UWR/MSAA demonstration of coordinated human-services transportation models - phase II : phased implementation.

DOT National Transportation Integrated Search

2012-12-01

This report presents the results of a 16-month project for system development and design of a model for a Travel Management Coordination Center (TMCC) using ITS capabilities. The system was designed as a tool to facilitate the exchange of knowledge a...

Recycling production designs: the value of coordination and flexibility in aluminum recycling operations

NASA Astrophysics Data System (ADS)

Brommer, Tracey H.

The growing motivation for aluminum recycling has prompted interest in recycling alternative and more challenging secondary materials. The nature of these alternative secondary materials necessitates the development of an intermediate recycling facility that can reprocess the secondary materials into a liquid product Two downstream aluminum remelters will incorporate the liquid products into their aluminum alloy production schedules. Energy and environmental benefits result from delivering the products as liquid but coordination challenges persist because of the energy cost to maintain the liquid. Further coordination challenges result from the necessity to establish a long term recycling production plan in the presence of long term downstream aluminum remelter production uncertainty and inherent variation in the daily order schedule of the downstream aluminum remelters. In this context a fundamental question arises, considering the metallurgical complexities of dross reprocessing, what is the value of operating a coordinated set of by-product reprocessing plants and remelting cast houses? A methodology is presented to calculate the optimal recycling center production parameters including 1) the number of recycled products, 2) the volume of recycled products, 3) allocation of recycled materials across recycled products, 4) allocation of recycled products across finished alloys, 4) the level of flexibility for the recycling center to operate. The methods implemented include, 1) an optimization model to describe the long term operations of the recycling center, 2) an uncertainty simulation tool, 3) a simulation optimization method, 4) a dynamic simulation tool with four embedded daily production optimization models of varying degrees of flexibility. This methodology is used to quantify the performance of several recycling center production designs of varying levels of coordination and flexibility. This analysis allowed the identification of the optimal recycling center production design based on maximizing liquid recycled product incorporation and minimizing cast sows. The long term production optimization model was used to evaluate the theoretical viability of the proposed two stage scrap and aluminum dross reprocessing operation including the impact of reducing coordination on model performance. Reducing the coordination between the recycling center and downstream remelters by reducing the number of recycled products from ten to five resulted in only 1.3% less secondary materials incorporated into downstream production. The dynamic simulation tool was used to evaluate the performance of the calculated recycling center production plan when resolved on a daily timeframe for varying levels of operational flexibility. The dynamic simulation revealed the optimal performance corresponded to the fixed recipe with flexible production daily optimization model formulation. Calculating recycled product characteristics using the proposed simulation optimization method increased profitability in cases of uncertain downstream remelter production and expensive aluminum dross and post-consumed secondary materials. (Copies available exclusively from MIT Libraries, libraries.mit.edu/docs - docs@mit.edu)

Hamiltonian theory of guiding-center motion

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

Littlejohn, R.G.

1980-05-01

A Hamiltonian treatment of the guiding center problem is given which employs noncanonical coordinates in phase space. Separation of the unperturbed system from the perturbation is achieved by using a coordinate transformation suggested by a theorem of Darboux. As a model to illustrate the method, motion in the magnetic field B=B(x,y)z is studied. Lie transforms are used to carry out the perturbation expansion.

Kent, Ohio traveler management coordination center (TMCC).

DOT National Transportation Integrated Search

2014-03-01

A project team consisting of the Portage Area Regional Transportation Authority (PARTA), Geauga County Transit, Trapeze Group, and : Kotting Consulting assembled a proposal to design a model system of human service transportation coordination using I...

Space Weather Model Testing And Validation At The Community Coordinated Modeling Center

NASA Astrophysics Data System (ADS)

Hesse, M.; Kuznetsova, M.; Rastaetter, L.; Falasca, A.; Keller, K.; Reitan, P.

The Community Coordinated Modeling Center (CCMC) is a multi-agency partner- ship aimed at the creation of next generation space weather models. The goal of the CCMC is to undertake the research and developmental work necessary to substantially increase the present-day modeling capability for space weather purposes, and to pro- vide models for transition to the rapid prototyping centers at the space weather forecast centers. This goal requires close collaborations with and substantial involvement of the research community. The physical regions to be addressed by CCMC-related activities range from the solar atmosphere to the Earth's upper atmosphere. The CCMC is an integral part of NASA's Living With aStar initiative, of the National Space Weather Program Implementation Plan, and of the Department of Defense Space Weather Tran- sition Plan. CCMC includes a facility at NASA Goddard Space Flight Center, as well as distributed computing facilities provided by the Air Force. CCMC also provides, to the research community, access to state-of-the-art space research models. In this paper we will provide updates on CCMC status, on current plans, research and devel- opment accomplishments and goals, and on the model testing and validation process undertaken as part of the CCMC mandate.

Cohesion and coordination effects on transition metal surface energies

NASA Astrophysics Data System (ADS)

Ruvireta, Judit; Vega, Lorena; Viñes, Francesc

2017-10-01

Here we explore the accuracy of Stefan equation and broken-bond model semiempirical approaches to obtain surface energies on transition metals. Cohesive factors are accounted for either via the vaporization enthalpies, as proposed in Stefan equation, or via cohesive energies, as employed in the broken-bond model. Coordination effects are considered including the saturation degree, as suggested in Stefan equation, employing Coordination Numbers (CN), or as the ratio of broken bonds, according to the bond-cutting model, considering as well the square root dependency of the bond strength on CN. Further, generalized coordination numbers CN bar are contemplated as well, exploring a total number of 12 semiempirical formulations on the three most densely packed surfaces of 3d, 4d, and 5d Transition Metals (TMs) displaying face-centered cubic (fcc), body-centered cubic (bcc), or hexagonal close-packed (hcp) crystallographic structures. Estimates are compared to available experimental surface energies obtained extrapolated to zero temperature. Results reveal that Stefan formula cohesive and coordination dependencies are only qualitative suited, but unadvised for quantitative discussion, as surface energies are highly overestimated, favoring in addition the stability of under-coordinated surfaces. Broken-bond cohesion and coordination dependencies are a suited basis for quantitative comparison, where square-root dependencies on CN to account for bond weakening are sensibly worse. An analysis using Wulff shaped averaged surface energies suggests the employment of broken-bond model using CN to gain surface energies for TMs, likely applicable to other metals.

Coordinating Educational Assessment Across College Centers.

ERIC Educational Resources Information Center

Churchill, Ruth; And Others

An operational model developed as a result of a systematic analysis of three distinctly different Antioch centers--Juarez Lincoln University, Philadelphia Graduate Center, and Antioch-New England (the Keene Center)--is presented. Juarez Lincoln offers a 15-month program leading to the Master of Education degree. Many of the students are Mexican…

Transformation formulas relating geodetic coordinates to a tangent to Earth, plane coordinate system

NASA Technical Reports Server (NTRS)

Credeur, L.

1981-01-01

Formulas and their approximation were developed to map geodetic position to an Earth tangent plane with an airport centered rectangular coordinate system. The transformations were developed for use in a terminal area air traffic model with deterministic aircraft traffic. The exact configured vehicle's approximation equations used in their precision microwave landing system navigation experiments.

Space Weather Modeling Services at the Community Coordinated Modeling Center

NASA Technical Reports Server (NTRS)

Hesse, Michael

2006-01-01

The Community Coordinated Modeling Center (CCMC) is a multi-agency partnership, which aims at the creation of next generation space weather models. The goal of the CCMC is to support the research and developmental work necessary to substantially increase the present-day modeling capability for space weather purposes, and to provide models for transition to the Rapid Prototyping Centers at the space weather forecast centers. This goal requires close collaborations with and substantial involvement of the research community. The physical regions to be addressed by CCMC-related activities range from the solar atmosphere to the Earth's upper atmosphere. The CCMC is an integral part of the National Space Weather Program Implementation Plan, of NASA's Living With a Star (LWS) initiative, and of the Department of Defense Space Weather Transition Plan. CCMC includes a facility at NASA Goddard Space Flight Center. CCMC also provides, to the research community, access to state-of-the-art space research models. In this paper we will provide a description of the current CCMC status, discuss current plans, research and development accomplishments and goals, and describe the model testing and validation process undertaken as part of the CCMC mandate. Special emphasis will be on solar and heliospheric models currently residing at CCMC, and on plans for validation and verification.

Space Weather Modeling at the Community Coordinated Modeling Center

NASA Technical Reports Server (NTRS)

Hesse M.

2005-01-01

The Community Coordinated Modeling Center (CCMC) is a multi-agency partnership, which aims at the creation of next generation space weather models. The goal of the CCMC is to support the research and developmental work necessary to substantially increase the present-day modeling capability for space weather purposes, and to provide models for transition to the rapid prototyping centers at the space weather forecast centers. This goal requires dose collaborations with and substantial involvement of the research community. The physical regions to be addressed by CCMC-related activities range from the solar atmosphere to the Earth's upper atmosphere. The CCMC is an integral part of the National Space Weather Program Implementation Plan, of NASA's Living With a Star (LWS) initiative, and of the Department of Defense Space Weather Transition Plan. CCMC includes a facility at NASA Goddard Space Flight Center, as well as distributed computing facilities provided by the US Air Force. CCMC also provides, to the research community, access to state-of-the-art space research models. In this paper we will provide updates on CCMC status, on current plans, research and development accomplishments and goals, and on the model testing and validation process undertaken as part of the CCMC mandate. Special emphasis will be on solar and heliospheric models currently residing at CCMC, and on plans for validation and verification.

Enhancing Services to the Rural Elderly through Primary Care Centers.

ERIC Educational Resources Information Center

Leighton, Jeannette; Sprague, Patricia

This paper describes a systematic, coordinated approach to the delivery of health and social services to the rural elderly of Maine provided by the Kennebec Valley Regional Health Agency. Four points of the model are described which distinguish it from other models of coordination: (1) a strong medical orientation in the assessment process; (2)…

Patient-centered care coordination in hematopoietic cell transplantation

PubMed Central

Martin, Patricia; Edsall, Kristen; Bonagura, Anthony; Burns, Linda J.; Juckett, Mark; King, Olivia; LeMaistre, C. Frederick; Majhail, Navneet S.

2017-01-01

Hematopoietic cell transplantation (HCT) is an expensive, resource-intensive, and medically complicated modality for treatment of many hematologic disorders. A well-defined care coordination model through the continuum can help improve health care delivery for this high-cost, high-risk medical technology. In addition to the patients and their families, key stakeholders include not only the transplantation physicians and care teams (including subspecialists), but also hematologists/oncologists in private and academic-affiliated practices. Initial diagnosis and care, education regarding treatment options including HCT, timely referral to the transplantation center, and management of relapse and late medical or psychosocial complications after HCT are areas where the referring hematologists/oncologists play a significant role. Payers and advocacy and community organizations are additional stakeholders in this complex care continuum. In this article, we describe a care coordination framework for patients treated with HCT within the context of coordination issues in care delivery and stakeholders involved. We outline the challenges in implementing such a model and describe a simplified approach at the level of the individual practice or center. This article also highlights ongoing efforts from physicians, medical directors, payer representatives, and patient advocates to help raise awareness of and develop access to adequate tools and resources for the oncology community to deliver well-coordinated care to patients treated with HCT. Lastly, we set the stage for policy changes around appropriate reimbursement to cover all aspects of care coordination and generate successful buy-in from all stakeholders. PMID:29296802

Do Over or Make Do? Climate Models as a Software Development Challenge (Invited)

NASA Astrophysics Data System (ADS)

Easterbrook, S. M.

2010-12-01

We present the results of a comparative study of the software engineering culture and practices at four different earth system modeling centers: the UK Met Office Hadley Centre, the National Center for Atmospheric Research (NCAR), The Max-Planck-Institut für Meteorologie (MPI-M), and the Institut Pierre Simon Laplace (IPSL). The study investigated the software tools and techniques used at each center to assess their effectiveness. We also investigated how differences in the organizational structures, collaborative relationships, and technical infrastructures constrain the software development and affect software quality. Specific questions for the study included 1) Verification and Validation - What techniques are used to ensure that the code matches the scientists’ understanding of what it should do? How effective are these are at eliminating errors of correctness and errors of understanding? 2) Coordination - How are the contributions from across the modeling community coordinated? For coupled models, how are the differences in the priorities of different, overlapping communities of users addressed? 3) Division of responsibility - How are the responsibilities for coding, verification, and coordination distributed between different roles (scientific, engineering, support) in the organization? 4) Planning and release processes - How do modelers decide on priorities for model development, how do they decide which changes to tackle in a particular release of the model? 5) Debugging - How do scientists debug the models, what types of bugs do they find in their code, and how they find them? The results show that each center has evolved a set of model development practices that are tailored to their needs and organizational constraints. These practices emphasize scientific validity, but tend to neglect other software qualities, and all the centers struggle frequently with software problems. The testing processes are effective at removing software errors prior to release, but the code is hard to understand and hard to change. Software errors and model configuration problems are common during model development, and appear to have a serious impact on scientific productivity. These problems have grown dramatically in recent years with the growth in size and complexity of earth system models. Much of the success in obtaining valid simulations from the models depends on the scientists developing their own code, experimenting with alternatives, running frequent full system tests, and exploring patterns in the results. Blind application of generic software engineering processes is unlikely to work well. Instead, each center needs to lean how to balance the need for better coordination through a more disciplined approach with the freedom to explore, and the value of having scientists work directly with the code. This suggests that each center can learn a lot from comparing their practices with others, but that each might need to develop a different set of best practices.

Space Weather Modeling at the Community Coordinated Modeling Center

NASA Astrophysics Data System (ADS)

Hesse, M.; Falasca, A.; Johnson, J.; Keller, K.; Kuznetsova, M.; Rastaetter, L.

2003-04-01

The Community Coordinated Modeling Center (CCMC) is a multi-agency partnership aimed at the creation of next generation space weather models. The goal of the CCMC is to support the research and developmental work necessary to substantially increase the present-day modeling capability for space weather purposes, and to provide models for transition to the rapid prototyping centers at the space weather forecast centers. This goal requires close collaborations with and substantial involvement of the research community. The physical regions to be addressed by CCMC-related activities range from the solar atmosphere to the Earth's upper atmosphere. The CCMC is an integral part of NASA's Living With a Star (LWS) initiative, of the National Space Weather Program Implementation Plan, and of the Department of Defense Space Weather Transition Plan. CCMC includes a facility at NASA Goddard Space Flight Center, as well as distributed computing facilities provided by the US Air Force. CCMC also provides, to the research community, access to state-of-the-art space research models. In this paper we will provide updates on CCMC status, on current plans, research and development accomplishments and goals, and on the model testing and validation process undertaken as part of the CCMC mandate. We will demonstrate the capabilities of models resident at CCMC via the analysis of a geomagnetic storm, driven by a shock in the solar wind.

Community Coordinated Modeling Center: Paving the Way for Progress in Space Science Research to Operational Space Weather Forecasting

NASA Astrophysics Data System (ADS)

Kuznetsova, M. M.; Maddox, M. M.; Mays, M. L.; Mullinix, R.; MacNeice, P. J.; Pulkkinen, A. A.; Rastaetter, L.; Shim, J.; Taktakishvili, A.; Zheng, Y.; Wiegand, C.

2013-12-01

Community Coordinated Modeling Center (CCMC) was established at the dawn of the millennium as an essential element on the National Space Weather Program. One of the CCMC goals was to pave the way for progress in space science research to operational space weather forecasting. Over the years the CCMC acquired the unique experience in preparing complex models and model chains for operational environment, in developing and maintaining powerful web-based tools and systems ready to be used by space weather service providers and decision makers as well as in space weather prediction capabilities assessments. The presentation will showcase latest innovative solutions for space weather research, analysis, forecasting and validation and review on-going community-wide initiatives enabled by CCMC applications.

Enhanced human service transportation models : joint demonstration. Phase 1, System planning and design process evaluation : baseline analysis

DOT National Transportation Integrated Search

2007-11-13

This document presents the findings from the baseline phase of the evaluation of the process being used by eight sites to develop a design for a Travel Management Coordination Center (TMCC) for improved coordination of human service transportation wi...

Health IT-Enabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians.

PubMed

Morton, Suzanne; Shih, Sarah C; Winther, Chloe H; Tinoco, Aldo; Kessler, Rodger S; Scholle, Sarah Hudson

2015-01-01

Health information technology (IT) offers promising tools for improving care coordination. We assessed the feasibility and acceptability of 6 proposed care coordination objectives for stage 3 of the Centers for Medicare and Medicaid Services electronic health record incentive program (Meaningful Use) related to referrals, notification of care from other facilities, patient clinical summaries, and patient dashboards. We surveyed physician-owned and hospital/health system-affiliated primary care practices that achieved patient-centered medical home recognition and participated in the Meaningful Use program, and community health clinics with patient-centered medical home recognition (most with certified electronic health record systems). The response rate was 35.1%. We ascertained whether practices had implemented proposed objectives and perceptions of their importance. We analyzed the association of organizational and contextual factors with self-reported use of health IT to support care coordination activities. Although 78% of the 350 respondents viewed timely notification of hospital discharges as very important, only 48.7% used health IT systems to accomplish this task. The activity most frequently supported by health IT was providing clinical summaries to patients, in 76.6% of practices; however, merely 47.7% considered this activity very important. Greater use of health IT to support care coordination activities was positively associated with the presence of a nonclinician responsible for care coordination and the practice's capacity for systematic change. Even among practices having a strong commitment to the medical home model, the use of health IT to support care coordination objectives is not consistent. Health IT capabilities are not currently aligned with clinicians' priorities. Many practices will need financial and technical assistance for health IT to enhance care coordination. © 2015 Annals of Family Medicine, Inc.

Health IT–Enabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians

PubMed Central

Morton, Suzanne; Shih, Sarah C.; Winther, Chloe H.; Tinoco, Aldo; Kessler, Rodger S.; Scholle, Sarah Hudson

2015-01-01

PURPOSE Health information technology (IT) offers promising tools for improving care coordination. We assessed the feasibility and acceptability of 6 proposed care coordination objectives for stage 3 of the Centers for Medicare and Medicaid Services electronic health record incentive program (Meaningful Use) related to referrals, notification of care from other facilities, patient clinical summaries, and patient dashboards. METHODS We surveyed physician-owned and hospital/health system–affiliated primary care practices that achieved patient-centered medical home recognition and participated in the Meaningful Use program, and community health clinics with patient-centered medical home recognition (most with certified electronic health record systems). The response rate was 35.1%. We ascertained whether practices had implemented proposed objectives and perceptions of their importance. We analyzed the association of organizational and contextual factors with self-reported use of health IT to support care coordination activities. RESULTS Although 78% of the 350 respondents viewed timely notification of hospital discharges as very important, only 48.7% used health IT systems to accomplish this task. The activity most frequently supported by health IT was providing clinical summaries to patients, in 76.6% of practices; however, merely 47.7% considered this activity very important. Greater use of health IT to support care coordination activities was positively associated with the presence of a nonclinician responsible for care coordination and the practice’s capacity for systematic change. CONCLUSIONS Even among practices having a strong commitment to the medical home model, the use of health IT to support care coordination objectives is not consistent. Health IT capabilities are not currently aligned with clinicians’ priorities. Many practices will need financial and technical assistance for health IT to enhance care coordination. PMID:25964403

The Center for In-Service Education. Final Evaluation Report. Volume I. Part 1.

ERIC Educational Resources Information Center

Tennessee State Dept. of Education, Nashville.

The primary objectives of the Center for In-Service Education in implementing a model for in-service education were to a) implement and demonstrate the comprehensive in-service model developed during the planning phase, b) provide coordinated planning of in-service education for all participating school systems, c) directly assist regional…

The Role of Social Work Leadership: Mount Sinai Care, the Accountable Care Organization, and Population Health Management.

PubMed

Xenakis, Nancy

2015-10-01

In July 2012, The Mount Sinai Medical Center was selected by the Centers for Medicare and Medicaid to join the first cohort of Accountable Care Organizations (ACOs) in this country under its Medicare Shared Savings Program. A critical component of an ACO is care coordination of patients, which is a complex concept, intertwined with other concepts related to quality, delivery and organization of health care. This article provides an overview of the development, structure and functionality of Mount Sinai Care, the ACO of The Mount Sinai Health System, and how it was the beginning of its work in population health management. It describes the important role of social work leadership in the development and operation of its care coordination model. The model's successes and challenges and recommendations for future development of care coordination and population health management are outlined.

Proceedings of the Workshop on High Altitude Data Assimilation and Modeling

DTIC Science & Technology

2015-06-24

Masha  Kuznetsova,  NASA  GSFC)   1330-­‐1400    Upper  Atmospheric  Data...prediction.       The  Community  Coordinated  Modeling  Center:  Overview  of  Activities   Masha  Kuznetsova  (Space...Division,  Naval  Research  Laboratory,  Washington  DC     Masha  Kuznetsov      Community  Coordinated

A hierarchical distributed control model for coordinating intelligent systems

NASA Technical Reports Server (NTRS)

Adler, Richard M.

1991-01-01

A hierarchical distributed control (HDC) model for coordinating cooperative problem-solving among intelligent systems is described. The model was implemented using SOCIAL, an innovative object-oriented tool for integrating heterogeneous, distributed software systems. SOCIAL embeds applications in 'wrapper' objects called Agents, which supply predefined capabilities for distributed communication, control, data specification, and translation. The HDC model is realized in SOCIAL as a 'Manager'Agent that coordinates interactions among application Agents. The HDC Manager: indexes the capabilities of application Agents; routes request messages to suitable server Agents; and stores results in a commonly accessible 'Bulletin-Board'. This centralized control model is illustrated in a fault diagnosis application for launch operations support of the Space Shuttle fleet at NASA, Kennedy Space Center.

The Internet and Global Telecommunications: Exploring the Boundaries of International Coordination. A Report of the Annual Aspen Institute Roundtable on International Telecommunications (4th, Shonan Village Center, Japan, September 21-24, 1998).

ERIC Educational Resources Information Center

Kleeman, Michael J.

The goals of the Fourth Annual Aspen Institute Roundtable on International Telecommunications were: to address procedural and substantive solutions for international coordination of Internet policy issues; to suggest different models for dispute resolution and policy coordination that might be employed in the various contexts of Internet usage;…

Economic analysis of centralized vs. decentralized electronic data capture in multi-center clinical studies.

PubMed

Walden, Anita; Nahm, Meredith; Barnett, M Edwina; Conde, Jose G; Dent, Andrew; Fadiel, Ahmed; Perry, Theresa; Tolk, Chris; Tcheng, James E; Eisenstein, Eric L

2011-01-01

New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs.

Economic Analysis of Centralized vs. Decentralized Electronic Data Capture in Multi-Center Clinical Studies

PubMed Central

Walden, Anita; Nahm, Meredith; Barnett, M. Edwina; Conde, Jose G.; Dent, Andrew; Fadiel, Ahmed; Perry, Theresa; Tolk, Chris; Tcheng, James E.; Eisenstein, Eric L.

2012-01-01

Background New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. Methods We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. Main Outcome Measures The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Results Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Conclusion Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs. PMID:21335692

75 FR 38506 - Office of Postsecondary Education: Overview Information; Coordinating Center for Transition and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

... to establish a coordinating center for institutions of higher education that offer inclusive... DEPARTMENT OF EDUCATION Office of Postsecondary Education: Overview Information; Coordinating... purpose of this program is to establish a coordinating center for institutions of higher education that...

Rationale and design of a patient-centered medical home intervention for patients with end-stage renal disease on hemodialysis.

PubMed

Porter, Anna C; Fitzgibbon, Marian L; Fischer, Michael J; Gallardo, Rani; Berbaum, Michael L; Lash, James P; Castillo, Sheila; Schiffer, Linda; Sharp, Lisa K; Tulley, John; Arruda, Jose A; Hynes, Denise M

2015-05-01

In the U.S., more than 400,000 individuals with end-stage renal disease (ESRD) require hemodialysis (HD) for renal replacement therapy. ESRD patients experience a high burden of morbidity, mortality, resource utilization, and poor quality of life (QOL). Under current care models, ESRD patients receive fragmented care from multiple providers at multiple locations. The Patient-Centered Medical Home (PCMH) is a team approach, providing coordinated care across the healthcare continuum. While this model has shown some early benefits for complex chronic diseases such as diabetes, it has not been applied to HD patients. This study is a non-randomized quasi-experimental intervention trial implementing a Patient-Centered Medical Home for Kidney Disease (PCMH-KD). The PCMH-KD extends the existing dialysis care team (comprised of a nephrologist, dialysis nurse, dialysis technician, social worker, and dietitian) by adding a general internist, pharmacist, nurse coordinator, and a community health worker, all of whom will see the patients together, and separately, as needed. The primary goal is to implement a comprehensive, multidisciplinary care team to improve care coordination, quality of life, and healthcare use for HD patients. Approximately 240 patients will be recruited from two sites; a non-profit university-affiliated dialysis center and an independent for-profit dialysis center. Outcomes include (i) patient-reported outcomes, including QOL and satisfaction; (ii) clinical outcomes, including blood pressure and diet; (iii) healthcare use, including emergency room visits and hospitalizations; and (iv) staff perceptions. Given the significant burden that patients with ESRD on HD experience, enhanced care coordination provides an opportunity to reduce this burden and improve QOL. Copyright © 2015 Elsevier Inc. All rights reserved.

Modelling Accuracy of a Car Steering Mechanism with Rack and Pinion and McPherson Suspension

NASA Astrophysics Data System (ADS)

Knapczyk, J.; Kucybała, P.

2016-08-01

Modelling accuracy of a car steering mechanism with a rack and pinion and McPherson suspension is analyzed. Geometrical parameters of the model are described by using the coordinates of centers of spherical joints, directional unit vectors and axis points of revolute, cylindrical and prismatic joints. Modelling accuracy is assumed as the differences between the values of the wheel knuckle position and orientation coordinates obtained using a simulation model and the corresponding measured values. The sensitivity analysis of the parameters on the model accuracy is illustrated by two numerical examples.

IHY Modeling Support at the Community Coordinated Modeling Center

NASA Technical Reports Server (NTRS)

Chulaki, A.; Hesse, Michael; Kuznetsova, Masha; MacNeice, P.; Rastaetter, L.

2005-01-01

The Community Coordinated Modeling Center (CCMC) is a US inter-agency activity aiming at research in support of the generation of advanced space weather models. As one of its main functions, the CCMC provides to researchers the use of space science models, even if they are not model owners themselves. In particular, the CCMC provides to the research community the execution of "runs-onrequest" for specific events of interest to space science researchers. Through this activity and the concurrent development of advanced visualization tools, CCMC provides, to the general science community, unprecedented access to a large number of state-of-the-art research models. CCMC houses models that cover the entire domain from the Sun to the Earth. In this presentation, we will provide an overview of CCMC modeling services that are available to support activities during the International Heliospheric Year. In order to tailor CCMC activities to IHY needs, we will also invite community input into our IHY planning activities.

Elements of the patient-centered medical home associated with health outcomes among veterans: the role of primary care continuity, expanded access, and care coordination.

PubMed

Nelson, Karin; Sun, Haili; Dolan, Emily; Maynard, Charles; Beste, Laruen; Bryson, Christopher; Schectman, Gordon; Fihn, Stephan D

2014-01-01

Care continuity, access, and coordination are important features of the patient-centered medical home model and have been emphasized in the Veterans Health Administration patient-centered medical home implementation, called the Patient Aligned Care Team. Data from more than 4.3 million Veterans were used to assess the relationship between these attributes of Patient Aligned Care Team and Veterans Health Administration hospitalization and mortality. Controlling for demographics and comorbidity, we found that continuity with a primary care provider was associated with a lower likelihood of hospitalization and mortality among a large population of Veterans receiving VA primary care.

Next Generation Climate Change Experiments Needed to Advance Knowledge and for Assessment of CMIP6

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

Katzenberger, John; Arnott, James; Wright, Alyson

2014-10-30

The Aspen Global Change Institute hosted a technical science workshop entitled, “Next generation climate change experiments needed to advance knowledge and for assessment of CMIP6,” on August 4-9, 2013 in Aspen, CO. Jerry Meehl (NCAR), Richard Moss (PNNL), and Karl Taylor (LLNL) served as co-chairs for the workshop which included the participation of 32 scientists representing most of the major climate modeling centers for a total of 160 participant days. In August 2013, AGCI gathered a high level meeting of representatives from major climate modeling centers around the world to assess achievements and lessons learned from the most recent generationmore » of coordinated modeling experiments known as the Coupled Model Intercomparison Project – 5 (CMIP5) as well as to scope out the science questions and coordination structure desired for the next anticipated phase of modeling experiments called CMIP6. The workshop allowed for reflection on the coordination of the CMIP5 process as well as intercomparison of model results, such as were assessed in the most recent IPCC 5th Assessment Report, Working Group 1. For example, this slide from Masahiro Watanabe examines performance on a range of models capturing Atlantic Meridional Overturning Circulation (AMOC).« less

Health Information Technology Coordination to Support Patient-centered Care Coordination.

PubMed

Steichen, O; Gregg, W

2015-08-13

To select papers published in 2014, illustrating how information technology can contribute to and improve patient-centered care coordination. The two section editors performed a literature review from Medline and Web of Science to select a list of candidate best papers on the use of information technology for patient-centered care coordination. These papers were peer-reviewed by external reviewers and three of them were selected as "best papers". The first selected paper reports a qualitative study exploring the gap between current practices of care coordination in various settings and idealized longitudinal care plans. The second selected paper illustrates several unintended consequences of HIT designed to improve care coordination. The third selected paper shows that advanced analytic techniques in medical informatics can be instrumental in studying patient-centered care coordination. The realization of true patient-centered care coordination is dependent upon a number of factors. Standardization of clinical documentation and HIT interoperability across organization and settings is a critical prerequisite for HIT to support patient-centered care coordination. Enabling patient involvement is an efficient means for goal setting and health information sharing. Additionally, unintended consequences of HIT tools (both positive and negative) must be measured and taken into account for quality improvement.

Innovative approach to patient-centered care coordination in primary care practices.

PubMed

Clarke, Robin; Bharmal, Nazleen; Di Capua, Paul; Tseng, Chi-Hong; Mangione, Carol M; Mittman, Brian; Skootsky, Samuel A

2015-09-01

Although care coordination is an essential component of the patient-centered medical home structure, current case manager models have limited usefulness to population health because they typically serve a small group of patients defined based on disease or utilization. Our objective was to support our health system's population health by implementing and evaluating a program that embedded nonlicensed coordinators within our primary care practices to support physicians in executing care plans and communicating with patients. Matched case-control differences-in-differences. Comprehensive care coordinators (CCC) were introduced into 14 of the system's 28 practice sites in 2 waves. After a structured training program, CCCs identified, engaged, and intervened among patients within the practice in conjunction with practice primary care providers. We counted and broadly coded CCC activities that were documented in the intervention database. We examined the impact of CCC intervention on emergency department (ED) utilization at the practice level using a negative binomial multivariate regression model controlling for age, gender, and medical complexity. CCCs touched 10,500 unique patients over a 1-year period. CCC interventions included execution of care (38%), coordination of transitions (32%), self-management support/link to community resources (15%), monitor and follow-up (10%), and patient assessment (1%). The CCC intervention group had a 20% greater reduction in its prepost ED visit rate compared with the control group (P < .0001). Our CCC intervention demonstrated a significant reduction in ED visits by focusing on the centrality of the primary care provider and practice. Our model may serve as a cost-effective and scalable alternative for care coordination in primary care.

Scientific Visualization to Study Flux Transfer Events at the Community Coordinated Modeling Center

NASA Technical Reports Server (NTRS)

Rastatter, Lutz; Kuznetsova, Maria M.; Sibeck, David G.; Berrios, David H.

2011-01-01

In this paper we present results of modeling of reconnection at the dayside magnetopause with subsequent development of flux transfer event signatures. The tools used include new methods that have been added to the suite of visualization methods that are used at the Community Coordinated Modeling Center (CCMC). Flux transfer events result from localized reconnection that connect magnetosheath magnetic field and plasma with magnetospheric fields and plasma and results in flux rope structures that span the dayside magnetopause. The onset of flux rope formation and the three-dimensional structure of flux ropes are studied as they have been modeled by high-resolution magnetohydrodynamic simulations of the dayside magnetosphere of the Earth. We show that flux transfer events are complex three-dimensional structures that require modern visualization and analysis techniques. Two suites of visualization methods are presented and we demonstrate the usefulness of those methods through the CCMC web site to the general science user.

Primary care nursing role and care coordination: an observational study of nursing work in a community health center.

PubMed

Anderson, Daren R; St Hilaire, Daniel; Flinter, Margaret

2012-05-31

Care coordination is a core element of the Patient-Centered Medical Home and requires an effective, well educated nursing staff. A greater understanding of roles and tasks currently being carried out by nurses in primary care is needed to help practices determine how best to implement care coordination and transform into PCMHs. We conducted an observational study of primary care nursing in a Community Health Center by creating a classification schema for nursing responsibilities, directly observing and tracking nurses' work, and categorizing their activities. Ten nurses in eight different practice sites were observed for a total of 61 hours. The vast majority of nursing time was spent in vaccine and medication administration; telephone work; and charting and paper work, while only 15% of their time was spent in activity that was classified broadly as care coordination. Care coordination work appeared to be subsumed by other daily tasks, many of which could have been accomplished by other, lesser trained members of the health care team. Practices looking to implement care coordination need a detailed look at work flow, task assignments, and a critical assessment of staffing, adhering to the principal of each team member working to the highest level of his or her education and license. Care coordination represents a distinct responsibility that requires dedicated nursing time, separate from the day to day tasks in a busy practice. To fully support these new functions, reimbursement models are needed that support such non visit-based work and provide incentives to coordinate and manage complex cases, achieve improved clinical outcomes and enhance efficiency of the health system. This article describes our study methods, data collection, and analysis, results, and discussion about reorganizing nursing roles to promote care coordination.

Care coordination, the family-centered medical home, and functional disability among children with special health care needs.

PubMed

Litt, Jonathan S; McCormick, Marie C

2015-01-01

Children with special health care needs (CSHCN) are at increased risk for functional disabilities. Care coordination has been shown to decrease unmet health service use but has yet been shown to improve functional status. We hypothesize that care coordination services lower the odds of functional disability for CSHCN and that this effect is greater within the context of a family-centered medical home. A secondary objective was to test the mediating effect of unmet care needs on functional disability. Our sample included children ages 0 to 17 years participating the 2009-2010 National Survey of Children with Special Health Care Needs. Care coordination, unmet needs, and disability were measured by parent report. We used logistic regression models with covariate adjustment for confounding and a mediation analysis approach for binary outcomes to assess the effect of unmet needs. There were 34,459 children in our sample. Care coordination was associated with lower odds of having a functional disability (adjusted odds ratio 0.82, 95% confidence interval 0.77, 0.88). This effect was greater for care coordination in the context of a medical home (adjusted odds ratio 0.71, 95% confidence interval 0.66, 0.76). The relationship between care coordination and functional disability was mediated by reducing unmet services. Care coordination is associated with lower odds of functional disability among CSHCN, especially when delivered in the setting of a family-centered medical home. Reducing unmet service needs mediates this effect. Our findings support a central role for coordination services in improving outcomes for vulnerable children. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

A one-day centralized work-up for kidney transplant recipient candidates: a quality improvement report.

PubMed

Formica, Richard N; Barrantes, Fidel; Asch, William S; Bia, Margaret J; Coca, Steven; Kalyesubula, Robert; McCloskey, Barbara; Leary, Tucker; Arvelakis, Antonios; Kulkarni, Sanjay

2012-08-01

Waiting time for a kidney transplant is calculated from the date the patient is placed on the UNOS (United Network for Organ Sharing) waitlist to the date the patient undergoes transplant. Time from transplant evaluation to listing represents unaccounted waiting time, potentially resulting in longer dialysis exposure for some patients with prolonged evaluation times. There are established disparities demonstrating that groups of patients take longer to be placed on the waitlist and thus have less access to kidney transplant. Quality improvement report. 905 patients from a university-based hospital were evaluated for kidney transplant candidacy, and analysis was performed from July 1, 2004, to January 31, 2010. A 1-day centralized work-up was implemented on July 1, 2007, whereby the transplant center coordinated the necessary tests needed to fulfill minimal listing criteria. Time from evaluation to UNOS listing was compared between the 2 cohorts. Multivariable Cox proportional hazards models were created to assess the relative hazards of waitlist placement comparing 1-day versus conventional work-up and were adjusted for age, sex, race, and education. Of 905 patients analyzed, 378 underwent conventional evaluation and 527 underwent a 1-day center-coordinated evaluation. Median time to listing in the 1-day center-coordinated evaluation compared with conventional was significantly less (46 vs 226 days, P < 0.001). On multivariable analysis controlling for age, sex, and education level, the 1-day in-center group was 3 times more likely to place patients on the wait list (adjusted HR, 3.08; 95% CI, 2.64-3.59). Listing time was significantly decreased across race, sex, education, and ethnicity. Single center, retrospective. Variables that may influence transplant practitioners, such as comorbid conditions or functional status, were not assessed. A 1-day center-coordinated pretransplant work-up model significantly decreased time to listing for kidney transplant. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Child Forensic Interviewing in Children's Advocacy Centers: Empirical Data on a Practice Model

ERIC Educational Resources Information Center

Cross, Theodore P.; Jones, Lisa M.; Walsh, Wendy A.; Simone, Monique; Kolko, David

2007-01-01

Objective: Children's Advocacy Centers (CACs) aim to improve child forensic interviewing following allegations of child abuse by coordinating multiple investigations, providing child-friendly interviewing locations, and limiting redundant interviewing. This analysis presents one of the first rigorous evaluations of CACs' implementation of these…

Coordinating Center: Molecular and Cellular Findings of Screen-Detected Lesions | Division of Cancer Prevention

Cancer.gov

The Molecular and Cellular Characterization of Screen‐Detected Lesions ‐ Coordinating Center and Data Management Group will provide support for the participating studies responding to RFA CA14‐10. The coordinating center supports three main domains: network coordination, statistical support and computational analysis and protocol development and database support. Support for

Impact of type 1 diabetes mellitus on the family is reduced with the medical home, care coordination, and family-centered care.

PubMed

Katz, Michelle L; Laffel, Lori M; Perrin, James M; Kuhlthau, Karen

2012-05-01

To examine whether the medical home, care coordination, or family-centered care was associated with less impact of type 1 diabetes mellitus (T1D) on families' work, finances, time, and school attendance. With the 2005 to 2006 National Survey of Children with Special Health Care Needs, we compared impact in children with T1D (n = 583) with that in children with other special health care needs (n = 39 944) and children without special health care needs (n = 4945). We modeled the associations of the medical home, care coordination, and family-centered care with family impact in T1D. Seventy-five percent of families of children with T1D reported a major impact compared with 45% of families of children with special health care needs (P < .0001) and 17% of families of children without special health care needs (P < .0001). In families of children with T1D, 35% reported restricting work, 38% reported financial impact, 41% reported medical expenses >$1000/year, 24% reported spending ≥11 hours/week caring or coordination care, and 20% reported ≥11 school absences/year. The medical home, care coordination, and family-centered care were associated with less work and financial impact. In childhood T1D, most families experience major impact. Better systems of health care delivery may help families reduce some of this impact. Copyright © 2012 Mosby, Inc. All rights reserved.

Bringing Wellness to Schools: Opportunities for and Challenges to Mental Health Integration in School-Based Health Centers.

PubMed

Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H

2016-12-01

School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.

