Rates of controlled medications prescribed generally increased, as children got older, regardless of provider type. NPs overall prescribe in a similar pattern to physicians when given the authority to prescribe controlled substances for ADHD. Comparisons between prescriber types for controlled substance prescribing by age should be explored further to identify possible variance from national guidelines.

Impact of referral letters on scheduling of hospital appointments: a randomised control trial

PubMed Central

Jiwa, Moyez; Meng, Xingqiong; O’Shea, Carolyn; Magin, Parker; Dadich, Ann; Pillai, Vinita

2014-01-01

Background Communication is essential for triage, but intervention trials to improve it are scarce. Referral Writer (RW), a referral letter software program, enables documentation of clinical data and extracts relevant patient details from clinical software. Aim To evaluate whether specialists are more confident about scheduling appointments when they receive more information in referral letters. Design and setting Single-blind, parallel-groups, controlled design with a 1:1 randomisation. Australian GPs watched video vignettes virtually. Method GPs wrote referral letters after watching vignettes of patients with cancer symptoms. Letter content was scored against a benchmark. The proportions of referral letters triagable by a specialist with confidence, and in which the specialist was confident the patient had potentially life-limiting pathology were determined. Categorical outcomes were tested with χ2 and continuous outcomes with t-tests. A random-effects logistic model assessed the influence of group randomisation (RW versus control), GP demographics, clinical specialty, and specialist referral assessor on specialist confidence in the information provided. Results The intervention (RW) group referred more patients and scored significantly higher on information relayed (mean difference 21.6 [95% confidence intervals {CI} = 20.1 to 23.2]). There was no difference in the proportion of letters for which specialists were confident they had sufficient information for appointment scheduling (RW 77.7% versus control 80.6%, P = 0.16). In the logistic model, limited agreement among specialists contributed substantially to the observed differences in appointment scheduling (P = 35% [95% CI 16% to 59%]). Conclusion In isolation, referral letter templates are unlikely to improve the scheduling of specialist appointments, even when more information is relayed. PMID:24982494

Air traffic control specialist decision making and strategic planning : a field survey

DOT National Transportation Integrated Search

2001-03-01

This study investigated Air Traffic Control Specialists' perspective regarding decision making and planning and related cognitive processes such as learning, memory, and situation awareness. The results of 100 semi-structured interviews indicated tha...

Organizational Analysis of Food Service Management

DTIC Science & Technology

2011-06-01

35  d.  Senior Culinary Specialists on “Twilight” Tour ...................35  e.  NAVSUP Controls Quality of Life...Supply Centers COMSUBFOR Commander Submarine Force CS Culinary Specialist CSCS Culinary Specialist Senior Chief CVN Carrier Vessel Nuclear DDG Guided...attention of the Culinary Specialists. The type of assist visit can be tailored to the requirements identified by the requesting command. Normally

The relationships between chronological age, length of experience, and job performance ratings of air route traffic control specialists.

DOT National Transportation Integrated Search

1967-06-01

The survey-type study of several hundred journeymen radar control specialists of four Air Route Traffic Control Centers was conducted in order to determine the extent to which job performance might be associative with chronological age and length of ...

Ophthalmic requirements and considerations for the en route air traffic control specialist : an ergonomic analysis of the visual work environment.

DOT National Transportation Integrated Search

1996-04-01

The Federal Air Surgeon requested continued investigation of visual disorders and vision corrective devices as to their relevance to the medical certification of airmen and controllers. The en route Air Traffic Control Specialist (ATCS) works with a ...

Three studies of biographical factors associated with success in air traffic control specialist screening/training at the FAA Academy.

DOT National Transportation Integrated Search

1983-04-01

The current Air Traffic Control Specialist (ATCS) selection procedure requires that all applicants pass the Office of Personnel Management (OPM) air traffic control aptitude test. In addition to the test scores, applicants may also receive points for...

NASA/ESA CV-990 Spacelab Simulation (ASSESS 2)

NASA Technical Reports Server (NTRS)

1977-01-01

Cost effective techniques for addressing management and operational activities on Spacelab were identified and analyzed during a ten day NASA-ESA cooperative mission with payload and flight responsibilities handled by the organization assigned for early Spacelabs. Topics discussed include: (1) management concepts and interface relationships; (2) experiment selection; (3) hardware development; (4) payload integration and checkout; (5) selection and training of mission specialists and payload specialists; (6) mission control center/payload operations control center interactions with ground and flight problems; (7) real time interaction during flight between principal investigators and the mission specialist/payload specialist flight crew; and (8) retrieval of scientific data and its analysis.

Negotiating jurisdiction in the workplace: a multiple-case study of nurse prescribing in hospital settings.

PubMed

Kroezen, M; Mistiaen, P; van Dijk, L; Groenewegen, P P; Francke, A L

2014-09-01

This paper reports on a multiple-case study of prescribing by nurse specialists in Dutch hospital settings. Most analyses of interprofessional negotiations over professional boundaries take a macro sociological approach and ignore workplace jurisdictions. Yet boundary blurring takes place and healthcare professionals renegotiate formal policies in the workplace. This paper studies the division of jurisdictional control over prescribing between nurse specialists and medical specialists in the workplace, and examines the relationship between workplace jurisdiction and legal jurisdiction over prescribing. Data collection took place in the Netherlands during the first half of 2013. The study used in-depth interviews with fifteen nurse specialists and fourteen medical specialists, non-participant observation of nurse specialists' prescribing consultations and document analysis. Great variety was found in the extent to which and way in which nurse specialists' legal prescriptive authority had been implemented. These findings suggest that there is considerable discrepancy between the division of jurisdictional control over prescribing at the macro (legal) level and the division at the micro (workplace) level. Copyright © 2014 Elsevier Ltd. All rights reserved.

78 FR 23548 - Draft Supplemental Environmental Impact Statement for the Long-Term Management and Storage of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-19

... Control Specialists, LLC, site near Andrews, Texas. Since publication of the 2011 Mercury Storage EIS, DOE... identified the Waste Control Specialists, LLC location near Andrews, Texas, as the Preferred Alternative in...

EPA's Review of DOE's Inventory Tracking for TRU Wastes at Waste Control Specialists

EPA Pesticide Factsheets

On April 9, 2014, EPA's Waste Isolation Pilot Plant (WIPP) waste characterization team visited Waste Control Specialists (WCS) to determine whether DOE was meeting EPA's waste inventory tracking requirements at 40 CFR 194.24(c)(4).

Development, validation, and fairness of a biographical data questionnaire for the air traffic control specialist occupation.

DOT National Transportation Integrated Search

2012-12-01

Development and validation of a biographical data (biodata) instrument for selection into the Air Traffic : Control Specialist occupation is described. Bootstrapping was used to estimate correlations between item : responses to the Applicant Ba...

Incremental Validity of Biographical Data in the Prediction of En Route Air Traffic Control Specialist Technical Skills

DOT National Transportation Integrated Search

2012-07-01

Previous research demonstrated that an empirically-keyed, response-option scored biographical data (biodata) : scale predicted supervisory ratings of air traffic control specialist (ATCS) job performance (Dean & Broach, : 2011). This research f...

Validity of clinical color vision tests for air traffic control specialists.

DOT National Transportation Integrated Search

1992-10-01

An experiment on the relationship between aeromedical color vision screening test performance and performance on color-dependent tasks of Air Traffic Control Specialists was replicated to expand the data base supporting the job-related validity of th...

Studies of poststrike air traffic control specialist trainees. II., Selection and screening programs.

DOT National Transportation Integrated Search

1988-07-01

Specific contributions of aviation psychologists to the selection and Academy training of FAA air traffic control specialists are presented in an historical context. Research results which formed the basis for the written aptitude selection tests, Th...

Problems in air traffic management. VII., Job training performance of air traffic control specialists - measurement, structure, and prediction.

DOT National Transportation Integrated Search

1965-07-01

A statistical study of training- and job-performance measures of several hundred Air Traffic Control Specialists (ATCS) representing Enroute, Terminal, and Flight Service Station specialties revealed that training-performance measures reflected: : 1....

Performance of air traffic control specialists (ATCS'S) on a laboratory radar monitoring task : an exploratory study of complacency and a comparison of ATCS and non-ATCS performance.

DOT National Transportation Integrated Search

1982-04-01

The role of the air traffic control specialist (ATCS) is proposed highly automated air traffic systems of the future is currently receiving considerable attention. At the present time, a prevalent conception of the controller's role in such systems i...

Validation of the Federal Aviation Administration Air Traffic Control Specialist Pre-Training Screen.

DOT National Transportation Integrated Search

1994-02-01

Two formal validation studies of the Air Traffic Control Specialist Pre Training Screen (ATCS/PTS), a 5 day computer administered test battery, are described. The ATCS/PTS was designed to replace the 9 week US Federal Aviation Administration (FAA) Ac...

A formative evaluation of the collegiate training initiative--air traffic control specialist (CTI-ATCS) program.

DOT National Transportation Integrated Search

1996-02-01

This report describes the initial formative evaluation of the Federal Aviation Administration (FAA) College Training Initiative - Air Traffic Control Specialist (CTI-ATCS) Program. The purpose of the CTI-ATCS program is to test "the concept that non-...

Fidelity of Implementation in Project Towards No Drug Abuse (TND): A Comparison of Classroom Teachers and Program Specialists

PubMed Central

Dent, Clyde W.; Skara, Silvana; Sun, Ping; Sussman, Steve

2011-01-01

This paper presents the results of an effectiveness trial of Project Towards No Drug Abuse [TND], in which we compared program delivery by regular classroom teachers and program specialists within the same high schools. Within 18 schools that were randomly assigned to the program or control conditions, health classrooms were assigned to program delivery by teachers or (outside) specialists. Classroom sessions were observed by pairs of observers to assess three domains of implementation fidelity: adherence, classroom process, and perceived student acceptance of the program. Pre- and immediate posttest survey data were collected from 2331 students. Of the four composite indexes of implementation fidelity that were examined, only one (quality of delivery) showed a difference between specialists and teachers, with marginally higher ratings of specialists (p < .10). Both teachers and program specialists achieved effects on three of the five immediate outcome measures, including program-specific knowledge, addiction concern, and social self-control. Students’ posttest ratings of the program overall and the quality of program delivery failed to reveal differences between the teacher- and specialist-led classrooms. These results suggest that motivated, trained classroom teachers can implement evidence-based prevention programs with fidelity and achieve immediate effects. PMID:17180722

[Research activity in clinical biochemistry].

PubMed

Jørgensen, Henrik L; Larsen, Birger; Ingwersen, Peter; Rehfeld, Jens F

2008-09-01

Quantitative bibliometric measurements of research activity are frequently used, e.g. for evaluating applicants for academic positions. The purpose of this investigation is to assess research activity within the medical speciality of Clinical Biochemistry by comparing it with a matched control group from other medical specialities in Denmark. A list of all physicians registered in Denmark (23,127 persons) was drawn from the database "Laeger.dk". Of these, 5,202 were generalists (not included) while 11,691 were from other specialities. Of the 126 specialists from Clinical Biochemistry, 57 fulfilled the inclusion criteria. Each of these 57 was matched according to medical title with two randomly chosen specialists from other specialities, totaling 114. Using Medline and the Web of Science, the number of publications and the number of citations were then ascertained. 25% of the 11,691 specialists held a PhD degree or doctoral degree, DMSci, (Clinical Biochemistry: 61%). The 171 specialists included in the study had 9,823 papers in Medline and 10,140 papers in the Web of Science. The number of Medline papers per specialist was 71 for Clinical Biochemistry compared to 51 for the control group. The number of citations per specialist was 1,844 for Clinical Biochemistry compared to 816 for the control group. The top ten H-indices (of which 8 were in Clinical Biochemistry) ranged from 30 to 69. Both the number of papers and the number of citations were higher for Clinical Biochemistry than for the control group. The difference was most pronounced among professors.

Association between the 2012 Health and Social Care Act and specialist visits and hospitalisations in England: A controlled interrupted time series analysis.

PubMed

Lopez Bernal, James A; Lu, Christine Y; Gasparrini, Antonio; Cummins, Steven; Wharam, J Frank; Soumerai, Steven B

2017-11-01

The 2012 Health and Social Care Act (HSCA) in England led to among the largest healthcare reforms in the history of the National Health Service (NHS). It gave control of £67 billion of the NHS budget for secondary care to general practitioner (GP) led Clinical Commissioning Groups (CCGs). An expected outcome was that patient care would shift away from expensive hospital and specialist settings, towards less expensive community-based models. However, there is little evidence for the effectiveness of this approach. In this study, we aimed to assess the association between the NHS reforms and hospital admissions and outpatient specialist visits. We conducted a controlled interrupted time series analysis to examine rates of outpatient specialist visits and inpatient hospitalisations before and after the implementation of the HSCA. We used national routine hospital administrative data (Hospital Episode Statistics) on all NHS outpatient specialist visits and inpatient hospital admissions in England between 2007 and 2015 (with a mean of 26.8 million new outpatient visits and 14.9 million inpatient admissions per year). As a control series, we used equivalent data on hospital attendances in Scotland. Primary outcomes were: total, elective, and emergency hospitalisations, and total and GP-referred specialist visits. Both countries had stable trends in all outcomes at baseline. In England, after the policy, there was a 1.1% (95% CI 0.7%-1.5%; p < 0.001) increase in total specialist visits per quarter and a 1.6% increase in GP-referred specialist visits (95% CI 1.2%-2.0%; p < 0.001) per quarter, equivalent to 12.7% (647,000 over the 5,105,000 expected) and 19.1% (507,000 over the 2,658,000 expected) more visits per quarter by the end of 2015, respectively. In Scotland, there was no change in specialist visits. Neither country experienced a change in trends in hospitalisations: change in slope for total, elective, and emergency hospitalisations were -0.2% (95% CI -0.6%-0.2%; p = 0.257), -0.2% (95% CI -0.6%-0.1%; p = 0.235), and 0.0% (95% CI -0.5%-0.4%; p = 0.866) per quarter in England. We are unable to exclude confounding due to other events occurring around the time of the policy. However, we limited the likelihood of such confounding by including relevant control series, in which no changes were seen. Our findings suggest that giving control of healthcare budgets to GP-led CCGs was not associated with a reduction in overall hospitalisations and was associated with an increase in specialist visits.

Association between the 2012 Health and Social Care Act and specialist visits and hospitalisations in England: A controlled interrupted time series analysis

PubMed Central

Lu, Christine Y.; Wharham, J. Frank; Soumerai, Steven B.

2017-01-01

Background The 2012 Health and Social Care Act (HSCA) in England led to among the largest healthcare reforms in the history of the National Health Service (NHS). It gave control of £67 billion of the NHS budget for secondary care to general practitioner (GP) led Clinical Commissioning Groups (CCGs). An expected outcome was that patient care would shift away from expensive hospital and specialist settings, towards less expensive community-based models. However, there is little evidence for the effectiveness of this approach. In this study, we aimed to assess the association between the NHS reforms and hospital admissions and outpatient specialist visits. Methods and findings We conducted a controlled interrupted time series analysis to examine rates of outpatient specialist visits and inpatient hospitalisations before and after the implementation of the HSCA. We used national routine hospital administrative data (Hospital Episode Statistics) on all NHS outpatient specialist visits and inpatient hospital admissions in England between 2007 and 2015 (with a mean of 26.8 million new outpatient visits and 14.9 million inpatient admissions per year). As a control series, we used equivalent data on hospital attendances in Scotland. Primary outcomes were: total, elective, and emergency hospitalisations, and total and GP-referred specialist visits. Both countries had stable trends in all outcomes at baseline. In England, after the policy, there was a 1.1% (95% CI 0.7%–1.5%; p < 0.001) increase in total specialist visits per quarter and a 1.6% increase in GP-referred specialist visits (95% CI 1.2%–2.0%; p < 0.001) per quarter, equivalent to 12.7% (647,000 over the 5,105,000 expected) and 19.1% (507,000 over the 2,658,000 expected) more visits per quarter by the end of 2015, respectively. In Scotland, there was no change in specialist visits. Neither country experienced a change in trends in hospitalisations: change in slope for total, elective, and emergency hospitalisations were −0.2% (95% CI −0.6%–0.2%; p = 0.257), −0.2% (95% CI −0.6%–0.1%; p = 0.235), and 0.0% (95% CI −0.5%–0.4%; p = 0.866) per quarter in England. We are unable to exclude confounding due to other events occurring around the time of the policy. However, we limited the likelihood of such confounding by including relevant control series, in which no changes were seen. Conclusions Our findings suggest that giving control of healthcare budgets to GP-led CCGs was not associated with a reduction in overall hospitalisations and was associated with an increase in specialist visits. PMID:29135978

Evaluation of functional color vision requirements and current color vision screening tests for air traffic control specialists.

DOT National Transportation Integrated Search

1990-08-01

An experiment was conducted to evaluate the relation of type and degree of color vision deficiency and aeromedical color vision screening test scores to performance of color-dependent tasks of Air Traffic Control Specialists. The subjects included 37...

STS-98 Flight Control Team Photo in the WFCR

NASA Image and Video Library

2001-01-08

JSC2001-00001 (January 2001) --- The STS-98 astronaut crew poses with about five dozen flight controllers making up its ascent/entry team in the shuttle flight control room of the Johnson Space Center's Mission Control Center (MCC). Standing with the STS-98 insignia is flight director LeRoy Cain. He is flanked by astronauts Marsha S. Ivins, mission specialist, and Kenneth D. Cockrell, mission commander. Behind Cockrell is astronaut Robert L. Curbeam, Jr., mission specialist; and behind Ivins and Cain is astronaut Mark L. Polansky, pilot. Astronaut Thomas D. Jones, mission specialist (blue shirt) stands near the flight director sign. Astronaut Scott D. Altman, CAPCOM or Spacecraft Communicator, is immediately behind Cain. Launch is currently scheduled for February 6, 2001.

[The fiscal position of medical specialists].

PubMed

Stevens, S; Moors, M

2013-01-01

Independent medical specialists in the Netherlands are treated as entrepreneurs for tax purposes and therefore enjoy tax benefits. A change in the legal relationship between medical specialists and hospitals is foreseen in 2015. Independent medical specialists will then no longer be considered to be entrepreneurs. This could negatively affect their tax position. The Dutch government has adopted a policy aimed at controlling expenses arising from medical specialists' fees. According to this policy, the formation of regional practices or mega-practices of specialists will be discouraged. In contrast, the current fiscal legislation encourages medical specialists to incorporate their practice into regional practices or mega-practices or to become shareholders of their hospitals. It has been proposed that fiscal benefits be linked to certain aspects of entrepreneurship, such as investing in medical equipment or employing medical personnel.

A facility specialist model for improving retention of nursing home staff: results from a randomized, controlled study.

PubMed

Pillemer, Karl; Meador, Rhoda; Henderson, Charles; Robison, Julie; Hegeman, Carol; Graham, Edwin; Schultz, Leslie

2008-07-01

This article reports on a randomized, controlled intervention study designed to reduce employee turnover by creating a retention specialist position in nursing homes. We collected data three times over a 1-year period in 30 nursing homes, sampled in stratified random manner from facilities in New York State and Connecticut and randomly assigned to treatment and control conditions. Staff outcomes were measured through certified nursing assistant interviews, and turnover rates were measured over the course of the year. In the intervention condition, a staff member was selected to be the facility retention specialist, who would advocate for and implement programs to improve staff retention and commitment throughout the facility. Retention specialists received an intensive 3-day training in retention leadership and in a number of evidence-based retention programs. Ongoing support was provided throughout the project. Treatment facilities experienced significant declines in turnover rates compared to control facilities. As predicted, we found positive effects on certified nursing assistant assessments of the quality of retention efforts and of care provided in the facility; we did not find effects for job satisfaction or stress. The study provides evidence for the effectiveness of the retention specialist model. Findings from a detailed process evaluation suggest modifications of the program that may increase program effects.

Internal Corrosion Control of Water Supply Systems Code of Practice

EPA Science Inventory

This Code of Practice is part of a series of publications by the IWA Specialist Group on Metals and Related Substances in Drinking Water. It complements the following IWA Specialist Group publications: 1. Best Practice Guide on the Control of Lead in Drinking Water 2. Best Prac...

Validity of the air traffic control specialist nonradar screen as a predictor of performance in radar based ATC training.

DOT National Transportation Integrated Search

1994-04-01

Between January 1986 and March 1992, the Federal Aviation Administration's 42-day Nonradar Screen was used to identify Air Traffic Control Specialist (ATCS) candidates with the highest potential to succeed in the rigorous ATCS field training program....

Problems in air traffic management. VI., Interaction of training-entry age with intellectual and personality characteristics of air traffic control specialists.

DOT National Transportation Integrated Search

1965-07-01

Over 900 Enroute and Terminal Air Traffic Controller Specialist (ATCS) trainees were administered a large number of aptitude and personality tests. Examination of the relationships between the performance scores and age at entry into training reveale...

Performance of color-dependent tasks of air traffic control specialists as a function of type and degree of color vision deficiency.

DOT National Transportation Integrated Search

1992-08-01

This experiment was conducted to expand initial efforts to validate the requirement for normal color vision in Air Traffic Control Specialist (ATCS) personnel who work at en route center, terminal, and flight service station facilities. An enlarged d...

The selection of air traffic control specialists : two studies demonstrating methods to insure an accurate validity coefficient for selection devices.

DOT National Transportation Integrated Search

1979-03-01

There are several conditions that can influence the calculation of the statistical validity of a test battery such as that used to selected Air Traffic Control Specialists. Two conditions of prime importance to statistical validity are recruitment pr...

Differential prediction of FAA Academy performance on the basis of gender and written air traffic control specialist aptitude test scores.

DOT National Transportation Integrated Search

1996-04-01

The technical fairness of the written air traffic control specialist (ATCS) aptitude test battery was investigated within the framework of the Uniform Guidelines on Employee Selection Procedures (29 CFR 1607). First, the adverse impact of using a com...

Differences in quality standards when prescribing nutritional support: Differences between specialist and non-specialist physicians.

PubMed

Morán López, Jesús Manuel; Piedra León, María; Enciso Izquierdo, Fidel Jesús; Luengo Pérez, Luis Miguel; Amado Señaris, José Antonio

2016-01-01

Adequate nutritional support includes many different aspects, but poor understanding of clinical nutrition by health care professionales often results in an inadequate prescription. A study was conducted to compare enteral and parenteral nutritional support plans prescribed by specialist and non-specialist physicians. Non-specialist physicians recorded anthropometric data from only 13.3% of patients, and none of them performed nutritional assessments. Protein amounts provided by non-specialist physicians were lower than estimated based on ESPEN (10.29g of nitrogen vs 14.62; P<.001). Differences were not statistically significant in the specialist group (14.88g of nitrogen; P=.072). Calorie and glutamine provision and laboratory controls prescribed by specialists were significantly closer to those recommended by clinical guidelines. Nutritional support prescribed by specialists in endocrinology and nutrition at San Pedro de Alcántara Hospital was closer to clinical practice guideline standards and of higher quality as compared to that prescribed by non-specialists. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Studies of poststrike air traffic control specialist trainees. I., Age, biographic factors, and selection test performance related to academy training success.

DOT National Transportation Integrated Search

1984-06-01

The August 1981 strike of air traffic control specialists (ATCS's) and their subsequent firing led to the air traffic strike recovery program, which included the unprecedented hiring and basic training of over 8,000 ATCS applicants in a 2-year period...

Comparison of performance on the Shipley Institute of Living Scale, air traffic control specialist selection test, and FAA Academy screen.

DOT National Transportation Integrated Search

1992-11-01

This study was conducted to establish norms for ATCS personnel on a group test of intellectual functioning, the Shipley Institute of Living Scale (SILS), to screen subjects for future research on the effects of Air Traffic Control Specialist (ATCS) r...

An EHR Prototype Using Structured ISO/EN 13606 Documents to Respond to Identified Clinical Information Needs of Diabetes Specialists: A Controlled Study on Feasibility and Impact

PubMed Central

Huebner-Bloder, Gudrun; Duftschmid, Georg; Kohler, Michael; Rinner, Christoph; Saboor, Samrend; Ammenwerth, Elske

2012-01-01

Cross-institutional longitudinal Electronic Health Records (EHR), as introduced in Austria at the moment, increase the challenge of information overload of healthcare professionals. We developed an innovative cross-institutional EHR query prototype that offers extended query options, including searching for specific information items or sets of information items. The available query options were derived from a systematic analysis of information needs of diabetes specialists during patient encounters. The prototype operates in an IHE-XDS-based environment where ISO/EN 13606-structured documents are available. We conducted a controlled study with seven diabetes specialists to assess the feasibility and impact of this EHR query prototype on efficient retrieving of patient information to answer typical clinical questions. The controlled study showed that the specialists were quicker and more successful (measured in percentage of expected information items found) in finding patient information compared to the standard full-document search options. The participants also appreciated the extended query options. PMID:23304308

Consumer satisfaction among patients and their general practitioners about involving nurse specialists in primary care for patients with urinary incontinence.

PubMed

Albers-Heitner, Pytha; Winkens, Ron; Berghmans, Bary; Joore, Manuela; Nieman, Fred; Severens, Johan; Lagro-Janssen, Toine

2013-06-01

Urinary incontinence (UI) is a very common problem, but existing guidelines on UI are not followed. To bring care in line with guidelines, we planned an intervention to involve nurse specialists on UI in primary care and assessed this in a randomised controlled trial. Alongside this intervention, we assessed consumer satisfaction among patients and general practitioners (GPs). Patients' satisfaction with the care provided by either nurse specialists (intervention group) or GPs (control group), respectively, was measured with a self-completed questionnaire. GPs' views on the involvement of nurse specialists were measured in a structured telephone interview. The patient satisfaction score on the care offered by nurse specialists was 8.4 (scale 1-10), vs. 6.7 for care-as-usual by GPs. Over 85% of patients would recommend nurse specialist care to their best friends and 77% of the GPs considered the role of the nurse specialist to be beneficial, giving it a mean score of 7.2. Although the sample was relatively small and the stability of the results only provisionally established, substituting UI care from GP to nurse specialist appears to be welcomed by both patients and GPs. Small changes like giving additional UI-specific information and devoting more attention to UI (which had been given little attention before) would provide a simple instrument to stimulate patients to change their behaviour in the right direction. © 2012 Nordic College of Caring Science.

International Atomic Energy Agency specialists meeting on experience in ageing, maintenance, and modernization of instrumentation and control systems for improving nuclear power plant availability

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

Not Available

1993-10-01

This report presents the proceedings of the Specialist`s Meeting on Experience in Aging, Maintenance and Modernization of Instrumentation and Control Systems for Improving Nuclear Power Plant Availability that was held at the Ramada Inn in Rockville, Maryland on May 5--7, 1993. The Meeting was presented in cooperation with the Electric Power Research Institute, Oak Ridge National Laboratory and the International Atomic Energy Agency. There were approximately 65 participants from 13 countries at the Meeting. Individual reports have been cataloged separately.

Preferential edge habitat colonization by a specialist weevil, Rhinoncomimus latipes (Coleoptera: Curculionidae)

Treesearch

J.A. Hough-Goldstein; E. Lake; V. D' Amico; S.H. Berg

2012-01-01

Understanding the behavioral basis of dispersal and colonization is critical in biological control systems, where success of a natural enemy depends in part on its ability to find and move to new host patches. We studied behavior of the specialist weevil Rhinoncomimus latipes Korotyaev, a biological control agent of mile-a-minute weed, ...

Problems in air traffic management. IV., Comparison of pre-employment, job-related experience with aptitude tests as predictors of training and job performance of air traffic control specialists.

DOT National Transportation Integrated Search

1963-12-01

In addition to passing a second class aviation medical examination, individuals applying for training as an Air Traffic Control Specialist (ATCS) with the Federal Aviation Agency have, in the past, been required to have previous experience which was ...

Impact of the introduction of a specialist critical care pharmacist on the level of pharmaceutical care provided to the critical care unit.

PubMed

Richter, Anja; Bates, Ian; Thacker, Meera; Jani, Yogini; O'Farrell, Bryan; Edwards, Caroline; Taylor, Helen; Shulman, Rob

2016-08-01

To evaluate the impact of a dedicated specialist critical care pharmacist service on patient care at a UK critical care unit (CCU). Pharmacist intervention data was collected in two phases. Phase 1 was with the provision of a non-specialist pharmacist chart review service and Phase 2 was after the introduction of a specialist dedicated pharmacy service. Two CCUs with established critical care pharmacist services were used as controls. The impact of pharmacist interventions on optimising drug therapy or preventing harm from medication errors was rated on a 4-point scale. There was an increase in the mean daily rate of pharmacist interventions after the introduction of the specialist critical care pharmacist (5.45 versus 2.69 per day, P < 0.0005). The critical care pharmacist intervened on more medication errors preventing potential harm and optimised more medications. There was no significant change to intervention rates at the control sites. Across all study sites the majority of pharmacist interventions were graded to have at least moderate impact on patient care. The introduction of a specialist critical care pharmacist resulted in an increased rate of pharmacist interventions compared to a non-specialist pharmacist service thus improving the quality of patient care. © 2016 The Authors. IJPP © 2016 Royal Pharmaceutical Society.

A Facility Specialist Model for Improving Retention of Nursing Home Staff: Results from a Randomized, Controlled Study

ERIC Educational Resources Information Center

Pillemer, Karl; Meador, Rhoda; Henderson, Charles, Jr.; Robison, Julie; Hegeman, Carol; Graham, Edwin; Schultz, Leslie

2008-01-01

Purpose: This article reports on a randomized, controlled intervention study designed to reduce employee turnover by creating a retention specialist position in nursing homes. Design and Methods: We collected data three times over a 1-year period in 30 nursing homes, sampled in stratified random manner from facilities in New York State and…

KSC00pp1761

NASA Image and Video Library

2000-11-18

KENNEDY SPACE CENTER, FLA. -- In Orbiter Processing Facility bay 3, the STS-98 crew talks with United Space Alliance worker Larry Oshein (right). Standing left to right are Mission Specialist Robert Curbeam, Commander Ken Cockrell, Mission Specialist Tom Jones, and Mission Specialists Mark Polansky and Marsha Ivins. The crew is at KSC for Crew Equipment Interface Test activities. Launch on mission STS-98 is scheduled for Jan. 18, 2001. It will be transporting the U.S. Lab, Destiny, to the International Space Station with five system racks already installed inside of the module. After delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated

KSC-00pp1761

NASA Image and Video Library

2000-11-18

KENNEDY SPACE CENTER, FLA. -- In Orbiter Processing Facility bay 3, the STS-98 crew talks with United Space Alliance worker Larry Oshein (right). Standing left to right are Mission Specialist Robert Curbeam, Commander Ken Cockrell, Mission Specialist Tom Jones, and Mission Specialists Mark Polansky and Marsha Ivins. The crew is at KSC for Crew Equipment Interface Test activities. Launch on mission STS-98 is scheduled for Jan. 18, 2001. It will be transporting the U.S. Lab, Destiny, to the International Space Station with five system racks already installed inside of the module. After delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated

Functional specialization in regulation and quality control in thermal adaptive evolution.

PubMed

Yama, Kazuma; Matsumoto, Yuki; Murakami, Yoshie; Seno, Shigeto; Matsuda, Hideo; Gotoh, Kazuyoshi; Motooka, Daisuke; Nakamura, Shota; Ying, Bei-Wen; Yomo, Tetsuya

2015-11-01

Distinctive survival strategies, specialized in regulation and in quality control, were observed in thermal adaptive evolution with a laboratory Escherichia coli strain. The two specialists carried a single mutation either within rpoH or upstream of groESL, which led to the activated global regulation by sigma factor 32 or an increased amount of GroEL/ES chaperonins, respectively. Although both specialists succeeded in thermal adaptation, the common winner of the evolution was the specialist in quality control, that is, the strategy of chaperonin-mediated protein folding. To understand this evolutionary consequence, multilevel analyses of cellular status, for example, transcriptome, protein and growth fitness, were carried out. The specialist in quality control showed less change in transcriptional reorganization responding to temperature increase, which was consistent with the finding of that the two specialists showed the biased expression of molecular chaperones. Such repressed changes in gene expression seemed to be advantageous for long-term sustainability because a specific increase in chaperonins not only facilitated the folding of essential gene products but also saved cost in gene expression compared with the overall transcriptional increase induced by rpoH regulation. Functional specialization offered two strategies for successful thermal adaptation, whereas the evolutionary advantageous was more at the points of cost-saving in gene expression and the essentiality in protein folding. © 2015 The Authors. Genes to Cells published by Molecular Biology Society of Japan and Wiley Publishing Asia Pty Ltd.

Surveying air traffic control specialist perception of scheduling regulations

NASA Astrophysics Data System (ADS)

Thompson, Darrius E.

While there have been several studies conducted on air traffic controller fatigue, there is a lack of research on the subject since the scheduling policy changes that took place in 2012. The effectiveness of these changes has yet to be measured. The goal of this study was to investigate air traffic control specialist views towards the number of hours scheduled between shifts, changes in perception since 2012 regulation changes, and external factors that impact fatigue. A total of 54 FAA air traffic control specialist completed an online questionnaire. The results from the survey showed that the majority of respondents felt the 2012 regulation changes were not sufficient to address fatigue issues, and work with some amount sleep deprivation. The factors that appeared to have the most significant effect on fatigue included facility level, age group, availability of recuperative breaks, and children under 18 in the home.

Parent training for Attention Deficit/Hyperactivity Disorder: is it as effective when delivered as routine rather than as specialist care?

PubMed

Sonuga-Barke, Edmund J S; Thompson, Margaret; Daley, David; Laver-Bradbury, Cathy

2004-11-01

The effectiveness of parent training (PT) when delivered as part of specialist tier-two services for preschool AD/HD children has been recently demonstrated. To assess the effectiveness of the same PT programme when delivered as part of routine primary care by non-specialist nurses. A sample of 89 3-year-old children with preschool AD/HD took part in a controlled trial of an eight-week (one hour a week), health visitor delivered, PT package. Children, allocated randomly to PT (n = 59) and waiting list control (WLC; n = 30) groups, were compared. PT did not reduce AD/HD symptoms. Maternal well-being decreased in both PT and WLC groups. While PT is an effective intervention for preschool AD/HD when delivered in specialized settings, these benefits do not appear to generalize when programme are delivered as part of routine primary care by non-specialist nurses.

Impact of specialist home-based palliative care services in a tertiary oncology set up: a prospective non-randomized observational study.

PubMed

Dhiliwal, Sunil R; Muckaden, Maryann

2015-01-01

Home-based specialist palliative care services are developed to meet the needs of the patients in advanced stage of cancer at home with physical symptoms and distress. Specialist home care services are intended to improve symptom control and quality of life, enable patients to stay at home, and avoid unnecessary hospital admission. Total 690 new cases registered under home-based palliative care service in the year 2012 were prospectively studied to assess the impact of specialist home-based services using Edmonton symptom assessment scale (ESAS) and other parameters. Out of the 690 registered cases, 506 patients received home-based palliative care. 50.98% patients were cared for at home, 28.85% patients needed hospice referral and 20.15% patients needed brief period of hospitalization. All patients receiving specialist home care had good relief of physical symptoms (P < 0.005). 83.2% patients received out of hours care (OOH) through liaising with local general practitioners; 42.68% received home based bereavement care and 91.66% had good bereavement outcomes. Specialist home-based palliative care improved symptom control, health-related communication and psychosocial support. It promoted increased number of home-based death, appropriate and early hospice referral, and averted needless hospitalization. It improved bereavement outcomes, and caregiver satisfaction.

Corrosion Control Specialist Career Ladder AFSC 53530, 53550, 53570, and 53690

DTIC Science & Technology

1975-03-01

AD-AO08 189 CORROSION CONTROL SPECIALIST CAREER LADDER AFSC 53530, 53550, 53570, AND 53690 Air Force Occupational Measurement Center Lackland Air... Force Base, Texas 1 March 1975 I DISTRIBUTED BY: National Technical Information Service U. S. DEPARTMENT OF COMMERCE *I 11 5091 OCCUPATIONAL SURVEY...DISCUSSION OF BACKGROUJND INFORMATION --------------------------- xxvi 01L< R PREFACE This report presents the results cf detailed Air Force

The Development of a Technical Conceptual Structure for the Concepts Possessed by Selected Quality Control Specialists. Report of a Research Project.

ERIC Educational Resources Information Center

Nee, John G.

This project had as its specific objective the development and field testing of a procedure for identifying the structure of technical concepts possessed by a group of selected quality control specialists. The associative theory of verbal behavior served as the rationale by which conceptual structures depicted by graphical maps of technical…

Comparing specialist medical care with specialist medical care plus the Lightning Process for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME): study protocol for a randomised controlled trial (SMILE Trial).

PubMed

Crawley, Esther; Mills, Nicola; Hollingworth, Will; Deans, Zuzana; Sterne, Jonathan A; Donovan, Jenny L; Beasant, Lucy; Montgomery, Alan

2013-12-26

Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a relatively common and potentially serious condition with a limited evidence base for treatment. Specialist treatment for paediatric CFS/ME uses interventions recommended by National Institute for Health and Clinical Excellence (NICE) including cognitive behavioural therapy, graded exercise therapy and activity management. The Lightning Process (LP) is a trademarked intervention derived from osteopathy, life-coaching and neuro-linguistic programming, delivered over three consecutive days as group sessions. Although over 250 children with CFS/ME attend LP courses each year, there are no reported studies on the effectiveness or cost-effectiveness. This pragmatic randomised controlled trial is set within a specialist paediatric CFS/ME service in the south west of England. Children and young people with CFS/ME (n = 80 to 112), aged 12 to 18 years old will be randomised to specialist medical care (SMC) or SMC plus the LP. The primary outcome will be physical function (SF-36 physical function short form) and fatigue (Chalder Fatigue Scale). This study will tell us whether adding the LP to SMC is effective and cost-effective compared to SMC alone. This study will also provide detailed information on the implementation of the LP and SMC. Current Controlled Trials ISRCTN81456207 (31 July 2012).

[Mobile geriatric consultant services for rest homes. Study of the effects of consultations by internal medicine specialists in the medical care of rest home residents].

PubMed

Schippinger, W; Hartinger, G; Hierzer, A; Osprian, I; Bohnstingl, M; Pilgram, E H

2012-12-01

Hospital admissions are frequent among long-term residents of nursing homes and can result in detrimental complications affecting the patients' somatic, psychological, and cognitive status. In this prospective controlled study, we investigated the effects of a mobile geriatric consultant service (GECO) offered by specialists in internal medicine on frequency of hospitalizations in nursing home residents. During a 10-month observation period, residents in a control nursing home received medical attendance by general practitioners as is common in Austrian nursing homes. Residents in the intervention nursing home also received the medical service of GECO. Within the group of rest home residents receiving GECO support, a statistically significant lower frequency of acute transports to hospitals was observed in comparison to residents of the control nursing home (mean number of acute transports to hospitals/100 residents/month: 6.1 versus 11.7; p < 0.01). The number of planned non-acute hospital and specialist office presentations was also lower in the intervention nursing home (mean number of hospital and specialist office presentations/100 residents/month: 14.4 versus 18.0); however, this difference did not reach statistical significance. This study shows that a mobile medical geriatric consultant service based on specialists in internal medicine can improve medical care in nursing homes resulting in a statistically significant reduction of acute transports to hospitals.

Basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations.

PubMed

Orozco-Beltran, D; Pan, C; Svendsen, A L; Faerch, L; Caputo, S

2016-03-01

To investigate the effect of healthcare provider (HCP) type (primary vs. specialist) on glycaemic control and other treatment parameters. Study of Once-Daily Levemir (SOLVE(™) ) is an international, 24-week, observational study of insulin initiation in people with type 2 diabetes. A total of 17,374 subjects were included, comprising 4144 (23.9%) primary care subjects. Glycaemic control improved in both HCP groups from baseline to final visit [glycated haemoglobin (HbA1c) -1.2 ± 1.4% (-13.1 ± 15.3 mmol/mol) and -1.3 ± 1.6% (-14.2 ± 17.5 mmol/mol), respectively]. After adjustment for known confounders, there was no statistically significant effect of HCP group on final HbA1c [-0.04%, 95% confidence interval (CI) -0.09 to -0.01 (-0.4 mmol/mol, 95% CI -1.0-0.1 mmol/mol), p = 0.1590]. However, insulin doses at the final visit were higher in primary care patients (+0.06, 95% CI 0.06-0.07 U/kg, p < 0.0001). Logistic regression demonstrated a significant effect of HCP type (primary vs. specialist care) on hypoglycaemia risk [odds ratio (OR) 0.75, 95% CI 0.64-0.87, p = 0.0002]. Primary care physicians took more time to train patients and had more frequent contact with patients than specialists (both p < 0.0001). Primary care physicians and specialists achieved comparable improvements in glycaemic control following insulin initiation. © 2016 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

Assessing Prior Experience in the Selection of Air Traffic Control Specialists

DTIC Science & Technology

2013-04-01

Crosstabulation --------------------------B1 APPENDIX C: IFR Operations Experience • Academy Training Performance Crosstabulation ---------C1 APPENDIX...Control Specialist (ATCS) rating? (n=9,333) BQ35 – Do you have prior Instrument Flight Rules ( IFR ) operations experience? (n = 9,349) 2. Hold or...not have a prior ATCS rating. Do you have prior IFR (Instrument Flight Rules) Operations experience? Of the 9,349 respondents to this question

Training Medical Specialists to Communicate Better with Patients with Medically Unexplained Physical Symptoms (MUPS). A Randomized, Controlled Trial

PubMed Central

Weiland, Anne; Blankenstein, Annette H.; Van Saase, Jan L. C. M.; Van der Molen, Henk T.; Jacobs, Mariël E.; Abels, Dineke C.; Köse, Nedim; Van Dulmen, Sandra; Vernhout, René M.; Arends, Lidia R.

2015-01-01

Background Patients with medically unexplained physical symptoms (MUPS) are prevalent 25–50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don’t feel understood. We developed an evidence-based communication training, aimed to improve specialists’ interviewing, information-giving and planning skills in MUPS consultations, and tested its effectiveness. Methods The intervention group in this multi-center randomized controlled trial received a 14-hour training program to which experiential learning and feedback were essential. Using techniques from Cognitive Behavioral Therapy, they were stimulated to seek interrelating factors (symptoms, cognitions, emotions, behavior, and social environment) that reinforced a patient’s symptoms. They were taught to explain MUPS understandably, reassure patients effectively and avoid unnecessary diagnostic testing. Before and after the intervention training, specialists videotaped a total of six consultations with different MUPS patients. These were evaluated to assess doctors’ MUPS-focused communicating skills using an adapted version of the Four Habit Coding Scheme on five-point Likert scales. Participants evaluated the training by self-report on three-point Likert scales. Doctors in the control group received training after completion of the study. Results 123 doctors (40% specialists, 60% residents) and 478 MUPS patients from 11 specialties were included; 98 doctors completed the study (80%) and 449 videotaped consultations were assessed. Trained doctors interviewed patients more effectively than untrained ones (p < 0.001), summarized information in a more patient-centered way (p = 0.001), and better explained MUPS and the role of perpetuating factors (p < 0.05). No effects on planning skills were found. On a 3-point scale the training was evaluated with 2.79. Conclusion MUPS-focused communication training increases the interviewing and information-giving skills of medical specialists. We recommend that the training is incorporated in postgraduate education for medical specialists and residents who frequently encounter patients with MUPS. Trial Registration Dutch Trial Registration NTR2612 PMID:26381400

A multicentre non-blinded randomised controlled trial to assess the impact of regular early specialist symptom control treatment on quality of life in malignant mesothelioma (RESPECT-MESO): study protocol for a randomised controlled trial.

PubMed

Gunatilake, Samal; Brims, Fraser J H; Fogg, Carole; Lawrie, Iain; Maskell, Nick; Forbes, Karen; Rahman, Najib; Morris, Steve; Ogollah, Reuben; Gerry, Stephen; Peake, Mick; Darlison, Liz; Chauhan, Anoop J

2014-09-19

Malignant pleural mesothelioma is an incurable cancer caused by exposure to asbestos. The United Kingdom has the highest death rate from mesothelioma in the world and this figure is increasing. Median survival is 8 to 12 months, and most patients have symptoms at diagnosis. The fittest patients may be offered chemotherapy with palliative intent. For patients not fit for systemic anticancer treatment, best supportive care remains the mainstay of management. A study from the United States examining advanced lung cancer showed that early specialist palliative care input improved patient health related quality of life and depression symptoms 12 weeks after diagnosis. While mesothelioma and advanced lung cancer share many symptoms and have a poor prognosis, oncology and palliative care services in the United Kingdom, and many other countries, vary considerably compared to the United States. The aim of this trial is to assess whether regular early symptom control treatment provided by palliative care specialists can improve health related quality of life in patients newly diagnosed with mesothelioma. This multicentre study is an non-blinded, randomised controlled, parallel group trial. A total of 174 patients with a new diagnosis of malignant pleural mesothelioma will be minimised with a random element in a 1:1 ratio to receive either 4 weekly regular early specialist symptom control care, or standard care. The primary outcome is health related quality of life for patients at 12 weeks. Secondary outcomes include health related quality of life for patients at 24 weeks, carer health related quality of life at 12 and 24 weeks, patient and carer mood at 12 and 24 weeks, overall survival and analysis of healthcare utilisation and cost. Current practice in the United Kingdom is to involve specialist palliative care towards the final weeks or months of a life-limiting illness. This study aims to investigate whether early, regular specialist care input can result in significant health related quality of life gains for patients with mesothelioma and if this change in treatment model is cost-effective. The results will be widely applicable to many institutions and patients both in the United Kingdom and internationally. Current controlled trials ISRCTN18955704. Date ISRCTN assigned: 31 January 2014.

Heating Systems Specialist.

ERIC Educational Resources Information Center

Air Force Training Command, Sheppard AFB, TX.

This instructional package is intended for use in training Air Force personnel enrolled in a program for apprentice heating systems specialists. Training includes instruction in fundamentals and pipefitting; basic electricity; controls, troubleshooting, and oil burners; solid and gas fuel burners and warm air distribution systems; hot water…

Stress in air traffic personnel : low-density towers and flight service stations.

DOT National Transportation Integrated Search

1977-09-01

Stress and anxiety levels were measured in 10 air traffic control specialists (ATCS) at two low-traffic-density towers, Fayetteville (FYV), Arkansas, and Roswell (ROW), New Mexico, and in 24 flight service (FS) specialists at Oklahoma City (OKC), Okl...

Improved Sweetpotato Whitefly and Potato Psyllid Control in Tomato by Combining the Mirid Dicyphus hesperus (Heteroptera: Miridae) With Specialist Parasitic Wasps.

PubMed

Calvo, F J; Torres-Ruiz, A; Velázquez-González, J; Rodríguez-Leyva, E; Lomeli-Flores, J R

2018-04-02

Bemisia tabaci Gennadius (Hemiptera: Aleyrodidae) and Bactericera cockerelli Sulcer (Hemiptera: Psyllidae) are important pests in tomato, and the mirid Dicyphus hesperus Knight (Heteroptera: Miridae) has been shown as an effective predator of both pests. Although the predator was able to suppress populations of both pests, the remaining levels could still exceed tolerable levels. Thus, we here hypothesized whether the combination of D. hesperus with the specialist parasitoids Eretmocerus eremicus Rose y Zolnerowich (Hymenoptera: Aphelinidae) (whitefly) and Tamarixia triozae (Burks) (Hymenoptera: Eulophidae) (psyllid) would result in better pest control on a greenhouse scale. For that, we conducted a trial in which we compared the results against B. tabaci and B. cockerelli in greenhouses treated with D. hesperus alone or the predator in combination with the specialist parasitoids. The results showed that the predator was able to establish and suppress B. tabaci and B. cockerelli in tomato, but the addition of the specialist parasitoids resulted in better and more cost-effective pest control. Implementation of this method would therefore increase the robustness and reliability of biocontrol-based integrated pest management programmes for tomato crops, over methods based exclusively on D. hesperus release.

Poor glycemic control as a reason for referral of diabetes patients to specialists in Israel

PubMed Central

Fogelman, Yacov; Karkabi, Khaled; Goldfracht, Margalit

2016-01-01

Aims/introduction Family physicians face the dilemma of when to refer patients with diabetes to specialists. This study examined attitudes of family physicians to referring patients with poor glucose control to diabetes specialists. Materials and methods At continuous medical education courses, family physicians were asked to respond anonymously, as to whether they generally manage the diabetes of their patients, and specifically those with poor glycemic control (HbA1c>9.0%). Results Of 470 respondents, 426 (90%) reported that they generally manage their patients’ diabetes; 202 (43%) reported that they manage the diabetes of patients with HbA1c>9.0%. Board certification in family medicine and affiliation to a health maintenance organization, but not sex, age, years of professional experience, or the proportion of patients with diabetes at their clinics, were associated with referral practices. Conclusions Family medicine residency and organizational support appear to promote treatment by family physicians of patients with poorly controlled diabetes in the primary care setting. PMID:27124172

Parts Specialist.

ERIC Educational Resources Information Center

Fuqua, Lou; Fuqua, Debbie

Designed to address the skills that an auto parts specialist must master in order to be effective in the market place, this manual consists of 13 units of instruction. Covered in the units are orientation; human relations; communications; safety; parts and systems identification; stocking, shipping, and receiving; inventory control; cataloging and…

STS-98 crew members take part in CEIT

NASA Technical Reports Server (NTRS)

2000-01-01

STS-98 Mission Specialist Robert Curbeam (right) raises his arms as he checks out equipment inside the U.S. Lab, Destiny. At left of center is Mission Specialist Marsha Ivins. Curbeam and Ivins, along with other crew members, are taking part in Crew Equipment Interface Test activities becoming familiar with equipment they will be handling during the mission. Others in the crew are Commander Ken Cockrell, Pilot Mark Polansky and Mission Specialist Thomas Jones. The mission will be transporting the Lab to the International Space Station with five system racks already installed inside of the module. With delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated. The STS-98 launch is scheduled for Jan. 18, 2001.

Host plant invests in growth rather than chemical defense when attacked by a specialist herbivore.

PubMed

Arab, Alberto; Trigo, José Roberto

2011-05-01

Plant defensive compounds may be a cost rather than a benefit when plants are attacked by specialist insects that may overcome chemical barriers by strategies such as sequestering plant compounds. Plants may respond to specialist herbivores by compensatory growth rather than chemical defense. To explore the use of defensive chemistry vs. compensatory growth we studied Brugmansia suaveolens (Solanaceae) and the specialist larvae of the ithomiine butterfly Placidina euryanassa, which sequester defensive tropane alkaloids (TAs) from this host plant. We investigated whether the concentration of TAs in B. suaveolens was changed by P. euryanassa damage, and whether plants invest in growth, when damaged by the specialist. Larvae feeding during 24 hr significantly decreased TAs in damaged plants, but they returned to control levels after 15 days without damage. Damaged and undamaged plants did not differ significantly in leaf area after 15 days, indicating compensatory growth. Our results suggest that B. suaveolens responds to herbivory by the specialist P. euryanassa by investing in growth rather than chemical defense.

Environmental Medicine Specialist (AFSC 90850).

ERIC Educational Resources Information Center

Air Univ., Gunter AFS, Ala. Extension Course Inst.

This five-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for environmental medical specialists. Covered in the individual volumes are (1) control of communicable diseases (principles of epidemiology and biology; food, waterborne, airborne, and sexually transmitted diseases; medical zoology;…

Response of pest control by generalist predators to local-scale plant diversity: a meta-analysis.

PubMed

Dassou, Anicet Gbèblonoudo; Tixier, Philippe

2016-02-01

Disentangling the effects of plant diversity on the control of herbivores is important for understanding agricultural sustainability. Recent studies have investigated the relationships between plant diversity and arthropod communities at the landscape scale, but few have done so at the local scale. We conducted a meta-analysis of 32 papers containing 175 independent measures of the relationship between plant diversity and arthropod communities. We found that generalist predators had a strong positive response to plant diversity, that is, their abundance increased as plant diversity increased. Herbivores, in contrast, had an overall weak and negative response to plant diversity. However, specialist and generalist herbivores differed in their response to plant diversity, that is, the response was negative for specialists and not significant for generalists. While the effects of scale remain unclear, the response to plant diversity tended to increase for specialist herbivores, but decrease for generalist herbivores as the scale increased. There was no clear effect of scale on the response of generalist predators to plant diversity. Our results suggest that the response of herbivores to plant diversity at the local scale is a balance between habitat and trophic effects that vary according to arthropod specialization and habitat type. Synthesis and applications. Positive effects of plant diversity on generalist predators confirm that, at the local scale, plant diversification of agroecosystems is a credible and promising option for increasing pest regulation. Results from our meta-analysis suggest that natural control in plant-diversified systems is more likely to occur for specialist than for generalist herbivores. In terms of pest management, our results indicate that small-scale plant diversification (via the planting of cover crops or intercrops and reduced weed management) is likely to increase the control of specialist herbivores by generalist predators.

Incremental Validity of Biographical Data in the Prediction of En Route Air Traffic Control Specialist Technical Skills

DTIC Science & Technology

2012-07-01

Incremental Validity of Biographical Data in the Prediction of En Route Air Traffic Control Specialist Technical Skills Dana Broach Civil Aerospace...Medical Institute Federal Aviation Administration Oklahoma City, OK 73125 July 2012 Final Report DOT/FAA/AM- 12 /8 Office of Aerospace Medicine...FAA/AM- 12 /8 4. Title and Subtitle 5. Report Date July 2012 Incremental Validity of Biographical Data in the Prediction of En Route Air

Preferential Edge Habitat Colonization by a Specialist Weevil, Rhinoncomimus latipes (Coleoptera: Curculionidae)

USDA-ARS?s Scientific Manuscript database

Understanding the behavioral basis of dispersal and colonization is critical in biological control systems, where success of a natural enemy depends in part on its ability to find and move to new host patches. We studied behavior of the specialist weevil Rhinoncomimus latipes Korotyaev, a biological...

Refrigeration and Cryogenics Specialist. J3ABR54530

ERIC Educational Resources Information Center

Air Force Training Command, Sheppard AFB, TX.

This document package contains an Air Force course used to train refrigeration and cryogenics specialists. The course is organized in six blocks designed for group instruction. The blocks cover the following topics: electrical principles; fundamentals of tubing and piping; metering devices, motor controls, domestic and commercial refrigeration;…

Post-graduate education for medical specialists focused on patients with medically unexplained physical symptoms; development of a communication skills training programme.

PubMed

Weiland, Anne; Blankenstein, Annette H; Willems, Mariëtte H A; Van Saase, Jan L C M; Van der Molen, Henk T; Van Dulmen, Alexandra M; Arends, Lidia R

2013-09-01

Stepwise description of the development of a post-graduate communication skills training programme for medical specialists focused on patients with medically unexplained physical symptoms (MUPS) to improve specialist interaction with MUPS patients. Using the 'intervention mapping approach' we accomplished a needs assessment (literature study and pilot) to formulate intervention objectives and identify methods and techniques for a MUPS-focused communication skills training programme for medical specialists. A 14-h training programme which consists of experiential learning, role-play and feedback. Using skills from Cognitive Behavioural Therapy, medical specialists are stimulated to explore interrelating factors that reinforce symptoms, to reassure patients effectively and to provide plausible and understandable explanations for MUPS. Dealing with complex referrals and informing GPs properly are also practiced. By applying the 'intervention mapping approach' we were able to create a feasible and promising intervention to improve specialist interaction with MUPS patients. Intervention effects are currently being assessed in a randomized controlled trial. If the RCT demonstrates sufficient effectiveness and efficiency of the MUPS focused communication skills training programme for medical specialists the intervention could be embedded in post-graduate education of medical specialists and residents. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Exploring the situational motivation of medical specialists: a qualitative study.

PubMed

van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Croiset, Gerda; Peerdeman, Saskia M

2018-02-26

The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day. A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus. Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists' motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one's planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists' motivation. Regarding the design of the study, we found that situational motivation is indeed observable. The basic psychological needs autonomy, competence, and relatedness are important for specialists' motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research.

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Specialist Andrew Thomas (right) shows some of the mission equipment to other crew members (from left) Wendy Lawrence, mission specialist; Eileen Collins, commander; and Charles Camarda, mission specialist. Crew members are at KSC for equipment familiarization. STS-114 is classified as Logistics Flight 1 to the International Space Station, delivering new supplies and replacing one of the orbital outpost’s Control Moment Gyroscopes (CMGs). STS-114 will also carry a Raffaello Multi-Purpose Logistics Module and the External Stowage Platform-2. The crew is slated to conduct at least three spacewalks: They will demonstrate repair techniques of the Shuttle’s Thermal Protection System, replace the failed CMG with one delivered by the Shuttle, and install the External Stowage Platform.

NASA Image and Video Library

2004-01-27

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Specialist Andrew Thomas (right) shows some of the mission equipment to other crew members (from left) Wendy Lawrence, mission specialist; Eileen Collins, commander; and Charles Camarda, mission specialist. Crew members are at KSC for equipment familiarization. STS-114 is classified as Logistics Flight 1 to the International Space Station, delivering new supplies and replacing one of the orbital outpost’s Control Moment Gyroscopes (CMGs). STS-114 will also carry a Raffaello Multi-Purpose Logistics Module and the External Stowage Platform-2. The crew is slated to conduct at least three spacewalks: They will demonstrate repair techniques of the Shuttle’s Thermal Protection System, replace the failed CMG with one delivered by the Shuttle, and install the External Stowage Platform.

Sexual health clinics for women led by specialist nurses or senior house officers in a central London GUM service: a randomised controlled trial.

PubMed

Miles, K; Penny, N; Mercey, D; Power, R

2002-04-01

To assess the care process and clinical outcomes for two different models of GUM clinic for women: one led by specialist nurses and the other by senior house officers (SHOs). An open randomised controlled trial was carried out in a central London genitourinary medicine (GUM) women's clinic. Of 1172 women telephoning for an appointment, 880 were randomised to provide 169 eligible patients in the specialist nurse arm and 178 in the SHO arm. Of the eligible patients a total of 224 attended their appointment. The clinical records of the randomised women were audited for adequacy of care according to local guidelines. 30 key variables were objectively assessed and recorded on a standard audit form. An overall unitary index score (%) was calculated for each patient. The main variables associated with the outcome of specialist nurse and SHO decision making (diagnostic test request, preliminary diagnosis, and treatment provided) were then analysed independently. The median documentation audit scores for specialist nurses (n=103) and SHOs (n=121) were 92% and 85% respectively (p<0.0001). The specialist nurses' documentation was significantly (p<0.05) more complete than the SHOs' for five variables: details of menstrual cycle, physical examination, medication instructions given to patients, health promotion discussion, and provision of condoms. Specialist nurses performed equally to the SHOs with regard to requesting the correct diagnostic tests, providing the correct preliminary diagnosis, and providing the correct treatment. A model of care using trained GUM nurses working within agreed protocols can provide comprehensive patient care for female patients that is equal to care provided by SHOs. Our results raise important issues regarding advanced GUM nursing education and training, protocol development, and accountability.

Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review.

PubMed

Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A

2017-07-01

Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles and should be routinely followed. However, seven out of 15 current guideline sections (describing a decision problem, choosing type of economic evaluation, selecting comparators, determining the study perspective, estimating effectiveness, measuring and valuing health, and assessing resource use and costs) may require additional role-specific considerations to capture costs and effects of these roles. Current guidelines for economic evaluation should form the foundation for economic evaluations of nurse practitioner and clinical nurse specialist roles. The proposed role-specific considerations, which clarify application of standard guidelines sections to economic evaluation of nurse practitioner and clinical nurse specialist roles, may strengthen the quality and comprehensiveness of future economic evaluations of these roles. Copyright © 2017 Elsevier Ltd. All rights reserved.

Tour by Saudi prince Salman Abdelazize Al-Saud prior to mission

NASA Technical Reports Server (NTRS)

1985-01-01

Tour by Saudi prince Salman Abdelazize Al-Saud, payload specialists for STS 51-G mission, prior to mission. Al-Saud and Abdulmohsen Hamad Al-Bassam, the backup payload specialist, man the controls on the flight deck of the crew compartment trainer in the Shuttle mockup and integration laboratory (29788); the Saudi payload specialists share the hatch of the crew compartment trainer (29789); Portrait view of Abdulmohsen Hamad Al-Bassam during a visit to the Shuttle mockup and integraion laboratory (29790); Don Sirroco, left, explains the middeck facilities in the Shuttle mockup and integration laboratory (29791); Portrait view of Sultan Salman Abdelazize Al-Saud in the Shuttle Mockup and Integration laboratory (29792); The Saudi payload specialists witness a space food demonstration in the life sciences laboratory at JSC. Al-Saud (left) and Al-Bassam (second left) listen as Rita M. Rapp, food specialist, discusses three preparations of re-hydratable food for space travelers. Lynn S. Coll

STS-95 Day 09 Highlights

NASA Technical Reports Server (NTRS)

1998-01-01

On this ninth day of the STS-95 mission, the flight crew, Cmdr. Curtis L. Brown, Pilot Steven W. Lindsey, Mission Specialists Scott E. Parazynski, Stephen K. Robinson, and Pedro Duque, and Payload Specialists Chiaki Mukai and John H. Glenn, spend a good part of their day checking out important spacecraft systems for entry and landing. The commander and pilot begin the flight control system checkout by powering up one auxiliary power unit and evaluating the performance of aerodynamic surfaces and flight controls. The flight crew conducts a reaction control system hot fire, followed by a test of the communications system.

Medical Surveillance Monthly Report (MSMR). Volume 5, Number 6, August/September 1999

DTIC Science & Technology

1999-09-01

Medical, cardiovascular, respiratory specialist 234 19,338 12.1 (10.4, 13.5) 311 Medical lab, cytology , and sterile pharmacy specialist 26 2,163 12.0...7.9, 17.6) 121 Missile guidance and control repairer 19 1,583 12.0 (7.2, 18.7) 041 Cannon crewmember, field artillery senior sergeant 141 11,753 12.0...operator, senior sergeant 122 10,792 11.3 (9.2, 13.3) 321 Veterinary food inspection, animal care specialist 16 1,430 11.2 (6.4, 18.2) 000 Infantry, gun

Mission Specialist (MS) Ride on middeck

NASA Image and Video Library

1992-06-24

STS007-02-020 (21 June 1983) --- Astronaut Sally K. Ride, STS-7 mission specialist, STS-7 mission specialist, stands in the mid deck of the orbiting Space Shuttle Challenger near one of the experiment with which she has devoted a great deal of time. The continuous flow electrophoresis system (CFES) experiment, about the size of a household refrigerator, stands nearby. One of her fellow crewmembers moves partially out of frame in the background. The tube on her face is part of a communications system linking Dr. Ride to ground controllers in Houston.

STS-109 MS Massimino and Newman replace Reaction Wheel assembly during EVA 2

NASA Image and Video Library

2002-03-05

STS109-E-5401 (5 March 2002) --- With his feet secured on a platform connected to the remote manipulator system (RMS) robotic arm of the Space Shuttle Columbia, astronaut Michael J. Massimino, mission specialist, hovers over the shuttle's cargo bay while working in tandem with astronaut James H. Newman, mission specialist, during the STS-109 mission's second day of extravehicular activity (EVA). Inside Columbia's cabin, astronaut Nancy J. Currie, mission specialist, controlled the RMS. The image was recorded with a digital still camera.

STS-109 MS Massimino and Newman replace Reaction Wheel assembly during EVA 2

NASA Image and Video Library

2002-03-05

STS109-E-5402 (5 March 2002) --- With his feet secured on a platform connected to the remote manipulator system (RMS) robotic arm of the Space Shuttle Columbia, astronaut Michael J. Massimino, mission specialist, hovers over the shuttle's cargo bay while working in tandem with astronaut James H. Newman, mission specialist, during the STS-109 mission's second day of extravehicular activity (EVA). Inside Columbia's cabin, astronaut Nancy J. Currie, mission specialist, controlled the RMS. The image was recorded with a digital still camera.

Molecular identification of Azolla invasions in Africa: The Azolla specialist, Stenopelmus rufinasus proves to be an excellent taxonomist

USDA-ARS?s Scientific Manuscript database

Biological control of Azolla filiculoides in South Africa with the Azolla specialist Stenopelmus rufinasus has been highly successful. However, field surveys showed that the agent utilized another Azolla species, thought to be the native Azolla pinnata subsp. africana, which contradicted host specif...

Apprentice Heating Systems Specialist, 11-1. Military Curriculum Materials for Vocational and Technical Education.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This military-developed text consists of four volumes of materials for use by those studying to become apprentice heating system specialists. Covered in the individual volumes are the following topics: related subjects (basic electricity, electrical controls, pipe and copper tubing, the principles of heating, fuels, and fuel systems); heating…

Environmental Support Specialist, Blocks VI & VII, 17-7. Military Curriculum Materials for Vocational and Technical Education.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This military-developed text contains the final section of a four-part course to train environmental support specialists. Covered in the individual course blocks are maintenance of water and waste processing system components (external corrosion control, cathodic protection, drive equipment, pipelines and valves, meters and recorders, chemical…

Remote mission specialist - A study in real-time, adaptive planning

NASA Technical Reports Server (NTRS)

Rokey, Mark J.

1990-01-01

A high-level planning architecture for robotic operations is presented. The remote mission specialist integrates high-level directives with low-level primitives executable by a run-time controller for command of autonomous servicing activities. The planner has been designed to address such issues as adaptive plan generation, real-time performance, and operator intervention.

STS-90 Day 14 Highlights

NASA Technical Reports Server (NTRS)

1998-01-01

On this fourteenth day of the STS-90 mission, the flight crew, Cmdr. Richard A. Searfoss, Pilot Scott D. Altman, and Mission Specialists Richard M. Linnehan, Dafydd Rhys Williams and Kathryn P. Hire, and Payload Specialists Jay C. Buckey and James A. Pawelczyk focus on the efforts of Neurolab's Neuronal Plasticity Team to better understand how the adult nervous system adapts to the new environment of space. Columbia's science crew -- Mission Specialists Rick Linnehan and Dave Williams and Payload Specialists Jay Buckey and Jim Pawelczyk -- perform the second and final in-flight dissections of the adult male rats on board. The crew euthanizes and dissects nine rats and remove the vestibular or balance organs of the inner ear; the cerebellum, the part of the brain critical for maintaining balance and for processing information from the limbs so they can be moved smoothly; and the cerebrum, one part of which controls automatic functions such as body temperature regulation and the body's internal clock, and the cortical region that controls cognitive functions such as thinking. The first dissection, which was performed on the second day of the flight, went extremely well, according to Neurolab scientists.

Specialist Bibliographic Databases

PubMed Central

2016-01-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls. PMID:27134485

Specialist Bibliographic Databases.

PubMed

Gasparyan, Armen Yuri; Yessirkepov, Marlen; Voronov, Alexander A; Trukhachev, Vladimir I; Kostyukova, Elena I; Gerasimov, Alexey N; Kitas, George D

2016-05-01

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls.

Specialist outreach clinics in primary care and rural hospital settings.

PubMed

Gruen, R L; Weeramanthri, T S; Knight, S E; Bailie, R S

2004-01-01

Specialist medical practitioners have conducted clinics in primary care and rural hospital settings for a variety of reasons in many different countries. Such clinics have been regarded as an important policy option for increasing the accessibility and effectiveness of specialist services and their integration with primary care services. To undertake a descriptive overview of studies of specialist outreach clinics and to assess the effectiveness of specialist outreach clinics on access, quality, health outcomes, patient satisfaction, use of services, and costs. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) specialised register (March 2002), the Cochrane Controlled Trials Register (CCTR) (Cochrane Library Issue 1, 2002), MEDLINE (including HealthStar) (1966 to May 2002), EMBASE (1988 to March 2002), CINAHL (1982 to March 2002), the Primary-Secondary Care Database previously maintained by the Centre for Primary Care Research in the Department of General Practice at the University of Manchester, a collection of studies from the UK collated in "Specialist Outreach Clinics in General Practice" (Roland 1998), and the reference lists of all retrieved articles. Randomised trials, controlled before and after studies and interrupted time series analyses of visiting specialist outreach clinics in primary care or rural hospital settings, either providing simple consultations or as part of complex multifaceted interventions. The participants were patients, specialists, and primary care providers. The outcomes included objective measures of access, quality, health outcomes, satisfaction, service use, and cost. Four reviewers working in pairs independently extracted data and assessed study quality. 73 outreach interventions were identified covering many specialties, countries and settings. Nine studies met the inclusion criteria. Most comparative studies came from urban non-disadvantaged populations in developed countries. Simple 'shifted outpatients' styles of specialist outreach were shown to improve access, but there was no evidence of impact on health outcomes. Specialist outreach as part of more complex multifaceted interventions involving collaboration with primary care, education or other services was associated with improved health outcomes, more efficient and guideline-consistent care, and less use of inpatient services. The additional costs of outreach may be balanced by improved health outcomes. This review supports the hypothesis that specialist outreach can improve access, outcomes and service use, especially when delivered as part of a multifaceted intervention. The benefits of simple outreach models in urban non-disadvantaged settings seem small. There is a need for good comparative studies of outreach in rural and disadvantaged settings where outreach may confer most benefit to access and health outcomes.

Environmental Support Specialist, Blocks III & IV, 17-5. Military Curriculum Materials for Vocational and Technical Education.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This military-developed text contains the second section of a four-part course to train environmental support specialists. Covered in the individual course blocks are operative principles of water treatment plants (principles of water treatment plants, the clarification process, water systems filters, chemical disinfection, taste and odor control,…

Aircraft Electrical Systems Specialist (AFSC 42350), Volumes 1-3, and Change Supplement, Volume 3.

ERIC Educational Resources Information Center

Savage, Leslie R.

This three-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for aircraft electrical systems specialists. Covered in the individual volumes are career field fundamentals, electrical systems and test equipment, and aircraft control and warning systems. Each volume in the set contains a series…

Referrals in Primary Care: Is the Family Physician a “Gatekeeper”?

PubMed Central

Norton, Peter G.; Dunn, Earl V.; Bestvater, David

1989-01-01

The increasing financial restraints on the use of health care resources make it important to examine the appropriateness of present usage patterns. The authors studied referral patterns for a group of academic family physicians practising in a health service organization in Ontario. They found that for all consultant encounters, the family physician directly controlled 65% of these consultations, whereas 13% were continuing consultations with the specialist without direct family physician referral. The remainder were either unknown or referred from other sources, for example, emergency room or specialist-to-specialist referrals. The family physician made the exact same diagnosis as the consultant in 73.4% of cases for which data were available, and the patient was referred to an inappropriate specialist in only 2.7% of cases. PMID:21249055

Controller response to conflict resolution advisory

DOT National Transportation Integrated Search

1992-12-01

Conflict Resolution Advisory (CRA) is an automated software aid for air traffic control specialists at air route traffic control centers (ARTCCs). CRA calculates, validates, and displays to the en route controller a single resolution for predicted se...

Controller Response to Conflict Resolution Advisory

DOT National Transportation Integrated Search

1992-12-01

Conflict Resolution Advisory (CRA) is an automated software aid for air traffic : control specialists at air route traffic control centers (ARTCCs). CRA calculates, : validates, and displays to the en route controller a single resolution for predicte...

Controller Response to Conflict Resolution Advisory Prototype

DOT National Transportation Integrated Search

1991-01-01

Conflict Resolution Advisory (CRA) is an automated software aid for air traffic : control specialists at air route traffic control centers (ARTCCs). CRA calculates, : validates, and displays to the en route controller a single resolution for predicte...

Referral physician marketing.

PubMed

Lewis, A

1993-01-01

Marketing of specialist services to referring physicians can be highly effective at influencing referral patterns if the referring physician's needs are taken into account. Furthermore, it is possible to generate referrals from nonreferring physicians by approaching them correctly. The ideal approach is for a specialist to treat non-referring physicians as though they referred the patient, even when they didn't. This practice allows the specialist to demonstrate communications service quality in a non-aggressive, non-sales context. The United Weight Control case study summarizes the impact of a referral-generation strategy with "before" and "after" analyses of the strategy's cost and effectiveness.

STS-125 MS5 Feustel during EVA5

NASA Image and Video Library

2009-05-18

S125-E-010049 (18 May 2009) --- Astronaut Andrew Feustel, STS-125 mission specialist, participates in the mission?s fifth and final session of extravehicular activity (EVA) as work continues to refurbish and upgrade the Hubble Space Telescope. During the seven-hour and two-minute spacewalk, Feustel and astronaut John Grunsfeld (out of frame), mission specialist, installed a battery group replacement, removed and replaced a Fine Guidance Sensor and three thermal blankets (NOBL) protecting Hubble?s electronics. Astronaut Megan McArthur, STS-125 mission specialist, at the controls of the remote manipulator system (RMS), can be seen through an aft flight deck window.

Predictors of Acquisition of Competitive Employment for People Enrolled in Supported Employment Programs.

PubMed

Corbière, Marc; Lecomte, Tania; Reinharz, Daniel; Kirsh, Bonnie; Goering, Paula; Menear, Matthew; Berbiche, Djamal; Genest, Karine; Goldner, Elliot M

2017-04-01

This study aims at assessing the relative contribution of employment specialist competencies working in supported employment (SE) programs and client variables in determining the likelihood of obtaining competitive employment. A total of 489 persons with a severe mental illness and 97 employment specialists working in 24 SE programs across three Canadian provinces were included in the study. Overall, 43% of the sample obtained competitive work. Both client variables and employment specialist competencies, while controlling for the quality of SE programs implementation, predicted job acquisition. Multilevel analyses further indicated that younger client age, shorter duration of unemployment, and client use of job search strategies, as well as the working alliance perceived by the employment specialist, were the strongest predictors of competitive employment for people with severe mental illness, with 51% of variance explained. For people with severe mental illness seeking employment, active job search behaviors, relational abilities, and employment specialist competencies are central contributors to acquisition of competitive employment.

STS-88 Pilot Sturckow and Mission Specialist Currie arrive for launch

NASA Technical Reports Server (NTRS)

1998-01-01

Pilot Frederick W. 'Rick' Sturckow and Mission Specialist Nancy J. Currie walk across the landing strip at the Shuttle Landing Facility after exiting the T-38 jet aircraft behind them that brought them to KSC. They join other crew members Mission Commander Robert D. Cabana, Mission Specialist Jerry L. Ross, Mission Specialist James H. Newman and Mission Specialist Sergei Konstantinovich Krikalev, a Russian cosmonaut, for pre-launch preparations for mission STS-88 aboard Space Shuttle Endeavour. The scheduled time of launch is 3:56 a.m. EST on Dec. 3 from Launch Pad 39A. The mission is the first U.S. launch for the International Space Station. Endeavour carries the Unity connecting module which the crew will be mating with the Russian- built Zarya control module already in orbit. In addition to Unity, two small replacement electronics boxes are on board for possible repairs to Zarya batteries. Endeavour is expected to land at KSC at 10:17 p.m. on Monday, Dec. 14.

Specificity of extrafloral nectar induction by herbivores differs among native and invasive populations of tallow tree.

PubMed

Wang, Yi; Carrillo, Juli; Siemann, Evan; Wheeler, Gregory S; Zhu, Lin; Gu, Xue; Ding, Jianqing

2013-08-01

Invasive plants can be released from specialist herbivores and encounter novel generalists in their introduced ranges, leading to variation in defence among native and invasive populations. However, few studies have examined how constitutive and induced indirect defences change during plant invasion, especially during the juvenile stage. Constitutive extrafloral nectar (EFN) production of native and invasive populations of juvenile tallow tree (Triadica sebifera) were compared, and leaf clipping, and damage by a native specialist (Noctuid) and two native generalist caterpillars (Noctuid and Limacodid) were used to examine inducible EFN production. Plants from introduced populations had more leaves producing constitutive EFN than did native populations, but the content of soluble solids of EFN did not differ. Herbivores induced EFN production more than simulated herbivory. The specialist (Noctuid) induced more EFN than either generalist for native populations. The content of soluble solids in EFN was higher (2·1 times), with the specialist vs. the generalists causing the stronger response for native populations, but the specialist response was always comparable with the generalist responses for invasive populations. These results suggest that constitutive and induced indirect defences are retained in juvenile plants of invasive populations even during plant establishment, perhaps due to generalist herbivory in the introduced range. However, responses specific to a specialist herbivore may be reduced in the introduced range where specialists are absent. This decreased defence may benefit specialist insects that are introduced for classical biological control of invasive plants.

Service innovation in glaucoma management: using a Web-based electronic patient record to facilitate virtual specialist supervision of a shared care glaucoma programme.

PubMed

Wright, Heathcote R; Diamond, Jeremy P

2015-03-01

To assess the importance of specialist supervision in a new model of glaucoma service delivery. An optometrist supported by three technicians managed each glaucoma clinic. Patients underwent testing and clinical examination before the optometrist triaged them into one of five groups: 'normal', 'stable', 'low risk', 'unstable' and 'high risk'. Patient data were uploaded to an electronic medical record to facilitate virtual review by a glaucoma specialist. 24 257 glaucoma reviews at three glaucoma clinics during a 31-month period were analysed. The clinic optometrists and glaucoma specialists had substantial agreement (κ 0.69). 13 patients were identified to be high risk by the glaucoma specialist that had not been identified as such by the optometrist. Glaucoma specialists amended 13% of the optometrists' interim decisions resulting in an overall reduction in review appointments by 2.4%. Employing technicians and optometrists to triage glaucoma patients into groups defined by risk of blindness allows higher risk patients to be directed to a glaucoma specialist. Virtual review allows the glaucoma specialist to remain in overall control while reducing the risk that patients are treated or followed-up unnecessarily. Demand for glaucoma appointments can be reduced allowing scarce medical resources to be directed to patients most in need. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Clinician Agreement, Self-Efficacy, and Adherence with the Guidelines for the Diagnosis and Management of Asthma.

PubMed

Cloutier, Michelle M; Salo, Paivi M; Akinbami, Lara J; Cohn, Richard D; Wilkerson, Jesse C; Diette, Gregory B; Williams, Sonja; Elward, Kurtis S; Mazurek, Jacek M; Spinner, Jovonni R; Mitchell, Tracey A; Zeldin, Darryl C

The 2007 Guidelines for the Diagnosis and Management of Asthma provide evidence-based recommendations to improve asthma care. Limited national-level data are available about clinician agreement and adherence to these guidelines. To assess clinician-reported adherence with specific guideline recommendations, as well as agreement with and self-efficacy to implement guidelines. We analyzed 2012 National Asthma Survey of Physicians data for 1412 primary care clinicians and 233 asthma specialists about 4 cornerstone guideline domains: asthma control, patient education, environmental control, and pharmacologic treatment. Agreement and self-efficacy were measured using Likert scales; 2 overall indices of agreement and self-efficacy were compiled. Adherence was compared between primary care clinicians and asthma specialists. Logistic regression models assessed the association of agreement and self-efficacy indices with adherence. Asthma specialists expressed stronger agreement, higher self-efficacy, and greater adherence with guideline recommendations than did primary care clinicians. Adherence was low among both groups for specific core recommendations, including written asthma action plan (30.6% and 16.4%, respectively; P < .001); home peak flow monitoring, (12.8% and 11.2%; P = .34); spirometry testing (44.7% and 10.8%; P < .001); and repeated assessment of inhaler technique (39.7% and 16.8%; P < .001). Among primary care clinicians, greater self-efficacy was associated with greater adherence. For specialists, self-efficacy was associated only with increased odds of spirometry testing. Guideline agreement was generally not associated with adherence. Agreement with and adherence to asthma guidelines was higher for specialists than for primary care clinicians, but was low in both groups for several key recommendations. Self-efficacy was a good predictor of guideline adherence among primary care clinicians but not among specialists. Published by Elsevier Inc.

Management by Trajectory Trade Study of Roles and Responsibilities Between Participants and Automation Report

NASA Technical Reports Server (NTRS)

Fernandes, Alicia D.; Kaler, Curt; Leiden, Kenneth; Atkins, Stephen; Bell, Alan; Kilbourne, Todd; Evans, Mark

2017-01-01

This report describes a trade study of roles and responsibilities associated with the Management by Trajectory (MBT) concept. The MBT concept describes roles, responsibilities, and information and automation requirements for providing air traffic controllers and managers the ability to quickly generate, evaluate and implement changes to an aircraft's trajectory. In addition, the MBT concept describes mechanisms for imposing constraints on flight operator preferred trajectories only to the extent necessary to maintain safe and efficient traffic flows, and the concept provides a method for the exchange of trajectory information between ground automation systems and the aircraft that allows for trajectory synchronization and trajectory negotiation. The participant roles considered in this trade study include: airline dispatcher, flight crew, radar controller, traffic manager, and Air Traffic Control System Command Center (ATCSCC) traffic management specialists. The proposed allocation of roles and responsibilities was based on analysis of several use cases that were developed for this purpose as well as for walking through concept elements. The resulting allocation of roles and responsibilities reflects both increased automation capability to support many aviation functions, as well as increased flexibility to assign responsibilities to different participants - in many cases afforded by the increased automation capabilities. Note that the selection of participants to consider for allocation of each function is necessarily rooted in the current environment, in that MBT is envisioned as an evolution of the National Airspace System (NAS), and not a revolution. A key feature of the MBT allocations is a vision for the traffic management specialist to take on a greater role. This is facilitated by the vision that separation management functions, in addition to traffic management functions, will be carried out as trajectory management functions. This creates an opportunity for flexibility, allowing the traffic management specialist to carry out tasks that today can only be carried out by the controller currently in contact with the aircraft. This additional tasking for the traffic management specialist comes with requirements for workload management. An increased role for the Data-side (D-side) controller relative to the Radar-side (R-side) controller is a potential approach to mitigating workload for the traffic management specialist, as the D-side controller would have similar ability to perform separation management functions in what today might be considered the "trajectory management" timeframe. This analysis did not distinguish between the D-side and R-side controllers since in many cases the R-side controller works unassisted.

STS-112 crew with President of Ajara in Georgia (Russia)

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- In the Operations and Checkout Building, Aslan Abashidze (right), President of the Autonomous Republic of Ajara in Georgia (Russia), visits with the STS-112 crew. From left, they are Mission Specialist Piers J. Sellers; Pilot Pamela Ann Melroy; Mission Specialist Fyodor N. Yurchikhin, a cosmonaut with the Russian Space Agency; Mission Specialist Sandra H. Magnus; and CommanderJeffrey S. Ashby. Mission Specialist David A. Wolf, not pictured, is also a member of the crew. The crew is awaiting launch on mission STS-112 to the International Space Station aboard Space Shuttle Atlantis. The launch has been postponed to no earlier than Monday, Oct. 7, so that the Mission Control Center, located at the Lyndon B. Johnson Space Center in Houston, Texas, can be secured and protected from potential storm impacts from Hurricane Lili.

The STS-92 crew is ready to leave KSC after CEIT

NASA Technical Reports Server (NTRS)

2000-01-01

The STS-92 crew strides across the runway at KSC's Shuttle Landing Facility, heading toward the aircraft that will take them back to Houston. They were at KSC for Crew Equipment Interface Test (CEIT) activities, looking over their mission payload and related equipment. From left are Mission Specialists Bill McArthur and Jeff Wisoff, Pilot Pam Melroy, Mission Specialist Michael Lopez-Alegria, Commander Brian Duffy and Mission Specialist Koichi Wakata, who is with the Japanese space agency. Not seen is Mission Specialist Leroy Chiao, who was also at KSC for the CEIT. STS-92 is scheduled to launch Oct. 5 on Shuttle Discovery from Launch Pad 39A on the fifth flight to the International Space Station. Discovery will carry the Integrated Truss Structure (ITS) Z1, the PMA-3, Ku-band Communications System, and Control Moment Gyros (CMGs).

A meta-analysis of crop pest and natural enemy response to landscape complexity.

PubMed

Chaplin-Kramer, Rebecca; O'Rourke, Megan E; Blitzer, Eleanor J; Kremen, Claire

2011-09-01

Many studies in recent years have investigated the relationship between landscape complexity and pests, natural enemies and/or pest control. However, no quantitative synthesis of this literature beyond simple vote-count methods yet exists. We conducted a meta-analysis of 46 landscape-level studies, and found that natural enemies have a strong positive response to landscape complexity. Generalist enemies show consistent positive responses to landscape complexity across all scales measured, while specialist enemies respond more strongly to landscape complexity at smaller scales. Generalist enemy response to natural habitat also tends to occur at larger spatial scales than for specialist enemies, suggesting that land management strategies to enhance natural pest control should differ depending on whether the dominant enemies are generalists or specialists. The positive response of natural enemies does not necessarily translate into pest control, since pest abundances show no significant response to landscape complexity. Very few landscape-scale studies have estimated enemy impact on pest populations, however, limiting our understanding of the effects of landscape on pest control. We suggest focusing future research efforts on measuring population dynamics rather than static counts to better characterise the relationship between landscape complexity and pest control services from natural enemies. © 2011 Blackwell Publishing Ltd/CNRS.

Design of a cluster-randomized minority recruitment trial: RECRUIT.

PubMed

Tilley, Barbara C; Mainous, Arch G; Smith, Daniel W; McKee, M Diane; Amorrortu, Rossybelle P; Alvidrez, Jennifer; Diaz, Vanessa; Ford, Marvella E; Fernandez, Maria E; Hauser, Robert A; Singer, Carlos; Landa, Veronica; Trevino, Aron; DeSantis, Stacia M; Zhang, Yefei; Daniels, Elvan; Tabor, Derrick; Vernon, Sally W

2017-06-01

Racial/ethnic minority groups remain underrepresented in clinical trials. Many strategies to increase minority recruitment focus on minority communities and emphasize common diseases such as hypertension. Scant literature focuses on minority recruitment to trials of less common conditions, often conducted in specialty clinics and dependent on physician referrals. We identified trust/mistrust of specialist physician investigators and institutions conducting medical research and consequent participant reluctance to participate in clinical trials as key-shared barriers across racial/ethnic groups. We developed a trust-based continuous quality improvement intervention to build trust between specialist physician investigators and community minority-serving physicians and ultimately potential trial participants. To avoid the inherent biases of non-randomized studies, we evaluated the intervention in the national Randomized Recruitment Intervention Trial (RECRUIT). This report presents the design of RECRUIT. Specialty clinic follow-up continues through April 2017. We hypothesized that specialist physician investigators and coordinators trained in the trust-based continuous quality improvement intervention would enroll a greater proportion of minority participants in their specialty clinics than specialist physician investigators in control specialty clinics. Specialty clinic was the unit of randomization. Using continuous quality improvement, the specialist physician investigators and coordinators tailored recruitment approaches to their specialty clinic characteristics and populations. Primary analyses were adjusted for clustering by specialty clinic within parent trial and matching covariates. RECRUIT was implemented in four multi-site clinical trials (parent trials) supported by three National Institutes of Health institutes and included 50 associated specialty clinics from these parent trials. Using current data, we have 88% power or greater to detect a 0.15 or greater difference from the currently observed control proportion adjusting for clustering. We detected no differences in baseline matching criteria between intervention and control specialty clinics (all p values > 0.17). RECRUIT was the first multi-site randomized control trial to examine the effectiveness of a trust-based continuous quality improvement intervention to increase minority recruitment into clinical trials. RECRUIT's innovations included its focus on building trust between specialist investigators and minority-serving physicians, the use of continuous quality improvement to tailor the intervention to each specialty clinic's specific racial/ethnic populations and barriers to minority recruitment, and the use of specialty clinics from more than one parent multi-site trial to increase generalizability. The effectiveness of the RECRUIT intervention will be determined after the completion of trial data collection and planned analyses.

STS-107 Flight Day 13 Highlights

NASA Technical Reports Server (NTRS)

2003-01-01

This video shows the activities of the STS-107 crew on flight day 13 of the Columbia orbiter's final mission. The crew members include: Rick Husband, Commander; William McCool, Pilot; Kalpana Chawla, David Brown, Michael Anderson, Laurel Clark, Mission Specialists; Ilan Ramon, Payload Specialist. The primary activities of flight day 13 are spaceborne experiments, including troubleshooting undertaken by Mission Specialist Chawla on the Water Mist Fire Suppression (MIST) experiment. Chawla performs troubleshooting tasks relayed to her by Mission Control. She shows Mission Control the location of air and water in a transparent hose that is part of the atomizer on the exterior of the combustion module. She also changes the atomizer head. All six Space Technology and Research Students (STARS) experiments are profiled in the video. These experiments are on ants, crystal growth in a chemical garden, fish embryos, carpenter bees, spiders, and silkworms. The video also includes a view of the southeast Texas coast near Houston, and a view of Portugal, Spain, Gibraltar, Morocco, and the Sahara Desert. The video ends with an explanation of roses at Mission Control which commemorate astronauts who have died on missions.

STS-120 Mission Specialist Doug Wheelock During EVA

NASA Technical Reports Server (NTRS)

2007-01-01

Astronaut Doug Wheelock, STS-120 mission specialist, participated in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery was docked with the International Space Station (ISS). During the 7-hour and 19-minute space walk, astronaut Scott Parazynski (out of frame), mission specialist, cut a snagged wire and installed homemade stabilizers designed to strengthen the structure and stability of the damaged P6 4B solar array wing. Wheelock assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

STS-109 MS Newman replace Reaction Wheel assembly during EVA 2

NASA Image and Video Library

2002-03-05

STS109-E-5399 (5 March 2002) --- Astronaut James H. Newman, mission specialist, moves about in the Space Shuttle Columbia's cargo bay while working in tandem with astronaut Michael J. Massimino (out of frame), mission specialist, during the STS-109 mission's second day of extravehicular activity (EVA). Inside Columbia's cabin, astronaut Nancy J. Currie, mission specialist, controlled the Remote Manipulator System (RMS) to assist the two in their work on the Hubble Space Telescope (HST). Part of the giant telescope's base, latched down in the payload bay, can be seen just above Newman. The image was recorded with a digital still camera.

STS-47 MS Davis holds mixed protein sample while working at SLJ Rack 7 FFEU

NASA Image and Video Library

1992-09-20

STS047-03-024 (12 - 20 Sept 1992) --- Astronaut N. Jan Davis, mission specialist, talks to ground controllers as she works with the Free Flow Electrophoresis Unit (FFEU) in the Science Module of the Earth-orbiting Space Shuttle Endeavour. Davis joined five other NASA astronauts and a Japanese payload specialist for eight days of scientific research onboard Endeavour.

Mission Specialist (MS) Ride adjusts headset (HDST) on middeck

NASA Image and Video Library

1983-06-24

STS007-11-495 (18-24 June 1983) --- Astronaut Sally K. Ride, STS-7 mission specialist, communicates with ground controllers from the mid deck of the Earth-orbiting Space Shuttle Challenger. She has just opened one of the large lockers during the operation and monitoring of the continuous flow electrophoresis system (CFES) experiment at left edge. This photograph was made with a 35mm camera.

STS-87 Day 04 Highlights

NASA Technical Reports Server (NTRS)

1997-01-01

On this fourth day of the STS-87 mission, the flight crew, Cmdr. Kevin R. Kregel, Pilot Steven W. Lindsey, Mission Specialists Winston E. Scott, Kalpana Chawla, and Takao Doi, and Payload Specialist Leonid K. Kadenyuk check out the spacesuits for the EVA planned for later during the mission. Mission Control developed plans that may allow Scott and Doi to recapture the Spartan satellite by hand during that EVA.

Non-Specialist Psychosocial Interventions for Children and Adolescents with Intellectual Disability or Lower-Functioning Autism Spectrum Disorders: A Systematic Review

PubMed Central

Yasamy, M. Taghi; Barbui, Corrado; Saxena, Shekhar

2013-01-01

Background The development of effective treatments for use by non-specialists is listed among the top research priorities for improving the lives of people with mental illness worldwide. The purpose of this review is to appraise which interventions for children with intellectual disabilities or lower-functioning autism spectrum disorders delivered by non-specialist care providers in community settings produce benefits when compared to either a no-treatment control group or treatment-as-usual comparator. Methods and Findings We systematically searched electronic databases through 24 June 2013 to locate prospective controlled studies of psychosocial interventions delivered by non-specialist providers to children with intellectual disabilities or lower-functioning autism spectrum disorders. We screened 234 full papers, of which 34 articles describing 29 studies involving 1,305 participants were included. A majority of the studies included children exclusively with a diagnosis of lower-functioning autism spectrum disorders (15 of 29, 52%). Fifteen of twenty-nine studies (52%) were randomized controlled trials and just under half of all effect sizes (29 of 59, 49%) were greater than 0.50, of which 18 (62%) were statistically significant. For behavior analytic interventions, the best outcomes were shown for development and daily skills; cognitive rehabilitation, training, and support interventions were found to be most effective for improving developmental outcomes, and parent training interventions to be most effective for improving developmental, behavioral, and family outcomes. We also conducted additional subgroup analyses using harvest plots. Limitations include the studies' potential for performance bias and that few were conducted in lower- and middle-income countries. Conclusions The findings of this review support the delivery of psychosocial interventions by non-specialist providers to children who have intellectual disabilities or lower-functioning autism spectrum disorders. Given the scarcity of specialists in many low-resource settings, including many lower- and middle-income countries, these findings may provide guidance for scale-up efforts for improving outcomes for children with developmental disorders or lower-functioning autism spectrum disorders. Protocol Registration PROSPERO CRD42012002641 Please see later in the article for the Editors' Summary PMID:24358029

Specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality.

PubMed

Chang, Alvin S M; Berry, Andrew; Jones, Lisa J; Sivasangari, Subramaniam

2015-10-28

Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring transport to NICU. To determine the effects of specialist transport teams compared with non-specialist transport teams on the risk of neonatal mortality and morbidity among high-risk newborn infants requiring transport to neonatal intensive care. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7), MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982 to 31 July 2015), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. randomised, quasi-randomised or cluster randomised controlled trials. neonates requiring transport to a neonatal intensive care unit. transport by a specialist team compared to a non-specialist team. any of the following outcomes - death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit. The methodological quality of the trials was assessed using the information provided in the studies and by personal communication with the author. Data on relevant outcomes were extracted and the effect size estimated and reported as risk ratio (RR), risk difference (RD), number needed to treat for an additional beneficial outcome (NNTB) or number needed to treat for an additional harmful outcome (NNTH) and mean difference (MD) for continuous outcomes. Data from cluster randomised trials were not combined for analysis. One trial met the inclusion criteria of this review but was considered ineligible owing to serious bias in the reporting of the results. There is no reliable evidence from randomised trials to support or refute the effects of specialist neonatal transport teams for neonatal retrieval on infant morbidity and mortality. Cluster randomised trial study designs may be best suited to provide us with answers on effectiveness and clinical outcomes.

Cost-Effectiveness of a Specialist Geriatric Medical Intervention for Frail Older People Discharged from Acute Medical Units: Economic Evaluation in a Two-Centre Randomised Controlled Trial (AMIGOS).

PubMed

Tanajewski, Lukasz; Franklin, Matthew; Gkountouras, Georgios; Berdunov, Vladislav; Edmans, Judi; Conroy, Simon; Bradshaw, Lucy E; Gladman, John R F; Elliott, Rachel A

2015-01-01

Poor outcomes and high resource-use are observed for frail older people discharged from acute medical units. A specialist geriatric medical intervention, to facilitate Comprehensive Geriatric Assessment, was developed to reduce the incidence of adverse outcomes and associated high resource-use in this group in the post-discharge period. To examine the costs and cost-effectiveness of a specialist geriatric medical intervention for frail older people in the 90 days following discharge from an acute medical unit, compared with standard care. Economic evaluation was conducted alongside a two-centre randomised controlled trial (AMIGOS). 433 patients (aged 70 or over) at risk of future health problems, discharged from acute medical units within 72 hours of attending hospital, were recruited in two general hospitals in Nottingham and Leicester, UK. Participants were randomised to the intervention, comprising geriatrician assessment in acute units and further specialist management, or to control where patients received no additional intervention over and above standard care. Primary outcome was incremental cost per quality adjusted life year (QALY) gained. We undertook cost-effectiveness analysis for 417 patients (intervention: 205). The difference in mean adjusted QALYs gained between groups at 3 months was -0.001 (95% confidence interval [CI]: -0.009, 0.007). Total adjusted secondary and social care costs, including direct costs of the intervention, at 3 months were £4412 (€5624, $6878) and £4110 (€5239, $6408) for the intervention and standard care groups, the incremental cost was £302 (95% CI: 193, 410) [€385, $471]. The intervention was dominated by standard care with probability of 62%, and with 0% probability of cost-effectiveness (at £20,000/QALY threshold). The specialist geriatric medical intervention for frail older people discharged from acute medical unit was not cost-effective. Further research on designing effective and cost-effective specialist service for frail older people discharged from acute medical units is needed. ISRCTN registry ISRCTN21800480 http://www.isrctn.com/ISRCTN21800480.

Ageing Mechanisms and Control. Specialists’ Meeting on Life Management Techniques for Ageing Air Vehicles (Les mecanismes vieillissants et le controle) (Reunions des specialistes des techniques de gestion du cycle de vie pour vehicules aeriens vieillissants)

DTIC Science & Technology

2003-02-01

Beam Weld Repair and Qualification of Titanium Fan Blades for Military Gas Turbine Engines”, NATO-RTO-AVT Workshop on Cost Effective Applications of...announced in the Meeting Announcement Research of Extension of the Life Cycle of Helicopter Rotor Blade in Hungary 39 by M. Balaskó, G. Endröczi, J...and Power Systems MP-069(I), February 2003 Low Cost Composite Structures / Cost Effective Application of Titanium Alloys in Military Platforms MP-069

STS-103 crew perform virtual reality training in building 9N

NASA Image and Video Library

1999-05-24

S99-05678 (24 May 1999)--- Astronaut Jean-Francois Clervoy (right), STS-103 mission specialist representing the European Space Agency (ESA), "controls" the shuttle's remote manipulator system (RMS) during a simulation using virtual reality type hardware at the Johnson Space Center (JSC). Looking on is astronaut John M. Grunsfeld, mission specialist. Both astronauts are assigned to separate duties supporting NASA's third Hubble Space Telescope (HST) servicing mission. Clervoy will be controlling Discovery's RMS and Grunsfeld is one of four astronauts that will be paired off for a total of three spacewalks on the mission.

Specificity of extrafloral nectar induction by herbivores differs among native and invasive populations of tallow tree

PubMed Central

Wang, Yi; Carrillo, Juli; Siemann, Evan; Wheeler, Gregory S.; Zhu, Lin; Gu, Xue; Ding, Jianqing

2013-01-01

Background and Aims Invasive plants can be released from specialist herbivores and encounter novel generalists in their introduced ranges, leading to variation in defence among native and invasive populations. However, few studies have examined how constitutive and induced indirect defences change during plant invasion, especially during the juvenile stage. Methods Constitutive extrafloral nectar (EFN) production of native and invasive populations of juvenile tallow tree (Triadica sebifera) were compared, and leaf clipping, and damage by a native specialist (Noctuid) and two native generalist caterpillars (Noctuid and Limacodid) were used to examine inducible EFN production. Key results Plants from introduced populations had more leaves producing constitutive EFN than did native populations, but the content of soluble solids of EFN did not differ. Herbivores induced EFN production more than simulated herbivory. The specialist (Noctuid) induced more EFN than either generalist for native populations. The content of soluble solids in EFN was higher (2·1 times), with the specialist vs. the generalists causing the stronger response for native populations, but the specialist response was always comparable with the generalist responses for invasive populations. Conclusions These results suggest that constitutive and induced indirect defences are retained in juvenile plants of invasive populations even during plant establishment, perhaps due to generalist herbivory in the introduced range. However, responses specific to a specialist herbivore may be reduced in the introduced range where specialists are absent. This decreased defence may benefit specialist insects that are introduced for classical biological control of invasive plants. PMID:23761685

Effects of health-related physical education on academic achievement: project SPARK.

PubMed

Sallis, J F; McKenzie, T L; Kolody, B; Lewis, M; Marshall, S; Rosengard, P

1999-06-01

The effects of a 2-year health-related school physical education program on standardized academic achievement scores was assessed in 759 children who completed Metropolitan Achievement Tests before and after the program. Schools were randomly assigned to condition: (a) Specialists taught the Sports, Play, and Active Recreation for Kids curriculum; (b) classroom teachers were trained to implement the curriculum; and (c) controls continued their usual programs. The Trained Teacher condition was superior to Control on Language, Reading, and Basic Battery. The Specialist condition was superior to Control on Reading, but inferior on Language. Despite devoting twice as many minutes per week to physical education as Controls, the health-related physical education program did not interfere with academic achievement. Health-related physical education may have favorable effects on students' academic achievement.