Development of the Surface Management System Integrated with CTAS Arrival Tools

NASA Technical Reports Server (NTRS)

Jung, Yoon C.; Jara, Dave

2005-01-01

The Surface Management System (SMS) developed by NASA Ames Research Center in coordination with the Federal Aviation Administration (FAA) is a decision support tool to help tower traffic coordinators and Ground/Local controllers in managing and controlling airport surface traffic in order to increase capacity, efficiency, and flexibility. SMS provides common situation awareness to personnel at various air traffic control facilities such as airport traffic control towers (ATCT s), airline ramp towers, Terminal Radar Approach Control (TRACON), and Air Route Traffic Control Center (ARTCC). SMS also provides a traffic management tool to assist ATCT traffic management coordinators (TMCs) in making decisions such as airport configuration and runway load balancing. The Build 1 of the SMS tool was installed and successfully tested at Memphis International Airport (MEM) and received high acceptance scores from ATCT controllers and coordinators, as well as airline ramp controllers. NASA Ames Research Center continues to develop SMS under NASA s Strategic Airspace Usage (SAU) project in order to improve its prediction accuracy and robustness under various modeling uncertainties. This paper reports the recent development effort performed by the NASA Ames Research Center: 1) integration of Center TRACON Automation System (CTAS) capability with SMS and 2) an alternative approach to obtain airline gate information through a publicly available website. The preliminary analysis results performed on the air/surface traffic data at the DFW airport have shown significant improvement in predicting airport arrival demand and IN time at the gate. This paper concludes with recommendations for future research and development.

Identifying and collecting pertinent medical records for centralized abstraction in a multi-center randomized clinical trial: the model used by the American College of Radiology arm of the National Lung Screening Trial.

PubMed

Gareen, Ilana F; Sicks, JoRean D; Jain, Amanda Adams; Moline, Denise; Coffman-Kadish, Nancy

2013-01-01

In clinical trials and epidemiologic studies, information on medical care utilization and health outcomes is often obtained from medical records. For multi-center studies, this information may be gathered by personnel at individual sites or by staff at a central coordinating center. We describe the process used to develop a HIPAA-compliant centralized process to collect medical record information for a large multi-center cancer screening trial. The framework used to select, request, and track medical records incorporated a participant questionnaire with unique identifiers for each medical provider. De-identified information from the questionnaires was sent to the coordinating center indexed by these identifiers. The central coordinating center selected specific medical providers for abstraction and notified sites using these identifiers. The site personnel then linked the identifiers with medical provider information. Staff at the sites collected medical records and provided them for central abstraction. Medical records were successfully obtained and abstracted to ascertain information on outcomes and health care utilization in a study with over 18,000 study participants. Collection of records required for outcomes related to positive screening examinations and lung cancer diagnosis exceeded 90%. Collection of records for all aims was 87.32%. We designed a successful centralized medical record abstraction process that may be generalized to other research settings, including observational studies. The coordinating center received no identifying data. The process satisfied requirements imposed by the Health Insurance Portability and Accountability Act and concerns of site institutional review boards with respect to protected health information. Copyright © 2012 Elsevier Inc. All rights reserved.

Identifying and collecting pertinent medical records for centralized abstraction in a multi-center randomized clinical trial: The model used by the American College of Radiology arm of the National Lung Screening Trial

PubMed Central

Gareen, Ilana F.; Sicks, JoRean; Adams, Amanda; Moline, Denise; Coffman-Kadish, Nancy

2012-01-01

Background In clinical trials and epidemiologic studies, information on medical care utilization and health outcomes is often obtained from medical records. For multi-center studies, this information may be gathered by personnel at individual sites or by staff at a central coordinating center. We describe the process used to develop a HIPAA-compliant centralized process to collect medical record information for a large multi-center cancer screening trial. Methods The framework used to select, request, and track medical records incorporated a participant questionnaire with unique identifiers for each medical provider. De-identified information from the questionnaires was sent to the coordinating center indexed by these identifiers. The central coordinating center selected specific medical providers for abstraction and notified sites using these identifiers. The site personnel then linked the identifiers with medical provider information. Staff at the sites collected medical records and provided them for central abstraction. Results Medical records were successfully obtained and abstracted to ascertain information on outcomes and health care utilization in a study with over 18,000 study participants. Collection of records required for outcomes related to positive screening examinations and lung cancer diagnosis exceeded 90%. Collection of records for all aims was 87.32%. Conclusions We designed a successful centralized medical record abstraction process that may be generalized to other research settings, including observational studies. The coordinating center received no identifying data. The process satisfied requirements imposed by the Health Insurance Portability and Accountability Act and concerns of site institutional review boards with respect to protected health information. PMID:22982342

Community Coordinated Modeling Center (CCMC): Using innovative tools and services to support worldwide space weather scientific communities and networks

NASA Astrophysics Data System (ADS)

Mendoza, A. M.; Bakshi, S.; Berrios, D.; Chulaki, A.; Evans, R. M.; Kuznetsova, M. M.; Lee, H.; MacNeice, P. J.; Maddox, M. M.; Mays, M. L.; Mullinix, R. E.; Ngwira, C. M.; Patel, K.; Pulkkinen, A.; Rastaetter, L.; Shim, J.; Taktakishvili, A.; Zheng, Y.

2012-12-01

Community Coordinated Modeling Center (CCMC) was established to enhance basic solar terrestrial research and to aid in the development of models for specifying and forecasting conditions in the space environment. In achieving this goal, CCMC has developed and provides a set of innovative tools varying from: Integrated Space Weather Analysis (iSWA) web -based dissemination system for space weather information, Runs-On-Request System providing access to unique collection of state-of-the-art solar and space physics models (unmatched anywhere in the world), Advanced Online Visualization and Analysis tools for more accurate interpretation of model results, Standard Data formats for Simulation Data downloads, and recently Mobile apps (iPhone/Android) to view space weather data anywhere to the scientific community. The number of runs requested and the number of resulting scientific publications and presentations from the research community has not only been an indication of the broad scientific usage of the CCMC and effective participation by space scientists and researchers, but also guarantees active collaboration and coordination amongst the space weather research community. Arising from the course of CCMC activities, CCMC also supports community-wide model validation challenges and research focus group projects for a broad range of programs such as the multi-agency National Space Weather Program, NSF's CEDAR (Coupling, Energetics and Dynamics of Atmospheric Regions), GEM (Geospace Environment Modeling) and Shine (Solar Heliospheric and INterplanetary Environment) programs. In addition to performing research and model development, CCMC also supports space science education by hosting summer students through local universities; through the provision of simulations in support of classroom programs such as Heliophysics Summer School (with student research contest) and CCMC Workshops; training next generation of junior scientists in space weather forecasting; and educating the general public about the importance and impacts of space weather effects. Although CCMC is organizationally comprised of United States federal agencies, CCMC services are open to members of the international science community and encourages interagency and international collaboration. In this poster, we provide an overview of using Community Coordinated Modeling Center (CCMC) tools and services to support worldwide space weather scientific communities and networks.;

Optimizing Patient-centered Communication and Multidisciplinary Care Coordination in Emergency Diagnostic Imaging: A Research Agenda.

PubMed

Sabbatini, Amber K; Merck, Lisa H; Froemming, Adam T; Vaughan, William; Brown, Michael D; Hess, Erik P; Applegate, Kimberly E; Comfere, Nneka I

2015-12-01

Patient-centered emergency diagnostic imaging relies on efficient communication and multispecialty care coordination to ensure optimal imaging utilization. The construct of the emergency diagnostic imaging care coordination cycle with three main phases (pretest, test, and posttest) provides a useful framework to evaluate care coordination in patient-centered emergency diagnostic imaging. This article summarizes findings reached during the patient-centered outcomes session of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The primary objective was to develop a research agenda focused on 1) defining component parts of the emergency diagnostic imaging care coordination process, 2) identifying gaps in communication that affect emergency diagnostic imaging, and 3) defining optimal methods of communication and multidisciplinary care coordination that ensure patient-centered emergency diagnostic imaging. Prioritized research questions provided the framework to define a research agenda for multidisciplinary care coordination in emergency diagnostic imaging. © 2015 by the Society for Academic Emergency Medicine.

A customizable model for chronic disease coordination: Lessons learned from the coordinated chronic disease program

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

Voetsch, Karen; Sequeira, Sonia; Chavez, Amy Holmes

In 2012, the Centers for Disease Control and Prevention provided funding and technical assistance to all states and territories to implement the Coordinated Chronic Disease Program, marking the first time that all state health departments had federal resources to coordinate chronic disease prevention and control programs. This article describes lessons learned from this initiative and identifies key elements of a coordinated approach. We analyzed 80 programmatic documents from 21 states and conducted semistructured interviews with 7 chronic disease directors. Six overarching themes emerged: 1) focused agenda, 2) identification of functions, 3) comprehensive planning, 4) collaborative leadership and expertise, 5) managedmore » resources, and 6) relationship building. Furthermore, these elements supported 4 essential activities: 1) evidence-based interventions, 2) strategic use of staff, 3) consistent communication, and 4) strong program infrastructure. On the basis of these elements and activities, we propose a conceptual model that frames overarching concepts, skills, and strategies needed to coordinate state chronic disease prevention and control programs.« less

A customizable model for chronic disease coordination: Lessons learned from the coordinated chronic disease program

DOE PAGES

Voetsch, Karen; Sequeira, Sonia; Chavez, Amy Holmes

2016-03-31

In 2012, the Centers for Disease Control and Prevention provided funding and technical assistance to all states and territories to implement the Coordinated Chronic Disease Program, marking the first time that all state health departments had federal resources to coordinate chronic disease prevention and control programs. This article describes lessons learned from this initiative and identifies key elements of a coordinated approach. We analyzed 80 programmatic documents from 21 states and conducted semistructured interviews with 7 chronic disease directors. Six overarching themes emerged: 1) focused agenda, 2) identification of functions, 3) comprehensive planning, 4) collaborative leadership and expertise, 5) managedmore » resources, and 6) relationship building. Furthermore, these elements supported 4 essential activities: 1) evidence-based interventions, 2) strategic use of staff, 3) consistent communication, and 4) strong program infrastructure. On the basis of these elements and activities, we propose a conceptual model that frames overarching concepts, skills, and strategies needed to coordinate state chronic disease prevention and control programs.« less

76 FR 46814 - Medicare Program; Evaluation Criteria and Standards for Quality Improvement Program Contracts...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-03

... Work) The Patient Safety initiatives are designed to help achieve the goals of improving individual... coordinating center, the Center for Medicare and Medicaid Innovation, and the Agency for Healthcare Research... outreach activities required to complete all Aims of the 10th SOW successfully. The CRISP Model is designed...

On the Scene: Developing a Nurse Care Coordinator Role at City of Hope.

PubMed

Johnson, Shirley A; Giesie, Pamela D; Ireland, Anne M; Rice, Robert David; Thomson, Brenda K

2016-01-01

We describe the development of an oncology solid tumor disease-focused care coordination model. Consistent with our strategic plan to provide patient- and family-centered care and to organize care around disease management teams, we developed the role of nurse care coordinator as an integral team member in our care delivery model. Managing a defined high-risk patient population across the care trajectory, these nurses provide stable points of contact and continuity for patients and families as they navigate the complex treatments and systems required to deliver cancer care. We describe role delineation and staffing models; role clarity between the role of the nurse care coordinator and the case manager; core curriculum development; the use of workflow management tools to support the touch points of the patient and members of the care team; and the incorporation of electronic medical records and data streams to inform the care delivery model. We identify measures that we will use to evaluate the success of our program.

Semianalytical computation of path lines for finite-difference models

USGS Publications Warehouse

Pollock, D.W.

1988-01-01

A semianalytical particle tracking method was developed for use with velocities generated from block-centered finite-difference ground-water flow models. Based on the assumption that each directional velocity component varies linearly within a grid cell in its own coordinate directions, the method allows an analytical expression to be obtained describing the flow path within an individual grid cell. Given the intitial position of a particle anywhere in a cell, the coordinates of any other point along its path line within the cell, and the time of travel between them, can be computed directly. For steady-state systems, the exit point for a particle entering a cell at any arbitrary location can be computed in a single step. By following the particle as it moves from cell to cell, this method can be used to trace the path of a particle through any multidimensional flow field generated from a block-centered finite-difference flow model. -Author

Affordability, accountability, and accessibility in health care reform: implications for cardiovascular and pulmonary rehabilitation.

PubMed

King, Marjorie L

2013-01-01

Because health care costs in the United States have been growing disproportionately compared to inflation for many years, without a clear connection to improved quality or increased access to care, employers and payers have begun to test new models of health care delivery and payment. These models are linked to the concepts of affordability, accountability, and accessibility and incorporate the premise that there must be shared responsibility for improving meaningful patient outcomes, with attention to the coordination of team-based and patient-centered care, and value for services purchased. This article explores emerging health care delivery and payment models, including expanded access to care related to the Affordable Care Act of 2010, patient-centered medical homes and neighborhoods, accountable and coordinated care organizations, and value-based purchasing and insurance design, with an emphasis on implications for cardiovascular and pulmonary rehabilitation programs and the American Association of Cardiovascular and Pulmonary Rehabilitation.

Coordination and Data Management of the International Arctic Buoy Programme (IABP)

DTIC Science & Technology

2002-09-30

for forcing, validation and assimilation into numerical climate models , and for forecasting weather and ice conditions. TRANSITIONS Using IABP ...Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor 1013 NE 40th Street Polar Science Center...analyzed geophysical fields. APPROACH The IABP is a collaboration between 25 different institutions from 8 different countries, which work together

Generic magnetohydrodynamic model at the Community Coordinated Modeling Center

NASA Astrophysics Data System (ADS)

Honkonen, I. J.; Rastaetter, L.; Glocer, A.

2016-12-01

The Community Coordinated Modeling Center (CCMC) at NASA Goddard Space Flight Center is a multi-agency partnership to enable, support and perform research and development for next-generation space science and space weather models. CCMC currently hosts nearly 100 numerical models and a cornerstone of this activity is the Runs on Request (RoR) system which allows anyone to request a model run and analyse/visualize the results via a web browser. CCMC is also active in the education community by organizing student research contests, heliophysics summer schools, and space weather forecaster training for students, government and industry representatives. Recently a generic magnetohydrodynamic (MHD) model was added to the CCMC RoR system which allows the study of a variety of fluid and plasma phenomena in one, two and three dimensions using a dynamic point-and-click web interface. For example students can experiment with the physics of fundamental wave modes of hydrodynamic and MHD theory, behavior of discontinuities and shocks as well as instabilities such as Kelvin-Helmholtz.Students can also use the model to experiments with numerical effects of models, i.e. how the process of discretizing a system of equations and solving them on a computer changes the solution. This can provide valuable background understanding e.g. for space weather forecasters on the effects of model resolution, numerical resistivity, etc. on the prediction.

Coordination- and Redox-Noninnocent Behavior of Ambiphilic Ligands Containing Antimony.

PubMed

Jones, J Stuart; Gabbaï, François P

2016-05-17

Stimulated by applications in catalysis, the chemistry of ambiphilic ligands featuring both donor and acceptor functionalities has experienced substantial growth in the past several years. The unique opportunities in catalysis offered by ambiphilic ligands stem from the ability of their acceptor functionalities to play key roles via metal-ligand cooperation or modulation of the reactivity of the metal center. Ligands featuring group 13 centers, most notably boranes, as their acceptor functionalities have undoubtedly spearheaded these developments, with remarkable results having been achieved in catalytic hydrogenation and hydrosilylation. Motivated by these developments as well as by our fundamental interest in the chemistry of heavy group 15 elements, we became fascinated by the possibility of employing antimony centers as Lewis acids within ambiphilic ligands. The chemistry of antimony-based ligands, most often encountered as trivalent stibines, has historically been considered to mirror that of their lighter phosphorus-based congeners. There is growing evidence, however, that antimony-based ligands may display unique coordination behavior and reactivity. Additionally, despite the diverse Lewis acid and redox chemistry that antimony exhibits, there have been only limited efforts to explore this chemistry within the coordination sphere of a transition metal. By incorporation of antimony into the framework of polydentate ligands in order to enforce the main group metal-transition metal interaction, the effect of redox and coordination events at the antimony center on the structure, electronics, and reactivity of the metal complex may be investigated. This Account describes our group's continuing efforts to probe the coordination behavior, reactivity, and application of ambiphilic ligands incorporating antimony centers. Structural and theoretical studies have established that both Sb(III) and Sb(V) centers in polydentate ligands may act as Z-type ligands toward late transition metals. Although coordinated to a metal, the antimony centers in these complexes retain residual Lewis acidity, as evidenced by their ability to participate in anion binding. Anion binding events at the antimony center have been shown by structural, spectroscopic, and theoretical studies to perturb the antimony-transition metal interaction and in some cases to trigger reactivity at the metal center. Coordinated Sb(III) centers in polydentate ligands have also been found to readily undergo two-electron oxidation, generating strongly Lewis acidic Sb(V) centers in the coordination sphere of the metal. Theoretical studies suggest that oxidation of the coordinated antimony center induces an umpolung of the antimony-metal bond, resulting in depletion of electron density at the metal center. In addition to elucidating the fundamental coordination and redox chemistry of antimony-containing ambiphilic ligands, our work has demonstrated that these unusual behaviors show promise for use in a variety of applications. The ability of coordinated antimony centers to bind anions has been exploited for sensing applications, in which anion coordination at antimony leads to a colorimetric response via a change in the geometry about the metal center. In addition, the capacity of antimony Lewis acids to modulate the electron density of coordinated metals has proved to be key in facilitating photochemical activation of M-X bonds as well as antimony-centered redox-controlled catalysis.

Estimating the Geocenter from GNSS Observations

NASA Astrophysics Data System (ADS)

Dach, Rolf; Michael, Meindl; Beutler, Gerhard; Schaer, Stefan; Lutz, Simon; Jäggi, Adrian

2014-05-01

The satellites of the Global Navigation Satellite Systems (GNSS) are orbiting the Earth according to the laws of celestial mechanics. As a consequence, the satellites are sensitive to the coordinates of the center of mass of the Earth. The coordinates of the (ground) tracking stations are referring to the center of figure as the conventional origin of the reference frame. The difference between the center of mass and center of figure is the instantaneous geocenter. Following this definition the global GNSS solutions are sensitive to the geocenter. Several studies demonstrated strong correlations of the GNSS-derived geocenter coordinates with parameters intended to absorb radiation pressure effects acting on the GNSS satellites, and with GNSS satellite clock parameters. One should thus pose the question to what extent these satellite-related parameters absorb (or hide) the geocenter information. A clean simulation study has been performed to answer this question. The simulation environment allows it in particular to introduce user-defined shifts of the geocenter (systematic inconsistencies between the satellite's and station's reference frames). These geocenter shifts may be recovered by the mentioned parameters - provided they were set up in the analysis. If the geocenter coordinates are not estimated, one may find out which other parameters absorb the user-defined shifts of the geocenter and to what extent. Furthermore, the simulation environment also allows it to extract the correlation matrix from the a posteriori covariance matrix to study the correlations between different parameter types of the GNSS analysis system. Our results show high degrees of correlations between geocenter coordinates, orbit-related parameters, and satellite clock parameters. These correlations are of the same order of magnitude as the correlations between station heights, troposphere, and receiver clock parameters in each regional or global GNSS network analysis. If such correlations are accepted in a GNSS analysis when estimating station coordinates, geocenter coordinates must be considered as mathematically estimable in a global GNSS analysis. The geophysical interpretation may of course become difficult, e.g., if insufficient orbit models are used.

Comprehensive home-based care coordination for vulnerable elders with dementia: Maximizing Independence at Home-Plus-Study protocol.

PubMed

Samus, Quincy M; Davis, Karen; Willink, Amber; Black, Betty S; Reuland, Melissa; Leoutsakos, Jeannie; Roth, David L; Wolff, Jennifer; Gitlin, Laura N; Lyketsos, Constantine G; Johnston, Deirdre

2017-12-01

Despite availability of effective care strategies for dementia, most health care systems are not yet organized or equipped to provide comprehensive family-centered dementia care management. Maximizing Independence at Home-Plus is a promising new model of dementia care coordination being tested in the U.S. through a Health Care Innovation Award funded by the Centers for Medicare and Medicaid Services that may serve as a model to address these delivery gaps, improve outcomes, and lower costs. This report provides an overview of the Health Care Innovation Award aims, study design, and methodology. This is a prospective, quasi-experimental intervention study of 342 community-living Medicare-Medicaid dual eligibles and Medicare-only beneficiaries with dementia in Maryland. Primary analyses will assess the impact of Maximizing Independence at Home-Plus on risk of nursing home long-term care placement, hospitalization, and health care expenditures (Medicare, Medicaid) at 12, 18 (primary end point), and 24 months, compared to a propensity-matched comparison group. The goals of the Maximizing Independence at Home-Plus model are to improve care coordination, ability to remain at home, and life quality for participants and caregivers, while reducing total costs of care for this vulnerable population. This Health Care Innovation Award project will provide timely information on the impact of Maximizing Independence at Home-Plus care coordination model on a variety of outcomes including effects on Medicaid and Medicare expenditures and service utilization. Participant characteristic data, cost savings, and program delivery costs will be analyzed to develop a risk-adjusted payment model to encourage sustainability and facilitate spread.

Integrated care management: aligning medical call centers and nurse triage services.

PubMed

Kastens, J M

1998-01-01

Successful integrated delivery systems must aggressively design new approaches to managing patient care. Implementing a comprehensive care management model to coordinate patient care across the continuum is essential to improving patient care and reducing costs. The practice of telephone nursing and the need for experienced registered nurses to staff medical call centers, nurse triage centers, and outbound telemanagement is expanding as the penetration of full-risk capitated managed care contracts are signed. As health systems design their new care delivery approaches and care management models, medical call centers will be an integral approach to managing demand for services, chronic illnesses, and prevention strategies.

Community-wide validation of geospace model local K-index predictions to support model transition to operations

NASA Astrophysics Data System (ADS)

Glocer, A.; Rastätter, L.; Kuznetsova, M.; Pulkkinen, A.; Singer, H. J.; Balch, C.; Weimer, D.; Welling, D.; Wiltberger, M.; Raeder, J.; Weigel, R. S.; McCollough, J.; Wing, S.

2016-07-01

We present the latest result of a community-wide space weather model validation effort coordinated among the Community Coordinated Modeling Center (CCMC), NOAA Space Weather Prediction Center (SWPC), model developers, and the broader science community. Validation of geospace models is a critical activity for both building confidence in the science results produced by the models and in assessing the suitability of the models for transition to operations. Indeed, a primary motivation of this work is supporting NOAA/SWPC's effort to select a model or models to be transitioned into operations. Our validation efforts focus on the ability of the models to reproduce a regional index of geomagnetic disturbance, the local K-index. Our analysis includes six events representing a range of geomagnetic activity conditions and six geomagnetic observatories representing midlatitude and high-latitude locations. Contingency tables, skill scores, and distribution metrics are used for the quantitative analysis of model performance. We consider model performance on an event-by-event basis, aggregated over events, at specific station locations, and separated into high-latitude and midlatitude domains. A summary of results is presented in this report, and an online tool for detailed analysis is available at the CCMC.

Community-Wide Validation of Geospace Model Local K-Index Predictions to Support Model Transition to Operations

NASA Technical Reports Server (NTRS)

Glocer, A.; Rastaetter, L.; Kuznetsova, M.; Pulkkinen, A.; Singer, H. J.; Balch, C.; Weimer, D.; Welling, D.; Wiltberger, M.; Raeder, J.;

Model Deformation Measurements of Sonic Boom Models in the NASA Ames 9- by 7-Ft Supersonic Wind Tunnel

NASA Technical Reports Server (NTRS)

Schairer, Edward T.; Kushner, Laura K.; Garbeff, Theodore J.; Heineck, James T.

2015-01-01

The deformations of two sonic-boom models were measured by stereo photogrammetry during tests in the 9- by 7-Ft Supersonic Wind Tunnel at NASA Ames Research Center. The models were geometrically similar but one was 2.75 times as large as the other. Deformation measurements were made by simultaneously imaging the upper surfaces of the models from two directions by calibrated cameras that were mounted behind windows of the test section. Bending and twist were measured at discrete points using conventional circular targets that had been marked along the leading and trailing edges of the wings and tails. In addition, continuous distributions of bending and twist were measured from ink speckles that had been applied to the upper surfaces of the model. Measurements were made at wind-on (M = 1.6) and wind-off conditions over a range of angles of attack between 2.5 deg. and 5.0 deg. At each condition, model deformation was determined by comparing the wind-off and wind-on coordinates of each measurement point after transforming the coordinates to reference coordinates tied to the model. The necessary transformations were determined by measuring the positions of a set of targets on the rigid center-body of the models whose model-axes coordinates were known. Smoothly varying bending and twist measurements were obtained at all conditions. Bending displacements increased in proportion to the square of the distance to the centerline. Maximum deflection of the wingtip of the larger model was about 5 mm (2% of the semispan) and that of the smaller model was 0.9 mm (1% of the semispan). The change in wing twist due to bending increased in direct proportion to distance from the centerline and reached a (absolute) maximum of about -1? at the highest angle of attack for both models. The measurements easily resolved bending displacements as small as 0.05 mm and bending-induced changes in twist as small as 0.05 deg.

Bimetallic iron–iron and iron–zinc complexes of the redox-active ONO pincer ligand† †Electronic supplementary information (ESI) available: Complete experimental procedures and magnetic measurements and models. CCDC 1417565–1417567. For ESI and crystallographic data in CIF or other electronic format see DOI: 10.1039/c5sc03006d Click here for additional data file. Click here for additional data file.

PubMed Central

Wong, Janice L.; Higgins, Robert F.; Bhowmick, Indrani; Cao, David Xi; Szigethy, Géza; Ziller, Joseph W.

2016-01-01

A new bimetallic platform comprising a six-coordinate Fe(ONO)2 unit bound to an (ONO)M (M = Fe, Zn) has been discovered ((ONOcat)H3 = bis(3,5-di-tert-butyl-2-phenol)amine). Reaction of Fe(ONO)2 with either (ONOcat)Fe(py)3 or with (ONOq)FeCl2 under reducing conditions led to the formation of the bimetallic complex Fe2(ONO)3, which includes unique five- and six-coordinate iron centers. Similarly, the reaction of Fe(ONO)2 with the new synthon (ONOsq˙)Zn(py)2 led to the formation of the heterobimetallic complex FeZn(ONO)3, with a six-coordinate iron center and a five-coordinate zinc center. Both bimetallic complexes were characterized by single-crystal X-ray diffraction studies, solid-state magnetic measurements, and multiple spectroscopic techniques. The magnetic data for FeZn(ONO)3 are consistent with a ground state S = 3/2 spin system, generated from a high-spin iron(ii) center that is antiferromagnetically coupled to a single (ONOsq˙)2– radical ligand. In the case of Fe2(ONO)3, the magnetic data revealed a ground state S = 7/2 spin system arising from the interactions of one high-spin iron(ii) center, one high-spin iron(iii) center, and two (ONOsq˙)2– radical ligands. PMID:28808535

Gaze Compensation as a Technique for Improving Hand–Eye Coordination in Prosthetic Vision

PubMed Central

Titchener, Samuel A.; Shivdasani, Mohit N.; Fallon, James B.; Petoe, Matthew A.

2018-01-01

Purpose Shifting the region-of-interest within the input image to compensate for gaze shifts (“gaze compensation”) may improve hand–eye coordination in visual prostheses that incorporate an external camera. The present study investigated the effects of eye movement on hand-eye coordination under simulated prosthetic vision (SPV), and measured the coordination benefits of gaze compensation. Methods Seven healthy-sighted subjects performed a target localization-pointing task under SPV. Three conditions were tested, modeling: retinally stabilized phosphenes (uncompensated); gaze compensation; and no phosphene movement (center-fixed). The error in pointing was quantified for each condition. Results Gaze compensation yielded a significantly smaller pointing error than the uncompensated condition for six of seven subjects, and a similar or smaller pointing error than the center-fixed condition for all subjects (two-way ANOVA, P < 0.05). Pointing error eccentricity and gaze eccentricity were moderately correlated in the uncompensated condition (azimuth: R2 = 0.47; elevation: R2 = 0.51) but not in the gaze-compensated condition (azimuth: R2 = 0.01; elevation: R2 = 0.00). Increased variability in gaze at the time of pointing was correlated with greater reduction in pointing error in the center-fixed condition compared with the uncompensated condition (R2 = 0.64). Conclusions Eccentric eye position impedes hand–eye coordination in SPV. While limiting eye eccentricity in uncompensated viewing can reduce errors, gaze compensation is effective in improving coordination for subjects unable to maintain fixation. Translational Relevance The results highlight the present necessity for suppressing eye movement and support the use of gaze compensation to improve hand–eye coordination and localization performance in prosthetic vision. PMID:29321945

Vehicle autonomous localization in local area of coal mine tunnel based on vision sensors and ultrasonic sensors

PubMed Central

Yang, Wei; You, Kaiming; Li, Wei; Kim, Young-il

2017-01-01

This paper presents a vehicle autonomous localization method in local area of coal mine tunnel based on vision sensors and ultrasonic sensors. Barcode tags are deployed in pairs on both sides of the tunnel walls at certain intervals as artificial landmarks. The barcode coding is designed based on UPC-A code. The global coordinates of the upper left inner corner point of the feature frame of each barcode tag deployed in the tunnel are uniquely represented by the barcode. Two on-board vision sensors are used to recognize each pair of barcode tags on both sides of the tunnel walls. The distance between the upper left inner corner point of the feature frame of each barcode tag and the vehicle center point can be determined by using a visual distance projection model. The on-board ultrasonic sensors are used to measure the distance from the vehicle center point to the left side of the tunnel walls. Once the spatial geometric relationship between the barcode tags and the vehicle center point is established, the 3D coordinates of the vehicle center point in the tunnel’s global coordinate system can be calculated. Experiments on a straight corridor and an underground tunnel have shown that the proposed vehicle autonomous localization method is not only able to quickly recognize the barcode tags affixed to the tunnel walls, but also has relatively small average localization errors in the vehicle center point’s plane and vertical coordinates to meet autonomous unmanned vehicle positioning requirements in local area of coal mine tunnel. PMID:28141829

Vehicle autonomous localization in local area of coal mine tunnel based on vision sensors and ultrasonic sensors.

PubMed

Xu, Zirui; Yang, Wei; You, Kaiming; Li, Wei; Kim, Young-Il

2017-01-01

This paper presents a vehicle autonomous localization method in local area of coal mine tunnel based on vision sensors and ultrasonic sensors. Barcode tags are deployed in pairs on both sides of the tunnel walls at certain intervals as artificial landmarks. The barcode coding is designed based on UPC-A code. The global coordinates of the upper left inner corner point of the feature frame of each barcode tag deployed in the tunnel are uniquely represented by the barcode. Two on-board vision sensors are used to recognize each pair of barcode tags on both sides of the tunnel walls. The distance between the upper left inner corner point of the feature frame of each barcode tag and the vehicle center point can be determined by using a visual distance projection model. The on-board ultrasonic sensors are used to measure the distance from the vehicle center point to the left side of the tunnel walls. Once the spatial geometric relationship between the barcode tags and the vehicle center point is established, the 3D coordinates of the vehicle center point in the tunnel's global coordinate system can be calculated. Experiments on a straight corridor and an underground tunnel have shown that the proposed vehicle autonomous localization method is not only able to quickly recognize the barcode tags affixed to the tunnel walls, but also has relatively small average localization errors in the vehicle center point's plane and vertical coordinates to meet autonomous unmanned vehicle positioning requirements in local area of coal mine tunnel.

Community Coordinated Modeling Center Support of Science Needs for Integrated Data Environment

NASA Technical Reports Server (NTRS)

Kuznetsova, M. M.; Hesse, M.; Rastatter, L.; Maddox, M.

2007-01-01

Space science models are essential component of integrated data environment. Space science models are indispensable tools to facilitate effective use of wide variety of distributed scientific sources and to place multi-point local measurements into global context. The Community Coordinated Modeling Center (CCMC) hosts a set of state-of-the- art space science models ranging from the solar atmosphere to the Earth's upper atmosphere. The majority of models residing at CCMC are comprehensive computationally intensive physics-based models. To allow the models to be driven by data relevant to particular events, the CCMC developed an online data file generation tool that automatically downloads data from data providers and transforms them to required format. CCMC provides a tailored web-based visualization interface for the model output, as well as the capability to download simulations output in portable standard format with comprehensive metadata and user-friendly model output analysis library of routines that can be called from any C supporting language. CCMC is developing data interpolation tools that enable to present model output in the same format as observations. CCMC invite community comments and suggestions to better address science needs for the integrated data environment.

Care coordination and provider stress in primary care management of high-risk patients.

PubMed

Okunogbe, Adeyemi; Meredith, Lisa S; Chang, Evelyn T; Simon, Alissa; Stockdale, Susan E; Rubenstein, Lisa V

2018-01-01

Care coordination is a critical component of managing high-risk patients, who tend to have complex and multiple medical and psychosocial problems and are typically at high risk for increased hospitalization and incur high health care expenditures. Primary care models such as the patient-centered medical homes (PCMHs) are designed to improve care coordination and reduce care fragmentation. However, little is known about how the burden of care coordination for high-risk patients influences PCMH team members' stress. To evaluate the relationship between provider stress and care coordination time in high-risk patient care and whether availability of help is associated with reduced stress. Multivariable regression analysis of a cross-sectional survey of PCMH primary care providers (PCPs) and nurses. A total of 164 PCPs and 272 nurses in primary care practices at five geographically diverse Veteran Health Administration (VA) medical center health systems. The main outcome variable was provider stress due to high-risk patient care. Independent variables were the reported proportion of high-risk patients in PCP/nurse patient panels, time spent coordinating care for these patients, and provider satisfaction with help received in caring for them. The response rate was 44%. Spending more than 8 h per week coordinating care was significantly associated with a 0.21-point increase in reported provider stress compared to spending 8 h or less per week (95% CI: 0.04-0.39; p = 0.015). The magnitude of the association between stress and care coordination time was diminished when provider satisfaction with help received was included in the model. Perceived provider stress from care of high-risk patients may arise from challenges related to coordinating their care. Our findings suggest that the perception of receiving help for high-risk patient care may be valuable in reducing provider stress.

Need and unmet need for care coordination among children with mental health conditions.

PubMed

Brown, Nicole M; Green, Jeremy C; Desai, Mayur M; Weitzman, Carol C; Rosenthal, Marjorie S

2014-03-01

To determine prevalence and correlates of need and unmet need for care coordination in a national sample of children with mental health conditions. Using data from the 2007 National Survey of Children's Health, we identified children aged 2 to 17 years with ≥1 mental health condition (attention-deficit/hyperactivity disorder, anxiety disorder, conduct disorder, or depression) who had received ≥2 types of preventive or subspecialty health services in the past year. We defined 2 outcome measures of interest: (1) prevalence of need for care coordination; and (2) prevalence of unmet need for care coordination in those with a need. Logistic regression models were used to estimate associations of clinical, sociodemographic, parent psychosocial, and health care characteristics with the outcome measures. In our sample (N = 7501, representing an estimated 5,750,000 children), the prevalence of having any need for care coordination was 43.2%. Among parents reporting a need for care coordination, the prevalence of unmet need was 41.2%. Higher risk of unmet need for care coordination was associated with child anxiety disorder, parenting stress, lower income, and public or no insurance. Parents reporting social support and receipt of family-centered care had a lower risk of unmet need for care coordination. Approximately 40% of parents of children with mental health conditions who reported a need for care coordination also reported that their need was unmet. Delivery of family-centered care and enhancing family supports may help to reduce unmet need for care coordination in this vulnerable population.

Patient-centered medical home model: do school-based health centers fit the model?

PubMed

Larson, Satu A; Chapman, Susan A

2013-01-01

School-based health centers (SBHCs) are an important component of health care reform. The SBHC model of care offers accessible, continuous, comprehensive, family-centered, coordinated, and compassionate care to infants, children, and adolescents. These same elements comprise the patient-centered medical home (PCMH) model of care being promoted by the Affordable Care Act with the hope of lowering health care costs by rewarding clinicians for primary care services. PCMH survey tools have been developed to help payers determine whether a clinician/site serves as a PCMH. Our concern is that current survey tools will be unable to capture how a SBHC may provide a medical home and therefore be denied needed funding. This article describes how SBHCs might meet the requirements of one PCMH tool. SBHC stakeholders need to advocate for the creation or modification of existing survey tools that allow the unique characteristics of SBHCs to qualify as PCMHs.

Algorithm design for a gun simulator based on image processing

NASA Astrophysics Data System (ADS)

Liu, Yu; Wei, Ping; Ke, Jun

2015-08-01

In this paper, an algorithm is designed for shooting games under strong background light. Six LEDs are uniformly distributed on the edge of a game machine screen. They are located at the four corners and in the middle of the top and the bottom edges. Three LEDs are enlightened in the odd frames, and the other three are enlightened in the even frames. A simulator is furnished with one camera, which is used to obtain the image of the LEDs by applying inter-frame difference between the even and odd frames. In the resulting images, six LED are six bright spots. To obtain the LEDs' coordinates rapidly, we proposed a method based on the area of the bright spots. After calibrating the camera based on a pinhole model, four equations can be found using the relationship between the image coordinate system and the world coordinate system with perspective transformation. The center point of the image of LEDs is supposed to be at the virtual shooting point. The perspective transformation matrix is applied to the coordinate of the center point. Then we can obtain the virtual shooting point's coordinate in the world coordinate system. When a game player shoots a target about two meters away, using the method discussed in this paper, the calculated coordinate error is less than ten mm. We can obtain 65 coordinate results per second, which meets the requirement of a real-time system. It proves the algorithm is reliable and effective.

Extended Follow-Up Frequently Asked Questions | Division of Cancer Prevention

Cancer.gov

1. What is the PLCO Central Data Coordinating Center?The PLCO Central Data Coordinating Center (CDCC) is an extension of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. The extension will be coordinated by one site under the direction of the National Cancer Institute (NCI) rather than ten PLCO Screening Centers to reduce costs. Westat which has served

Payment and Care for Hematopoietic Cell Transplantation Patients: Toward a Specialized Medical Home for Complex Care Patients.

PubMed

Gajewski, James L; McClellan, Mark B; Majhail, Navneet S; Hari, Parameswaran N; Bredeson, Christopher N; Maziarz, Richard T; LeMaistre, Charles F; Lill, Michael C; Farnia, Stephanie H; Komanduri, Krishna V; Boo, Michael J

2018-01-01

Patient-centered medical home models are fundamental to the advanced alternative payment models defined in the Medicare Access and Children's Health Insurance Plan Reauthorization Act (MACRA). The patient-centered medical home is a model of healthcare delivery supported by alternative payment mechanisms and designed to promote coordinated medical care that is simultaneously patient-centric and population-oriented. This transformative care model requires shifting reimbursement to include a per-patient payment intended to cover services not previously reimbursed such as disease management over time. Payment is linked to quality measures, including proportion of care delivered according to predefined pathways and demonstrated impact on outcomes. Some medical homes also include opportunities for shared savings by reducing overall costs of care. Recent proposals have suggested expanding the medical home model to specialized populations with complex needs because primary care teams may not have the facilities or the requisite expertise for their unique needs. An example of a successful care model that may provide valuable lessons for those creating specialty medical home models already exists in many hematopoietic cell transplantation (HCT) centers that deliver multidisciplinary, coordinated, and highly specialized care. The integration of care delivery in HCT centers has been driven by the specialty care their patients require and by the payment methodology preferred by the commercial payers, which has included bundling of both inpatient and outpatient care in the peritransplant interval. Commercial payers identify qualified HCT centers based on accreditation status and comparative performance, enabled in part by center-level comparative performance data available within a national outcomes database mandated by the Stem Cell Therapeutic and Research Act of 2005. Standardization across centers has been facilitated via voluntary accreditation implemented by Foundation for the Accreditation of Cell Therapy. Payers have built on these community-established programs and use public outcomes and program accreditation as standards necessary for inclusion in specialty care networks and contracts. Although HCT centers have not been described as medical homes, most HCT providers have already developed the structures that address critical requirements of MACRA for medical homes. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Arkansas Public Higher Education Operating & Capital Recommendations, 2009-2011 Biennium. 6-A. Volume 1: Universities

ERIC Educational Resources Information Center

Arkansas Department of Higher Education, 2008

2008-01-01

At its April 25, 2008 meeting, the Arkansas Higher Education Coordinating Board (AHECB) approved the funding models for the two-year colleges, the universities, and the technical centers. These models had been developed in conjunction with the presidents and chancellors after numerous meetings and revisions. The funding models were used to develop…

Global Ocean Prediction with the HYbrid Coordinate Ocean Model, HYCOM

NASA Astrophysics Data System (ADS)

Chassignet, E.