KSC-98pc316

NASA Image and Video Library

1998-02-26

Members of the STS-90 crew participate in the Crew Equipment Interface Test (CEIT) in Kennedy Space Center's Orbiter Processing Facility Bay 3. The CEIT gives astronauts an opportunity to get a hands-on look at the payloads with which they will be working on-orbit. Investigations during the STS-90 Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90, slated for launch in April, are, left to right, Pilot Scott Altman; Payload Specialist James Pawelczyk, Ph.D.; Commander Richard Searfoss; Mission Specialists Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire; Payload Specialist Jay Buckey, M.D.; and Mission Specialist Richard Linnehan

Relative costs of specialist services in a family practice population

PubMed Central

Norton, Peter G.; Nelson, Wendy; Rudner, Howard L.; Dunn, Earl V.

1985-01-01

The frequency and cost of referrals to specialists in March 1984 for 8980 rostered patients attending a family practice clinic located in a teaching hospital were analysed. The patients made 1891 visits to specialists. In all age groups and for all specialties female patients were more likely to be seen. The total direct provider costs were higher for female patients than for male patients. However, costs per patient seen were higher for male patients, except for psychiatry and medicine. Visits to surgeons had the highest total cost, while visits to psychiatrists had the highest cost per patient seen. Of the direct provider costs 61% was for specialist services. The family physician, in the “gatekeeper” role, has an opportunity to control some of the costs of the health care system by ensuring that the best and most efficient use is made of the referral network. PMID:4042059

Beliefs about personal control and self-management in 30-40 year olds living with Inflammatory Bowel Disease: a qualitative study.

PubMed

Cooper, Joanne M; Collier, Jacqueline; James, Veronica; Hawkey, Christopher J

2010-12-01

Inflammatory Bowel Disease is a collective term for two distinct long term conditions: Ulcerative Colitis and Crohn's disease. There is increasing emphasis on patients taking greater personal control and self-management of this condition, reflecting earlier research into the management of chronic illness. Nurses play a pivotal role in this process, yet how optimal personal control is self-assessed and self-managed in Inflammatory Bowel Disease is poorly understood. This study set out to explore beliefs about personal control and self-management of Inflammatory Bowel Disease. It focused on the role of physical, psychological and socio-economic factors within the individual's life experience. A qualitative approach was used comprising 24, one-to-one, semi-structured interviews with participants aged 30-40 years. Participants with a histological diagnosis of Inflammatory Bowel Disease for at least 12 months were eligible and recruited by gastrointestinal specialist staff from outpatient clinics at a large National Health Service Trust in the United Kingdom. Interviews were transcribed verbatim. Data analysis was informed by existing theories of personal control and used the 'systematic framework analysis' approach. In addition to existing theories of personal control, self-discrepancy theory helped to explain how people viewed the control and self-management of Inflammatory Bowel Disease. One main theme emerged from the findings: 'Reconciliation of the self in IBD', this was supported by three sub-themes and eight basic themes. Some participants found that being unable to control and predict the course of their condition was distressing, however for others this limited control was not viewed as a negative outcome. Being able to share control of IBD with specialist health care staff was beneficial, and participants stated that other priorities in life were as equally important to manage and control. A key barrier to ensuring greater personal control and self-management was a lack of knowledge and awareness by non-specialist health care staff, employers and the wider society. Nurses involved in the care of individuals with Inflammatory Bowel Disease should support and prepare patients for the discrepancies and uncertainties of living with the condition. Greater training about Inflammatory Bowel Disease is recommended, specifically for non-specialist health care staff and employers. Copyright © 2010 Elsevier Ltd. All rights reserved.

The Extent of Restrictions on the Service of Active-Component Military Women

DTIC Science & Technology

2012-01-01

from www.rand.org as a public service of the RAND Corporation. CHILDREN AND FAMILIES EDUCATION AND THE ARTS ENERGY AND ENVIRONMENT HEALTH AND...EN engineman, GM gunner’s mate, IT information systems, ET electronics technician, FC fire control, LS logistics spe- cialist, and CS culinary ...sonar technician rating. Women in non–submarine- specific ratings, such as YN yeoman, CS culinary specialist, and LS logistics specialist, are

KENNEDY SPACE CENTER, FLA. - While touring the SRB Retrieval Ship Freedom Star, STS-114 Commander Eileen Collins and Mission Specialist Soichi Noguchi point at something on the Banana River. Noguchi is with the Japanese space agency NASDA. The ships routinely are docked at Hangar AF on the river. On their mission, the crew - which also includes Pilot James Kelly and Mission Specialist Stephen Robinson - will carry the MultiPurpose Logistics Module (MPLM) Raffaello and External Stowage Platform 2 to the International Space Station. The MPLM will contain supplies and equipment. Another goal of the mission is to remove and replace a Control Moment Gyro. Launch date for mission STS-114 is under review.

NASA Image and Video Library

2003-08-13

KENNEDY SPACE CENTER, FLA. - While touring the SRB Retrieval Ship Freedom Star, STS-114 Commander Eileen Collins and Mission Specialist Soichi Noguchi point at something on the Banana River. Noguchi is with the Japanese space agency NASDA. The ships routinely are docked at Hangar AF on the river. On their mission, the crew - which also includes Pilot James Kelly and Mission Specialist Stephen Robinson - will carry the MultiPurpose Logistics Module (MPLM) Raffaello and External Stowage Platform 2 to the International Space Station. The MPLM will contain supplies and equipment. Another goal of the mission is to remove and replace a Control Moment Gyro. Launch date for mission STS-114 is under review.

KENNEDY SPACE CENTER, FLA. - The STS-114 crew poses on deck with the captain of the Liberty Star, one of the SRB Retrieval Ships docked at Hangar AF on the Banana River. From left are Pilot James Kelly, Mission Specialist Soichi Noguchi, Capt. Bren Wade, Commander Eileen Collins and Mission Specialist Stephen Robinson. Noguchi is with the Japanese space agency NASDA. Mission STS-114 will carry the MultiPurpose Logistics Module (MPLM) Raffaello and External Stowage Platform 2 to the International Space Station. The MPLM will contain supplies and equipment. Another goal of the mission is to remove and replace a Control Moment Gyro. Launch date for mission STS-114 is under review.

NASA Image and Video Library

2003-08-13

KENNEDY SPACE CENTER, FLA. - The STS-114 crew poses on deck with the captain of the Liberty Star, one of the SRB Retrieval Ships docked at Hangar AF on the Banana River. From left are Pilot James Kelly, Mission Specialist Soichi Noguchi, Capt. Bren Wade, Commander Eileen Collins and Mission Specialist Stephen Robinson. Noguchi is with the Japanese space agency NASDA. Mission STS-114 will carry the MultiPurpose Logistics Module (MPLM) Raffaello and External Stowage Platform 2 to the International Space Station. The MPLM will contain supplies and equipment. Another goal of the mission is to remove and replace a Control Moment Gyro. Launch date for mission STS-114 is under review.

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Specialist Soichi Noguchi, who is with the Japanese space agency NASDA, poses on the deck of one of the SRB Retrieval Ships docked at Hangar AF on the Banana River. He and other crew members Commander Eileen Collins, Pilot James Kelly and Mission Specialist Stephen Robinson toured the ships. Mission STS-114 will carry the MultiPurpose Logistics Module (MPLM) Raffaello and External Stowage Platform 2 to the International Space Station. The MPLM will contain supplies and equipment. Another goal of the mission is to remove and replace a Control Moment Gyro. Launch date for mission STS-114 is under review.

NASA Image and Video Library

2003-08-13

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Specialist Soichi Noguchi, who is with the Japanese space agency NASDA, poses on the deck of one of the SRB Retrieval Ships docked at Hangar AF on the Banana River. He and other crew members Commander Eileen Collins, Pilot James Kelly and Mission Specialist Stephen Robinson toured the ships. Mission STS-114 will carry the MultiPurpose Logistics Module (MPLM) Raffaello and External Stowage Platform 2 to the International Space Station. The MPLM will contain supplies and equipment. Another goal of the mission is to remove and replace a Control Moment Gyro. Launch date for mission STS-114 is under review.

Effectiveness and Persistence of Liraglutide Treatment Among Patients with Type 2 Diabetes Treated in Primary Care and Specialist Settings: A Subgroup Analysis from the EVIDENCE Study, a Prospective, 2-Year Follow-up, Observational, Post-Marketing Study.

PubMed

Martinez, Luc; Penfornis, Alfred; Gautier, Jean-Francois; Eschwège, Eveline; Charpentier, Guillaume; Bouzidi, Amira; Gourdy, Pierre

2017-03-01

The objective of this subgroup analysis is to investigate the effectiveness of liraglutide in people with type 2 diabetes (T2D) treated within the primary care physician (PCP) and specialist care settings. EVIDENCE is a prospective, observational study of 3152 adults with T2D recently starting or about to start liraglutide treatment in France. We followed patients in the PCP and specialist settings for 2 years to evaluate the effectiveness of liraglutide in glycemic control and body weight reduction. Furthermore, we evaluated the changes in combined antihyperglycemic treatments, the reasons for prescribing liraglutide, patient satisfaction, and safety of liraglutide in these two treatment settings. After 2 years of follow-up, 477 out of 1209 (39.0%) of PCP and 297 out of 1398 (21.2%) of specialist-treated patients still used liraglutide and maintained the glycated hemoglobin (HbA 1c ) target of <7.0%. Significant reductions from baseline were observed in both PCP- and specialist-treated cohorts in mean HbA 1c (-1.22% and -0.8%, respectively), fasting plasma glucose (FPG) concentration (-39 and -23 mg/dL), body weight (-4.4 and -3.8 kg), and body mass index (BMI) (-1.5 and -1.4 kg/m 2 ), all p < 0.0001. Reductions in HbA 1c and FPG were significantly greater among PCP- compared with specialist-treated patients, p < 0.0001 for both. Patient treatment satisfaction was also significantly increased in both cohorts. Reported gastrointestinal adverse events were less frequent among PCP-treated patients compared with specialist-treated patients (4.5% vs. 16.1%). Despite differences in demography and clinical characteristics of patients treated for T2D in PCP and specialty care, greater reduction in HbA 1c and increased glycemic control durability were observed with liraglutide in primary care, compared with specialist care. These data suggest that liraglutide treatment could benefit patients in primary care by delaying the need for further treatment intensification. ClinicalTrials.gov identifier, NCT01226966. Novo Nordisk A/S.

Influence of cnicin, a sesquiterpene lactone ofCentaurea maculosa (Asteraceae), on specialist and generalist insect herbivores.

PubMed

Landau, I; Müller-Schärer, H; Ward, P I

1994-04-01

The sesquiterpene lactone cnicin was extracted fromCentaurea maculosa andCentaurea vallesiaca. We examined its effects on the ovipositional response and larval development of generalist and specialist insect herbivores associated withC. maculosa. For the oviposition trials, three plant species (C. maculosa, Achillea millefolium, andCichorium intybus), half of which were sprayed with 3% of cnicin, were exposed to the specialist mothsStenodes straminea, Agapeta zoegana, andPterolonche inspersa in field cages. All three species significantly preferredC. maculosa to other plants andP. inspersa significantly preferred cnicin-sprayed plants to untreated plants for oviposition. Tested over all species, cnicin significantly increased the number of eggs laid on a given plant. A larval diet test examined the toxicity of cnicin for larvae of the generalist noctuid mothSpodoptera littoralis. Cnicin concentrations of 3% and 6% were lethal and 1% and 0.5% seriously inhibited growth and development. The larvae of theC. maculosa specialistStenodes straminea survived at 6% cnicin, but none of the pupae hatched.Agapeta zoegana was able to survive at 1% and 3% cnicin. Both specialists had difficulties with the artificial diet, but weight increase and survival was not further reduced when cnicin was present compared with on the control diet. In conclusion, cnicin influenced host recognition by the specialist species, and larvae of the generalist did not survive on natural levels of cnicin. Growth and survival of the specialist were not influenced by cnicin but were considerably hampered on artificial diet.

Specialist mental health consultation for depression in Australian aged care residents with dementia: a cluster randomized trial.

PubMed

McSweeney, Kate; Jeffreys, Aimee; Griffith, Joanne; Plakiotis, Chris; Kharsas, Renee; O'Connor, Daniel W

2012-11-01

This cluster randomized controlled trial sought to determine whether multidisciplinary specialist mental health consultation was more effective than care as usual in treating the depression of aged care residents with dementia. Three hundred and eighty nine aged care residents were screened for dementia and major depression. Forty four were ultimately included in the intervention sample, selected from 20 aged care facilities located in Melbourne, Australia. Facilities were randomly allocated to an intervention condition involving the provision of multidisciplinary specialist consultation regarding the best-practice management of depression in dementia, or to a care as usual condition. Consultations involved individually tailored medical and psychosocial recommendations provided to care staff and general practitioners. All residents participated in a comprehensive pre-intervention diagnostic assessment, including the administration of the Cornell Scale for Depression in Dementia. This assessment was repeated approximately 15 weeks post-intervention by a rater blind to study condition. Multidisciplinary specialist mental health consultation was significantly more effective than care as usual in treating the clinical depression of aged care residents with dementia (p < 0.05, partial η(2)  = 0.16). At follow-up, the mean Cornell Scale for Depression in Dementia score for the intervention group was 9.47, compared with 14.23 for the control group. In addition, 77% of the intervention group no longer met criteria for major depression. The results of this study suggest that the psychosocial and medical management of depressed aged care residents can be improved by increasing access to specialist mental health consultation. Copyright © 2012 John Wiley & Sons, Ltd.

Reproductive intentions and use of reproductive health care among female survivors of childhood cancer.

PubMed

van Dijk, M; van den Berg, M H; Overbeek, A; Lambalk, C B; van den Heuvel-Eibrink, M M; Tissing, W J; Kremer, L C; van der Pal, H J; Loonen, J J; Versluys, B; Bresters, D; Kaspers, G J L; van Leeuwen, F E; van Dulmen-den Broeder, E

2018-06-01

Do female childhood cancer survivors (CCSs) express a decreased desire to have children and do they use reproductive health care more often compared to women without a history of cancer? Overall, no difference was found in the desire to have children between CCSs and controls, whereas CCSs consult a fertility specialist more often, at a younger age, and sooner after their first attempt at conceiving. Female CCSs may face a shorter than anticipated reproductive window as a result of their cancer treatment. Little is known about their desire to have children and use of reproductive health care, especially in relation to their former cancer treatment. This study is part of the DCOG LATER-VEVO study, a nationwide retrospective cohort study on female fertility in Dutch CCSs. In total, 1749 CCSs and 1673 controls were invited for the study. Data collection took place between January 2008 and May 2014. Data on the desire to have children and use of reproductive health care were collected by questionnaire. The control group consisted of sisters from CCSs and females from the general population. In total, 1106 (63%) CCSs and 818 (49%) controls completed the questionnaire. Overall, no difference was found in the desire to have children between CCSs and controls (86% and 89%, respectively). However, survivors of a CNS tumour were less likely to desire children and CCSs without biological children at time of study were more likely to report that their desire to have children was unfulfilled because of medical reasons (9%), compared to controls (1%). In total, 12% of CCSs ever consulted a fertility specialist compared to 10% of controls (OR = 1.7, 95% CI: 1.3-2.4). Mean (SD) age at time of their first visit was 27.7 (4.4) years for CCSs and 29.9 (3.9) years for controls (P < 0.01). In total, 43% of CCSs consulted a fertility specialist within 12 months after they had started trying to achieve a pregnancy, compared to 27% of controls. Risk factors for consulting a fertility specialist included a previous diagnosis of renal tumour, leukaemia, lymphoma or a CNS tumour, and treatment with alkylating chemotherapy, gonadotoxic radiotherapy or both. In total, 70% of CCSs reported a female factor as cause of subfertility compared to 34% of controls (OR = 4.5, 95% CI: 2.3-8.7) and in this specific group, CCSs seemed more likely to use fertility treatment (OR = 2.9, 95% CI: 1.0-8.2). Because of the low number of CCSs who used fertility treatment, we were not able to look at specific diagnoses and treatment types associated with using fertility treatment. Nevertheless, we were able to identify diagnostic- and treatment-related risk factors for consulting a fertility specialist. Details regarding consultations with a fertility specialist and fertility treatment were based on self-report and may therefore be subject to recall bias. Decisions about parenthood affect all CCSs. It's important to evaluate reproductive intentions and function timely after cancer treatment, so CCSs can be adequately counselled regarding family planning and fertility treatment. This work was supported by the Dutch Cancer Society (Grant no. VU 2006-3622) and the Children Cancer Free Foundation (Project no. 20). NTR2922.

KSC00pp1770

NASA Image and Video Library

2000-11-18

KENNEDY SPACE CENTER, FLA. -- Lowered into the payload bay of the orbiter Atlantis, some of the STS-98 crew look over part of the payload. At center is Mission Specialist Robert Curbeam; at right are Mission Specialists Marsha Ivins (standing) and Tom Jones (kneeling). They and the rest of the crew are at KSC for Crew Equipment Interface Test activities. Launch on mission STS-98 is scheduled for Jan. 18, 2001. It will be transporting the U.S. Lab, Destiny, to the International Space Station with five system racks already installed inside of the module. After delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated

KSC-00pp1770

NASA Image and Video Library

2000-11-18

KENNEDY SPACE CENTER, FLA. -- Lowered into the payload bay of the orbiter Atlantis, some of the STS-98 crew look over part of the payload. At center is Mission Specialist Robert Curbeam; at right are Mission Specialists Marsha Ivins (standing) and Tom Jones (kneeling). They and the rest of the crew are at KSC for Crew Equipment Interface Test activities. Launch on mission STS-98 is scheduled for Jan. 18, 2001. It will be transporting the U.S. Lab, Destiny, to the International Space Station with five system racks already installed inside of the module. After delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated

A new mode of community continuing care service for COPD patients in China: participation of respiratory nurse specialists.

PubMed

Li, Pingdong; Gong, Yucui; Zeng, Guangqiao; Ruan, Liang; Li, Guifen

2015-01-01

This study explored a community nursing service mode in which respiratory nurse specialists cared for patients with chronic obstructive pulmonary disease (COPD) in a 12-week period after hospital discharge, with the aim of better preventing acute exacerbations, improving health-related quality of life (HRQOL) and reducing medical expenses in these patients. We carried out a prospective randomized controlled study in which 68 COPD patients discharged were recruited from a general hospital in Guangzhou, China, were randomized divided into two groups. The control group underwent conventional nursing care, and the intervention group received community continuing care by respiratory nurse specialists. The observation period was 12 weeks. The results of intervention were evaluated using the Seattle Obstructive Lung Disease Questionnaire (SOLDQ) and the COPD Self-Efficacy Scale (CSES). In addition, the frequency of acute exacerbations, emergency treatments or hospitalizations, and medical expenses were recorded in the 12-week observation period. After six weeks, the total and subscale scores (P < 0.05) of SOLDQ and CSES significantly improved compared to the baseline ones in the intervention group. The control group had significantly higher scores in the treatment satisfaction (TS) of SOLDQ, the total score, and the weather/environment and behavioral risk factors of CSES. After 12 weeks, the total and subscale scores of SOLDQ and CSES showed a sustained and significant growth in the intervention group (P < 0.05). The control group had significantly higher scores only in the weather/environment risk factor of CSES. During the 12-week observation, the intervention group had significantly fewer acute exacerbations, emergency treatments or re-hospitalizations and significantly lower average medical expenses than the control group (P < 0.05). Community continuing care by respiratory nurse specialists may improve HRQOL, increase self-efficacy, reduce incidence of acute exacerbation, and lower medical expenses in patients with COPD after hospital discharge.

A new mode of community continuing care service for COPD patients in China: participation of respiratory nurse specialists

PubMed Central

Li, Pingdong; Gong, Yucui; Zeng, Guangqiao; Ruan, Liang; Li, Guifen

2015-01-01

Objective: This study explored a community nursing service mode in which respiratory nurse specialists cared for patients with chronic obstructive pulmonary disease (COPD) in a 12-week period after hospital discharge, with the aim of better preventing acute exacerbations, improving health-related quality of life (HRQOL) and reducing medical expenses in these patients. Methods: We carried out a prospective randomized controlled study in which 68 COPD patients discharged were recruited from a general hospital in Guangzhou, China, were randomized divided into two groups. The control group underwent conventional nursing care, and the intervention group received community continuing care by respiratory nurse specialists. The observation period was 12 weeks. The results of intervention were evaluated using the Seattle Obstructive Lung Disease Questionnaire (SOLDQ) and the COPD Self-Efficacy Scale (CSES). In addition, the frequency of acute exacerbations, emergency treatments or hospitalizations, and medical expenses were recorded in the 12-week observation period. Results: After six weeks, the total and subscale scores (P < 0.05) of SOLDQ and CSES significantly improved compared to the baseline ones in the intervention group. The control group had significantly higher scores in the treatment satisfaction (TS) of SOLDQ, the total score, and the weather/environment and behavioral risk factors of CSES. After 12 weeks, the total and subscale scores of SOLDQ and CSES showed a sustained and significant growth in the intervention group (P < 0.05). The control group had significantly higher scores only in the weather/environment risk factor of CSES. During the 12-week observation, the intervention group had significantly fewer acute exacerbations, emergency treatments or re-hospitalizations and significantly lower average medical expenses than the control group (P < 0.05). Conclusions: Community continuing care by respiratory nurse specialists may improve HRQOL, increase self-efficacy, reduce incidence of acute exacerbation, and lower medical expenses in patients with COPD after hospital discharge. PMID:26629091

Conversion of the TRACON operations concepts database into a formal sentence outline job task taxonomy.

DOT National Transportation Integrated Search

1995-05-01

FAA Air Traffic Control Operations Concepts Volume VII.- TRACON Controllers (1989) developed by CTA, Inc., a technical description of the duties of a TRACON air traffic control specialist (ATCS), formatted in User Interface Language, was restructured...

Recruitment and Employment of the Water Pollution Control Specialist.

ERIC Educational Resources Information Center

Sherrard, J. H.; Sherrard, F. A.

1979-01-01

Presented are the basic principles of personnel recruitment and employment for the water pollution control field. Attention is given to determination of staffing requirements, effective planning, labor sources, affirmative action, and staffing policies. (CS)

Anxiety, Depression, and Asthma Control: Changes After Standardized Treatment.

PubMed

Sastre, Joaquín; Crespo, Astrid; Fernandez-Sanchez, Antonio; Rial, Manuel; Plaza, Vicente

2018-02-15

It has been documented that anxiety and depression are prevalent in patients with asthma and are associated with greater frequency of exacerbations, increased use of health care resources, and poor asthma control. To examine the association of asthma diagnosis with symptoms of depression/anxiety and asthma control not only at baseline but also over a 6-month period of specialist supervision. We enrolled 3182 patients with moderate to severe asthma. All were evaluated with spirometry, the Asthma Control Test, and the Hospital Anxiety and Depression Scale at baseline and at 6 months. Treatments were decided by specialists according to published guidelines. At baseline, 24.2% and 12% of the patients were diagnosed with anxiety and depression, respectively, according to the Hospital Anxiety and Depression Scale. After 6 months, anxiety and depression improved, affecting 15.3% and 8.1% of patients, respectively (P < .001); mean FEV 1 and asthma control also improved (FEV 1 from 81.6% ± 20.9% to 86% ± 20.8%; Asthma Control Test score from 15.8 ± 4.7 to 19.4 ± 4.4; both P < .001). Patients with anxiety and depression used significantly more health care resources and had more exacerbations. A multivariate analysis showed that patients with anxiety, depression, and lower FEV 1 (odds ratio, 0.20, 0.34, 0.62, respectively; P < .001) were independently associated with poor asthma control. A multiple linear regression analysis showed that anxiety had a nearly 4-fold greater influence over asthma control than depression (0.326/0.85 = 4.075). Under standardized asthma care and after a specific visit with the specialist, patients present significant improvement in these psychological disorders and exhibit better asthma control and functional parameters. Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

[Level of knowledge and action on lipaemia among Spanish primary and specialist care doctors. Press cholesterol study].

PubMed

Abellán Alemán, José; Leal Hernández, Mariano; Martínez Pastor, Antonio; Hernández Menárguez, Fernando; García-Galbis Marín, José Antonio; Jara Gómez, Purificación

2006-09-01

To find the level of knowledge, the guidelines for action and the monitoring of lipaemia by Spanish primary care and specialist doctors. A self-defined questionnaire of 12 items was designed. Data on the population treated and the subjective evaluation of objectives, and on the management and monitoring of lipid parameters were filled in. A total of 1998 doctors from the whole of Spain took part; 68.8% of the doctors interviewed worked in primary health care and 30.2% in specialist centres or hospitals. A 91% of the doctors said they followed international consensus on monitoring lipaemia. The most commonly used objective therapeutic parameter for treating lipaemia was LDL-cholesterol (83%), followed by total cholesterol (62%), HDL-cholesterol (56%) and triglycerides (51%). If the patient's lipaemia was well controlled, then 21.8% of doctors reduced the doses of lipid-lowerers. In general terms, no great differences were appreciated between the criteria followed by PC and by specialist doctors. The criteria for action on lipaemia could be improved. There are no important differences of view or action in clinical and therapeutic criteria for Lipaemia cases between PC and specialist doctors.

Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline.

PubMed

Rees, Jon; Abrahams, Mark; Doble, Andrew; Cooper, Alison

2015-10-01

To improve awareness and recognition of chronic bacterial prostatitis (CBP) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among non-specialists and patients. To provide guidance to healthcare professionals treating patients with CBP and CP/CPPS, in both non-specialist and specialist settings. To promote efficient referral of care between non-specialists and specialists and the involvement of the multidisciplinary team (MDT). The guideline population were men with CBP or CP/CPPS (persistent or recurrent symptoms and no other urogenital pathology for ≥3 of the previous 6 months). Consensus recommendations for the guidelines were based on a search to identify literature on the diagnosis and management of CBP and CP/CPPS (published between 1999 and February 2014). A Delphi panel process was used where high-quality, published evidence was lacking. CBP and CP/CPPS can present with a wide range of clinical manifestations. The four main symptom domains are urogenital pain, lower urinary tract symptoms (LUTS - voiding or storage symptoms), psychological issues and sexual dysfunction. Patients should be managed according to their individual symptom pattern. Options for first-line treatment include antibiotics, α-adrenergic antagonists (if voiding LUTS are present) and simple analgesics. Repeated use of antibiotics, such as quinolones, should be avoided if there is no obvious symptomatic benefit from infection control or cultures do not support an infectious cause. Early use of treatments targeting neuropathic pain and/or referral to specialist services should be considered for patients who do not respond to initial measures. An MDT approach (urologists, pain specialists, nurse specialists, specialist physiotherapists, general practitioners, cognitive behavioural therapists/psychologists, and sexual health specialists) is recommended. Patients should be fully informed about the possible underlying causes and treatment options, including an explanation of the chronic pain cycle. Chronic prostatitis can present with a wide variety of signs and symptoms. Identification of individual symptom patterns and a symptom-based treatment approach are recommended. Further research is required to evaluate management options for CBP and CP/CPPS. © 2015 The Authors BJU International published by John Wiley & Sons Ltd on behalf of BJU International.

MS Ivins at the Atlantis aft flight deck controls

NASA Image and Video Library

2001-02-10

STS98-E-5078 (10 February 2001) --- Astronaut Marsha S. Ivins, STS-98 mission specialist, monitors communications from ground controllers from her post at the aft flight deck controls on the Space Shuttle Atlantis. The scene was recorded with a digital still camera.

STS-120 Mission Specialist Scott Parazynski Repairs ISS Solar Array

NASA Technical Reports Server (NTRS)

2007-01-01

While anchored to a foot restraint on the end of the Orbiter Boom Sensor System (OBSS), astronaut Scott Parazynski, STS-120 mission specialist, participated in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery was docked with the International Space Station (ISS). During the 7-hour and 19-minute space walk, Parazynski cut a snagged wire and installed homemade stabilizers designed to strengthen the structure and stability of the damaged P6 4B solar array wing. Astronaut Doug Wheelock (out of frame), mission specialist, assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

STS-120 Mission Specialist Scott Parazynski Repairs ISS Solar Array

NASA Technical Reports Server (NTRS)

2006-01-01

While anchored to a foot restraint on the end of the Orbiter Boom Sensor System (OBSS), astronaut Scott Parazynski, STS-120 mission specialist, participated in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery was docked with the International Space Station (ISS). During the 7-hour and 19-minute space walk, Parazynski cut a snagged wire and installed homemade stabilizers designed to strengthen the structure and stability of the damaged P6 4B solar array wing. Astronaut Doug Wheelock (out of frame), mission specialist, assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

[The National Reference Centres and Reference Laboratories. Importance and tasks].

PubMed

Laude, G; Ammon, A

2005-09-01

Since 1995, the German Federal Ministry for Health and Social Security funds National Reference Centres (NRC) for the laboratory surveillance of important pathogens and syndromes. Which pathogens or syndromes are selected to be covered by a NRC depends on their epidemiological relevance, the special diagnostic tools, problems with antimicrobial resistance and necessary infection control measures. Currently, there are 15 NRC, which are appointed for a period of 3 years (currently from January 2005 through December 2007). Towards the end of their appointment all NRC are evaluated by a group of specialists. The assessment of their achievements is guided by a catalogue of tasks for the NRC. In addition to the NRC, a total of 50 laboratories are appointed which provide specialist expertise for additional pathogens in order to have a broad range of pathogens for which specialist laboratories are available. Their predominant task is to give advice and support for special diagnostic problems. Both NRC and the specialist laboratories are important parts of the network for infectious disease epidemiology.

Physiological stress in air traffic controllers : a review.

DOT National Transportation Integrated Search

1982-08-01

Ten years of research on physiological stress in air traffic control specialists (ATCS's) is reviewed. Data were derived from 20 tasks involving the experimental variables of workload, shift-rotation patterns, and automation. : Laboratories at the Ci...

Astronaut Dale Gardner rehearses control of MMU during EVA practice

NASA Technical Reports Server (NTRS)

1984-01-01

Astronaut Dale A. Gardner, 51-A mission specialist, rehearses control of manned maneuvering unit (MMU) during a practice for an extravehicular activity (EVA). Gardner is in the Shuttle mockup and integration laboratory at JSC.

Situation awareness in air traffic control : enhanced displays for advanced operations

DOT National Transportation Integrated Search

2000-01-01

Future changes in the National Airspace System indicate a self-separation operational concept. This study examined the Air Traffic : Control Specialists ability to maintain situation awareness and provide needed monitoring and separation functions...

Currie on the aft flight deck

NASA Image and Video Library

2013-11-19

STS088-335-031 (4-15 Dec. 1998) --- Astronaut Nancy J. Currie, mission specialist, makes a notation in a log book on Endeavour's flight deck as astronaut Jerry L. Ross, mission specialist, eyes a control display near the commander's station. The two were joined by a Russian cosmonaut and three NASA astronauts for eleven days in Earth orbit, spending the majority of their time and efforts in support of important initial links to the International Space Station (ISS).

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Specialist Charles Camarda (left) watches as Mission Specialist Andrew Thomas manipulates equipment that will be used on the mission. Crew members are at KSC for equipment familiarization. STS-114 is classified as Logistics Flight 1 to the International Space Station, delivering new supplies and replacing one of the orbital outpost’s Control Moment Gyroscopes (CMGs). STS-114 will also carry a Raffaello Multi-Purpose Logistics Module and the External Stowage Platform-2. The crew is slated to conduct at least three spacewalks: They will demonstrate repair techniques of the Shuttle’s Thermal Protection System, replace the failed CMG with one delivered by the Shuttle, and install the External Stowage Platform.

NASA Image and Video Library

2004-01-27

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Specialist Charles Camarda (left) watches as Mission Specialist Andrew Thomas manipulates equipment that will be used on the mission. Crew members are at KSC for equipment familiarization. STS-114 is classified as Logistics Flight 1 to the International Space Station, delivering new supplies and replacing one of the orbital outpost’s Control Moment Gyroscopes (CMGs). STS-114 will also carry a Raffaello Multi-Purpose Logistics Module and the External Stowage Platform-2. The crew is slated to conduct at least three spacewalks: They will demonstrate repair techniques of the Shuttle’s Thermal Protection System, replace the failed CMG with one delivered by the Shuttle, and install the External Stowage Platform.

Implications of reduced involvement in en route air traffic control.

DOT National Transportation Integrated Search

1999-08-01

The expansion of the National Route Program will allow airlines to be more flexible in filing and amending flight plans. This may : result in a change in the role of the air traffic control specialist from direct control to a position with more monit...

Minimum intervention dentistry approach to managing early childhood caries: a randomized control trial.

PubMed

Arrow, Peter; Klobas, Elizabeth

2015-12-01

A pragmatic randomized control trial was undertaken to compare the minimum intervention dentistry (MID) approach, based on the atraumatic restorative treatment procedures (MID-ART: Test), against the standard care approach (Control) to treat early childhood caries in a primary care setting. Consenting parent/child dyads were allocated to the Test or Control group using stratified block randomization. Inclusion and exclusion criteria were applied. Participants were examined at baseline and at follow-up by two calibrated examiners blind to group allocation status (κ = 0.77), and parents completed a questionnaire at baseline and follow-up. Dental therapists trained in MID-ART provided treatment to the Test group and dentists treated the Control group using standard approaches. The primary outcome of interest was the number of children who were referred for specialist pediatric care. Secondary outcomes were the number of teeth treated, changes in child oral health-related quality of life and dental anxiety and parental perceptions of care received. Data were analyzed on an intention to treat basis; risk ratio for referral for specialist care, test of proportions, Wilcoxon rank test and logistic regression were used. Three hundred and seventy parents/carers were initially screened; 273 children were examined at baseline and 254 were randomized (Test = 127; Control = 127): mean age = 3.8 years, SD 0.90; 59% male, mean dmft = 4.9, SD 4.0. There was no statistically significant difference in age, sex, baseline caries experience or child oral health-related quality of life between the Test and Control group. At follow-up (mean interval 11.4 months, SD 3.1 months), 220 children were examined: Test = 115, Control = 105. Case-notes review of 231 children showed Test = 6 (5%) and Control = 53 (49%) were referred for specialist care, P < 0.0001. More teeth were filled in the Test group (mean = 2.93, SD 2.48) than in the Control group (mean = 1.54, SD 2.20), Wilcoxon's test, P < 0.0001. Logistic regression, after controlling for age and baseline caries experience, showed a higher risk of referral by allocation to control group, OR 32.6, 95% CI 10.8-98.4, P < 0.0001. The MID-ART approach reduced significantly the likelihood of referral for specialist care, and more children and teeth were provided with treatment. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

KSC-00pp1605

NASA Image and Video Library

2000-10-23

Inside the U.S. Lab, Destiny, members of the STS-98 crew work with technicians (in the background) to learn more about the equipment in the module. They are taking part in Crew Equipment Interface Test activities. At left, back to camera, is Mission Specialist Marsha Ivins. Standing are Mission Specialists Thomas Jones (left) and Robert Curbeam (right). Other crew members not seen are Commander Ken Cockrell and Pilot Mark Polansky. The mission will be transporting the Lab to the International Space Station with five system racks already installed inside of the module. With delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated. The STS-98 launch is scheduled for Jan. 18, 2001

KSC-00pp1604

NASA Image and Video Library

2000-10-23

In the Space Station Processing Facility, STS-98 Mission Specialist Marsha Ivins wields a tool on part of the U.S. Lab, Destiny. The crew is checking out equipment inside the lab as part of Crew Equipment Interface Test activities, becoming familiar with equipment it will be handling during the mission. Others in the crew are Commander Ken Cockrell, Pilot Mark Polansky and Mission Specialists Robert Curbeam and Thomas Jones. The mission will be transporting the Lab to the International Space Station with five system racks already installed inside of the module. With delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated. The STS-98 launch is scheduled for Jan. 18, 2001

KSC-00pp1603

NASA Image and Video Library

2000-10-23

In the Space Station Processing Facility, STS-98 Mission Specialist Marsha Ivins maneuvers a part of the U.S. Lab, Destiny. The crew is checking out equipment inside the lab as part of Crew Equipment Interface Test activities, becoming familiar with equipment it will be handling during the mission. Others in the crew are Commander Ken Cockrell, Pilot Mark Polansky and Mission Specialists Robert Curbeam and Thomas Jones. The mission will be transporting the Lab to the International Space Station with five system racks already installed inside of the module. With delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated. The STS-98 launch is scheduled for Jan. 18, 2001

KSC-00pp1607

NASA Image and Video Library

2000-10-23

In the Space Station Processing Facility, members of the STS-98 crew, sitting in front of the U.S. Lab, Destiny, listen to a trainer during Crew Equipment Interface Test (CEIT) activities. Seen, left to right, are Mission Specialist Thomas Jones, Pilot Mark Polansky and Mission Specialists Robert Curbeam and Marsha Ivins (with camera). The CEIT allows a crew to become familiar with equipment they will be handling during the mission. With launch scheduled for Jan. 18, 2001, the STS-98 mission will be transporting the Lab to the International Space Station with five system racks already installed inside of the module. After delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated

STS-98 crew members take part in CEIT

NASA Technical Reports Server (NTRS)

2000-01-01

In the Space Station Processing Facility, STS-98 Mission Specialist Marsha Ivins maneuvers a part of the U.S. Lab, Destiny. The crew is checking out equipment inside the lab as part of Crew Equipment Interface Test activities, becoming familiar with equipment it will be handling during the mission. Others in the crew are Commander Ken Cockrell, Pilot Mark Polansky and Mission Specialists Robert Curbeam and Thomas Jones. The mission will be transporting the Lab to the International Space Station with five system racks already installed inside of the module. With delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated. The STS-98 launch is scheduled for Jan. 18, 2001.

KSC-00pp1766

NASA Image and Video Library

2000-11-18

KENNEDY SPACE CENTER, FLA. -- Some of the STS-98 crew look over the Canadian robotic arm in the payload bay of orbiter Atlantis, which is undergoing testing in the Orbiter Processing Facility bay 3. At right, pointing, is Mission Specialist Tom Jones. Second from right is Mission Specialist Robert Curbeam. They and the rest of the crew are at KSC for Crew Equipment Interface Test activities. Launch on mission STS-98 is scheduled for Jan. 18, 2001. It will be transporting the U.S. Lab, Destiny, to the International Space Station with five system racks already installed inside of the module. After delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated

KSC00pp1766

NASA Image and Video Library

2000-11-18

KENNEDY SPACE CENTER, FLA. -- Some of the STS-98 crew look over the Canadian robotic arm in the payload bay of orbiter Atlantis, which is undergoing testing in the Orbiter Processing Facility bay 3. At right, pointing, is Mission Specialist Tom Jones. Second from right is Mission Specialist Robert Curbeam. They and the rest of the crew are at KSC for Crew Equipment Interface Test activities. Launch on mission STS-98 is scheduled for Jan. 18, 2001. It will be transporting the U.S. Lab, Destiny, to the International Space Station with five system racks already installed inside of the module. After delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated

Early discharge with tube feeding at home for preterm infants is associated with longer duration of breast feeding.

PubMed

Meerlo-Habing, Z E; Kosters-Boes, E A; Klip, H; Brand, P L P

2009-07-01

Mothers of preterm infants are more likely to discontinue breast feeding early than mothers of term infants. We evaluated the effect of early discharge with tube feeding of preterm infants under close supervision by paediatric nurse specialists on the duration of breast feeding. Case-control study. Medium/high-care neonatal unit of a large district general hospital. Preterm infants (<37 weeks' gestational age). Early discharge with tube feeding under close supervision by paediatric nurse specialists or regular follow-up of preterm infants discharged with oral feeding. Duration of breast feeding assessed by telephone interview 6 months after birth. There were 50 preterm infants in the early discharge group and 78 in the control group. Mothers in the early discharge group continued to breast feed longer than mothers in the control group (log rank test, p = 0.028). Four months after discharge, 63% of preterm infants in the control group were fed formula compared to 36% in the early discharge group (95% CI for difference 9% to 43%, p = 0.04). The relative risk of breast feeding cessation 6 months after birth in the early discharge group compared to the control group was 0.63 (95% CI 0.41 to 0.96). After adjustment for smoking, gestational age and birth weight, this relative risk was 0.67 (95% CI 0.43 to 1.05). Close supervision and follow-up by paediatric nurse specialists of preterm infants discharged early with tube feeding appears to increase duration of breast feeding. A randomised controlled trial to confirm these findings is warranted.

Rationale for classical biological control of cattle fever ticks and proposed methods for field collection of natural enemies

USDA-ARS?s Scientific Manuscript database

Classical biological control using specialist parasitoids, predators and/or nematodes from the native ranges of cattle fever ticks Rhipicephalus microplus and Rhipicephalus annulatus could complement existing control strategies for this livestock pest in the transboundary region between Mexico and T...

Conversion of the CTA, Inc., en route operations concepts database into a formal sentence outline job task taxonomy.

DOT National Transportation Integrated Search

1993-01-01

FAA Air Traffic Control Operations Concepts Volume VI: ARTCC-Host En Route Controllers (1990) developed by CTA, Inc., a technical description of the duties of an En Route air traffic control specialist (ATCS), formatted in User Interface Language, wa...

A review of people who did not attend an epilepsy clinic and their clinical outcomes.

PubMed

Minshall, I; Neligan, A

2017-08-01

To review the clinical outcomes of people who failed to attend or failed subsequent follow up in a Primary Care based specialist epilepsy service. The case notes of 200 people who had failed to initially attend the service or subsequent follow up from 2005 to 2013 were reviewed. Clinical outcomes were determined for 152 people, with the remaining 48 having left the area. For those not attending at all, 64% had no further recorded events, a further 22% came under alternative specialist care and were managed appropriately, 6% were already in remission at the time of referral or at follow up and stayed seizure free. For people attending, but were subsequently lost to follow up, 78% were in remission, had improved seizure frequency, and normal pregnancies. In total 6% of those with poor control came under subsequent Neurological care. This study suggests that for the majority of people who fail to attend or are lost to follow up in a primary care specialist epilepsy clinic, the primary reasons appear to be that they had no further events, improved seizure control or that seizure remission has been achieved. The majority with persistent poor control came under Neurological care. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Referral by outreach specialist reduces hospitalisation costs of rural patients with digestive tract cancer: a report from medical consortium in China.

PubMed

Shi, Ge; Zhou, Bin; Cai, Zhi-Chang; Wu, Tao; Li, Xian-Feng; Xu, Weiguo

2014-01-01

The authors examined the effect of referrals from outreach specialists on total hospitalisation costs of rural Chinese patients receiving surgical treatment for digestive tract cancer at a tertiary hospital within a vertically integrated medical consortium. A retrospective cohort study was conducted within the Taiyuan Central Hospital medical consortium between January 2008 and December 2010. This consortium consists of Taiyuan Central Hospital (a tertiary hospital) and three county hospitals in Taiyuan city, the capital of Shanxi province in China. Patients admitted for surgery to treat digestive tract cancer (N=359) were assigned to control (direct admission without referral), referral by local doctor (RL), or referral by outreach specialist (RO) groups according to referral type. Length of stay (LOS) and hospitalisation costs were examined. Regression-adjusted costs were estimated by a multivariate model that controlled for gender, age, type of cancer, Charlson Comorbidity Index (CCI) score, and referral type. Significant differences were found between the three groups (p<0.001) for LOS and total hospitalisation costs. Both were highest for the control group, followed by RL and then the RO groups (LOS: 28.3 ± 4.9, 24.2 ± 5.9, and 19.2 ± 3.7 days; hospitalisation cost: Chinese yuan (CNY)35,087.87 ± 6208.30, 32,853.38 ± 5195.40, and 29,794.56 ± 5250.20). A strong association was found between RO and substantially reduced hospitalisation costs in patients receiving digestive tract cancer surgery within the medical consortium as compared to RL. This finding suggests that the strengthened collaboration between outreach specialists and local doctors, herein referred to as the green referral channel, is the key factor leading to reduced hospitalisation costs.

[The frequency of performing smoking cessation outpatient clinic in chest disease specialists who are members of Turkish Thoracic Society and factors affecting this performance].

PubMed

Pazarli Bostan, Pınar; Elbek, Osman; Kilinç, Oğuz; Akçay, Müşerref Şule; Kiran, Sibel

2014-01-01

Although helping patients to stop smoking is a good clinical practice that has to be carried out by physicians everywhere and in every area, it is known that carrying out this help systematically in accordance to a programme in smoking cessation outpatient clinics significantly improves the chance of success. The study is a cross-sectional survey performed among chest disease specialists who are members of Turkish Thoracic Society (TTS), between June 2010 and February 2011. As independent variables relevant to status of performing/not performing Smoking Cessation Outpatient Clinic (SCOC); sex, age (younger or older than 40), being graduated before or after 1996, being or not being in a consultant position, work place (Hospital of Ministry of Health/private hospital/university hospital), having or not having an education for smoking cessation help and being or not being member of a City Tobacco Control Committee (CTCC) were investigated. Data was collected via a web-questionnaire prepared by using WHO Global Health Professionals Questionnaire which was sent to members through TTS secreteriat. 41% (699/1701) of members of TTS responded. 39.5% of responders reported that they perform SCOC. When the factors possibly affecting the performance of SCOC are evaluated with logistic regression analysis; being graduated after 1996, having an education for smoking cessation help, being a member of CTCC and not being an active smoker are found to improve this performance. Our study showed that having an education for smoking cessation help (and tobacco control) makes chest disease specialists get more responsibility on this topic. Accordingly, continuous efforts for improving awareness of personal and social responsibilities of all physicians, especially chest disease specialists, have to be made to provide their taking active roles in tobacco control.

Creature co-op: Achieving robust remote operations with a community of low-cost robots

NASA Technical Reports Server (NTRS)

Bonasso, R. Peter

1990-01-01

The concept is advanced of carrying out space based remote missions using a cooperative of low cost robot specialists rather than monolithic, multipurpose systems. A simulation is described wherein a control architecture for such a system of specialists is being investigated. Early results show such co-ops to be robust in the face of unforeseen circumstances. Descriptions of the platforms and sensors modeled and the beacon and retriever creatures that make up the co-op are included.

MS Thomas on middeck with TIPS messages

NASA Image and Video Library

2016-08-12

STS083-309-003 (4-8 April 1997) --- Astronaut Donald A. Thomas, mission specialist, checks a fresh delivery of messages from ground controllers onboard the Earth-orbiting Space Shuttle Columbia. The Thermal Impulse Imaging System (TIPS) is located on the mid deck of Columbia. Thomas, along with four other NASA astronauts and two payload specialists supporting the Microgravity Sciences Laboratory (MSL-1) mission were less than a fourth of the way through a scheduled 16-day flight when a power problem cut short their planned stay.

Inclusion of Specialist and Generalist Stimuli in Attract-and-Kill Programs: Their Relative Efficacy in Apple Maggot Fly (Diptera: Tephritidae) Pest Management.

PubMed

Morrison, William R; Lee, Doo-Hyung; Reissig, W Harvey; Combs, David; Leahy, Kathleen; Tuttle, Arthur; Cooley, Daniel; Leskey, Tracy C

2016-08-01

Investigating the chemical ecology of agricultural systems continues to be a salient part of integrated pest management programs. Apple maggot fly, a key pest of apple in eastern North America, is a visual specialist with attraction to host fruit-mimicking cues. These cues have been incorporated into red spherical traps used for both monitoring and behaviorally based management. Incorporating generalist or specialist olfactory cues can potentially increase the overall success of this management system. The primary aim of this study was to evaluate the attractiveness of a generalist olfactory cue, ammonium carbonate, and the specialist olfactory cue, a five-component apple volatile blend, when included as a component of a red attracticidal sphere system. Secondly, we assessed how critical it was to maintain minimal deviation from the optimal, full-round specialist visual stimulus provided by red spheres. Finally, attracticidal spheres were deployed with specialist olfactory cues in commercial apple orchards to evaluate their potential for effective management of apple maggot. Ammonium carbonate did not increase residency, feeding time, or mortality in the laboratory-based trials. Field deployment of specialist olfactory cues increased apple maggot captures on red spheres, while the generalist cue did not. Apple maggot tolerated some deviation from the optimal visual stimulus without reducing captures on red spheres. Attracticidal spheres hung in perimeter trees in orchards resulted in acceptable and statistically identical levels of control compared with standard insecticide programs used by growers. Overall, our study contributes valuable information for developing a reliable attract-and-kill system for apple maggot. Published by Oxford University Press on behalf of Entomological Society of America 2016. This work is written by US Government employees and is in the public domain in the United States.

Private or public? An empirical analysis of the importance of work values for work sector choice among Norwegian medical specialists.

PubMed

Midttun, Linda

2007-03-01

In the aftermath of the Norwegian hospital reform of 2002, the private supply of specialized healthcare has increased substantially. This article analyses the likelihood of medical specialists working in the private sector. Sector choice is operationalized in two ways: first, as the likelihood of medical specialists working in the private sector at all (at least 1% of the total work hours), and second, as the likelihood of working full-time (90-100%) privately. The theoretical framework is embedded in work values theory and the results suggest that work values are important predictors of sector choice. All analyses are based on a postal questionnaire survey of medical specialists working in private contract practices and for-profit hospitals and a control group of specialists selected from the Norwegian Medical Association's member register. The analyses revealed that while autonomy values impact positively on the propensity for allocating any time at all to the private sector, professional values have a negative effect. Given that the medical specialist already works in the private sector, a high valuation of professional values and payment and benefit values increases the likelihood of having a dual sector job rather than a full-time private position. However, due to the cross-sectional structure of the data and limitations in the dataset, causality questions cannot be fully settled on the basis of the analyses. The relationship between work values and sector choice should, therefore, be regarded as associations rather than causality links. Finally, the likelihood of working in the private sector varies significantly at the municipality level, suggesting that medical specialist's location is important for sector choice.

[Main ways of improvements of the systems of medical rehabilitation of military servicemen after cardiovascular surgery].

PubMed

Iudin, V E; Klimko, V V; Shkarupa, O F; Guzenko, I E

2014-08-01

For better improvement of medical rehabilitation referred to effective restoration of functional status of servicemen after cardiovascular surgery it is necessary to introduce standards of medical rehabilitation at all stages of rehabilitation, syndrome-pathologic principle of grouping patients, multidisciplinary organisation of medical activity: cardiologist-physician, specialist of functional diagnostics, specialist of physical therapy, psychotherapist, physical therapeutic, surgeon and specialist of professional rehabilitation. Basic ways of improvement of the system of rehabilitation were organisational technologies of interaction during early and late stages of rehabilitation and persistent control of quality and effectiveness of rehabilitation. Optimization of organisation of late stage of hospitalisation allowed to reduce the average time of rehabilitation to 33,3% and at the same time to improve effectiveness of rehabilitation.