A broad partnership of institutions is collaborating in developing and demonstrating the performance and application of eddy-resolving, real-time global and Atlantic ocean prediction systems using the the HYbrid Coordinate Ocean Model (HYCOM). These systems will be transitioned for operational use by both the U.S. Navy at the Naval Oceanographic Office (NAVOCEANO), Stennis Space Center, MS, and the Fleet Numerical Meteorology and Oceanography Centre (FNMOC), Monterey, CA, and by NOAA at the National Centers for Environmental Prediction (NCEP), Washington, D.C. These systems will run efficiently on a variety of massively parallel computers and will include sophisticated data assimilation techniques for assimilation of satellite altimeter sea surface height and sea surface temperature as well as in situ temperature, salinity, and float displacement. The Partnership addresses the Global Ocean Data Assimilation Experiment (GODAE) goals of three-dimensional (3D) depiction of the ocean state at fine resolution in real-time and provision of boundary conditions for coastal and regional models. An overview of the effort will be presented.

Lensing in the geodesic light-cone coordinates and its (exact) illustration to an off-center observer in Lemaȋtre-Tolman-Bondi models

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

Fanizza, G.; Nugier, F., E-mail: giuseppe.fanizza@ba.infn.it, E-mail: fabienjean.nugier@unibo.it

We present in this paper a new application of the geodesic light-cone (GLC) gauge for weak lensing calculations. Using interesting properties of this gauge, we derive an exact expression of the amplification matrix—involving convergence, magnification and shear—and of the deformation matrix—involving the optical scalars. These expressions are simple and non-perturbative as long as no caustics are created on the past light-cone and are, by construction, free from the thin lens approximation. We apply these general expressions on the example of an Lemaȋtre-Tolman-Bondi (LTB) model with an off-center observer and obtain explicit forms for the lensing quantities as a direct consequencemore » of the non-perturbative transformation between GLC and LTB coordinates. We show their evolution in redshift after a numerical integration, for underdense and overdense LTB models, and interpret their respective variations in the simple non-curvature case.« less

Leveraging the principles of osteopathic medicine to improve diabetes outcomes within a new era of health care reform.

PubMed

Ciervo, Carman A; Shubrook, Jay H; Grundy, Paul

2015-04-01

First introduced conceptually decades before the passage of the Patient Protection and Affordable Care Act, the patient-centered medical home (PCMH) has evolved as a foundational element within the larger health care system or medical neighborhood, highlighting a coordinated and comprehensive disease management approach centered on intensive primary care interventions. More recently, in the wake of health care reform, accountable care organizations (ACOs) have been established to help health plans, physicians, hospitals, home health care practitioners, and other health care providers better coordinate care through an incentive-based payment arrangement. Osteopathic medicine is poised to proactively capitalize on these emerging health care models, with the anticipated end result of improved quality of care and reduced health care costs. As such, osteopathic physicians involved in the prevention and care of patients with type 2 diabetes mellitus need to identify models, best practices, and solutions to advance the medical neighborhood.

Mandibular kinematics represented by a non-orthogonal floating axis joint coordinate system.

PubMed

Leader, Joseph K; Boston, J Robert; Debski, Richard E; Rudy, Thomas E

2003-02-01

There are many methods used to represent joint kinematics (e.g., roll, pitch, and yaw angles; instantaneous center of rotation; kinematic center; helical axis). Often in biomechanics internal landmarks are inferred from external landmarks. This study represents mandibular kinematics using a non-orthogonal floating axis joint coordinate system based on 3-D geometric models with parameters that are "clinician friendly" and mathematically rigorous. Kinematics data for two controls were acquired from passive fiducial markers attached to a custom dental clutch. The geometric models were constructed from MRI data. The superior point along the arc of the long axis of the condyle was used to define the coordinate axes. The kinematic data and geometric models were registered through fiducial markers visible during both protocols. The mean absolute maxima across the subjects for sagittal rotation, coronal rotation, axial rotation, medial-lateral translation, anterior-posterior translation, and inferior-superior translation were 34.10 degrees, 1.82 degrees, 1.14 degrees, 2.31, 21.07, and 6.95 mm, respectively. All the parameters, except for one subject's axial rotation, were reproducible across two motion recording sessions. There was a linear correlation between sagittal rotation and translation, the dominant motion plane, with approximately 1.5 degrees of rotation per millimeter of translation. The novel approach of combining the floating axis system with geometric models succinctly described mandibular kinematics with reproducible and clinician friendly parameters.

75 FR 22607 - Board of Scientific Counselors, Coordinating Center for Infectious Diseases (CCID)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of Scientific Counselors, Coordinating Center for Infectious Diseases (CCID) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and...

The HYCOM (HYbrid Coordinate Ocean Model) Data Assimilative System

DTIC Science & Technology

2007-06-01

Systems Inc., Stennis Space Center. MS, USA d SHOM/CMO, Toulouse. France € Los Alamos National Laboratory, Los Alamos, NM. USA Received 1 October 2004...Global Ocean Data Assimilation ’U. of Miami, NRL, Los Alamos, NOAA/NCEP, NOAA/AOML, Experiment (GODAE). GODAE is a coordinated inter- NOAA/PMEL, PSI...of Miami, the Naval all three approaches and the optimal distribution is Research Laboratory (NRL), and the Los Alamos chosen at every time step. The

Arkansas Public Higher Education Operating Recommendations: Fiscal Year 2010-11. Volume 1: Universities

ERIC Educational Resources Information Center

Arkansas Department of Higher Education, 2010

2010-01-01

At its April 25, 2008 meeting, the Arkansas Higher Education Coordinating Board approved the funding models for the two-year colleges, universities, and the technical centers (former technical institutes merged with universities). These models had been developed in conjunction with presidents and chancellors after meetings and revisions. The…

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

PubMed

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

2011-01-01

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

Optimal coordination of maximal-effort horizontal and vertical jump motions – a computer simulation study

PubMed Central

Nagano, Akinori; Komura, Taku; Fukashiro, Senshi

2007-01-01

Background The purpose of this study was to investigate the coordination strategy of maximal-effort horizontal jumping in comparison with vertical jumping, using the methodology of computer simulation. Methods A skeletal model that has nine rigid body segments and twenty degrees of freedom was developed. Thirty-two Hill-type lower limb muscles were attached to the model. The excitation-contraction dynamics of the contractile element, the tissues around the joints to limit the joint range of motion, as well as the foot-ground interaction were implemented. Simulations were initiated from an identical standing posture for both motions. Optimal pattern of the activation input signal was searched through numerical optimization. For the horizontal jumping, the goal was to maximize the horizontal distance traveled by the body's center of mass. For the vertical jumping, the goal was to maximize the height reached by the body's center of mass. Results As a result, it was found that the hip joint was utilized more vigorously in the horizontal jumping than in the vertical jumping. The muscles that have a function of joint flexion such as the m. iliopsoas, m. rectus femoris and m. tibialis anterior were activated to a greater level during the countermovement in the horizontal jumping with an effect of moving the body's center of mass in the forward direction. Muscular work was transferred to the mechanical energy of the body's center of mass more effectively in the horizontal jump, which resulted in a greater energy gain of the body's center of mass throughout the motion. Conclusion These differences in the optimal coordination strategy seem to be caused from the requirement that the body's center of mass needs to be located above the feet in a vertical jumping, whereas this requirement is not so strict in a horizontal jumping. PMID:17543118

A Model for Integrating Ambulatory Surgery Centers Into an Academic Health System Using a Novel Ambulatory Surgery Coordinating Council.

PubMed

Ishii, Lisa; Pronovost, Peter J; Demski, Renee; Wylie, Gill; Zenilman, Michael

2016-06-01

An increasing volume of ambulatory surgeries has led to an increase in the number of ambulatory surgery centers (ASCs). Some academic health systems have aligned with ASCs to create a more integrated care delivery system. Yet, these centers are diverse in many areas, including specialty types, ownership models, management, physician employment, and regulatory oversight. Academic health systems then face challenges in integrating these ASCs into their organizations. Johns Hopkins Medicine created the Ambulatory Surgery Coordinating Council in 2014 to manage, standardize, and promote peer learning among its eight ASCs. The Armstrong Institute for Patient Safety and Quality provided support and a model for this organization through its quality management infrastructure. The physician-led council defined a mission and created goals to identify best practices, uniformly provide the highest-quality patient-centered care, and continuously improve patient outcomes and experience across ASCs. Council members built trust and agreed on a standardized patient safety and quality dashboard to report measures that include regulatory, care process, patient experience, and outcomes data. The council addressed unintentional outcomes and process variation across the system and agreed to standard approaches to optimize quality. Council members also developed a process for identifying future goals, standardizing care practices and electronic medical record documentation, and creating quality and safety policies. The early success of the council supports the continuation of the Armstrong Institute model for physician-led quality management. Other academic health systems can learn from this model as they integrate ASCs into their complex organizations.

Building Student and Family-Centered Care Coordination Through Ongoing Delivery System Design.

PubMed

Baker, Dian; Anderson, Lori; Johnson, Jody

2017-01-01

In 2016 the National Association of School Nurses released an updated framework for school nurse practice. One highlight of the new framework is 21st century care coordination. That is, moving beyond basic case management to a systems-level approach for delivery of school health services. The framework broadly applies the term care coordination to include direct care and communication across systems. School nurses are often engaged in efforts to create school health care homes that serve as an axis of coordination for students and families between primary care offices and the schools. Effective care coordination requires that the school nurses not only know the principles of traditional case management but also understand complex systems that drive effective care coordination. The outcome of a system-level approach is enhanced access to services in an integrated health care delivery system that includes the school nurse as an integral member of the school's health care team. This article presents a comprehensive, system-level model of care coordination for school nurse leadership and practice.

Frequently Asked Questions about Improved Academic Performance

EPA Pesticide Factsheets

A healthy school environment is one of the keys to keeping young minds and bodies strong. In fact, a healthy school environment is one of eight core components in the Centers for Disease Control and Prevention (CDC) model “Healthy Youth! Coordinated

Collective coordinates theory for discrete soliton ratchets in the sine-Gordon model

NASA Astrophysics Data System (ADS)

Sánchez-Rey, Bernardo; Quintero, Niurka R.; Cuevas-Maraver, Jesús; Alejo, Miguel A.

2014-10-01

A collective coordinate theory is developed for soliton ratchets in the damped discrete sine-Gordon model driven by a biharmonic force. An ansatz with two collective coordinates, namely the center and the width of the soliton, is assumed as an approximated solution of the discrete nonlinear equation. The dynamical equations of these two collective coordinates, obtained by means of the generalized travelling wave method, explain the mechanism underlying the soliton ratchet and capture qualitatively all the main features of this phenomenon. The numerical simulation of these equations accounts for the existence of a nonzero depinning threshold, the nonsinusoidal behavior of the average velocity as a function of the relative phase between the harmonics of the driver, the nonmonotonic dependence of the average velocity on the damping, and the existence of nontransporting regimes beyond the depinning threshold. In particular, it provides a good description of the intriguing and complex pattern of subspaces corresponding to different dynamical regimes in parameter space.

Collective coordinates theory for discrete soliton ratchets in the sine-Gordon model.

PubMed

Sánchez-Rey, Bernardo; Quintero, Niurka R; Cuevas-Maraver, Jesús; Alejo, Miguel A

2014-10-01

A collective coordinate theory is developed for soliton ratchets in the damped discrete sine-Gordon model driven by a biharmonic force. An ansatz with two collective coordinates, namely the center and the width of the soliton, is assumed as an approximated solution of the discrete nonlinear equation. The dynamical equations of these two collective coordinates, obtained by means of the generalized travelling wave method, explain the mechanism underlying the soliton ratchet and capture qualitatively all the main features of this phenomenon. The numerical simulation of these equations accounts for the existence of a nonzero depinning threshold, the nonsinusoidal behavior of the average velocity as a function of the relative phase between the harmonics of the driver, the nonmonotonic dependence of the average velocity on the damping, and the existence of nontransporting regimes beyond the depinning threshold. In particular, it provides a good description of the intriguing and complex pattern of subspaces corresponding to different dynamical regimes in parameter space.

Percolation Network Study on the Gas Apparent Permeability of Rock

NASA Astrophysics Data System (ADS)

Wang, Y.; Tang, Y. B.; Li, M.

2017-12-01

We modeled the gas single phase transport behaviors of monomodal porous media using percolation networks. Different from the liquid absolute permeability, which is only related to topology and morphology of pore space, the gas permeability depends on pore pressure as well. A published gas flow conductance model, included usual viscous flow, slip flow and Knudsen diffusion in cylinder pipe, was used to simulated gas flow in 3D, simple cubic, body-center cubic and face-center cubic networks with different hydraulic radius, different coordination number, and different pipe radius distributions under different average pore pressure. The simulation results showed that the gas apparent permeability kapp obey the `universal' scaling law (independence of network lattices), kapp (z-zc)β, where exponent β is related to pore radius distribution, z is coordination number and zc=1.5. Following up on Bernabé et al.'s (2010) study of the effects of pore connectivity and pore size heterogeneity on liquid absolute permeability, gas apparent permeability kapp model and a new joint gas-liquid permeability (i.e., kapp/k∞) model, which could explain the Klinkenberg phenomenon, were proposed. We satisfactorily tested the models by comparison with published experimental data on glass beads and other datasets.

Survey on Early Childhood Advisory Councils. NGA Center for Best Practices Backgrounder

ERIC Educational Resources Information Center

National Governors Association, 2007

2007-01-01

During fall 2007, the NGA Center surveyed states regarding the presence and nature of state early childhood coordinating councils, which may exist as Early Learning Councils, Task Forces, Children's Cabinets, Interagency Coordinating Councils, etc. For brevity, these coordinating entities are referred to below as Early Childhood Advisory Councils…

Environmental Modeling Center / Marine Modeling and Analysis Branch

Science.gov Websites

Ocean Waves Sea Ice SST Marine Met. Real Time Ocean Forecasting System (RTOFS) Global RTOFS A hybrid time (0Z) out to 144 hours (6 days). Atlantic RTOFS Discontinued A hybrid coordinate, nominally 1/12Â initial time (0Z) out to 144 hours (6 days). Fukushima Tracers NCEP/NWS deployed three-dimensional

Care coordination in epilepsy: Measuring neurologists' connectivity using social network analysis.

PubMed

Altalib, Hamada Hamid; Fenton, Brenda T; Cheung, Kei-Hoi; Pugh, Mary Jo V; Bates, Jonathan; Valente, Thomas W; Kerns, Robert D; Brandt, Cynthia A

2017-08-01

The study sought to quantify coordination of epilepsy care, over time, between neurologists and other health care providers using social network analysis (SNA). The Veterans Health Administration (VA) instituted an Epilepsy Center of Excellence (ECOE) model in 2008 to enhance care coordination between neurologists and other health care providers. Provider networks in the 16 VA ECOE facilities (hub sites) were compared to a subset of 33 VA facilities formally affiliated (consortium sites) and 14 unaffiliated VA facilities. The number of connections between neurologists and each provider (node degree) was measured by shared epilepsy patients and tallied to generate estimates at the facility level separately within and across facilities. Mixed models were used to compare change of facility-level node degree over time across the three facility types, adjusted for number of providers per facility. Over the time period 2000-2013, epilepsy care coordination both within and across facilities significantly increased. These increases were seen in all three types of facilities namely hub, consortium, and unaffiliated site, relatively equally. The increase in connectivity was more dramatic with providers across facilities compared to providers within the same facilities. Establishment of the ECOE hub and spoke model contributed to an increase in epilepsy care coordination both within and across facilities from 2000 to 2013, but there was substantial variation across different facilities. SNA is a tool that may help measure coordination of specialty care. Published by Elsevier Inc.

14 CFR 1213.104 - Public information coordination and concurrence.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and published by the NASA Assistant Administrator for Public Affairs. (b) Coordination. To ensure... offices and approved by the Center Director and Center Public Affairs Director. The Center Public Affairs Director is required to provide proper notification to the Office of Public Affairs, NASA Headquarters...

Evaluating the Sustainability of School-Based Health Centers.

PubMed

Navarro, Stephanie; Zirkle, Dorothy L; Barr, Donald A

2017-01-01

The United States is facing a surge in the number of school-based health centers (SBHCs) owing to their success in delivering positive health outcomes and increasing access to care. To preserve this success, experts have developed frameworks for creating sustainable SBHCs; however, little research has affirmed or added to these models. This research seeks to analyze elements of sustainability in a case study of three SBHCs in San Diego, California, with the purpose of creating a research-based framework of SBHC sustainability to supplement expertly derived models. Using a mixed methods study design, data were collected from interviews with SBHC stakeholders, observations in SBHCs, and SBHC budgets. A grounded theory qualitative analysis and a quantitative budget analysis were completed to develop a theoretical framework for the sustainability of SBHCs. Forty-one interviews were conducted, 6 hours of observations were completed, and 3 years of SBHC budgets were analyzed to identify care coordination, community buy-in, community awareness, and SBHC partner cooperation as key themes of sustainability promoting patient retention for sustainable billing and reimbursement levels. These findings highlight the unique ways in which SBHCs gain community buy-in and awareness by becoming trusted sources of comprehensive and coordinated care within communities and among vulnerable populations. Findings also support ideas from expert models of SBHC sustainability calling for well-defined and executed community partnerships and quality coordinated care in the procurement of sustainable SBHC funding.

Safety-net providers in some US communities have increasingly embraced coordinated care models.

PubMed

Cunningham, Peter; Felland, Laurie; Stark, Lucy

2012-08-01

Safety-net organizations, which provide health services to uninsured and low-income people, increasingly are looking for ways to coordinate services among providers to improve access to and quality of care and to reduce costs. In this analysis, a part of the Community Tracking Study, we examined trends in safety-net coordination activities from 2000 to 2010 within twelve communities in the United States and found a notable increase in such activities. Six of the twelve communities had made formal efforts to link uninsured people to medical homes and coordinate care with specialists in 2010, compared to only two communities in 2000. We also identified key attributes of safety-net coordinated care systems, such as reliance on a medical home for meeting patients' primary care needs, and lingering challenges to safety-net integration, such as competition among hospitals and community health centers for Medicaid patients.

Incorporation of local structure into kriging models for the prediction of atomistic properties in the water decamer.

PubMed

Davie, Stuart J; Di Pasquale, Nicodemo; Popelier, Paul L A

2016-10-15

Machine learning algorithms have been demonstrated to predict atomistic properties approaching the accuracy of quantum chemical calculations at significantly less computational cost. Difficulties arise, however, when attempting to apply these techniques to large systems, or systems possessing excessive conformational freedom. In this article, the machine learning method kriging is applied to predict both the intra-atomic and interatomic energies, as well as the electrostatic multipole moments, of the atoms of a water molecule at the center of a 10 water molecule (decamer) cluster. Unlike previous work, where the properties of small water clusters were predicted using a molecular local frame, and where training set inputs (features) were based on atomic index, a variety of feature definitions and coordinate frames are considered here to increase prediction accuracy. It is shown that, for a water molecule at the center of a decamer, no single method of defining features or coordinate schemes is optimal for every property. However, explicitly accounting for the structure of the first solvation shell in the definition of the features of the kriging training set, and centring the coordinate frame on the atom-of-interest will, in general, return better predictions than models that apply the standard methods of feature definition, or a molecular coordinate frame. © 2016 The Authors. Journal of Computational Chemistry Published by Wiley Periodicals, Inc. © 2016 The Authors. Journal of Computational Chemistry Published by Wiley Periodicals, Inc.

The Oral Health Care Manager in a Patient-Centered Health Facility.

PubMed

Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley

2016-06-01

The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

Bringing Wellness to Schools: Opportunities and Challenges to Mental Health Integration in School Health Centers

PubMed Central

Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H.

2016-01-01

Objective School-based health centers (SBHCs) reduce mental health access-to-care barriers and improve educational outcomes for youth. This qualitative study evaluates the innovations and challenges of a unique network of SBHCs in a large, urban school district, as they attempt to integrate health, mental health, and educational services. Methods The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semi-structured interviews with each participant were audio-recorded and transcribed. Themes were identified and coded using Atlas.ti 5.1, and collapsed into three domains: Operations, Partnership, and Engagement. Results Interviews revealed provider models ranging from single agencies offering both health and mental health services to co-located services. Sites with the Health Agency providing at least some mental health services reported more mental health screenings. Many sites utilized SBHC coordinators and coordination team meetings to facilitate relationships between schools and Health Agency and Community Mental Health Clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement, through culturally sensitive services, peer health advocates, and “drop-in” lunches. Conclusions Staffing and operational models are critical in the success of health-mental health-education integration. Among the provider models observed, the combined health and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions for operational problems and family engagement in mental health services. Implications for future SBHCs as an integrated model are described. PMID:27417895

Luminescence of silicon dioxide different polymorph modification: Silica glass, α-quartz, stishovite, coesite

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

Trukhin, A. N., E-mail: truhins@cfi.lu.lv

2014-10-21

Stishovite, coesite, oxygen deficient silica glass as well as irradiated α-quartz, exhibit two luminescence bands: a blue one and an UV one both excitable in the range within optical gap. There are similarities in spectral position and in luminescence decay kinetics among centers in these materials. The interpretation was done on the model of Oxygen Deficient Centers (ODC) [1]. The ODC(II) or twofold coordinated silicon and ODC(I) are distinguished. ODC(I) is object of controversial interpretation. The Si-Si oxygen vacancy [2] and complex defect including latent twofold coordinated silicon [3] are proposed. Remarkably, this luminescence center does not exist in asmore » grown crystalline α-quartz. However, destructive irradiation of α-quartz crystals with fast neutrons, γ rays, or dense electron beams [4–6] creates ODC(I) like defect. In tetrahedron structured coesite the self trapped exciton (STE) luminescence observed with high energetic yield (∼30%) like in α-quartz crystals. STE in coesite coexists with oxygen deficient-like center. In octahedron structured stishovite STE was not found and only ODC exists.« less

Application of theory to family-centered care: a role for social workers.

PubMed

Miller, Gary

2012-01-01

Family-centered care is an emerging trend in health care settings today. An explanation, principles, and a definition of family-centered care are offered and discussed. A theoretical framework, Balance Theory of Coordination, which can be utilized by social workers to develop and enhance family-centered care practices, is explained and discussed. Various family-centered care practices are examined within the context of Balance Theory of Coordination as examples.

Dissemination and adoption of the advanced primary care model in the Maryland multi-payer patient centered medical home program.

PubMed

Khanna, Niharika; Shaya, Fadia; Chirikov, Viktor; Steffen, Ben; Sharp, David

2014-02-01

The Maryland Learning Collaborative together with the Maryland Multi-Payer Program transformed 52 medical practices into patient-centered medical homes (PCMH). The Maryland Learning Collaborative developed an Internet-based 14-question Likert scale survey to assess the impact of the PCMH model on practices and providers, concerning how this new method is affecting patient care and outcomes. The survey was sent to 339 practitioners and 52 care management teams at 18 months into the program. Sixty-seven survey results were received and analyzed. After 18 months of participation in the PCMH initiative, participants demonstrated a better understanding of the PCMH initiative, improved patient access to care, improved care coordination, and increased health information technology optimization (p > .001). The findings from the survey evaluation suggest that practice participation in the Maryland Multi-Payer Program has enhanced access to care, influenced patient outcomes, improved care coordination, and increased use of health information technology.

NASA's Internal Space Weather Working Group

NASA Technical Reports Server (NTRS)

St. Cyr, O. C.; Guhathakurta, M.; Bell, H.; Niemeyer, L.; Allen, J.

2011-01-01

Measurements from many of NASA's scientific spacecraft are used routinely by space weather forecasters, both in the U.S. and internationally. ACE, SOHO (an ESA/NASA collaboration), STEREO, and SDO provide images and in situ measurements that are assimilated into models and cited in alerts and warnings. A number of years ago, the Space Weather laboratory was established at NASA-Goddard, along with the Community Coordinated Modeling Center. Within that organization, a space weather service center has begun issuing alerts for NASA's operational users. NASA's operational user community includes flight operations for human and robotic explorers; atmospheric drag concerns for low-Earth orbit; interplanetary navigation and communication; and the fleet of unmanned aerial vehicles, high altitude aircraft, and launch vehicles. Over the past three years we have identified internal stakeholders within NASA and formed a Working Group to better coordinate their expertise and their needs. In this presentation we will describe this activity and some of the challenges in forming a diverse working group.

The JPL Neptune Radiation Model (NMOD)

NASA Technical Reports Server (NTRS)

Garrett, Henry; Evans, Robin

2017-01-01

The objective of this study is the development of a comprehensive radiation model of the Neptunian environment for JPL mission planning. The ultimate goal is to provide a description of the high-energy electron and proton environments and the magnetic field at Neptune that can be used for engineering design. The JPL Neptune Radiation Model (NMOD) models the high-energy electrons and protons between 0.025 MeV and 5 MeV based on the California Institute of Technology's Cosmic Ray Subsystem and the Applied Physics Laboratory's Low Energy Charged Particle Detector on Voyager 2. As in previous JPL radiation models, the form of the Neptunian model is based on magnetic field coordinates and requires a conversion from spacecraft coordinates to Neptunian-centered magnetic "B-L" coordinates. Two types of magnetic field models have been developed for Neptune: 1) simple "offset, tilted dipoles" (OTD), and 2) a complex, multi-pole expansion model ("O8"). A review of the existing data on Neptune and a search of the NASA Planetary Data System (PDS) were completed to obtain the most current descriptions of the Neptunian high-energy particle environment. These data were fit in terms of the O8 B-L coordinates to develop the electron and proton flux models. The flux predictions of the new model were used to estimate the total ionizing dose (TID) rate along the Neptunian equator, meridional flux contours for the electrons and protons, and for flux and dose comparisons with the other radiation belts in the Solar System.

Discrete-vortex model for the symmetric-vortex flow on cones

NASA Technical Reports Server (NTRS)

Gainer, Thomas G.

1990-01-01

A relatively simple but accurate potential flow model was developed for studying the symmetric vortex flow on cones. The model is a modified version of the model first developed by Bryson, in which discrete vortices and straight-line feeding sheets were used to represent the flow field. It differs, however, in the zero-force condition used to position the vortices and determine their circulation strengths. The Bryson model imposed the condition that the net force on the feeding sheets and discrete vortices must be zero. The proposed model satisfies this zero-force condition by having the vortices move as free vortices, at a velocity equal to at the local crossflow velocity at their centers. When the free-vortex assumption is made, a solution is obtained in the form of two nonlinear algebraic equations that relate the vortex center coordinates and vortex strengths to the cone angle and angle of attack. The vortex center locations calculated using the model are in good agreement with experimental values. The cone normal forces as well as center locations are in good agreement with the vortex cloud method of calculating symmetric flow fields.

The real-world problem of care coordination: a longitudinal qualitative study with patients living with advanced progressive illness and their unpaid caregivers.

PubMed

Daveson, Barbara A; Harding, Richard; Shipman, Cathy; Mason, Bruce L; Epiphaniou, Eleni; Higginson, Irene J; Ellis-Smith, Clare; Henson, Lesley; Munday, Dan; Nanton, Veronica; Dale, Jeremy R; Boyd, Kirsty; Worth, Allison; Barclay, Stephen; Donaldson, Anne; Murray, Scott

2014-01-01

To develop a model of care coordination for patients living with advanced progressive illness and their unpaid caregivers, and to understand their perspective regarding care coordination. A prospective longitudinal, multi-perspective qualitative study involving a case-study approach. Serial in-depth interviews were conducted, transcribed verbatim and then analyzed through open and axial coding in order to construct categories for three cases (sites). This was followed by continued thematic analysis to identify underlying conceptual coherence across all cases in order to produce one coherent care coordination model. Fifty-six purposively sampled patients and 27 case-linked unpaid caregivers. Three cases from contrasting primary, secondary and tertiary settings within Britain. Coordination is a deliberate cross-cutting action that involves high-quality, caring and well-informed staff, patients and unpaid caregivers who must work in partnership together across health and social care settings. For coordination to occur, it must be adequately resourced with efficient systems and services that communicate. Patients and unpaid caregivers contribute substantially to the coordination of their care, which is sometimes volunteered at a personal cost to them. Coordination is facilitated through flexible and patient-centered care, characterized by accurate and timely information communicated in a way that considers patients' and caregivers' needs, preferences, circumstances and abilities. Within the midst of advanced progressive illness, coordination is a shared and complex intervention involving relational, structural and information components. Our study is one of the first to extensively examine patients' and caregivers' views about coordination, thus aiding conceptual fidelity. These findings can be used to help avoid oversimplifying a real-world problem, such as care coordination. Avoiding oversimplification can help with the development, evaluation and implementation of real-world coordination interventions for patients and their unpaid caregivers in the future.

Scientific Benefits of Space Science Models Archiving at Community Coordinated Modeling Center

NASA Technical Reports Server (NTRS)

Kuznetsova, Maria M.; Berrios, David; Chulaki, Anna; Hesse, Michael; MacNeice, Peter J.; Maddox, Marlo M.; Pulkkinen, Antti; Rastaetter, Lutz; Taktakishvili, Aleksandre

2009-01-01

The Community Coordinated Modeling Center (CCMC) hosts a set of state-of-the-art space science models ranging from the solar atmosphere to the Earth's upper atmosphere. CCMC provides a web-based Run-on-Request system, by which the interested scientist can request simulations for a broad range of space science problems. To allow the models to be driven by data relevant to particular events CCMC developed a tool that automatically downloads data from data archives and transform them to required formats. CCMC also provides a tailored web-based visualization interface for the model output, as well as the capability to download the simulation output in portable format. CCMC offers a variety of visualization and output analysis tools to aid scientists in interpretation of simulation results. During eight years since the Run-on-request system became available the CCMC archived the results of almost 3000 runs that are covering significant space weather events and time intervals of interest identified by the community. The simulation results archived at CCMC also include a library of general purpose runs with modeled conditions that are used for education and research. Archiving results of simulations performed in support of several Modeling Challenges helps to evaluate the progress in space weather modeling over time. We will highlight the scientific benefits of CCMC space science model archive and discuss plans for further development of advanced methods to interact with simulation results.

A National Coordinating Center for Trauma Research

DTIC Science & Technology

2016-10-01

of ketamine during the first three days following injury has a sustained effect on reducing the incidence or severity of Post -Traumatic Stress... design , medical modeling, physical modeling, engineering and system integration. Progress Reported: The subcontract was fully executed on 05...were posted on the NTI website (www.nationaltraumainstitute.org). The goal is to comprehensively disseminate published works to the wider trauma

Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology

PubMed Central

Apte, Sachin M.; Patel, Kavita

2016-01-01

With the signing of the Medicare Access and CHIP Reauthorization Act in April 2015, the Centers for Medicare and Medicaid Services (CMS) is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology-related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology-specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations. Despite the positive results of some pilot programs, adoption remains limited. The goals are to eliminate unnecessary variation in cancer treatment, provide coordinated patient-centered care, while controlling costs. Yet, meaningful payment reform in oncology remains elusive. As the largest payer for oncology services in the United States, CMS has the leverage to make cancer services more value based. Thus far, the focus has been around pricing of physician-administered drugs with recent work in the area of the Oncology Medical Home. Gynecologic oncology is a unique sub-specialty that blends surgical and medical oncology, with treatment that often involves radiation therapy. This forward-thinking, multidisciplinary model works to keep the patient at the center of the care continuum and emphasizes care coordination. Because of the breadth and depth of gynecologic oncology, this sub-specialty has both the potential to be disrupted by payment reform as well as potentially benefit from the aspects of reform that can align incentives appropriately to improve coordination. Although the precise future payment models are unknown at this time, focused engagement of gynecologic oncologists and the full care team is imperative to assure that the practice remains patient centered, embodies the highest quality in research and education, yet transforms into a sustainable and agile sub-specialty to pro-actively and effectively manage the immense and relentless financial pressures and regulatory expectations that will be faced over the next decade. PMID:27148476

Payment Reform: Unprecedented and Evolving Impact on Gynecologic Oncology.

PubMed

Apte, Sachin M; Patel, Kavita

2016-01-01

With the signing of the Medicare Access and CHIP Reauthorization Act in April 2015, the Centers for Medicare and Medicaid Services (CMS) is now positioned to drive the development and implementation of sweeping changes to how physicians and hospitals are paid for the provision of oncology-related services. These changes will have a long-lasting impact on the sub-specialty of gynecologic oncology, regardless of practice structure, physician employment and compensation model, or local insurance market. Recently, commercial payers have piloted various models of payment reform via oncology-specific clinical pathways, oncology medical homes, episode payment arrangements, and accountable care organizations. Despite the positive results of some pilot programs, adoption remains limited. The goals are to eliminate unnecessary variation in cancer treatment, provide coordinated patient-centered care, while controlling costs. Yet, meaningful payment reform in oncology remains elusive. As the largest payer for oncology services in the United States, CMS has the leverage to make cancer services more value based. Thus far, the focus has been around pricing of physician-administered drugs with recent work in the area of the Oncology Medical Home. Gynecologic oncology is a unique sub-specialty that blends surgical and medical oncology, with treatment that often involves radiation therapy. This forward-thinking, multidisciplinary model works to keep the patient at the center of the care continuum and emphasizes care coordination. Because of the breadth and depth of gynecologic oncology, this sub-specialty has both the potential to be disrupted by payment reform as well as potentially benefit from the aspects of reform that can align incentives appropriately to improve coordination. Although the precise future payment models are unknown at this time, focused engagement of gynecologic oncologists and the full care team is imperative to assure that the practice remains patient centered, embodies the highest quality in research and education, yet transforms into a sustainable and agile sub-specialty to pro-actively and effectively manage the immense and relentless financial pressures and regulatory expectations that will be faced over the next decade.

Latest Community Coordinated Modeling Center (CCMC) services and innovative tools supporting the space weather research and operational communities.

NASA Astrophysics Data System (ADS)

Mendoza, A. M. M.; Rastaetter, L.; Kuznetsova, M. M.; Mays, M. L.; Chulaki, A.; Shim, J. S.; MacNeice, P. J.; Taktakishvili, A.; Collado-Vega, Y. M.; Weigand, C.; Zheng, Y.; Mullinix, R.; Patel, K.; Pembroke, A. D.; Pulkkinen, A. A.; Boblitt, J. M.; Bakshi, S. S.; Tsui, T.

2017-12-01

The Community Coordinated Modeling Center (CCMC), with the fundamental goal of aiding the transition of modern space science models into space weather forecasting while supporting space science research, has been serving as an integral hub for over 15 years, providing invaluable resources to both space weather scientific and operational communities. CCMC has developed and provided innovative web-based point of access tools varying from: Runs-On-Request System - providing unprecedented global access to the largest collection of state-of-the-art solar and space physics models, Integrated Space Weather Analysis (iSWA) - a powerful dissemination system for space weather information, Advanced Online Visualization and Analysis tools for more accurate interpretation of model results, Standard Data formats for Simulation Data downloads, and Mobile apps to view space weather data anywhere to the scientific community. In addition to supporting research and performing model evaluations, CCMC also supports space science education by hosting summer students through local universities. In this poster, we will showcase CCMC's latest innovative tools and services, and CCMC's tools that revolutionized the way we do research and improve our operational space weather capabilities. CCMC's free tools and resources are all publicly available online (http://ccmc.gsfc.nasa.gov).

75 FR 42448 - Board of Scientific Counselors (BSC), Coordinating Center for Health Promotion (CCHP): Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Board of Scientific Counselors (BSC), Coordinating Center for Health Promotion (CCHP): Notice of Charter Amendment... both the CDC and the Agency for Toxic Substances and Disease Registry. Dated: July 13, 2010. Elaine L...

Toroidal regularization of the guiding center Lagrangian

DOE PAGES

Burby, J. W.; Ellison, C. L.

2017-11-22

In the Lagrangian theory of guiding center motion, an effective magnetic field B* = B+ (m/e)v ∥∇ x b appears prominently in the equations of motion. Because the parallel component of this field can vanish, there is a range of parallel velocities where the Lagrangian guiding center equations of motion are either ill-defined or very badly behaved. Moreover, the velocity dependence of B* greatly complicates the identification of canonical variables and therefore the formulation of symplectic integrators for guiding center dynamics. Here, this letter introduces a simple coordinate transformation that alleviates both these problems simultaneously. In the new coordinates, themore » Liouville volume element is equal to the toroidal contravariant component of the magnetic field. Consequently, the large-velocity singularity is completely eliminated. Moreover, passing from the new coordinate system to canonical coordinates is extremely simple, even if the magnetic field is devoid of flux surfaces. We demonstrate the utility of this approach in regularizing the guiding center Lagrangian by presenting a new and stable one-step variational integrator for guiding centers moving in arbitrary time-dependent electromagnetic fields.« less

Toroidal regularization of the guiding center Lagrangian

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

Burby, J. W.; Ellison, C. L.

In the Lagrangian theory of guiding center motion, an effective magnetic field B* = B+ (m/e)v ∥∇ x b appears prominently in the equations of motion. Because the parallel component of this field can vanish, there is a range of parallel velocities where the Lagrangian guiding center equations of motion are either ill-defined or very badly behaved. Moreover, the velocity dependence of B* greatly complicates the identification of canonical variables and therefore the formulation of symplectic integrators for guiding center dynamics. Here, this letter introduces a simple coordinate transformation that alleviates both these problems simultaneously. In the new coordinates, themore » Liouville volume element is equal to the toroidal contravariant component of the magnetic field. Consequently, the large-velocity singularity is completely eliminated. Moreover, passing from the new coordinate system to canonical coordinates is extremely simple, even if the magnetic field is devoid of flux surfaces. We demonstrate the utility of this approach in regularizing the guiding center Lagrangian by presenting a new and stable one-step variational integrator for guiding centers moving in arbitrary time-dependent electromagnetic fields.« less

A modular, energy-based approach to the development of nickel containing molecular electrocatalysts for hydrogen production and oxidation.

PubMed

Shaw, Wendy J; Helm, Monte L; DuBois, Daniel L

2013-01-01

This review discusses the development of molecular electrocatalysts for H2 production and oxidation based on nickel. A modular approach is used in which the structure of the catalyst is divided into first, second, and outer coordination spheres. The first coordination sphere consists of the ligands bound directly to the metal center, and this coordination sphere can be used to control such factors as the presence or absence of vacant coordination sites, redox potentials, hydride donor abilities and other important thermodynamic parameters. The second coordination sphere includes functional groups such as pendent acids or bases that can interact with bound substrates such as H2 molecules and hydride ligands, but that do not form strong bonds with the metal center. These functional groups can play diverse roles such as assisting the heterolytic cleavage of H2, controlling intra- and intermolecular proton transfer reactions, and providing a physical pathway for coupling proton and electron transfer reactions. By controlling both the hydride donor ability of the catalysts using the first coordination sphere and the proton donor abilities of the functional groups in the second coordination sphere, catalysts can be designed that are biased toward H2 production, oxidation, or bidirectional (catalyzing both H2 oxidation and production). The outer coordination sphere is defined as that portion of the catalytic system that is beyond the second coordination sphere. This coordination sphere can assist in the delivery of protons and electrons to and from the catalytically active site, thereby adding another important avenue for controlling catalytic activity. Many features of these simple catalytic systems are good models for enzymes, and these simple systems provide insights into enzyme function and reactivity that may be difficult to probe in enzymes. This article is part of a Special Issue entitled: Metals in Bioenergetics and Biomimetics Systems. Copyright © 2013 Elsevier B.V. All rights reserved.