Studies of next generation air traffic control specialists : why be an air traffic controller?

DOT National Transportation Integrated Search

2011-08-01

With phrases such as Managing Millennials (Gimbel, 2007), descriptions of generational differences are a staple in the : human resources (HR) trade press and corporate training. The Federal Aviation Administration (FAA) offers a course in : man...

Exploring the situational motivation of medical specialists: a qualitative study

PubMed Central

Kusurkar, Rashmi A.; Croiset, Gerda; Peerdeman, Saskia M.

2018-01-01

Objectives The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day. Methods A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus. Results Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists’ motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one’s planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists’ motivation. Regarding the design of the study, we found that situational motivation is indeed observable. Conclusions The basic psychological needs autonomy, competence, and relatedness are important for specialists’ motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research. PMID:29485972

Lesion detectability in 2D-mammography and digital breast tomosynthesis using different targets and observers

NASA Astrophysics Data System (ADS)

Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R.; Young, Kenneth C.; Wells, Kevin

2018-05-01

This work investigates the detection performance of specialist and non-specialist observers for different targets in 2D-mammography and digital breast tomosynthesis (DBT) using the OPTIMAM virtual clinical trials (VCT) Toolbox and a 4-alternative forced choice (4AFC) assessment paradigm. Using 2D-mammography and DBT images of virtual breast phantoms, we compare the detection limits of simple uniform spherical targets and irregular solid masses. Target diameters of 4 mm and 6 mm have been chosen to represent target sizes close to the minimum detectable size found in breast screening, across a range of controlled contrast levels. The images were viewed by a set of specialist observers (five medical physicists and six experienced clinical readers) and five non-specialists. Combined results from both observer groups indicate that DBT has a significantly lower detectable threshold contrast than 2D-mammography for small masses (4 mm: 2.1% [DBT] versus 6.9% [2D]; 6 mm: 0.7% [DBT] versus 3.9% [2D]) and spheres (4 mm: 2.9% [DBT] versus 5.3% [2D]; 6 mm: 0.3% [DBT] versus 2.2% [2D]) (p  <  0.0001). Both observer groups found spheres significantly easier to detect than irregular solid masses for both sizes and modalities (p  <  0.0001) (except 4 mm DBT). The detection performances of specialist and non-specialist observers were generally found to be comparable, where each group marginally outperformed the other in particular detection tasks. Within the specialist group, the clinical readers performed better than the medical physicists with irregular masses (p  <  0.0001). The results indicate that using spherical targets in such studies may produce over-optimistic detection thresholds compared to more complex masses, and that the superiority of DBT for detecting masses over 2D-mammography has been quantified. The results also suggest specialist observers may be supplemented by non-specialist observers (with training) in some types of 4AFC studies.

ELECTRICAL AND ELECTRONIC INDUSTRIAL CONTROL, STATIC CONTROL SERIES. BASIC CONTROL FUNCTIONS, UNIT 9A.

ERIC Educational Resources Information Center

SUTTON, MACK C.

THIS SELF-INSTRUCTIONAL PROGRAMED TEXT IS FOR INDIVIDUAL STUDENT USE IN STUDYING STATIC CONTROL IN ELECTRICAL-ELECTRONIC PROGRAMS. IT WAS DEVELOPED BY AN INSTRUCTIONAL MATERIALS SPECIALIST AND ADVISERS AND HAS BEEN TESTED BY STUDENT USE. THE OBJECTIVE OF THE COURSE IS TO HELP THE ELECTRICAL-TECHNICIAN DEVELOP AN UNDERSTANDING OF STATIC CONTROL…

The effectiveness of telemedicine for paediatric retrieval consultations: rationale and study design for a pragmatic multicentre randomised controlled trial.

PubMed

Armfield, Nigel R; Coulthard, Mark G; Slater, Anthony; McEniery, Julie; Elcock, Mark; Ware, Robert S; Scuffham, Paul A; Bensink, Mark E; Smith, Anthony C

2014-11-11

In many health systems, specialist services for critically ill children are typically regionalised or centralised. Studies have shown that high-risk paediatric patients have improved survival when managed in specialist centres and that volume of cases is a predictor of care quality. In acute cases where distance and time impede access to specialist care, clinical advice may be provided remotely by telephone. Emergency retrieval services, attended by medical and nursing staff may be used to transport patients to specialist centres. Even with the best quality retrieval services, stabilisation of the patient and transport logistics may delay evacuation to definitive care. Several studies have examined the use of telemedicine for providing specialist consultations for critically ill children. However, no studies have yet formally examined the clinical effectiveness and economic implications of using telemedicine in the context of paediatric patient retrieval. The study is a pragmatic, multicentre randomised controlled trial running over 24 months which will compare the use of telemedicine with the use of the telephone for paediatric retrieval consultations between four referring hospitals and a tertiary paediatric intensive care unit. We aim to recruit 160 children for whom a specialist retrieval consultation is required. The primary outcome measure is stabilisation time (time spent on site at the referring hospital by the retrieval team) adjusted for initial risk. Secondary outcome measures are change in patient's physiological status (repeated measure, two time points) scored using the Children's Emergency Warning Tool; change in diagnosis (repeated measure taken at three time points); change in destination of retrieved patients at the tertiary hospital (general ward or paediatric intensive care unit); retrieval decision, and length of stay in the Paediatric Intensive Care Unit for retrieved patients. The trial has been approved by the Human Research Ethics Committees of Children's Health Services Queensland and The University of Queensland, Australia. Health services are adopting telemedicine, however formal evidence to support its use in paediatric acute care is limited. Generalisable evidence is required to inform clinical use and health system policy relating to the effectiveness and economic implications of the use in telemedicine in paediatric retrieval. Australian and New Zealand Clinical Trials Registry ACTRN12612000156886 .

46 CFR 11.472 - Officer endorsements as barge supervisor.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., mechanic, electrician, crane operator, subsea specialist, ballast control operator or equivalent... 168 days of service as driller, assistant driller, toolpusher, assistant toolpusher, mechanic...

46 CFR 11.472 - Officer endorsements as barge supervisor.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., mechanic, electrician, crane operator, subsea specialist, ballast control operator or equivalent... 168 days of service as driller, assistant driller, toolpusher, assistant toolpusher, mechanic...

46 CFR 11.472 - Officer endorsements as barge supervisor.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., mechanic, electrician, crane operator, subsea specialist, ballast control operator or equivalent... 168 days of service as driller, assistant driller, toolpusher, assistant toolpusher, mechanic...

Diagnostic Accuracy of Nonmydriatic Fundus Photography for the Detection of Glaucoma in Diabetic Patients.

PubMed

Muñoz-Negrete, Francisco J; Contreras, Inés; Oblanca, Noelia; Pinazo-Durán, M Dolores; Rebolleda, Gema

2015-01-01

To determine the diagnostic accuracy for glaucoma of a set of criteria with nonmydriatic monoscopic fundus photography (NMFP) in diabetics. Diabetics recruited from a screening program for diabetic retinopathy and diabetic glaucoma patients recruited from our glaucoma unit were included. Any patient with evidence of diabetic retinopathy was excluded. Diabetic patients had to have no visual field defects to be included as controls. Glaucoma patients had to have a glaucomatous field defect in at least one eye to be included. One NMFP was taken per eye for all subjects. These photographs were evaluated by two masked glaucoma specialists for the presence of the following: bilateral cup to disc (C/D) ratio ≥ 0.6, notching or thinning of the neuroretinal rim, disc hemorrhages, and asymmetry in the C/D ratio between both eyes ≥ 0.2. This evaluation led to a dichotomous classification: if any of the above criteria was present, the patient was classified as glaucoma. If none were present, the patient was classified as normal. 72 control subjects and 72 glaucoma patients were included. Evaluation of NMFP had a sensitivity of 79.17% and a specificity of 80.56% for specialist 1 and a sensitivity of 72.22% and a specificity of 88.88% for specialist 2 for the detection of glaucoma. The overall accuracy was 79.83% and 80.55%, respectively. NMFP evaluation by a glaucoma specialist may be useful for the detection of glaucoma in diabetics.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, STS-114 Mission Specialist Andrew Thomas (left) works with equipment while Mission Specialist Soichi Noguchi watches. Noguchi is with the Japanese Aerospace Exploration Agency (JAXA). They and other crew members are at KSC for equipment familiarization. STS-114 is classified as Logistics Flight 1 to the International Space Station, delivering new supplies and replacing one of the orbital outpost’s Control Moment Gyroscopes (CMGs). STS-114 will also carry a Raffaello Multi-Purpose Logistics Module and the External Stowage Platform-2. The crew is slated to conduct at least three spacewalks: They will demonstrate repair techniques of the Shuttle’s Thermal Protection System, replace the failed CMG with one delivered by the Shuttle, and install the External Stowage Platform.

NASA Image and Video Library

2004-01-27

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, STS-114 Mission Specialist Andrew Thomas (left) works with equipment while Mission Specialist Soichi Noguchi watches. Noguchi is with the Japanese Aerospace Exploration Agency (JAXA). They and other crew members are at KSC for equipment familiarization. STS-114 is classified as Logistics Flight 1 to the International Space Station, delivering new supplies and replacing one of the orbital outpost’s Control Moment Gyroscopes (CMGs). STS-114 will also carry a Raffaello Multi-Purpose Logistics Module and the External Stowage Platform-2. The crew is slated to conduct at least three spacewalks: They will demonstrate repair techniques of the Shuttle’s Thermal Protection System, replace the failed CMG with one delivered by the Shuttle, and install the External Stowage Platform.

View of MS Mastracchio participating in EVA 2 during STS-118/Expedition 15 Joint Operations

NASA Image and Video Library

2007-08-13

S118-E-06969 (13 Aug. 2007) --- Astronaut Rick Mastracchio, STS-118 mission specialist, participates in the mission's second planned session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the 6-hour, 28-minute spacewalk, Mastracchio and astronaut Dave Williams (out of frame), mission specialist representing the Canadian Space Agency, removed a faulty control moment gyroscope (CMG-3) and installed a new CMG into the station's Z1 truss. The failed CMG will remain at its temporary stowage location on the station's exterior until it is returned to Earth on a later shuttle mission. The new gyroscope is one of four CMGs that are used to control the station's attitude in orbit.

View of MS Williams installing the new CMG during Expedition 15/STS-118 EVA 2

NASA Image and Video Library

2007-08-13

ISS015-E-22358 (13 Aug. 2007) --- Astronaut Dave Williams, STS-118 mission specialist representing the Canadian Space Agency, participates in the mission's second planned session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the 6-hour, 28-minute spacewalk Williams and astronaut Rick Mastracchio (out of frame), mission specialist, removed a faulty control moment gyroscope (CMG-3) and installed a new CMG into the station's Z1 truss. The failed CMG will remain at its temporary stowage location on the station's exterior until it is returned to Earth on a later shuttle mission. The new gyroscope is one of four CMGs that are used to control the station's attitude in orbit.

View of MS Mastracchio participating in EVA 2 during STS-118/Expedition 15 Joint Operations

NASA Image and Video Library

2007-08-13

S118-E-06968 (13 Aug. 2007) --- Astronaut Rick Mastracchio, STS-118 mission specialist, participates in the mission's second planned session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the 6-hour, 28-minute spacewalk, Mastracchio and astronaut Dave Williams (out of frame), mission specialist representing the Canadian Space Agency, removed a faulty control moment gyroscope (CMG-3) and installed a new CMG into the station's Z1 truss. The failed CMG will remain at its temporary stowage location on the station's exterior until it is returned to Earth on a later shuttle mission. The new gyroscope is one of four CMGs that are used to control the station's attitude in orbit.

View of MS Williams installing the new CMG during Expedition 15/STS-118 EVA 2

NASA Image and Video Library

2007-08-13

ISS015-E-22371 (13 Aug. 2007) --- Astronaut Dave Williams, STS-118 mission specialist representing the Canadian Space Agency, participates in the mission's second planned session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the 6-hour, 28-minute spacewalk, Williams and astronaut Rick Mastracchio (out of frame), mission specialist, removed a faulty control moment gyroscope (CMG-3) and installed a new CMG into the station's Z1 truss. The failed CMG will remain at its temporary stowage location on the station's exterior until it is returned to Earth on a later shuttle mission. The new gyroscope is one of four CMGs that are used to control the station's attitude in orbit.

View of MS Williams installing the new CMG during Expedition 15/STS-118 EVA 2

NASA Image and Video Library

2007-08-13

ISS015-E-22355 (13 Aug. 2007) --- Astronaut Dave Williams, STS-118 mission specialist representing the Canadian Space Agency, participates in the mission's second planned session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the 6-hour, 28-minute spacewalk Williams and astronaut Rick Mastracchio (out of frame), mission specialist, removed a faulty control moment gyroscope (CMG-3) and installed a new CMG into the station's Z1 truss. The failed CMG will remain at its temporary stowage location on the station's exterior until it is returned to Earth on a later shuttle mission. The new gyroscope is one of four CMGs that are used to control the station's attitude in orbit.

KSC-00pp1606

NASA Image and Video Library

2000-10-23

In the Space Station Processing Facility, STS-98 Mission Specialist Thomas Jones works on a part of the U.S. Lab, Destiny. Watching at right is Pilot Mark Polansky. Jones and Polansky, along with other crew members, are taking part in Crew Equipment Interface Test activities to become familiar with equipment they will be handling during the mission. Others in the crew are Commander Ken Cockrell and Mission Specialists Robert Curbeam and Marsha Ivins. The mission will be transporting the Lab to the International Space Station with five system racks already installed inside of the module. With delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated. The STS-98 launch is scheduled for Jan. 18, 2001

View of MS Williams installing the new CMG during Expedition 15/STS-118 EVA 2

NASA Image and Video Library

2007-08-13

ISS015-E-22364 (13 Aug. 2007) --- Astronaut Dave Williams, STS-118 mission specialist representing the Canadian Space Agency, participates in the mission's second planned session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the 6-hour, 28-minute spacewalk, Williams and astronaut Rick Mastracchio (out of frame), mission specialist, removed a faulty control moment gyroscope (CMG-3) and installed a new CMG into the station's Z1 truss. The failed CMG will remain at its temporary stowage location on the station's exterior until it is returned to Earth on a later shuttle mission. The new gyroscope is one of four CMGs that are used to control the station's attitude in orbit.

View of MS Mastracchio as he makes his way to the ESP2 during EVA 2

NASA Image and Video Library

2007-08-13

S118-E-07019 (13 Aug. 2007) --- Astronaut Rick Mastracchio, STS-118 mission specialist, participates in the mission's second planned session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the 6-hour, 28-minute spacewalk, Mastracchio and astronaut Dave Williams (out of frame), mission specialist representing the Canadian Space Agency, removed a faulty control moment gyroscope (CMG-3) and installed a new CMG into the station's Z1 truss. The failed CMG will remain at its temporary stowage location on the station's exterior until it is returned to Earth on a later shuttle mission. The new gyroscope is one of four CMGs that are used to control the station's attitude in orbit.

STS-98 crew members take part in CEIT

NASA Technical Reports Server (NTRS)

2000-01-01

Inside the U.S. Lab, Destiny, members of the STS-98 crew work with technicians (in the background) to learn more about the equipment in the module. They are taking part in Crew Equipment Interface Test activities. At left, back to camera, is Mission Specialist Marsha Ivins. Standing are Mission Specialists Thomas Jones (left) and Robert Curbeam (right). Other crew members not seen are Commander Ken Cockrell and Pilot Mark Polansky. The mission will be transporting the Lab to the International Space Station with five system racks already installed inside of the module. With delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated. The STS-98 launch is scheduled for Jan. 18, 2001.

KSC-00pp1602

NASA Image and Video Library

2000-10-23

In the Space Station Processing Facility, members of the STS-98 crew check out equipment in the U.S. Lab, Destiny, with the help of workers. In the background, looking over her shoulder, is Mission Specialist Marsha Ivins. Others in the crew are Commander Ken Cockrell, Pilot Mark Polansky and Mission Specialists Robert Curbeam and Thomas Jones. The crew is taking part in Crew Equipment Interface Test activities, becoming familiar with equipment it will be handling during the mission. The mission will be transporting the Lab to the International Space Station with five system racks already installed inside of the module. With delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated. The STS-98 launch is scheduled for Jan. 18, 2001

STS-98 crew members take part in CEIT

NASA Technical Reports Server (NTRS)

2000-01-01

In the Space Station Processing Facility, members of the STS-98 crew, sitting in front of the U.S. Lab, Destiny, listen to a trainer during Crew Equipment Interface Test (CEIT) activities. Seen, left to right, are Mission Specialist Thomas Jones, Pilot Mark Polansky and Mission Specialists Robert Curbeam and Marsha Ivins (with camera). The CEIT allows a crew to become familiar with equipment they will be handling during the mission. With launch scheduled for Jan. 18, 2001, the STS-98 mission will be transporting the Lab to the International Space Station with five system racks already installed inside of the module. After delivery of electronics in the lab, electrically powered attitude control for Control Moment Gyroscopes will be activated.

Astronaut Anna Fisher practices control of the RMS in a trainer

NASA Technical Reports Server (NTRS)

1984-01-01

Astronaut Anna Lee Fisher, mission specialist for 51-A, practices control of the remote manipulator system (RMS) at a special trainer at JSC. Dr. Fisher is pictured in the manipulator development facility (MDF) of JSC's Shuttle mockup and integration laboratory.

STS-33 MS Carter operates translation hand control (THC) on aft flight deck

NASA Technical Reports Server (NTRS)

1989-01-01

STS-33 Mission Specialist (MS) Manley L. Carter, Jr operates translation hand control (THC) at the aft flight deck onorbit station while peering out overhead window W7. Carter's communications kit assembly headset microphone extends across his face.

Relationship of employee attitudes and supervisor-controller ratio to en route operational error rates : final report.

DOT National Transportation Integrated Search

2002-05-01

An operational error (OE) results when an air traffic control specialist (ATCS) fails to maintain appropriate separation between aircraft, obstacles, etc. Recent research on OEs has focused on situational and individual characteristics (Center for Na...

A proposed new test for aptitude screening of air traffic controller applicants.

DOT National Transportation Integrated Search

1972-05-01

The study concerns the development and experimental validation of a novel aptitude test, referred to as 'Directional Headings' (or DHT), for the selection of Air Traffic Control Specialist (ATCS) trainees. The test requires the subject to rapidly int...

Kavandi at controls of Canadarm2 in Destiny module

NASA Image and Video Library

2001-07-16

S104-E-5114 (16 July 2001) --- Janet L. Kavandi, STS-104 mission specialist, looks over the Canadarm2, Space Station Remote Manipulator System (SSRMS), control station in the Destiny laboratory during STS-104's visit to the International Space Station (ISS).

Glycemic control and type 1 diabetes: the differential impact of model of care and income.

PubMed

Hatherly, Kristy; Smith, Lorraine; Overland, Jane; Johnston, Christine; Brown-Singh, Lin; Waller, Dan; Taylor, Sue

2011-03-01

To examine the effect of model of care (specialist care vs. shared care), and income, on glycemic control in a sample of young people with type 1 diabetes. A total of 158 children and young people with type 1 diabetes, aged 8-19 yr, and their families, were recruited independent of their source of care as part of a longitudinal, cross-sectional exploratory study. At enrollment, participants completed a series of questionnaires and underwent a structured interview to gather data regarding the type of specialist and healthcare services attended, as well as demographic, healthcare, and self-care information. Capillary sample was taken for HbA1c determination. The mean HbA1c for the group as a whole was 8.6 ± 1.4%. There was no effect for model of care on glycemic control. However, young people living in households with a family income of less than AUS$83,000 (US$73,500) per year had a significantly higher mean HbA1c than their counterparts reporting a higher household income (8.8 ± 1.4% vs. 8.3 ± 1.1%; p = 0.019). Although no differences were found with respect to the short-term impact of specialist vs. shared care, it is evident that more support is required to improve glycemic control in this sample of young people where the mean level of HbA1c was significantly higher than target. Further research is also indicated to determine the relationship between glycemic control and socioeconomic status. © 2010 John Wiley & Sons A/S.

ELECTRICAL AND ELECTRONIC INDUSTRIAL CONTROL. D-C MAGNETIC MOTOR CONTROL, UNIT 7, ASSIGNMENTS.

ERIC Educational Resources Information Center

SUTTON, MACK C.

THIS GUIDE IS FOR INDIVIDUAL STUDENT USE IN STUDYING DIRECT CURRENT MAGNETIC MOTOR CONTROL IN ELECTRICAL-ELECTRONIC PROGRAMS. IT WAS DEVELOPED BY AN INSTRUCTIONAL MATERIALS SPECIALIST AND ADVISERS. EACH OF THE 15 ASSIGNMENT SHEETS PROVIDES THE LESSON SUBJECT, PURPOSE, INTRODUCTORY INFORMATION, STUDY REFERENCES, AND PROBLEMS. SOME OF THE LESSONS…

ELECTRICAL AND ELECTRONIC INDUSTRIAL CONTROL. A-C CONVENTIONAL MAGNETIC MOTOR CONTROL, PART I, UNIT 5, ASSIGNMENTS.

ERIC Educational Resources Information Center

SUTTON, MACK C.

THIS GUIDE IS FOR INDIVIDUAL STUDENT USE IN STUDYING ALTERNATING CURRENT CONVENTIONAL MAGNETIC MOTOR CONTROL IN ELECTRICAL-ELECTRONIC PROGRAMS. IT WAS DEVELOPED BY AN INSTRUCTIONAL MATERIALS SPECIALIST AND ADVISERS. EACH OF THE 10 ASSIGNMENT SHEETS PROVIDES THE LESSON SUBJECT, PURPOSE, INTRODUCTORY INFORMATION, STUDY REFERENCES, SUPPLEMENTARY…

Challenges of pain control and the role of the ambulatory pain specialist in the outpatient surgery setting.

PubMed

Vadivelu, Nalini; Kai, Alice M; Kodumudi, Vijay; Berger, Jack M

2016-01-01

Ambulatory surgery is on the rise, with an unmet need for optimum pain control in ambulatory surgery centers worldwide. It is important that there is a proportionate increase in the availability of acute pain-management services to match the rapid rise of clinical patient load with pain issues in the ambulatory surgery setting. Focus on ambulatory pain control with its special challenges is vital to achieve optimum pain control and prevent morbidity and mortality. Management of perioperative pain in the ambulatory surgery setting is becoming increasingly complex, and requires the employment of a multimodal approach and interventions facilitated by ambulatory surgery pain specialists, which is a new concept. A focused ambulatory pain specialist on site at each ambulatory surgery center, in addition to providing safe anesthesia, could intervene early once problematic pain issues are recognized, thus preventing emergency room visits, as well as readmissions for uncontrolled pain. This paper reviews methods of acute-pain management in the ambulatory setting with risk stratification, the utilization of multimodal interventions, including pharmacological and nonpharmacological options, opioids, nonopioids, and various routes with the goal of preventing delayed discharge and unexpected hospital admissions after ambulatory surgery. Continued research and investigation in the area of pain management with outcome studies in acute surgically inflicted pain in patients with underlying chronic pain treated with opioids and the pattern and predictive factors for pain in the ambulatory surgical setting is needed.

Primary health care utilization prior to suicide: a retrospective case-control study among active-duty military personnel.

PubMed

Hochman, Eldar; Shelef, Leah; Mann, J John; Portugese, Shirly; Krivoy, Amir; Shoval, Gal; Weiser, Mark; Fruchter, Eyal

2014-08-01

About 45% of civilians who died by suicide had contact with a doctor within 1 month of death. Thus, educating primary care physicians (PCP) to detect and mitigate depression is an important suicide-prevention strategy. However, the PCP consulting rate before suicide has not been examined in a military population. We investigated the utilization of primary health care and mental health services by active-duty military personnel suicide cases prior to death in comparison to matched military controls. All suicides (N = 170) were extracted from a cohort of all active-duty Israeli military male personnel between 2002 and 2012. Applying a retrospective, nested case-control design, we compared primary care services utilization by suicide cases with demographic and occupationally matched military controls (N = 500). Whereas 38.3% of suicide cases contacted a PCP within the last month before death, only 27.6% of suicide cases contacted a mental health specialist during their entire service time. The PCP contact rate within 1 month before death or index day did not differ between suicide cases and military controls (38.3% vs. 33.8%, χ²₁ = 1.05, P = .3). More suicide cases contacted a mental health specialist within service time than did military controls (27.6% vs. 13.6%, χ²₁ = 10.85, P = .001). Even though PCP contact rate by military personnel who died by suicide is slightly lower than that reported for civilians who died by suicide prior to their death, it is higher than mental health specialist contact rate and higher than that by age-matched civilians who died by suicide. These results imply that PCPs education is a viable approach to suicide prevention in a military setting. © Copyright 2014 Physicians Postgraduate Press, Inc.

The role of specialist nurses in multiple sclerosis: a rapid and systematic review.

PubMed

De Broe, S; Christopher, F; Waugh, N

2001-01-01

Multiple sclerosis (MS) is a disease of the central nervous system. The cause is unknown. There are about 80-160 people with MS per 100,000 population, with twice as many women affected as men. The management of individuals with MS includes treatment of acute relapses and chronic symptoms. The care of MS patients is provided by various healthcare professionals, such as general practitioners (GPs), neurologists, physiotherapists, occupational therapists and nurses. Some MS patients have access to an MS specialist nurse, although this provision varies geographically. The aim of this report is to assess the effectiveness and relative cost-effectiveness of MS specialist nurses in improving care and outcomes for patients with MS. A systematic review of the literature, involving a range of databases, was performed. Full details are described in the main report. Only one study was identified that tried to evaluate the benefit of MS specialist nurses. The study concluded that MS patients and their carers found the MS specialist nurse to be helpful, particularly in improving their knowledge of MS, ability to cope, mood and confidence about the future. GPs also reported finding the nurse to be helpful with their MS patients, and 40% of the GPs stated they would purchase the services of an MS specialist nurse if their practices became fundholding. However, there were considerable methodological weaknesses inherent in the study design, and it was unclear whether the results of the study could be extrapolated to other settings or to other MS patient groups. RESULTS - ONGOING RESEARCH: There are two ongoing research studies regarding MS specialist nurses. One of these studies involves the provision of MS nurses to several areas, but also has two control populations to allow evaluation of the health benefits of the nurses to MS patients and their carers. This study will help to fill the evidence gap. RESULTS - COSTS: The costs of providing MS specialist nurses consist of their yearly salary (usually NHS grade G), as well as additional costs for travelling, administration, computer and telephone use, a pension scheme, National Insurance and study leave. The MS Society of Great Britain and Northern Ireland allows a generous total yearly cost to the employer of 40,000 pounds. The present evidence does not make it possible to comment with any certainty on the value of specialist nurses in MS. The best evidence available to the authors is specialist opinion from neurologists and nurses, and comments from patients with MS; this opinion supports the provision of MS specialist nurses. CONCLUSIONS - RECOMMENDATIONS FOR RESEARCH: Further research is needed before it will be feasible to make firm recommendations on the value of MS specialist nurses relative to other possible uses of funds.

Views of the mission control center during STS-9

NASA Technical Reports Server (NTRS)

1983-01-01

The two backup payload specialists for Drs. Byron K. Lichtenberg and Ulf Merbold huddle in the mission control center during day three activity aboard Spacelab. Seated at the Console is Dr. Michael Lampton. Leaning over Lampton's shoulder is Dutch scientist Wubbo Ockels. The two are surrounded by a few of the flight controllers in the payload operations control center (POCC) portion of JSC's mission control center.

Community palliative care clinical nurse specialists as independent prescribers: part 2.

PubMed

Latham, Kathy; Nyatanga, Brian

2018-03-02

This study explored the lived experiences of clinical nurse specialists who can prescribe independently in their role of providing support to patients with palliative care needs within the community. Part 1 of this study examined how the study was carried out; this second part explores the findings. The nurses reported that being able to prescribe enabled them to provide seamless, holistic care, which gave patients faster access to medicines, especially at weekends when their GP was unavailable. Prompt availability of medicines led to effective symptom control and consequently a better quality of life for patients. The main barrier to prescribing was difficulty in accessing patient records. Independent prescribing by community nurse specialists is beneficial for patients receiving palliative care and their families while they are being cared for at home, and provides job satisfaction for the nurses.

KSC-07pd0229

NASA Image and Video Library

2007-02-02

KENNEDY SPACE CENTER, FLA. -- In the Space Station Processing Facility, members of the STS-118 crew learn important information from technicians about the control moment gyro (CMG) in front of them that is part of the payload on their mission. Second from left is Mission Specialist Tracy Caldwell; at center, behind the CMG, is Mission Specialist Richard Mastracchio; second from right is Mission Specialist Clayton Anderson, who will be flying on STS-118 to join the Expedition 15 crew as flight engineer on the International Space Station. The CMG will replace a faulty one on the International Space Station. The payload also includes the SPACEHAB single cargo module, the third starboard truss segment (ITS S5) and the external stowage platform 3 (ESP3). STS-118 is targeted to launch June 28 from Launch Pad 39A. Photo credit: NASA/Kim Shiflett

National Airspace System. Operational Requirements.

DTIC Science & Technology

1984-10-01

1. Access to manned NAS tacilities shall be control’ed at all times to prevent intc.rruptio;i of service., distraction of specialists, and theft of...user requirements which cannot otherwise be accomplished. ALTRVs are approved by the appropriate FAA facility. AREA CONTROL1 FACILITY (ACF) - A

Practical color vision tests for air traffic control applicants : en route center and terminal facilities.

DOT National Transportation Integrated Search

1995-04-01

Two practical color vision tests were developed and validated for use in screening Air Traffic Control specialist (ATCS) applicants for work at en route center or terminal facilities. The development of the tests involved careful reproduction/simulat...

The STS-88 crew talks to media before DEPARTing for Houston

NASA Technical Reports Server (NTRS)

1998-01-01

The STS-88 crew meet with news media at the Cape Canaveral Air Station Skid Strip before leaving for Houston. From left, they are Mission Specialists Sergei Konstantinovich Krikalev and James H. Newman, Commander Robert D. Cabana (at microphone), Mission Specialists Jerry L. Ross and Nancy J. Currie, and Pilot Frederick W. 'Rick' Sturckow. The STS-88 crew returned Dec. 15 from a 12-day mission on orbit constructing the first elements of the International Space Station, the U.S.-built Unity connecting module and Russian-built Zarya control module.

The STS-88 crew talks to media before DEPARTing for Houston

NASA Technical Reports Server (NTRS)

1998-01-01

STS-88 Commander Robert D. Cabana (at microphone) speaks to the news media before the crew's departure at Cape Canaveral Air Station. At left are Mission Specialists Sergei Konstantinovich Krikalev and James H. Newman. The other crew members (not shown) are Mission Specialists Jerry L. Ross and Nancy J. Currie, and Pilot Frederick W. 'Rick' Sturckow. The STS-88 crew returned Dec. 15 from a 12-day mission on orbit constructing the first elements of the International Space Station, the U.S.-built Unity connecting module and Russian-built Zarya control module.

["Two professions for a single task". The introduction of chemical engineering in Spain during the first Francoism].

PubMed

Toca, Angel

2006-01-01

Through the first half of the 20th century, chemical engineering was established as an academic option in the training of specialists for the North-American and European chemical industry, whereas it was not a special field of study in Spain until the 1990s. The reason for this delay was a battle of interests between chemist and industrial engineers to control this career during the first Francoism. This article will try to show the development and professionalization of specialists for the Spanish chemical industry.

STS-88 Mission Specialist Currie prepares to enter Endeavour

NASA Technical Reports Server (NTRS)

1998-01-01

STS-88 Mission Specialist Nancy Jane Currie is assisted with her ascent and re-entry flight suit in the white room at Launch Pad 39A before entering Space Shuttle Endeavour for launch. During the nearly 12-day mission, the six-member crew will mate the first two elements of the International Space Station -- the already-orbiting Zarya control module with the Unity connecting module carried by Endeavour. She is making her third spaceflight as the crew's flight engineer and prime operator of the Remote Manipulator System, the robotic arm.

46 CFR 11.472 - National officer endorsements as barge supervisor.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., toolpusher, assistant tool pusher, mechanic, electrician, crane operator, subsea specialist, ballast control... least 168 days of service as driller, assistant driller, toolpusher, assistant toolpusher, mechanic...

Effect of specialist palliative care services on quality of life in adults with advanced incurable illness in hospital, hospice, or community settings: systematic review and meta-analysis

PubMed Central

Siemens, Waldemar; Meerpohl, Joerg J; Antes, Gerd; Meffert, Cornelia; Xander, Carola; Stock, Stephanie; Mueller, Dirk; Schwarzer, Guido; Becker, Gerhild

2017-01-01

Objective To assess the effect of specialist palliative care on quality of life and additional outcomes relevant to patients in those with advanced illness. Design Systematic review with meta-analysis. Data sources Medline, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and trial registers searched up to July 2016. Eligibility criteria for selecting studies Randomised controlled trials with adult inpatients or outpatients treated in hospital, hospice, or community settings with any advanced illness. Minimum requirements for specialist palliative care included the multiprofessional team approach. Two reviewers independently screened and extracted data, assessed the risk of bias (Cochrane risk of bias tool), and evaluated the quality of evidence (GRADE tool). Data synthesis Primary outcome was quality of life with Hedges’ g as standardised mean difference (SMD) and random effects model in meta-analysis. In addition, the pooled SMDs of the analyses of quality of life were re-expressed on the global health/QoL scale (item 29 and 30, respectively) of the European Organization for Research and Treatment of Cancer QLQ-C30 (0-100, high values=good quality of life, minimal clinically important difference 8.1). Results Of 3967 publications, 12 were included (10 randomised controlled trials with 2454 patients randomised, of whom 72% (n=1766) had cancer). In no trial was integration of specialist palliative care triggered according to patients’ needs as identified by screening. Overall, there was a small effect in favour of specialist palliative care (SMD 0.16, 95% confidence interval 0.01 to 0.31; QLQ-C30 global health/QoL 4.1, 0.3 to 8.2; n=1218, six trials). Sensitivity analysis showed an SMD of 0.57 (−0.02 to 1.15; global health/QoL 14.6, −0.5 to 29.4; n=1385, seven trials). The effect was marginally larger for patients with cancer (0.20, 0.01 to 0.38; global health/QoL 5.1, 0.3 to 9.7; n=828, five trials) and especially for those who received specialist palliative care early (0.33, 0.05 to 0.61, global health/QoL 8.5, 1.3 to 15.6; n=388, two trials). The results for pain and other secondary outcomes were inconclusive. Some methodological problems (such as lack of blinding) reduced the strength of the evidence. Conclusions Specialist palliative care was associated with a small effect on QoL and might have most pronounced effects for patients with cancer who received such care early. It could be most effective if it is provided early and if it identifies though screening those patients with unmet needs. Systematic review registration PROSPERO CRD42015020674. PMID:28676557

Outcomes of a four-year specialist-taught physical education program on physical activity: a cluster randomized controlled trial, the LOOK study.

PubMed

Telford, Rohan M; Olive, Lisa S; Cochrane, Thomas; Davey, Rachel; Telford, Richard D

2016-06-08

The objective of this study was to investigate the effect of a 4-year specialist-taught Physical Education (PE) program on physical activity (PA) among primary school children. A 4-year cluster randomised controlled trial was conducted in children (initially aged 8 years) from 29 primary schools (13 Intervention, 16 Control). Intervention students (N = 457) received 2 × 45 min PE lessons per week from specialist-trained PE teachers (68 lessons per year, 272 lessons over 4 years). Control group students (N = 396) received usual practice PE from generalist classroom teachers. PA during PE lessons was examined using the System for Observing Fitness Instruction Time (SOFIT). Pedometers (steps/day) were worn for 7 days each year, and accelerometers were worn concurrently in the final two years to assess moderate to vigorous (MVPA) and sedentary activity. Linear and generalized mixed models were used to determine differences in Intervention and Control student PA and the proportion of students meeting PA guidelines. The intervention increased SOFIT-observed student MVPA during PE lessons by 6.5 mins (16.7 v 10.2, p < 0.001). Within intervention schools, participants increased their whole-day step counts (boys = 449 [CI,140 to 756]; girls = 424 [CI,222 to 626]) and minutes of MVPA (boys = 8.0 [CI,6.8 to 9.2]; girls = 3.5 [CI,1.7 to 5.4]) on PE days. However, compared to the Control group the Intervention did not: increase habitual steps/day or MVPA when averaged over 7 days; elicit greater improvements in these measures over time; or increase the odds of meeting step/day or MVPA recommendations. At age 11 years Intervention group boys were 20 mins less sedentary per day (380 [CI,369 to 391] vs 360 [CI,350 to 369]) and this effect was sustained at age 12 years. Well-designed specialist-taught PE can improve student PA during PE lessons. However for PE to be a significant contributor to improving habitual PA in pre-adolescent children, daily classes are likely to be required, and even this would need to be supplemented with a wider multicomponent strategy. Our finding of a reduction in sedentary time among Intervention boys warrants further investigation into the potential role PE could play in influencing sedentary behaviour.

The work left undone. Understanding the challenge of providing holistic lung cancer nursing care in the UK.

PubMed

Leary, Alison; White, John; Yarnell, Laura

2014-02-01

In England best practice guidance in cancer recommends that all patients have access to a specialist nurse such as the tumour specific clinical nurse specialist. The role has become pivotal providing aspects of care e.g. meeting information needs, holistic nurse led follow up including symptom control, managing care and providing psychological and social interventions including referral to others in the role of keyworker. There are approximately 295 lung cancer nurse specialists in England and recent study to model optimum caseload used an on line survey to look at workload of lung cancer specialist nurses. A survey of 100 lung cancer nurses from across the UK (RR78%) examined the perception of the work left undone against best practice guidance, caseload size, workload and other factors. 67 of 78 respondents perceived they left work such as proactive management (52) undertaking holistic needs assessments (46) providing appropriate psychological care (26) and meeting information needs (16). The majority (70) worked unpaid overtime (mean 3.8 h range 1-10 h) per week. Although proactive management is thought to result in better outcomes for lung cancer patients in terms of survival, quality of life and decisions of end of life a substantial number of the specialist nurses felt that factors such as caseload and organisational factors inhibited this. Copyright © 2013 Elsevier Ltd. All rights reserved.

Work-related stress, job resources, and well-being among psychiatrists and other medical specialists in Finland.

PubMed

Heponiemi, Tarja; Aalto, Anna-Mari; Puttonen, Sampsa; Vänskä, Jukka; Elovainio, Marko

2014-06-01

Previous studies suggest that psychiatrists may be more stressed than other medical specialists and mental health professionals. This study examined differences in stress factors, job resources, psychological distress, and job satisfaction between psychiatrists and other medical specialists. In addition, the study examined whether stress factors or job resources accounted for possible differences between the groups in psychological distress or job satisfaction. In 2010, the authors obtained cross-sectional, Web-based survey data from a random sample of 2,776 Finnish physicians, including 1,647 women (59%), ranging in age from 25 to 69 years old. Comparisons between the two groups used analyses of covariance adjusted for gender, age, and employment sector. Psychiatrists were less satisfied with their jobs, felt more stressed about patients, and experienced more psychological distress compared with other medical specialists. However, psychiatrists had more opportunities to control their jobs and better team climate compared with other medical specialists. High psychological distress among psychiatrists was partly accounted for by high patient-related stress. The differences in psychological distress and job satisfaction between the two groups were not accounted for by work-family conflicts or optimism. It is important to try to alleviate the high levels of patient-related stress among psychiatrists and to further increase their job resources. Doing so may enhance the attractiveness of psychiatry as a specialty choice.

Population-level compensation impedes biological control of an invasive forb and indirect release of a native grass

Treesearch

Yvette K. Ortega; Dean E. Pearson; Lauren P. Waller; Nancy J. Sturdevant; John L. Maron

2012-01-01

The intentional introduction of specialist insect herbivores for biological control of exotic weeds provides ideal but understudied systems for evaluating important ecological concepts related to top-down control, plant compensatory responses, indirect effects, and the influence of environmental context on these processes. Centaurea stoebe (spotted knapweed) is a...

Molecular comparison of cattle fever ticks from native and introduced ranges with insights into optimal search areas for classical biological control agents

USDA-ARS?s Scientific Manuscript database

Classical biological control using specialist parasitoids, predators and/or nematodes from the native ranges of cattle fever ticks could complement existing control strategies for this livestock pest in the transboundary region between Mexico and Texas. DNA fingerprinting tools were used to compare ...

Correlates of two experimental tests with performance in the FAA Academy air traffic control nonradar screen program.

DOT National Transportation Integrated Search

1990-08-01

This study was designed to determine the relationships among experimental tests, the tests currently used to select entrants into the FAA's Air Traffic Control Specialist (ATCS) Academy Nonradar Screening Program, and Academy success. A battery of pa...

Brown at RMS controls on the aft flight deck

NASA Image and Video Library

1998-11-24

STS095-366-031 (29 Oct-7 Nov 1998) --- Astronaut Curtis L. Brown, Jr., mission commander, operates controls on the aft flight deck of the Space Shuttle Discovery. Brown was joined by four other NASA astronauts and two payload specialists for the nine-day mission.

Brown, Rominger and Curbeam conduct flight control systems checkout

NASA Image and Video Library

1997-08-29

STS085-330-034 (7 - 19 August 1997) --- From the left, astronauts Curtis L. Brown, Jr., mission commander; Robert L. Curbeam, Jr., mission specialist; and Kent V. Rominger, pilot, are pictured on the Space Shuttle Discovery's flight deck during a checkout of flight control systems.

Environmental Impact Analysis Process, Environmental Assessment Space Test Experiments Platform Mission 1, Vandenberg Air Force Base, CA

DTIC Science & Technology

1994-01-05

Information LOCAL AGENCIES Santa Barbara County Air Pollution Control District, California Hallerman , Richard Air Quality Specialist City of...Base. Provided by Richard Hallerman , SBCAPCD, to Bob Baxter, Engineering-Science. 11 June. ____, 1991. Santa Barbara County Air Pollution Control

Health maintenance organization penetration and the practice location choices of new physicians: a study of large metropolitan areas in the United States.

PubMed

Escarce, J J; Polsky, D; Wozniak, G D; Pauly, M V; Kletke, P R

1998-11-01

The rapid growth of health maintenance organizations is reshaping the practice opportunities available to physicians. The practice location decisions of new physicians provide a sensitive bellwether of these changes. This study assessed the effect of health maintenance organization penetration on practice location for physicians completing graduate medical education (GME). Conditional logit regression analysis was used to determine the effect of health maintenance organization penetration on practice location, controlling for other market characteristics. Subjects were physicians who finished GME between 1989 and 1994 and who located in one of the 98 US metropolitan areas with more than 500,000 population. The outcome measure was the particular metropolitan area chosen by each new physician. Early in the study period, new generalists were significantly more likely to locate in metropolitan areas with high health maintenance organization penetration than in low penetration areas, whereas new specialists' practice location choices were not associated with health maintenance organization penetration. The likelihood of choosing a high penetration relative to a low penetration area declined with time, however, for both generalists and specialists. Consequently, by the end of the study period, health maintenance organization penetration had a weak but significant negative effect on practice location for generalists and a strong negative influence on practice location for specialists. New generalists who completed graduate medical education between 1989 and 1994 were more likely than new specialists to locate in market areas with high health maintenance organization penetration; however, the proportions of both generalists and specialists who chose high penetration areas decreased during the study period. This finding may reflect reduced practice opportunities in high penetration areas relative to low penetration areas as health maintenance organizations' systems for controlling utilization began to yield results. Alternatively, new physicians may have become more hesitant to accept available positions in high penetration areas.

STS-55 German Payload Specialist Schlegel manipulates ROTEX controls in SL-D2

NASA Technical Reports Server (NTRS)

1993-01-01

STS-55 German Payload Specialist 2 Hans Schlegel, wearing goggles (eye glasses) and positioned in front of Spacelab Deutsche 2 (SL-D2) Rack 4 System Rack controls, operates Robotics Technology Experiment (ROTEX) arm. ROTEX is a robotic arm that operates within an enclosed workcell in Rack 6 (partially visible in the foreground) and uses teleoperation from both an onboard station located nearby in Rack 4 and from a station on the ground. The device uses teleprogramming and artificial intelligence to look at the design, verification and operation of advanced autonomous systems for use in future applications. Schlegel represents the German Aerospace Research Establishment (DLR). SL-D2, a German-managed payload, is aboard Columbia, Orbiter Vehicle (OV) 102, for this science research mission.

Understanding the needs of hand control users, driver rehabilitation specialists, and dealers/installers.

PubMed

Lowe, Evan; Drouin, Nathalie; Venhovens, Paul J; Brooks, Johnell O

2014-10-01

Understanding unique perspectives from key stakeholder groups involved in the hand control (HC) industry, including driver rehabilitation specialists (DRSs) who train users how to use their HCs, dealers/installers, and users, may become increasingly important in the United States due to increases in elderly, diabetic, and wounded warrior amputee driving populations. In this exploratory study, phone interviews were conducted with 20 DRSs, 20 dealers/installers, and 20 users regarding their perspectives about HC training, maintenance and operation, and design improvements. Results revealed common views and differences in perspectives about whether HC users should receive training and for how long, when and how often users should receive maintenance on their HCs, and what DRSs, dealers/installers, and users would like to see in the future.

Improved glycemic control in veterans with poorly controlled diabetes mellitus using a Specialty Care Access Network-Extension for Community Healthcare Outcomes model at primary care clinics.

PubMed

Watts, Sharon A; Roush, Laura; Julius, Mary; Sood, Ajay

2016-06-01

An increasing number of patients with diabetes mellitus has created a need for innovative delivery of specialized care not only by diabetes specialists but also by primary care providers (PCPs) as well. A potential avenue to address this need is training of PCPs by specialists via telehealth. The Veteran Affairs (VA) Specialty Care Access Network-Extension for Community Healthcare Outcomes (SCAN-ECHO) program includes education and case-based learning for PCPs by a multidisciplinary specialty team utilizing videoconferencing technology. Two PCPs completed a year of SCAN-ECHO diabetes training. These two PCPs set up "diabetes mini-clinics" to treat difficult-to-control high-risk patients with diabetes mellitus from their own panel and from their colleagues in the same community-based outpatient clinic (CBOC). We utilized a retrospective program evaluation by t-test using pre/post glycated hemoglobin (HbA1c) lab values after being seen by the two PCPs. A total of 39 patients, all with HbA1c > 9.0%, were seen in the two PCP mini-clinics over 15 months. The mean HbA1c improved from 10.2 ± 1.4% to 8.4 ± 1.8% (p < 0.001) over the average follow-up period of five months. This was not explained by system-wide changes or improvements. Care of veteran patients with poorly controlled diabetes by PCPs who participated in SCAN-ECHO program leads to improvement in glycemic control. This model of health care delivery can be effective in remote or rural areas with limited availability of specialists. © The Author(s) 2015.

The impact of dysfunctional breathing on the assessment of asthma control.

PubMed

Veidal, Sandra; Jeppegaard, Maria; Sverrild, Asger; Backer, Vibeke; Porsbjerg, Celeste

2017-02-01

Dysfunctional breathing (DB) is a respiratory disorder, which involves a pattern of breathing too deeply, too superficially and/or too rapidly. In asthma patients, DB may lead to an overestimation of the severity of asthma symptoms, and hence potentially to overtreatment. However, it is not known to which degree DB may affect estimates of asthma control, in a specialist clinical setting. The MAPOut-study examined all patients referred consecutively over a 12-months period for specialist assessment of asthma at the Respiratory Outpatient Clinic at Bispebjerg Hospital in Copenhagen. All patients were examined with the Nijmegen questionnaire with a DB defined as a score ≥23 and the ACQ questionnaire. Linear regression analysis of predictors of ACQ score was performed. Asthma was defined as asthma symptoms and a positive asthma test. Of the 256 patients referred to the lung clinic, data on both the Nijmegen questionnaire and ACQ score was obtained in 127 patients, who were included in the present analysis. Median (range) age: 30 (15-63) years, and 76 (59.8%) were females. DB was found in 31 (24.4%). Asthmatic patients with co-existing DB had a poorer asthma control compared to asthmatics without DB (Median (range) ACQ score: 2.40 (0.20-4.60) vs 1.20 (0.00-4.40); p < 0.001.). A regression analysis showed that the effect of DB on asthma control was independent of airway hyperresponsiveness or airway inflammation in patients with DB. Dysfunctional breathing is common among asthma patients in a specialist setting, and results in a clinically significant underestimation of asthma control, which may potentially lead to overtreatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, astronaut Stephen Frick and STS-114 Mission Specialist Wendy Lawrence watch as crew members work with equipment that will be used on the mission. Frick is a tile specialist, who joined the STS-114 crew during equipment familiarization at KSC. STS-114 is classified as Logistics Flight 1 to the International Space Station, delivering new supplies and replacing one of the orbital outpost’s Control Moment Gyroscopes (CMGs). STS-114 will also carry a Raffaello Multi-Purpose Logistics Module and the External Stowage Platform-2. The crew is slated to conduct at least three spacewalks: They will demonstrate repair techniques of the Shuttle’s Thermal Protection System, replace the failed CMG with one delivered by the Shuttle, and install the External Stowage Platform.

NASA Image and Video Library

2004-01-27

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, astronaut Stephen Frick and STS-114 Mission Specialist Wendy Lawrence watch as crew members work with equipment that will be used on the mission. Frick is a tile specialist, who joined the STS-114 crew during equipment familiarization at KSC. STS-114 is classified as Logistics Flight 1 to the International Space Station, delivering new supplies and replacing one of the orbital outpost’s Control Moment Gyroscopes (CMGs). STS-114 will also carry a Raffaello Multi-Purpose Logistics Module and the External Stowage Platform-2. The crew is slated to conduct at least three spacewalks: They will demonstrate repair techniques of the Shuttle’s Thermal Protection System, replace the failed CMG with one delivered by the Shuttle, and install the External Stowage Platform.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, STS-114 Mission Specialists Andrew Thomas (center) and Soichi Noguchi (right) work with equipment while Mission Specialist Charles Camarda (left) watches. Noguchi is with the Japanese Aerospace Exploration Agency (JAXA). They and other crew members are at KSC for equipment familiarization. STS-114 is classified as Logistics Flight 1 to the International Space Station, delivering new supplies and replacing one of the orbital outpost’s Control Moment Gyroscopes (CMGs). STS-114 will also carry a Raffaello Multi-Purpose Logistics Module and the External Stowage Platform-2. The crew is slated to conduct at least three spacewalks: They will demonstrate repair techniques of the Shuttle’s Thermal Protection System, replace the failed CMG with one delivered by the Shuttle, and install the External Stowage Platform.