How Sensor, Signal, and Imaging Informatics May Impact Patient Centered Care and Care Coordination

PubMed Central

Moreau-Gaudry, A.

2015-01-01

Summary Objective This synopsis presents a selection for the IMIA (International Medical Informatics Association) Yearbook 2015 of excellent research in the broad field of Sensor, Signal, and Imaging Informatics published in the year 2014, with a focus on patient centered care coordination. Methods The two section editors performed a systematic initial selection and a double blind peer review process to select a list of candidate best papers in the domain published in 2014, from the PubMed and Web of Science databases. A set of MeSH keywords provided by experts was used. This selection was peer-reviewed by external reviewers. Results The review process highlighted articles illustrating two current trends related to care coordination and patient centered care: the enhanced capacity to predict the evolution of a disease based on patient-specific information can impact care coordination; similarly, better perception of the patient and his treatment could lead to enhanced personalized care with a potential impact on care coordination. Conclusions This review shows the multiplicity of angles from which the question of patient-centered care can be addressed, with consequences on care coordination that will need to be confirmed and demonstrated in the future. PMID:26293856

Preface Article for the Atmospheric Environment Special Issue on AQMEII Phase 2

EPA Science Inventory

Since its start in 2008, the Air Quality Model Evaluation International Initiative (AQMEII), coordinated by the European-Commission Joint Research Center (JRC) and the US-Environmental Protection Agency (EPA) has had as its primary goal the collaboration of the European and North...

Community Coordinated Modeling Center: Addressing Needs of Operational Space Weather Forecasting

NASA Technical Reports Server (NTRS)

Kuznetsova, M.; Maddox, M.; Pulkkinen, A.; Hesse, M.; Rastaetter, L.; Macneice, P.; Taktakishvili, A.; Berrios, D.; Chulaki, A.; Zheng, Y.;

Analyzing Impact Area of Osym Offices in Istanbul by Idw Method

NASA Astrophysics Data System (ADS)

Kalkan, Y.; Ozturk, O.; Gülnerman, A. G.; Bilgi, S.

2016-12-01

OSYM is the main institute for organizing the national level large scale exams in Turkey. According to the Ministry of National Education of Turkey data, there are 17.588.958 students in the country. Therefore, OSYM has a significant role for everyone from every level of education. More than 15% of the total students are studying in Istanbul. These students have various exams throughout a year, which brings some procedures for each exam to be applied. OSYM Coordination Offices were founded to meet the demands and procedures of these exams and applicants. There are 9 Coordination Offices in Istanbul. Moreover, OSYM Application Centers were founded as support units to OSYM Coordination Offices. These units are under the high schools. There are 67 OSYM Application Centers in Istanbul. In the study, spatial distribution of OSYM Coordination Offices and OSYM Application Centers in Istanbul have been studied related to the transportation network of each district of Istanbul city. Origin Destination Cost Matrix (ODCM) and Invers Distance Weighting (IDW) Method were used to visualize the distribution of OSYM Coordination Offices and Application Centers accessibilities. ODCM measures the nearest paths along the transportation network from origins to destinations. IDW is one of the several interpolation methods allocating values to unknown points. ODCM Method was used to calculate the distances over the transportation network. The results obtained from ODCM Method were used in IDW Method to interpolate the weightings of the OSYM offices and centers. Accessibility of the OSYM Coordination Offices and Application Centers has been detected according to surrounding transportation network. Spatial distribution of existing offices and application centers were evaluated by districts of Istanbul city in conclusion of the study by the ODCM and IDW Methods.

An isocenter estimation tool for proton gantry alignment

NASA Astrophysics Data System (ADS)

Hansen, Peter; Hu, Dongming

2017-12-01

A novel tool has been developed to automate the process of locating the isocenter, center of rotation, and sphere of confusion of a proton therapy gantry. The tool uses a Radian laser tracker to estimate how the coordinate frame of the front-end beam-line components changes as the gantry rotates. The coordinate frames serve as an empirical model of gantry flexing. Using this model, the alignment of the front and back-end beam-line components can be chosen to minimize the sphere of confusion, improving the overall beam positioning accuracy of the gantry. This alignment can be performed without the beam active, improving the efficiency of installing new systems at customer sites.

High-spin europium and gadolinium centers in yttrium-aluminum garnet

NASA Astrophysics Data System (ADS)

Vazhenin, V. A.; Potapov, A. P.; Asatryan, G. R.; Uspenskaya, Yu. A.; Petrosyan, A. G.; Fokin, A. V.

2016-08-01

Electron-spin resonance spectra of Eu2+ and Gd3+ centers substituting Y3+ ions in single-crystal yttrium-aluminum garnet have been studied and the parameters of their rhombic spin Hamiltonian have been determined. The fine-structure parameters of the above ions have been calculated in the superposition model disregarding changes in the angular coordinates of the ligand environment of the impurity defect thus demonstrating the necessity of taking these changes into account.

Models and applications for space weather forecasting and analysis at the Community Coordinated Modeling Center.

NASA Astrophysics Data System (ADS)

Kuznetsova, Maria

The Community Coordinated Modeling Center (CCMC, http://ccmc.gsfc.nasa.gov) was established at the dawn of the new millennium as a long-term flexible solution to the problem of transition of progress in space environment modeling to operational space weather forecasting. CCMC hosts an expanding collection of state-of-the-art space weather models developed by the international space science community. Over the years the CCMC acquired the unique experience in preparing complex models and model chains for operational environment and developing and maintaining custom displays and powerful web-based systems and tools ready to be used by researchers, space weather service providers and decision makers. In support of space weather needs of NASA users CCMC is developing highly-tailored applications and services that target specific orbits or locations in space and partnering with NASA mission specialists on linking CCMC space environment modeling with impacts on biological and technological systems in space. Confidence assessment of model predictions is an essential element of space environment modeling. CCMC facilitates interaction between model owners and users in defining physical parameters and metrics formats relevant to specific applications and leads community efforts to quantify models ability to simulate and predict space environment events. Interactive on-line model validation systems developed at CCMC make validation a seamless part of model development circle. The talk will showcase innovative solutions for space weather research, validation, anomaly analysis and forecasting and review on-going community-wide model validation initiatives enabled by CCMC applications.

Integrating community health workers within Patient Protection and Affordable Care Act implementation.

PubMed

Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C; Trinh-Shevrin, Chau

2015-01-01

The Patient Protection and Affordable Care Act's (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers' role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers' unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Community health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural brokers and bridges among medically underserved communities and health care delivery systems is fully tapped. Patient Protection and Affordable Care Act and current payment structures provide an unprecedented and important vehicle for integrating and sustaining CHWs as part of these new delivery and enrollment models.

Integrating Community Health Workers Within Patient Protection and Affordable Care Act Implementation

PubMed Central

Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C.; Trinh-Shevrin, Chau

2015-01-01

Context The Patient Protection and Affordable Care Act’s (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. Objective This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Results Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers’ role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers’ unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Conclusion Community health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural brokers and bridges among medically underserved communities and health care delivery systems is fully tapped. Patient Protection and Affordable Care Act and current payment structures provide an unprecedented and important vehicle for integrating and sustaining CHWs as part of these new delivery and enrollment models. PMID:25414955

The Epital Care Model: A New Person-Centered Model of Technology-Enabled Integrated Care for People With Long Term Conditions

PubMed Central

Phanareth, Klaus; Vingtoft, Søren; Christensen, Anders Skovbo; Nielsen, Jakob Sylvest; Svenstrup, Jørgen; Berntsen, Gro Karine Rosvold; Newman, Stanton Peter

2017-01-01

Background There is worldwide recognition that the future provision of health care requires a reorganization of provision of care, with increased empowerment and engagement of patients, along with skilled health professionals delivering services that are coordinated across sectors and organizations that provide health care. Technology may be a way to enable the creation of a coherent, cocreative, person-centered method to provide health care for individuals with one or more long-term conditions (LTCs). It remains to be determined how a new care model can be introduced that supports the intentions of the World Health Organization (WHO) to have integrated people-centered care. Objective To design, pilot, and test feasibility of a model of health care for people with LTCs based on a cocreative, iterative, and stepwise process in a way that recognizes the need for person-centered care, and embraces the use of digital technology. Methods The overall research method was inspired by action research and used an agile, iterative approach. In 2012, a living lab was established in a Danish municipality which allowed for the freedom of redesigning health care processes. As the first step, a wide group of stakeholders was gathered to create a layout for the reorganization of services and development of technology, based on established principles for innovative management of people with chronic conditions. The next three steps were (1) a proof of concept in 2012, (2) a pilot study, and (3) a feasibility study from 2013 to 2015, in which a total of 93 chronic obstructive pulmonary disease (COPD) patients were enrolled. Citizens were provided a tablet-based solution for remote follow-up and communication purposes, and access to a 24/7 response and coordination center that coordinated both virtual and face-to-face support for COPD management. In step five the initial model was extended with elements that support continuity of care. Beginning in the autumn of 2013, 1102 frail elderly individuals were included and offered two additional services: an outgoing acute medical team and a local subacute bed function. Results Based on the findings from the iterative process, and evolving technology and workflow solutions, we propose a robust and feasible model that can provide a framework for developing solutions to support an active life with one or more LTCs. The resulting Epital Care Model (ECM) consists of six stages, and serves as a template for how a digitally-enhanced health service can be provided based on patients’ medical needs. The model is designed to be a proactive, preventive, and monitoring health care system that involves individuals in the management of their own health conditions. Conclusions The ECM is in accordance with WHO’s framework for integrated people-centered health services, and may serve as a framework for the development of new technologies and provide a template for future reorganization. PMID:28093379

KENNEDY SPACE CENTER, FLA. - Center Director Jim Kennedy (center) shares the kudos for Spaceport Super Safety and Health Day with members of the coordinating committee. Astronaut Barry E. Wilmore (at right) presented the award to Kennedy. Next to Wilmore at right is Dr. Woodrow Whitlow, KSC’s deputy director.

NASA Image and Video Library

2003-10-15

KENNEDY SPACE CENTER, FLA. - Center Director Jim Kennedy (center) shares the kudos for Spaceport Super Safety and Health Day with members of the coordinating committee. Astronaut Barry E. Wilmore (at right) presented the award to Kennedy. Next to Wilmore at right is Dr. Woodrow Whitlow, KSC’s deputy director.

The oral healthcare manager in a patient-centered health facility

PubMed Central

Theile, Cheryl Westphal; Strauss, Shiela; Northridge, Mary Evelyn; Birenz, Shirley

2016-01-01

Background and Purpose Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral healthcare manager who can facilitate integration of oral and primary care in a variety of healthcare settings. Methods Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral healthcare manager who would address both oral healthcare and a patient’s related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral healthcare manager. Conclusion A healthcare provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive healthcare. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral healthcare manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. PMID:27236994

A General Model of Sensitized Luminescence in Lanthanide-Based Coordination Polymers and Metal-Organic Framework Materials.

PubMed

Einkauf, Jeffrey D; Clark, Jessica M; Paulive, Alec; Tanner, Garrett P; de Lill, Daniel T

2017-05-15

Luminescent lanthanides containing coordination polymers and metal-organic frameworks hold great potential in many applications due to their distinctive spectroscopic properties. While the ability to design coordination polymers for specific functions is often mentioned as a major benefit bestowed on these compounds, the lack of a meaningful understanding of the luminescence in lanthanide coordination polymers remains a significant challenge toward functional design. Currently, the study of these compounds is based on the antenna effect as derived from molecular systems, where organic antennae are used to facilitate lanthanide-centered luminescence. This molecular-based approach does not take into account the unique features of extended network solids, particularly the formation of band structure. While guidelines for the antenna effect are well established, they require modification before being applied to coordination polymers. A series of nine coordination polymers with varying topologies and organic linkers were studied to investigate the accuracy of the antenna effect in coordination polymer systems. By comparing a molecular-based approach to a band-based one, it was determined that the band structure that occurs in aggregated organic solids needs to be considered when evaluating the luminescence of lanthanide coordination polymers.

Between the Rock and a Hard Place: The CCMC as a Transit Station Between Modelers and Forecasters

NASA Technical Reports Server (NTRS)

Hesse, Michael

2009-01-01

The Community Coordinated Modeling Center (CCMC) is a US inter-agency activity aiming at research in support of the generation of advanced space weather models. As one of its main functions, the CCMC provides to researchers the use of space science models, even if they are not model owners themselves. The second CCMC activity is to support Space Weather forecasting at national Space Weather Forecasting Centers. This second activity involved model evaluations, model transitions to operations, and the development of draft Space Weather forecasting tools. This presentation will focus on the latter element. Specifically, we will discuss the process of transition research models, or information generated by research models, to Space Weather Forecasting organizations. We will analyze successes as well as obstacles to further progress, and we will suggest avenues for increased transitioning success.

Remote Infrared Imaging of the Space Shuttle During Hypersonic Flight: HYTHIRM Mission Operations and Coordination

NASA Technical Reports Server (NTRS)

Schwartz, Richard J.; McCrea, Andrew C.; Gruber, Jennifer R.; Hensley, Doyle W.; Verstynen, Harry A.; Oram, Timothy D.; Berger, Karen T.; Splinter, Scott C.; Horvath, Thomas J.; Kerns, Robert V.

2011-01-01

The Hypersonic Thermodynamic Infrared Measurements (HYTHIRM) project has been responsible for obtaining spatially resolved, scientifically calibrated in-flight thermal imagery of the Space Shuttle Orbiter during reentry. Starting with STS-119 in March of 2009 and continuing through to the majority of final flights of the Space Shuttle, the HYTHIRM team has to date deployed during seven Shuttle missions with a mix of airborne and ground based imaging platforms. Each deployment of the HYTHIRM team has resulted in obtaining imagery suitable for processing and comparison with computational models and wind tunnel data at Mach numbers ranging from over 18 to under Mach 5. This paper will discuss the detailed mission planning and coordination with the NASA Johnson Space Center Mission Control Center that the HYTHIRM team undergoes to prepare for and execute each mission.

DoD Information Assurance and Agile: Challenges and Recommendations Gathered Through Interviews with Agile Program Managers and DoD Accreditation Reviewers

DTIC Science & Technology

2012-11-01

Tradeoff Analysis Method; ATAM, Capability Maturity Model , Capability Maturity Modeling , Carnegie Mellon, CERT, CERT Coordination Center, CMM, CMMI...Hermansen, Product Design, Sphere of Influence (https://www.SphereOfInfluence.com) Joel McAteer, Information Assurance Manager, Modeling ...use of them does introduce some challenges related to delivering software features rapidly and/or in- crementally . • Challenges with respect to

Evolution of a 90-day model of care for bundled episodic payments for congestive heart failure in home care.

PubMed

Feld, April; Madden-Baer, Rose; McCorkle, Ruth

2016-01-01

The Centers for Medicare and Medicaid Services Innovation Center's Episode-Based Payment initiatives propose a large opportunity to reduce cost from waste and variation and stand to align hospitals, physicians, and postacute providers in the redesign of care that achieves savings and improve quality. Community-based organizations are at the forefront of this care redesign through innovative models of care aimed at bridging gaps in care coordination and reducing hospital readmissions. This article describes a community-based provider's approach to participation under the Bundled Payments for Care Improvement initiative and a 90-day model of care for congestive heart failure in home care.

Louisville region demonstration of travel management coordination center : system pre-deployment preparation.

DOT National Transportation Integrated Search

2013-03-01

The purpose of the Greater Louisville Region Demonstration of Travel Management Coordination Center (TMCC): System Pre-Deploy-ment Preparation grant was to further phased implementation of the regions TMCC design by focusing on two major component...

Coordination and Data Management of the International Arctic Buoy Programme (IABP)

DTIC Science & Technology

2001-09-30

Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor 1013 NE 40th Street Polar Science Center...analyzed geophysical fields. APPROACH Coordination of the IABP falls into the categories of information, resource management, and meeting...the Polar Science Center (PSC) via anonymous ftp. These data and other research products of the IABP are available on the World Wide Web at http

A Hierarchical Modeling for Reactive Power Optimization With Joint Transmission and Distribution Networks by Curve Fitting

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

Ding, Tao; Li, Cheng; Huang, Can

Here, in order to solve the reactive power optimization with joint transmission and distribution networks, a hierarchical modeling method is proposed in this paper. It allows the reactive power optimization of transmission and distribution networks to be performed separately, leading to a master–slave structure and improves traditional centralized modeling methods by alleviating the big data problem in a control center. Specifically, the transmission-distribution-network coordination issue of the hierarchical modeling method is investigated. First, a curve-fitting approach is developed to provide a cost function of the slave model for the master model, which reflects the impacts of each slave model. Second,more » the transmission and distribution networks are decoupled at feeder buses, and all the distribution networks are coordinated by the master reactive power optimization model to achieve the global optimality. Finally, numerical results on two test systems verify the effectiveness of the proposed hierarchical modeling and curve-fitting methods.« less

A Hierarchical Modeling for Reactive Power Optimization With Joint Transmission and Distribution Networks by Curve Fitting

DOE PAGES

Ding, Tao; Li, Cheng; Huang, Can; ...

2017-01-09

Here, in order to solve the reactive power optimization with joint transmission and distribution networks, a hierarchical modeling method is proposed in this paper. It allows the reactive power optimization of transmission and distribution networks to be performed separately, leading to a master–slave structure and improves traditional centralized modeling methods by alleviating the big data problem in a control center. Specifically, the transmission-distribution-network coordination issue of the hierarchical modeling method is investigated. First, a curve-fitting approach is developed to provide a cost function of the slave model for the master model, which reflects the impacts of each slave model. Second,more » the transmission and distribution networks are decoupled at feeder buses, and all the distribution networks are coordinated by the master reactive power optimization model to achieve the global optimality. Finally, numerical results on two test systems verify the effectiveness of the proposed hierarchical modeling and curve-fitting methods.« less

Draft Forecasts from Real-Time Runs of Physics-Based Models - A Road to the Future

NASA Technical Reports Server (NTRS)

Hesse, Michael; Rastatter, Lutz; MacNeice, Peter; Kuznetsova, Masha

2008-01-01

The Community Coordinated Modeling Center (CCMC) is a US inter-agency activity aiming at research in support of the generation of advanced space weather models. As one of its main functions, the CCMC provides to researchers the use of space science models, even if they are not model owners themselves. The second focus of CCMC activities is on validation and verification of space weather models, and on the transition of appropriate models to space weather forecast centers. As part of the latter activity, the CCMC develops real-time simulation systems that stress models through routine execution. A by-product of these real-time calculations is the ability to derive model products, which may be useful for space weather operators. After consultations with NOAA/SEC and with AFWA, CCMC has developed a set of tools as a first step to make real-time model output useful to forecast centers. In this presentation, we will discuss the motivation for this activity, the actions taken so far, and options for future tools from model output.

Information Architecture for Interactive Archives at the Community Coordianted Modeling Center

NASA Astrophysics Data System (ADS)

De Zeeuw, D.; Wiegand, C.; Kuznetsova, M.; Mullinix, R.; Boblitt, J. M.

2017-12-01

The Community Coordinated Modeling Center (CCMC) is upgrading its meta-data system for model simulations to be compliant with the SPASE meta-data standard. This work is helping to enhance the SPASE standards for simulations to better describe the wide variety of models and their output. It will enable much more sophisticated and automated metrics and validation efforts at the CCMC, as well as much more robust searches for specific types of output. The new meta-data will also allow much more tailored run submissions as it will allow some code options to be selected for Run-On-Request models. We will also demonstrate data accessibility through an implementation of the Heliophysics Application Programmer's Interface (HAPI) protocol of data otherwise available throught the integrated space weather analysis system (iSWA).

Space Weather Models at the CCMC And Their Capabilities

NASA Technical Reports Server (NTRS)

Hesse, Michael; Rastatter, Lutz; MacNeice, Peter; Kuznetsova, Masha

2007-01-01

The Community Coordinated Modeling Center (CCMC) is a US inter-agency activity aiming at research in support of the generation of advanced space weather models. As one of its main functions, the CCMC provides to researchers the use of space science models, even if they are not model owners themselves. The second focus of CCMC activities is on validation and verification of space weather models, and on the transition of appropriate models to space weather forecast centers. As part of the latter activity, the CCMC develops real-time simulation systems that stress models through routine execution. A by-product of these real-time calculations is the ability to derive model products, which may be useful for space weather operators. In this presentation, we will provide an overview of the community-provided, space weather-relevant, model suite, which resides at CCMC. We will discuss current capabilities, and analyze expected future developments of space weather related modeling.

Deriving Tools from Real-time Runs: A New CCMC Support for SEC and AFWA

NASA Technical Reports Server (NTRS)

Hesse, Michael; Rastatter, Lutz; MacNeice, Peter; Kuznetsova, Masha

2008-01-01

The Community Coordinated Modeling Center (CCMC) is a US inter-agency activity aiming at research in support of the generation of advanced space weather models. As one of its main functions. the CCMC provides to researchers the use of space science models, even if they are not model owners themselves. The second focus of CCMC activities is on validation and verification of space weather models. and on the transition of appropriate models to space weather forecast centers. As part of the latter activity. the CCMC develops real-time simulation systems that stress models through routine execution. A by-product of these real-time calculations is the ability to derive model products, which may be useful for space weather operators. After consultations with NOA/SEC and with AFWA, CCMC has developed a set of tools as a first step to make real-time model output useful to forecast centers. In this presentation, we will discuss the motivation for this activity, the actions taken so far, and options for future tools from model output.

A diketiminate-bound diiron complex with a bridging carbonate ligand

PubMed Central

Sadique, Azwana R.; Brennessel, William W.; Holland, Patrick L.

2009-01-01

Reduction of carbon dioxide by a diiron(I) complex gives μ-carbonato-κ3 O:O′,O′′-bis­{[2,2,6,6-tetra­methyl-3,5-bis­(2,4,6-triisopropyl­phenyl)heptane-2,5-diiminate(1−)-κ2 N,N′]iron(II)} toluene disolvate, [Fe2(C41H65N)2(CO3)]·2C7H8, a diiron(II) species with a bridging carbonate ligand. The asymmetric unit contains one diiron complex and two cocrystallized toluene solvent mol­ecules that are distributed over three sites, one with atoms in general positions and two in crystallographic sites. Both FeII atoms are η2-coordinated to diketiminate ligands, but η1- and η2-coordinated to the bridging carbonate ligand. Thus, one FeII center is three-coordinate and the other is four-coordinate. The bridging carbonate ligand is nearly perpendicular to the iron–diketiminate plane of the four-coordinate FeII center and parallel to the plane of the three-coordinate FeII center. PMID:19407402

Locating Vocational Education Curricula. ERIC Digest No. 97.

ERIC Educational Resources Information Center

Wagner, Judith O.

To find vocational education curriculum materials, educators can contact their State Liaison Representative (SLR) to the National Network for Curriculum Coordination in Vocational and Technical Education (NNCCVTE), regional Curriculum Coordination Center (CCC), state vocational education resource center (SVERC), and/or one of the consortia that…

Operator performance-enhancing technologies to improve safety. A US DOT safety initiative for meeting the human-centered systems challenge.

DOT National Transportation Integrated Search

1999-11-01

The program implements DOT Human Factors Coordinating Committee (HFCC) recommendations for a coordinated Departmental Human Factors Research Program to advance the human-centered systems approach for enhancing transportation safety. Human error is a ...

38 CFR 21.6420 - Coordination with the Veterans Service Center.

Code of Federal Regulations, 2012 CFR

2012-07-01

... rehabilitation facility, or employment in a rehabilitation facility or sheltered workshop; (2) On-job training... Training for Certain New Pension Recipients Coordination with the Veterans Service Center § 21.6420... work or training which may affect the veteran's continued entitlement to pension, including...

38 CFR 21.6420 - Coordination with the Veterans Service Center.

Code of Federal Regulations, 2013 CFR

2013-07-01

... rehabilitation facility, or employment in a rehabilitation facility or sheltered workshop; (2) On-job training... Training for Certain New Pension Recipients Coordination with the Veterans Service Center § 21.6420... work or training which may affect the veteran's continued entitlement to pension, including...

38 CFR 21.6420 - Coordination with the Veterans Service Center.

Code of Federal Regulations, 2014 CFR

2014-07-01

... rehabilitation facility, or employment in a rehabilitation facility or sheltered workshop; (2) On-job training... Training for Certain New Pension Recipients Coordination with the Veterans Service Center § 21.6420... work or training which may affect the veteran's continued entitlement to pension, including...

Coordinating Centers in Cancer-Epidemiology Research: The Asia Cohort Consortium Coordinating Center

PubMed Central

Rolland, Betsy; Smith, Briana R; Potter, John D

2011-01-01

Although it is tacitly recognized that a good Coordinating Center (CC) is essential to the success of any multi-site collaborative project, very little study has been done on what makes a CC successful, why some CCs fail, or how to build a CC that meets the needs of a given project. Moreover, very little published guidance is available, as few CCs outside the clinical-trial realm write about their work. The Asia Cohort Consortium (ACC) is a collaborative cancer-epidemiology research project that has made strong scientific and organizational progress over the past three years by focusing its CC on the following activities: collaboration development; operations management; statistical and data management; and communications infrastructure and tool development. Our hope is that, by sharing our experience building the ACC CC, we can begin a conversation about what it means to run a coordinating center for multi-institutional collaboration in cancer epidemiology, help other collaborative projects solve some of the issues associated with collaborative research, and learn from others. PMID:21803842

Workforce development to provide person-centered care

PubMed Central

Austrom, Mary Guerriero; Carvell, Carly A.; Alder, Catherine A.; Gao, Sujuan; Boustani, Malaz; LaMantia, Michael

2018-01-01

Objectives Describe the development of a competent workforce committed to providing patient-centered care to persons with dementia and/or depression and their caregivers; to report on qualitative analyses of our workforce’s case reports about their experiences; and to present lessons learned about developing and implementing a collaborative care community-based model using our new workforce that we call care coordinator assistants (CCAs). Method Sixteen CCAs were recruited and trained in person-centered care, use of mobile office, electronic medical record system, community resources, and team member support. CCAs wrote case reports quarterly that were analyzed for patient-centered care themes. Results Qualitative analysis of 73 cases using NVivo software identified six patient-centered care themes: (1) patient familiarity/understanding; (2) patient interest/engagement encouraged; (3) flexibility and continuity of care; (4) caregiver support/engagement; (5) effective utilization/integration of training; and (6) teamwork. Most frequently reported themes were patient familiarity – 91.8% of case reports included reference to patient familiarity, 67.1% included references to teamwork and 61.6% of case reports included the theme flexibility/continuity of care. CCAs made a mean number of 15.7 (SD = 15.6) visits, with most visits for coordination of care services, followed by home visits and phone visits to over 1200 patients in 12 months. Discussion Person-centered care can be effectively implemented by well-trained CCAs in the community. PMID:26666358

The United States Special Operations Command Civil Military Engagement Program - A Model for Military-Interagency Low Cost / Small Footprint Activities

DTIC Science & Technology

2014-05-02

Interagency Coordination Centers (JIACs), Interagency Task Forces ( IATFs ) are found within GCCs and subordinate military units in an attempt to bridge...Interagency Tasks Forces ( IATFs ) that exist at each Geographic Combatant Command (GCC). Rather, this chapter serves to highlight the Civil Military

Macroergonomics in Healthcare Quality and Patient Safety

PubMed Central

Carayon, Pascale; Karsh, Ben-Tzion; Gurses, Ayse P.; Holden, Richard; Hoonakker, Peter; Hundt, Ann Schoofs; Montague, Enid; Rodriguez, Joy; Wetterneck, Tosha B.

2014-01-01

The US Institute of Medicine and healthcare experts have called for new approaches to manage healthcare quality problems. In this chapter, we focus on macroergonomics, a branch of human factors and ergonomics that is based on the systems approach and considers the organizational and sociotechnical context of work activities and processes. Selected macroergonomic approaches to healthcare quality and patient safety are described such as the SEIPS model of work system and patient safety and the model of healthcare professional performance. Focused reviews on job stress and burnout, workload, interruptions, patient-centered care, health IT and medical devices, violations, and care coordination provide examples of macroergonomics contributions to healthcare quality and patient safety. Healthcare systems and processes clearly need to be systematically redesigned; examples of macroergonomic approaches, principles and methods for healthcare system redesign are described. Further research linking macroergonomics and care processes/patient outcomes is needed. Other needs for macroergonomics research are highlighted, including understanding the link between worker outcomes (e.g., safety and well-being) and patient outcomes (e.g., patient safety), and macroergonomics of patient-centered care and care coordination. PMID:24729777

Medical Transport of Children with Complex Chronic Conditions

PubMed Central

Lerner, Carlos F.; Kelly, Robert B.; Hamilton, Leslie J.; Klitzner, Thomas S.

2012-01-01

One of the most notable trends in child health has been the increase in the number of children with special health care needs, including those with complex chronic conditions. Care of these children accounts for a growing fraction of health care resources. We examine recent developments in health care, especially with regard to medical transport and prehospital care, that have emerged to adapt to this remarkable demographic trend. One such development is the focus on care coordination, including the dissemination of the patient-centered medical home concept. In the prehospital setting, the need for greater coordination has catalyzed the development of the emergency information form. Training programs for prehospital providers now incorporate specific modules for children with complex conditions. Another notable trend is the shift to a family-centered model of care. We explore efforts toward regionalization of care, including the development of specialized pediatric transport teams, and conclude with recommendations for a research agenda. PMID:22315689

75 FR 69573 - Export Enforcement Coordination Center

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-15

... Export Enforcement Coordination Center By the authority vested in me as President by the Constitution and... enforcement of United States export control laws and enhanced intelligence exchange in support of such enforcement efforts, it is hereby ordered as follows: Section 1. Policy. Export controls are critical to...

The Real-World Problem of Care Coordination: A Longitudinal Qualitative Study with Patients Living with Advanced Progressive Illness and Their Unpaid Caregivers

PubMed Central

Daveson, Barbara A.; Harding, Richard; Shipman, Cathy; Mason, Bruce L.; Epiphaniou, Eleni; Higginson, Irene J.; Ellis-Smith, Clare; Henson, Lesley; Munday, Dan; Nanton, Veronica; Dale, Jeremy R.; Boyd, Kirsty; Worth, Allison; Barclay, Stephen; Donaldson, Anne; Murray, Scott

2014-01-01

Objectives To develop a model of care coordination for patients living with advanced progressive illness and their unpaid caregivers, and to understand their perspective regarding care coordination. Design A prospective longitudinal, multi-perspective qualitative study involving a case-study approach. Methods Serial in-depth interviews were conducted, transcribed verbatim and then analyzed through open and axial coding in order to construct categories for three cases (sites). This was followed by continued thematic analysis to identify underlying conceptual coherence across all cases in order to produce one coherent care coordination model. Participants Fifty-six purposively sampled patients and 27 case-linked unpaid caregivers. Settings Three cases from contrasting primary, secondary and tertiary settings within Britain. Results Coordination is a deliberate cross-cutting action that involves high-quality, caring and well-informed staff, patients and unpaid caregivers who must work in partnership together across health and social care settings. For coordination to occur, it must be adequately resourced with efficient systems and services that communicate. Patients and unpaid caregivers contribute substantially to the coordination of their care, which is sometimes volunteered at a personal cost to them. Coordination is facilitated through flexible and patient-centered care, characterized by accurate and timely information communicated in a way that considers patients’ and caregivers’ needs, preferences, circumstances and abilities. Conclusions Within the midst of advanced progressive illness, coordination is a shared and complex intervention involving relational, structural and information components. Our study is one of the first to extensively examine patients’ and caregivers’ views about coordination, thus aiding conceptual fidelity. These findings can be used to help avoid oversimplifying a real-world problem, such as care coordination. Avoiding oversimplification can help with the development, evaluation and implementation of real-world coordination interventions for patients and their unpaid caregivers in the future. PMID:24788451

Fighting Fragmentation: Coordination of Services for Children and Families.

ERIC Educational Resources Information Center

Soler, Mark; Shauffer, Carole

1993-01-01

Discusses efforts to coordinate services (mental health services in particular) for children and families, and reports initial findings of research by the Youth Law Center to identify specific characteristics of effective coordination programs. Sixteen characteristics of effective coordinated service programs have been identified. (SLD)

The Epital Care Model: A New Person-Centered Model of Technology-Enabled Integrated Care for People With Long Term Conditions.

PubMed

Phanareth, Klaus; Vingtoft, Søren; Christensen, Anders Skovbo; Nielsen, Jakob Sylvest; Svenstrup, Jørgen; Berntsen, Gro Karine Rosvold; Newman, Stanton Peter; Kayser, Lars

2017-01-16

There is worldwide recognition that the future provision of health care requires a reorganization of provision of care, with increased empowerment and engagement of patients, along with skilled health professionals delivering services that are coordinated across sectors and organizations that provide health care. Technology may be a way to enable the creation of a coherent, cocreative, person-centered method to provide health care for individuals with one or more long-term conditions (LTCs). It remains to be determined how a new care model can be introduced that supports the intentions of the World Health Organization (WHO) to have integrated people-centered care. To design, pilot, and test feasibility of a model of health care for people with LTCs based on a cocreative, iterative, and stepwise process in a way that recognizes the need for person-centered care, and embraces the use of digital technology. The overall research method was inspired by action research and used an agile, iterative approach. In 2012, a living lab was established in a Danish municipality which allowed for the freedom of redesigning health care processes. As the first step, a wide group of stakeholders was gathered to create a layout for the reorganization of services and development of technology, based on established principles for innovative management of people with chronic conditions. The next three steps were (1) a proof of concept in 2012, (2) a pilot study, and (3) a feasibility study from 2013 to 2015, in which a total of 93 chronic obstructive pulmonary disease (COPD) patients were enrolled. Citizens were provided a tablet-based solution for remote follow-up and communication purposes, and access to a 24/7 response and coordination center that coordinated both virtual and face-to-face support for COPD management. In step five the initial model was extended with elements that support continuity of care. Beginning in the autumn of 2013, 1102 frail elderly individuals were included and offered two additional services: an outgoing acute medical team and a local subacute bed function. Based on the findings from the iterative process, and evolving technology and workflow solutions, we propose a robust and feasible model that can provide a framework for developing solutions to support an active life with one or more LTCs. The resulting Epital Care Model (ECM) consists of six stages, and serves as a template for how a digitally-enhanced health service can be provided based on patients' medical needs. The model is designed to be a proactive, preventive, and monitoring health care system that involves individuals in the management of their own health conditions. The ECM is in accordance with WHO's framework for integrated people-centered health services, and may serve as a framework for the development of new technologies and provide a template for future reorganization. ©Klaus Phanareth, Søren Vingtoft, Anders Skovbo Christensen, Jakob Sylvest Nielsen, Jørgen Svenstrup, Gro Karine Rosvold Berntsen, Stanton Peter Newman, Lars Kayser. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 16.01.2017.

A Novel Coordination Polymer Constructed by Hetero-Metal Ions and 2,3-Pyridine Dicarboxylic Acid: Synthesis and Structure of [NiNa2(PDC)2(μ-H2O)(H2O)2] n

NASA Astrophysics Data System (ADS)

Dou, Ming-Yu; Lu, Jing

2017-12-01

A novel coordination polymer containing hetero-metal ions, [NiNa2(PDC)2(μ-H2O)(H2O)2] n , where PDC is 2,3-pyridine dicarboxylate ion, has been synthesized. In the structure, the PDC ligand chelates and bridges two Ni(II) and two Na(I) centers. Two kinds of metal centers are connected by μ4-PDC and μ2-H2O to form 2D coordination layers. Hydrogen bonds between coordination water molecules and carboxylate oxygen atoms further link these 2D coordination layers to form 3D supramolecular network.

Updates on CCMC Activities and GSFC Space Weather Services

NASA Technical Reports Server (NTRS)

Zhengm Y.; Hesse, M.; Kuznetsova, M.; Pulkkinen, A.; Rastaetter, L.; Maddox, M.; Taktakishvili, A.; Berrios, D.; Chulaki, A.; Lee, H.;

Deriving Tools from Real-Time Runs: A New CCMC Support for SEC and AFWA

NASA Technical Reports Server (NTRS)

Hesse, Michael; Rastatter, Lutz; MacNeice, Peter; Kuznetsova, Masha

2007-01-01

The Community Coordinated Modeling Center (CCMC) is a US inter-agency activity aiming at research in support of the generation of advanced space weather models. As one of its main functions, the CCMC provides to researchers the use of space science models, even if they are not model owners themselves. In particular, the CCMC provides to the research community the execution of "runs-on-request" for specific events of interest to space science researchers. Through this activity and the concurrent development of advanced visualization tools, CCMC provides, to the general science community, unprecedented access to a large number of state-of-the-art research models. CCMC houses models that cover the entire domain from the Sun to the Earth. In this presentation, we will provide an overview of CCMC modeling services that are available to support activities at the Space Environment Center, or at the Air Force Weather Agency.

Covalency in the f element-chalcogen bond. computational studies of M[N(EPR2)2]3 (M = La, Ce, Pr, Pm, Eu, U, Np, Pu, Am, Cm; E = O, S, Se, Te; R = H, (i)Pr, Ph).

PubMed

Ingram, Kieran I M; Tassell, Matthew J; Gaunt, Andrew J; Kaltsoyannis, Nikolas

2008-09-01

The geometric and electronic structures of the title complexes have been studied using scalar relativistic, gradient-corrected density functional theory. Extension of our previous work on six-coordinate M[N(EPH 2) 2] 3 (M = La, Ce, U, Pu; E = O, S, Se, Te), models for the experimentally characterized M[N(EP (i)Pr 2) 2] 3, yields converged geometries for all of the other 4f and 5f metals studied and for all four group 16 elements. By contrast, converged geometries for nine-coordinate M[N(EPPh 2) 2] 3 are obtained only for E = S and Se. Comparison of the electronic structures of six- and nine-coordinate M[N(EPH 2) 2] 3 suggests that coordination of the N atoms produces only minor changes in the metal-chalcogen interactions. Six-coordinate Eu[N(EPH 2) 2] 3 and Am[N(EPH 2) 2] 3 with the heavier group 16 donors display geometric and electronic properties rather different from those of the other members of the 4f and 5f series, in particular, longer than expected Eu-E and Am-E bond lengths, smaller reductions in charge difference between M and E down group 16, and larger f populations. The latter are interpreted not as evidence of f-based metal-ligand covalency but rather as being indicative of ionic metal centers closer to M (II) than M (III). The Cm complexes are found to be very ionic, with very metal-localized f orbitals and Cm (III) centers. The implications of the results for the separation of the minor actinides from nuclear wastes are discussed, as is the validity of using La (III)/U (III) comparisons as models for minor actinide/Eu systems.

Patient- and family-centered care coordination: a framework for integrating care for children and youth across multiple systems.

PubMed

2014-05-01

Understanding a care coordination framework, its functions, and its effects on children and families is critical for patients and families themselves, as well as for pediatricians, pediatric medical subspecialists/surgical specialists, and anyone providing services to children and families. Care coordination is an essential element of a transformed American health care delivery system that emphasizes optimal quality and cost outcomes, addresses family-centered care, and calls for partnership across various settings and communities. High-quality, cost-effective health care requires that the delivery system include elements for the provision of services supporting the coordination of care across settings and professionals. This requirement of supporting coordination of care is generally true for health systems providing care for all children and youth but especially for those with special health care needs. At the foundation of an efficient and effective system of care delivery is the patient-/family-centered medical home. From its inception, the medical home has had care coordination as a core element. In general, optimal outcomes for children and youth, especially those with special health care needs, require interfacing among multiple care systems and individuals, including the following: medical, social, and behavioral professionals; the educational system; payers; medical equipment providers; home care agencies; advocacy groups; needed supportive therapies/services; and families. Coordination of care across settings permits an integration of services that is centered on the comprehensive needs of the patient and family, leading to decreased health care costs, reduction in fragmented care, and improvement in the patient/family experience of care. Copyright © 2014 by the American Academy of Pediatrics.

Conference on Standards for the Interoperability of Defense Simulations (2nd) Held in Orlando, Florida on 15-17 January 1990. Volume 3. Position Papers

DTIC Science & Technology

1990-01-01

major part of Europe and include We recommend adoption of a Cartesian geocentric participation by Army, Air Force and Navy forces. In coordinate...The coordinate system chosen is the World Geodetic surface. For example, a location on a beach may be System, an Earth-centered ( geocentric ), Earth...toPlane Is W Figure 4. Universal Polar Stereographic (UPS) Projection 3. 0 ASSUMPTIONS 1. Geocentric coordinates: Earth geodetic centered, Earth-fixed

Nonsingular expansions of the gravity potential and its derivatives at satellite altitudes in the ellipsoidal coordinate system

NASA Astrophysics Data System (ADS)

Vershkov, A. N.; Petrovskaya, M. S.

2016-11-01

The series in ellipsoidal harmonics for derivatives of the Earth's gravity potential are used only on the reference ellipsoid enveloping the Earth due to their very complex mathematical structure. In the current study, the series in ellipsoidal harmonics are constructed for first- and second-order derivatives of the potential at satellite altitudes; their structure is similar to the series on the reference ellipsoid. The point P is chosen at a random satellite altitude; then, the ellipsoid of revolution is described, which passes through this point and is confocal to the reference ellipsoid. An object-centered coordinate system with the origin at the point P is considered. Using a sequence of transformations, the nonsingular series in ellipsoidal harmonics is constructed for first and second derivatives of the potential in the object-centered coordinate system. These series can be applied to develop a model of the Earth's potential, based on combined use of surface gravitational force measurements, data on the satellite orbital position, its acceleration, or measurements of the gravitational force gradients of the first and second order. The technique is applicable to any other planet of the Solar System.

Registered dietitian nutritionists bring value to emerging health care delivery models.

PubMed

Jortberg, Bonnie T; Fleming, Michael O

2014-12-01

Health care in the United States is the most expensive in the world; however, most citizens do not receive quality care that is comprehensive and coordinated. To address this gap, the Institute for Healthcare Improvement developed the Triple Aim (ie, improving population health, improving the patient experience, and reducing costs), which has been adopted by patient-centered medical homes and accountable care organizations. The patient-centered medical home and other population health models focus on improving the care for all people, particularly those with multiple morbidities. The Joint Principles of the Patient-Centered Medical Home, developed by the major primary care physician organizations in 2007, recognizes the key role of the multidisciplinary team in meeting the challenge of caring for these individuals. Registered dietitian nutritionists (RDNs) bring value to this multidisciplinary team by providing care coordination, evidence-based care, and quality-improvement leadership. RDNs have demonstrated efficacy for improvements in outcomes for patients with a wide variety of medical conditions. Primary care physicians, as well as several patient-centered medical home and population health demonstration projects, have reported the benefits of RDNs as part of the integrated primary care team. One of the most significant barriers to integrating RDNs into primary care has been an insufficient reimbursement model. Newer innovative payment models provide the opportunity to overcome this barrier. In order to achieve this integration, the Academy of Nutrition and Dietetics and RDNs must fully understand and embrace the opportunities and challenges that the new health care delivery and payment models present, and be prepared and empowered to lead the necessary changes. All stakeholders within the health care system need to more fully recognize and embrace the value and multidimensional role of the RDN on the multidisciplinary team. The Academy's Patient-Centered Medical Home/Accountable Care Organizations Workgroup Report provides a framework for the Academy, its members, and key partners to use to achieve this goal. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

76 FR 33306 - Medicare Program; Pioneer Accountable Care Organization Model, Request for Applications; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... information posted on our Center for Medicare and Medicaid Innovation (CMMI) Web site and in the Pioneer ACO Application. (For more information see http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care... postmarked on or before July 18, 2011.'' Authority: Section 1115A of the Social Security Act. Dated: June 2...

Rural-to-Urban Migrants' Experiences with Primary Care under Different Types of Medical Institutions in Guangzhou, China

PubMed Central

Zeng, Jiazhi; Shi, Leiyu; Zou, Xia; Chen, Wen; Ling, Li

2015-01-01

Objectives China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Migrants are in a vulnerable state when they attempt to access to primary care services. This study was designed to explore rural-to-urban migrants’ experiences in primary care, comparing their quality of primary care experiences under different types of medical institutions in Guangzhou, China. Methods The study employed a cross-sectional survey of 736 rural-to-urban migrants in Guangzhou, China in 2014. A validated Chinese version of Primary Care Assessment Tool—Adult Short Version (PCAT-AS), representing 10 primary care domains was used to collect information on migrants’ quality of primary care experiences. These domains include first contact (utilization), first contact (accessibility), ongoing care, coordination (referrals), coordination (information systems), comprehensiveness (services available), comprehensiveness (services provided), family-centeredness, community orientation and culturally competent. These measures were used to assess the quality of primary care performance as reported from patients’ perspective. Analysis of covariance was conducted for comparison on PCAT scores among migrants accessing primary care in tertiary hospitals, municipal hospitals, community health centers/community health stations, and township health centers/rural health stations. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results After adjustments were made, migrants accessing primary care in tertiary hospitals (25.49) reported the highest PCAT total scores, followed by municipal hospitals (25.02), community health centers/community health stations (24.24), and township health centers/rural health stations (24.18). Tertiary hospital users reported significantly better performance in first contact (utilization), first contact (accessibility), coordination (information system), comprehensiveness (service available), and cultural competence. Community health center/community health station users reported significantly better experience in the community orientation domain. Township health center/rural health station users expressed significantly better experience in the ongoing care domain. There were no statistically significant differences across settings in the ongoing care, comprehensiveness (services provided), and family-centeredness domains. Multiple linear regression models showed that factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P<0.001). Conclusions This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. PMID:26474161

[Family and chronic paediatric illness].

PubMed

Grau Rubio, Claudia; Fernández Hawrylak, M

2010-01-01

Pediatric illnesses are always a family problem. Hospitalization, treatments and their long term consequences constitute a challenge for the family. In this paper, we describe the structural, procedural and emotional alterations that affect the family dynamic. We argue that the child should be treated within the family context and propose a multi-dimensional intervention model centered on the family's singularities and specific needs, the support available in their environment, the development of capacities and resilience, and also the organization of user-centered services that are coordinated with all the services provided by the community.

NHEXAS PHASE I MARYLAND STUDY--STANDARD OPERATING PROCEDURE FOR TRAINING OF FIELD COORDINATION CENTER STAFF (G11)

EPA Science Inventory

The purpose of this SOP is to outline (1) the responsibilities of the Field Coordination Center (FCC) staff before, during, and after sampling at residences, and (2) to outline the training program that teaches FCC staff what they need to know to handle these responsibilities. F...

International VLBI Service for Geodesy and Astrometry 2004 Annual Report

NASA Technical Reports Server (NTRS)

Behrend, Dirk (Editor); Baver, Karen D. (Editor)

2005-01-01

Contents include the following: Combination Studies using the Cont02 Campaign. Coordinating Center report. Analysis coordinator report. Network coordinator report. IVS Technology coordinator report. Algonquin Radio observatory. Fortaleza Station report for 2004. Gilmore Creek Geophysical Observatory. Goddard Geophysical and Astronomical observatory. Hartebeesthoek Radio Astronomy Observatory (HartRAO). Hbart, Mt Pleasant, station report for 2004. Kashima 34m Radio Telescope. Kashima and Koganei 11-m VLBI Stations. Kokee Park Geophysical Observatory. Matera GGS VLBI Station. The Medicina Station status report. Report of the Mizusawa 10m Telescope. Noto Station Activity. NYAL Ny-Alesund 20 metre Antenna. German Antarctic receiving Station (GARS) O'higgins. The IVS network station Onsala space Observatory. Sheshan VLBI Station report for 2004. 10 Years of Geodetic Experiments at the Simeiz VLBI Station. Svetloe RAdio Astronomical Observatory. JARE Syowa Station 11-m Antenna, Antarctica. Geodetic Observatory TIGO in Concepcion. Tsukuba 32-m VLBI Station. Nanshan VLBI Station Report. Westford Antenna. Fundamental-station Wettzell 20m Radiotelescope. Observatorio Astroonomico Nacional Yebes. Yellowknife Observatory. The Bonn Geodetic VLBI Operation Center. CORE Operation Center Report. U.S. Naval Observatory Operation Center. The Bonn Astro/Geo Mark IV Correlator.

Intra- and inter-group coordination patterns reveal collective behaviors of football players near the scoring zone.

PubMed

Duarte, Ricardo; Araújo, Duarte; Freire, Luís; Folgado, Hugo; Fernandes, Orlando; Davids, Keith

2012-12-01

This study examined emergent coordination processes in collective patterns of behavior in 3 vs 3 sub-phases of the team sport of association football near the scoring zone. We identified coordination tendencies for the centroid (i.e., team center) and surface area (i.e., occupied space) of each sub-group of performers (n=20 plays). We also compared these kinematic variables at three key moments of play using mixed-model ANOVAs. The centroids demonstrated a strong symmetric relation that described the coordinated attacking/defending actions of performers in this sub-phase of play. Conversely, analysis of the surface area of each team did not reveal a clear coordination pattern between sub-groups. But the difference in the occupied area between the attacking and defending sub-groups significantly increased over time. Findings emphasized that major changes in sub-group behaviors occurred just before an assisted pass was made (i.e., leading to a loss of stability in the 3 vs 3 sub-phases). Copyright © 2012 Elsevier B.V. All rights reserved.

Electronic Structure and Bonding in Transition Metal Inorganic and Organometallic Complexes: New Basis Sets, Linear Semibridging Carbonyls and Thiocarbonyls, and Oxidative Addition of Molecular Hydrogen to Square - Iridium Complexes.

NASA Astrophysics Data System (ADS)

Sargent, Andrew Landman

Approximate molecular orbital and ab initio quantum chemical techniques are used to investigate the electronic structure, bonding and reactivity of several transition metal inorganic and organometallic complexes. Modest-sized basis sets are developed for the second-row transition metal atoms and are designed for use in geometry optimizations of inorganic and organometallic complexes incorporating these atoms. The basis sets produce optimized equilibrium geometries which are slightly better than those produced with standard 3-21G basis sets, and which are significantly better than those produced with effective core potential basis sets. Linear semibridging carbonyl ligands in heterobimetallic complexes which contain a coordinatively unsaturated late transition metal center are found to accept electron density from, rather than donate electron density to, these centers. Only when the secondary metal center is a coordinatively unsaturated early transition metal center does the semibridging ligand donate electron density to this center. Large holes in the d shell around the metal center are more prominent and prevalent in early than in late transition metal centers, and the importance of filling in these holes outweighs the importance of mitigating the charge imbalance due to the dative metal-metal interaction. Semibridging thiocarbonyl ligands are more effective donors of electron density than the carbonyl ligands since the occupied donor orbitals of pi symmetry are higher in energy. The stereoselectivity of H_2 addition to d^8 square-planar transition metal complexes is controlled by the interactions between the ligands in the plane of addition and the concentrations of electronic charge around the metal center as the complex evolves from a four-coordinate to a six-coordinate species. Electron -withdrawing ligands help stabilize the five-coordinate species while strong electron donor ligands contribute only to the destabilizing repulsive interactions. The relative thermodynamic stabilities of the final complexes can be predicted based on the relative orientations of the strongest sigma-donor ligands.

Attitude stability of spinning flexible spacecraft

NASA Technical Reports Server (NTRS)

Likins, P. W.; Barbera, F. J.

1971-01-01

The stability of spinning flexible satellites in a force-free environment was analyzed. The satellite was modeled as a rigid core having attached to it a flexible appendage idealized as a collection of particles (point masses) interconnected by springs. Both Liapunov and Routh-Hurwitz stability procedures are used. In the former, the Hamiltonian of the system, constrained through the angular momentum integral so as to admit complete damping, is used as a testing function. Equations of motion are written using the hybrid coordinate formulation, which readily accepts a modal coordinate transformation ultimately allowing truncation to a level amenable to literal stability analysis. Closed form stability criteria are generated for the first mode of a restricted appendage model lying in a plane containing the system center of mass and orthogonal to the spin axis. The effects of spin on flexible bodies are discussed by considering a very elementary particle model. Control of passively unstable spacecraft is briefly considered.

A Model-Based Approach for the Measurement of Eye Movements Using Image Processing

NASA Technical Reports Server (NTRS)

Sung, Kwangjae; Reschke, Millard F.

1997-01-01

This paper describes a video eye-tracking algorithm which searches for the best fit of the pupil modeled as a circular disk. The algorithm is robust to common image artifacts such as the droopy eyelids and light reflections while maintaining the measurement resolution available by the centroid algorithm. The presented algorithm is used to derive the pupil size and center coordinates, and can be combined with iris-tracking techniques to measure ocular torsion. A comparison search method of pupil candidates using pixel coordinate reference lookup tables optimizes the processing requirements for a least square fit of the circular disk model. This paper includes quantitative analyses and simulation results for the resolution and the robustness of the algorithm. The algorithm presented in this paper provides a platform for a noninvasive, multidimensional eye measurement system which can be used for clinical and research applications requiring the precise recording of eye movements in three-dimensional space.

Synthesis and crystal structure of the coordination compound of pyridoxine with manganese sulfate

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

Furmanova, N. G., E-mail: furm@ns.crys.ras.ru; Verin, I. A.; Shyityeva, N.

2011-11-15

The reaction of pyridoxine with manganese sulfate in an aqueous solution gave the coordination compound MnSO{sub 4} {center_dot} 2C{sub 8}H{sub 11}O{sub 3}N {center_dot} 2H{sub 2}O (I). The structure of I was determined from single-crystal X-ray diffraction data. In the centrosymmetric complex (sp. gr. P1-bar, Z = 1), the Mn atom is coordinated by two pyridoxine molecules and two water molecules, thus adopting an octahedral coordination. The sulfate anion is also at a center of symmetry and, consequently, is disordered. The pyridoxine molecules are coordinated to the metal atom through the oxygen atoms of the deprotonated hydroxyl group and the CH{submore » 2}OH group that retains the hydrogen atom. The nitrogen atom is protonated in such a way that the heterocycle assumes a pyridinium character. The crystal structure also contains six water molecules of crystallization. A thermogravimetric study showed that the decomposition of I occurs in several successive steps, such as dehydration, the combustion of organic ligands, and the formation of an inorganic residue.« less

Stereochemistry of complexes with double and triple metal-ligand bonds: a continuous shape measures analysis.

PubMed

Alvarez, Santiago; Menjón, Babil; Falceto, Andrés; Casanova, David; Alemany, Pere

2014-11-17

To each coordination polyhedron we can associate a normalized coordination polyhedron that retains the angular orientation of the central atom-ligand bonds but has all the vertices at the same distance from the center. The use of shape measures of these normalized coordination polyhedra provides a simple and efficient way of discriminating angular and bond distance distortions from an ideal polyhedron. In this paper we explore the applications of such an approach to analyses of several stereochemical problems. Among others, we discuss how to discern the off-center displacement of the metal from metal-ligand bond shortening distortions in families of square planar biscarbene and octahedral dioxo complexes. The normalized polyhedron approach is also shown to be very useful to understand stereochemical trends with the help of shape maps, minimal distortion pathways, and ligand association/dissociation pathways, illustrated by the Berry and anti Berry distortions of triple-bonded [X≡ML4] complexes, the square pyramidal geometries of Mo coordination polyhedra in oxido-reductases, the coordination geometries of actinyl complexes, and the tetrahedricity of heavy atom-substituted carbon centers.

Optical properties of Ni2+ and radiation defects in MgF sub 2 and MnF sub 2

NASA Astrophysics Data System (ADS)

Feuerhelm, L. N.

1980-03-01

The radiation defects in pure MgF2 were made by observating the polarized absorption, luminescence, and excitation spectra in electron-irradiated MgF2. Additionally, studies of the absorption, emission, excitation, and temperature dependence of the lifetimes of transitions in nickel-doped MgF2 and MnF2 were accomplished, as well as the observation of radiation effects on these crystals. The absorption band at about 320 nm in irradiated MgF2 is identified to be due to the F2(D2b) center, and to have an emission at about 450 nm. Analysis of the temperature dependence of this band indicates a dominant phonon mode of 255 cm(-1) for the excited state. The F2(C1) center is identified with an absorption of about 360 nm and an emission of 410 nm. An absorption peak at 300 nm, for which no corresponding emission was found, is tentatively identified to be the F3-center, and to have a dominant phonon mode of 255 cm(-1). The temperature dependence of the lifetimes of transitions in nickel-doped MgF2 is analyzed by the quantum mechanical single configuration coordinate model of Struck and Fonger, and a complete configuration coordinate model is made for this crystal. Similar studies are made in MnF2:Ni.

Reactivity of fluoroalkanes in reactions of coordinated molecular decomposition

NASA Astrophysics Data System (ADS)

Pokidova, T. S.; Denisov, E. T.

2017-08-01

Experimental results on the coordinated molecular decomposition of RF fluoroalkanes to olefin and HF are analyzed using the model of intersecting parabolas (IPM). The kinetic parameters are calculated to allow estimates of the activation energy ( E) and rate constant ( k) of these reactions, based on enthalpy and IPM algorithms. Parameters E and k are found for the first time for eight RF decomposition reactions. The factors that affect activation energy E of RF decomposition (the enthalpy of the reaction, the electronegativity of the atoms of reaction centers, and the dipole-dipole interaction of polar groups) are determined. The values of E and k for reverse reactions of addition are estimated.

Validation for Global Solar Wind Prediction Using Ulysses Comparison: Multiple Coronal and Heliospheric Models Installed at the Community Coordinated Modeling Center

NASA Technical Reports Server (NTRS)

Jian, L. K.; MacNeice, P. J.; Mays, M. L.; Taktakishvili, A.; Odstrcil, D.; Jackson, B.; Yu, H.-S.; Riley, P.; Sokolov, I. V.

2016-01-01

The prediction of the background global solar wind is a necessary part of space weather forecasting. Several coronal and heliospheric models have been installed and/or recently upgraded at the Community Coordinated Modeling Center (CCMC), including the Wang-Sheely-Arge (WSA)-Enlil model, MHD-Around-a-Sphere (MAS)-Enlil model, Space Weather Modeling Framework (SWMF), and Heliospheric tomography using interplanetary scintillation data. Ulysses recorded the last fast latitudinal scan from southern to northern poles in 2007. By comparing the modeling results with Ulysses observations over seven Carrington rotations, we have extended our third-party validation from the previous near-Earth solar wind to middle to high latitudes, in the same late declining phase of solar cycle 23. Besides visual comparison, wehave quantitatively assessed the models capabilities in reproducing the time series, statistics, and latitudinal variations of solar wind parameters for a specific range of model parameter settings, inputs, and grid configurations available at CCMC. The WSA-Enlil model results vary with three different magnetogram inputs.The MAS-Enlil model captures the solar wind parameters well, despite its underestimation of the speed at middle to high latitudes. The new version of SWMF misses many solar wind variations probably because it uses lower grid resolution than other models. The interplanetary scintillation-tomography cannot capture the latitudinal variations of solar wind well yet. Because the model performance varies with parameter settings which are optimized for different epochs or flow states, the performance metric study provided here can serve as a template that researchers can use to validate the models for the time periods and conditions of interest to them.

Validation for global solar wind prediction using Ulysses comparison: Multiple coronal and heliospheric models installed at the Community Coordinated Modeling Center

NASA Astrophysics Data System (ADS)

Jian, L. K.; MacNeice, P. J.; Mays, M. L.; Taktakishvili, A.; Odstrcil, D.; Jackson, B.; Yu, H.-S.; Riley, P.; Sokolov, I. V.

2016-08-01

The prediction of the background global solar wind is a necessary part of space weather forecasting. Several coronal and heliospheric models have been installed and/or recently upgraded at the Community Coordinated Modeling Center (CCMC), including the Wang-Sheely-Arge (WSA)-Enlil model, MHD-Around-a-Sphere (MAS)-Enlil model, Space Weather Modeling Framework (SWMF), and heliospheric tomography using interplanetary scintillation data. Ulysses recorded the last fast latitudinal scan from southern to northern poles in 2007. By comparing the modeling results with Ulysses observations over seven Carrington rotations, we have extended our third-party validation from the previous near-Earth solar wind to middle to high latitudes, in the same late declining phase of solar cycle 23. Besides visual comparison, we have quantitatively assessed the models' capabilities in reproducing the time series, statistics, and latitudinal variations of solar wind parameters for a specific range of model parameter settings, inputs, and grid configurations available at CCMC. The WSA-Enlil model results vary with three different magnetogram inputs. The MAS-Enlil model captures the solar wind parameters well, despite its underestimation of the speed at middle to high latitudes. The new version of SWMF misses many solar wind variations probably because it uses lower grid resolution than other models. The interplanetary scintillation-tomography cannot capture the latitudinal variations of solar wind well yet. Because the model performance varies with parameter settings which are optimized for different epochs or flow states, the performance metric study provided here can serve as a template that researchers can use to validate the models for the time periods and conditions of interest to them.

Community-wide Validation of Geospace Model Ground Magnetic Field Perturbation Predictions to Support Model Transition to Operations

NASA Technical Reports Server (NTRS)

Pulkkinen, A.; Rastaetter, L.; Kuznetsova, M.; Singer, H.; Balch, C.; Weimer, D.; Toth, G.; Ridley, A.; Gombosi, T.; Wiltberger, M.;

Families at risk of poor parenting: a model for service delivery, assessment, and intervention.

PubMed

Ayoub, C; Jacewitz, M M

1982-01-01

The At Risk Parent Child Program is a multidisciplinary network agency designed for the secondary prevention of poor parenting and the extremes of child abuse and neglect. This model system of service delivery emphasizes (1) the coordination of existing community resources to access a target population of families at risk of parenting problems, (2) the provision of multiple special services in a neutral location (ambulatory pediatric clinic), and (3) the importance of intensive individual contact with a clinical professional who serves as primary therapist, social advocate and service coordinator for client families. Identification and assessment of families is best done during prenatal and perinatal periods. Both formal and informal procedures for screening for risk factors are described, and a simple set of at risk criteria for use by hospital nursing staff is provided. Preventive intervention strategies include special medical, psychological, social and developmental services, offered in an inpatient; outpatient, or in-home setting. Matching family needs to modality and setting of treatment is a major program concern. All direct services to at risk families are supplied by professionals employed within existing local agencies (hospital, public health department, state guidance center, and medical school pediatric clinic). Multiple agency involvement allows a broad-based screening capacity which allows thousands of families routine access to program services. The administrative center of the network stands as an independent, community-funded core which coordinates and monitors direct clinical services, and provides local political advocacy for families at risk of parenting problems.

Optoelectronic scanning system upgrade by energy center localization methods

NASA Astrophysics Data System (ADS)

Flores-Fuentes, W.; Sergiyenko, O.; Rodriguez-Quiñonez, J. C.; Rivas-López, M.; Hernández-Balbuena, D.; Básaca-Preciado, L. C.; Lindner, L.; González-Navarro, F. F.

2016-11-01

A problem of upgrading an optoelectronic scanning system with digital post-processing of the signal based on adequate methods of energy center localization is considered. An improved dynamic triangulation analysis technique is proposed by an example of industrial infrastructure damage detection. A modification of our previously published method aimed at searching for the energy center of an optoelectronic signal is described. Application of the artificial intelligence algorithm of compensation for the error of determining the angular coordinate in calculating the spatial coordinate through dynamic triangulation is demonstrated. Five energy center localization methods are developed and tested to select the best method. After implementation of these methods, digital compensation for the measurement error, and statistical data analysis, a non-parametric behavior of the data is identified. The Wilcoxon signed rank test is applied to improve the result further. For optical scanning systems, it is necessary to detect a light emitter mounted on the infrastructure being investigated to calculate its spatial coordinate by the energy center localization method.

Reactivity of bromoalkanes in reactions of coordinated molecular decay

NASA Astrophysics Data System (ADS)

Pokidova, T. S.; Denisov, E. T.

2016-09-01

The results from experiments on reactions of the coordinated molecular decay of RBr bromoalkanes on olefin and HBr are analyzed using the model of intersecting parabolas (MIP). Kinetic parameters within the MIP are calculated from the experimental data, enabling calculation of the activation energies ( E) and rate constants ( k) of such reactions, based on the enthalphy of the reaction and the MIP algorithms. The factors affecting the E of the RBr decay reaction are established: the enthalphy of the reaction, triplet repulsion, the energy of radical R• stabilization, the presence of a π bond adjacent to the reaction center, and the dipole-dipole interaction of polar groups. The energy spectrum of the partial energies of activation is constructed for the reaction of coordinated molecular decay of RBr, and the E and k of inverse addition reactions are evaluated.

2008 GEM Modeling Challenge: Metrics Study of the Dst Index in Physics-Based Magnetosphere and Ring Current Models and in Statistical and Analytic Specifications

NASA Technical Reports Server (NTRS)

Rastaetter, L.; Kuznetsova, M.; Hesse, M.; Pulkkinen, A.; Glocer, A.; Yu, Y.; Meng, X.; Raeder, J.; Wiltberger, M.; Welling, D.;

Patient Care Coordinator | Center for Cancer Research

Cancer.gov

We are looking for a Patient Care Coordinator to join our thoracic and gastrointestinal oncology clinical team to help us coordinate care for patients enrolled on our clinical research protocols. Duties include scheduling appointments, coordinating new patients, obtaining patient records, attending weekly clinic meetings, and data base entry.  Be part of our mission to solve

Patient Care Coordinator | Center for Cancer Research

Cancer.gov

We are looking for a Patient Care Coordinator to join our clinical team to help us coordinate care for patients enrolled on our clinical research protocols. Duties include scheduling appointments, coordinating new patients, obtaining patient records, attending weekly clinic meetings, and data base entry. Be part of our mission to solve the most important, challenging and

Patient Care Coordinator | Center for Cancer Research

Cancer.gov

We are looking for a Patient Care Coordinator to join our women's malignancies clinical team to help us coordinate care for patients enrolled on our clinical research protocols. Duties include scheduling appointments, coordinating new patients, obtaining patient records, attending weekly clinic meetings, and data base entry. Be part of our mission to solve the most important,

Dynamics of Electron Transfer for a Nonsuperexchange Coherent Mechanism. I

DTIC Science & Technology

1989-10-13

observation. In the treatment three collective nuclear coordinates are introduced, permitting independent reorganization energies for each reactive center... nuclear coordinates are introduced, permitting independent reorganization energies for each reactive center. With certain approximations, namely, equal...numerically. One rough but simple analytical result for the latter is also given. tPresent address: Departmento de Quimica , Facultad de Ciencias

Geodetic results from ISAGEX data. [for obtaining center of mass coordinates for geodetic camera sites

NASA Technical Reports Server (NTRS)

Marsh, J. G.; Douglas, B. C.; Walls, D. M.

1974-01-01

Laser and camera data taken during the International Satellite Geodesy Experiment (ISAGEX) were used in dynamical solutions to obtain center-of-mass coordinates for the Astro-Soviet camera sites at Helwan, Egypt, and Oulan Bator, Mongolia, as well as the East European camera sites at Potsdam, German Democratic Republic, and Ondrejov, Czechoslovakia. The results are accurate to about 20m in each coordinate. The orbit of PEOLE (i=15) was also determined from ISAGEX data. Mean Kepler elements suitable for geodynamic investigations are presented.

Clinical case management and navigation for colonoscopy screening in an academic medical center.

PubMed

Cavanagh, Mary F; Lane, Dorothy S; Messina, Catherine R; Anderson, Joseph C

2013-08-01

One of 5 nationally funded Centers for Disease Control and Prevention Colorectal Cancer (CRC) Screening Demonstration Programs, Project SCOPE, was conducted at an academic medical center and provided colonoscopy screening at no cost to underserved minority patients from local community health centers. Established barriers to CRC screening (eg, financial, language, transportation) among the target population were addressed through clinical coordination of care by key project staff. The use of a clinician with a patient navigator allowed for the performance of precolonoscopy "telephone visits" instead of office visits to the gastroenterologist in virtually all patients. The clinician elicited information relevant to making screening decisions (eg, past medical and surgical history, focused review of systems, medication/supplement use, CRC screening history). The patient navigator reduced barriers, including, but not limited to, scheduling, transportation, and physical navigation of the medical center on the day of colonoscopy. Preprogram preparation was vital in laying groundwork for the project, yet enhancements to the program were ongoing throughout the screening period. Detailed referral forms from primary care physicians, coupled with information obtained during telephone interviews, facilitated high colonoscopy completion rates and excellent patient satisfaction. Similarly valuable was the employment of a bilingual patient navigator, who provided practical and emotional patient support. Academic medical centers can be efficient models for providing CRC screening to disadvantaged populations. Coordination of care by a preventive medicine department, directing the recruitment, scheduling, prescreening education, and the evaluation and preparation of target populations had an overall positive effect on CRC screening with colonoscopy among patients from a community health center. © 2013 American Cancer Society.

Addressing a silent killer - The International Conference on Betel Quid and Areca Nut

Cancer.gov

The Center for Global Health, National Cancer Institute, in coordination with the National Institute of Dental and Craniofacial Research , The University of Texas at MD Anderson Cancer Center, Oral Cancer Research Coordinating Center, University of Malaya, Taiwan Health Promotion Administration, Ministry of Health and Welfare, and with the generous support of the Malaysia Ministry of Health, hosted the International Conference on Betel Quid and Areca Nut in Kuala Lumpur Malaysia on April 27-28, 2016.

Visual shape perception as Bayesian inference of 3D object-centered shape representations.

PubMed

Erdogan, Goker; Jacobs, Robert A

2017-11-01

Despite decades of research, little is known about how people visually perceive object shape. We hypothesize that a promising approach to shape perception is provided by a "visual perception as Bayesian inference" framework which augments an emphasis on visual representation with an emphasis on the idea that shape perception is a form of statistical inference. Our hypothesis claims that shape perception of unfamiliar objects can be characterized as statistical inference of 3D shape in an object-centered coordinate system. We describe a computational model based on our theoretical framework, and provide evidence for the model along two lines. First, we show that, counterintuitively, the model accounts for viewpoint-dependency of object recognition, traditionally regarded as evidence against people's use of 3D object-centered shape representations. Second, we report the results of an experiment using a shape similarity task, and present an extensive evaluation of existing models' abilities to account for the experimental data. We find that our shape inference model captures subjects' behaviors better than competing models. Taken as a whole, our experimental and computational results illustrate the promise of our approach and suggest that people's shape representations of unfamiliar objects are probabilistic, 3D, and object-centered. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Finding Order in Randomness: Single-Molecule Studies Reveal Stochastic RNA Processing | Center for Cancer Research

Cancer.gov

Producing a functional eukaryotic messenger RNA (mRNA) requires the coordinated activity of several large protein complexes to initiate transcription, elongate nascent transcripts, splice together exons, and cleave and polyadenylate the 3’ end. Kinetic competition between these various processes has been proposed to regulate mRNA maturation, but this model could lead to

An Analysis of Program Issues Perceived by Cooperative Education Coordinators in Pennsylvania Secondary Schools and Career and Technology Centers

ERIC Educational Resources Information Center

Richard, Elizabeth D.; Clark, Robert W.; Welch, Steven M.

2011-01-01

Cooperative education has been a long-standing component of career and technical education. The practice embodies many established theories of learning and is a premier delivery model for the school-to-work connections espoused by modern legislation. Yet in this era of high-stakes testing and academic accountability, allocated time for cooperative…

Naval Surface Warfare Center Carderock Division, Technical Digest

DTIC Science & Technology

2001-12-01

Survivability Systems: An Overview Fred J. Fisch 139 Modeling and Simulation of Weapons Effects on Ships Robert R. Wunderlick 143 Intelligent Networks ...communications capability of forces afloat to support emerging network -centric warfare doc- trines. Stealth, for our next generation of warships...fully-inte- grated, fully- networked electronic countermeasures system, developed in parallel and in close coordination with sister systems. An

Teaching STEM through Horticulture: Implementing an Edible Plant Curriculum at a STEM-Centric Elementary School

ERIC Educational Resources Information Center

Graves, Leila A.; Hughes, Harrison; Balgopal, Meena M.

2016-01-01

School gardens are ideal places for students to ask and answer questions about science. This paper describes a case study of two 3rd grade teachers and two STEM coordinators who were recruited to implement and evaluate a horticultural-based curriculum developed for this study. Informed by the Teacher-Centered Systemic Reform model we conducted a…

The JPL Uranian Radiation Model (UMOD)

NASA Technical Reports Server (NTRS)

Garrett, Henry; Martinez-Sierra, Luz Maria; Evans, Robin

2015-01-01

The objective of this study is the development of a comprehensive radiation model (UMOD) of the Uranian environment for JPL mission planning. The ultimate goal is to provide a description of the high energy electron and proton environments and the magnetic field at Uranus that can be used for engineering design. Currently no model exists at JPL. A preliminary electron radiation model employing Voyager 2 data was developed by Selesnick and Stone in 1991. The JPL Uranian Radiation Model extends that analysis, which modeled electrons between 0.7 MeV and 2.5 MeV based on the Voyager Cosmic Ray Subsystem electron telescope, down to an energy of 0.022 MeV for electrons and from 0.028 MeV to 3.5 MeV for protons. These latter energy ranges are based on measurements by the Applied Physics Laboratory Low Energy Charged Particle Detector on Voyager 2. As in previous JPL radiation models, the form of the Uranian model is based on magnetic field coordinates and requires a conversion from spacecraft coordinates to Uranian-centered magnetic "B-L" coordinates. Two magnetic field models have been developed for Uranus: 1) a simple "offset, tilted dipole" (OTD), and 2) a complex, multi-pole expansion model ("Q3"). A review of the existing data on Uranus and a search of the NASA Planetary Data System (PDS) were completed to obtain the latest, up to date descriptions of the Uranian high energy particle environment. These data were fit in terms of the Q3 B-L coordinates to extend and update the original Selesnick and Stone electron model in energy and to develop the companion proton flux model. The flux predictions of the new model were used to estimate the total ionizing dose for the Voyager 2 flyby, and a movie illustrating the complex radiation belt variations was produced to document the uses of the model for planning purposes.

The use of head/eye-centered, hand-centered and allocentric representations for visually guided hand movements and perceptual judgments.

PubMed

Thaler, Lore; Todd, James T

2009-04-01

Two experiments are reported that were designed to measure the accuracy and reliability of both visually guided hand movements (Exp. 1) and perceptual matching judgments (Exp. 2). The specific procedure for informing subjects of the required response on each trial was manipulated so that some tasks could only be performed using an allocentric representation of the visual target; others could be performed using either an allocentric or hand-centered representation; still others could be performed based on an allocentric, hand-centered or head/eye-centered representation. Both head/eye and hand centered representations are egocentric because they specify visual coordinates with respect to the subject. The results reveal that accuracy and reliability of both motor and perceptual responses are highest when subjects direct their response towards a visible target location, which allows them to rely on a representation of the target in head/eye-centered coordinates. Systematic changes in averages and standard deviations of responses are observed when subjects cannot direct their response towards a visible target location, but have to represent target distance and direction in either hand-centered or allocentric visual coordinates instead. Subjects' motor and perceptual performance agree quantitatively well. These results strongly suggest that subjects process head/eye-centered representations differently from hand-centered or allocentric representations, but that they process visual information for motor actions and perceptual judgments together.

AIDS Clinical Trials Group Network

MedlinePlus

... ACTG (PDF - 42 KB) Bylaws, SOPs, and Guidelines Leadership and Operations Center Network Coordinating Center Statistical and Data Management Center Performance Evaluation Program Sites Community General Information ...

NASA's Astrophysics Data Archives

NASA Astrophysics Data System (ADS)

Hasan, H.; Hanisch, R.; Bredekamp, J.

2000-09-01

The NASA Office of Space Science has established a series of archival centers where science data acquired through its space science missions is deposited. The availability of high quality data to the general public through these open archives enables the maximization of science return of the flight missions. The Astrophysics Data Centers Coordinating Council, an informal collaboration of archival centers, coordinates data from five archival centers distiguished primarily by the wavelength range of the data deposited there. Data are available in FITS format. An overview of NASA's data centers and services is presented in this paper. A standard front-end modifyer called `Astrowbrowse' is described. Other catalog browsers and tools include WISARD and AMASE supported by the National Space Scince Data Center, as well as ISAIA, a follow on to Astrobrowse.

Three Dimensional Thermal Model of Newberry Volcano, Oregon

DOE Data Explorer

Trenton Cladouhos

2015-01-30

Final results of a 3D finite difference thermal model of Newberry Volcano, Oregon. Model data are formatted as a text file with four data columns (X, Y, Z, T). X and Y coordinates are in UTM (NAD83 Zone 10N), Z is elevation from mean sea level (meters), T is temperature in °C. Model is 40km X 40km X 12.5 km, grid node spacing is 100m in X, Y, and Z directions. A symmetric cylinder shaped magmatic heat source centered on the present day caldera is the modeled heat source. The center of the modeled body is a -1700 m (elevation) and is 600m thick with a radius of 8700m. This is the best fit results from 2D modeling of the west flank of the volcano. The model accounts for temperature dependent thermal properties and latent heat of crystallization. For additional details, assumptions made, data used, and a discussion of the validity of the model see Frone, 2015 (http://search.proquest.com/docview/1717633771).

Structure and decays of nuclear three-body systems: The Gamow coupled-channel method in Jacobi coordinates

NASA Astrophysics Data System (ADS)

Wang, S. M.; Michel, N.; Nazarewicz, W.; Xu, F. R.

2017-10-01

Background: Weakly bound and unbound nuclear states appearing around particle thresholds are prototypical open quantum systems. Theories of such states must take into account configuration mixing effects in the presence of strong coupling to the particle continuum space. Purpose: To describe structure and decays of three-body systems, we developed a Gamow coupled-channel (GCC) approach in Jacobi coordinates by employing the complex-momentum formalism. We benchmarked the complex-energy Gamow shell model (GSM) against the new framework. Methods: The GCC formalism is expressed in Jacobi coordinates, so that the center-of-mass motion is automatically eliminated. To solve the coupled-channel equations, we use hyperspherical harmonics to describe the angular wave functions while the radial wave functions are expanded in the Berggren ensemble, which includes bound, scattering, and Gamow states. Results: We show that the GCC method is both accurate and robust. Its results for energies, decay widths, and nucleon-nucleon angular correlations are in good agreement with the GSM results. Conclusions: We have demonstrated that a three-body GSM formalism explicitly constructed in the cluster-orbital shell model coordinates provides results similar to those with a GCC framework expressed in Jacobi coordinates, provided that a large configuration space is employed. Our calculations for A =6 systems and 26O show that nucleon-nucleon angular correlations are sensitive to the valence-neutron interaction. The new GCC technique has many attractive features when applied to bound and unbound states of three-body systems: it is precise, is efficient, and can be extended by introducing a microscopic model of the core.

Redesigning care for patients at increased hospitalization risk: the Comprehensive Care Physician model.

PubMed

Meltzer, David O; Ruhnke, Gregory W

2014-05-01

Patients who have been hospitalized often experience care coordination problems that worsen outcomes and increase costs. One reason is that hospital care and ambulatory care are often provided by different physicians. However, interventions to improve care coordination for hospitalized patients have not consistently improved outcomes and generally have not reduced costs. We describe the rationale for the Comprehensive Care Physician model, in which physicians focus their practice on patients at increased risk of hospitalization so that they can provide both inpatient and outpatient care to their patients. We also describe the design and implementation of a study supported by the Center for Medicare and Medicaid Innovation to assess the model's effects on costs and outcomes. Evidence concerning the effectiveness of the program is expected by 2016. If the program is found to be effective, the next steps will be to assess the durability of its benefits and the model's potential for dissemination; evidence to the contrary will provide insights into how to alter the program to address sources of failure.