NASA Image and Video Library

2004-01-27

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, STS-114 Mission Specialists Andrew Thomas (center) and Soichi Noguchi (right) work with equipment while Mission Specialist Charles Camarda (left) watches. Noguchi is with the Japanese Aerospace Exploration Agency (JAXA). They and other crew members are at KSC for equipment familiarization. STS-114 is classified as Logistics Flight 1 to the International Space Station, delivering new supplies and replacing one of the orbital outpost’s Control Moment Gyroscopes (CMGs). STS-114 will also carry a Raffaello Multi-Purpose Logistics Module and the External Stowage Platform-2. The crew is slated to conduct at least three spacewalks: They will demonstrate repair techniques of the Shuttle’s Thermal Protection System, replace the failed CMG with one delivered by the Shuttle, and install the External Stowage Platform.

Comparative Effectiveness of Web-Based vs. Educator-Delivered HIV Prevention for Adolescent Substance Users: A Randomized, Controlled Trial.

PubMed

Marsch, Lisa A; Guarino, Honoria; Grabinski, Michael J; Syckes, Cassandra; Dillingham, Elaine T; Xie, Haiyi; Crosier, Benjamin S

2015-12-01

Young people who engage in substance use are at risk for becoming infected with HIV and diseases with similar transmission dynamics. Effective disease prevention programs delivered by prevention specialists exist but are rarely provided in systems of care due to staffing/resource constraints and operational barriers-and are thus of limited reach. Web-based prevention interventions could possibly offer an effective alternative to prevention specialist-delivered interventions and may enable widespread, cost-effective access to evidence-based prevention programming. Previous research has shown the HIV/disease prevention program within the Web-based therapeutic education system (TES) to be an effective adjunct to a prevention specialist-delivered intervention. The present study was the first randomized, clinical trial to evaluate the comparative effectiveness of this Web-based intervention as a standalone intervention relative to a traditional, prevention specialist-delivered intervention. Adolescents entering outpatient treatment for substance use participated in this multi-site trial. Participants were randomly assigned to either a traditional intervention delivered by a prevention specialist (n=72) or the Web-delivered TES intervention (n=69). Intervention effectiveness was assessed by evaluating changes in participants' knowledge about HIV, hepatitis, and sexually transmitted infections, intentions to engage in safer sex, sex-related risk behavior, self-efficacy to use condoms, and condom use skills. Participants in the TES intervention achieved significant and comparable increases in HIV/disease-related knowledge, condom use self-efficacy, and condom use skills and comparable decreases in HIV risk behavior relative to participants who received the intervention delivered by a prevention specialist. Participants rated TES as easier to understand. This study indicates that TES is as effective as HIV/disease prevention delivered by a prevention specialist. Because technology-based interventions such as TES have high fidelity, are inexpensive and scalable, and can be implemented in a wide variety of settings, they have the potential to greatly increase access to effective prevention programming. Copyright © 2015 Elsevier Inc. All rights reserved.

Selection of the next generation of air traffic control specialists : aptitude requirements for the air traffic control tower cab in 2018.

DOT National Transportation Integrated Search

2013-03-01

The Federal Aviation Administration (FAA) faces two significant organizational challenges in the 21st century: (1) transformation of the current NAS into the Next Generation Air Transportation System (NextGen); and (2) recruitment, selection, a...

STS-41 crew communicates with ground controllers from OV-103's flight deck

NASA Image and Video Library

1990-10-10

STS041-02-035 (6-10 Oct 1990) --- A fish-eye lens view shows two of STS-41's three mission specialists on the flight deck of Discovery. Astronaut William M. Shepherd, right, communicates with ground controllers as Astronaut Bruce E. Melnick looks on.

Problems in air traffic management. V., Identification and potential aptitude test measures for selection of tower air traffic controller trainees.

DOT National Transportation Integrated Search

1965-07-01

A study of over 200 Terminal Air Traffic Control Specialists indicated that their training performance could be well predicted by a composite of four aptitude tests measuring: numerical ability, non-verbal abstract reasoning, ability to solve simplif...

STS-33 MS Carter operates translation hand control (THC) on aft flight deck

NASA Image and Video Library

1989-11-27

STS033-93-011 (27 Nov 1989) --- Astronaut Manley L. Carter, Jr., STS-33 mission specialist, operates translation hand control (THC) at the aft flight deck on orbit station while peering out overhead window W7. Carter's communications kit assembly headset microphone extends across his face.

75 FR 14385 - Revocation of Class D and E Airspace; Panama City, FL

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-25

..., as the old airport and control tower is scheduled to be closed. Controlled airspace will be..., Airspace Specialist, Operations Support Group, Eastern Service Center, Air Traffic Organization, Federal... the proposed rule. The proposal contained in this notice may be changed in light of the comments...

VISITOR - SULTAN - JSC

NASA Image and Video Library

1985-04-04

S85-29711 (April 1985) --- Ronald C. Epps, right of the training division in the mission operations directorate, briefs the Saudi Arabian payload specialist, Sultan Salman Abdelazize Al-Saud, and his backup, Abdulmohsen Hamad Al-Bassam, in the flight control room (FCR) of the mission control center (MCC). Erlinda Stevenson is also pictured.

STS-94 Columbia Landing at KSC

NASA Technical Reports Server (NTRS)

1997-01-01

The Space Shuttle orbiter Columbia glides in for a touchdown on Runway 33 at KSCs Shuttle Landing Facility at approximately 6:46 a.m. EDT with Mission Commander James D. Halsell Jr. and Pilot Susan L. Still at the controls to complete the STS-94 mission. Also on board are Mission Specialist Donald A. Thomas, Mission Specialist Michael L. Gernhardt, Payload Commander Janice Voss, and Payload Specialists Roger K.Crouch and Gregory T. Linteris. During the Microgravity Science Laboratory-1 (MSL-1) mission, the Spacelab module was used to test some of the hardware, facilities and procedures that are planned for use on the International Space Station while the flight crew conducted combustion, protein crystal growth and materials processing experiments. This mission was a reflight of the STS-83 mission that lifted off from KSC in April of this year. That space flight was cut short due to indications of a faulty fuel cell.

Stigma Predicts Treatment Preferences and Care Engagement among Veterans Affairs Primary Care Patients with Depression

PubMed Central

Campbell, Duncan G.; Bonner, Laura M.; Bolkan, Cory R.; Lanto, Andrew B.; Zivin, Kara; Waltz, Thomas J.; Klap, Ruth; Rubenstein, Lisa V.; Chaney, Edmund F.

2016-01-01

Background Whereas stigma regarding mental health concerns exists, the evidence for stigma as a depression treatment barrier among patients in Veterans Affairs (VA) primary care (PC) is mixed. Purpose To test whether stigma, defined as depression label avoidance, predicted patients' preferences for depression treatment providers, patients' prospective engagement in depression care, and care quality. Methods We conducted cross-sectional and prospective analyses of existing data from 761 VA PC patients with probable major depression. Results Relative to low stigma patients, those with high stigma were less likely to prefer treatment from mental health specialists. In prospective controlled analyses, high stigma predicted lower likelihood of the following: taking medications for mood, treatment by mental health specialists, treatment for emotional concerns in PC, and appropriate depression care. Conclusions High stigma is associated with lower preferences for care from mental health specialists and confers risk for minimal depression treatment engagement. PMID:26935310

STS-94 Columbia Landing at KSC (before main gear touchdown)

NASA Technical Reports Server (NTRS)

1997-01-01

The Space Shuttle orbiter Columbia glides in for a touchdown on Runway 33 at KSCs Shuttle Landing Facility at approximately 6:46 a.m. EDT with Mission Commander James D. Halsell Jr. and Pilot Susan L. Still at the controls to complete the STS-94 mission. Also on board are Mission Specialist Donald A. Thomas, Mission Specialist Michael L. Gernhardt, Payload Commander Janice Voss, and Payload Specialists Roger K.Crouch and Gregory T. Linteris. During the Microgravity Science Laboratory-1 (MSL-1) mission, the Spacelab module was used to test some of the hardware, facilities and procedures that are planned for use on the International Space Station while the flight crew conducted combustion, protein crystal growth and materials processing experiments. This mission was a reflight of the STS-83 mission that lifted off from KSC in April of this year. That space flight was cut short due to indications of a faulty fuel cell.

Computer tablet distraction reduces pain and anxiety in pediatric burn patients undergoing hydrotherapy: A randomized trial.

PubMed

Burns-Nader, Sherwood; Joe, Lindsay; Pinion, Kelly

2017-09-01

Distraction is often used in conjunction with analgesics to minimize pain in pediatric burn patients during treatment procedures. Computer tablets provide many options for distraction items in one tool and are often used during medical procedures. Few studies have examined the effectiveness of tablet distraction in improving the care of pediatric burn patients. This study examines the effectiveness of tablet distraction provided by a child life specialist to minimize pain and anxiety in pediatric burn patients undergoing hydrotherapy. Thirty pediatric patients (4-12) undergoing hydrotherapy for the treatment of burns participated in this randomized clinical trial. The tablet distraction group received tablet distraction provided by a child life specialist while those in the control group received standard care. Pain was assessed through self-reports and observation reports. Anxiety was assessed through behavioral observations. Length of procedure was also recorded. Nurses reported significantly less pain for the tablet distraction group compared to the control group. There was no significant difference between groups on self-reported pain. The tablet distraction group displayed significantly less anxiety during the procedure compared to the control group. Also, the tablet distraction group returned to baseline after the procedure while those in the control group displayed higher anxiety post-procedure. There was no difference in the length of the procedure between groups. These findings suggest tablet distraction provided by a child life specialist may be an effective method for improving pain and anxiety in children undergoing hydrotherapy treatment for burns. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Cost-effectiveness of monitoring glaucoma patients in shared care: an economic evaluation alongside a randomized controlled trial.

PubMed

Holtzer-Goor, Kim M; van Sprundel, Esther; Lemij, Hans G; Plochg, Thomas; Klazinga, Niek S; Koopmanschap, Marc A

2010-11-17

Population aging increases the number of glaucoma patients which leads to higher workloads of glaucoma specialists. If stable glaucoma patients were monitored by optometrists and ophthalmic technicians in a glaucoma follow-up unit (GFU) rather than by glaucoma specialists, the specialists' workload and waiting lists might be reduced.We compared costs and quality of care at the GFU with those of usual care by glaucoma specialists in the Rotterdam Eye Hospital (REH) in a 30-month randomized clinical trial. Because quality of care turned out to be similar, we focus here on the costs. Stable glaucoma patients were randomized between the GFU and the glaucoma specialist group. Costs per patient year were calculated from four perspectives: those of patients, the Rotterdam Eye Hospital (REH), Dutch healthcare system, and society. The outcome measures were: compliance to the protocol; patient satisfaction; stability according to the practitioner; mean difference in IOP; results of the examinations; and number of treatment changes. Baseline characteristics (such as age, intraocular pressure and target pressure) were comparable between the GFU group (n = 410) and the glaucoma specialist group (n = 405).Despite a higher number of visits per year, mean hospital costs per patient year were lower in the GFU group (€139 vs. €161). Patients' time and travel costs were similar. Healthcare costs were significantly lower for the GFU group (€230 vs. €251), as were societal costs (€310 vs. €339) (p < 0.01). Bootstrap-, sensitivity- and scenario-analyses showed that the costs were robust when varying hospital policy and the duration of visits and tests. We conclude that this GFU is cost-effective and deserves to be considered for implementation in other hospitals.

Influences of Plant Traits on Immune Responses of Specialist and Generalist Herbivores

PubMed Central

Lampert, Evan

2012-01-01

Specialist and generalist insect herbivore species often differ in how they respond to host plant traits, particularly defensive traits, and these responses can include weakened or strengthened immune responses to pathogens and parasites. Accurate methods to measure immune response in the presence and absence of pathogens and parasites are necessary to determine whether susceptibility to these natural enemies is reduced or increased by host plant traits. Plant chemical traits are particularly important in that host plant metabolites may function as antioxidants beneficial to the immune response, or interfere with the immune response of both specialist and generalist herbivores. Specialist herbivores that are adapted to process and sometimes accumulate specific plant compounds may experience high metabolic demands that may decrease immune response, whereas the metabolic demands of generalist species differ due to more broad-substrate enzyme systems. However, the direct deleterious effects of plant compounds on generalist herbivores may weaken their immune responses. Further research in this area is important given that the ecological relevance of plant traits to herbivore immune responses is equally important in natural systems and agroecosystems, due to potential incompatibility of some host plant species and cultivars with biological control agents of herbivorous pests. PMID:26466545

The feasibility and acceptability of conducting a trial of specialist medical care and the Lightning Process in children with chronic fatigue syndrome: feasibility randomized controlled trial (SMILE study)

PubMed Central

2013-01-01

Background Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is relatively common in children with limited evidence for treatment. The Phil Parker Lightning Process (LP) is a trademarked intervention, which >250 children use annually. There are no reported studies investigating the effectiveness or possible side effects of LP. Methods The trial population was drawn from the Bath and Bristol NHS specialist paediatric CFS or ME service. The study was designed as a pilot randomized trial with children (aged 12 to 18 years) comparing specialist medical care with specialist medical care plus the Lightning Process. Integrated qualitative methodology was used to explore the feasibility and acceptability of the recruitment, randomization and interventions. Results A total of 56 children were recruited from 156 eligible children (1 October 2010 to 16 June 2012). Recruitment, randomization and both interventions were feasible and acceptable. Participants suggested changes to improve feasibility and acceptability and we incorporated the following in the trial protocol: stopped collecting 6-week outcomes; introduced a second reminder letter; used phone calls to collect primary outcomes from nonresponders; informed participants about different approaches of each intervention and changed our recommendation for the primary outcome for the full study from school attendance to disability (SF-36 physical function subscale) and fatigue (Chalder Fatigue Scale). Conclusions Conducting randomized controlled trials (RCTs) to investigate an alternative treatment such as LP is feasible and acceptable for children with CFS or ME. Feasibility studies that incorporate qualitative methodology enable changes to be made to trial protocols to improve acceptability to participants. This is likely to improve recruitment rate and trial retention. Trial registration Feasibility study first randomization: 29 September 2010. Trial registration: Current Controlled Trials ISRCTN81456207 (31 July 2012). Full trial first randomization: 19 September 2012. PMID:24304689

Habit training versus habit training with direct visual biofeedback in adults with chronic constipation: study protocol for a randomised controlled trial.

PubMed

Norton, Christine; Emmanuel, Anton; Stevens, Natasha; Scott, S Mark; Grossi, Ugo; Bannister, Sybil; Eldridge, Sandra; Mason, James M; Knowles, Charles H

2017-03-24

Constipation affects up to 20% of adults. Chronic constipation (CC) affects 1-2% of adults. Patient dissatisfaction is high; nearly 80% feel that laxative therapy is unsatisfactory and symptoms have significant impact on quality of life. There is uncertainty about the value of specialist investigations and whether equipment-intensive therapies using biofeedback confer additional benefit when compared with specialist conservative advice. A three-arm, parallel-group, multicentre randomised controlled trial. to determine whether standardised specialist-led habit training plus pelvic floor retraining using computerised biofeedback is more clinically effective than standardised specialist-led habit training alone; to determine whether outcomes are improved by stratification based on prior investigation of anorectal and colonic pathophysiology. Primary outcome measure is response to treatment, defined as a 0.4-point (10% of scale) or greater reduction in Patient Assessment of Constipation-Quality of Life (PAC-QOL) score 6 months after the end of treatment. Other outcomes up to 12 months include symptoms, quality of life, health economics, psychological health and qualitative experience. (1) habit training (HT) with computer-assisted direct visual biofeedback (HTBF) results in an average reduction in PAC-QOL score of 0.4 points at 6 months compared to HT alone in unselected adults with CC, (2) stratification to either HT or HTBF informed by pathophysiological investigation (INVEST) results in an average 0.4-point reduction in PAC-QOL score at 6 months compared with treatment not directed by investigations (No-INVEST). Inclusion: chronic constipation in adults (aged 18-70 years) defined by self-reported symptom duration of more than 6 months; failure of previous laxatives or prokinetics and diet and lifestyle modifications. Consenting participants (n = 394) will be randomised to one of three arms in an allocation ratio of 3:3:2: [1] habit training, [2] habit training and biofeedback or [3] investigation-led allocation to one of these arms. Analysis will be on an intention-to-treat basis. This trial has the potential to answer some of the major outstanding questions in the management of chronic constipation, including whether costly invasive tests are warranted and whether computer-assisted direct visual biofeedback confers additional benefit to well-managed specialist advice alone. International Standard Randomised Controlled Trial Number: ISRCTN11791740. Registered on 16 July 2015.

A Management-Decision-Oriented View of Medical School Information System Requirements

ERIC Educational Resources Information Center

Kutina, Kenneth L.; Lee, Edgar

1973-01-01

At Case Western Reserve University an interdisciplinary management team has been formed of educators and management specialists to effectively organize, plan and control the medical school. (Editor/PG)

STS-109 Post Flight Presentation

NASA Astrophysics Data System (ADS)

2002-04-01

The STS-109 Post Flight presentation begins with Mission Specialists Nancy J. Currie, Michael J. Massimino, James H. Newman, and Richard M. Linnehan shown getting suited on launch day. Actual footage of the liftoff of the Space Shuttle Columbia is shown. Five spacewalks are performed to service the Hubble Space Telescope. Richard Linnehan and John Grunsfield are replacing solar arrays, connectors and power control units on the Hubble Space Telescope. Mission Specialist Nancy Currie will use Space Shuttle Columbia's robotic arm to grab the telescope, move it away from the orbiter and release it. A look at the coast of South America is also presented.

International Space Station (ISS)

NASA Image and Video Library

2007-11-03

Astronaut Doug Wheelock, STS-120 mission specialist, participated in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery was docked with the International Space Station (ISS). During the 7-hour and 19-minute space walk, astronaut Scott Parazynski (out of frame), mission specialist, cut a snagged wire and installed homemade stabilizers designed to strengthen the structure and stability of the damaged P6 4B solar array wing. Wheelock assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

Color perception and ATC job performance.

DOT National Transportation Integrated Search

1983-07-01

Current OMP policy and guidance requires demonstrated job-relatedness and reasonable accommodation in the application of physical qualifications. The OPM has accomplished an analysis of the Air Traffic Control Specialist (ATCS) series and recommended...

[Decrease in nosocomial infection based on continuous monitoring and control. 7 years' experience in a women's clinic].

PubMed

Hirsch, H A; Niehues, U; Decker, K

1985-12-13

During a seven-year programme of surveillance and control of infection data were collected by a specialist hygiene nurse on 47 551 gynaecological, obstetric and post-partum patients. The infection rate was highest (40.5%) after major surgical procedures. Infection rate after cesarian section was 16%, eight times the rate after vaginal delivery (2%). The most frequent type of infection was of the urinary tract (70%), usually asymptomatic bacteriuria. Next most frequent were pelvic infections, abdominal wound infections, and phlebitis via an intravenous entry in long-term parenteral nutrition. During the period of observation bacteriuria rate decreased by 75%, the other nosocomial infections by 64%, febrile standard morbidity by 81%. The decrease is largely due to the infection surveillance programme with the employment of a specialist hygiene nurse.

Piloting Vertical Flight Aircraft: A Conference on Flying Qualities and Human Factors

NASA Technical Reports Server (NTRS)

Blanken, Christopher L. (Editor); Whalley, Matthew S. (Editor)

1993-01-01

This document contains papers from a specialists' meeting entitled 'Piloting Vertical Flight Aircraft: A Conference on Flying Qualities and Human Factors.' Vertical flight aircraft, including helicopters and a variety of Vertical Takeoff and Landing (VTOL) concepts, place unique requirements on human perception, control, and performance for the conduct of their design missions. The intent of this conference was to examine, for these vehicles, advances in: (1) design of flight control systems for ADS-33C standards; (2) assessment of human factors influences of cockpit displays and operational procedures; (3) development of VTOL design and operational criteria; and (4) development of theoretical methods or models for predicting pilot/vehicle performance and mission suitability. A secondary goal of the conference was to provide an initial venue for enhanced interaction between human factors and handling qualities specialists.

Methodology for a randomised controlled trial of preschool vision screening. A new approach with the 'ALSPAC' project.

PubMed

Williams, C; Harrad, R A; Harvey, I; Frankel, S; Golding, J

1996-06-01

We present the methodology of a population-based Randomised Controlled Trial, comparing an intensive programme of primary preschool vision screening by orthoptists with the usual non-specialist screening. The aims of the trial are to compare the effectiveness and costs of intensive orthoptic screening with non-specialist measures. The orthoptic screening programme will be evaluated both as a composite package and in terms of the screening value of the individual tests at specific ages. This trial is nested within a large population-based longitudinal study. Additional demographic and developmental data on the children in the trial are therefore available. The results of the trial will be used to help clarify which methods of preschool ophthalmic population screening are best in terms of disease detection and cost efficiency.

Power, Control and Status in Physical Education.

ERIC Educational Resources Information Center

Thomson, Ian

2003-01-01

For most of the 20th century, Scottish teacher education in physical education, sport, and recreation were divided by gender and philosophy and provided by two specialist colleges. Analysis of the government's 1986 decision to merge the colleges focuses on the shift in power and control from the self-contained world of physical education to…

Funding needed for assessments of weed biological control

Treesearch

John L. Maron; Dean E. Pearson; Stephen M. Hovick; Walter P. Carson

2010-01-01

Invasive non-native plants are a serious economic and ecological problem worldwide, and major efforts are therefore devoted to reducing weed abundance in agricultural and natural settings. Effective options for reducing invasive abundance and spread are few, although one common approach is biological control - the introduction of specialist herbivores or pathogens from...

MS Currie at RMS controls during EVA 2

NASA Image and Video Library

2002-03-05

STS109-E-5625 (5 March 2002) --- Astronaut Nancy J. Currie, mission specialist, controls the Remote Manipulator System (RMS) robotic arm of the Space Shuttle Columbia as two astronauts perform work on the Hubble Space Telescope (HST), temporarily hosted in the shuttle's cargo bay. The image was recorded with a digital still camera.

Large space structures fabrication experiment. [on-orbit fabrication of graphite/thermoplastic beams

NASA Technical Reports Server (NTRS)

1978-01-01

The fabrication machine used for the rolltrusion and on-orbit forming of graphite thermoplastic (CTP) strip material into structural sections is described. The basic process was analytically developed parallel with, and integrated into the conceptual design of, a flight experiment machine for producing a continuous triangular cross section truss. The machine and its associated ancillary equipment are mounted on a Space Lab pallet. Power, thermal control, and instrumentation connections are made during ground installation. Observation, monitoring, caution and warning, and control panels and displays are installed at the payload specialist station in the orbiter. The machine is primed before flight by initiation of beam forming, to include attachment of the first set of cross members and anchoring of the diagonal cords. Control of the experiment will be from the orbiter mission specialist station. Normal operation is by automatic processing control software. Machine operating data are displayed and recorded on the ground. Data is processed and formatted to show progress of the major experiment parameters including stable operation, physical symmetry, joint integrity, and structural properties.

Differential physiological responses of dalmatian toadflax, Linaria dalmatica L. Miller, to injury from two insect biological control agents: Implications for decision-making in biological control

Treesearch

Robert K. D. Peterson; Sharlene E. Sing; David K. Weaver

2005-01-01

Successful biological control of invasive weeds with specialist herbivorous insects is predicated on the assumption that the injury stresses the weeds sufficiently to cause reductions in individual fitness. Because plant gas exchange directly impacts growth and fitness, characterizing how injury affects these primary processes may provide a key indicator of...

Policy Innovation and Policy Pathways: Tuberculosis Control in Sri Lanka, 1948-1990.

PubMed

Jones, Margaret

2016-10-01

This paper, based on World Health Organization and Sri Lankan sources, examines the attempts to control tuberculosis in Sri Lanka from independence in 1948. It focuses particularly on the attempt in 1966 to implement a World Health Organization model of community-orientated tuberculosis control that sought to establish a horizontally structured programme through the integration of control into the general health services. The objective was to create a cost- effective method of control that relied on a simple bacteriological test for case finding and for treatment at the nearest health facility that would take case detection and treatment to the rural periphery where specialist services were lacking. In the late 1940s and early 1950s, Sri Lanka had already established a specialist control programme composed of chest clinics, mass X-ray, inpatient and domiciliary treatment, and social assistance for sufferers. This programme had both reduced mortality and enhanced awareness of the disease. This paper exposes the obstacles presented in trying to impose the World Health Organization's internationally devised model onto the existing structure of tuberculosis control already operating in Sri Lanka. One significant hindrance to the WHO approach was lack of resources but, equally important, was the existing medical culture that militated against its acceptance.

Policy Innovation and Policy Pathways: Tuberculosis Control in Sri Lanka, 1948–1990

PubMed Central

Jones, Margaret

2016-01-01

This paper, based on World Health Organization and Sri Lankan sources, examines the attempts to control tuberculosis in Sri Lanka from independence in 1948. It focuses particularly on the attempt in 1966 to implement a World Health Organization model of community-orientated tuberculosis control that sought to establish a horizontally structured programme through the integration of control into the general health services. The objective was to create a cost- effective method of control that relied on a simple bacteriological test for case finding and for treatment at the nearest health facility that would take case detection and treatment to the rural periphery where specialist services were lacking. In the late 1940s and early 1950s, Sri Lanka had already established a specialist control programme composed of chest clinics, mass X-ray, inpatient and domiciliary treatment, and social assistance for sufferers. This programme had both reduced mortality and enhanced awareness of the disease. This paper exposes the obstacles presented in trying to impose the World Health Organization’s internationally devised model onto the existing structure of tuberculosis control already operating in Sri Lanka. One significant hindrance to the WHO approach was lack of resources but, equally important, was the existing medical culture that militated against its acceptance. PMID:27628860

Randomized, single-blind, controlled trial of a specialist behavior therapy team for challenging behavior in adults with intellectual disabilities.

PubMed

Hassiotis, Angela; Robotham, Dan; Canagasabey, Anton; Romeo, Renee; Langridge, Diane; Blizard, Robert; Murad, Shahed; King, Michael

2009-11-01

Community-based specialist behavior therapy teams may be helpful in managing challenging behavior, but evidence of their effectiveness is limited. This study was designed to examine the effectiveness and costs associated with treatment by a specialist behavior therapy team. This was a parallel-group, randomized, single-blind controlled trial carried out in an intellectual disabilities service in England. Participants were 63 male and female service users with mild to severe intellectual disability who presented with challenging behavior. The interventions were standard treatment plus applied behavioral analysis (N=32) and standard treatment only (N=31). The primary outcome measure was challenging behavior, as measured by total and subscale scores on the Aberrant Behavior Checklist 3 and 6 months after randomization. Secondary outcome measures were psychiatric comorbidity assessed at 3 and 6 months using the Psychiatric Assessment Schedule for Adults With a Developmental Disability Checklist (PAS-ADD) and total costs recorded at 6 months. Multilevel modeling was used to compare square root transformations of Aberrant Behavior Checklist scores. Significant differences were found in the transformed total scores on the Aberrant Behavior Checklist (difference=-0.89, 95% CI=-1.74 to -0.04) and transformed lethargy and hyperactivity subscale scores (common intervention effect=-0.56, 95% CI=-0.97 to -0.15). Standard care participants fared worse on the PAS-ADD comorbid organic disorder subscale. There was a clear trend for lower overall costs of the intervention. Use of a specialist behavior therapy team in addition to standard treatment appears to be more effective in improving challenging behavior and may have financial advantages over standard treatment.

Hearing Impairment Affects Dementia Incidence. An Analysis Based on Longitudinal Health Claims Data in Germany

PubMed Central

Teipel, Stefan; Óvári, Attila; Kilimann, Ingo; Witt, Gabriele; Doblhammer, Gabriele

2016-01-01

Recent research has revealed an association between hearing impairment and dementia. The objective of this study is to determine the effect of hearing impairment on dementia incidence in a longitudinal study, and whether ear, nose, and throat (ENT) specialist care, care level, institutionalization, or depression mediates or moderates this pathway. The present study used a longitudinal sample of 154,783 persons aged 65 and older from claims data of the largest German health insurer; containing 14,602 incident dementia diagnoses between 2006 and 2010. Dementia and hearing impairment diagnoses were defined according to International Classification of Diseases, Tenth Revision, codes. We used a Kaplan Meier estimator and performed Cox proportional hazard models to explore the effect of hearing impairment on dementia incidence, controlling for ENT specialist care, care level, institutionalization, and depression. Gender, age, and comorbidities were controlled for as potential confounders. Patients with bilateral (HR = 1.43, p<0.001) and side-unspecified (HR = 1.20, p<0.001) hearing impairment had higher risks of dementia incidence than patients without hearing impairment. We found no significant effect for unilateral hearing impairment and other diseases of the ear. The effect of hearing impairment was only partly mediated through ENT specialist utilization. Significant interaction between hearing impairment and specialist care, care level, and institutionalization, respectively, indicated moderating effects. We discuss possible explanations for these effects. This study underlines the importance of the association between hearing impairment and dementia. Preserving hearing ability may maintain social participation and may reduce the burden associated with dementia. The particular impact of hearing aid use should be the subject of further investigations, as it offers potential intervention on the pathway to dementia. PMID:27391486

Variability in disease burden and management of rheumatic fever and rheumatic heart disease in two regions of tropical Australia.

PubMed

Rémond, M G W; Severin, K L; Hodder, Y; Martin, J; Nelson, C; Atkinson, D; Maguire, G P

2013-04-01

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) contribute to Aboriginal Australian and Torres Strait Islander health disadvantage. At the time of this study, specialist ARF/RHD care in the Kimberley region of Western Australia was delivered by a broad range of providers. In contrast, in Far North Queensland (FNQ), a single-provider model was used as part of a coordinated RHD control programme. To review ARF/RHD management in the Kimberley and FNQ to ascertain whether differing models of service delivery are associated with different disease burden and patient care. An audit of ARF/RHD management. Classification and clinical management data were abstracted from health records, specialist letters, echocardiograms and regional registers using a standardised data collection tool. Four hundred and seven patients were identified, with 99% being Aboriginal and/or Torres Strait Islanders. ARF without RHD was seen in 0.4% of Aboriginal and/or Torres Strait Islander residents and RHD in 1.1%. The prevalence of RHD was similar in both regions but with more severe disease in the Kimberley. More FNQ RHD patients had specialist review within recommended time frames (67% vs 45%, χ(2) , P < 0.001). Of patients recommended benzathine penicillin secondary prophylaxis, 17.7% received ≥80% of scheduled doses in the preceding 12 months. Prescription and delivery of secondary prophylaxis was greater in FNQ. FNQ's single-provider model of specialist care and centralised RHD control programme were associated with improved patient care and may partly account for the fewer cases of severe disease and reduced surgical procedures and other interventions observed in this region. © 2012 The Authors; Internal Medicine Journal © 2012 Royal Australasian College of Physicians.

Exploring the evidence base for Tier 3 weight management interventions for adults: a systematic review.

PubMed

Brown, T J; O'Malley, C; Blackshaw, J; Coulton, V; Tedstone, A; Summerbell, C; Ells, L J

2017-10-01

Specialist weight management services provide a treatment option for severe obesity. The objective of the study is to review the characteristics, impact and practice implications of specialist weight management services for adults in the UK. Systematic review: EMBASE, MEDLINE and PsycINFO were searched from January 2005 to March 2016 with supplementary searches. Adults with a body mass index of ≥40 kg m -2 , or ≥35 kg m -2 with comorbidity or ≥30 kg m -2 with type 2 diabetes and any study of multicomponent interventions, in any UK or Ireland setting, delivered by a specialist multidisciplinary team are the inclusion criteria. Fourteen studies in a variety of settings were included: 1 randomized controlled trial, 3 controlled and 10 observational studies. Mean baseline body mass index and age ranged from 40 to 54 kg m -2 and from 40 to 58 years. The studies were heterogeneous making comparisons of service characteristics difficult. Multidisciplinary team composition and eligibility criteria varied; dropout rates were high (43-62%). Statistically significant reduction in mean body mass index over time ranged from -1.4 to -3.1 kg m -2 and mean weight changes ranged from -2.2 to -12.4 kg. Completers achieving at least 5% reduction of initial body weight ranged from 32 to 51%. There was evidence for improved outcomes in diabetics. Specialist weight management services can demonstrate clinically significant weight loss and have an important role in supporting adults to manage severe and often complex forms of obesity. This review highlights important variations in provision and strongly indicates the need for further research into effective approaches to support severely obese adults. © 2017 World Obesity Federation.

Radar Training Facility initial validation.

DOT National Transportation Integrated Search

1983-05-01

The Radar Training Facility (RTF), part of the Federal Aviation Administration Academy located at the Oklahoma City Mike Monroney Aeronautical Center, is designed to identify, as early as possible, air traffic control specialists who do not demonstra...

Evaluation of outreach clinics held by specialists in general practice in England

PubMed Central

Bond, M.; Bowling, A.; Abery, A.; McClay, M.; Dickinson, E.

2000-01-01

OBJECTIVES—To measure the processes of care, health benefits and costs of outreach clinics held by hospital specialists in primary care settings.
DESIGN—The study was designed as a case-referent (comparative) study in which the features of 19 outreach clinics (cases) were compared with matched outpatient clinics (controls). The measuring instruments were self administered questionnaires. Patients were followed up at six months to reassess health status. The specialties included in the study were cardiology, ENT, general medicine, general surgery, gynaecology and rheumatology.
SETTING—Specialist outreach clinics in general practice in England, with matched outpatient clinic controls.
SUBJECTS—Consecutive patient attenders in the outreach and outpatient clinics, their specialists, the outreach patients' general practitioners, practice managers and trust accountants. Patients' response rate at baseline: 78% (1420).
MAIN OUTCOME MEASURES—Patient satisfaction, doctors' attitudes, processes and health outcomes, costs.
RESULTS—Outreach patients were more satisfied with the processes of their care than outpatients, their access to specialist care was better than that for outpatients and they were more likely to be discharged. Doctors reported that the main advantages of the outreach clinic were improved patient access to specialists and convenience for patients, in comparison with outpatients, and most GPs and specialists felt the outreach clinic was "worthwhile". At six month follow up, the health status of the outreach sample had significantly improved more than that of the outpatients on all eight sub-scales of the HSQ-12, but this was probably because of their better starting point at baseline. The impact of outreach on health outcomes was small. The NHS costs of outreach were significantly higher than outpatients. An increase in outreach clinic size would reduce cost per patient, but would lead to the loss of most of the clinics' benefits.
CONCLUSIONS—While the process of care was of higher quality in outreach than in outpatients, and the efficiency of care was also greater in the latter, the effect on patients' health outcomes was small. Responsiveness to patients' views and preferences is an essential component of good quality service provision. However, the greater cost of outreach raises the issue of whether improvements in the quality and efficiency of health care, without a substantial impact on health outcomes, is money well spent in a publicly funded health service. On the other hand, the real costs of outreach in comparison with outpatients clinics can probably only be truly estimated in a longitudinal study with a resource based costing model derived from documented patient attendances and treatment costs over time in relation to longer term outcome (for example, at a two year end point).


Keywords: outreach clinics; general practice PMID:10715749

Care in specialist medical and mental health unit compared with standard care for older people with cognitive impairment admitted to general hospital: randomised controlled trial (NIHR TEAM trial)

PubMed Central

Goldberg, Sarah E; Bradshaw, Lucy E; Kearney, Fiona C; Russell, Catherine; Whittamore, Kathy H; Foster, Pippa E R; Mamza, Jil; Gladman, John R F; Jones, Rob G; Lewis, Sarah A; Porock, Davina

2013-01-01

Objective To develop and evaluate a best practice model of general hospital acute medical care for older people with cognitive impairment. Design Randomised controlled trial, adapted to take account of constraints imposed by a busy acute medical admission system. Setting Large acute general hospital in the United Kingdom. Participants 600 patients aged over 65 admitted for acute medical care, identified as “confused” on admission. Interventions Participants were randomised to a specialist medical and mental health unit, designed to deliver best practice care for people with delirium or dementia, or to standard care (acute geriatric or general medical wards). Features of the specialist unit included joint staffing by medical and mental health professionals; enhanced staff training in delirium, dementia, and person centred dementia care; provision of organised purposeful activity; environmental modification to meet the needs of those with cognitive impairment; delirium prevention; and a proactive and inclusive approach to family carers. Main outcome measures Primary outcome: number of days spent at home over the 90 days after randomisation. Secondary outcomes: structured non-participant observations to ascertain patients’ experiences; satisfaction of family carers with hospital care. When possible, outcome assessment was blind to allocation. Results There was no significant difference in days spent at home between the specialist unit and standard care groups (median 51 v 45 days, 95% confidence interval for difference −12 to 24; P=0.3). Median index hospital stay was 11 versus 11 days, mortality 22% versus 25% (−9% to 4%), readmission 32% versus 35% (−10% to 5%), and new admission to care home 20% versus 28% (−16% to 0) for the specialist unit and standard care groups, respectively. Patients returning home spent a median of 70.5 versus 71.0 days at home (−6.0 to 6.5). Patients on the specialist unit spent significantly more time with positive mood or engagement (79% v 68%, 2% to 20%; P=0.03) and experienced more staff interactions that met emotional and psychological needs (median 4 v 1 per observation; P<0.001). More family carers were satisfied with care (overall 91% v 83%, 2% to 15%; P=0.004), and severe dissatisfaction was reduced (5% v 10%, −10% to 0%; P=0.05). Conclusions Specialist care for people with delirium and dementia improved the experience of patients and satisfaction of carers, but there were no convincing benefits in health status or service use. Patients’ experience and carers’ satisfaction might be more appropriate measures of success for frail older people approaching the end of life. Trial registration Clinical Trials NCT01136148 PMID:23819964

Agreement among health care professionals in diagnosing case Vignette-based surgical site infections.

PubMed

Lepelletier, Didier; Ravaud, Philippe; Baron, Gabriel; Lucet, Jean-Christophe

2012-01-01

To assess agreement in diagnosing surgical site infection (SSI) among healthcare professionals involved in SSI surveillance. Case-vignette study done in 2009 in 140 healthcare professionals from seven specialties (20 in each specialty, Anesthesiologists, Surgeons, Public health specialists, Infection control physicians, Infection control nurses, Infectious diseases specialists, Microbiologists) in 29 University and 36 non-University hospitals in France. We developed 40 case-vignettes based on cardiac and gastrointestinal surgery patients with suspected SSI. Each participant scored six randomly assigned case-vignettes before and after reading the SSI definition on an online secure relational database. The intraclass correlation coefficient (ICC) was used to assess agreement regarding SSI diagnosis on a seven-point Likert scale and the kappa coefficient to assess agreement for superficial or deep SSI on a three-point scale. Based on a consensus, SSI was present in 21 of 40 vignettes (52.5%). Intraspecialty agreement for SSI diagnosis ranged across specialties from 0.15 (95% confidence interval, 0.00-0.59) (anesthesiologists and infection control nurses) to 0.73 (0.32-0.90) (infectious diseases specialists). Reading the SSI definition improved agreement in the specialties with poor initial agreement. Intraspecialty agreement for superficial or deep SSI ranged from 0.10 (-0.19-0.38) to 0.54 (0.25-0.83) (surgeons) and increased after reading the SSI definition only among the infection control nurses from 0.10 (-0.19-0.38) to 0.41 (-0.09-0.72). Interspecialty agreement for SSI diagnosis was 0.36 (0.22-0.54) and increased to 0.47 (0.31-0.64) after reading the SSI definition. Among healthcare professionals evaluating case-vignettes for possible surgical site infection, there was large disagreement in diagnosis that varied both between and within specialties.

The role of allergy in the etiology of Reinke's edema on vocal folds.

PubMed

Kravos, Alenka; Zupevc, Avgust; Cizmarevic, Bogdan; Hocevar-Boltezar, Irena

2010-05-01

To identify the role of allergy in the occurrence of Reinke's edema on vocal folds. This was a prospective study in patients with Reinke's edema on vocal folds (n = 80) and a control group of patients without Reinke's edema (n = 80). All the patients were examined by the same ENT specialist at an ENT outpatient center in the period 2001-2003. The control group comprised 80 successive patients from the same clinic who were willing to cooperate in the study and were not already being treated for allergic disease by any specialist other than an ENT specialist. Patients from both groups were examined by rigid laryngoscope, skin prick allergic testing (type I allergy) and laboratory determination of serum thyroid-stimulating hormone level. The prevalence of allergy was not significantly different between the two groups: 20.0% in the patients with Reinke's edema and 23.8% in the control group (P = 0.576). No significant difference was detected in the prevalence of allergy when comparing patients with recurrent Reinke's edema after previous surgical treatment (n = 10) with patients with a first occurrence (n = 70) (P = 1.000). However, we found significantly more type I allergy in the patients with Reinke's edema and chronic hyperplastic rhinitis than in the patients with Reinke's edema without chronic hyperplastic rhinitis. All other risk factors (reflux of gastric content to the larynx, vocal abuse or misuse, unfavorable microclimate conditions at work, thyroid diseases) appeared significantly more often in the group with Reinke's edema on vocal folds than in the control group. Type I allergy is not a crucial factor in the pathogenesis of Reinke's edema on vocal folds or in recurrence of the disease after surgical treatment.

Are general practitioners characteristics associated with the quality of type 2 diabetes care in general practice? Results from the Norwegian ROSA4 study from 2014.

PubMed

Tran, Anh Thi; Bakke, Åsne; Berg, Tore J; Gjelsvik, Bjørn; Mdala, Ibrahimu; Nøkleby, Kjersti; Shakil Rai, Anam; Cooper, John G; Claudi, Tor; Løvaas, Karianne; Thue, Geir; Sandberg, Sverre; Jenum, Anne K

2018-06-01

To explore the associations between general practitioners (GPs) characteristics such as gender, specialist status, country of birth and country of graduation and the quality of care for patients with type 2 diabetes (T2DM). Cross-sectional survey. The 277 GPs provided care for 10082 patients with T2DM in Norway in 2014. The GPs characteristics were self-reported: 55% were male, 68% were specialists in General Practice, 82% born in Norway and 87% had graduated in Western Europe. Of patients, 81% were born in Norway and 8% in South Asia. Data regarding diabetes care were obtained from electronic medical records and manually verified. Performance of recommended screening procedures, prescribed medication and level of HbA1c, blood pressure and LDL-cholesterol stratified according to GPs characteristics, adjusted for patient and GP characteristics. Female GPs, specialists, GPs born in Norway and GPs who graduated in Western Europe performed recommended procedures more frequently than their counterparts. Specialists achieved lower mean HbA1c (7.14% vs. 7.25%, p < 0.01), a larger proportion of their patients achieved good glycaemic control (HbA1c = 6.0%-7.0%) (49.1% vs. 44.4%, p = 0.018) and lower mean systolic blood pressure (133.0 mmHg vs. 134.7 mmHg, p < 0.01) compared with non-specialists. GPs who graduated in Western Europe achieved lower diastolic blood pressure than their counterparts (76.6 mmHg vs. 77.8 mmHg, p < 0.01). Several quality indicators for type 2 diabetes care were better if the GPs were specialists in General Practice. Key Points Research on associations between General Practitioners (GPs) characteristics and quality of care for patients with type 2 diabetes is limited. Specialists in General Practice performed recommended procedures more frequently, achieved better HbA1c and blood pressure levels than non-specialists. GPs who graduated in Western Europe performed screening procedures more frequently and achieved lower diastolic blood pressure compared with their counterparts. There were few significant differences in the quality of care between GP groups according to their gender and country of birth.

Using technology to improve access to specialist care in amyotrophic lateral sclerosis: A systematic review.

PubMed

Hobson, Esther V; Baird, Wendy O; Cooper, Cindy L; Mawson, Sue; Shaw, Pamela J; Mcdermott, Christopher J

2016-01-01

Our objective was to review the evidence for using technology to improve access to specialist care for patients with amyotrophic lateral sclerosis (ALS) and their carers. Medline, Google Scholar and the Cochrane library were searched for articles describing technology that enabled clinical care of patients with ALS or their carers where the patient/carer and clinician were not in the same location. Two applications were identified: telemedicine to facilitate video conferencing as an alternative to outpatient consultations and telehealth monitoring for patients with respiratory failure. One randomized controlled trial using telehealth in patients with respiratory failure including 22 patients with ALS was identified. While rates of hospitalization were reduced, overall mortality was unchanged and there were too few patients with ALS in the study to detect significant benefit. In conclusion, there is limited evidence to support the use of telemedicine or telehealth in the care of patients with ALS. Future research needs to develop an understanding of the key beneficial aspects of the traditional specialist ALS service and how these factors could be delivered using technology. Successful evaluation and implementation of technologies to facilitate access to specialist care will only be possible if all the relevant impacts of an intervention are understood and measured.

Shift work, age, and performance : investigation of the 2-2-1 shift schedule used in air traffic control facilities. I., The sleep/wake cycle.

DOT National Transportation Integrated Search

1995-05-01

Air Traffic Control Specialists (ATCS) work rotating shift schedules for most of their careers. Specifically, many work a counterclockwise rotating shift schedule, called the 2-2-1, or some variation of the schedule. The 2-2-1 involves rotating from ...

Astronaut Garneau working with Audio Control System panel

NASA Image and Video Library

1996-06-05

STS077-392-007 (19-29 May 1996) --- Inside the Spacehab Module onboard the Earth-orbiting Space Shuttle Endeavour, Canadian astronaut Marc Garneau, mission specialist, joins astronaut Curtis L. Brown, Jr., pilot, in checking out the audio control system for Spacehab. The two joined four other NASA astronauts for nine days of research and experimentation in Earth-orbit.

Horticultural technique for rearing and redistribution of the sessile biological control agent, Rhizaspidiotus donacis on its host plant, Arundo donax

USDA-ARS?s Scientific Manuscript database

Arundo donax, giant reed, is an invasive weed in the riparian habitats of the Rio Grande Basin. A biological control program using specialist insects from the native range in Mediterranean Europe, including the arundo scale, Rhizaspidiotus donacis, has been implemented. The arundo scale is a sessile...

78 FR 64503 - Advisory Committee to the Director (ACD), Centers for Disease Control and Prevention (CDC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... Committee to the Director (ACD), Centers for Disease Control and Prevention (CDC) Cancellation: This notice... Information: Gayle Hickman, Committee Management Specialist, Office Chief of Staff, CDC, 1600 Clifton Road [email protected]cdc.gov . This notice is published less than the required 15 days prior to the start of the announced...

Hawley controls the RMS arm from the flight deck during EVA on Flight Day 6

NASA Image and Video Library

1997-02-16

S82-E-5568 (16 Feb. 1997) --- Astronaut Steven A. Hawley, at controls for Remote Manipulator System (RMS), during third Extravehicular Activity (EVA). Hawley had been a mission specialist for the NASA mission which deployed the giant HST in 1990. This view was taken with an Electronic Still Camera (ESC).

MS Reilly at work on Endeavour

NASA Image and Video Library

1998-03-04

S89-E-5536 (22-31 Jan 1998) --- This Electronic Still Camera (ESC) image taken on the Space Shuttle Endeavour's middeck, shows astronaut James F. Reilly, mission specialist, looks over a long roll of "mail" from ground controllers.

FUTURE OF ENERGY

EPA Science Inventory

A complete Scientific American issue of nine specialist articles was devoted to the concern of powering the global economy and addressing the effects of global warming. Control of atmospheric carbon, transportation fuel, efficient use of energy, the disposition of coal, opportuni...

KSC-03PD-2331

NASA Technical Reports Server (NTRS)

2003-01-01

KENNEDY SPACE CENTER, FLA. While touring the SRB Retrieval Ship Freedom Star, STS-114 Commander Eileen Collins and Mission Specialist Soichi Noguchi point at something on the Banana River. Noguchi is with the Japanese space agency NASDA. The ships routinely are docked at Hangar AF on the river. On their mission, the crew which also includes Pilot James Kelly and Mission Specialist Stephen Robinson will carry the MultiPurpose Logistics Module (MPLM) Raffaello and External Stowage Platform 2 to the International Space Station. The MPLM will contain supplies and equipment. Another goal of the mission is to remove and replace a Control Moment Gyro. Launch date for mission STS-114 is under review.

KSC-03PD-2332

NASA Technical Reports Server (NTRS)

2003-01-01

KENNEDY SPACE CENTER, FLA. STS-114 Mission Specialist Soichi Noguchi, who is with the Japanese space agency NASDA, poses on the deck of one of the SRB Retrieval Ships docked at Hangar AF on the Banana River. He and other crew members Commander Eileen Collins, Pilot James Kelly and Mission Specialist Stephen Robinson toured the ships. Mission STS-114 will carry the MultiPurpose Logistics Module (MPLM) Raffaello and External Stowage Platform 2 to the International Space Station. The MPLM will contain supplies and equipment. Another goal of the mission is to remove and replace a Control Moment Gyro. Launch date for mission STS-114 is under review.

KSC-03PD-2334

NASA Technical Reports Server (NTRS)

2003-01-01

KENNEDY SPACE CENTER, FLA. The STS-114 crew poses on deck with the captain of the Liberty Star, one of the SRB Retrieval Ships docked at Hangar AF on the Banana River. From left are Pilot James Kelly, Mission Specialist Soichi Noguchi, Capt. Bren Wade, Commander Eileen Collins and Mission Specialist Stephen Robinson. Noguchi is with the Japanese space agency NASDA. Mission STS-114 will carry the MultiPurpose Logistics Module (MPLM) Raffaello and External Stowage Platform 2 to the International Space Station. The MPLM will contain supplies and equipment. Another goal of the mission is to remove and replace a Control Moment Gyro. Launch date for mission STS-114 is under review.