MATILDA: A Military Laser Range Safety Tool Based on Probabilistic Risk Assessment (PRA) Techniques

DTIC Science & Technology

2014-08-01

Figure 6: MATILDA Coordinate Transformations ....................................................... 22  Figure 7: Geocentric and MICS Coordinates...Target – Range Boundary Undershoot Geometry .............. 34  Figure 19: Geocentric Overshoot Geometry and Parameters...transformed into Geocentric coordinates, a Cartesian (x,y,z) coordinate system with origin at the center of the Earth and z-axis oriented towards the

Pediatric Specialty Care Model for Management of Chronic Respiratory Failure: Cost and Savings Implications and Misalignment With Payment Models.

PubMed

Graham, Robert J; McManus, Michael L; Rodday, Angie Mae; Weidner, Ruth Ann; Parsons, Susan K

2018-05-01

To describe program design, costs, and savings implications of a critical care-based care coordination model for medically complex children with chronic respiratory failure. All program activities and resultant clinical outcomes were tracked over 4 years using an adapted version of the Care Coordination Measurement Tool. Patient characteristics, program activity, and acute care resource utilization were prospectively documented in the adapted version of the Care Coordination Measurement Tool and retrospectively cross-validated with hospital billing data. Impact on total costs of care was then estimated based on program outcomes and nationally representative administrative data. Tertiary children's hospital. Critical Care, Anesthesia, Perioperative Extension and Home Ventilation Program enrollees. None. The program provided care for 346 patients and families over the study period. Median age at enrollment was 6 years with more than half deriving secondary respiratory failure from a primary neuromuscular disease. There were 11,960 encounters over the study period, including 1,202 home visits, 673 clinic visits, and 4,970 telephone or telemedicine encounters. Half (n = 5,853) of all encounters involved a physician and 45% included at least one care coordination activity. Overall, we estimated that program interventions were responsible for averting 556 emergency department visits and 107 hospitalizations. Conservative monetization of these alone accounted for annual savings of $1.2-2 million or $407/pt/mo net of program costs. Innovative models, such as extension of critical care services, for high-risk, high-cost patients can result in immediate cost savings. Evaluation of financial implications of comprehensive care for high-risk patients is necessary to complement clinical and patient-centered outcomes for alternative care models. When year-to-year cost variability is high and cost persistence is low, these savings can be estimated from documentation within care coordination management tools. Means of financial sustainability, scalability, and equal access of such care models need to be established.

Coordinated Care Management For Dementia In A Large, Academic Health System

PubMed Central

Tan, Zaldy S.; Jennings, Lee; Reuben, David

2014-01-01

Alzheimer’s disease and other dementias are chronic, incurable diseases that require coordinated care that addresses the medical, behavioral, and social aspects of the disease. With funding from the Center for Medicare and Medicaid Innovation (the Innovation Center), we launched a dementia care program in which a nurse practitioner acting as a dementia care manager worked with primary care physicians to develop and implement a dementia care plan that offers training and support to caregivers, manages care transitions, and facilitates access to community-based services. Post-visit surveys showed high levels of caregiver satisfaction. As program enrollment grows, outcomes will be tracked based on the triple aim developed by the Institute for Healthcare Improvement and adopted by the Centers for Medicare and Medicaid Services: better care, better health, and lower cost and utilization. The program, if successful at achieving the triple aim, may serve as a national model for how dementia and other chronic diseases can be managed in partnership with primary care practices. The program may also inform policy and reimbursement decisions for the recently released transitional care management codes and the complex chronic care management codes to be released by Medicare in 2015. PMID:24711323

SMART DOCS: A New Patient-Centered Outcomes and Coordinated-Care Management Approach for the Future Practice of Sleep Medicine

PubMed Central

Kushida, Clete A.; Nichols, Deborah A.; Holmes, Tyson H.; Miller, Ric; Griffin, Kara; Cardell, Chia-Yu; Hyde, Pamela R.; Cohen, Elyse; Manber, Rachel; Walsh, James K.

2015-01-01

The practice of medicine is currently undergoing a transformation to become more efficient, cost-effective, and patient centered in its delivery of care. The aim of this article is to stimulate discussion within the sleep medicine community in addressing these needs by our approach as well as other approaches to sleep medicine care. The primary goals of the Sustainable Methods, Algorithms, and Research Tools for Delivering Optimal Care Study (SMART DOCS) are: (1) to introduce a new Patient-Centered Outcomes and Coordinated-Care Management (PCCM) approach for the future practice of sleep medicine, and (2) to test the PCCM approach against a Conventional Diagnostic and Treatment Outpatient Medical Care (CONV) approach in a randomized, two-arm, single-center, long-term, comparative effectiveness trial. The PCCM approach is integrated into a novel outpatient care delivery model for patients with sleep disorders that includes the latest technology, allowing providers to obtain more accurate and rapid diagnoses and to make evidence-based treatment recommendations, while simultaneously enabling patients to have access to personalized medical information and reports regarding their diagnosis and treatment so that they can make more informed health care decisions. Additionally, the PCCM approach facilitates better communication between patients, referring primary care physicians, sleep specialists, and allied health professionals so that providers can better assist patients in achieving their preferred outcomes. A total of 1,506 patients 18 y or older will be randomized to either the PCCM or CONV approach and will be followed for at least 1 y with endpoints of improved health care performance, better health, and cost control. Clinical Trials Registration: ClinicalTrials.gov Identifier: NCT02037438. Citation: Kushida CA, Nichols DA, Holmes TH, Miller R, Griffin K, Cardell CY, Hyde PR, Cohen E, Manber R, Walsh JK. SMART DOCS: a new patient-centered outcomes and coordinated-care management approach for the future practice of sleep medicine. SLEEP 2015;38(2):315–326. PMID:25409112

Consortium for Molecular Characterization of Screen-Detected Lesions Created: Eight Grants Awarded | Division of Cancer Prevention

Cancer.gov

The NCI has awarded eight grants to create the Consortium for Molecular Characterization of Screen-Detected Lesions. The consortium has seven molecular characterization laboratories (MCLs) and a coordinating center, and is supported by the Division of Cancer Prevention and the Division of Cancer Biology. | 7 laboratories and a coordinating center focused on identifying

Integrating kidney transplantation into value-based care for people with renal failure.

PubMed

Hippen, Benjamin E; Maddux, Franklin W

2018-01-01

Healthcare reimbursement is increasingly tied to value instead of volume, with special attention paid to resource-intensive populations such as patients with renal disease. To this end, Medicare has sponsored pilot projects to encourage providers to develop care coordination and population health management strategies to provide quality care while reducing resource utilization. In this Personal Viewpoint essay, we argue in favor of expanding one such pilot project-the Comprehensive ESRD Care (CEC) initiative-to include patients with advanced chronic kidney disease and kidney transplant recipients. The implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) offers a time-sensitive incentive for transplant centers in particular to align with extant CECs. An "expanded" CEC model proffers opportunity for robust cooperation between general nephrology practices, dialysis providers, and transplant centers to develop care coordination strategies for all patients with renal disease, realign incentives for all clinical stakeholders to increase kidney transplantation rates, and reduce total costs of care. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Recovery of a geocentric reference frame using the present-day GPS system

NASA Technical Reports Server (NTRS)

Malla, Rajendra P.; Wu, Sien-Chong

1990-01-01

A geocentric reference frame adopts the center of mass of the earth as the origin of the coordinate axes. The center of mass of the earth is the natural and unambiguous origin of a geocentric satellite dynamical system. But in practice a kinematically obtained terrestrial reference frame may assume an origin other than the geocenter. The establishment of a geocentric reference frame, to which all relevant observations and results can be referred and in which geodynamic theories or models for the dynamic behavior of earth can be formulated, requires the ability to accurately recover a given coordinate frame origin offset from the geocenter. GPS measurements, because of their abundance and broad distribution, provide a powerful tool to obtain this origin offset in a short period of time. Two effective strategies have been devised. Data from the First Central And South America (Casa Uno) geodynamics experiment has been studied, in order to demonstrate the ability of recovering the geocenter location with present day GPS satellites and receivers.

Unifying Screening Processes Within the PROSPR Consortium: A Conceptual Model for Breast, Cervical, and Colorectal Cancer Screening

PubMed Central

Kim, Jane J.; Schapira, Marilyn M.; Tosteson, Anna N. A.; Zauber, Ann G.; Geiger, Ann M.; Kamineni, Aruna; Weaver, Donald L.; Tiro, Jasmin A.

2015-01-01

General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. We present a trans-organ conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based on clinical guidelines and protocols; the model concepts could be expanded to other organ sites. The model covers four types of care in the screening process: risk assessment, detection, diagnosis, and treatment. Interfaces between different provider teams (eg, primary care and specialty care), including communication and transfer of responsibility, may occur when transitioning between types of care. Our model highlights across each organ site similarities and differences in steps, interfaces, and transitions in the screening process and documents the conclusion of a screening episode. This model was developed within the National Cancer Institute–funded consortium Population-based Research Optimizing Screening through Personalized Regimens (PROSPR). PROSPR aims to optimize the screening process for breast, cervical, and colorectal cancer and includes seven research centers and a statistical coordinating center. Given current health care reform initiatives in the United States, this conceptual model can facilitate the development of comprehensive quality metrics for cancer screening and promote trans-organ comparative cancer screening research. PROSPR findings will support the design of interventions that improve screening outcomes across multiple cancer sites. PMID:25957378

SENR /NRPy + : Numerical relativity in singular curvilinear coordinate systems

NASA Astrophysics Data System (ADS)

Ruchlin, Ian; Etienne, Zachariah B.; Baumgarte, Thomas W.

2018-03-01

We report on a new open-source, user-friendly numerical relativity code package called SENR /NRPy + . Our code extends previous implementations of the BSSN reference-metric formulation to a much broader class of curvilinear coordinate systems, making it ideally suited to modeling physical configurations with approximate or exact symmetries. In the context of modeling black hole dynamics, it is orders of magnitude more efficient than other widely used open-source numerical relativity codes. NRPy + provides a Python-based interface in which equations are written in natural tensorial form and output at arbitrary finite difference order as highly efficient C code, putting complex tensorial equations at the scientist's fingertips without the need for an expensive software license. SENR provides the algorithmic framework that combines the C codes generated by NRPy + into a functioning numerical relativity code. We validate against two other established, state-of-the-art codes, and achieve excellent agreement. For the first time—in the context of moving puncture black hole evolutions—we demonstrate nearly exponential convergence of constraint violation and gravitational waveform errors to zero as the order of spatial finite difference derivatives is increased, while fixing the numerical grids at moderate resolution in a singular coordinate system. Such behavior outside the horizons is remarkable, as numerical errors do not converge to zero near punctures, and all points along the polar axis are coordinate singularities. The formulation addresses such coordinate singularities via cell-centered grids and a simple change of basis that analytically regularizes tensor components with respect to the coordinates. Future plans include extending this formulation to allow dynamical coordinate grids and bispherical-like distribution of points to efficiently capture orbiting compact binary dynamics.

USDA Human Nutrition Center, 1978-1982, and coordination of human nutrition research agencies.

PubMed

Combs, Gerald F

2009-01-01

Survey findings, confirming widespread malnutrition, led to the 1969 White House Conference on Food, Nutrition, and Health and increased funding of related Federal programs. In 1976, the ARS Administrator proposed to Congress a greatly expanded program for human nutrition research. This led to the development of USDA Human Nutrition Research Centers at Universities. Funding of these Centers resulted mainly from efforts of scientists and others from the states where Centers were located. USDA formed the Science and Education Administration (SEA) by merging several related research and education agencies, expecting to improve coordination and focus. Human nutrition research activities were placed in SEA under a USDA Human Nutrition Center in 1978, which was terminated in 1982 when SEA was disbanded. Coordination of human nutrition research within USDA and with other federal agencies required specific mechanisms. Within USDA, a subcommittee met regularly to exchange information and generate policy recommendations. Quarterly meetings of USDA Human Nutrition Center directors were held to enhance information exchange and cooperation. A Human Nutrition Board of Scientific Counselors was established to advise the Secretary regarding program direction and priorities. Human nutrition at the federal level was coordinated through the Interagency Committee on Human Nutrition Research (ICHNR). ICHNR devised a computerized database of ongoing federal food and nutrition research, developed a comprehensive 5-y research plan, and held biennial conferences for scientific presentations. Most important were the several interagency committees, which worked together to ensure that all federal agencies spoke with 1 voice. These committees functioned most effectively.

Towards successful coordination of electronic health record based-referrals: a qualitative analysis.

PubMed

Hysong, Sylvia J; Esquivel, Adol; Sittig, Dean F; Paul, Lindsey A; Espadas, Donna; Singh, Simran; Singh, Hardeep

2011-07-27

Successful subspecialty referrals require considerable coordination and interactive communication among the primary care provider (PCP), the subspecialist, and the patient, which may be challenging in the outpatient setting. Even when referrals are facilitated by electronic health records (EHRs) (i.e., e-referrals), lapses in patient follow-up might occur. Although compelling reasons exist why referral coordination should be improved, little is known about which elements of the complex referral coordination process should be targeted for improvement. Using Okhuysen & Bechky's coordination framework, this paper aims to understand the barriers, facilitators, and suggestions for improving communication and coordination of EHR-based referrals in an integrated healthcare system. We conducted a qualitative study to understand coordination breakdowns related to e-referrals in an integrated healthcare system and examined work-system factors that affect the timely receipt of subspecialty care. We conducted interviews with seven subject matter experts and six focus groups with a total of 30 PCPs and subspecialists at two tertiary care Department of Veterans Affairs (VA) medical centers. Using techniques from grounded theory and content analysis, we identified organizational themes that affected the referral process. Four themes emerged: lack of an institutional referral policy, lack of standardization in certain referral procedures, ambiguity in roles and responsibilities, and inadequate resources to adapt and respond to referral requests effectively. Marked differences in PCPs' and subspecialists' communication styles and individual mental models of the referral processes likely precluded the development of a shared mental model to facilitate coordination and successful referral completion. Notably, very few barriers related to the EHR were reported. Despite facilitating information transfer between PCPs and subspecialists, e-referrals remain prone to coordination breakdowns. Clear referral policies, well-defined roles and responsibilities for key personnel, standardized procedures and communication protocols, and adequate human resources must be in place before implementing an EHR to facilitate referrals.

Towards successful coordination of electronic health record based-referrals: a qualitative analysis

PubMed Central

2011-01-01

Background Successful subspecialty referrals require considerable coordination and interactive communication among the primary care provider (PCP), the subspecialist, and the patient, which may be challenging in the outpatient setting. Even when referrals are facilitated by electronic health records (EHRs) (i.e., e-referrals), lapses in patient follow-up might occur. Although compelling reasons exist why referral coordination should be improved, little is known about which elements of the complex referral coordination process should be targeted for improvement. Using Okhuysen & Bechky's coordination framework, this paper aims to understand the barriers, facilitators, and suggestions for improving communication and coordination of EHR-based referrals in an integrated healthcare system. Methods We conducted a qualitative study to understand coordination breakdowns related to e-referrals in an integrated healthcare system and examined work-system factors that affect the timely receipt of subspecialty care. We conducted interviews with seven subject matter experts and six focus groups with a total of 30 PCPs and subspecialists at two tertiary care Department of Veterans Affairs (VA) medical centers. Using techniques from grounded theory and content analysis, we identified organizational themes that affected the referral process. Results Four themes emerged: lack of an institutional referral policy, lack of standardization in certain referral procedures, ambiguity in roles and responsibilities, and inadequate resources to adapt and respond to referral requests effectively. Marked differences in PCPs' and subspecialists' communication styles and individual mental models of the referral processes likely precluded the development of a shared mental model to facilitate coordination and successful referral completion. Notably, very few barriers related to the EHR were reported. Conclusions Despite facilitating information transfer between PCPs and subspecialists, e-referrals remain prone to coordination breakdowns. Clear referral policies, well-defined roles and responsibilities for key personnel, standardized procedures and communication protocols, and adequate human resources must be in place before implementing an EHR to facilitate referrals. PMID:21794109

Access to Formally Ni(I) States in a Heterobimetallic NiZn System

PubMed Central

Uyeda, Christopher

2014-01-01

Heterobimetallic NiZn complexes featuring metal centers in distinct coordination environments have been synthesized using diimine-dioxime ligands as binucleating scaffolds. A tetramethylfuran-containing ligand derivative enables a stable one-electron-reduced S = 1/2 species to be accessed using Cp2Co as a chemical reductant. The resulting pseudo-square planar complex exhibits spectroscopic and crystallographic characteristics of a ligand-centered radical bound to a Ni(II) center. Upon coordination of a π-acidic ligand such as PPh3, however, a five-coordinate Ni(I) metalloradical is formed. The electronic structures of these reduced species provide insight into the subtle effects of ligand structure on the potential and reversibility of the NiII/I couple for complexes of redox-active tetraazamacrocycles. PMID:25614786

Mathematical modeling of a class of multibody flexible spacecraft structures

NASA Technical Reports Server (NTRS)

Kelkar, Atul, G.

1994-01-01

A mathematical model for a general multibody flexible spacecraft is obtained. The generic spacecraft considered consists of a flexible central body to which a number of flexible multibody structures are attached. The coordinate systems used in the derivation allow effective decoupling of the translational motion of the entire spacecraft from its rotational motion about its center of mass. The derivation assumes that the deformations in the bodies are only due to elastic motions. The dynamic model derived is a closed-form vector-matrix differential equation. The model developed can be used for analysis and simulation of many realistic spacecraft configurations.

Interaction of different poisons with MgCl2/TiCl4 based Ziegler-Natta catalysts

NASA Astrophysics Data System (ADS)

Bahri-Laleh, Naeimeh

2016-08-01

Adsorption of different poison molecules on activated MgCl2 is investigated within DFT using a cluster model of the MgCl2 surface with (MgCl2)16 formula containing four 4-coordinated and eight 5-coordinated Mg atoms as (110) and (104) surfaces, respectively. Studied poison molecules are chosen as possible impurities in hydrocarbon solvents and monomer feeds and contain water, hydrogensulfide, carbondioxide, molecular oxygen and methanol. First, adsorption of 1-4 molecules of different poisons to the (104) and (110) lateral cuts of MgCl2, as well as their adsorption on [MgCl2]/TiCl2Et active center and AlEt3 cocatalyst is considered. Results reveal that poisons strongly stabilize both crystal surfaces, mostly Ti active center relative to the unpoisoned solid. Second, energy barrier (ETS) for ethylene insertion in the presence of different poisons located on the first and second Mg atom relative to the active Ti is calculated. While poison molecule located on the second Mg does not change ETS, coordination of it into the first Mg atom increases ETS by 0.9-1.2 kcal mol-1. In the last part of this manuscript, the stereoselective behavior of active Ti species, with and without poison molecules and external electron donor, is fully explored.

Center of gravity estimation using a reaction board instrumented with fiber Bragg gratings

NASA Astrophysics Data System (ADS)

Oliveira, Rui; Roriz, Paulo; Marques, Manuel B.; Frazão, Orlando

2018-03-01

The purpose of the present work is to construct a reaction board based on fiber Bragg gratings (FBGs) that could be used for estimation of the 2D coordinates of the projection of center of gravity (CG) of an object. The apparatus is consisted of a rigid equilateral triangular board mounted on three supports at the vertices, two of which have cantilevers instrumented with FBGs. When an object of known weight is placed on the board, the bending strain of the cantilevers is measured by a proportional wavelength shift of the FBGs. Applying the equilibrium conditions of a rigid body and proper calibration procedures, the wavelength shift is used to estimate the vertical reaction forces and moments of force at the supports and the coordinates of the object's CG projection on the board. This method can be used on a regular basis to estimate the CG of the human body or objects with complex geometry and density distribution. An example is provided for the estimation of the CG projection coordinates of two orthopaedic femur bone models, one intact, and the other with a hip stem implant encased. The clinical implications of changing the normal CG location by means of a prosthesis have been discussed.

Evaluation of Team-Based Care in an Urban Free Clinic Setting.

PubMed

Iddins, Brenda W; Frank, Jennifer Sandson; Kannar, Pegah; Curry, William A; Mullins, Melissa; Hites, Lisle; Selleck, Cynthia

2015-01-01

This article reports the experiences of a school of nursing, academic health center, and community-based organization working via an interprofessional collaborative practice model to meet the mutual goal of serving the health care needs of an indigent, largely minority population in Birmingham, Alabama. The population suffers disproportionately from chronic health problems including diabetes, obesity, cardiovascular disease, asthma, and mental health disorders. The program emphasizes diabetes management because the academic health center recognized the need for transitional and primary care, including mental health services, for the increasing numbers of uninsured patients with diabetes and its comorbidities. Half of the clinicians involved in this project had no prior experience with interprofessional collaborative practice, and there was confusion regarding the roles of team members from the partnering institutions. Activities involving care coordination consistently received low scores on weekly rating scales leading to the creation of positions for a nurse care manager and pharmaceutical patient assistance program coordinator. Conversely, shared decision making and cooperation ratings were consistently high. Evaluation identified the need for reliable, accessible data and data analysis to target clinically effective interventions and care coordination and to assess cost effectiveness. The strengths, challenges, lessons learned, and next steps required for sustainability of this alignment are discussed.

Implementing the patient-centered medical home in residency education.

PubMed

Doolittle, Benjamin R; Tobin, Daniel; Genao, Inginia; Ellman, Matthew; Ruser, Christopher; Brienza, Rebecca

2015-01-01

In recent years, physician groups, government agencies and third party payers in the United States of America have promoted a Patient-centered Medical Home (PCMH) model that fosters a team-based approach to primary care. Advocates highlight the model's collaborative approach where physicians, mid-level providers, nurses and other health care personnel coordinate their efforts with an aim for high-quality, efficient care. Early studies show improvement in quality measures, reduction in emergency room visits and cost savings. However, implementing the PCMH presents particular challenges to physician training programs, including institutional commitment, infrastructure expenditures and faculty training. Teaching programs must consider how the objectives of the PCMH model align with recent innovations in resident evaluation now required by the Accreditation Council of Graduate Medical Education (ACGME) in the US. This article addresses these challenges, assesses the preliminary success of a pilot project, and proposes a viable, realistic model for implementation at other institutions.

Better trauma care. How Maryland does it.

PubMed

Wish, John R; Long, William B; Edlich, Richard F

2005-01-01

In March, 1970, the Maryland State Police, in cooperation with the University of Maryland, started the first statewide airborne transportation system. It was modeled after the army's success in Korea and Vietnam, where battlefield injuries were flown to front-line MASH units. The world's premier statewide medical aviation division was made possible through a cooperative effort between the Maryland State Police Aviation Division and Dr. R Adams Cowley at the University of Maryland Hospital as a public service to the citizens of the state. The Maryland Institute for Emergency Medical Services Systems (MIEMSS) has five components: (1) aircraft, (2) state troopers, (3) system communications (SYSCOM) center, (4) ambulance and fire emergency rescue, and (5) Level I adult and pediatric trauma centers and a regional burn center. The Maryland State Police Aviation Division now has 12 Aerospace Dauphin AS365N helicopters that operate out of eight fixed points throughout the state. Each helicopter has a two-person crew that consists of a pilot and a paramedic. Since 1993, the overall coordination of emergency medical services (EMS) has been under the purview of MIEMSS, an independent executive-level state agency that is governed by an appointed board and advisory council. To ensure stable funding for Maryland's world renowned emergency medical services (EMS) system, including med-evac helicopters, ambulances, fire equipment, rescue squads, and trauma units, a "surcharge" of $13.50 per year is collected with the automobile registration fee where applicable. The SYSCOM center in Baltimore coordinates the helicopter transport to the scene of the accident as well as referral to the specialty care facility: Adult Level I Trauma Center, Pediatric Level I Trauma Center, and Regional Burn Center. An on-the-scene evaluation of this exemplary emergency medical system in Maryland provides further convincing evidence of the performance of the Maryland State Police Aviation Division as they transported an injured child to the Johns Hopkins Pediatric Level I Trauma Center. It is our belief that the model emergency medical system in Maryland, if replicated throughout our nation, would save the lives of the critically injured.

Synthesis and Structural Characterization of Magnesium Based Coordination Networks in Different Solvents

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

D Banerjee; J Finkelstein; A Smirnov

2011-12-31

Three magnesium based metal-organic frameworks, Mg{sub 3}(3,5-PDC){sub 3}(DMF){sub 3} {center_dot} DMF [1], Mg(3,5-PDC)(H{sub 2}O) {center_dot} (H{sub 2}O) [3], and Mg{sub 4}(3,5-PDC){sub 4}(DMF){sub 2}(H{sub 2}O){sub 2} {center_dot} 2DMF {center_dot} 4.5H{sub 2}O [4], and a 2-D coordination polymer, [Mg(3,5-PDC)(H{sub 2}O){sub 2}] [2] [PDC = pyridinedicarboxylate], were synthesized using a combination of DMF, methanol, ethanol, and water. Compound 1 [space group P2{sub 1}/n, a = 12.3475(5) {angstrom}, b = 11.1929(5) {angstrom}, c = 28.6734(12) {angstrom}, {beta} = 98.8160(10){sup o}, V = 3916.0(3) {angstrom}{sup 3}] consists of a combination of isolated and corner-sharing magnesium octahedra connected by the organic linkers to form a 3-Dmore » network with a 12.2 {angstrom} x 4.6 {angstrom} 1-D channel. The channel contains coordinated and free DMF molecules. In compound 2 [space group C2/c, a = 9.964(5) {angstrom}, b = 12.0694(6) {angstrom}, c = 7.2763(4) {angstrom}, {beta} = 106.4970(6){sup o}, V = 836.70(6) {angstrom}{sup 3}], PDC connects isolated seven coordinated magnesium polyhedra into a layered structure. Compound 3 [space group P6{sub 1}22, a = 11.479(1) {angstrom}, c = 14.735(3) {angstrom}, V = 1681.7(4) {angstrom}{sup 3}] (previously reported) contains isolated magnesium octahedra connected by the organic linker with each other forming a 3D network. Compound 4 [space group P2{sub 1}/c, a = 13.7442(14) {angstrom}, b = 14.2887(15) {angstrom}, c = 14.1178(14) {angstrom}, {beta} = 104.912(2){sup o}, V = 2679.2(5) {angstrom}{sup 3}] also exhibits a 3D network based on isolated magnesium octahedra with square cavities containing both disordered DMF and water molecules. The structural topologies originate due to the variable coordination ability of solvent molecules with the metal center. Water molecules coordinate with the magnesium metal centers preferably over other polar solvents (DMF, methanol, ethanol) used to synthesize the coordination networks. Despite testing multiple desolvation routes, we were unable to measure BET surface areas greater than 51.9 m{sup 2}/g for compound 1.« less

Synthesis and Structural Characterization of Magnesium Based Coordination Networks in Different Solvents

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

Banerjee, Debasis; Finkelstein, Jeffrey; Smirnov, A.

2015-10-15

Three magnesium based metal-organic frameworks, Mg{sub 3}(3,5-PDC){sub 3}(DMF){sub 3} {center_dot} DMF [1], Mg(3,5-PDC)(H{sub 2}O) {center_dot} (H{sub 2}O) [3], and Mg4(3,5-PDC)4(DMF){sub 2}(H{sub 2}O){sub 2} {center_dot} 2DMF {center_dot} 4.5H{sub 2}O [4], and a 2-D coordination polymer, [Mg(3,5-PDC)(H{sub 2}O){sub 2}] [2] [PDC = pyridinedicarboxylate], were synthesized using a combination of DMF, methanol, ethanol, and water. Compound 1 [space group P2{sub 1}/n, a = 12.3475(5) {angstrom}, b = 11.1929(5) {angstrom}, c = 28.6734(12) {angstrom}, {beta} = 98.8160(10){sup o}, V = 3916.0(3) {angstrom}{sup 3}] consists of a combination of isolated and corner-sharing magnesium octahedra connected by the organic linkers to form a 3-D network withmore » a 12.2 {angstrom} x 4.6 {angstrom} 1-D channel. The channel contains coordinated and free DMF molecules. In compound 2 [space group C2/c, a = 9.964(5) {angstrom}, b = 12.0694(6) {angstrom}, c = 7.2763(4) {angstrom}, {beta} = 106.4970(6){sup o}, V = 836.70(6) {angstrom}{sup 3}], PDC connects isolated seven coordinated magnesium polyhedra into a layered structure. Compound 3 [space group P6{sub 1}22, a = 11.479(1) {angstrom}, c = 14.735(3) {angstrom}, V = 1681.7(4) {angstrom}{sup 3}] (previously reported) contains isolated magnesium octahedra connected by the organic linker with each other forming a 3D network. Compound 4 [space group P2{sub 1}/c, a = 13.7442(14) {angstrom}, b = 14.2887(15) {angstrom}, c = 14.1178(14) {angstrom}, {beta} = 104.912(2){sup o}, V = 2679.2(5) {angstrom}{sup 3}] also exhibits a 3D network based on isolated magnesium octahedra with square cavities containing both disordered DMF and water molecules. The structural topologies originate due to the variable coordination ability of solvent molecules with the metal center. Water molecules coordinate with the magnesium metal centers preferably over other polar solvents (DMF, methanol, ethanol) used to synthesize the coordination networks. Despite testing multiple desolvation routes, we were unable to measure BET surface areas greater than 51.9 m{sup 2}/g for compound 1.« less

On push-forward representations in the standard gyrokinetic model

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

Miyato, N., E-mail: miyato.naoaki@jaea.go.jp; Yagi, M.; Scott, B. D.

2015-01-15

Two representations of fluid moments in terms of a gyro-center distribution function and gyro-center coordinates, which are called push-forward representations, are compared in the standard electrostatic gyrokinetic model. In the representation conventionally used to derive the gyrokinetic Poisson equation, the pull-back transformation of the gyro-center distribution function contains effects of the gyro-center transformation and therefore electrostatic potential fluctuations, which is described by the Poisson brackets between the distribution function and scalar functions generating the gyro-center transformation. Usually, only the lowest order solution of the generating function at first order is considered to explicitly derive the gyrokinetic Poisson equation. This ismore » true in explicitly deriving representations of scalar fluid moments with polarization terms. One also recovers the particle diamagnetic flux at this order because it is associated with the guiding-center transformation. However, higher-order solutions are needed to derive finite Larmor radius terms of particle flux including the polarization drift flux from the conventional representation. On the other hand, the lowest order solution is sufficient for the other representation, in which the gyro-center transformation part is combined with the guiding-center one and the pull-back transformation of the distribution function does not appear.« less

A continuum of sociotechnical requirements for patient-centered problem lists.

PubMed

Collins, Sarah; Tsivkin, Kira; Hongsermeier, Tonya; Dubois, David; Nandigam, Hari Krishna; Rocha, Roberto A

2013-01-01

Specific requirements for patient-centered health information technology remain ill-defined. To create operational definitions of patient-centered problem lists, we propose a continuum of sociotechnical requirements with five stages: 1) Intradisciplinary Care Planning: Viewing and searching for problems by discipline; 2) Multi-disciplinary Care Planning: Categorizing problem states to meet discipline-specific needs; 3) Interdisciplinary Care Planning: Sharing and linking problems between disciplines; 4) Integrated and Coordinated Care Planning: Associating problems with assessments, tasks, interventions and outcomes across disciplines for coordination, knowledge development, and reporting; and 5) Patient-Centered Care Planning: Engaging patients in identification of problems and maintenance of their problem list.

Developing the role of the social worker as coordinator of services at the surrogate parenting center.

PubMed

Gagin, Roni; Cohen, Miri; Greenblatt, Lee; Solomon, Hanah; Itskovitz-Eldor, Joseph

2004-01-01

A law permitting couples to conceive biological children through surrogacy was legislated in Israel in March 1996. The Rambam Medical Center has established the only nonprofit Surrogate Parenting Center at a public hospital in Israel. The multidisciplinary teamwork at the Center is case managed by a social worker. An important role of the social work intervention is consultation and support for the couple and the surrogate at all stages of the process. The case study presented in the article illustrates the need for sensitive and professional intervention due to the complexity of the surrogacy process and the crisis it involves for both the surrogate and the couple. In light of the growing parenting surrogacy cases in the United States, Europe, and Israel, a structured social work intervention model is described, which may be implemented at public or private surrogate parenting centers.

EXODUS: Integrating intelligent systems for launch operations support

NASA Technical Reports Server (NTRS)

Adler, Richard M.; Cottman, Bruce H.

1991-01-01

Kennedy Space Center (KSC) is developing knowledge-based systems to automate critical operations functions for the space shuttle fleet. Intelligent systems will monitor vehicle and ground support subsystems for anomalies, assist in isolating and managing faults, and plan and schedule shuttle operations activities. These applications are being developed independently of one another, using different representation schemes, reasoning and control models, and hardware platforms. KSC has recently initiated the EXODUS project to integrate these stand alone applications into a unified, coordinated intelligent operations support system. EXODUS will be constructed using SOCIAL, a tool for developing distributed intelligent systems. EXODUS, SOCIAL, and initial prototyping efforts using SOCIAL to integrate and coordinate selected EXODUS applications are described.

Disaster planning: the basics of creating a burn mass casualty disaster plan for a burn center.

PubMed

Kearns, Randy D; Conlon, Kathe M; Valenta, Andrea L; Lord, Graydon C; Cairns, Charles B; Holmes, James H; Johnson, Daryhl D; Matherly, Annette F; Sawyer, Dalton; Skarote, Mary Beth; Siler, Sean M; Helminiak, Radm Clare; Cairns, Bruce A

2014-01-01

In 2005, the American Burn Association published burn disaster guidelines. This work recognized that local and state assets are the most important resources in the initial 24- to 48-hour management of a burn disaster. Historical experiences suggest there is ample opportunity to improve local and state preparedness for a major burn disaster. This review will focus on the basics of developing a burn surge disaster plan for a mass casualty event. In the event of a disaster, burn centers must recognize their place in the context of local and state disaster plan activation. Planning for a burn center takes on three forms; institutional/intrafacility, interfacility/intrastate, and interstate/regional. Priorities for a burn disaster plan include: coordination, communication, triage, plan activation (trigger point), surge, and regional capacity. Capacity and capability of the plan should be modeled and exercised to determine limitations and identify breaking points. When there is more than one burn center in a given state or jurisdiction, close coordination and communication between the burn centers are essential for a successful response. Burn surge mass casualty planning at the facility and specialty planning levels, including a state burn surge disaster plan, must have interface points with governmental plans. Local, state, and federal governmental agencies have key roles and responsibilities in a burn mass casualty disaster. This work will include a framework and critical concepts any burn disaster planning effort should consider when developing future plans.

The perioperative surgical home (PSH): a comprehensive review of US and non-US studies shows predominantly positive quality and cost outcomes.

PubMed

Kash, Bita A; Zhang, Yichen; Cline, Kayla M; Menser, Terri; Miller, Thomas R

2014-12-01

Policy Points: The perioperative surgical home (PSH) is complementary to the patient-centered medical home (PCMH) and defines methods for improving the patient experience and clinical outcomes, and controlling costs for the care of surgical patients. The PSH is a physician-led care delivery model that includes multi-specialty care teams and cost-efficient use of resources at all levels through a patient-centered, continuity of care delivery model with shared decision making. The PSH emphasizes "prehabilitation" of the patient before surgery, intraoperative optimization, improved return to function through follow-up, and effective transitions to home or post-acute care to reduce complications and readmissions. The evolving concept of more rigorously coordinated and integrated perioperative management, often referred to as the perioperative surgical home (PSH), parallels the well-known concept of a patient-centered medical home (PCMH), as they share a vision of improved clinical outcomes and reductions in cost of care through patient engagement and care coordination. Elements of the PSH and similar surgical care coordination models have been studied in the United States and other countries. This comprehensive review of peer-reviewed literature investigates the history and evolution of PSH and PSH-like models and summarizes the results of studies of PSH elements in the United States and in other countries. We reviewed more than 250 potentially relevant studies. At the conclusion of the selection process, our search had yielded a total of 152 peer-reviewed articles published between 1980 and 2013. The literature reports consistent and significant positive findings related to PSH initiatives. Both US and non-US studies stress the role of anesthesiologists in perioperative patient management. The PSH may have the greatest impact on preparing patients for surgery and ensuring their safe and effective transition to home or other postoperative rehabilitation. There appear to be some subtle differences between US and non-US research on the PSH. The literature in non-US settings seems to focus strictly on the comparison of outcomes from changing policies or practices, whereas US research seems to be more focused on the discovery of innovative practice models and other less direct changes, for example, information technology, that may be contributing to the evolution toward the PSH model. The PSH model may have significant implications for policymakers, payers, administrators, clinicians, and patients. The potential for policy-relevant cost savings and quality improvement is apparent across the perioperative continuum of care, especially for integrated care organizations, bundled payment, and value-based purchasing. © 2014 Milbank Memorial Fund.

New and Promising: Software Worth a Look. A MicroSIFT Survey of Educational Software Preview Center Coordinators. Volume II, No. 2.

ERIC Educational Resources Information Center

Podany, Zita

This guide lists 19 software packages considered to be worthy of further consideration by other reviewing agencies and schools by a group of 17 computer coordinators from educational software preview centers and evaluation agencies. The following software is listed: (1) ASK-IT, an authoring tool; (2) Balance of the Planet, an environmental…

New and Promising: Software Worth a Look. A MicroSIFT Survey of Educational Software Preview Center Coordinators. Volume II, No. 1.

ERIC Educational Resources Information Center

Podany, Zita

This guide lists 21 software packages considered to be worthy of further consideration by other reviewing agencies and schools by a group of 12 computer coordinators from educational software preview centers and evaluation agencies. These software products have been selected as not being likely to appear in the reviews produced by major software…

The International GPS Service: A Global Resource for GPS Applications and Research

NASA Technical Reports Server (NTRS)

Neilan, Ruth E.; Zumberge, James F.; Beutler, Gerhard; Kouba, Jan

1997-01-01

Since June, 1992, the International GPS service has been coordinating a global civilian GPS infrastructure in order to support numerous GPS applications and research activities. A key aspect of the IGS is the reliability and quality of the analysis products that have been made available over the past five years through the IGS Analysis Centers and the Analysis Center Coordinator.

Crystal structure of Helicobacter pylori neutrophil-activating protein with a di-nuclear ferroxidase center in a zinc or cadmium-bound form

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

Yokoyama, Hideshi, E-mail: h-yokoya@u-shizuoka-ken.ac.jp; Tsuruta, Osamu; Akao, Naoya

2012-06-15

Highlights: Black-Right-Pointing-Pointer Structures of a metal-bound Helicobacter pylori neutrophil-activating protein were determined. Black-Right-Pointing-Pointer Two zinc ions were tetrahedrally coordinated by ferroxidase center (FOC) residues. Black-Right-Pointing-Pointer Two cadmium ions were coordinated in a trigonal-bipyramidal and octahedral manner. Black-Right-Pointing-Pointer The second metal ion was more weakly coordinated than the first at the FOC. Black-Right-Pointing-Pointer A zinc ion was found in one negatively-charged pore suitable as an ion path. -- Abstract: Helicobacter pylori neutrophil-activating protein (HP-NAP) is a Dps-like iron storage protein forming a dodecameric shell, and promotes adhesion of neutrophils to endothelial cells. The crystal structure of HP-NAP in a Zn{sup 2+}-more » or Cd{sup 2+}-bound form reveals the binding of two zinc or two cadmium ions and their bridged water molecule at the ferroxidase center (FOC). The two zinc ions are coordinated in a tetrahedral manner to the conserved residues among HP-NAP and Dps proteins. The two cadmium ions are coordinated in a trigonal-bipyramidal and distorted octahedral manner. In both structures, the second ion is more weakly coordinated than the first. Another zinc ion is found inside of the negatively-charged threefold-related pore, which is suitable for metal ions to pass through.« less

A two-level approach to VLBI terrestrial and celestial reference frames using both least-squares adjustment and Kalman filter algorithms

NASA Astrophysics Data System (ADS)

Soja, B.; Krasna, H.; Boehm, J.; Gross, R. S.; Abbondanza, C.; Chin, T. M.; Heflin, M. B.; Parker, J. W.; Wu, X.

2017-12-01

The most recent realizations of the ITRS include several innovations, two of which are especially relevant to this study. On the one hand, the IERS ITRS combination center at DGFI-TUM introduced a two-level approach with DTRF2014, consisting of a classical deterministic frame based on normal equations and an optional coordinate time series of non-tidal displacements calculated from geophysical loading models. On the other hand, the JTRF2014 by the combination center at JPL is a time series representation of the ITRF determined by Kalman filtering. Both the JTRF2014 and the second level of the DTRF2014 are thus able to take into account short-term variations in the station coordinates. In this study, based on VLBI data, we combine these two approaches, applying them to the determination of both terrestrial and celestial reference frames. Our product has two levels like DTRF2014, with the second level being a Kalman filter solution like JTRF2014. First, we compute a classical TRF and CRF in a global least-squares adjustment by stacking normal equations from 5446 VLBI sessions between 1979 and 2016 using the Vienna VLBI and Satellite Software VieVS (solution level 1). Next, we obtain coordinate residuals from the global adjustment by applying the level-1 TRF and CRF in the single-session analysis and estimating coordinate offsets. These residuals are fed into a Kalman filter and smoother, taking into account the stochastic properties of the individual stations and radio sources. The resulting coordinate time series (solution level 2) serve as an additional layer representing irregular variations not considered in the first level of our approach. Both levels of our solution are implemented in VieVS in order to test their individual and combined performance regarding the repeatabilities of estimated baseline lengths, EOP, and radio source coordinates.

[Interest of a collaboration between the vigilances' coordination and care-related risks management committees in a health care center].

PubMed

Lassale, B; Ragni, J; Besse-Moreau, M

2013-05-01

Health care vigilance committees appeared with time in France. Some vigilance entities are present at a regional level, but all are found at the National Drugs and Health Care Products Safety Agency. Along with health care centers' certification, vigilance committees' coordination has evolved: whereas its presence was optional in the first version of certification, it has now imposed itself within health care centers with the more recent versions of certification, detailing the actions it must undertake. In parallel, a lot of attention is put on health care-related risk management with a health care center. Vigilances' coordination can thus take advantage of this in sharing an incident declaration system common with that of health care-related risks management. This collaboration will enable the generation of a priori risks' maps, help analyze adverse events and use the notion of criticality within a global safe care policy in each health care facility. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

NHERI: Advancing the Research Infrastructure of the Multi-Hazard Community

NASA Astrophysics Data System (ADS)

Blain, C. A.; Ramirez, J. A.; Bobet, A.; Browning, J.; Edge, B.; Holmes, W.; Johnson, D.; Robertson, I.; Smith, T.; Zuo, D.

2017-12-01

The Natural Hazards Engineering Research Infrastructure (NHERI), supported by the National Science Foundation (NSF), is a distributed, multi-user national facility that provides the natural hazards research community with access to an advanced research infrastructure. Components of NHERI are comprised of a Network Coordination Office (NCO), a cloud-based cyberinfrastructure (DesignSafe-CI), a computational modeling and simulation center (SimCenter), and eight Experimental Facilities (EFs), including a post-disaster, rapid response research facility (RAPID). Utimately NHERI enables researchers to explore and test ground-breaking concepts to protect homes, businesses and infrastructure lifelines from earthquakes, windstorms, tsunamis, and surge enabling innovations to help prevent natural hazards from becoming societal disasters. When coupled with education and community outreach, NHERI will facilitate research and educational advances that contribute knowledge and innovation toward improving the resiliency of the nation's civil infrastructure to withstand natural hazards. The unique capabilities and coordinating activities over Year 1 between NHERI's DesignSafe-CI, the SimCenter, and individual EFs will be presented. Basic descriptions of each component are also found at https://www.designsafe-ci.org/facilities/. Additionally to be discussed are the various roles of the NCO in leading development of a 5-year multi-hazard science plan, coordinating facility scheduling and fostering the sharing of technical knowledge and best practices, leading education and outreach programs such as the recent Summer Institute and multi-facility REU program, ensuring a platform for technology transfer to practicing engineers, and developing strategic national and international partnerships to support a diverse multi-hazard research and user community.

Coordinated control system modelling of ultra-supercritical unit based on a new T-S fuzzy structure.

PubMed

Hou, Guolian; Du, Huan; Yang, Yu; Huang, Congzhi; Zhang, Jianhua

2018-03-01

The thermal power plant, especially the ultra-supercritical unit is featured with severe nonlinearity, strong multivariable coupling. In order to deal with these difficulties, it is of great importance to build an accurate and simple model of the coordinated control system (CCS) in the ultra-supercritical unit. In this paper, an improved T-S fuzzy model identification approach is proposed. First of all, the k-means++ algorithm is employed to identify the premise parameters so as to guarantee the number of fuzzy rules. Then, the local linearized models are determined by using the incremental historical data around the cluster centers, which are obtained via the stochastic gradient descent algorithm with momentum and variable learning rate. Finally, with the proposed method, the CCS model of a 1000 MW USC unit in Tai Zhou power plant is developed. The effectiveness of the proposed approach is validated by the given extensive simulation results, and it can be further employed to design the overall advanced controllers for the CCS in an USC unit. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

The Hurricane Rainband and Intensity Change Experiment (RAINEX): Observations and Modeling of Hurricanes Katrina, Ophelia, and Rita (2005)

NASA Astrophysics Data System (ADS)

Houze, R. A.

2006-12-01

The Hurricane Rainband and Intensity Change Experiment (RAINEX) used three P3 aircraft aided by high- resolution numerical modeling and satellite communications to investigate the 2005 Hurricanes Katrina, Ophelia, and Rita. The aim was to increase the understanding of tropical cyclone intensity change by interactions between a tropical cyclone's inner core and rainbands. All three aircraft had dual-Doppler radars, with the ELDORA radar on board the Naval Research Laboratory's P3 aircraft, providing particularly detailed Doppler radar data. Numerical model forecasts helped plan the aircraft missions, and innovative communications and data transfer in real time allowed the flights to be coordinated from a ground-based operations center. The P3 aircraft released approximately 600 dropsondes in locations targeted for optimal coordination with the Doppler radar data, as guided by the operations center. The storms were observed in all stages of development, from Tropical Depression to Category 5 hurricane. The data from RAINEX are readily available through an online Field Catalog and RAINEX Data Archive. The RAINEX dataset is illustrated by a preliminary analysis of Hurricane Rita, which was documented by multi-aircraft flights on five days: 1) while a tropical storm, 2) while rapidly intensifying to a Category 5 hurricane, 3) during an eyewall replacement, 4) when the hurricane became asymmetric upon encountering environmental shear, and 5) just prior to landfall.

Implementing chronic care for COPD: planned visits, care coordination, and patient empowerment for improved outcomes.

PubMed

Fromer, Len

2011-01-01

Current primary care patterns for chronic obstructive pulmonary disease (COPD) focus on reactive care for acute exacerbations, often neglecting ongoing COPD management to the detriment of patient experience and outcomes. Proactive diagnosis and ongoing multifactorial COPD management, comprising smoking cessation, influenza and pneumonia vaccinations, pulmonary rehabilitation, and symptomatic and maintenance pharmacotherapy according to severity, can significantly improve a patient's health-related quality of life, reduce exacerbations and their consequences, and alleviate the functional, utilization, and financial burden of COPD. Redesign of primary care according to principles of the chronic care model, which is implemented in the patient-centered medical home, can shift COPD management from acute rescue to proactive maintenance. The chronic care model and patient-centered medical home combine delivery system redesign, clinical information systems, decision support, and self-management support within a practice, linked with health care organization and community resources beyond the practice. COPD care programs implementing two or more chronic care model components effectively reduce emergency room and inpatient utilization. This review guides primary care practices in improving COPD care workflows, highlighting the contributions of multidisciplinary collaborative team care, care coordination, and patient engagement. Each primary care practice can devise a COPD care workflow addressing risk awareness, spirometric diagnosis, guideline-based treatment and rehabilitation, and self-management support, to improve patient outcomes in COPD.

Emergency Operations Center

EPA Pesticide Factsheets

EOC serves as the response operational focal point. A communication and coordination hub designed to increase data management and coordination abilities, provides communication support for Watch Officer, Homeland Security, regional and field assets.

Patient Care Coordinator | Center for Cancer Research

Cancer.gov

We are looking for a Patient Care Coordinator to join our clinical team to help us coordinate care for patients enrolled on our clinical research protocols. Duties include scheduling appointments, coordinating new patients, obtaining patient records, attending weekly clinic meetings, and data base entry. Be part of our mission to solve the most important, challenging and neglected problems in modern cancer research and patient care.  The National Cancer Institute’s Center for Cancer Research is a world-leading cancer research organization working toward scientific breakthroughs at medicine’s cutting edge.   Our scientists can’t do it alone. It takes an extraordinary team of researchers, clinical experts and administrators to improve the lives of cancer patients and answer the most important questions in cancer biology and treatment.

Measuring primary care organizational capacity for diabetes care coordination: the Diabetes Care Coordination Readiness Assessment.

PubMed

Weeks, Douglas L; Polello, Jennifer M; Hansen, Daniel T; Keeney, Benjamin J; Conrad, Douglas A

2014-01-01

Not all primary care clinics are prepared to implement care coordination services for chronic conditions, such as diabetes. Understanding true capacity to coordinate care is an important first-step toward establishing effective and efficient care coordination. Yet, we could identify no diabetes-specific instruments to systematically assess readiness and/or status of primary care clinics to engage in diabetes care coordination. This report describes the development and initial validation of the Diabetes Care Coordination Readiness Assessment (DCCRA), which is intended to measure primary care clinic readiness to coordinate care for adult patients with diabetes. The instrument was developed through iterative item generation within a framework of five domains of care coordination: Organizational Capacity, Care Coordination, Clinical Management, Quality Improvement, and Technical Infrastructure. Validation data was collected on 39 primary care clinics. Content validity, inter-rater reliability, internal consistency, and construct validity of the 49-item instrument were assessed. Inter-rater agreement indices per item ranged from 0.50 to 1.0. Cronbach's alpha of the entire instrument was 0.964, and for the five domain scales ranged from 0.688 to 0.961. Clinics with existing care coordinators were rated as more ready to support care coordination than clinics without care coordinators for the entire DCCRA and for each domain, supporting construct validity. As providers increasingly attempt to adopt patient-centered approaches, introduction of the DCCRA is timely and appropriate for assisting clinics with identifying gaps in provision of care coordination services. The DCCRA's strengths include promising psychometric properties. A valid measure of diabetes care coordination readiness should be useful in diabetes program evaluation, assistance with quality improvement initiatives, and measurement of patient-centered care in research.

Independent but Coordinated Trials: Insights from the Practice Based Opportunities for Weight Reduction (POWER) Trials Collaborative Research Group

PubMed Central

Yeh, Hsin-Chieh; Clark, Jeanne M.; Emmons, Karen M.; Moore, Renee H.; Bennett, Gary G; Warner, Erica T.; Sarwer, Davis B.; Jerome, Gerald J; Miller, Edgar R; Volger, Sheri; Louis, Thomas A.; Wells, Barbara; Wadden, Thomas A.; Colditz, Graham A.; Appel, Lawrence J.

2011-01-01

Background The National Heart, Lung, and Blood Institute (NHLBI) funded three institutions to conduct effectiveness trials of weight loss interventions in primary care settings. Unlike traditional multi-center clinical trials, each study was established as an independent trial with a distinct protocol. Still, efforts were made to coordinate and standardize several aspects of the trials. The three trials formed a collaborative group, the “Practice Based Opportunities for Weight Reduction (POWER) Trials Collaborative Research Group.” Purpose We describe the common and distinct features of the three trials, the key characteristics of the collaborative group, and the lessons learned from this novel organizational approach. Methods The Collaborative Research Group consists of three individual studies: “Be Fit, Be Well“(Washington University in St. Louis/Harvard University), “POWER Hopkins” (Johns Hopkins), and “POWER-UP” (University of Pennsylvania). There are a total of 15 participating clinics with ~1,100 participants. The common primary outcome is change in weight at 24 months of follow-up, but each protocol has trial-specific elements including different interventions and different secondary outcomes. A Resource Coordinating Unit at Johns Hopkins provides administrative support. Results The Collaborative Research Group established common components to facilitate potential cross-site comparisons. The main advantage of this approach is to develop and evaluate several interventions, when there is insufficient evidence to test one or two approaches, as would be done in a traditional multi-center trial. Limitations The challenges of the organizational design include the complex decision making process, the extent of potential data pooling, time intensive efforts to standardize reports, and the additional responsibilities of the DSMB to monitor three distinct protocols. Conclusions The POWER Trials Collaborative Research Group is a case study of an alternative organizational model to conduct independent, yet coordinated trials. Such a model is increasingly being used in NHLBI supported trials , especially given the interest in comparative effectiveness research. Nevertheless, the ultimate utility of this model will not be fully understood until the trials are completed. PMID:20573639

Disability care coordination organizations: improving health and function in people with disabilities.

PubMed

Palsbo, Susan E; Mastal, Margaret F; O'Donnell, Lolita T

2006-01-01

Disability care coordination organizations (DCCOs) combine attributes of the medical home model and community nursing. Teams of nurses and social workers collaborate with the client to arrange disability-competent medical and social services. This article synthesizes observational findings from site visits to approximately half of the DCCOs operating in 2004. DCCOs have 6 core clinical activities: comprehensive assessment; self-directed, person-centered planning; health visit support; centralized medical-social record; community resource engagement; and constant communication. We also identified 3 core business competencies: service coordination, patient education/behavioral modification, and continuous enhancement of disability competency. Each DCCO started as a new company rather than as a product line of an existing business, and each included the target population in the design stage. Most DCCOs contract with state Medicaid agencies under a prepaid capitation arrangement, and some also enroll Medicare beneficiaries. Capitated DCCOs retain cost savings and may be financially stronger than fee-for-service DCCOs. Although studies suggest that DCCOs improve coordination and clinical outcomes while reducing costs, the current evidence has not been peer reviewed.

The coordination hub: Toward patient-centered and collaborative care processes.

PubMed

Winge, Monica; Johannesson, Paul; Perjons, Erik; Wangler, Benkt

2015-12-01

The organization and processes of today's health and social care are becoming ever more complex as a consequence of societal trends, including an aging population and an increased reliance on care at home. One aspect of the increased complexity is that a single patient may receive care from several care providers, which easily results in situations with potentially incoherent, uncoordinated, and interfering care processes. In order to describe and analyze such situations, the article introduces the notion of a process conglomeration. This is defined as a set of patient-care processes that all concern the same patient, that are overlapping in time, and that all are sharing the overall goal of improving or maintaining the health and social well-being of the patient. Problems and challenges of process conglomerations are investigated using coordination theory and models for continuous process improvement. In order to address the challenges, a solution is proposed in the form of a Coordination Hub, being an integrated software service that offers a number of information services for coordinating the activities of the processes in a process conglomeration. © The Author(s) 2014.

Precision Departure Release Capability (PDRC) Final Report

NASA Technical Reports Server (NTRS)

Engelland, Shawn A.; Capps, Richard; Day, Kevin Brian; Kistler, Matthew Stephen; Gaither, Frank; Juro, Greg

2013-01-01

After takeoff, aircraft must merge into en route (Center) airspace traffic flows that may be subject to constraints that create localized demand/capacity imbalances. When demand exceeds capacity, Traffic Management Coordinators (TMCs) and Frontline Managers (FLMs) often use tactical departure scheduling to manage the flow of departures into the constrained Center traffic flow. Tactical departure scheduling usually involves a Call for Release (CFR) procedure wherein the Tower must call the Center to coordinate a release time prior to allowing the flight to depart. In present-day operations release times are computed by the Center Traffic Management Advisor (TMA) decision support tool, based upon manual estimates of aircraft ready time verbally communicated from the Tower to the Center. The TMA-computed release time is verbally communicated from the Center back to the Tower where it is relayed to the Local controller as a release window that is typically three minutes wide. The Local controller will manage the departure to meet the coordinated release time window. Manual ready time prediction and verbal release time coordination are labor intensive and prone to inaccuracy. Also, use of release time windows adds uncertainty to the tactical departure process. Analysis of more than one million flights from January 2011 indicates that a significant number of tactically scheduled aircraft missed their en route slot due to ready time prediction uncertainty. Uncertainty in ready time estimates may result in missed opportunities to merge into constrained en route flows and lead to lost throughput. Next Generation Air Transportation System plans call for development of Tower automation systems capable of computing surface trajectory-based ready time estimates. NASA has developed the Precision Departure Release Capability (PDRC) concept that improves tactical departure scheduling by automatically communicating surface trajectory-based ready time predictions and departure runway assignments to the Center scheduling tool. The PDRC concept also incorporates earlier NASA and FAA research into automation-assisted CFR coordination. The PDRC concept reduces uncertainty by automatically communicating coordinated release times with seconds-level precision enabling TMCs and FLMs to work with target times rather than windows. NASA has developed a PDRC prototype system that integrates the Center's TMA system with a research prototype Tower decision support tool. A two-phase field evaluation was conducted at NASA's North Texas Research Station in Dallas/Fort Worth. The field evaluation validated the PDRC concept and demonstrated reduced release time uncertainty while being used for tactical departure scheduling of more than 230 operational flights over 29 weeks of operations. This paper presents research results from the PDRC research activity. Companion papers present the Concept of Operations and a Technology Description.

Precision Departure Release Capability (PDRC) Technology Description

NASA Technical Reports Server (NTRS)

Engelland, Shawn A.; Capps, Richard; Day, Kevin; Robinson, Corissia; Null, Jody R.

2013-01-01

After takeoff, aircraft must merge into en route (Center) airspace traffic flows which may be subject to constraints that create localized demand-capacity imbalances. When demand exceeds capacity, Traffic Management Coordinators (TMCs) often use tactical departure scheduling to manage the flow of departures into the constrained Center traffic flow. Tactical departure scheduling usually involves use of a Call for Release (CFR) procedure wherein the Tower must call the Center TMC to coordinate a release time prior to allowing the flight to depart. In present-day operations release times are computed by the Center Traffic Management Advisor (TMA) decision support tool based upon manual estimates of aircraft ready time verbally communicated from the Tower to the Center. The TMA-computed release is verbally communicated from the Center back to the Tower where it is relayed to the Local controller as a release window that is typically three minutes wide. The Local controller will manage the departure to meet the coordinated release time window. Manual ready time prediction and verbal release time coordination are labor intensive and prone to inaccuracy. Also, use of release time windows adds uncertainty to the tactical departure process. Analysis of more than one million flights from January 2011 indicates that a significant number of tactically scheduled aircraft missed their en route slot due to ready time prediction uncertainty. Uncertainty in ready time estimates may result in missed opportunities to merge into constrained en route flows and lead to lost throughput. Next Generation Air Transportation System (NextGen) plans call for development of Tower automation systems capable of computing surface trajectory-based ready time estimates. NASA has developed the Precision Departure Release Capability (PDRC) concept that uses this technology to improve tactical departure scheduling by automatically communicating surface trajectory-based ready time predictions to the Center scheduling tool. The PDRC concept also incorporates earlier NASA and FAA research into automation-assisted CFR coordination. The PDRC concept helps reduce uncertainty by automatically communicating coordinated release times with seconds-level precision enabling TMCs to work with target times rather than windows. NASA has developed a PDRC prototype system that integrates the Center's TMA system with a research prototype Tower decision support tool. A two-phase field evaluation was conducted at NASA's North Texas Research Station (NTX) in Dallas-Fort Worth. The field evaluation validated the PDRC concept and demonstrated reduced release time uncertainty while being used for tactical departure scheduling of more than 230 operational flights over 29 weeks of operations. This paper presents the Technology Description. Companion papers include the Final Report and a Concept of Operations.

Precision Departure Release Capability (PDRC): NASA to FAA Research Transition

NASA Technical Reports Server (NTRS)

Engelland, Shawn; Davis, Thomas J.

2013-01-01

After takeoff, aircraft must merge into en route (Center) airspace traffic flows which may be subject to constraints that create localized demand-capacity imbalances. When demand exceeds capacity, Traffic Management Coordinators (TMCs) and Frontline Managers (FLMs) often use tactical departure scheduling to manage the flow of departures into the constrained Center traffic flow. Tactical departure scheduling usually involves use of a Call for Release (CFR) procedure wherein the Tower must call the Center to coordinate a release time prior to allowing the flight to depart. In present-day operations release times are computed by the Center Traffic Management Advisor (TMA) decision support tool based upon manual estimates of aircraft ready time verbally communicated from the Tower to the Center. The TMA-computed release time is verbally communicated from the Center back to the Tower where it is relayed to the Local controller as a release window that is typically three minutes wide. The Local controller will manage the departure to meet the coordinated release time window. Manual ready time prediction and verbal release time coordination are labor intensive and prone to inaccuracy. Also, use of release time windows adds uncertainty to the tactical departure process. Analysis of more than one million flights from January 2011 indicates that a significant number of tactically scheduled aircraft missed their en route slot due to ready time prediction uncertainty. Uncertainty in ready time estimates may result in missed opportunities to merge into constrained en route flows and lead to lost throughput. Next Generation Air Transportation System plans call for development of Tower automation systems capable of computing surface trajectory-based ready time estimates. NASA has developed the Precision Departure Release Capability (PDRC) concept that improves tactical departure scheduling by automatically communicating surface trajectory-based ready time predictions and departure runway assignments to the Center scheduling tool. The PDRC concept also incorporates earlier NASA and FAA research into automation-assisted CFR coordination. The PDRC concept reduces uncertainty by automatically communicating coordinated release times with seconds-level precision enabling TMCs and FLMs to work with target times rather than windows. NASA has developed a PDRC prototype system that integrates the Center's TMA system with a research prototype Tower decision support tool. A two-phase field evaluation was conducted at NASA's North Texas Research Station in Dallas-Fort Worth. The field evaluation validated the PDRC concept and demonstrated reduced release time uncertainty while being used for tactical departure scheduling of more than 230 operational flights over 29 weeks of operations.

Precision Departure Release Capability (PDRC) Concept of Operations

NASA Technical Reports Server (NTRS)

Engelland, Shawn; Capps, Richard A.; Day, Kevin Brian

2013-01-01

After takeoff, aircraft must merge into en route (Center) airspace traffic flows which may be subject to constraints that create localized demandcapacity imbalances. When demand exceeds capacity Traffic Management Coordinators (TMCs) often use tactical departure scheduling to manage the flow of departures into the constrained Center traffic flow. Tactical departure scheduling usually involves use of a Call for Release (CFR) procedure wherein the Tower must call the Center TMC to coordinate a release time prior to allowing the flight to depart. In present-day operations release times are computed by the Center Traffic Management Advisor (TMA) decision support tool based upon manual estimates of aircraft ready time verbally communicated from the Tower to the Center. The TMA-computed release is verbally communicated from the Center back to the Tower where it is relayed to the Local controller as a release window that is typically three minutes wide. The Local controller will manage the departure to meet the coordinated release time window. Manual ready time prediction and verbal release time coordination are labor intensive and prone to inaccuracy. Also, use of release time windows adds uncertainty to the tactical departure process. Analysis of more than one million flights from January 2011 indicates that a significant number of tactically scheduled aircraft missed their en route slot due to ready time prediction uncertainty. Uncertainty in ready time estimates may result in missed opportunities to merge into constrained en route flows and lead to lost throughput. Next Generation Air Transportation System (NextGen) plans call for development of Tower automation systems capable of computing surface trajectory-based ready time estimates. NASA has developed the Precision Departure Release Capability (PDRC) concept that uses this technology to improve tactical departure scheduling by automatically communicating surface trajectory-based ready time predictions to the Center scheduling tool. The PDRC concept also incorporates earlier NASA and FAA research into automation-assisted CFR coordination. The PDRC concept helps reduce uncertainty by automatically communicating coordinated release times with seconds-level precision enabling TMCs to work with target times rather than windows. NASA has developed a PDRC prototype system that integrates the Center's TMA system with a research prototype Tower decision support tool. A two-phase field evaluation was conducted at NASA's North Texas Research Station (NTX) in DallasFort Worth. The field evaluation validated the PDRC concept and demonstrated reduced release time uncertainty while being used for tactical departure scheduling of more than 230 operational flights over 29 weeks of operations. This paper presents the Concept of Operations. Companion papers include the Final Report and a Technology Description. ? SUBJECT:

Calculation of Latitude and Longitude for Points on Perimeter of a Circle on a Sphere

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

Morris, Heidi E.

2015-08-14

This document describes the calculation of the Earth-Centered Earth Fixed (ECEF) coordinates for points lying on the perimeter of a circle. Here, the perimeter of the circle lies on the surface of the sphere and the center of the planar circle is below the surface. These coordinates are converted to latitude and longitude for mapping fields on the surface of the earth.

An Initial Study Examining the Feasibility of Expert System Technology for Command and Control of Supporting Arms in the United States Marine Corps.

DTIC Science & Technology

1988-03-01

A 11 7. MISSION TARGET COORDINATION a SAFETY’ CH- ECKS FIRE SUPPORT COORDINATION CENTERS S’. iN NFA jNQQ MSSIN C o CFL RqESSIN81 TARGET NO iYs YS...INITIAL DISTRIBUTION LIST No. Copies I. Defense Technical Information Center 2 Cameron Station Alexandria, Virginia 22304-6145 2. Library, Code 0142 2

A single particle model to simulate the dynamics of entangled polymer melts.

PubMed

Kindt, P; Briels, W J

2007-10-07

We present a computer simulation model of polymer melts representing each chain as one single particle. Besides the position coordinate of each particle, we introduce a parameter n(ij) for each pair of particles i and j within a specified distance from each other. These numbers, called entanglement numbers, describe the deviation of the system of ignored coordinates from its equilibrium state for the given configuration of the centers of mass of the polymers. The deviations of the entanglement numbers from their equilibrium values give rise to transient forces, which, together with the conservative forces derived from the potential of mean force, govern the displacements of the particles. We have applied our model to a melt of C(800)H(1602) chains at 450 K and have found good agreement with experiments and more detailed simulations. Properties addressed in this paper are radial distribution functions, dynamic structure factors, and linear as well as nonlinear rheological properties.

CHRR: coordinate hit-and-run with rounding for uniform sampling of constraint-based models

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

Haraldsdóttir, Hulda S.; Cousins, Ben; Thiele, Ines

In constraint-based metabolic modelling, physical and biochemical constraints define a polyhedral convex set of feasible flux vectors. Uniform sampling of this set provides an unbiased characterization of the metabolic capabilities of a biochemical network. However, reliable uniform sampling of genome-scale biochemical networks is challenging due to their high dimensionality and inherent anisotropy. Here, we present an implementation of a new sampling algorithm, coordinate hit-and-run with rounding (CHRR). This algorithm is based on the provably efficient hit-and-run random walk and crucially uses a preprocessing step to round the anisotropic flux set. CHRR provably converges to a uniform stationary sampling distribution. Wemore » apply it to metabolic networks of increasing dimensionality. We show that it converges several times faster than a popular artificial centering hit-and-run algorithm, enabling reliable and tractable sampling of genome-scale biochemical networks.« less

CHRR: coordinate hit-and-run with rounding for uniform sampling of constraint-based models

DOE PAGES

Haraldsdóttir, Hulda S.; Cousins, Ben; Thiele, Ines; ...

2017-01-31

In constraint-based metabolic modelling, physical and biochemical constraints define a polyhedral convex set of feasible flux vectors. Uniform sampling of this set provides an unbiased characterization of the metabolic capabilities of a biochemical network. However, reliable uniform sampling of genome-scale biochemical networks is challenging due to their high dimensionality and inherent anisotropy. Here, we present an implementation of a new sampling algorithm, coordinate hit-and-run with rounding (CHRR). This algorithm is based on the provably efficient hit-and-run random walk and crucially uses a preprocessing step to round the anisotropic flux set. CHRR provably converges to a uniform stationary sampling distribution. Wemore » apply it to metabolic networks of increasing dimensionality. We show that it converges several times faster than a popular artificial centering hit-and-run algorithm, enabling reliable and tractable sampling of genome-scale biochemical networks.« less

Exploring the usefulness of comprehensive care plans for children with medical complexity (CMC): a qualitative study.

PubMed

Adams, Sherri; Cohen, Eyal; Mahant, Sanjay; Friedman, Jeremy N; Macculloch, Radha; Nicholas, David B

2013-01-19

The Medical Home model recommends that Children with Special Health Care Needs (CSHCN) receive a medical care plan, outlining the child's major medical issues and care needs to assist with care coordination. While care plans are a primary component of effective care coordination, the creation and maintenance of care plans is time, labor, and cost intensive, and the desired content of the care plan has not been studied. The purpose of this qualitative study was to understand the usefulness and desired content of comprehensive care plans by exploring the perceptions of parents and health care providers (HCPs) of children with medical complexity (CMC). This qualitative study utilized in-depth semi-structured interviews and focus groups. HCPs (n = 15) and parents (n = 15) of CMC who had all used a comprehensive care plan were recruited from a tertiary pediatric academic health sciences center. Themes were identified through grounded theory analysis of interview and focus group data. A multi-dimensional model of perceived care plan usefulness emerged. The model highlights three integral aspects of the care plan: care plan characteristics, activating factors and perceived outcomes of using a care plan. Care plans were perceived as a useful tool that centralized and focused the care of the child. Care plans were reported to flatten the hierarchical relationship between HCPs and parents, resulting in enhanced reciprocal information exchange and strengthened relationships. Participants expressed that a standardized template that is family-centered and includes content relevant to both the medical and social needs of the child is beneficial when integrated into overall care planning and delivery for CMC. Care plans are perceived to be a useful tool to both health care providers and parents of CMC. These findings inform the utility and development of a comprehensive care plan template as well as a model of how and when to best utilize care plans within family-centered models of care.

How the Recovery Act's Federal Coordinating Council paved the way for the Patient-Centered Outcomes Research Institute.

PubMed

Conway, Patrick H

2010-11-01

The American Recovery and Reinvestment Act of 2009 provided $1.1 billion for comparative effectiveness research and established the Federal Coordinating Council for Comparative Effectiveness Research to direct that investment. The council laid a critical foundation for comparative effectiveness research in the steps it took to gather information, invite public input, set priorities, coordinate project solicitations, and stress the importance of evaluating research investments. Although the council has been superseded by a successor--the Patient-Centered Outcomes Research Institute--the experiences of the council can and should inform the work of the new institute as it begins its operations.

Near infrared photographic sky survey - A field index

NASA Technical Reports Server (NTRS)

Rossano, G. S.; Craine, E. R.

1980-01-01

The book presents an index of previously cataloged objects located in the fields of the northern sky included in the Steward Observatory Near Infrared Photographic Sky Survey, which was intended to be used for identification purposes in an effort to locate extremely red objects. The objects included in the index were taken from 16 catalogs of bright nebulae, dark nebulae, infrared objects, reflection nebulae, supernova remnants and other objects, and appear with their corresponding field numbers, computed field center coordinates, object name and 1950 epoch equatorial coordinates, as well as supplementary descriptive information as available. An appendix is also provided in which the center coordinates of each field are listed.

Academic investigator-initiated trials and the challenge of sponsor responsibility: the Cologne Sponsor Model.

PubMed

Georgias, Christine; Grunow, Andrea; Olderog, Miriam; May, Alexander; Paulus, Ursula

2012-12-01

With the amendment to the German Drug Law in 2004, the conduct of clinical trials changed by at least two main aspects: (1) The principles of Good Clinical Practice (GCP) were implemented in the national legislation, and (2) for the first time, the function of the sponsor of a clinical trial and the clinical trial itself have become legally binding definitions. By that, legal differences between industrial and academic clinical trials no longer exist. Clinical trials initiated by investigators have to fulfil the same requirements while the entire sponsor responsibility has to be carried out by the Coordinating Investigator or his institution including implementation of a quality management system according to the GCP. The Cologne Sponsor Model is an effective approach with settings, structures, basic features, action, and reporting lines, as well as funding for clinical trials initiated in an academic environment. The University of Cologne assumes the sponsor responsibility for clinical trials organised by the university researchers according to law. Sponsor's duties are delegated to a central operational unit of the sponsor - the Clinical Trials Center Cologne - which further delegates duties to the Coordinating Investigator. Clinical Trials Center Cologne was established in 2002 to support the performance of clinical trials at the university by offering comprehensive advisory and practical services covering all aspects of study planning and conduct. Furthermore, a specialised division of its quality management department acts as an independent sponsor's Quality Assurance Unit. The Clinical Trials Center Cologne has established a quality management system consisting of different components (1) to enable a reasoned decision to subsequent delegation, (2) for risk-based surveillance of trial conduct (audits, monitoring-checks, and reports), and (3) support and training of the Coordinating Investigator. Double functions of persons and departments in the university environment sometimes make it difficult to define roles in such a model. Therefore, it is necessary to establish clear reporting lines and moreover to monitor regularly and carefully the roles and responsibilities. With the combination of central management and support, control and independence of the researchers, our model represents a 'risk-based' system that offers a sensible option that fulfils the requirements of legal regulations and GCP for trials organised within the university environment.

How 3 rural safety net clinics integrate care for patients: a qualitative case study.

PubMed

Derrett, Sarah; Gunter, Kathryn E; Nocon, Robert S; Quinn, Michael T; Coleman, Katie; Daniel, Donna M; Wagner, Edward H; Chin, Marshall H

2014-11-01

Integrated care focuses on care coordination and patient centeredness. Integrated care supports continuity of care over time, with care that is coordinated within and between settings and is responsive to patients' needs. Currently, little is known about care integration for rural patients. To examine challenges to care integration in rural safety net clinics and strategies to address these challenges. Qualitative case study. Thirty-six providers and staff from 3 rural clinics in the Safety Net Medical Home Initiative. Interviews were analyzed using the framework method with themes organized within 3 constructs: Team Coordination and Empanelment, External Coordination and Partnerships, and Patient-centered and Community-centered Care. Participants described challenges common to safety net clinics, including limited access to specialists for Medicaid and uninsured patients, difficulty communicating with external providers, and payment models with limited support for care integration activities. Rurality compounded these challenges. Respondents reported benefits of empanelment and team-based care, and leveraged local resources to support care for patients. Rural clinics diversified roles within teams, shared responsibility for patient care, and colocated providers, as strategies to support care integration. Care integration was supported by 2 fundamental changes to organize and deliver care to patients-(1) empanelment with a designated group of patients being cared for by a provider; and (2) a multidisciplinary team able to address rural issues. New funding and organizational initiatives of the Affordable Care Act may help to further improve care integration, although additional solutions may be necessary to address particular needs of rural communities.

42 CFR 431.630 - Coordination of Medicaid with QIOs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Coordination of Medicaid with QIOs. 431.630 Section 431.630 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... With Other Agencies § 431.630 Coordination of Medicaid with QIOs. (a) The State plan may provide for...

Network Performance and Coordination in the Health, Education, Telecommunications System. Satellite Technology Demonstration, Technical Report No. 0422.

ERIC Educational Resources Information Center

Braunstein, Jean; Janky, James M.

This paper describes the network coordination for the Health, Education, Telecommunications (HET) system. Specifically, it discusses HET network performance as a function of a specially-developed coordination system which was designed to link terrestrial equipment to satellite operations centers. Because all procedures and equipment developed for…

Establishing Outcomes for Service Coordination: A Step Toward Evidence-Based Practice

ERIC Educational Resources Information Center

Bruder, Mary Beth; Harbin, Gloria L.; Whitbread, Kathleen; Conn-Powers, Michael; Roberts, Richard; Dunst, Carl J.; Van Buren, Melissa; Mazzarella, Cindy; Gabbard, Glenn

2005-01-01

The Research and Training Center (RTC) in Service Coordination is a federally funded project charged with carrying out an advanced research program to analyze current, and recommend future, policies and practices for service coordination under Part C of the Individuals with Disabilities Education Act amendments of 1997. One RTC objective was to…

Bending nanofibers into nanospirals: coordination chemistry as a tool for shaping hydrophobic assemblies.

PubMed

Kossoy, Elizaveta; Weissman, Haim; Rybtchinski, Boris

2015-01-02

In the current work, we demonstrate how coordination chemistry can be employed to direct self-assembly based on strong hydrophobic interactions. To investigate the influence of coordination sphere geometry on aqueous self-assembly, we synthesized complexes of the amphiphilic perylene diimide terpyridine ligand with the first-row transition-metal centers (zinc, cobalt, and nickel). In aqueous medium, aggregation of these complexes is induced by hydrophobic interactions between the ligands. However, the final shapes of the resulting assemblies depend on the preferred geometry of the coordination spheres typical for the particular metal center. The self-assembly process was characterized by UV/Vis spectroscopy, zeta potential measurements, and cryogenic transmission electron microscopy (cryo-TEM). Coordination of zinc(II) and cobalt(II) leads to the formation of unique nanospiral assemblies, whereas complexation of nickel(II) leads to the formation of straight nanofibers. Notably, coordination bonds are utilized not as connectors between elementary building blocks, but as directing interactions, enabling control over supramolecular geometry. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Unifying screening processes within the PROSPR consortium: a conceptual model for breast, cervical, and colorectal cancer screening.

PubMed

Beaber, Elisabeth F; Kim, Jane J; Schapira, Marilyn M; Tosteson, Anna N A; Zauber, Ann G; Geiger, Ann M; Kamineni, Aruna; Weaver, Donald L; Tiro, Jasmin A

2015-06-01

General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. We present a trans-organ conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based on clinical guidelines and protocols; the model concepts could be expanded to other organ sites. The model covers four types of care in the screening process: risk assessment, detection, diagnosis, and treatment. Interfaces between different provider teams (eg, primary care and specialty care), including communication and transfer of responsibility, may occur when transitioning between types of care. Our model highlights across each organ site similarities and differences in steps, interfaces, and transitions in the screening process and documents the conclusion of a screening episode. This model was developed within the National Cancer Institute-funded consortium Population-based Research Optimizing Screening through Personalized Regimens (PROSPR). PROSPR aims to optimize the screening process for breast, cervical, and colorectal cancer and includes seven research centers and a statistical coordinating center. Given current health care reform initiatives in the United States, this conceptual model can facilitate the development of comprehensive quality metrics for cancer screening and promote trans-organ comparative cancer screening research. PROSPR findings will support the design of interventions that improve screening outcomes across multiple cancer sites. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Coordination Mechanism in Fast Human Movements - Experimental and Modelling Studies. Volume 1.

DTIC Science & Technology

1982-02-01

journal, possible the Journal of Motor Behavior of Experimental Brain Research. I. Proposed Experimental Studies - Year 3 At the present time we are...stimulation regimens must be devised to produce sensory imparted learning which manipulates each of these brain control mechanisms. Following the...movement center in the brain , presumably via the pyramidal tract from the cerebellum to the brainstem and spinal cord (cf. Miles and Evarts, 1979

Modeling relief demands in an emergency supply chain system under large-scale disasters based on a queuing network.

PubMed

He, Xinhua; Hu, Wenfa

2014-01-01

This paper presents a multiple-rescue model for an emergency supply chain system under uncertainties in large-scale affected area of disasters. The proposed methodology takes into consideration that the rescue demands caused by a large-scale disaster are scattered in several locations; the servers are arranged in multiple echelons (resource depots, distribution centers, and rescue center sites) located in different places but are coordinated within one emergency supply chain system; depending on the types of rescue demands, one or more distinct servers dispatch emergency resources in different vehicle routes, and emergency rescue services queue in multiple rescue-demand locations. This emergency system is modeled as a minimal queuing response time model of location and allocation. A solution to this complex mathematical problem is developed based on genetic algorithm. Finally, a case study of an emergency supply chain system operating in Shanghai is discussed. The results demonstrate the robustness and applicability of the proposed model.