Wheelock during Expedition 16/STS-120 EVA 4

NASA Image and Video Library

2007-11-03

ISS016-E-009179 (3 Nov. 2007) --- Astronaut Doug Wheelock, STS-120 mission specialist, participates in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery is docked with the International Space Station. During the 7-hour, 19-minute spacewalk, astronaut Scott Parazynski (out of frame), mission specialist, cut a snagged wire and installed homemade stabilizers designed to strengthen the damaged solar array's structure and stability in the vicinity of the damage. Wheelock assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

Wheelock during Expedition 16/STS-120 EVA 4

NASA Image and Video Library

2007-11-03

ISS016-E-009192 (3 Nov. 2007) --- Astronaut Doug Wheelock, STS-120 mission specialist, participates in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery is docked with the International Space Station. During the 7-hour, 19-minute spacewalk, astronaut Scott Parazynski (out of frame), mission specialist, cut a snagged wire and installed homemade stabilizers designed to strengthen the damaged solar array's structure and stability in the vicinity of the damage. Wheelock assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

KSC-02pd1416

NASA Image and Video Library

2002-10-01

KENNEDY SPACE CENTER, FLA. - Members of the STS-112 crew pose in front of Launch Pad 39B during a tour of Kennedy Space Center prior to launch. From left, they are Mission Specialist Sandra H. Magnus, Commander Jeffrey S. Ashby, Pilot Pamela Ann Melroy, and Mission Specialists David A. Wolf, Fyodor N. Yurchikhin of the Russian Space Agency, and Piers J. Sellers. The launch of Space Shuttle Atlantis was postponed today to no earlier than Thursday, Oct. 3, while weather forecasters and the mission management team assess the possible effect Hurricane Lili may have on the Mission Control Center located at the Lyndon B. Johnson Space Center in Houston, Texas.

STS-88 Mission Specialists Currie and Ross inside Endeavour

NASA Technical Reports Server (NTRS)

1998-01-01

STS-88 Mission Specialists Nancy J. Currie, Ph.D., (back) and Jerry L. Ross (front) check over equipment inside orbiter Endeavour during Terminal Countdown Demonstration Activities (TCDT). The TCDT includes mission familiarization activities, emergency egress training, and the simulated main engine cut-off exercise. Mission STS-88 is targeted for launch on Dec. 3, 1998. It is the first U.S. flight for the assembly of the International Space Station and will carry the Unity connecting module. Unity will be mated with the already orbiting Russian-built Zarya control module. The 12-day mission includes three planned spacewalks to connect power, data and utility lines and install exterior equipment.

Checkout activity on the Remote Manipulator System (RMS) arm

NASA Image and Video Library

1997-02-12

S82-E-5016 (12 Feb. 1997) --- Astronaut Steven A. Hawley, STS-82 mission specialist, controls Discovery's Remote Manipulation System (RMS), from the aft flight deck. Hawley and his crew mates are preparing for a scheduled Extravehicular Activity (EVA) with the Hubble Space Telescope (HST), which will be pulled into the Space Shuttle Discovery's cargo bay with the aid of the Remote Manipulator System (RMS). A series of EVA's will be required to properly service the giant telescope. Hawley served as a mission specialist on NASA's 1990 mission which was responsible for placing HST in Earth-orbit. This view was taken with an Electronic Still Camera (ESC).

Assess 2: Spacelab simulation. Executive summary

NASA Technical Reports Server (NTRS)

1977-01-01

An Airborne Science/Spacelab Experiments System Simulation (ASSESS II) mission, was conducted with the CV-990 airborne laboratory in May 1977. The project studied the full range of Spacelab-type activities including management interactions, experiment selection and funding, hardware development, payload integration and checkout, mission specialist and payload specialist selection and training, mission control center payload operations control center arrangements and interactions, real time interaction during flight between principal investigators and the flight crew, and retrieval of scientific flight data. ESA established an integration and coordination center for the ESA portion of the payload as planned for Spacelab. A strongly realistic Spacelab mission was conducted on the CV-990 aircraft. U.S. and ESA scientific experiments were integrated into a payload and flown over a 10 day period, with the payload flight crew fully-confined to represent a Spacelab mission. Specific conclusions for Spacelab planning are presented along with a brief explanation of each.

[The standardization of medical care and the training of medical personnel].

PubMed

Korbut, V B; Tyts, V V; Boĭshenko, V A

1997-09-01

The medical specialist training at all levels (medical orderly, doctor's assistant, general practitioner, doctors) should be based on the medical care standards. Preliminary studies in the field of military medicine standards have demonstrated that the medical service of the Armed Forces of Russia needs medical resources' standards, structure and organization standards, technology standards. Military medical service resources' standards should reflect the requisitions for: all medical specialists' qualification, equipment and material for medical set-ups, field medical systems, drugs, etc. Standards for structures and organization should include requisitions for: command and control systems in military formations' and task forces' medical services and their information support; health-care and evacuation functions, sanitary control and anti-epidemic measures and personnel health protection. Technology standards development could improve and regulate the health care procedures in the process of evacuation. Standards' development will help to solve the problem of the data-base for the military medicine education system and medical research.

Inflight views of the crew of STS-7

NASA Technical Reports Server (NTRS)

1983-01-01

Inflight views of the crew of STS-7. Views include Astronaut Sally K. Ride, misison specialist, using a screw driver to clean out an air filtering system in the middeck of the Challenger. Dr. Ride's constant wear garment bears a cartoon of 35 busy astronauts around a space shuttle and the acronym TFNG, below which is written, 'We deliver!'. TFNG stands for thirty five new guys, referring to the 1978 class of astronauts from which Dr. Ride and three of her crewmates hail (35768); Astronaut Robert L. Crippen, crew commander, chooses to remain in the commander's station to shave his face using an electric razor. Forward control panels (L1, L5, O5), and windows appear in this view (35769); On middeck, Dr. Norman E. Thagard, mission specialist, conducts Detailed Supplementary Objective (DSO) 404 - On Orbit Head and Eye Tracking Tasks. Seated in the mission specialists seat, Thagard, wearing unicorn cap (pantograph attached) and with electrodes on his face and forehead, monitors DC Ampere (A

Knowledge assistant for robotic environmental characterization

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

Feddema, J.; Rivera, J.; Tucker, S.

1996-08-01

A prototype sensor fusion framework called the {open_quotes}Knowledge Assistant{close_quotes} has been developed and tested on a gantry robot at Sandia National Laboratories. This Knowledge Assistant guides the robot operator during the planning, execution, and post analysis stages of the characterization process. During the planning stage, the Knowledge Assistant suggests robot paths and speeds based on knowledge of sensors available and their physical characteristics. During execution, the Knowledge Assistant coordinates the collection of data through a data acquisition {open_quotes}specialist.{close_quotes} During execution and postanalysis, the Knowledge Assistant sends raw data to other {open_quotes}specialists,{close_quotes} which include statistical pattern recognition software, a neural network,more » and model-based search software. After the specialists return their results, the Knowledge Assistant consolidates the information and returns a report to the robot control system where the sensed objects and their attributes (e.g., estimated dimensions, weight, material composition, etc.) are displayed in the world model. This report highlights the major components of this system.« less

STS-88 Mission Commander Cabana looks at the mission payload Unity at pad

NASA Technical Reports Server (NTRS)

1998-01-01

At Launch Pad 39A, STS-88 Mission Commander Robert D. Cabana gets a close look at the Unity connecting module that is in the payload bay of the orbiter Endeavour. Cabana and the STS-88 crew arrived at KSC in the early morning hours of Nov. 30 for pre- launch preparations. The other crew members are Pilot Frederick W. 'Rick' Sturckow, Mission Specialist Nancy J. Currie, Mission Specialist James H. Newman and Mission Specialist Sergei Konstantinovich Krikalev, a Russian cosmonaut. The scheduled lift-off is at 3:56 a.m. on Dec. 3. Unity is the primary payload of the mission, which is the first U.S. launch for the International Space Station. The crew will be mating Unity with the Russian-built Zarya control module already in orbit. In addition to Unity, two small replacement electronics boxes are on board for possible repairs to Zarya batteries. Endeavour is expected to land at KSC at 10:17 p.m. on Monday, Dec. 14.

STS-88 Pilot Sturckow and Commander Cabana look over the payload Unity at pad

NASA Technical Reports Server (NTRS)

1998-01-01

At Launch Pad 39A, STS-88 Pilot Frederick W. 'Rick' Sturckow and Mission Commander Robert D. Cabana look over the Unity connecting module that is in the payload bay of the orbiter Endeavour. Cabana, Sturckow and the STS-88 crew arrived at KSC in the early morning hours of Nov. 30 for pre-launch preparations. The other crew members are Mission Specialist Nancy J. Currie, Mission Specialist James H. Newman and Mission Specialist Sergei Konstantinovich Krikalev, a Russian cosmonaut. The scheduled lift-off is at 3:56 a.m. on Dec. 3. Unity is the primary payload of the mission, which is the first U.S. launch for the International Space Station. The crew will be mating Unity with the Russian-built Zarya control module already in orbit. In addition to Unity, two small replacement electronics boxes are on board for possible repairs to Zarya batteries. Endeavour is expected to land at KSC at 10:17 p.m. on Monday, Dec. 14.

A qualitative evaluation of an aerobic exercise program for young people with cerebral palsy in specialist schools.

PubMed

Cleary, Stacey L; Taylor, Nicholas F; Dodd, Karen J; Shields, Nora

2017-08-01

To explore the perceived effects of an aerobic exercise program delivered in specialist schools for young people with cerebral palsy with high support needs. In-depth interviews were completed with 8 students with cerebral palsy, 10 parents, 8 teachers and 7 physiotherapists. Interviews were audio-recorded, transcribed verbatim and independently coded by two researchers. Data were analyzed using thematic analysis. Two themes emerged: one about program impact and the second about influential design features. Exercise was perceived as important, and participants indicated that the program had resulted in positive physical (e.g., improved ease of mobility, fitness and stamina) and psychosocial (e.g., happiness, social experience, challenge) impacts. The school setting, program staff and student attitudes were key features of the program. These data converge with those from a randomized controlled trial and attribute physical and psychosocial benefits to a specialist school-based exercise program for young people with cerebral palsy.

STS-107 Flight Day 10 Highlights

NASA Technical Reports Server (NTRS)

2003-01-01

This video shows the activities of the STS-107 crew (Rick Husband, Commander; William McCool, Pilot; Kalpana Chawla, David Brown, Michael Anderson, Laurel Clark, Mission Specialists; Ilan Ramon, Payload Specialist) during flight day 10 of the Columbia orbiter's final mission. Flight day 10 includes an interview by Mission Control of astronauts Brown, McCool, and Anderson, who answer questions on the mission's spaceborne experiments, as well as biographical and other questions. Much of the video is shot and narrated by Payload Specialist Ramon, who shows the crew members at work on experiments in the SpaceHab RDM (Research Double Module), and performing other tasks. Experiments featured in the video include SOFBALL (Structure of Flame Balls at Low Lewis-Number), the STARS (Space Technology and Research Students) experiments, and experiments on cancer and osteoporosis. Crew activities shown include making a video of Earth, and preparing for sleep. Earth views shown in the video include the Gulf of Aden, Ghana, Lake Chad, and the coast of North Carolina.

[Training of medical practitioners of Russian Federation for dealing with dangerous infections in Stavropol Institute for plague control and for working under the conditions of the emergency situation].

PubMed

Efremenko, V I; Kal'noĭ, S M; Shvetsova, N M; Bogdanov, I K; Grizhebovskiĭ, G M; Briukhanova, G D; Onatskaia, T G

2001-01-01

There are no doubts at present concerning the necessity of training medical practitioners in Russia for dealing with specially dangerous infections and for work under the conditions of emergency situations. From the day this institute was founded the training of the corresponding personnel was started: first physicians, then biologists and other specialists, including medical assistants and technicians. Additional programs for training specialists were developed, the State License for conducting the course of special post-diploma training was obtained. Research works on improving the methods of the indication and rapid diagnostics of the causative agents of dangerous infections, reflected in training programs for specialists and practically used in the process of the realization of antiepidemic measures in the zones of emergency situations, were carried out. In training the students the experience of the work of the institute on ensuring the epidemiological safety of the population under the conditions of different emergency situations was taken into consideration.

STS-105 coverage of Mission Control Center employees in the WFCR & BFCR

NASA Image and Video Library

2003-03-25

JSC2001-E-25114 (16 August 2001) --- Flight director John Shannon monitors data at his console in the shuttle flight control room (WFCR) in Houston’s Mission Control Center (MCC). At the time this photo was taken, STS-105 mission specialists Daniel T. Barry and Patrick G. Forrester were performing the first of two scheduled space walks to perform work on the International Space Station (ISS).

Arms Control Fellowship

NASA Astrophysics Data System (ADS)

The U.S. Arms Control and Disarmament Agency (ACDA) has announced that it is accepting applications for visiting scholars under the William C. Foster Fellows Program for 1986-1987. This program is designed to give specialists in the physical sciences and other disciplines relevant to ACDA activities an opportunity to participate actively in the arms control and disarmament activities of this agency and to give ACDA the perspective and expertise that such people can offer.

Cognition and aging in a complex work environment: relationships with performance among air traffic control specialists.

PubMed

Becker, J T; Milke, R M

1998-10-01

Chronological age affects the performance of demanding cognitive tasks within the aviation environment. Within the domain of air traffic control (ATC), the ability to handle simultaneous visual and auditory input, or to return to a task after a break to complete another task, is critical to success and is the sort of cognitive function most affected by age. The limited available data suggest a strong relationship between age and job performance among ATC specialists, whether measured at the time of entry into the system or during the working lifetime of a full-performance-level controller. An analysis of the distribution of the ages of controllers currently in the system, and a projection for the years 2001 and 2006, leads to the conclusion that a high proportion of the ATC work force will be at risk for displaying age-related changes in job performance efficiency over the next 10 yr. It seems important, therefore, to determine the nature and extent of the age-related cognitive changes that can occur during the lifespan of a controller (i.e., 25-55 yr of age) and how these changes may affect job performance. The results of such an analysis should aid in the design and implementation of new control systems to minimize any deleterious effects of aging on performance.

Eating disorders in the context of preconception care: fertility specialists' knowledge, attitudes, and clinical practices.

PubMed

Rodino, Iolanda S; Byrne, Susan M; Sanders, Katherine A

2017-02-01

To gauge fertility specialists' knowledge, clinical practices, and training needs in regard to eating disorders. Cross-sectional study. Fertility clinics. Eighty Australian and New Zealand fertility specialists who were members of the Fertility Society of Australia. None. Responses to an anonymously completed online questionnaire. Approximately 54% of doctors correctly identified the body mass index relevant to anorexia nervosa, and 30% identified menstrual disturbances for anorexia, while 63.8% of doctors incorrectly nominated maladaptive weight control behaviors as a characteristic of binge eating disorder. While clinicians (83.7%) agreed it was important to screen for eating disorders during preconception assessments, 35% routinely screened for eating disorders and 8.8% indicated that their clinics had clinical practice guidelines for management of eating disorders. A minority of participants (13.8%) felt satisfied with their level of university training in eating disorders, 37.5% of doctors felt confident in their ability to recognize symptoms of an eating disorder, and 96.2% indicated a need for further education and clinical guidelines. On most items examined, knowledge and clinical practices regarding eating disorders did not differ according to doctor gender or years of clinical experience working as a fertility specialist. Knowledge about eating disorders in the context of fertility treatment is important. This study highlights the uncertainty among fertility specialists in detecting features of eating disorders. The findings point to the importance of further education and training, including the development of clinical guidelines specific to fertility health care providers. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Specialist health visitor-led weight management intervention in primary care: exploratory evaluation.

PubMed

Jackson, Cath; Coe, Anne; Cheater, Francine M; Wroe, Stephen

2007-04-01

This paper is a report of an exploratory study to evaluate the effectiveness and acceptability of a specialist health visitor-led weight management clinic in primary care. Tackling obesity is a global health priority. Whilst there is evidence to support a role for primary healthcare professionals in its management, provision in England varies widely. Using designated 'obesity specialists' is an approach warranting further investigation. In 2003-2004, patients with a body mass index of 30 or more received a specialist health visitor-led intervention based on the Jan Felgens 'I2E2' model. Clinical outcome data and self-reported dietary consumption data were collected at weeks 1, 13, 27 and 52. Quantitative and qualitative data on patient acceptability of the clinic were collected at week 26. Eighty-nine patients attended the clinic. Mean body weight and body mass index and systolic and diastolic blood pressure decreased over time by statistically significant amounts. There was a non-significant decrease in fasting blood sugar over time, but approximately one in 10 patients with undiagnosed diabetes were identified. No statistically significant change was evident for cholesterol levels. Mean self-reported weekly consumption of cakes, desserts and snacks decreased and that of fruit and vegetables increased, each by statistically significant amounts. Participants found the clinic highly acceptable and identified the specialist health visitor as fundamental to its success. A partnership approach to weight management through which patients are empowered to make sustainable lifestyle changes now needs to be tested in a multi-centre randomized controlled trial.

Comparison of Photovoltaic Energy Systems for the Solar Village

DTIC Science & Technology

1988-08-01

power -point-trackIng ( MPPT ) for the array. It also Includes AC and DC contactors, an isolation transformer, and a control system that fully automates...the day when the array is producing power , the battery controller uses excess array power , not needed for household use , to recharge the batteries. As...alone design) The battery controller used Is the Balance of System Specialists, Inc. Power Control Series model *8104820 rated at 48 volt, 20 amp. This

Selection of Applicants for the Air Traffic Controller Occupation,

DTIC Science & Technology

1981-07-01

DEVE[LOPMENT OF PRESENT SELECTION PROCEDURES 2 3. PROBLEM AND RESEARCH OBJECTIVES 4- 4. AIR TFAFF]C CONTROL JOB ANALYSIS 6 5. OVERVIEW OF RESEARCH STU...34at rogue a" CRT Ion paizu"s Vann 10 EL 1972 STUDY - SELECTION OF AIR TRAFFIC CONTROL SPECIALISTS Objectives. The focus of this research was on...Predictor and Criterion Measures of ATC "Success" (1975) for Controllers Participating in 1971 ATC Research Sepa- Progressior+ Present 1971 Supv. Sup

A Comparison of Selected Supervisory Skills of Content Specialist and Non-Content Specialist University Supervisors

ERIC Educational Resources Information Center

Hunt, Kevin; Mitchell, Murray; Maina, Michael; Griffin, Lisa

2015-01-01

The purpose of this study was to describe and contrast selected approaches to the supervision of student teachers between Content Specialist and Non-Content Specialist university supervisors. Content Specialist supervisors were identified as trained university supervisors with a background in physical education. Non-Content Specialist supervisors…

ATTITUDE OF CLEFT CARE SPECIALISTS IN AFRICA TOWARDS PRESURGICAL ORTHOPAEDICS.

PubMed

Adeyemi, A T; Bankole, O O

2012-12-01

To determine the attitude of cleft care specialists working in Africa towards pre-surgical orthopaedics. A cross sectional study. Pan-African conference on cleft lip and palate in Nigeria. Sixty cleft care specialists working in Africa. The general attitude towards pre-surgicalorthopaedics was positive. Majority of the specialists employ pre-surgical orthopaedics before surgical repair. Fifty four (91%) of the specialists use plaster strapping for cases of bilateral cleft, five (8.3%) use nasoalveolar molding and one (2%) use feeding plate. Half of the specialists (50%) felt that pre-surgical orthopaedics is to be managed by orthodontists alone. There were significant difference in attitude towards pre-surgical orthopaedics between providers (p < 0.05). Orthodontists had a strong positive attitude towards pre-surgical orthopaedics than other specialists. Younger specialists had a more positive attitude towards pre-surgical orthopaedics than older specialists. Cleft care specialists in Africa have a positive attitude towards pre-surgical orthopaedics. Majority of them use plaster strapping technique. Younger specialists have a more favorable attitude towards pre-surgical orthopaedics than older specialists.

Impact of ITP on physician visits and workplace productivity.

PubMed

Tarantino, Michael D; Mathias, Susan D; Snyder, Claire F; Isitt, John J; Gernsheimer, Terry; Young, Joan

2010-02-01

To assess the impact of immune thrombocytopenic purpura (ITP) on primary care and specialist visits and workplace productivity. This was a cross-sectional, descriptive study comparing ITP patients to age- and gender-matched controls. Subjects completed a one-time web-based survey, which included questions on work loss, work productivity, and physician visits. ITP patients and controls were compared on these outcomes. For ITP patients, the relationship between work-related issues and physician visits with clinical characteristics (time since diagnosis, platelet count, number of treatments received, and an ITP-specific health-related quality of life measure, the ITP-PAQ) was explored. A total of 1002 ITP patients and 1031 controls completed the survey. On average, ITP patients were 46 years old, diagnosed 9 years ago, and had platelet counts of 148 x 10(9)/L; 37% had undergone splenectomy. More ITP patients had primary care (20% vs. 11%) and specialist (28% vs. 11%) visits in the past month versus controls (p < or = 0.001). Higher proportions of ITP patients have ever taken sick leave (56% vs. 30%), and missed chore hours in the past week (18% vs. 13%) (p < or = 0.003). ITP patients scored significantly worse than controls on all six work productivity items. Patients diagnosed within the past year were more likely to have specialist visits and to miss chore hours versus those diagnosed less recently. Worse ITP-PAQ scores and more ITP-related treatments were related to more physician visits and worse work-related and productivity outcomes. Platelet count is not associated with these outcomes. The study is limited by the potential for biased samples due to recruitment approaches, the inherent issues of a cross-sectional study design and recall bias in questionnaire responses. ITP was consistently associated with more physician visits and worse work and productivity outcomes. Future research should build on these findings by calculating a comprehensive cost-of-illness of ITP including both direct and indirect costs.

Knowledge, attitudes, and practices of US practitioners who provide pre-travel advice.

PubMed

Kogelman, Laura; Barnett, Elizabeth D; Chen, Lin H; Quinn, Emily; Yanni, Emad; Wilson, Mary E; Benoit, Christine; Karchmer, Adolf W; Ooi, Winnie W; Jentes, Emily S; Hamer, Davidson H

2014-01-01

As international travel increases, many health care professionals are being asked to provide pre-travel advice. We designed an anonymous web-based survey to assess the extent to which primary care providers (PCPs) provide travel medicine advice and how their understanding and delivery of itinerary-specific advice and management compare with that of travel medicine specialists. We surveyed randomly selected US PCPs registered in the Pri-Med Institute (now pmiCME) database and US travel medicine specialists from the International Society of Travel Medicine (ISTM), American Society of Tropical Medicine and Hygiene (ASTMH), and Centers for Disease Control and Prevention (CDC) yellow fever (YF) vaccine provider mailing lists. SAS software (SAS Institute, Cary, NC, USA) was used for all analyses. Of 14,932 e-mails sent to valid e-mail addresses, 902 yielded complete or partially completed surveys (6.0% response rate). Eighty percent of respondents personally provided pre-travel advice (95% of travel medicine specialists versus 73% of PCPs). About two thirds of PCPs (68%) providing pre-travel consultations saw <50 travelers per year whereas 30% of travel medicine specialists saw <50 travelers per year. More travel medicine specialists (59%) than PCPs (18%) saw >500 travelers per year. Familiarity with travel-specific vaccines (YF, Japanese encephalitis) and provision of written educational materials increased as volume of travelers increased. Familiarity with antimalarial side effects and malaria resistance patterns, and knowledge scores based on brief pre-travel scenarios were higher in travel medicine specialists, ASTMH or ISTM certificate holders, and respondents who saw more pre-travel patients. Many PCP survey participants provided pre-travel advice, but most saw few travelers. Volume of travelers and holding an ASTMH or ISTM certificate had the greatest influence on knowledge of travel medicine and provision of appropriate advice and recommendations. Creating easily accessible travel medicine education programs for US providers from a wide range of disciplines is needed to improve the management of travelers. © 2014 International Society of Travel Medicine.

Two studies on participation in decision-making and equity among FAA personnel.

DOT National Transportation Integrated Search

1991-07-01

Study 1 Moderated multiple regression analyses on data collected from 2,177 FAA air traffic controller specialists indicated that equity perceptions moderated the relationship between participation in decision-making and level of job satisfaction. Sp...

Assessing prior experience in the selection of air traffic control specialists.

DOT National Transportation Integrated Search

2013-04-01

Qualification standards published by the U.S. Office of Personnel Management (OPM) describe the minimum experience or education that individuals must have to qualify for specific positions within the federal government (OPM, 2009). These standards ar...

Dietician prepares Gemini 7 crew preflight breakfast

NASA Image and Video Library

1965-12-04

S65-56311 (2 Dec. 1965) --- Kennedy Space Center food specialists prepare an Earth-bound meal for Gemini-7 astronauts. Astronauts' diet is strictly controlled before and during spaceflights to avoid interfering with planned medical experiments. Photo credit: NASA

Advances in pediatric asthma in 2014: Moving toward a population health perspective.

PubMed

Szefler, Stanley J

2015-03-01

Last year's "Advances in pediatric asthma in 2013: Coordinating asthma care" concluded that, "Enhanced communication systems will be necessary among parents, clinicians, health care providers and the pharmaceutical industry so that we continue the pathway of understanding the disease and developing new treatments that address the unmet needs of patients who are at risk for severe consequences of unchecked disease persistence or progression." This year's summary will focus on further advances in pediatric asthma related to prenatal and postnatal factors altering the natural history of asthma, assessment of asthma control, and new insights regarding the management of asthma in children as indicated in Journal of Allergy and Clinical Immunology publications in 2014. A major theme of this review is how new research reports can be integrated into medical communication in a population health perspective to assist clinicians in asthma management. The asthma specialist is in a unique position to convey important messages to the medical community related to factors that influence the course of asthma, methods to assess and communicate levels of control, and new targets for intervention, as well as new immunomodulators. By enhancing communication among patients, parents, primary care physicians, and specialists within provider systems, the asthma specialist can provide timely information that can help to reduce asthma morbidity and mortality. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Space Shuttle Projects

NASA Image and Video Library

2002-03-05

Astronaut James H. Newman, mission specialist, floats about in the Space Shuttle Columbia's cargo bay while working in tandem with astronaut Michael J. Massimino (out of frame),mission specialist, during the STS-109 mission's second day of extravehicular activity (EVA). Inside Columbia's cabin, astronaut Nancy J. Currie, mission specialist, controlled the Remote Manipulator System (RMS) to assist the two in their work on the Hubble Space Telescope (HST). The RMS was used to capture the telescope and secure it into Columbia's cargo bay.Part of the giant telescope's base, latched down in the payload bay, can be seen behind Newman. The Space Shuttle Columbia STS-109 mission lifted off March 1, 2002 with goals of repairing and upgrading the HST. The Marshall Space Flight Center in Huntsville, Alabama had responsibility for the design, development, and contruction of the HST, which is the most powerful and sophisticated telescope ever built. STS-109 upgrades to the HST included: replacement of the solar array panels; replacement of the power control unit (PCU); replacement of the Faint Object Camera (FOC) with a new advanced camera for Surveys (ACS); and installation of the experimental cooling system for the Hubble's Near-Infrared Camera and Multi-object Spectrometer (NICMOS), which had been dormant since January 1999 when its original coolant ran out. Lasting 10 days, 22 hours, and 11 minutes, the STS-109 mission was the 108th flight overall in NASA's Space Shuttle Program.

Controls on foliar nutrient and aluminium concentrations in a tropical tree flora: phylogeny, soil chemistry and interactions among elements.

PubMed

Metali, Faizah; Abu Salim, Kamariah; Tennakoon, Kushan; Burslem, David F R P

2015-01-01

Foliar elemental concentrations are predictors of life-history variation and contribute to spatial patterns in biogeochemical cycling. We examined the contributions of habitat association, local soil environment, and elemental interactions to variation in foliar elemental concentrations in tropical trees using methods that account for phylogeny. We sampled top-soils and leaves of 58 tropical trees in heath forest (HF) on nutrient-poor sand and mixed dipterocarp forest (MDF) on nutrient-rich clay soils. A phylogenetic generalized least squares method was used to determine how foliar nutrient and aluminium (Al) concentrations varied in response to habitat distribution, soil chemistry and other elemental concentrations. Foliar nitrogen (N) and Al concentrations were greater for specialists of MDF than for specialists of HF, while foliar calcium (Ca) concentrations showed the opposite trend. Foliar magnesium (Mg) concentrations were lower for generalists than for MDF specialists. Foliar element concentrations were correlated with fine-scale variation in soil chemistry in phylogenetically controlled analyses across species, but there was limited within-species plasticity in foliar elemental concentrations. Among Al accumulators, foliar Al concentration was positively associated with foliar Ca and Mg concentrations, and negatively associated with foliar phosphorus (P) concentrations. The Al-accumulation trait and relationships between foliar elemental and Al concentrations may contribute to species habitat partitioning and ecosystem-level differences in biogeochemical cycles. © 2014 The Authors. New Phytologist © 2014 New Phytologist Trust.

Severe and Refractory Hypertension in a Young Woman

PubMed Central

Cuadra, René H; White, William B

2016-01-01

Background Refractory hypertension in a young person is an uncommon clinical problem, but one that may be referred to hypertension specialists. Factitious hypertension is fortunately quite rare, but should be considered when evaluating patients who are refractory to numerous classes of antihypertensive therapies and have failed to achieve control despite input from multiple providers. Report of a Case A 19 year old woman was referred to us after failing to achieve blood pressure control by a primary physician and 2 subspecialists in nephrology and hypertension; she also had numerous emergency department visits for symptomatic and severe hypertension. Exhaustive diagnostic testing for secondary causes and witnessed medication dosing in an outpatient setting was unrevealing. Subsequent inpatient admission demonstrated normalization of BPs with small doses of intravenous antihypertensive agents. During the hospitalization, she was observed “pocketing” her oral medications in the buccal folds, and then discarding them in a trash container. Confrontation by psychiatrists and the hypertension specialists led to the admission that she had learned to start and stop beta-blockers and clonidine to induce severe, rebound hypertension. Discussion Factitious and induced hypertension is a rare cause of resistant or refractory hypertension. Nevertheless, hypertension specialists should suspect the diagnosis when there is a history of visits to multiple institutions and physicians, negative secondary workup, absence of overt target organ damage, history of psychiatric illness, and employment in the medical field. PMID:27160032

Introduction, establishment and dispersal in Mexico of the wasp Tetramesa romana, biological control agent of the giant reed

USDA-ARS?s Scientific Manuscript database

The arundo wasp, Tetramesa romana, is a specialist, plant-feeding insect biological control agent for the invasive weed - Arundo donax, also known as giant reed, carrizo cane, and in Mexico, carrizo gigante and el ladron de agua. This weed, which is native to Spain, grows along the banks of rivers, ...

Corrosion Control Specialist Career Ladder AFSC 53530, 53550, 53570, and 53690. Occupational Survey Report.

ERIC Educational Resources Information Center

Air Force Occupational Measurement Center, Lackland AFB, TX.

The report describes the results of a detailed occupational survey of the corrosion control career ladder. Responses to a 457-task, time rating inventory from 1,015 personnel (representing 64 percent of the career field) were analyzed to produce seven specific findings and the career ladder structure. The career ladder includes a variety of jobs…

Evaluation of biologic occupational risk control practices: quality indicators development and validation.

PubMed

Takahashi, Renata Ferreira; Gryschek, Anna Luíza F P L; Izumi Nichiata, Lúcia Yasuko; Lacerda, Rúbia Aparecida; Ciosak, Suely Itsuko; Gir, Elucir; Padoveze, Maria Clara

2010-05-01

There is growing demand for the adoption of qualification systems for health care practices. This study is aimed at describing the development and validation of indicators for evaluation of biologic occupational risk control programs. The study involved 3 stages: (1) setting up a research team, (2) development of indicators, and (3) validation of the indicators by a team of specialists recruited to validate each attribute of the developed indicators. The content validation method was used for the validation, and a psychometric scale was developed for the specialists' assessment. A consensus technique was used, and every attribute that obtained a Content Validity Index of at least 0.75 was approved. Eight indicators were developed for the evaluation of the biologic occupational risk prevention program, with emphasis on accidents caused by sharp instruments and occupational tuberculosis prevention. The indicators included evaluation of the structure, process, and results at the prevention and biologic risk control levels. The majority of indicators achieved a favorable consensus regarding all validated attributes. The developed indicators were considered validated, and the method used for construction and validation proved to be effective. Copyright (c) 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

STS-105 coverage of Mission Control Center employees in the WFCR & BFCR

NASA Image and Video Library

2003-03-25

JSC2001-E-25113 (16 August 2001) --- Flight director Kelly Beck monitors data at her console in the shuttle flight control room (WFCR) in Houston’s Mission Control Center (MCC). At the time this photo was taken, STS-105 mission specialists Daniel T. Barry and Patrick G. Forrester were performing the first of the two scheduled space walks to perform work on the International Space Station (ISS).

Selection of the Next Generation of Air Traffic Control Specialists: Aptitude Requirements for the Air Traffic Control Tower Cab in 2018

DTIC Science & Technology

2013-03-01

Sequencing; and 5) Taxi Routing (with Conformance Monitoring). Third, the impact of these DSTs on tower cab operational activities, sub-activities...keystroke or interface level. Fourth, the impact of the DSTs on aptitudes required of controllers is evaluated. The importance of the following aptitudes...Analysis of Mid-Term NextGen Impact on Aptitudes Required in the ATCT Cab ---------------- 36 Mid-Term DST Impact on Tower Cab Controller Roles

STS-118 Ascent/Entry Flight Control Team in WFCR

NASA Image and Video Library

2007-09-17

JSC2007-E-46429 (17 Sept. 2007) --- The members of the STS-118 Ascent/Entry flight control team and crewmembers pose for a group portrait in the space shuttle flight control room of Houston's Mission Control Center (MCC). Flight director Steve Stich holds the STS-118 mission logo. Astronauts Scott Kelly, commander, is at left foreground and astronaut Chris Ferguson, spacecraft communicator (CAPCOM), is at right foreground. Additional crewmembers pictured are Charlie Hobaugh, pilot; Barbara R. Morgan, Tracy Caldwell and Rick Mastracchio, all mission specialists.

Management of the Hospital Environment

ERIC Educational Resources Information Center

Turner, Alvis G.

1976-01-01

Hospital studies indicate the need for an environmental/sanitarian specialist for control of nosocomial infection and maintenance of a quality environment. The author recommends these requirements for certification as a hospital environmentalist: academic studies including toxicology, epidemiology, hygiene, management, and an internship in…

42 CFR 478.28 - Qualifications of a reconsideration reviewer.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.28... initial denial determination. (c) A specialist in the type of services under review, except where meeting...

STS-9 Spacelab 1 Press Kit

NASA Technical Reports Server (NTRS)

1983-01-01

Press information on the STS-9/SPACELAB 1 mission is provided. Launch preparations, launch window, flight objectives, experiments, life sciences baseline data collection, SPACELAB 1 payload operations and control crew and specialists, and tracking and data management are among the topics explained.

Air traffic control specialists in the Airway Science Curriculum Demonstration Project 1984-1990 : third summative report.

DOT National Transportation Integrated Search

1991-12-01

The objective of this summative evaluation of the Airway Science Curriculum Demonstration Project (ASCDP) was to compare the performance, job attitudes, retention rates, and perceived supervisory potential of graduates from recognized Airway Science ...

STS-55 German payload specialists (and backups) in LESs during JSC training

NASA Technical Reports Server (NTRS)

1992-01-01

STS-55 Columbia, Orbiter Vehicle (OV) 102, German payload specialists and backup (alternate) payload specialists, wearing launch and entry suits (LESs), pose for group portrait outside mockup side hatch in JSC's Mockup and Integration Laboratory (MAIL) Bldg 9NE. These payload specialists will support the STS-55 Spacelab Deutsche 2 (SL-D2) mission. It is the second dedicated German (Deutsche) Spacelab flight. Left to right are backup Payload Specialists Renate Brummer and Dr. P. Gerhard Thiele, Payload Specialist 1 Ulrich Walter, and Payload Specialist 2 Hans Schlegel.

KSC-98pc270

NASA Image and Video Library

1998-02-05

KENNEDY SPACE CENTER, FLA. -- The STS-90 Neurolab payload is lowered into its payload canister in KSC's Operations and Checkout Building. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90, slated for launch in April, will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-98pc292

NASA Image and Video Library

1998-02-12

The STS-90 Neurolab payload is positioned into the cargo bay of Space Shuttle Columbia today in Orbiter Processing Facility bay 3. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90, slated for launch in April, will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-98pc269

NASA Image and Video Library

1998-02-05

KENNEDY SPACE CENTER, FLA. -- The STS-90 Neurolab payload is lowered into its payload canister in KSC's Operations and Checkout Building. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90, slated for launch in April, will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

STS-40 crew trains in JSC's SLS mockup located in Bldg 36

NASA Image and Video Library

1987-03-10

STS-40 Payload Specialist Millie Hughes-Fulford along with backup payload specialist Robert Ward Phillips familiarize themselves with Spacelab Life Sciences 1 (SLS-1) equipment. The two scientists are in JSC's Life Sciences Project Division (LSPD) SLS mockup located in the Bioengineering and Test Support Facility Bldg 36. Hughes-Fulford, in the center aisle, pulls equipment from an overhead stowage locker while Phillips, in the foreground, experiments with the baroreflex neck pressure chamber at Rack 11. The baroreflex collar will be used in conjuction with Experiment No. 022, Influence of Weightlessness Upon Human Autonomic Cardiovascular Control. Behind Phillips in the center aisle are body mass measurement device (BMMD) (foreground) and the stowed bicycle ergometer.

Cassidy during EVA-5

NASA Image and Video Library

2009-07-27

S127-E-009315 (27 July 2009) --- Astronaut Christopher Cassidy, STS-127 mission specialist, participates in the mission's fifth and final session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the four-hour, 54-minute spacewalk, Cassidy and astronaut Tom Marshburn (out of frame), mission specialist, secured multi-layer insulation around the Special Purpose Dexterous Manipulator known as Dextre, split out power channels for two space station Control Moment Gyroscopes, installed video cameras on the front and back of the new Japanese Exposed Facility and performed a number of “get ahead” tasks, including tying down some cables and installing handrails and a portable foot restraint to aid future spacewalkers.

Marshburn during EVA-5

NASA Image and Video Library

2009-07-27

S127-E-009303 (27 July 2009) --- Astronaut Tom Marshburn, STS-127 mission specialist, participates in the mission's fifth and final session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the four-hour, 54-minute spacewalk, Marshburn and astronaut Christopher Cassidy (out of frame), mission specialist, secured multi-layer insulation around the Special Purpose Dexterous Manipulator known as Dextre, split out power channels for two space station Control Moment Gyroscopes, installed video cameras on the front and back of the new Japanese Exposed Facility and performed a number of “get ahead” tasks, including tying down some cables and installing handrails and a portable foot restraint to aid future spacewalkers.

iss020e025085

NASA Image and Video Library

2009-07-27

ISS020-E-025085 (27 July 2009) --- Astronaut Christopher Cassidy, STS-127 mission specialist, participates in the mission's fifth and final session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the four-hour, 54-minute spacewalk, Cassidy and astronaut Tom Marshburn (out of frame), mission specialist, secured multi-layer insulation around the Special Purpose Dexterous Manipulator known as Dextre, split out power channels for two space station Control Moment Gyroscopes, installed video cameras on the front and back of the new Japanese Exposed Facility and performed a number of ?get ahead? tasks, including tying down some cables and installing handrails and a portable foot restraint to aid future spacewalkers.

Cassidy during EVA-5

NASA Image and Video Library

2009-07-27

S127-E-009248 (27 July 2009) --- Astronaut Christopher Cassidy, STS-127 mission specialist, participates in the mission's fifth and final session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the four-hour, 54-minute spacewalk, Cassidy and astronaut Tom Marshburn (out of frame), mission specialist, secured multi-layer insulation around the Special Purpose Dexterous Manipulator known as Dextre, split out power channels for two space station Control Moment Gyroscopes, installed video cameras on the front and back of the new Japanese Exposed Facility and performed a number of “get ahead” tasks, including tying down some cables and installing handrails and a portable foot restraint to aid future spacewalkers.

Cassidy during EVA-5

NASA Image and Video Library

2009-07-27

S127-E-009347 (27 July 2009) --- Astronaut Christopher Cassidy, STS-127 mission specialist, participates in the mission's fifth and final session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the four-hour, 54-minute spacewalk, Cassidy and astronaut Tom Marshburn (out of frame), mission specialist, secured multi-layer insulation around the Special Purpose Dexterous Manipulator known as Dextre, split out power channels for two space station Control Moment Gyroscopes, installed video cameras on the front and back of the new Japanese Exposed Facility and performed a number of “get ahead” tasks, including tying down some cables and installing handrails and a portable foot restraint to aid future spacewalkers.

International Space Station (ISS)

NASA Image and Video Library

2006-11-03

While anchored to a foot restraint on the end of the Orbiter Boom Sensor System (OBSS), astronaut Scott Parazynski, STS-120 mission specialist, participated in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery was docked with the International Space Station (ISS). During the 7-hour and 19-minute space walk, Parazynski cut a snagged wire and installed homemade stabilizers designed to strengthen the structure and stability of the damaged P6 4B solar array wing. Astronaut Doug Wheelock (out of frame), mission specialist, assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

View of the STS-88 crew in the Node 1/Unity module

NASA Image and Video Library

1998-12-11

STS088-332-017 (4-15 Dec. 1998) --- From the left, astronauts Nancy J. Currie, mission specialist; Robert D. Cabana, commander, and Jerry L. Ross, mission specialist, go about various chores designed to put the United States-built Unity Connecting Module (Node 1) in readiness for its impending release in Earth-orbit. Currie talks with ground controllers while Cabana logs a note and Ross checks a supply bag. After devoting the major portion of its mission time to various tasks to ready the Russian-built FGB Module (Zarya) and the docked United States-built node, the six-member crew released the tandem from the Space Shuttle Endeavour’s cargo bay toward mission’s end.

The corporate transformation of medical specialty care: the exemplary case of neonatology.

PubMed

Kinney, Eleanor D

2008-01-01

The key to wealth in health care is the physician, who certifies to third-party payers that health care items and services are necessary for patient care. To compete more effectively for this wealth, physician specialists are organizing their practices into for-profit corporations and employing other physicians. Focusing on neonatology, this article describes the prevailing business model of these for-profit medical groups as controlling employed physicians through restrictive employment contract provisions, e.g., non-compete and mandatory arbitration clauses. With this business model and because of deficiencies in current law, for-profit medical groups eliminate competition from other physician specialists to the detriment of patients and consumers.

STS-88 Mission Specialist Nancy Currie suits up before launch

NASA Technical Reports Server (NTRS)

1998-01-01

In the Operations and Checkout Building, STS-88 Mission Specialist Nancy J. Currie gets help with her flight suit from suit technician Drew Billingsley before launch. Mission STS-88 is expected to launch at 3:56 a.m. EST with the six-member crew aboard Space Shuttle Endeavour on Dec. 3. Endeavour carries the Unity connecting module, which the crew will be mating with the Russian-built Zarya control module already in orbit. In addition to Unity, two small replacement electronics boxes are on board for possible repairs to Zarya batteries. The mission is expected to last 11 days, 19 hours and 49 minutes, landing at 10:17 p.m. EST on Dec. 14.

International Space Station (ISS)

NASA Image and Video Library

2007-11-03

While anchored to a foot restraint on the end of the Orbiter Boom Sensor System (OBSS), astronaut Scott Parazynski, STS-120 mission specialist, participated in the mission's fourth session of extravehicular activity (EVA) while Space Shuttle Discovery was docked with the International Space Station (ISS). During the 7-hour and 19-minute space walk, Parazynski cut a snagged wire and installed homemade stabilizers designed to strengthen the structure and stability of the damaged P6 4B solar array wing. Astronaut Doug Wheelock (out of frame), mission specialist, assisted from the truss by keeping an eye on the distance between Parazynski and the array. Once the repair was complete, flight controllers on the ground successfully completed the deployment of the array.

Establishing a Research Agenda for Understanding the Role and Impact of Mental Health Peer Specialists.

PubMed

Chinman, Matthew; McInnes, D Keith; Eisen, Susan; Ellison, Marsha; Farkas, Marianne; Armstrong, Moe; Resnick, Sandra G

2017-09-01

Mental health peer specialists are individuals with serious mental illnesses who receive training to use their lived experiences to help others with serious mental illnesses in clinical settings. This Open Forum discusses the state of the research for mental health peer specialists and suggests a research agenda to advance the field. Studies have suggested that peer specialists vary widely in their roles, settings, and theoretical orientations. Theories of action have been proposed, but none have been tested. Outcome studies have shown benefits of peer specialists; however, many studies have methodological shortcomings. Qualitative descriptions of peer specialists are plentiful but lack grounding in implementation science frameworks. A research agenda advancing the field could include empirically testing theoretical mechanisms of peer specialists, developing a measure of peer specialist fidelity, conducting more rigorous outcomes studies, involving peer specialists in executing the research, and assessing various factors that influence implementing peer specialist services and testing strategies that could address those factors.

Clinical nurse specialist prescriber characteristics and challenges in Oregon.

PubMed

Klein, Tracy

2015-01-01

The purpose of this study was to assess role characteristics of clinical nurse specialists (CNSs) with prescriptive authority in Oregon 10 years after passage of Senate Bill 460. Factors examined included role preparation and mentorship, use and maintenance of authority, prescribing benefits and barriers, and types of drugs/nondrugs prescribed. This study was a descriptive survey using both quantitative and qualitative analysis. The sample was obtained from a list provided on June 13, 2014, by the Oregon State Board of Nursing of all CNSs in Oregon who had ever been granted prescriptive authority (n = 40). Twenty-nine with active authority, 7 with expired authority, and 4 with inactive status were sampled. E-mail distribution with Qualtrics software was released on June 27, 2014. Reminder e-mails were sent at 1 and 2 weeks. Of the 38 e-mails successfully delivered, 23 responses were received for a total response rate of 60%. Clinical nurse specialists successfully maintained their authority in Oregon and felt well prepared for their role. Their prescribing mentorship included nurse and nonnurse prescribers. They were most likely to have ever prescribed psychiatric, noncontrolled analgesics and durable medical equipment. They most frequently prescribed nutrition/electrolytes/fluids, durable medical equipment, and controlled analgesics. Lapse in authority was attributed to constraints regarding certification or credentialing in the role. Clinical nurse specialists uniformly expressed benefits from prescriptive authority. There were no differences in perceptions of preparation based on type of mentorship or educational modality for completion of prescribing requirements. There were systems barriers including lack of employer and colleague support to use of authority. Durable medical equipment authority is important to the CNS role. Clinical nurse specialists valued and maintained their prescriptive authority despite barriers. Further research is recommended to support success for CNS prescribers from multiple settings and specialties.

Predictors of and barriers to service use for children at risk of ADHD: longitudinal study.

PubMed

Sayal, Kapil; Mills, Jonathan; White, Kate; Merrell, Christine; Tymms, Peter

2015-05-01

Many children with, or at risk of, ADHD do not receive healthcare services for their difficulties. This longitudinal study investigates barriers to and predictors of specialist health service use. This is a 5-year follow-up study of children who participated in a cluster randomised controlled trial, which investigated school-level interventions (provision of books with evidence-based information and/or feedback of names of children) for children at risk of ADHD. 162 children who had high levels of ADHD symptoms at age 5 (baseline) were followed up at age 10 years. Using baseline data and follow-up information collected from parents and teachers, children who had and had not used specialist health services over the follow-up period were compared and predictors (symptom severity, comorbid problems, parental perception of burden, parental mental health, and socio-demographic factors) of specialist service use investigated. The most common parent-reported barrier reflected lack of information about who could help. Amongst children using specialist health services who met criteria for ADHD at follow-up, 36% had been prescribed stimulant medication. Specialist health service use was associated with each one-point increase in teacher-rated symptoms at baseline [inattention symptoms (adjusted OR = 1.40; 95% CI 1.12-1.76) and hyperactivity/impulsivity symptoms (adjusted OR = 1.23; 95% CI 1.05-1.44)]. Parental mental health problems were also independently associated with service use (for each one-point increase in symptoms, adjusted OR = 1.41; 95% CI 1.04-1.91). Severity of teacher-rated ADHD symptoms in early school years is a determinant of subsequent service use. Clinicians and teachers should be aware that parental mental health problems are independently associated with service use for children at risk of ADHD.

Commissioning of specialist palliative care services in England.

PubMed

Lancaster, Harriet; Finlay, Ilora; Downman, Maxwell; Dumas, James

2018-03-01

Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise. We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services. 29 CCGs provided information about the number of patients with some form of palliative care needs in their population. For specialist palliative care services, CCGs allocated budgets ranging from £51.83 to £2329.19 per patient per annum. 163 CCGs (77.90%) currently commission 7-day admission to their specialist palliative care beds. 82.84% of CCGs commission 7-day specialist palliative care services in patients' own homes and out-of-hours services rely heavily on hospice provision. 64 CCGs (31.37%) commission pain control teams, the majority of whom only operate in regular working hours. 68.14% of CCGs reported commissioning palliative care education of any sort for healthcare professionals and 44.85% of CCGs had no plans to update or review their palliative care services. The most important finding from this exercise is that the information CCGs hold about their population and services is not standardised. However, information based on data that are more objective, for example, population and total budget for palliative care, demonstrate wide variations in commissioning. 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/.

Differing Experiences with Pre-Exposure Prophylaxis in Boston Among Lesbian, Gay, Bisexual, and Transgender Specialists and Generalists in Primary Care: Implications for Scale-Up.

PubMed

Krakower, Douglas S; Ware, Norma C; Maloney, Kevin M; Wilson, Ira B; Wong, John B; Mayer, Kenneth H

2017-07-01

The Centers for Disease Control and Prevention estimates that one in four sexually active men who have sex with men (MSM) could decrease their HIV risk by using HIV pre-exposure prophylaxis (PrEP). Because many MSM access healthcare from primary care providers (PCPs), these clinicians could play an important role in providing access to PrEP. Semistructured qualitative interviews were conducted with 31 PCPs in Boston, MA, to explore how they approach decisions about prescribing PrEP to MSM and their experiences with PrEP provision. Purposive sampling included 12 PCPs from an urban community health center specializing in the care of lesbian, gay, bisexual, and transgender persons ("LGBT specialists") and 19 PCPs from a general academic medical center ("generalists"). Analyses utilized an inductive approach to identify emergent themes. Both groups of PCPs approached prescribing decisions about PrEP as a process of informed decision-making with patients. Providers would defer to patients' preferences if they were unsure about the appropriateness of PrEP. LGBT specialists and generalists were at vastly different stages of adopting PrEP into practice. For LGBT specialists, PrEP was a disruptive innovation that rapidly became normative in practice. Generalists had limited experience with PrEP; however, they desired succinct decision-support tools to help them achieve proficiency, because they considered preventive medicine to be central to their professional role. As generalists vastly outnumber LGBT specialists in the United States, interventions to support PrEP provision by generalists could accelerate the scale-up of PrEP for MSM nationally, which could in turn decrease HIV incidence for this priority population.

Ethanol confers differential protection against generalist and specialist parasitoids of Drosophila melanogaster.

PubMed

Lynch, Zachary R; Schlenke, Todd A; Morran, Levi T; de Roode, Jacobus C

2017-01-01

As parasites coevolve with their hosts, they can evolve counter-defenses that render host immune responses ineffective. These counter-defenses are more likely to evolve in specialist parasites than generalist parasites; the latter face variable selection pressures between the different hosts they infect. Natural populations of the fruit fly Drosophila melanogaster are commonly threatened by endoparasitoid wasps in the genus Leptopilina, including the specialist L. boulardi and the generalist L. heterotoma, and both wasp species can incapacitate the cellular immune response of D. melanogaster larvae. Given that ethanol tolerance is high in D. melanogaster and stronger in the specialist wasp than the generalist, we tested whether fly larvae could use ethanol as an anti-parasite defense and whether its effectiveness would differ against the two wasp species. We found that fly larvae benefited from eating ethanol-containing food during exposure to L. heterotoma; we observed a two-fold decrease in parasitization intensity and a 24-fold increase in fly survival to adulthood. Although host ethanol consumption did not affect L. boulardi parasitization rates or intensities, it led to a modest increase in fly survival. Thus, ethanol conferred stronger protection against the generalist wasp than the specialist. We tested whether fly larvae can self-medicate by seeking ethanol-containing food after being attacked by wasps, but found no support for this hypothesis. We also allowed female flies to choose between control and ethanol-containing oviposition sites in the presence vs. absence of wasps and generally found significant preferences for ethanol regardless of wasp presence. Overall, our results suggest that D. melanogaster larvae obtain protection from certain parasitoid wasp species through their mothers' innate oviposition preferences for ethanol-containing food sources.

Ethanol confers differential protection against generalist and specialist parasitoids of Drosophila melanogaster

PubMed Central

Schlenke, Todd A.; Morran, Levi T.; de Roode, Jacobus C.

2017-01-01

As parasites coevolve with their hosts, they can evolve counter-defenses that render host immune responses ineffective. These counter-defenses are more likely to evolve in specialist parasites than generalist parasites; the latter face variable selection pressures between the different hosts they infect. Natural populations of the fruit fly Drosophila melanogaster are commonly threatened by endoparasitoid wasps in the genus Leptopilina, including the specialist L. boulardi and the generalist L. heterotoma, and both wasp species can incapacitate the cellular immune response of D. melanogaster larvae. Given that ethanol tolerance is high in D. melanogaster and stronger in the specialist wasp than the generalist, we tested whether fly larvae could use ethanol as an anti-parasite defense and whether its effectiveness would differ against the two wasp species. We found that fly larvae benefited from eating ethanol-containing food during exposure to L. heterotoma; we observed a two-fold decrease in parasitization intensity and a 24-fold increase in fly survival to adulthood. Although host ethanol consumption did not affect L. boulardi parasitization rates or intensities, it led to a modest increase in fly survival. Thus, ethanol conferred stronger protection against the generalist wasp than the specialist. We tested whether fly larvae can self-medicate by seeking ethanol-containing food after being attacked by wasps, but found no support for this hypothesis. We also allowed female flies to choose between control and ethanol-containing oviposition sites in the presence vs. absence of wasps and generally found significant preferences for ethanol regardless of wasp presence. Overall, our results suggest that D. melanogaster larvae obtain protection from certain parasitoid wasp species through their mothers’ innate oviposition preferences for ethanol-containing food sources. PMID:28700600

Forecasting the need for medical specialists in Spain: application of a system dynamics model

PubMed Central

2010-01-01

Background Spain has gone from a surplus to a shortage of medical doctors in very few years. Medium and long-term planning for health professionals has become a high priority for health authorities. Methods We created a supply and demand/need simulation model for 43 medical specialties using system dynamics. The model includes demographic, education and labour market variables. Several scenarios were defined. Variables controllable by health planners can be set as parameters to simulate different scenarios. The model calculates the supply and the deficit or surplus. Experts set the ratio of specialists needed per 1000 inhabitants with a Delphi method. Results In the scenario of the baseline model with moderate population growth, the deficit of medical specialists will grow from 2% at present (2800 specialists) to 14.3% in 2025 (almost 21 000). The specialties with the greatest medium-term shortages are Anesthesiology, Orthopedic and Traumatic Surgery, Pediatric Surgery, Plastic Aesthetic and Reparatory Surgery, Family and Community Medicine, Pediatrics, Radiology, and Urology. Conclusions The model suggests the need to increase the number of students admitted to medical school. Training itineraries should be redesigned to facilitate mobility among specialties. In the meantime, the need to make more flexible the supply in the short term is being filled by the immigration of physicians from new members of the European Union and from Latin America. PMID:21034458

Comparing stigmatising attitudes towards people with substance use disorders between the general public, GPs, mental health and addiction specialists and clients.

PubMed

van Boekel, Leonieke C; Brouwers, Evelien Pm; van Weeghel, Jaap; Garretsen, Henk Fl

2015-09-01

Substance use disorders (SUDs) are among the most severely stigmatised conditions; however, little is known about the nature of these stigmatising attitudes. To assess and compare stigmatising attitudes towards persons with SUDs among different stakeholders: general public, general practitioners (GPs), mental health and addiction specialists, and clients in treatment for substance abuse. Cross-sectional study (N = 3,326) in which stereotypical beliefs, attribution beliefs (e.g. perceptions about controllability and responsibility for having an addiction), social distance and expectations about rehabilitation opportunities for individuals with substance use disorders were assessed and compared between stakeholders. Individuals with substance use disorders elicited great social distance across all stakeholders. Stereotypical beliefs were not different between stakeholders, whereas attribution beliefs were more diverse. Considering social distance and expectations about rehabilitation opportunities, the general public was most pessimistic, followed by GPs, mental health and addiction specialists, and clients. Stereotypical and attribution beliefs, as well as age, gender and socially desirable answering, were not associated with social distance across all stakeholders. The general public and GPs expressed more social distance and were more negative in their expectations about rehabilitation opportunities, compared to mental health and addiction specialists and clients. Although stigmatising attitudes were prevalent across all groups, no striking differences were found between stakeholders. © The Author(s) 2014.

48 CFR 552.236-72 - Specialist.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 552.236-72... FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 552.236-72 Specialist. As prescribed in 536.570-3, insert the following clause: Specialist (APR 1984) The term “Specialist...

Elementary Reading Specialists' Perspectives towards Their Work

ERIC Educational Resources Information Center

Bunker, Wendy Woods

2017-01-01

The purpose of this qualitative interview study was to explore the narratives of 22 elementary reading specialists about their work. It asked: What were reading specialists' narratives about their work and their influences? The study looked at reading specialists' day-to-day functioning within an institution and at reading specialists'…

Various view with fish-eye lens of STS-103 crew on aft flight deck

NASA Image and Video Library

2000-01-28

STS103-375-027 (19 - 27 December 1999).--- Astronaut Jean-Francois Clervoy, mission specialist representing the European Space Agency (ESA), controls Discovery's remote manipulator system (RMS) robot arm during operations.with the Hubble Space Telescope (HST).

46 CFR 11.472 - Officer endorsements as barge supervisor.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., mechanic, electrician, crane operator, subsea specialist, ballast control operator or equivalent... or barge supervisor trainee; or (ii) A degree from a program in engineering or engineering technology which is accredited by the Accreditation Board for Engineering and Technology (ABET). Commanding Officer...

Activity on the flight deck during EVA on Flight Day 7

NASA Image and Video Library

1997-02-17

S82-E-5616 (17 Feb. 1997) --- Astronaut Steven A. Hawley, STS-82 mission specialist, controls the Remote Manipulator System (RMS) on the Space Shuttle Atlantis' aft flight deck. This view was taken with an Electronic Still Camera (ESC).

Aspects of intelligent electronic device based switchgear control training model application

NASA Astrophysics Data System (ADS)

Bogdanov, Dimitar; Popov, Ivaylo

2018-02-01

The design of the protection and control equipment for electrical power sector application was object of extensive advance in the last several decades. The modern technologies offer a wide range of multifunctional flexible applications, making the protection and control of facilities more sophisticated. In the same time, the advance of technology imposes the necessity of simulators, training models and tutorial laboratory equipment to be used for adequate training of students and field specialists

Index to FAA Office of Aerospace Medicine Reports

DTIC Science & Technology

2011-01-01

Development and evaluation of a radar air traffic control research task. AD660198 65-32 Gogel WC, Mertens HW: Problems in depth perception: A method of...and the air traffic control specialist: Some conclusions from a decade of research . ADA093266/5 80-15 Boone JO, Van Buskirk L, Steen JA: The Federal... control applicants. ADA328998 97-18 Marcus JH: A flexible cabin simulator. ADA328996 97-19 Broach D: Designing selection tests for the future National

Index to FAA Office of Aerospace Medicine Reports: 1961 Through 2012

DTIC Science & Technology

2013-01-01

air traffic control research task. AD660198 65-32 Gogel WC, Mertens HW: Problems in depth perception: A method of simulating objects moving in depth...ADA092529/7 80-14 Smith RC: Stress, anxiety, and the air traffic control specialist: Some conclusions from a decade of research . ADA093266/5 80-15...PS, Manning CA: Selection of air traffic controllers for automated systems: applications from current research . ADA230058 90-14 Parker JF Jr, Shepherd

STS-105 coverage of Mission Control Center employees in the WFCR & BFCR

NASA Image and Video Library

2003-03-25

JSC2001-E-25121 (16 August 2001) --- Astronaut Joseph R. Tanner, STS-105 spacecraft communicator (CAPCOM), monitors the progress of the extravehicular activity at his console in the shuttle flight control room (WFCR) in Houston’s Mission Control Center (MCC). At the time this photo was taken, mission specialists Daniel T. Barry and Patrick G. Forrester were performing the first of two scheduled space walks to perform work on the International Space Station (ISS).

A shared-care model of obesity treatment for 3-10 year old children: protocol for the HopSCOTCH randomised controlled trial.

PubMed

Wake, Melissa; Lycett, Kate; Sabin, Matthew A; Gunn, Jane; Gibbons, Kay; Hutton, Cathy; McCallum, Zoe; York, Elissa; Stringer, Michael; Wittert, Gary

2012-03-28

Despite record rates of childhood obesity, effective evidence-based treatments remain elusive. While prolonged tertiary specialist clinical input has some individual impact, these services are only available to very few children. Effective treatments that are easily accessible for all overweight and obese children in the community are urgently required. General practitioners are logical care providers for obese children but high-quality trials indicate that, even with substantial training and support, general practitioner care alone will not suffice to improve body mass index (BMI) trajectories. HopSCOTCH (the Shared Care Obesity Trial in Children) will determine whether a shared-care model, in which paediatric obesity specialists co-manage obesity with general practitioners, can improve adiposity in obese children. Randomised controlled trial nested within a cross-sectional BMI survey conducted across 22 general practices in Melbourne, Australia. Children aged 3-10 years identified as obese by Centers for Disease Control criteria at their family practice, and randomised to either a shared-care intervention or usual care. A single multidisciplinary obesity clinic appointment at Melbourne's Royal Children's Hospital, followed by regular appointments with the child's general practitioner over a 12 month period. To support both specialist and general practice consultations, web-based shared-care software was developed to record assessment, set goals and actions, provide information to caregivers, facilitate communication between the two professional groups, and jointly track progress. Primary - change in BMI z-score. Secondary - change in percentage fat and waist circumference; health status, body satisfaction and global self-worth. This will be the first efficacy trial of a general-practitioner based, shared-care model of childhood obesity management. If effective, it could greatly improve access to care for obese children. Australian New Zealand Clinical Trials Registry ACTRN12608000055303.

Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder.

PubMed

Morriss, Richard; Marttunnen, Sarah; Garland, Anne; Nixon, Neil; McDonald, Ruth; Sweeney, Tim; Flambert, Heather; Fox, Richard; Kaylor-Hughes, Catherine; James, Marilyn; Yang, Min

2010-11-29

Around 40 per cent of patients with unipolar depressive disorder who are treated in secondary care mental health services do not respond to first or second line treatments for depression. Such patients have 20 times the suicide rate of the general population and treatment response becomes harder to achieve and sustain the longer they remain depressed. Despite this there are no randomised controlled trials of community based service delivery interventions delivering both algorithm based pharmacotherapy and psychotherapy for patients with chronic depressive disorder in secondary care mental health services who remain moderately or severely depressed after six months treatment. Without such trials evidence based guidelines on services for such patients cannot be derived. Single blind individually randomised controlled trial of a specialist depression disorder team (psychiatrist and psychotherapist jointly assessing and providing algorithm based drug and psychological treatment) versus usual secondary care treatment. We will recruit 174 patients with unipolar depressive disorder in secondary mental health services with a Hamilton Depression Rating Scale (HDRS) score ≥ 16 and global assessment of function (GAF) ≤ 60 after ≥ 6 months treatment. The primary outcome measures will be the HDRS and GAF supplemented by economic analysis including the EQ5 D and analysis of barriers to care, implementation and the process of care. Audits to benchmark both treatment arms against national standards of care will aid the interpretation of the results of the study. This trial will be the first to assess the effectiveness and implementation of a community based specialist depression disorder team. The study has been specially designed as part of the CLAHRC Nottinghamshire, Derbyshire and Lincolnshire joint collaboration between university, health and social care organisations to provide information of direct relevance to decisions on commissioning, service provision and implementation.

Clinical nurse specialists as entrepreneurs: constrained or liberated.

PubMed

Austin, Lynn; Luker, Karen; Roland, Martin; Ronald, Martin

2006-12-01

This qualitative study explored the experiences of two groups of clinical nurse specialists--continence advisors and tissue viability nurses--working in primary care in the UK. In particular, the study focused on how clinical nurse specialists' relationships with other health-care professionals had an impact on their role. Clinical nurse specialists are recognized worldwide as having expertise in a given field, which they use to develop the practice of others. Additionally, clinical nurse specialists share many of the characteristics of entrepreneurs, which they use to develop services related to their speciality. However, little research has been conducted in relation to clinical nurse specialists' experiences as they attempt to diversify nursing practice. An ethnographic approach was adopted comprising many elements of Glaserian grounded theory. Data were collected via participant observation and face-to-face interviews with 22 clinical nurse specialists. Services provided by clinical nurse specialists were not static, clinical nurse specialists being the main drivers for service developments. However, clinical nurse specialists encountered difficulties when introducing new ideas. Given their role as advisors, clinical nurse specialists lacked authority to bring about change and were dependent on a number of mechanisms to bring about change, including 'cultivating relationships' with more powerful others, most notably the speciality consultant. The UK government has pledged to 'liberate the talents of nurses' so that their skills can be used to progress patient services. This study highlights the fact that a lack of collaborative working practices between health-care professionals led to clinical nurse specialists being constrained. Health-care organizations need to provide an environment in which the entrepreneurial skills of clinical nurse specialists may be capitalized on. In the absence of an outlet for their ideas regarding service developments, clinical nurse specialists may remain dependent on the mechanisms witnessed in this study for some time.

Library Media Specialists: Premier Information Specialists for the Information Age

ERIC Educational Resources Information Center

Neuman, Delia

2011-01-01

The information age has given library media specialists an unprecedented opportunity to play a leading role in helping teachers, administrators, and especially students access and use information intelligently. As the school's premier information specialist; the library media specialist has a unique role to play in helping everyone in the school…

76 FR 43738 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-21

... filed an immediately effective proposal regarding Remote Specialists (the ``Remote Specialist filing'') that expanded the Remote Specialist concept.\\3\\ By the Remote Specialist filing, the Exchange enhanced the existing Remote Specialist \\4\\ model so that all eligible ROTs \\5\\ on the Exchange could function...

STS-94 Columbia Landing at KSC (drag chute deploy)

NASA Technical Reports Server (NTRS)

1997-01-01

The Space Shuttle orbiter Columbia touches down on Runway 33 at KSCs Shuttle Landing Facility at 6:46:34 a.m. EDT with Mission Commander James D. Halsell Jr. and Pilot Susan L. Still at the controls to complete the STS-94 mission. Also on board are Mission Specialist Donald A. Thomas, Mission Specialist Michael L. Gernhardt, Payload Commander Janice Voss, and Payload Specialists Roger K. Crouch and Gregory T. Linteris. During the Microgravity Science Laboratory-1 (MSL-1) mission, the Spacelab module was used to test some of the hardware, facilities and procedures that are planned for use on the International Space Station while the flight crew conducted combustion, protein crystal growth and materials processing experiments. This mission was a reflight of the STS-83 mission that lifted off from KSC in April of this year. That space flight was cut short due to indications of a faulty fuel cell. This was Columbias 11th landing at KSC and the 38th landing at the space center in the history of the Shuttle program.

Knowledge assistant: A sensor fusion framework for robotic environmental characterization

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

Feddema, J.T.; Rivera, J.J.; Tucker, S.D.

1996-12-01

A prototype sensor fusion framework called the {open_quotes}Knowledge Assistant{close_quotes} has been developed and tested on a gantry robot at Sandia National Laboratories. This Knowledge Assistant guides the robot operator during the planning, execution, and post analysis stages of the characterization process. During the planning stage, the Knowledge Assistant suggests robot paths and speeds based on knowledge of sensors available and their physical characteristics. During execution, the Knowledge Assistant coordinates the collection of data through a data acquisition {open_quotes}specialist.{close_quotes} During execution and post analysis, the Knowledge Assistant sends raw data to other {open_quotes}specialists,{close_quotes} which include statistical pattern recognition software, a neuralmore » network, and model-based search software. After the specialists return their results, the Knowledge Assistant consolidates the information and returns a report to the robot control system where the sensed objects and their attributes (e.g. estimated dimensions, weight, material composition, etc.) are displayed in the world model. This paper highlights the major components of this system.« less

[The Potential Role of an Academic Society for Oncology Specialists to Promote Cancer Education in Schools].

PubMed

Nishiyama, Masahiko

2015-08-01

Cancer mortality in Japan is forecasted to become high; thus, learning about cancer, cancer prevention, and cancer treatment will be indispensable for the Japanese. Recognition of the increasing rates of cancer has initiated a discussion regarding the introduction of cancer education into the regular educational curriculum for the younger generation. The importance of cancer education is noww idely recognized, and the 2nd Basic Plan to Promote Cancer Control Programs is directed at early initiation of education. The Ministry of Education, Culture, Sports, Science and Technology is nowreview ing the detailed plan, with an intention to draw a conclusion by the end of the 2016 business year. However, ongoing debates have revealed that there are many obstacles in the way of this practice. Much effort should be directed at solving these issues in the most realistic way. This paper reviews potential actions by oncology specialists, and attempts to clarify the possible role of an academic society for oncology specialists in the development of cancer education systems at school.

[Interview study on autonomous chemical management system and the contribution of occupational health specialists in companies].

PubMed

Mori, Koji; Takebayashi, Toru

2004-09-01

Under the circumstance that autonomous risk management for chemicals is required in Japan, it is necessary to define fundamental steps for developing chemical management system that are applicable in various types of companies and to understand the effective contribution of chemical or occupational health specialists to the system. For the purposes, we conducted interviews with companies which have an advanced chemical management system in Japan. As the result, each company had a certain policy about detailedness level of collected hazard and exposure information, and also had an efficient risk management system to ensure workers' health in depending on the business type and situations. Moreover, it was commonly observed that the specialists played major roles in developing tools for risk assessment and control, and then business lines led execution of the risk management with their supports. Based on the interviews, we showed a hypothesis of basic steps in introducing autonomous chemical risk management system at the workplaces. It is necessary to verify the hypothesis and to develop a simple system that is applicable to middle or small size companies as the next step.

The visiting specialist model of rural health care delivery: a survey in Massachusetts.

PubMed

Drew, Jacob; Cashman, Suzanne B; Savageau, Judith A; Stenger, Joseph

2006-01-01

Hospitals in rural communities may seek to increase specialty care access by establishing clinics staffed by visiting specialists. To examine the visiting specialist care delivery model in Massachusetts, including reasons specialists develop secondary rural practices and distances they travel, as well as their degree of satisfaction and intention to continue the visiting arrangement. Visiting specialists at 11 rural hospitals were asked to complete a mailed survey. Visiting specialists were almost evenly split between the medical (54%) and surgical (46%) specialties, with ophthalmology, nephrology, and obstetrics/gynecology the most common specialties reported. A higher proportion of visiting specialists than specialists statewide were male (P = .001). Supplementing their patient base and income were the most important reasons visiting specialists reported for having initiated an ancillary clinic. There was a significant negative correlation between a hospital's number of staffed beds and the total number of visiting specialists it hosted (r =-0.573, P = .032); study hospitals ranged in bed size from 15 to 129. The goal of matching supply of health care services with demand has been elusive. Visiting specialist clinics may represent an element of a market structure that expands access to needed services in rural areas. They should be included in any enumeration of physician availability.

The validity of the air traffic selection and training (AT-SAT) test battery in operational use.

DOT National Transportation Integrated Search

2013-03-01

Applicants for the air traffic control specialist (ATCS) occupation from the general public and graduates from post-secondary institutions participating in the FAAs Air Traffic Collegiate Training Initiative (AT-CTI) must take and pass the Air Tra...

Health Reports.

DTIC Science & Technology

1992-09-01

Futui’e Structure of Veterans’ Health Program (Aug. 11, 1992, GAO/T-HRD-92-53). Recombinant Bovine Growth Hormone: FDA Approval Should be Withheld Until...the Mastitis Issue Is Resolved (Aug. 6, 1992, GAO/PEMD-92-26). VA Health Care: Inadequate Controls Over Scarce Medical Specialist Contracts (Aug. 5

A catalog of graphic symbols used at maintenance control centers : toward a symbol standardization process.

DOT National Transportation Integrated Search

2002-04-01

This document catalogs the symbols presented with the various interfaces used by Federal Aviation Administration Airway Facilities specialists. It includes a high-level overview of each system and the symbols and coding conventions used. These data w...

A laboratory comparison of clockwise and counter-clockwise rapidly rotating shift schedules, part I, sleep : final report.

DOT National Transportation Integrated Search

2002-05-01

INTRODUCTION. Many air traffic control specialists work relatively unique counter-clockwise, rapidly rotating shift schedules. Researchers recommend, however, that if rotating schedules are to be used, they should rotate in a clockwise, rather than a...

Caldwell in the aft FD of STS-118 Space Shuttle Endeavor

NASA Image and Video Library

2007-08-12

ISS015-E-22145 (12 Aug. 2007) --- Astronaut Tracy Caldwell, STS-118 mission specialist, looks over her shoulder for a photo while working the controls on the aft flight deck of Space Shuttle Endeavour while docked with the International Space Station.

Contribution of personality to the prediction of success in initial air traffic control specialist training.

DOT National Transportation Integrated Search

1993-04-01

Reviews have consistently concluded that the validity of personality as a predictor of job performance is low (Besco, 1991; Reilly & Chao, 1982: Tenopyr & Oeltjen, 1982). However, Barrick and Mount's (1991) meta-analysis of studies of personality and...

29 CFR 1960.56 - Training of safety and health specialists.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., laboratory experiences, field study, and other formal learning experiences to prepare them to perform the... program development and implementation, as well as hazard recognition, evaluation and control, equipment... tasks. (b) Each agency shall implement career development programs for their occupational safety and...

Job Prospects in HVAC Engineering.

ERIC Educational Resources Information Center

Basta, Nicholas

1985-01-01

Although heating, ventilation, and air conditioning (HVAC) engineering degrees are not offered, there is a serious need for specialists and consultants in this area (since most have been trained as mechanical engineers). Opportunities exist for individuals possessing a customer-oriented attitude, with knowledge in computerized controls, innovative…

78 FR 38983 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... specialties: clinical nurse specialist, nurse practitioner, certified nurse anesthetist, certified nurse... a decision aid for dialysis facility selection; (2) aid facilities with their internal quality... a new OMB control number); Title of Information Collection: Evaluation of the Graduate Nurse...

Organization and Functions: Field Operating Agencies of The Judge Advocate General

DTIC Science & Technology

1989-03-20

Criminal Investi- gation Command. (6) Army Military Command Contract Law Specialist Training Program, which trains officers in providing legal advice and...opera- tions in the functional areas of contract law . (7) Patents, Copyrights, and Trademarks Division, which— (a) Manages the administration, control

Pharmacy specialists' attitudes toward pharmaceutical service quality at community pharmacies.

PubMed

Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas

2010-01-01

The main objective of this study was to analyze pharmacy specialists' attitudes toward the quality of pharmaceutical services at Lithuanian community pharmacies. Between April and June 2009, a total of 471 Lithuanian community pharmacy specialists completed a questionnaire designed to evaluate their attitudes toward the quality of pharmaceutical services at community pharmacies. The main dimensions of pharmaceutical service quality were extracted by principal component analysis. Two main dimensions of pharmaceutical service quality were extracted: pharmacotherapeutic aspects (provision of information about drug therapy, possible side effects, health promotion, the amount of time spent with a patient, and the ascertainment that a patient understood the provided information) and socioeconomic aspects (considering patient's needs and financial capabilities, making a patient confident with the services provided). Pharmacy specialists evaluated the quality of both dimensions positively, but the quality of the first dimension was rated significantly worse than that of the second dimension. The attitudes of pharmacy specialists working at independent pharmacies were more positive toward pharmacotherapeutic aspects as compared to the specialists working at chain or state pharmacies. Pharmacotherapeutic aspects were rated better by pharmacy specialists, aged ≥ 55 years, than those younger than 45 years. Moreover, the attitudes of 45-54-year-old pharmacy specialists toward the socioeconomic aspects were more positive as compared with those of 35-44-year olds. Pharmacists rated the socioeconomic aspects of pharmaceutical service quality worse as compared with pharmacy technicians. The attitudes of pharmacy specialists working at pharmacies with 6-9 specialists were more negative toward pharmacotherapeutic aspects than those of the pharmacies with 1-2 specialists. Pharmacy specialists working at pharmacies with ≥ 10 specialists reported lower scores of socioeconomic aspects as compared to those working at pharmacies with fewer specialists. Men evaluated both pharmacotherapeutic and socioeconomic aspects worse than women. The evaluation of pharmaceutical service quality did not differ by pharmacy location. Two dimensions of pharmaceutical service quality were determined. According to Lithuanian pharmacy specialists, the quality of pharmacotherapeutic aspects at community pharmacies was worse than that of socioeconomic aspects. The evaluation of the quality of pharmaceutical service significantly differed according to the specialists' sex, age, qualification, and type and size of pharmacies.

Payload specialist station study: Volume 2, part 3: Program analysis and planning for phase C/D

NASA Technical Reports Server (NTRS)

1976-01-01

The controls and displays (C&D) required at the Orbiter aft-flight deck (AFD) and the core C&D required at the Payload Specialist Station (PSS) are identified in this document. The AFD C&D Concept consists of a multifunction display system (MFDS) and elements of multiuse mission support equipment (MMSE). The MFDS consists of two CRTs, a display electronics unit (DEU), and a keyboard. The MMSE consists of a manual pointing controller (MPC), five digit numeric displays, 10 character alphanumeric legends, event timers, analog meters, rotary and toggle switches. The MMSE may be hardwired to the experiment, or interface with a data bus at the PSS for signal processing. The MFDS has video capability, with alphanumeric and graphic overlay features, on one CRT and alphanumeric and graphic (tricolor) capability on a second CRT. The DEU will have the capability to communicate, via redundant data buses, with both the spacelab experiment and subsystem computers.

Driving Intervention for Returning Combat Veterans.

PubMed

Classen, Sherrilene; Winter, Sandra; Monahan, Miriam; Yarney, Abraham; Link Lutz, Amanda; Platek, Kyle; Levy, Charles

2017-04-01

Increased crash incidence following deployment and veterans' reports of driving difficulty spurred traffic safety research for this population. We conducted an interim analysis on the efficacy of a simulator-based occupational therapy driving intervention (OT-DI) compared with traffic safety education (TSE) in a randomized controlled trial. During baseline and post-testing, OT-Driver Rehabilitation Specialists and one OT-Certified Driver Rehabilitation Specialist measured driving performance errors on a DriveSafety CDS-250 high-fidelity simulator. The intervention group ( n = 13) received three OT-DI sessions addressing driving errors and visual-search retraining. The control group ( n = 13) received three TSE sessions addressing personal factors and defensive driving. Based on Wilcoxon rank-sum analysis, the OT-DI group's errors were significantly reduced when comparing baseline with Post-Test 1 ( p < .0001) and comparing the OT-DI group with the TSE group at Post-Test 1 ( p = .01). These findings provide support for the efficacy of the OT-DI and set the stage for a future effectiveness study.

76 FR 27105 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-10

... participants (including, for purposes of this rule only, Floor Brokers) over Remote Specialists,\\3\\ Remote... order book. \\3\\ A Remote Specialist is a qualified RSQT approved by the Exchange to function as a... floor based specialist. A Remote Specialist has all the rights and obligations of a specialist, unless...

The effect of managed care on the incomes of primary care and specialty physicians.

PubMed

Simon, C J; Dranove, D; White, W D

1998-08-01

To determine the effects of managed care growth on the incomes of primary care and specialist physicians. Data on physician income and managed care penetration from the American Medical Association, Socioeconomic Monitoring System (SMS) Surveys for 1985 and 1993. We use secondary data from the Area Resource File and U.S. Census publications to construct geographical socioeconomic control variables, and we examine data from the National Residency Matching Program. Two-stage least squares regressions are estimated to determine the effect of local managed care penetration on specialty-specific physician incomes, while controlling for factors associated with local variation in supply and demand and accounting for the potential endogeneity of managed care penetration. The SMS survey is an annual telephone survey conducted by the American Medical Association of approximately one percent of nonfederal, post-residency U.S. physicians. Response rates average 60-70 percent, and analysis is weighted to account for nonresponse bias. The incomes of primary care physicians rose most rapidly in states with higher managed care growth, while the income growth of hospital-based specialists was negatively associated with managed care growth. Incomes of medical subspecialists were not significantly affected by managed care growth over this period. These findings are consistent with trends in postgraduate training choices of new physicians. Evidence is consistent with a relative increase in the demand for primary care physicians and a decline in the demand for some specialists under managed care. Market adjustments have important implications for health policy and physician workforce planning.

[Current panorama of the teaching of microbiology and parasitology in Spain].

PubMed

Cantón, Rafael; Sánchez-Romero, María Isabel; Gómez-Mampaso, Enrique

2010-10-01

The training program of residents in microbiology and parasitology in Spain includes clinical skills, ranging from the diagnostic approach to the patient and adequate sample collection for diagnosis of infectious diseases to antimicrobial therapy and infection control measures. Training also includes new challenges in clinical microbiology that ensure residents' participation in infection control programs of health-care associated infections, training in the resolution of public health problems, and application of new molecular microbiology methods. Specialization in clinical microbiology may be undertaken by graduates in Medicine, Biology, Biochemistry and Chemistry. The training is performed in accredited microbiology laboratories at different hospitals (n = 61) across the country through 4-year residency programs. In the last few years, there has been a major imbalance between the number of intended residents (0.17 per 100,000 inhabitants) and those graduating as specialists in clinical microbiology (0.13 per 100,000 inhabitants), with wide variations across the country. The current tendency in Europe is to strengthen the role of clinical microbiologists as key figures in the diagnosis of infectious diseases and in public health microbiology. Training programs have been hampered by the practice of sending samples for microbiological tests to external, centralized multipurpose laboratories with few clinical microbiologists and without a core curriculum. Essential elements in the training of specialists in clinical microbiology are a close relationship between the laboratory and the clinical center and collaboration with other specialists. Copyright © 2010 Elsevier España S.L. All rights reserved.

Interventions to improve outpatient referrals from primary care to secondary care.

PubMed

Akbari, Ayub; Mayhew, Alain; Al-Alawi, Manal Alawi; Grimshaw, Jeremy; Winkens, Ron; Glidewell, Elizabeth; Pritchard, Chanie; Thomas, Ruth; Fraser, Cynthia

2008-10-08

The primary care specialist interface is a key organisational feature of many health care systems. Patients are referred to specialist care when investigation or therapeutic options are exhausted in primary care and more specialised care is needed. Referral has considerable implications for patients, the health care system and health care costs. There is considerable evidence that the referral processes can be improved. To estimate the effectiveness and efficiency of interventions to change outpatient referral rates or improve outpatient referral appropriateness. We conducted electronic searches of the Cochrane Effective Practice and Organisation of Care (EPOC) group specialised register (developed through extensive searches of MEDLINE, EMBASE, Healthstar and the Cochrane Library) (February 2002) and the National Research Register. Updated searches were conducted in MEDLINE and the EPOC specialised register up to October 2007. Randomised controlled trials, controlled clinical trials, controlled before and after studies and interrupted time series of interventions to change or improve outpatient referrals. Participants were primary care physicians. The outcomes were objectively measured provider performance or health outcomes. A minimum of two reviewers independently extracted data and assessed study quality. Seventeen studies involving 23 separate comparisons were included. Nine studies (14 comparisons) evaluated professional educational interventions. Ineffective strategies included: passive dissemination of local referral guidelines (two studies), feedback of referral rates (one study) and discussion with an independent medical adviser (one study). Generally effective strategies included dissemination of guidelines with structured referral sheets (four out of five studies) and involvement of consultants in educational activities (two out of three studies). Four studies evaluated organisational interventions (patient management by family physicians compared to general internists, attachment of a physiotherapist to general practices, a new slot system for referrals and requiring a second 'in-house' opinion prior to referral), all of which were effective. Four studies (five comparisons) evaluated financial interventions. One study evaluating change from a capitation based to mixed capitation and fee-for-service system and from a fee-for-service to a capitation based system (with an element of risk sharing for secondary care services) observed a reduction in referral rates. Modest reductions in referral rates of uncertain significance were observed following the introduction of the general practice fundholding scheme in the United Kingdom (UK). One study evaluating the effect of providing access to private specialists demonstrated an increase in the proportion of patients referred to specialist services but no overall effect on referral rates. There are a limited number of rigorous evaluations to base policy on. Active local educational interventions involving secondary care specialists and structured referral sheets are the only interventions shown to impact on referral rates based on current evidence. The effects of 'in-house' second opinion and other intermediate primary care based alternatives to outpatient referral appear promising.

STS-105 coverage of Mission Control Center employees in the WFCR & BFCR

NASA Image and Video Library

2003-03-25

JSC2001-E-25111 (16 August 2001) --- Flight directors John Shannon (left foreground), Kelly Beck, and Steve Stich monitor the data displayed at their consoles in the shuttle flight control room (WFCR) in Houston’s Mission Control Center (MCC). At the time this photo was taken, STS-105 mission specialists Daniel T. Barry and Patrick G. Forrester were performing the first of the two scheduled space walks to perform work on the International Space Station (ISS).

KSC-97pc458

NASA Image and Video Library

1997-03-13

The STS-83 crew poses in the White Room at Launch Complex 39A during the crew's Terminal Countdown Demonstration Test (TCDT). From left to right, standing, they are Payload Specialist Gregory T. Linteris, Pilot Susan L. Still, Mission Commander James D. Halsell, Mission Specialist Michael L. Gernhardt, Payload Specialist Roger K. Crouch, and Mission Specialist Donald Thomas. Mission Specialist Janice E. Voss is kneeling

Understanding specialist sharing: A mixed-method exploration in an increasingly price-competitive hospital market.

PubMed

Westra, Daan; Angeli, Federica; Jatautaitė, Evelina; Carree, Martin; Ruwaard, Dirk

2016-08-01

Medical specialists seem to increasingly work in- and be affiliated to- multiple organizations. We define this phenomenon as specialist sharing. This form of inter-organizational cooperation has received scant scholarly attention. We investigate the extent of- and motives behind- specialist sharing, in the price-competitive hospital market of the Netherlands. A mixed-method was adopted. Social network analysis was used to quantitatively examine the extent of the phenomenon. The affiliations of more than 15,000 medical specialists to any Dutch hospital were transformed into 27 inter-hospital networks, one for each medical specialty, in 2013 and in 2015. Between February 2014 and February 2016, 24 semi-structured interviews with 20 specialists from 13 medical specialties and four hospital executives were conducted to provide in-depth qualitative insights regarding the personal and organizational motives behind the phenomenon. Roughly, 20% of all medical specialists are affiliated to multiple hospitals. The phenomenon occurs in all medical specialties and all Dutch hospitals share medical specialists. Rates of specialist sharing have increased significantly between 2013 and 2015 in 14 of the 27 specialties. Personal motives predominantly include learning, efficiency, and financial benefits. Increased workload and discontinuity of care are perceived as potential drawbacks. Hospitals possess the final authority to decide whether and which specialists are shared. Adhering to volume norms and strategic considerations are seen as their main drivers to share specialists. We conclude that specialist sharing should be interpreted as a form of inter-organizational cooperation between healthcare organizations, facilitating knowledge flow between them. Although quality improvement is an important perceived factor underpinning specialist sharing, evidence of enhanced quality of care is anecdotal. Additionally, the widespread occurrence of the phenomenon and the underlying strategic considerations could pose an antitrust infringement. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lawrence and Kelly at SSRMS controls in Destiny laboratory module

NASA Image and Video Library

2005-08-05

S114-E-7490 (5 August 2005) --- Astronauts Wendy B. Lawrence (foreground), STS-114 mission specialist, and James M. Kelly, pilot, work with the Mobile Service System (MSS) and Canadarm2 controls in the Destiny laboratory of the International Space Station while Space Shuttle Discovery was docked to the Station. The two were re-stowing the Italian-built Raffaello Multi-Purpose Logistics Module (MPLM) in the cargo bay.

[Dermatomycoses and medically important fungi that are necessary subjects of study for dermatology specialists -a personal experience].

PubMed

Nishikawa, Takeji

2015-01-01

Among the numerous skin diseases, dermatomycosis is the one caused by fungus (parasite) infecting the skin (host) . Once diagnosis is made, dermatomycosis can be cured with the use of appropriate anti-fungal drugs. Therefore, it is a much more easily treatable disease compareds with intractable skin diseases. From his own experience, the author shows that dermatomycoses are good subspecialties to deal with because many of them are controllable. At the same time, the author points out that basic research on medically important fungi needs to be done as collaborative studies with basic scientists and dermatology specialists. This brief review covers several topics including diagnostics of medical mycoses, imported medical mycoses, tinea, and cutaneous deep mycoses.

KSC-97PC1813

NASA Image and Video Library

1997-12-12

The Neurolab payload for STS-90, scheduled to launch aboard the Shuttle Columbia from Kennedy Space Center (KSC) on April 2, 1998, undergoes further processing in the Operations and Checkout Building at KSC. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90 will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-97PC1815

NASA Image and Video Library

1997-12-12

The Neurolab payload for STS-90, scheduled to launch aboard the Shuttle Columbia from Kennedy Space Center (KSC) on April 2, 1998, undergoes further processing in the Operations and Checkout Building at KSC. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90 will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-98pc290

NASA Image and Video Library

1998-02-12

The STS-90 Neurolab payload is lowered into position into the cargo bay of Space Shuttle Columbia today in Orbiter Processing Facility bay 3. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90, slated for launch in April, will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-97PC1812

NASA Image and Video Library

1997-12-12

The Neurolab payload for STS-90, scheduled to launch aboard the Shuttle Columbia from Kennedy Space Center (KSC) on April 2, 1998, undergoes further processing in the Operations and Checkout Building at KSC. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90 will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-98pc343

NASA Image and Video Library

1998-03-09

KENNEDY SPACE CENTER, FLA. -- The STS-90 Neurolab payload and four Getaway Specials (GAS) await payload bay door closure in the orbiter Columbia today in Orbiter Processing Facility bay 3. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90, slated for launch in April, will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-97PC1714

NASA Image and Video Library

1997-11-11

The Neurolab payload for STS-90, scheduled to launch aboard the Shuttle Columbia from Kennedy Space Center (KSC) on April 2, 1998, is moved to its workstand in the Operations and Checkout Building at KSC. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90 will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-98pc267

NASA Image and Video Library

1998-02-05

KENNEDY SPACE CENTER, FLA. -- A technician looks at the STS-90 Neurolab payload as it is moved from its test stand in KSC's Operations and Checkout Building. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90, slated for launch in April, will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-98pc291

NASA Image and Video Library

1998-02-12

The STS-90 Neurolab payload is lowered into position into the cargo bay of Space Shuttle Columbia today in Orbiter Processing Facility bay 3. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90, slated for launch in April, will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-97PC1814

NASA Image and Video Library

1997-12-12

The Neurolab payload for STS-90, scheduled to launch aboard the Shuttle Columbia from Kennedy Space Center (KSC) on April 2, 1998, undergoes further processing in the Operations and Checkout Building at KSC. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90 will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-98pc289

NASA Image and Video Library

1998-02-12

The STS-90 Neurolab payload is prepared to be positioned into the cargo bay of Space Shuttle Columbia today in Orbiter Processing Facility bay 3. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90, slated for launch in April, will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-98pc268

NASA Image and Video Library

1998-02-05

KENNEDY SPACE CENTER, FLA. -- Technicians gather around the STS-90 Neurolab payload during weight and center-of-gravity measurements in KSC's Operations and Checkout Building. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90, slated for launch in April, will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-97PC1713

NASA Image and Video Library

1997-11-11

The Neurolab payload for STS-90, scheduled to launch aboard the Shuttle Columbia from Kennedy Space Center (KSC) on April 2, 1998, is moved to its workstand in the Operations and Checkout Building at KSC. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90 will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

KSC-97PC1715

NASA Image and Video Library

1997-11-11

The Neurolab payload for STS-90, scheduled to launch aboard the Shuttle Columbia from Kennedy Space Center (KSC) on April 2, 1998, is moved to its workstand in the Operations and Checkout Building at KSC. Investigations during the Neurolab mission will focus on the effects of microgravity on the nervous system. Specifically, experiments will study the adaptation of the vestibular system, the central nervous system, and the pathways that control the ability to sense location in the absence of gravity, as well as the effect of microgravity on a developing nervous system. The crew of STS-90 will include Commander Richard Searfoss, Pilot Scott Altman, Mission Specialists Richard Linnehan, Dafydd (Dave) Williams, M.D., and Kathryn (Kay) Hire, and Payload Specialists Jay Buckey, M.D., and James Pawelczyk, Ph.D

STS-55 German Payload Specialist Schlegel manipulates ROTEX controls in SL-D2

NASA Image and Video Library

1993-05-06

STS055-106-100 (26 April-6 May 1993) --- Hans Schlegel, wearing special glasses, works at the Robotics Experiment (ROTEX) workstation in the science module aboard the Earth-orbiting Space Shuttle Columbia. Schlegel was one of two payload specialists representing the German Aerospace Research Establishment (DLR) on the 10-day Spacelab D-2 mission. ROTEX is a robotic arm that operates within an enclosed workcell in rack 6 of the Spacelab module and uses teleoperation from both an onboard station located nearby in rack 4 and from a station on the ground. The device uses teleprogramming and artificial intelligence to look at the design, verification and operation of advanced autonomous systems for use in future applications.

Concerns with AED conversion: comparison of patient and physician perspectives.

PubMed

Smith, Brien J; St Louis, Erik K; Stern, John M; Green, Chad; Bramley, Thomas

2009-06-01

When discussing AED conversion in the clinic, both the patient and physician perspectives on the goals and risks of this change are important to consider. To identify patient-reported and clinician-perceived concerns, a panel of epilepsy specialists was questioned about the topics discussed with patients and the clinician's perspective of patient concerns. Findings of a literature review of articles that report patient-expressed concerns regarding their epilepsy and treatment were also reviewed. Results showed that the specialist panel appropriately identified patient-reported concerns of driving ability, medication cost, seizure control, and medication side effects. Additionally, patient-reported concerns of independence, employment issues, social stigma, medication dependence, and undesirable cognitive effects are important to address when considering and initiating AED conversion.

Sensors, Volume 4, Thermal Sensors

NASA Astrophysics Data System (ADS)

Scholz, Jorg; Ricolfi, Teresio

1996-12-01

'Sensors' is the first self-contained series to deal with the whole area of sensors. It describes general aspects, technical and physical fundamentals, construction, function, applications and developments of the various types of sensors. This volume describes the construction and applicational aspects of thermal sensors while presenting a rigorous treatment of the underlying physical principles. It provides a unique overview of the various categories of sensors as well as of specific groups, e.g. temperature sensors (resistance thermometers, thermocouples, and radiation thermometers), noise and acoustic thermometers, heat-flow and mass-flow sensors. Specific facettes of applications are presented by specialists from different fields including process control, automotive technology and cryogenics. This volume is an indispensable reference work and text book for both specialists and newcomers, researchers and developers.

Fully EMU suited MS Peterson and MS Musgrave in airlock

NASA Technical Reports Server (NTRS)

1983-01-01

Fully extravehicular mobility unit (EMU) suited Mission Specialist (MS) Peterson (wearing glasses) and MS Musgrave with service and cooling umbilical (SCU) connected to their displays and control modules (DCMs) participate in airlock prebreathe procedures. Three-fourths of the STS-6 astronaut crew appear in this unusual 35mm frame exposed in the airlock of the Earth-orbiting Challenger, Orbiter Vehicle (OV) 099. Musgrave's helmet visor encompasses all the action in the frame. Peterson is reflected on the right side of Musgrave's visor with Pilot Bobko, wearing conventional onboard clothing and photographing, the activity appearing at the center of the frame. The reversed numbers (1 and 2) in the mirrored image represents the extravehicular activity (EVA) designations for the two mission specialists.

BDPU, Favier places new test chamber into experiment module in LMS-1 Spacelab

NASA Image and Video Library

1996-07-09

STS078-301-021 (20 June - 7 July 1996) --- Payload specialist Jean-Jacques Favier, representing the French Space Agency (CNES), holds up a test container to a Spacelab camera. The test involves the Bubble Drop Particle Unit (BDPU), which Favier is showing to ground controllers at the Marshall Space Flight Center (MSFC) in order to check the condition of the unit prior to heating in the BDPU facility. The test container holds experimental fluid and allows experiment observation through optical windows. BDPU contains three internal cameras that are used to continuously downlink BDPU activity so that behavior of the bubbles can be monitored. Astronaut Richard M. Linnehan, mission specialist, conducts biomedical testing in the background.

Enhancing diabetes management while teaching quality improvement methods.

PubMed

Sievers, Beth A; Negley, Kristin D F; Carlson, Marny L; Nelson, Joyce L; Pearson, Kristina K

2014-01-01

Six medical units realized that they were having issues with accurate timing of bedtime blood glucose measurement for their patients with diabetes. They decided to investigate the issues by using their current staff nurse committee structure. The clinical nurse specialists and nurse education specialists decided to address the issue by educating and engaging the staff in the define, measure, analyze, improve, control (DMAIC) framework process. They found that two issues needed to be improved, including timing of bedtime blood glucose measurement and snack administration and documentation. Several educational interventions were completed and resulted in improved timing of bedtime glucose measurement and bedtime snack documentation. The nurses understood the DMAIC process, and collaboration and cohesion among the medical units was enhanced. Copyright 2014, SLACK Incorporated.

Application of a sub-specialties management model improves quality control in a central sterile supply department.

PubMed

Wang, Li; Cai, Xuejiao; Cheng, Ping

2018-05-30

The management of medical devices is crucial to safe, high-quality surgical care, but has received little attention in the medical literature. This study explored the effect of a sub-specialties management model in the Central Sterile Supply Department (CSSD). A traditional routine management model (control) was applied from September 2015 through April 2016, and a newly developed sub-specialties management model (observation) was applied from July 2016 through February 2017. Health personnel from various clinical departments were randomly selected to participate as the control (n = 86) and observation (n = 90) groups, respectively. The groups were compared for rates of personnel satisfaction, complaints regarding device errors, and damage of medical devices. The satisfaction score of the observation group (95.8 ± 1.2) was significantly higher than that of the control (90.2 ± 2.3; P = 0.000). The rate of complaints of the observation group (3.3%) was significantly lower than that of the control (11.6%; P = 0.035). The quality control regarding recycle and packing was significantly higher during the observation period than the control period, which favorably influenced the scores for satisfaction. The rate of damage to specialist medical devices during the observation period (0.40%) was lower than during the control period (0.61%; P = 0.003). The theoretical knowledge and practical skills of the CSSD professionals improved after application of the sub-specialties management model. A management model that considers the requirements of specialist medical devices can improve quality control in the CSSD.

STS-84 Crew Portrait

NASA Technical Reports Server (NTRS)

1997-01-01

The crew assigned to the STS-84 mission included (seated front left to right) Jerry M Linenger, mission specialist; Charles J. Precourt, commander; and C. Michael Foale, mission specialist. On the back row (left to right) are Jean-Francois Clervoy (ESA), mission specialist; Eileen M. Collins, pilot; Edward T. Lu, mission specialist; Elena V. Kondakova (RSA), mission specialist; and Carlos I. Noriega, mission specialist. Launched aboard the Space Shuttle Atlantis on May 15, 1997 at 4:07:48 am (EDT), the STS-84 mission served as the sixth U.S. Space Shuttle-Russian Space Station Mir docking.

The evolution of resource adaptation: how generalist and specialist consumers evolve.

PubMed

Ma, Junling; Levin, Simon A

2006-07-01

Why and how specialist and generalist strategies evolve are important questions in evolutionary ecology. In this paper, with the method of adaptive dynamics and evolutionary branching, we identify conditions that select for specialist and generalist strategies. Generally, generalist strategies evolve if there is a switching benefit; specialists evolve if there is a switching cost. If the switching cost is large, specialists always evolve. If the switching cost is small, even though the consumer will first evolve toward a generalist strategy, it will eventually branch into two specialists.

How is a specialist depression service effective for persistent moderate to severe depressive disorder?: a qualitative study of service user experience.

PubMed

Thomson, Louise; Barker, Marcus; Kaylor-Hughes, Catherine; Garland, Anne; Ramana, Rajini; Morriss, Richard; Hammond, Emily; Hopkins, Gail; Simpson, Sandra

2018-06-15

A specialist depression service (SDS) offering collaborative pharmacological and cognitive behaviour therapy treatment for persistent depressive disorder showed effectiveness against depression symptoms versus usual community based multidisciplinary care in a randomised controlled trial (RCT) in specialist mental health services in England. However, there is uncertainty concerning how specialist depression services effect such change. The current study aimed to evaluate the factors which may explain the greater effectiveness of SDS compared to Treatment as Usual (TAU) by exploring the experience of the RCT participants. Qualitative audiotaped and transcribed semi-structured interviews were conducted 12-18 months after baseline with 21 service users (12 SDS, 9 TAU arms) drawn from all three sites. Inductive thematic analysis using a grounded approach contrasted the experiences of SDS with TAU participants. Four themes emerged in relation to service user experience: 1. Specific treatment components of the SDS: which included sub-themes of the management of medication change, explaining and developing treatment strategies, setting realistic expectations, and person-centred and holistic approach; 2. Individual qualities of SDS clinicians; 3. Collaborative team context in SDS: which included sub-themes of communication between healthcare professionals, and continuity of team members; 4. Accessibility to SDS: which included sub-themes of flexibility of locations, frequent consultation as reinforcement, gradual pace of treatment, and challenges of returning to usual care. The study uncovered important mechanisms and contextual factors in the SDS that service users experience as different from TAU, and which may explain the greater effectiveness of the SDS: the technical expertise of the healthcare professionals, personal qualities of clinicians, teamwork, gradual pace of care, accessibility and managing service transitions. Usual care in other specialist mental health services may share many of the features from the SDS. "Trial of the Clinical and Cost Effectiveness of a Specialist Expert Mood Disorder Team for Refractory Unipolar Depressive Disorder" was registered in www.ClinicalTrials.gov ( NCT01047124 ) on 12-01-2010 and the ISRCTN registry was registered in www.isrctn.com ( ISRCTN10963342 ) on 25-11-2015 (retrospectively registered).

The impact of economic factors on migration considerations among Icelandic specialist doctors: a cross-sectional study.

PubMed

Solberg, Ingunn Bjarnadóttir; Tómasson, Kristinn; Aasland, Olaf; Tyssen, Reidar

2013-12-18

Globalization has facilitated the employability of doctors almost anywhere in the world. In recent years, the migration of doctors seems to have increased. However, we lack studies on doctors' migration from developed countries. Because the economic recession experienced by many countries might have affected the migration of doctors, research on this topic is important for the retention of doctors. Iceland was hit hard by the economic recession in 2008. Therefore, we want to explore how many specialist doctors in Iceland have considered migrating and whether economic factors at work and in private life, such as extensive cost-containment initiatives at work and worries about personal finances, are related to doctors' migration considerations. In 2010, all doctors in Iceland registered with the Icelandic Medical Association were sent an electronic cross-sectional survey by email. The 467 specialists who participated in this study represent 55% of all specialist doctors working in Iceland. Information on doctors' contemplation of migration was available from responses to the question: "Have you considered moving and working abroad?" The predictor variables in our logistic regression model are perceived cost-containment initiatives at work, stress related to personal finances, experience of working abroad during vacations, job dissatisfaction, job position, age, and gender. Sixty-three per cent of Iceland's specialist doctors had considered relocation abroad, 4% were moving in the next year or two, and 33% had not considered relocating. Logistic regression analysis shows that, controlling for age, gender, job position, job satisfaction, and experience of working abroad during vacations, doctors' migration considerations were significantly affected by their experiences of cost-containment initiatives at work (odds ratio (OR) = 2.0, p < 0.01) and being stressed about personal finances (OR = 1.6, p < 0.001). Age, job satisfaction, and working abroad during vacations also had an effect, whereas job position did not. Economic factors affect whether specialist doctors in Iceland consider migration. More studies on the effect of economic recession on migration by doctors are needed.

The impact of economic factors on migration considerations among Icelandic specialist doctors: a cross-sectional study

PubMed Central

2013-01-01

Background Globalization has facilitated the employability of doctors almost anywhere in the world. In recent years, the migration of doctors seems to have increased. However, we lack studies on doctors’ migration from developed countries. Because the economic recession experienced by many countries might have affected the migration of doctors, research on this topic is important for the retention of doctors. Iceland was hit hard by the economic recession in 2008. Therefore, we want to explore how many specialist doctors in Iceland have considered migrating and whether economic factors at work and in private life, such as extensive cost-containment initiatives at work and worries about personal finances, are related to doctors’ migration considerations. Methods In 2010, all doctors in Iceland registered with the Icelandic Medical Association were sent an electronic cross-sectional survey by email. The 467 specialists who participated in this study represent 55% of all specialist doctors working in Iceland. Information on doctors’ contemplation of migration was available from responses to the question: “Have you considered moving and working abroad?” The predictor variables in our logistic regression model are perceived cost-containment initiatives at work, stress related to personal finances, experience of working abroad during vacations, job dissatisfaction, job position, age, and gender. Results Sixty-three per cent of Iceland’s specialist doctors had considered relocation abroad, 4% were moving in the next year or two, and 33% had not considered relocating. Logistic regression analysis shows that, controlling for age, gender, job position, job satisfaction, and experience of working abroad during vacations, doctors’ migration considerations were significantly affected by their experiences of cost-containment initiatives at work (odds ratio (OR) = 2.0, p < 0.01) and being stressed about personal finances (OR = 1.6, p < 0.001). Age, job satisfaction, and working abroad during vacations also had an effect, whereas job position did not. Conclusions Economic factors affect whether specialist doctors in Iceland consider migration. More studies on the effect of economic recession on migration by doctors are needed. PMID:24350577

GKTC ACTIVITIES TO PROVIDE NUCLEAR MATERIAL PHYSICAL PROTECTION, CONTROL AND ACCOUNTING TRAINING FOR 2011-2012

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

Romanova, Olena; Gavrilyuk, Victor I.; Kirischuk, Volodymyr

2011-10-01

The GKTC was created at the Kyiv Institute of Nuclear Research as a result of collaborative efforts between the United States and Ukraine. The GKTC has been designated by the Ukrainian Government to provide the MPC&A training and methodological assistance to nuclear facilities and nuclear specialists. In 2010 the GKTC has conducted the planned assessment of training needs of Ukrainian MPC&A specialists. The objective of this work is to acquire the detailed information about the number of MPC&A specialists and guard personnel, who in the coming years should receive the further advanced training. As a result of the performed trainingmore » needs evaluation the GKTC has determined that in the coming years a number of new training courses need to be developed. Some training courses are already in the process of development. Also taking into account the specific of activity on the guarding of nuclear facilities, GKTC has begun to develop the specialized training courses for the guarding unit personnel. The evaluation of needs of training of Ukrainian specialists on the physical protection shows that without the technical base of learning is not possible to satisfy the needs of Ukrainian facilities, in particular, the need for further training of specialists who maintains physical protection technical means, provides vulnerability assessment and testing of technical means. To increase the training effectiveness and create the basis for specialized training courses holding the GKTC is now working on the construction of an Interior (non-classified) Physical Protection Training Site. The objective of this site is to simulate the actual conditions of the nuclear facility PP system including the complex of engineering and technical means that will help the GKTC training course participants to consolidate the knowledge and gain the practical skills in the work with PP system engineering and technical means for more effective performance of their official duties. This paper briefly describes the practical efforts applied to the provision of physical protection specialists advanced training in Ukraine and real results on the way to implement such efforts in 2011-2012.« less

A qualitative evaluation of the Scottish Staff and Associate Specialist Development Programme.

PubMed

Cleland, Jennifer; Burr, Jacqueline; Johnston, Peter

2016-05-01

The continued professional development of staff and associate specialist doctors in the UK was ill served prior to the introduction of the new staff and associate specialist doctor's contract in 2008. The aim of this study was to independently evaluate NHS Education for Scotland's approach to improving professional development for staff and associate specialist doctors, the staff and associate specialist Professional Development Fund. Semi-structured telephone interviews with key stakeholders, framed by a realistic approach to evaluate what works, for whom and in how and under what circumstances. An inductive and data-driven thematic analysis was carried out and then the realist framework was applied to the data. We interviewed 22 key stakeholders: staff and associate specialist doctors, staff and associate specialist educational advisors, programme architects and clinical directors, between end February and May 2014. The resultant data indicated five broad themes: organisational barriers to continued professional development for staff and associate specialist doctors, the purpose of funding, gains from funding, the need for better communication about the staff and associate specialist Programme Development Fund, and the interplay between individual and systems factors. The staff and associate specialist Programme Development Fund has changed the opportunities available to staff and associate specialist doctors in Scotland and, in that sense, has changed the context for this group - or at least those who have realised the opportunities. © The Author(s) 2016.

Reproductive and developmental biology of the emerald ash borer parasitoid Spathius galinae (Hymenoptera: Braconidae) as affected by temperature

USDA-ARS?s Scientific Manuscript database

Emerald ash borer Agrilus planipennis Fairmaire (Coleoptera: Buprestidae) is an invasive pest of serious concern in North America. To complement ongoing biological control efforts, Spathius galinae Belokobylskij and Strazenac (Hymenoptera: Braconidae), a recently-described specialist parasitoid of ...

A generic model for evaluation of the Federal Aviation Administration air traffic control specialist training programs.

DOT National Transportation Integrated Search

1982-03-01

The Systems Analysis Research Unit at the Civil Aeromedical Institute (CAMI) has developed a generic model for Federal Aviation Administration (FAA) Academy training program evaluation. The model will serve as a basis for integrating the total data b...

Organizing uninsured safety-net access to specialist physician services.

PubMed

Hall, Mark A

2013-05-01

Arranging referrals for specialist services is often the greatest difficulty that safety-net access programs face in attempting to provide fairly comprehensive services for the uninsured. When office-based community specialists are asked to care for uninsured patients, they cite the following barriers: difficulty determining which patients merit charity care, having to arrange for services patients need from other providers, and concerns about liability for providing inadequate care. Solutions to these barriers to specialist access can be found in the same institutional arrangements that support primary care and hospital services for the uninsured. These safety-net organization structures can be extended to include specialist physician care by funding community health centers to contract for specialist referrals, using free-standing referral programs to subsidize community specialists who accept uninsured patients at discounted rates, and encouraging hospitals through tax exemption or disproportionate share funding to require specialists on their medical staffs to accept an allocation of uninsured office-based referrals.

[Integral financing stifles innovation: consequences of the new form of financing for specialists].

PubMed

Berden, H J J M Bart; Keuzenkamp, Hugo A

2015-01-01

Of the 22,800 Dutch medical specialists, 43% are self-employed, which involves various tax benefits. In 2015 an important change took place. In the past, specialists declared their services independently from the hospital, which impeded process adjustments. Although this gives the impression of improvement, it is not, mainly because specialists are organized separately from the hospital organization. In addition, specialists are not entrepreneurs, which means that they avoid risks and uncertainty. The complex situation that has arisen is further complicated by fuzzy implementation that lacks an overall plan. For the individual specialist, the situation is unclear. The specialists consider necessary renewals and innovations to be irresponsible risks. This creates a cautious attitude and inertia. To achieve improvement, government and policy-makers should set clear rules and health insurers should value good governance. This protection would allow specialists and hospital boards to balance medical content and finance.

Mobilization and Defense Management Technical Reports Series. Military Health Professional Needs for Mobilization.

DTIC Science & Technology

1983-05-01

Specialist 880 Respiratory Specialist 506 Psychiatric Specialist 248 Orthopedic Specialist 379 Orthotic Specialist 35 Physical Therapist 200... Therapist 4 Physical Therapist 2 Hospital Dietician 26 Nuclear Medicine Service Officer 3 Entomologist 7 Physiologist 3 Podiatrist 17 Psychologist 6...requirements, working conditions, physical requirements, skill levels, etc. with the civilian health professional manpower pool. The first phase of this effort

Enabling factors for specialist outreach in western KwaZulu-Natal

PubMed Central

2018-01-01

Background There exists a major disparity in access to specialist care between patients in urban and rural areas. Specialists are a scarce resource and are concentrated in urban areas. Specialist outreach attempts to fill the gap in service provision for patients situated remotely. While there is international evidence that multifaceted specialist outreach has achieved varying levels of success, factors that influence the effectiveness of outreach have not yet been fully elucidated in South Africa. Aim This study attempts to uncover some of the factors that enable good multifaceted specialist outreach. Setting The study was conducted in hospitals in western KwaZulu-Natal province. This health area is served by a tertiary hospital and 20 peripheral hospitals; three of these are regional level and the majority are district level hospitals. Specialist outreach emanates from the tertiary hospital. Methods Specialists providing outreach services from the tertiary hospital and medical officers at seven receiving hospitals were interviewed to explore perceptions regarding factors that might enable successful specialist outreach. Framework analysis on the transcribed interviews was carried out using NVivo version 11. Results A major positive finding concerns the relationships formed between outreach specialists and doctors at the recipient hospitals. The management of the programme with respect to structure, dependability, data management, transport provision, communication technology and public health systems was also seen as beneficial in specialist outreach. Conclusion Specialist outreach plays an essential role in providing equality in health care. To enable effectiveness, it is important to make full use of the multifaceted nature of this intervention. PMID:29781691

Evaluation of infectious diseases and clinical microbiology specialists' preferences for hand hygiene: analysis using the multi-attribute utility theory and the analytic hierarchy process methods.

PubMed

Suner, Aslı; Oruc, Ozlem Ege; Buke, Cagri; Ozkaya, Hacer Deniz; Kitapcioglu, Gul

2017-08-31

Hand hygiene is one of the most effective attempts to control nosocomial infections, and it is an important measure to avoid the transmission of pathogens. However, the compliance of healthcare workers (HCWs) with hand washing is still poor worldwide. Herein, we aimed to determine the best hand hygiene preference of the infectious diseases and clinical microbiology (IDCM) specialists to prevent transmission of microorganisms from one patient to another. Expert opinions regarding the criteria that influence the best hand hygiene preference were collected through a questionnaire via face-to-face interviews. Afterwards, these opinions were examined with two widely used multi-criteria decision analysis (MCDA) methods, the Multi-Attribute Utility Theory (MAUT) and the Analytic Hierarchy Process (AHP). A total of 15 IDCM specialist opinions were collected from diverse private and public hospitals located in İzmir, Turkey. The mean age of the participants was 49.73 ± 8.46, and the mean experience year of the participants in their fields was 17.67 ± 11.98. The findings that we obtained through two distinct decision making methods, the MAUT and the AHP, suggest that alcohol-based antiseptic solution (ABAS) has the highest utility (0.86) and priority (0.69) among the experts' choices. In conclusion, the MAUT and the AHP, decision models developed here indicate that rubbing the hands with ABAS is the most favorable choice for IDCM specialists to prevent nosocomial infection.

Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Joyce, Catherine M; Stoelwinder, Johannes

2016-06-01

Objective This paper describes the service distribution and models of rural outreach by specialist doctors living in metropolitan or rural locations. Methods The present study was a national cross-sectional study of 902 specialist doctors providing 1401 rural outreach services in the Medicine in Australia: Balancing Employment and Life study, 2008. Five mutually exclusive models of rural outreach were studied. Results Nearly half of the outreach services (585/1401; 42%) were provided to outer regional or remote locations, most (58%) by metropolitan specialists. The most common model of outreach was drive-in, drive-out (379/902; 42%). In comparison, metropolitan-based specialists were less likely to provide hub-and-spoke models of service (odd ratio (OR) 0.31; 95% confidence interval (CI) 0.21-0.46) and more likely to provide fly-in, fly-out models of service (OR 4.15; 95% CI 2.32-7.42). The distance travelled by metropolitan specialists was not affected by working in the public or private sector. However, rural-based specialists were more likely to provide services to nearby towns if they worked privately. Conclusions Service distribution and models of outreach vary according to where specialists live as well as the practice sector of rural specialists. Multilevel policy and planning is needed to manage the risks and benefits of different service patterns by metropolitan and rural specialists so as to promote integrated and accessible services. What is known about this topic? There are numerous case studies describing outreach by specialist doctors. However, there is no systematic evidence describing the distribution of rural outreach services and models of outreach by specialists living in different locations and the broad-level factors that affect this. What does this paper add? The present study provides the first description of outreach service distribution and models of rural outreach by specialist doctors living in rural versus metropolitan areas. It shows that metropolitan and rural-based specialists have different levels of service reach and provide outreach through different models. Further, the paper highlights that practice sector has no effect on metropolitan specialists, but private rural specialists limit their travel distance. What are the implications for practitioners? The complexity of these patterns highlights the need for multilevel policy and planning approaches to promote integrated and accessible outreach in rural and remote Australia.

A randomized controlled evaluation of specialist nurse education following accident and emergency department attendance for acute asthma.

PubMed

Levy, M L; Robb, M; Allen, J; Doherty, C; Bland, J M; Winter, R J

2000-09-01

We investigated whether hospital-based specialist asthma nurses improved recognition and self-treatment of asthma episodes by patients followed up after attending accident and emergency departments (A&E) for asthma exacerbations. We carried out a randomized prospective controlled trial of adult asthma self-management, following a hospital outpatient nurse consultation in two outer-London District General Hospitals (secondary care centres). The study included 211 adults, over 18 years old (mean age 40 years) who attended for asthma in two accident and emergency departments over 13 months. One hundred and eight evaluable patients were randomized into the control group who continued with their usual medical treatment and were not offered any intervention during the study period. One hundred and three evaluable patients were randomized into the intervention group. They were offered three 6-weekly outpatient appointments with one of two specialist asthma nurses for a structured asthma consultation, after attendance at the accident and emergency department. Following assessment of their asthma treatment and control, the nurses advised patients, through the use of self-management-plans, how to recognize and manage uncontrolled asthma and when to seek medical assistance. Medication and inhaler device type were altered if necessary The primary outcome was patient reported self-management of asthma exacerbations for 6 months. Secondary outcomes were assessed at baseline, 3 months and 6 months. These included home peak flow and symptom diaries, structured telephone questionnaires and audit of general practitioner records to determine utilization of services (6 months before and after A&E). Data were analysed on an intention to treat basis by multiple and logistic regression. The intervention group increased their use of inhaled topical steroids in 31/61 (51%) vs. 15/70 (21%) attacks in controls (OR 3.91 CI 1.8-8.4, P<0.001) and their use of rescue medication in 54/61 (89%) severe attacks vs. 53/70 (76%) controls (OR 2.88 CI 1.1-7.9, P<0.05). Intervention patients had significantly higher (mean 20.1 l min(-1); CI 0.4-39.7; P<0.05) and less variable PEF and significantly lower and less variable symptom scores 6 months after entry. Thirty-four percent of intervention patients vs. 42% controls had severe attacks (61 and 70 respectively, OR 0.96 CI 0.7-1.4) during the 6 months. Intervention patients had fewer days off work than controls in the first 3 months (NS) but similar days off during the 6-month period. Intervention patients had fewer episodes away from work in the first (0.34 vs. 0.54, P = 0.08) and the second 3 months (0.25 vs. 0.30, NS) than the controls. Over 80% of the patients records were audited by their general practitioners; the active group had less routine consultations with the doctor (P = 0.03) and practice nurse (P = 0.03), less consultations for uncontrolled episodes (P = 0.06) and less hospital visits (NS) than the controls. Hospital-based specialist nurses reduced asthma morbidity by improving patient self-management behaviour in acute attacks leading to reduced symptoms, improved lung function, less time off work and fewer consultations with health professionals.

Health and Safety Intervention with First-Time Mothers

ERIC Educational Resources Information Center

Culp, Anne McDonald; Culp, R. E.; Anderson, J. W.; Carter, S.

2007-01-01

A health education program was evaluated which used child development specialists as home visitors and served a population of first-time mothers living in rural communities. The evaluation compared health and safety outcomes between intervention and control groups. The research staff, separate from the intervention staff, collected data in the…

US/USSR SYMPOSIUM ON PARTICULATE CONTROL (SECOND) HELD AT RESEARCH TRIANGLE PARK, NORTH CAROLINA ON MAY 25-28, 1977

EPA Science Inventory

Papers were presented by Soviet specialists from research design institutes and industry, and by representatives of US government agencies and the private sector. Topics included: electrostatic precipitator (ESP) research and application, ESP gas flow modeling, ESP rapping and re...

Training Injury Control Practitioners: The Indian Health Service Model.

ERIC Educational Resources Information Center

Smith, Richard J., III; Dellapenna, Alan J., Jr.; Berger, Lawrence R.

2000-01-01

Describes an innovative training program for injury prevention specialists developed by the Indian Health Service (IHS), noting its applicability to other community-based settings. Examines injuries and American Indians; designing the IHS program; IHS training courses; examples of community-based interventions organized by people who had completed…

Quality Control Specialist | Center for Cancer Research

Cancer.gov

Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID),

Screening Air Traffic Control Specialists for Psychopathology Using the Minnesota Multiphasic Personality Inventory-2

DTIC Science & Technology

2008-06-01

ng . Clinical scales Scale 1 – Hypochondriasis . hgh scores reflect ndvdu- als who have an excessve number of vague nonspecfic complants and...one reflects a general denal of physcal health and ncludes rather specfic somat c complants . The other group nvolves a general denal of

Environmental Impact Analysis Process, Environmental Assessment Space Test Experiments Platform Mission 3, Vandenberg Air Force Base, CA

DTIC Science & Technology

1994-09-01

Scientist LOCAL AGENCIES Santa Barbara County Air Pollution Control District, California Hallerman , Richard Air Quality Specialist 6-1 APPENDIX A REFERENCES...Vandenberg Air Force Base. Provided by Richard Hallerman , SBCAPCD, to Bob Baxter, Engineering-Science. 11 June. ____, 1991. Santa Barbara County Air

Planning for the Automation of School Library Media Centers.

ERIC Educational Resources Information Center

Caffarella, Edward P.

1996-01-01

Geared for school library media specialists whose centers are in the early stages of automation or conversion to a new system, this article focuses on major components of media center automation: circulation control; online public access catalogs; machine readable cataloging; retrospective conversion of print catalog cards; and computer networks…

Worldwide Report, Arms Control.

DTIC Science & Technology

1985-06-21

atmosphere of disappoint- ment," Koivisto said. It is, of course, sober realism to speak in this way. But the president himself showed that he has not...of journals known only to specialists to the front pages of newspapers all over the world. But this does not gladden us. It is not cinematic evil

Implications for Veterinary Medical Education: Preprofessional and Professional Education.

ERIC Educational Resources Information Center

Vaughan, J. T.

1980-01-01

The need to boost the productivity curve for production of animal protein and the demand for specialists in all areas of animal agriculture are discussed. Legislative action and academic priorities must be initiated to assume the responsibility for the control of disease, promotion of health, and efficiency of production. (MLW)

Astronaut Harbaugh on middeck with messages from TIPS

NASA Image and Video Library

1995-07-10

STS071-122-018 (27 June-7 July 1995) --- Astronaut Gregory J. Harbaugh, STS-71 mission specialist, is pictured on the space shuttle Atlantis' middeck, with a roll of messages from the Thermal Imaging Printing System (TIPS). The volume of information had been up-linked by ground controllers in Houston, Texas.

The utility of the air traffic selection and training test battery in hiring graduates of an air traffic-collegiate training initiative program.

DOT National Transportation Integrated Search

2013-06-01

The FAA recruits applicants for Air Traffic Control Specialist (ATCS) training positions from multiple hiring sources. Each hiring source has requirements that applicants must meet for eligibility. These hiring sources include the Air Traffic Col...

Some personality characteristics of air traffic control specialist trainees : interactions of personality and aptitude test scores with FAA Academy success and career expectations.

DOT National Transportation Integrated Search

1991-05-01

The State-Trait Personality Inventory (STPI) is a self-report inventory which measures anxiety, curiosity, and anger (Spielberger, 1979). The three 'trait' scale scores are determined by the frequency of each emotion as stable personality constructs....

BOOK REVIEW OF "ASSESSMENT AND CONTROL OF NONPOINT SOURCE POLLUTION OF AQUATIC ECOSYSTEMS: A PRACTICAL APPROACH"

EPA Science Inventory

This book is geared to environmental specialists and planners, heavy on the technical side. It goes beyond tranditional nonpoint source (NPS) approaches which typically only look at stormwater as athe sole NPS pollution driver. There is some overreaching material beyond the conte...

Active Epilepsy and Seizure Control in Adults - United States, 2013 and 2015.

PubMed

Tian, Niu; Boring, Michael; Kobau, Rosemarie; Zack, Matthew M; Croft, Janet B

2018-04-20

Approximately 3 million American adults reported active epilepsy* in 2015 (1). Active epilepsy, especially when seizures are uncontrolled, poses substantial burdens because of somatic, neurologic, and mental health comorbidity; cognitive and physical dysfunction; side effects of antiseizure medications; higher injury and mortality rates; poorer quality of life; and increased financial cost (2). Thus, prompt diagnosis and seizure control (i.e., seizure-free in the 12 months preceding the survey) confers numerous clinical and social advantages to persons with active epilepsy. To obtain recent and reliable estimates of active epilepsy and seizure control status in the U.S. population, CDC analyzed aggregated data from the 2013 and the 2015 National Health Interview Surveys (NHISs). Overall, an annual estimated 2.6 million (1.1%) U.S. adults self-reported having active epilepsy, 67% of whom had seen a neurologist or an epilepsy specialist in the past year, and 90% of whom reported taking epilepsy medication. Among those taking epilepsy medication, only 44% reported having their seizures controlled. A higher prevalence of active epilepsy and poorer seizure control were associated with low family income, unemployment, and being divorced, separated, or widowed. Use of epilepsy medication was higher among adults who saw an epilepsy specialist in the past year than among those who did not. Health care and public health should ensure that adults with uncontrolled seizures have appropriate care and self-management support in order to promote seizure control, improve health and social outcomes, and reduce health care costs.

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

Extension Specialists: A Self-Analysis.

ERIC Educational Resources Information Center

Gerber, John M.

1985-01-01

To document perceived changes in the role of the extension horticulture specialist, a national survey of state horticulture specialists was conducted in 1983. Extension specialists in horticulture appear to be moving away from the traditional activities of farm visits and personal interaction with individual producers. (CT)

Space Shuttle Projects

NASA Image and Video Library

1991-11-01

The STS-42 crew portrait includes from left to right: Stephen S. Oswald, pilot; Roberta L. Bondar, payload specialist 1; Norman E. Thagard, mission specialist 1; Ronald J. Grabe, commander; David C. Hilmers, mission specialist 2; Ulf D. Merbold, payload specialist 2; and William F. Readdy, mission specialist 3. Launched aboard the Space Shuttle Discovery on January 22, 1992 at 9:52:33 am (EST), the STS-42 served as the International Microgravity Laboratory-1 (ML-1 ) mission.

Clarifying the role of the mental health peer specialist in Massachusetts, USA: insights from peer specialists, supervisors and clients.

PubMed

Cabral, Linda; Strother, Heather; Muhr, Kathy; Sefton, Laura; Savageau, Judith

2014-01-01

Mental health peer specialists develop peer-to-peer relationships of trust with clients to improve their health and well-being, functioning in ways similar to community health workers. Although the number of peer specialists in use has been increasing, their role in care teams is less defined than that of the community health worker. This qualitative study explored how the peer specialist role is defined across different stakeholder groups, the expectations for this role and how the peer specialist is utilised and integrated across different types of mental health services. Data were collected through interviews and focus groups conducted in Massachusetts with peer specialists (N = 44), their supervisors (N = 14) and clients (N = 10) between September 2009 and January 2011. A consensus coding approach was used and all data outputs were reviewed by the entire team to identify themes. Peer specialists reported that their most important role is to develop relationships with clients and that having lived mental health experience is a key element in creating that bond. They also indicated that educating staff about the recovery model and peer role is another important function. However, they often felt a lack of clarity about their role within their organisation and care team. Supervisors valued the unique experience that peer specialists bring to an organisation. However, without a defined set of expectations for this role, they struggled with training, guiding and evaluating their peer specialist staff. Clients reported that the shared lived experience is important for the relationship and that working with a peer specialist has improved their mental health. With increasing support for person-centred integrated healthcare delivery models, the demand for mental health peer specialist services will probably increase. Therefore, clearer role definition, as well as workforce development focused on team orientation, is necessary for peer specialists to be fully integrated and supported in care teams. © 2013 John Wiley & Sons Ltd.

The content of the work of clinical nurse specialists described by use of daily activity diaries.

PubMed

Oddsdóttir, Elín Jakobína; Sveinsdóttir, Herdís

2011-05-01

Evaluate the usefulness of the role of clinical nurse specialists and the content of their work by mapping their activities. The clinical work of advanced practice nursing differs in different countries, and a clear picture is lacking on what exactly advanced practice nurses do. Prospective exploratory study. The setting of the study was the largest hospital in Iceland where over half of the country's active nursing workforce are employed, including the only clinical nurse specialists. Of 19 clinical nurse specialists working at the hospital, 15 participated. Data were collected over seven days with a structured activity diary that lists 65 activities, classified into six roles and three domains. In 17 instances, the 'role activities' and 'domain activities' overlap and form 17 categories of practice. The clinical nurse specialists coded their activities at 15-minutes interval and could code up to four activities simultaneously. Daily, the clinical nurse specialists evaluated their clinical nurse specialist background. The roles that occupied the greatest proportion of the clinical nurse specialists' time were education, expert practice and 'other' activities, while the smallest proportions were in counselling, research and practice development. The domain they worked in most was the institutional domain, followed by the client/family domain and the clinical outcome management domain. All of the clinical nurse specialists reported working on two activities simultaneously, 11 of them on three activities and six on four activities. They self-assessed their background as clinical nurse specialists as being very useful. The activity diary is a useful tool for assessing the content of practice. Clinical nurse specialists spend too much time on activities related to the institution. Nurse managers are advised to provide clinical nurse specialists with ample time to develop the direct practice role in the client/family domain. The development of advanced nursing practice requires that clinical nurse specialists take an active and visible part in direct patient care. © 2011 Blackwell Publishing Ltd.

The Surgical Nosology In Primary-care Settings (SNIPS): a simple bridging classification for the interface between primary and specialist care

PubMed Central

Gruen, Russell L; Knox, Stephanie; Britt, Helena; Bailie, Ross S

2004-01-01

Background The interface between primary care and specialist medical services is an important domain for health services research and policy. Of particular concern is optimising specialist services and the organisation of the specialist workforce to meet the needs and demands for specialist care, particularly those generated by referral from primary care. However, differences in the disease classification and reporting of the work of primary and specialist surgical sectors hamper such research. This paper describes the development of a bridging classification for use in the study of potential surgical problems in primary care settings, and for classifying referrals to surgical specialties. Methods A three stage process was undertaken, which involved: (1) defining the categories of surgical disorders from a specialist perspective that were relevant to the specialist-primary care interface; (2) classifying the 'terms' in the International Classification of Primary Care Version 2-Plus (ICPC-2 Plus) to the surgical categories; and (3) using referral data from 303,000 patient encounters in the BEACH study of general practice activity in Australia to define a core set of surgical conditions. Inclusion of terms was based on the probability of specialist referral of patients with such problems, and specialists' perception that they constitute part of normal surgical practice. Results A four-level hierarchy was developed, containing 8, 27 and 79 categories in the first, second and third levels, respectively. These categories classified 2050 ICPC-2 Plus terms that constituted the fourth level, and which covered the spectrum of problems that were managed in primary care and referred to surgical specialists. Conclusion Our method of classifying terms from a primary care classification system to categories delineated by specialists should be applicable to research addressing the interface between primary and specialist care. By describing the process and putting the bridging classification system in the public domain, we invite comment and application in other settings where similar problems might be faced. PMID:15142280

Brazilian infectious diseases specialists: who and where are they?

PubMed

Cassenote, Alex Jones Flores; Scheffer, Mario César; Segurado, Aluísio Augusto Cotrim

2016-01-01

The infectious diseases specialist is a medical doctor dedicated to the management of infectious diseases in their individual and collective dimensions. The aim of this paper was to evaluate the current profile and distribution of infectious diseases specialists in Brazil. This is a cross-sectional study using secondary data obtained from institutions that register medical specialists in Brazil. Variables of interest included gender, age, type of medical school (public or private) the specialist graduated from, time since finishing residency training in infectious diseases, and the interval between M.D. graduation and residency completion. Maps are used to study the geographical distribution of infectious diseases specialists. A total of 3229 infectious diseases specialist registries were counted, with 94.3% (3045) of individual counts (heads) represented by primary registries. The mean age was 43.3 years (SD 10.5), and a higher proportion of females was observed (57%; 95% CI 55.3-58.8). Most Brazilian infectious diseases specialists (58.5%) practice in the Southeastern region. However, when distribution rates were calculated, several states exhibited high concentration of infectious diseases specialists, when compared to the national rate (16.06). Interestingly, among specialists working in the Northeastern region, those trained locally had completed their residency programs more recently (8.7yrs; 95% CI 7.9-9.5) than physicians trained elsewhere in the country (13.6yrs: 95% CI 11.8-15.5). Our study shows that Brazilian infectious diseases specialists are predominantly young and female doctors. Most have concluded a medical residency training program. The absolute majority practice in the Southeastern region. However, some states from the Northern, Northeastern and Southeastern regions exhibit specialist rates above the national average. In these areas, nonetheless, there is a strong concentration of infectious diseases specialists in state capitals and in metropolitan areas. Copyright © 2016. Published by Elsevier Editora Ltda.

48 CFR 1519.201-72 - Small and disadvantaged business utilization specialists.

Code of Federal Regulations, 2011 CFR

2011-10-01

... prescribed from time to time in furtherance of overall small and small disadvantaged business utilization... business utilization specialists. 1519.201-72 Section 1519.201-72 Federal Acquisition Regulations System... disadvantaged business utilization specialists. (a) Small Business Specialists (SBS) shall be appointed in...

48 CFR 536.570-3 - Specialist.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 536.570-3... CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 536.570-3 Specialist. Insert 552.236-72, Specialist, in solicitations and contracts for construction if the technical sections...

7 CFR 1955.104 - Authorities and responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Director in this subpart, unless specifically excluded, to a Program Chief, Program Specialist, or Property Management Specialist on the State Office staff. (3) The District Director may redelegate, in writing, any... Loan Specialist. Authority of District Directors in this subpart applies to Area Loan Specialists in...

7 CFR 1955.54 - Redelegation of authority.

Code of Federal Regulations, 2010 CFR

2010-01-01

... excluded, to a Program Chief, Program Specialist, or Property Management Specialist on the State Office... Director in this subpart to an Assistant District Director or District Loan Specialist. Authority of District Directors in this subpart applies to Area Loan Specialists in Alaska and the Director for the...

Administrative Assistant and Correspondence Specialist: Task List Competency Record.

ERIC Educational Resources Information Center

Minnesota Instructional Materials Center, White Bear Lake.

One of a series of 12 in the secretarial/clerical area, this booklet for the vocational instructor contains job descriptions for two word processing occupations, the non-typing administrative assistant and the correspondence specialist (also called word processing correspondence specialist, magnetic keyboard specialist, or word processing…

STS 51-L crewmembers briefed during training session

NASA Technical Reports Server (NTRS)

1986-01-01

Five members of the STS 51-L crew and a backup crewmember are briefed during a training session in JSC's Shuttle mockup and integration laboratory. From left to right are Astronauts Ellison S. Onizuka, mission specialist; Ronald E. McNair, mission specialist; Gregory Jarvis, Hughes payload specialist; Judith A. Resnik, mission specialist; Sharon Christa McAuliffe, citizen observer/payload specialist representing the Teacher in Space project. Barbara R. Morgan, backup to McAuliffe, is in the right foreground.

Assessment of Detainee Medical Operations for OEF, GTMO, and OIF (REDACTED)

DTIC Science & Technology

2005-04-13

Administration Specialist), 74 91 W (Health Care Specialist), 17 91 WM6 (Health Care SpecialistlLicensed Practical Nurse ), 15 91X (Mental Health Specialist), and...91 W (Health Care Specialist), 17 91 WM6 (Licensed Practical Nurse ), 15 91X (Mental Health Specialist), and 40 OBC students. The findings, discussion...and principles of detainee care ." This policy does not identify when the required training should occur, nor who is responsible to provide the

STS-114: Discovery Crew Arrival for Launch at Shuttle Landing Facility

NASA Technical Reports Server (NTRS)

2005-01-01

Live Footage of Discovery's STS-114 Crew Arriving at the Shuttle Landing Facility at Kennedy Space Center is shown. George Diller is the narrator for this event. Commander, Eileen Collins, is seen introducing the STS-114 crew who consists of: Pilot, James Kelley, Mission Specialist, Charles Camarda, Mission Specialist, Wendy Lawrence, Mission Specialist, Soichi Noguchi, Mission Specialist, Steve Robinson, and Mission Specialist Andy Thomas. Each crewmember addresses the news media about their role on this mission.

Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-01-07

The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations. A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest. Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%). Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist's main practice is likely to support participation and improve service distribution.

Comparison of the capture efficiency, prey processing, and nutrient extraction in a generalist and a specialist spider predator.

PubMed

García, Luis Fernando; Viera, Carmen; Pekár, Stano

2018-04-02

Predators are traditionally classified as generalists and specialists based on the presence of adaptations that increase efficiency of prey capture and consumption and selection of particular prey types. Nevertheless, empirical evidence comparing foraging efficiency between generalist and specialist carnivores is scarce. We compared the prey-capture and feeding efficiency in a generalist and a specialist (araneophagous) spider predator. By using two related species, the generalist Harpactea rubicunda (Dysderidae) and the specialist Nops cf. variabilis (Caponiidae), we evaluated their fundamental trophic niche by studying the acceptance of different prey. Then, we compared their predatory behavior, efficiency in capturing prey of varying sizes, feeding efficiency, and nutrient extraction. Nops accepted only spiders as prey, while Harpactea accepted all offered prey, confirming that Nops is stenophagous, while Harpactea is euryphagous. Further, Nops displayed more specialized (stereotyped) capture behavior than Harpactea, suggesting that Nops is a specialist, while Harpactea is a generalist. The specialist immobilized prey faster, overcame much larger prey, and gained more mass (due to feeding on larger prey) than the generalist. Both the specialist and the generalist spider extracted more proteins than lipids, but the extraction of macronutrients in the specialist was achieved mainly by consuming the prosoma of the focal prey. We show that the specialist has more efficient foraging strategy than the generalist.

Analysis of pharmacologic and nonpharmacologic prescription patterns of general practitioners and specialists in the AMICA study.

PubMed

Scarpa, Raffaele; Sarzi-Puttini, Piercarlo; Cimmino, Marco A; Caporali, Roberto; Parazzini, Fabio; Zaninelli, Augusto; Canesi, Bianca

2005-08-01

To evaluate the prescription modalities of general practitioners (GPs) and specialists in symptomatic osteoarthritis (OA) patients enrolled in the AMICA study. This study started in 2001 as a cohort investigation of OA patients seen by 2764 GPs and 316 specialists. Enrolled were 28,981 patients with symptomatic OA of the hand, hip, or knee. GPs and physical medicine specialists treated OA less frequently with pharmacological therapy than rheumatologists (OR 0.35; CI 0.26 to 0.47) or orthopedic surgeons (OR 0.65; CI 0.54 to 0.77). Pharmacological therapies (alone or in association with nonpharmacological modalities) were selected by 97% of the GPs, 96% of the rheumatologists, 94% of the orthopedic surgeons, and 85% of the physical medicine specialists. In comparison with GPs, all of the specialists more frequently used disease-modifying OA drugs (DMOADs) (rheumatologists: OR 6.86, CI 6.03 to 7.80; orthopedic surgeons: OR 2.20, CI 1.94 to 2.49; physical medicine specialists: OR 2.11, CI 1.69 to 2.63). Nonpharmacological therapies were selected by 44% of the GPs, 54% of the rheumatologists, 71% of the orthopedic surgeons, and 90% of the physical medicine specialists. They were used alone uncommonly (by 3% of the GPs, 3% of the rheumatologists, 6% of the orthopedic surgeons, and 15% of the physical medicine specialists). GPs use nonpharmacological treatment less than specialists: OR 0.53; CI 0.47 to 0.60 versus rheumatologists; OR 0.20; CI 0.18 to 0.21 versus orthopedic surgeons; and OR 0.07; CI 0.05 to 0.09 versus physical medicine specialists. Ultrasound (US) (11%) and transcutaneous electrical nerve stimulation (TENS) (7%) were the nonpharmacological therapies most frequently prescribed by GPs. Among the specialists, physical medicine specialists most frequently prescribed US (35%) and TENS (21%); US was also preferred by rheumatologists, whereas the orthopedic surgeon's choice was magnetotherapy (21%). Exercises and other passive or active rehabilitation strategies were prescribed for only 13% of the patients seen by GPs, but all 3 categories of specialists prescribed exercises and manual techniques far more frequently: rheumatologists, OR 1.63: 1.40 to 1.63; orthopedic surgeons, OR 1.67: 1.48 to 1.88; physical medicine specialists, OR 3.19: 2.66 to 3.82. Italian rheumatologists and orthopedic surgeons are the specialists who most frequently use pharmacological treatment for OA. Nonpharmacological treatment is used commonly among both GPs and specialists but rarely as single therapy. Exercise and passive or active rehabilitation strategies are not frequently prescribed, although they are recommended by all the published guidelines.

STS-55 German payload specialists and backups pose in front of SL-D2 at KSC

NASA Technical Reports Server (NTRS)

1992-01-01

STS-55 Columbia, Orbiter Vehicle (OV) 102, German payload specialists and backup (alternate) payload specialists pose in front of the Spacelab Deutsche 2 (SL-D2) science module at a Kennedy Space Center (KSC) processing facility. These four Germans have been assigned to support the STS-55/SL-D2 mission. Left to right are Payload Specialist 2 Hans Schlegel, backup Payload Specialist Dr. P. Gerhard Thiele (kneeling), Payload Specialist 1 Ulrich Walter, and backup Payload Specialist Renate Brummer. Walter and Schlegel are scheduled to fly aboard OV-102 for the mission while Brummer and Thiele will serve as alternates and fill supportive roles on the ground. Clearly visible on the SL-D2 module are the European Space Agency (ESA) insignia, the feedthrough plate, and the D2 insignia.

Specialist participation in healthcare delivery transformation: influence of patient self-referral.

PubMed

Aliu, Oluseyi; Sun, Gordon; Burke, James; Chung, Kevin C; Davis, Matthew M

2014-01-01

Improving coordination of care and containing healthcare costs are prominent goals of healthcare reform. Specialist involvement in healthcare delivery transformation efforts like Accountable Care Organizations (ACOs) is necessary to achieve these goals. However, patients’ self-referrals to specialists may undermine care coordination and incur unnecessary costs if patients frequently receive care from specialists not engaged in such healthcare delivery transformation efforts. Additionally, frequent self-referrals may also diminish the incentive for specialist participation in reform endeavors like ACOs to get access to a referral base. To examine recent national trends in self-referred new visits to specialists. A descriptive cross-sectional study of new ambulatory visits to specialists from 2000 to 2009 using data from the National Ambulatory Medical Care Survey. We calculated nationally representative estimates of the proportion of new specialist visits through self-referrals among Medicare and private insurance beneficiaries. We also estimated the nationally representative absolute number of self-referred new specialist visits among both groups of beneficiaries. Among Medicare and private insurance beneficiaries, self-referred visits declined from 32.2% (95% confidence interval [CI], 24.0%-40.4%) to 19.6% (95% CI, 13.9%-23.3%) and from 32.4% (95% CI, 27.9%-36.8%) to 24.1% (95% CI,18.8%-29.4%), respectively. Hence, at least 1 in 5 and 1 in 4 new visits to specialists among Medicare and private insurance beneficiaries, respectively, are self-referred. The current considerable rate of self-referred new specialist visits among both Medicare and private insurance beneficiaries may have adverse implications for organizations attempting to transform healthcare delivery with improved care coordination.

The need for PGY2-trained clinical pharmacy specialists.

PubMed

Ragucci, Kelly R; O'Bryant, Cindy L; Campbell, Kristin Bova; Buck, Marcia L; Dager, William E; Donovan, Jennifer L; Emerson, Kayleigh; Gubbins, Paul O; Haight, Robert J; Jackevicius, Cynthia; Murphy, John E; Prohaska, Emily

2014-06-01

The American College of Clinical Pharmacy and other stakeholder organizations seek to advance clinical pharmacist practitioners, educators, and researchers. Unfortunately, there remains an inadequate supply of residency-trained clinical specialists to meet the needs of our health care system, and nonspecialists often are called on to fill open specialist positions. The impact of clinical pharmacy specialists on pharmacotherapy outcomes in both acute care and primary care settings demonstrates the value of these specialists. This commentary articulates the need for postgraduate year two (PGY2)-trained clinical specialists within the health care system by discussing various clinical and policy rationales, interprofessional support, economic justifications, and their impact on quality of care and drug safety. The integrated practice model that has grown out of the American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) could threaten the growth and development of future clinical specialists. Therefore, the ways in which PGY2-trained clinical pharmacist specialists are deployed in the PPMI require further consideration. PGY2 residencies provide education and training opportunities that cannot be achieved in traditional professional degree programs or postgraduate year one residencies. These specialists are needed to provide direct patient care to complex patient populations and to educate and train pharmacy students and postgraduate residents. Limitations to training and hiring PGY2-trained clinical pharmacy specialists include site capacity limitations and lack of funding. A gap analysis is needed to define the extent of the mismatch between the demand for specialists by health care systems and educational institutions versus the capacity to train clinical pharmacists at the specialty level. © 2014 Pharmacotherapy Publications, Inc.

Male imprisoned firesetters have different characteristics than other imprisoned offenders and require specialist treatment.

PubMed

Gannon, Theresa A; Ciardha, Caoilte Ó; Barnoux, Magali F L; Tyler, Nichola; Mozova, Katarina; Alleyne, Emma K A

2013-01-01

This study investigated whether a group of firesetters (n = 68) could be distinguished, psychologically, from a matched group of non-firesetting offenders (n = 68). Participants completed measures examining psychological variables relating to fire, emotional/self-regulation, social competency, self-concept, boredom proneness, and impression management. Official prison records were also examined to record offending history and other offense-related variables. A series of MANOVAs were conducted with conceptually related measures identified as the dependent variables. Follow-up discriminant function and clinical cut-off score analyses were also conducted to examine the best discriminating variables for firesetters. Firesetters were clearly distinguishable, statistically, from non-firesetters on three groups of conceptually related measures relating to: fire, emotional/self-regulation, and self-concept. The most successful variables for the discrimination of firesetters determined via statistical and clinical significance testing were higher levels of anger-related cognition, interest in serious fires, and identification with fire and lower levels of perceived fire safety awareness, general self-esteem, and external locus of control. Firesetters appear to be a specialist group of offenders who hold unique psychological characteristics. Firesetters are likely to require specialist treatment to target these psychological needs as opposed to generic offending behavior programs.

KSC-97PC1052

NASA Image and Video Library

1997-07-17

KENNEDY SPACE CENTER, FLA. -- With its drag chute deployed, the Space Shuttle Orbiter Columbia touches down on Runway 33 at KSC’s Shuttle Landing Facility at 6:46:34 a.m. EDT with Mission Commander James D. Halsell Jr. and Pilot Susan L. Still at the controls to complete the STS-94 mission. Also on board are Mission Specialist Donald A. Thomas, Mission Specialist Michael L. Gernhardt , Payload Commander Janice Voss, and Payload Specialists Roger K. Crouch and Gregory T. Linteris. Mission elapsed time for STS-94 was 15 days,16 hours, 44 seconds. During the Microgravity Science Laboratory-1 (MSL-1) mission, the Spacelab module was used to test some of the hardware, facilities and procedures that are planned for use on the International Space Station while the flight crew conducted combustion, protein crystal growth and materials processing experiments. This mission was a reflight of the STS-83 mission that lifted off from KSC in April of this year. That space flight was cut short due to indications of a faulty fuel cell. This was Columbia’s 11th landing at KSC and the 38th landing at the space center in the history of the Shuttle program

KSC-97PC1049

NASA Image and Video Library

1997-07-17

KENNEDY SPACE CENTER, FLA. -- With its drag chute deployed, the Space Shuttle Orbiter Columbia touches down on Runway 33 at KSC’s Shuttle Landing Facility at 6:46:34 a.m. EDT with Mission Commander James D. Halsell Jr. and Pilot Susan L. Still at the controls to complete the STS-94 mission. Also on board are Mission Specialist Donald A. Thomas, Mission Specialist Michael L. Gernhardt , Payload Commander Janice Voss, and Payload Specialists Roger K. Crouch and Gregory T. Linteris. Mission elapsed time for STS-94 was 15 days,16 hours, 44 seconds. During the Microgravity Science Laboratory-1 (MSL-1) mission, the Spacelab module was used to test some of the hardware, facilities and procedures that are planned for use on the International Space Station while the flight crew conducted combustion, protein crystal growth and materials processing experiments. This mission was a reflight of the STS-83 mission that lifted off from KSC in April of this year. That space flight was cut short due to indications of a faulty fuel cell. This was Columbia’s 11th landing at KSC and the 38th landing at the space center in the history of the Shuttle program

KSC-97PC1045

NASA Image and Video Library

1997-07-17

KENNEDY SPACE CENTER, FLA. -- With its drag chute deployed, the Space Shuttle Orbiter Columbia touches down on Runway 33 at KSC’s Shuttle Landing Facility at 6:46:34 a.m. EDT with Mission Commander James D. Halsell Jr. and Pilot Susan L. Still at the controls to complete the STS-94 mission. Also on board are Mission Specialist Donald A. Thomas, Mission Specialist Michael L. Gernhardt , Payload Commander Janice Voss, and Payload Specialists Roger K. Crouch and Gregory T. Linteris. Mission elapsed time for STS-94 was 15 days,16 hours, 44 seconds. During the Microgravity Science Laboratory-1 (MSL-1) mission, the Spacelab module was used to test some of the hardware, facilities and procedures that are planned for use on the International Space Station while the flight crew conducted combustion, protein crystal growth and materials processing experiments. This mission was a reflight of the STS-83 mission that lifted off from KSC in April of this year. That space flight was cut short due to indications of a faulty fuel cell. This was Columbia’s 11th landing at KSC and the 38th landing at the space center in the history of the Shuttle program

KSC-97PC1051

NASA Image and Video Library

1997-07-17

KENNEDY SPACE CENTER, FLA. -- With its drag chute deployed, the Space Shuttle Orbiter Columbia touches down on Runway 33 at KSC’s Shuttle Landing Facility at 6:46:34 a.m. EDT with Mission Commander James D. Halsell Jr. and Pilot Susan L. Still at the controls to complete the STS-94 mission. Also on board are Mission Specialist Donald A. Thomas, Mission Specialist Michael L. Gernhardt , Payload Commander Janice Voss, and Payload Specialists Roger K. Crouch and Gregory T. Linteris. Mission elapsed time for STS-94 was 15 days,16 hours, 44 seconds. During the Microgravity Science Laboratory-1 (MSL-1) mission, the Spacelab module was used to test some of the hardware, facilities and procedures that are planned for use on the International Space Station while the flight crew conducted combustion, protein crystal growth and materials processing experiments. This mission was a reflight of the STS-83 mission that lifted off from KSC in April of this year. That space flight was cut short due to indications of a faulty fuel cell. This was Columbia’s 11th landing at KSC and the 38th landing at the space center in the history of the Shuttle program