Modeling Relief Demands in an Emergency Supply Chain System under Large-Scale Disasters Based on a Queuing Network

PubMed Central

He, Xinhua

2014-01-01

This paper presents a multiple-rescue model for an emergency supply chain system under uncertainties in large-scale affected area of disasters. The proposed methodology takes into consideration that the rescue demands caused by a large-scale disaster are scattered in several locations; the servers are arranged in multiple echelons (resource depots, distribution centers, and rescue center sites) located in different places but are coordinated within one emergency supply chain system; depending on the types of rescue demands, one or more distinct servers dispatch emergency resources in different vehicle routes, and emergency rescue services queue in multiple rescue-demand locations. This emergency system is modeled as a minimal queuing response time model of location and allocation. A solution to this complex mathematical problem is developed based on genetic algorithm. Finally, a case study of an emergency supply chain system operating in Shanghai is discussed. The results demonstrate the robustness and applicability of the proposed model. PMID:24688367

Care Coordination with Schools: The Role of Family-Centered Care for Children with Special Health Care Needs.

PubMed

Barnard-Brak, Lucy; Stevens, Tara; Carpenter, Julianna

2017-05-01

Objectives Family-centered care has been associated with positive outcomes for children with special health care needs. The purpose of the current study was to examine the relationship of family-centered care as associated with care coordination with schools and school absences (e.g., missed days) as reported by parents of children with special health care needs. Methods The current study utilized data from the National Survey of Children with Special Health Care Needs 2009-201 (N = 40,242) to achieve this purpose. The National Survey of Children with Special Health Care Needs may be considered a nationally-representative and community-based sample of parent responses for children with special health care needs across the United States. Results Results from the current study indicate that family-centered care is associated with fewer absences and improved care coordination with schools when applicable. The variables of functional difficulties, poverty level, and the number of conditions were statistically controlled. Conclusions We suggest that the positive influence of family-centered care when practiced extends beyond the family and interacts with educational outcomes. We also suggest that the role of schools appears to be under-studied given the role that schools can play in family-centered care.

Can a Unified Service Delivery Philosophy Be Identified in Aging and Disability Organizations? Exploring Competing Service Delivery Models Through the Voices of the Workforce in These Organizations.

PubMed

Keefe, Bronwyn

2018-01-01

Services for older adults and younger people with disabilities are increasingly merging, as reflected in the creation of Aging and Disability Resource Centers (ADRCs). Using ADRCs to coordinate services is challenging, primarily because these fields have different service delivery philosophies. Independent Living Centers, which serve people with disabilities, have a philosophy that emphasizes consumer control and peer mentoring. However, the aging service delivery philosophy is based in a case management or medical model in which the role of consumers directing their services is less pronounced. Using institutional logics theory and a qualitative research design, this study explored whether a unified service delivery philosophy for ADRCs was emerging. Based on focus groups and questionnaires with staff from ADRCs, findings revealed that competing service delivery models continue to operate in the aging and disability fields.

Modeling and Analysis of Multidiscipline Research Teams at NASA Langley Research Center: A Systems Thinking Approach

NASA Technical Reports Server (NTRS)

Waszak, Martin R.; Barthelemy, Jean-Francois; Jones, Kenneth M.; Silcox, Richard J.; Silva, Walter A.; Nowaczyk, Ronald H.

1998-01-01

Multidisciplinary analysis and design is inherently a team activity due to the variety of required expertise and knowledge. As a team activity, multidisciplinary research cannot escape the issues that affect all teams. The level of technical diversity required to perform multidisciplinary analysis and design makes the teaming aspects even more important. A study was conducted at the NASA Langley Research Center to develop a model of multidiscipline teams that can be used to help understand their dynamics and identify key factors that influence their effectiveness. The study sought to apply the elements of systems thinking to better understand the factors, both generic and Langley-specific, that influence the effectiveness of multidiscipline teams. The model of multidiscipline research teams developed during this study has been valuable in identifying means to enhance team effectiveness, recognize and avoid problem behaviors, and provide guidance for forming and coordinating multidiscipline teams.

A stimulus-centered reading disorder for words and numbers: Is it neglect dyslexia?

PubMed

Arduino, Lisa S; Daini, Roberta; Caterina Silveri, Maria

2005-12-01

A single case, RCG, showing a unilateral reading disorder without unilateral spatial neglect was studied. The disorder was characterized by substitutions of the initial (left) letters of words, nonwords and Arabic numbers, independently of egocentered spatial coordinates. MRI showed a bilateral lesion with the involvement of the splenium. Although, within the framework of the visual word recognition model proposed by Caramazza and Hillis (1990), RCG disorder could be defined as a stimulus-centered neglect dyslexia, we discuss the hypothesis of a dissociation in neural correlates and mechanisms between the syndrome of unilateral spatial neglect and such a unilateral reading disorder.

Determination of the energy structure of recombination centers in heavily doped AlxGa1-xN:Si epitaxial layers with x > 0.5

NASA Astrophysics Data System (ADS)

Osinnykh, I. V.; Malin, T. V.; Zhuravlev, K. S.

2018-03-01

The photoluminescence properties of the intensive defect-related emission in heavily doped Al x Ga l-x N:Si layers with x > 0.5 have been investigated by photoluminescence (PL) spectroscopy. The PL band in AlN was attributed to donor-acceptor (DA) transitions. At the lowest Al content, the impurity band merges with the conduction band and DA transitions are replaced by electron-acceptor transitions involving the same acceptor. The energy structure of recombination centers was obtained using the model of configuration coordinates for Al0.67Ga0.33N.

Patient Care Coordinator | Center for Cancer Research

Cancer.gov

We are looking for a Patient Care Coordinator to join our thoracic and gastrointestinal oncology clinical team to help us coordinate care for patients enrolled on our clinical research protocols. Duties include scheduling appointments, coordinating new patients, obtaining patient records, attending weekly clinic meetings, and data base entry.  Be part of our mission to solve the most important, challenging and neglected problems in modern cancer research and patient care.  The National Cancer Institute’s Center for Cancer Research is a world-leading cancer research organization working toward scientific breakthroughs at medicine’s cutting edge.  Our scientists can’t do it alone. It takes an extraordinary team of researchers, clinical experts and administrators to improve the lives of cancer patients and answer the most important questions in cancer biology and treatment.

CODE's new solar radiation pressure model for GNSS orbit determination

NASA Astrophysics Data System (ADS)

Arnold, D.; Meindl, M.; Beutler, G.; Dach, R.; Schaer, S.; Lutz, S.; Prange, L.; Sośnica, K.; Mervart, L.; Jäggi, A.

2015-08-01

The Empirical CODE Orbit Model (ECOM) of the Center for Orbit Determination in Europe (CODE), which was developed in the early 1990s, is widely used in the International GNSS Service (IGS) community. For a rather long time, spurious spectral lines are known to exist in geophysical parameters, in particular in the Earth Rotation Parameters (ERPs) and in the estimated geocenter coordinates, which could recently be attributed to the ECOM. These effects grew creepingly with the increasing influence of the GLONASS system in recent years in the CODE analysis, which is based on a rigorous combination of GPS and GLONASS since May 2003. In a first step we show that the problems associated with the ECOM are to the largest extent caused by the GLONASS, which was reaching full deployment by the end of 2011. GPS-only, GLONASS-only, and combined GPS/GLONASS solutions using the observations in the years 2009-2011 of a global network of 92 combined GPS/GLONASS receivers were analyzed for this purpose. In a second step we review direct solar radiation pressure (SRP) models for GNSS satellites. We demonstrate that only even-order short-period harmonic perturbations acting along the direction Sun-satellite occur for GPS and GLONASS satellites, and only odd-order perturbations acting along the direction perpendicular to both, the vector Sun-satellite and the spacecraft's solar panel axis. Based on this insight we assess in the third step the performance of four candidate orbit models for the future ECOM. The geocenter coordinates, the ERP differences w. r. t. the IERS 08 C04 series of ERPs, the misclosures for the midnight epochs of the daily orbital arcs, and scale parameters of Helmert transformations for station coordinates serve as quality criteria. The old and updated ECOM are validated in addition with satellite laser ranging (SLR) observations and by comparing the orbits to those of the IGS and other analysis centers. Based on all tests, we present a new extended ECOM which substantially reduces the spurious signals in the geocenter coordinate (by about a factor of 2-6), reduces the orbit misclosures at the day boundaries by about 10 %, slightly improves the consistency of the estimated ERPs with those of the IERS 08 C04 Earth rotation series, and substantially reduces the systematics in the SLR validation of the GNSS orbits.

An Integrative Behavioral Health Care Model Using Automated SBIRT and Care Coordination in Community Health Care.

PubMed

Dwinnells, Ronald; Misik, Lauren

2017-10-01

Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99.5% ( P < .001) of medical patients completed behavioral health screenings; brief intervention rates nearly doubled to 83% ( P < .001) and 100% ( P < .001) of identified at-risk patients had referrals made using a combination of electronic tablets, electronic medical record, and behavioral health care coordination.

Computer simulation of formation and decomposition of Au13 nanoparticles

NASA Astrophysics Data System (ADS)

Stishenko, P.; Svalova, A.

2017-08-01

To study the Ostwald ripening process of Au13 nanoparticles a two-scale model is constructed: analytical approximation of average nanoparticle energy as function of nanoparticle size and structural motive, and the Monte Carlo model of 1000 particles ensemble. Simulation results show different behavior of particles of different structural motives. The change of the distributions of atom coordination numbers during the Ostwald ripening process was observed. The nanoparticles of the equal size and shape with the face-centered cubic structure of the largest sizes appeared to be the most stable.

Expansion of flight simulator capability for study and solution of aircraft directional control problems on runways, phase 1

NASA Technical Reports Server (NTRS)

1975-01-01

The MCAIR five-degree-of-freedom motion-base simulator (MBS) was used in combination with a six-degree-of-freedom aircraft mathematical model to demonstrate the simulation adequacy on uncrowned runways, under various conditions. Known aircraft parameters were used where possible to increase program credibility. Tire-runway friction models were coordinated with personnel of NASA, Langley Research Center. The F-4 experienced pilots representing NASA, FAA, and USAF participated in the 130 approach-touchdown-rollout demonstration and verified the simulation adequacy.

Defining Value-Based Care in Cardiac and Vascular Anesthesiology: The Past, Present, and Future of Perioperative Cardiovascular Care.

PubMed

Kolarczyk, Lavinia M; Arora, Harendra; Manning, Michael W; Zvara, David A; Isaak, Robert S

2018-02-01

Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes. In order to meet these patient outcomes, multidisciplinary care pathways must be designed, implemented, and sustained, a process that is challenging at best. This review (1) provides a historical perspective of health care reimbursement; (2) defines value as it pertains to quality, service, and cost; (3) reviews the history of value-based care for cardiac surgery; (4) describes the drive toward optimization for vascular surgery patients; and (5) discusses how programs like Enhanced Recovery After Surgery assist with the delivery of value-based care. Copyright © 2018 Elsevier Inc. All rights reserved.

DPOD2005: An extension of ITRF2005 for Precise Orbit Determination

NASA Astrophysics Data System (ADS)

Willis, P.; Ries, J. C.; Zelensky, N. P.; Soudarin, L.; Fagard, H.; Pavlis, E. C.; Lemoine, F. G.

2009-09-01

For Precise Orbit Determination of altimetry missions, we have computed a data set of DORIS station coordinates defined for specific time intervals called DPOD2005. This terrestrial reference set is an extension of ITRF2005. However, it includes all new DORIS stations and is more reliable, as we disregard stations with large velocity formal errors as they could contaminate POD computations in the near future. About 1/4 of the station coordinates need to be defined as they do not appear in the original ITRF2005 realization. These results were verified with available DORIS and GPS results, as the integrity of DPOD2005 is almost as critical as its accuracy. Besides station coordinates and velocities, we also provide additional information such as periods for which DORIS data should be disregarded for specific DORIS stations, and epochs of coordinate and velocity discontinuities (related to either geophysical events, equipment problem or human intervention). The DPOD model was tested for orbit determination for TOPEX/Poseidon (T/P), Jason-1 and Jason-2. Test results show DPOD2005 offers improvement over the original ITRF2005, improvement that rapidly and significantly increases after 2005. Improvement is also significant for the early T/P cycles indicating improved station velocities in the DPOD2005 model and a more complete station set. Following 2005 the radial accuracy and centering of the ITRF2005-original orbits rapidly degrades due to station loss.

Editor's Introduction and Review: Coordination and Context in Cognitive Science.

PubMed

Kello, Christopher T

2018-01-01

The role of coordination in cognitive science has been on the rise in recent years, in terms of coordination among neurons, coordination among sensory and motor systems, and coordination among individuals. Research has shown that coordination patterns corresponding to cognitive activities depend on the various contexts in which the underlying interactions are situated. The present issue of Topics in Cognitive Science centers on studies of coordination that address the role of context in shaping or interpreting dynamical patterns of human behavior. This introductory article reviews some of the prior literature leading up to current and future research on coordination and context in cognitive science. Copyright © 2017 Cognitive Science Society, Inc.

Understanding the relation between urbanization and the eco-environment in China's Yangtze River Delta using an improved EKC model and coupling analysis.

PubMed

Zhao, Yabo; Wang, Shaojian; Zhou, Chunshan

2016-11-15

Better understanding the relationship between urbanization (U) and the eco-environment (E) is necessary to coordinate the development of them. Using a comprehensive index system for U and E with statistic data, and an improved environmental Kuznets curve (EKC) model and dynamic coordination coupling degree (CCD) model, this study addressed the relationship between U and E in the Yangtze River Delta (YRD) in the period 1980-2013. The main conclusions were as follows: (1) Economic urbanization and eco-environment endowment were the highest weighted factors in the U and E system respectively, and thus constitute the key factors. (2) Differentiated inverted-U curves were shown to exist in the relation between U and E across the cities studied, thereby confirming the improved EKC hypothesis. We further found economically developed areas to have higher urbanization levels than less developed areas at the point at which the curve inflects, less developed areas have higher eco-environmental pressure at inflection. Before the appearance of the inflection point, a striking positive correlation was observed between eco-environmental pressure and the urbanization level, while a negative correlation was found to follow it. (3) A dynamic coordination coupling relation was found to exist between U and E, which conforms to an S-shaped curve. The coordination coupling process in the YRD has gradually moved from a "low-grade symbiosis" stage into a "break-in development" stage, but the pattern of coordination belonging to the eco-environment part of the relation was found to always show some lag. The dynamic CCD model showed a difference in the spatial distribution of CCD, presenting higher values in the periphery of the region, and lower values in the center during the study period. The improved EKC and coupling analysis detailed in this study may help Chinese decision makers to formulate sustainable measures to balance urbanization development and eco-environment protection. Copyright © 2016 Elsevier B.V. All rights reserved.

Explaining formation of Astronomical Jets using Dynamic Universe Model

NASA Astrophysics Data System (ADS)

Naga Parameswara Gupta, Satyavarapu

2016-07-01

Astronomical jets are observed from the centres of many Galaxies including our own Milkyway. The formation of such jet is explained using SITA simulations of Dynamic Universe Model. For this purpose the path traced by a test neutron is calculated and depicted using a set up of one densemass of the mass equivalent to mass of Galaxy center, 90 stars with similar masses of stars near Galaxy center, mass equivalents of 23 Globular Cluster groups, 16 Milkyway parts, Andromeda and Triangulum Galaxies at appropriate distances. Five different kinds of theoretical simulations gave positive results The path travelled by this test neutron was found to be an astronomical jet emerging from Galaxy center. This is another result from Dynamic Universe Model. It solves new problems like a. Variable Mass Rocket Trajectory Problem b. Explaining Very long baseline interferometry (VLBI) observations c. Astronomical jets observed from Milkyway Center d. Prediction of Blue shifted Galaxies e. Explaining Pioneer Anomaly f. Prediction of New Horizons satellite trajectory etc. Dynamic Universe Model never reduces to General relativity on any condition. It uses a different type of mathematics based on Newtonian physics. This mathematics used here is simple and straightforward. As there are no differential equations present in Dynamic Universe Model, the set of equations give single solution in x y z Cartesian coordinates for every point mass for every time step

An Expanded Theoretical Framework of Care Coordination Across Transitions in Care Settings.

PubMed

Radwin, Laurel E; Castonguay, Denise; Keenan, Carolyn B; Hermann, Cherice

2016-01-01

For many patients, high-quality, patient-centered, and cost-effective health care requires coordination among multiple clinicians and settings. Ensuring optimal care coordination requires a clear understanding of how clinician activities and continuity during transitions affect patient-centeredness and quality outcomes. This article describes an expanded theoretical framework to better understand care coordination. The framework provides clear articulation of concepts. Examples are provided of ways to measure the concepts.

Inner Magnetosphere Modeling at the CCMC: Ring Current, Radiation Belt and Magnetic Field Mapping

NASA Astrophysics Data System (ADS)

Rastaetter, L.; Mendoza, A. M.; Chulaki, A.; Kuznetsova, M. M.; Zheng, Y.

2013-12-01

Modeling of the inner magnetosphere has entered center stage with the launch of the Van Allen Probes (RBSP) in 2012. The Community Coordinated Modeling Center (CCMC) has drastically improved its offerings of inner magnetosphere models that cover energetic particles in the Earth's ring current and radiation belts. Models added to the CCMC include the stand-alone Comprehensive Inner Magnetosphere-Ionosphere (CIMI) model by M.C. Fok, the Rice Convection Model (RCM) by R. Wolf and S. Sazykin and numerous versions of the Tsyganenko magnetic field model (T89, T96, T01quiet, TS05). These models join the LANL* model by Y. Yu hat was offered for instant run earlier in the year. In addition to these stand-alone models, the Comprehensive Ring Current Model (CRCM) by M.C. Fok and N. Buzulukova joined as a component of the Space Weather Modeling Framework (SWMF) in the magnetosphere model run-on-request category. We present modeling results of the ring current and radiation belt models and demonstrate tracking of satellites such as RBSP. Calculations using the magnetic field models include mappings to the magnetic equator or to minimum-B positions and the determination of foot points in the ionosphere.

The Evolution of the Federal Monitoring and Assessment Center

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

NSTec Aerial Measurement System

2012-07-31

The Federal Radiological Monitoring and Assessment Center (FRMAC) is a federal emergency response asset whose assistance may be requested by the Department of Homeland Security (DHS), the Department of Defense (DoD), the Environmental Protection Agency (EPA), the Nuclear Regulatory Commission (NRC), and state and local agencies to respond to a nuclear or radiological incident. It is an interagency organization with representation from the Department of Energy’s National Nuclear Security Administration (DOE/NNSA), the Department of Defense (DoD), the Environmental Protection Agency (EPA), the Department of Health and Human Services (HHS), the Federal Bureau of Investigation (FBI), and other federal agencies. FRMAC,more » in its present form, was created in 1987 when the radiological support mission was assigned to the DOE’s Nevada Operations Office by DOE Headquarters. The FRMAC asset, including its predecessor entities, was created, grew, and evolved to function as a response to radiological incidents. Radiological emergency response exercises showed the need for a coordinated approach to managing federal emergency monitoring and assessment activities. The mission of FRMAC is to coordinate and manage all federal radiological environmental monitoring and assessment activities during a nuclear or radiological incident within the United States in support of state,local, tribal governments, DHS, and the federal coordinating agency. Radiological emergency response professionals with the DOE’s national laboratories support the Radiological Assistance Program (RAP), National Atmospheric Release Advisory Center (NARAC), the Aerial MeasuringSystem (AMS), and the Radiation Emergency Assistance Center/Training Site (REAC/TS). These teams support the FRMAC to provide: Atmospheric transport modeling; Radiation monitoring; Radiological analysis and data assessments; and Medical advice for radiation injuries In support of field operations, the FRMAC provides geographic information systems, communications, mechanical, electrical, logistics, and administrative support. The size of the FRMAC is tailored to the incident and is comprised of emergency response professionals drawn from across the federal government. State and local emergency response teams may also integrate their operations with FRMAC, but are not required to.« less

A three dimensional point cloud registration method based on rotation matrix eigenvalue

NASA Astrophysics Data System (ADS)

Wang, Chao; Zhou, Xiang; Fei, Zixuan; Gao, Xiaofei; Jin, Rui

2017-09-01

We usually need to measure an object at multiple angles in the traditional optical three-dimensional measurement method, due to the reasons for the block, and then use point cloud registration methods to obtain a complete threedimensional shape of the object. The point cloud registration based on a turntable is essential to calculate the coordinate transformation matrix between the camera coordinate system and the turntable coordinate system. We usually calculate the transformation matrix by fitting the rotation center and the rotation axis normal of the turntable in the traditional method, which is limited by measuring the field of view. The range of exact feature points used for fitting the rotation center and the rotation axis normal is approximately distributed within an arc less than 120 degrees, resulting in a low fit accuracy. In this paper, we proposes a better method, based on the invariant eigenvalue principle of rotation matrix in the turntable coordinate system and the coordinate transformation matrix of the corresponding coordinate points. First of all, we control the rotation angle of the calibration plate with the turntable to calibrate the coordinate transformation matrix of the corresponding coordinate points by using the least squares method. And then we use the feature decomposition to calculate the coordinate transformation matrix of the camera coordinate system and the turntable coordinate system. Compared with the traditional previous method, it has a higher accuracy, better robustness and it is not affected by the camera field of view. In this method, the coincidence error of the corresponding points on the calibration plate after registration is less than 0.1mm.

Assessing intervention fidelity in a multi-level, multi-component, multi-site program: the Children's Healthy Living (CHL) program.

PubMed

Butel, Jean; Braun, Kathryn L; Novotny, Rachel; Acosta, Mark; Castro, Rose; Fleming, Travis; Powers, Julianne; Nigg, Claudio R

2015-12-01

Addressing complex chronic disease prevention, like childhood obesity, requires a multi-level, multi-component culturally relevant approach with broad reach. Models are lacking to guide fidelity monitoring across multiple levels, components, and sites engaged in such interventions. The aim of this study is to describe the fidelity-monitoring approach of The Children's Healthy Living (CHL) Program, a multi-level multi-component intervention in five Pacific jurisdictions. A fidelity-monitoring rubric was developed. About halfway during the intervention, community partners were randomly selected and interviewed independently by local CHL staff and by Coordinating Center representatives to assess treatment fidelity. Ratings were compared and discussed by local and Coordinating Center staff. There was good agreement between the teams (Kappa = 0.50, p < 0.001), and intervention improvement opportunities were identified through data review and group discussion. Fidelity for the multi-level, multi-component, multi-site CHL intervention was successfully assessed, identifying adaptations as well as ways to improve intervention delivery prior to the end of the intervention.

A Coordination Network with Ligand-Centered Redox Activity Based on facial-[CrIII (2-mercaptophenolato)3 ]3- Metalloligands.

PubMed

Wakizaka, Masanori; Matsumoto, Takeshi; Kobayashi, Atsushi; Kato, Masako; Chang, Ho-Chol

2017-07-21

The design of redox-active metal-organic frameworks and coordination networks (CNs), which exhibit metal- and/or ligand-centered redox activity, has recently received increased attention. In this study, the redox-active metalloligand (RML) [Me 4 N] 3 fac-[Cr III (mp) 3 ] (1) (mp=2-mercaptophenolato) was synthesized and characterized by single-crystal X-ray diffraction analysis, and its reversible ligand-centered one-electron oxidation was examined by cyclic voltammetry and spectroelectrochemical measurements. Since complex 1 contains O/S coordination sites in three directions, complexation with K + ions led to the formation of the two-dimensional honeycomb sheet-structured [K 3 fac-{Cr III (mp) 3 }(H 2 O) 6 ] n (2⋅6 H 2 O), which is the first example of a redox-active CN constructed from a RML with o-disubstituted benzene ligands. Herein, we unambiguously demonstrate the ligand-centered redox activity of the RML within the CN 2⋅6 H 2 O in the solid state. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Technical Support for Contaminated Sites | Science Inventory ...

EPA Pesticide Factsheets

In 1987, the U.S. Environmental Protection Agency’s (EPA) Office of Research and Development (ORD), Office of Land and Emergency Management, and EPA Regional waste management offices established the Technical Support Project. The creation of the Technical Support Project enabled ORD to provide effective technical assistance by ensuring ORD scientists and engineers were accessible to the Agency’s Office and Regional decision makers, including Remedial Project Managers, On-Scene Coordinators, and corrective action staff. Five ORD Technical Support Centers (TSCs) were created to facilitate this technical assistance. Three of the five TSCs are supported by the Sustainable and Healthy Communities Research Program, and are summarized in the poster being presented:• Engineering Technical Support Center (ETSC) in Cincinnati, Ohio• Ground Water Technical Support Center (GWTSC) in Ada, Oklahoma• Site Characterization and Monitoring Technical Support Center (SCMTSC) in Atlanta, GeorgiaOver the past 29 years, the Technical Support Centers have provided numerous influential products to its internal Agency clients and to those at the State level (through the EPA Regions). These products include, but are not limited to the following: Annual TSC reports from the three Centers, a hard-rock mining conference every other year, PRO-UCL software development for site characterization statistics, groundwater modeling using state-of-the-art modeling software, numerical mo

Cancer Survivorship Care: Person Centered Care in a Multidisciplinary Shared Care Model.

PubMed

Loonen, Jacqueline J; Blijlevens, Nicole Ma; Prins, Judith; Dona, Desiree Js; Den Hartogh, Jaap; Senden, Theo; van Dulmen-Den Broeder, Eline; van der Velden, Koos; Hermens, Rosella Pmg

2018-01-16

Survivors of childhood and adult-onset cancer are at lifelong risk for the development of late effects of treatment that can lead to serious morbidity and premature mortality. Regular long-term follow-up aiming for prevention, early detection and intervention of late effects can preserve or improve health. The heterogeneous and often serious character of late effects emphasizes the need for specialized cancer survivorship care clinics. Multidisciplinary cancer survivorship care requires a coordinated and well integrated health care environment for risk based screening and intervention. In addition survivors engagement and adherence to the recommendations are also important elements. We developed an innovative model for integrated care for cancer survivors, the "Personalized Cancer Survivorship Care Model", that is being used in our clinic. This model comprises 1. Personalized follow-up care according to the principles of Person Centered Care, aiming to empower survivors and to support self management, and 2. Organization according to a multidisciplinary and risk based approach. The concept of person centered care is based on three components: initiating, integrating and safeguarding the partnership with the patient. This model has been developed as a universal model of care that will work for all cancer survivors in different health care systems. It could be used for studies to improve self efficacy and the cost-effectiveness of cancer survivorship care.

Multi-modular, tris(triphenylamine) zinc porphyrin-zinc phthalocyanine-fullerene conjugate as a broadband capturing, charge stabilizing, photosynthetic 'antenna-reaction center' mimic.

PubMed

Kc, Chandra B; Lim, Gary N; D'Souza, Francis

2015-04-21

A broadband capturing, charge stabilizing, photosynthetic antenna-reaction center model compound has been newly synthesized and characterized. The model compound is comprised of a zinc porphyrin covalently linked to three units of triphenylamine entities and a zinc phthalocyanine entity. The absorption and fluorescence spectra of zinc porphyrin complemented that of zinc phthalocyanine offering broadband coverage. Stepwise energy transfer from singlet excited triphenylamine to zinc porphyrin, and singlet excited zinc porphyrin to zinc phthalocyanine (kENT ∼ 10(11) s(-1)) was established from spectroscopic and time-resolved transient absorption techniques. Next, an electron acceptor, fullerene was introduced via metal-ligand axial coordination to both zinc porphyrin and zinc phthalocyanine centers, and they were characterized by spectroscopic and electrochemical techniques. An association constant of 4.9 × 10(4) M(-1) for phenylimidazole functionalized fullerene binding to zinc porphyrin, and 5.1 × 10(4) M(-1) for it binding to zinc phthalocyanine was obtained. An energy level diagram for the occurrence of different photochemical events within the multi-modular donor-acceptor conjugate was established from spectral and electrochemical data. Unlike the previous zinc porphyrin-zinc phthalocyanine-fullerene conjugates, the newly assembled donor-acceptor conjugate has been shown to undergo the much anticipated initial charge separation from singlet excited zinc porphyrin to the coordinated fullerene followed by a hole shift process to zinc phthalocyanine resulting in a long-lived charge separated state as revealed by femto- and nanosecond transient absorption spectroscopic techniques. The lifetime of the final charge separated state was about 100 ns.

Protection coordination of the Kennedy Space Center electric distribution network

NASA Technical Reports Server (NTRS)

1976-01-01

A computer technique is described for visualizing the coordination and protection of any existing system of devices and settings by plotting the tripping characteristics of the involved devices on a common basis. The program determines the optimum settings of a given set of protective devices and configuration in the sense of the best expected coordinated operation of these devices. Subroutines are given for simulating time versus current characteristics of the different relays, circuit breakers, and fuses in the system; coordination index computation; protection checks; plotting; and coordination optimation.

GSFC VLBI Analysis Center Annual Report

NASA Technical Reports Server (NTRS)

Gordon, David; Ma, Chopo; MacMillan, Dan

1999-01-01

The GSFC VLBI group, located at NASA's Goddard Space Flight Center in Greenbelt, MD, is a part of the NASA Space Geodesy Program. Since its inception in the mid 1970's, this group has been involved with and been a leader in most aspects of geodetic and astrometric VLBI. Current major activities include coordination of the international geodetic observing program; coordination and analysis of the CORE program; VLBI technique development; and all types of data processing, analysis, and research activities.

Modeled MT Resistivity Data for the McGregor Range, New Mexico

DOE Data Explorer

Nash, Greg; Wannamaker, Phil; Maris, Virginia

2017-04-30

This is the inversion resistivity data from a magnetotelluric survey done as part of Phase 2 Tularosa Basin, New Mexico, geothermal play fairway analysis. The data covers part of McGregor Range, Fort Bliss. The inversion was done by Phil Wannamaker and Virginia Maris of the Energy & Geoscience Institute at the University of Utah. The data are contained in a text file and data coordinates represent grid cell centers.

Mobile robotics research at Sandia National Laboratories

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

Morse, W.D.

Sandia is a National Security Laboratory providing scientific and engineering solutions to meet national needs for both government and industry. As part of this mission, the Intelligent Systems and Robotics Center conducts research and development in robotics and intelligent machine technologies. An overview of Sandia`s mobile robotics research is provided. Recent achievements and future directions in the areas of coordinated mobile manipulation, small smart machines, world modeling, and special application robots are presented.

Shuttle orbiter radar cross-sectional analysis

NASA Technical Reports Server (NTRS)

Cooper, D. W.; James, R.

1979-01-01

Theoretical and model simulation studies on signal to noise levels and shuttle radar cross section are described. Pre-mission system calibrations, system configuration, and postmission system calibration of the tracking radars are described. Conversion of target range, azimuth, and elevation into radar centered east north vertical position coordinates are evaluated. The location of the impinging rf energy with respect to the target vehicles body axis triad is calculated. Cross section correlation between the two radars is presented.

Impacts of dialysis transportation on Florida's coordinated public transportation programs.

DOT National Transportation Integrated Search

2014-04-01

The National Center for Transit Research (NCTR) at the University of South Florida (USF) collected quantitative and qualitative data from Community Transportation Coordinators (CTCs) throughout Florida. An online survey and a series of personal inter...

The importance of continuing education for transplant coordination staff.

PubMed

Tokalak, Ibrahim; Emiroğlu, Remzi; Karakayali, Hamdi; Bilgin, Nevzat; Haberal, Mehmet

2005-06-01

Continuous quality improvement activities are necessary to achieve excellence at any institution. The Başkent University Hospitals have implemented continuous in-service training programs to improve all health services provided. Also, continuing medical education programs are being instituted in organ procurement and transplantation centers. In addition to receiving basic orientation and training upon hiring, transplant coordination staff complete forms that detail their current training status, further job training needed, and other courses of interest. The information is used to monitor skill levels, to determine the success of educational programs, and to identify further education that is needed. Our aim is to improve the quality of transplant coordination activities and increase organ donation at the hospitals in our network through effective monitoring and evaluation of continuous in-service training. These training programs enhance staff members' understanding of and participation in procedures related to transplantation and improves the total quality of the transplantation process. In the near future, this training model may be used to improve the donor hospital education program in Turkey.

Retinotopic memory is more precise than spatiotopic memory.

PubMed

Golomb, Julie D; Kanwisher, Nancy

2012-01-31

Successful visually guided behavior requires information about spatiotopic (i.e., world-centered) locations, but how accurately is this information actually derived from initial retinotopic (i.e., eye-centered) visual input? We conducted a spatial working memory task in which subjects remembered a cued location in spatiotopic or retinotopic coordinates while making guided eye movements during the memory delay. Surprisingly, after a saccade, subjects were significantly more accurate and precise at reporting retinotopic locations than spatiotopic locations. This difference grew with each eye movement, such that spatiotopic memory continued to deteriorate, whereas retinotopic memory did not accumulate error. The loss in spatiotopic fidelity is therefore not a generic consequence of eye movements, but a direct result of converting visual information from native retinotopic coordinates. Thus, despite our conscious experience of an effortlessly stable spatiotopic world and our lifetime of practice with spatiotopic tasks, memory is actually more reliable in raw retinotopic coordinates than in ecologically relevant spatiotopic coordinates.

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the design and operation of multi-center clinical trials: a qualitative research study.

PubMed

Eisenstein, Eric L; Diener, Lawrence W; Nahm, Meredith; Weinfurt, Kevin P

2011-12-01

New technologies may be required to integrate the National Institutes of Health's Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies.

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

PubMed Central

Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

2013-01-01

New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies. PMID:20703765

Commentary: health care payment reform and academic medicine: threat or opportunity?

PubMed

Shomaker, T Samuel

2010-05-01

Discussion of the flaws of the current fee-for-service health care reimbursement model has become commonplace. Health care costs cannot be reduced without moving away from a system that rewards providers for providing more services regardless of need, effectiveness, or quality. What alternatives are likely under health care reform, and how will they impact the challenged finances of academic medical centers? Bundled payment methodologies, in which all providers rendering services to a patient during an episode of care split a global fee, are gaining popularity. Also under discussion are concepts like the advanced medical home, which would establish primary care practices as a regular source of care for patients, and the accountable care organization, under which providers supply all the health care services needed by a patient population for a defined time period in exchange for a share of the savings resulting from enhanced coordination of care and better patient outcomes or a per-member-per-month payment. The move away from fee-for-service reimbursement will create financial challenges for academic medicine because of the threat to clinical revenue. Yet academic health centers, because they are in many cases integrated health care organizations, may be aptly positioned to benefit from models that emphasize coordinated care. The author also has included a series of recommendations for how academic medicine can prepare for the implementation of new payment models to help ease the transition away from fee-for-service reimbursement.

Community Coordinated Modeling Center: A Powerful Resource in Space Science and Space Weather Education

NASA Astrophysics Data System (ADS)

Chulaki, A.; Kuznetsova, M. M.; Rastaetter, L.; MacNeice, P. J.; Shim, J. S.; Pulkkinen, A. A.; Taktakishvili, A.; Mays, M. L.; Mendoza, A. M. M.; Zheng, Y.; Mullinix, R.; Collado-Vega, Y. M.; Maddox, M. M.; Pembroke, A. D.; Wiegand, C.

2015-12-01

Community Coordinated Modeling Center (CCMC) is a NASA affiliated interagency partnership with the primary goal of aiding the transition of modern space science models into space weather forecasting while supporting space science research. Additionally, over the past ten years it has established itself as a global space science education resource supporting undergraduate and graduate education and research, and spreading space weather awareness worldwide. A unique combination of assets, capabilities and close ties to the scientific and educational communities enable this small group to serve as a hub for raising generations of young space scientists and engineers. CCMC resources are publicly available online, providing unprecedented global access to the largest collection of modern space science models (developed by the international research community). CCMC has revolutionized the way simulations are utilized in classrooms settings, student projects, and scientific labs and serves hundreds of educators, students and researchers every year. Another major CCMC asset is an expert space weather prototyping team primarily serving NASA's interplanetary space weather needs. Capitalizing on its unrivaled capabilities and experiences, the team provides in-depth space weather training to students and professionals worldwide, and offers an amazing opportunity for undergraduates to engage in real-time space weather monitoring, analysis, forecasting and research. In-house development of state-of-the-art space weather tools and applications provides exciting opportunities to students majoring in computer science and computer engineering fields to intern with the software engineers at the CCMC while also learning about the space weather from the NASA scientists.

Percolation connectivity, pore size, and gas apparent permeability: Network simulations and comparison to experimental data

NASA Astrophysics Data System (ADS)

Li, M.; Tang, Y. B.; Bernabé, Y.; Zhao, J. Z.; Li, X. F.; Li, T.

2017-07-01

We modeled single-phase gas flow through porous media using percolation networks. Gas permeability is different from liquid permeability. The latter is only related to the geometry and topology of the pore space, while the former depends on the specific gas considered and varies with gas pressure. As gas pressure decreases, four flow regimes can be distinguished as viscous flow, slip flow, transition flow, and free molecular diffusion. Here we use a published conductance model presumably capable of predicting the flow rate of an arbitrary gas through a cylindrical pipe in the four regimes. We incorporated this model into pipe network simulations. We considered 3-D simple cubic, body-centered cubic, and face-centered cubic lattices, in which we varied the pipe radius distribution and the bond coordination number. Gas flow was simulated at different gas pressures. The simulation results showed that the gas apparent permeability kapp obeys an identical scaling law in all three lattices, kapp (z-zc)β, where the exponent β depends on the width of the pipe radius distribution, z is the mean coordination number, and zc its critical value at the percolation threshold. Surprisingly, (z-zc) had a very weak effect on the ratio of the apparent gas permeability to the absolute liquid permeability, kapp/kabs, suggesting that the Klinkenberg gas slippage correction factor is nearly independent of connectivity. We constructed models of kapp and kapp/kabs based on the observed power law and tested them by comparison with published experimental data on glass beads and other materials.

Research-Based Monitoring, Prediction, and Analysis Tools of the Spacecraft Charging Environment for Spacecraft Users

NASA Technical Reports Server (NTRS)

Zheng, Yihua; Kuznetsova, Maria M.; Pulkkinen, Antti A.; Maddox, Marlo M.; Mays, Mona Leila

2015-01-01

The Space Weather Research Center (http://swrc. gsfc.nasa.gov) at NASA Goddard, part of the Community Coordinated Modeling Center (http://ccmc.gsfc.nasa.gov), is committed to providing research-based forecasts and notifications to address NASA's space weather needs, in addition to its critical role in space weather education. It provides a host of services including spacecraft anomaly resolution, historical impact analysis, real-time monitoring and forecasting, tailored space weather alerts and products, and weekly summaries and reports. In this paper, we focus on how (near) real-time data (both in space and on ground), in combination with modeling capabilities and an innovative dissemination system called the integrated Space Weather Analysis system (http://iswa.gsfc.nasa.gov), enable monitoring, analyzing, and predicting the spacecraft charging environment for spacecraft users. Relevant tools and resources are discussed.

Establishing an Integrative Medicine Program Within an Academic Health Center: Essential Considerations.

PubMed

Eisenberg, David M; Kaptchuk, Ted J; Post, Diana E; Hrbek, Andrea L; O'Connor, Bonnie B; Osypiuk, Kamila; Wayne, Peter M; Buring, Julie E; Levy, Donald B

2016-09-01

Integrative medicine (IM) refers to the combination of conventional and "complementary" medical services (e.g., chiropractic, acupuncture, massage, mindfulness training). More than half of all medical schools in the United States and Canada have programs in IM, and more than 30 academic health centers currently deliver multidisciplinary IM care. What remains unclear, however, is the ideal delivery model (or models) whereby individuals can responsibly access IM care safely, effectively, and reproducibly in a coordinated and cost-effective way.Current models of IM across existing clinical centers vary tremendously in their organizational settings, principal clinical focus, and services provided; practitioner team composition and training; incorporation of research activities and educational programs; and administrative organization (e.g., reporting structure, use of medical records, scope of clinical practice) and financial strategies (i.e., specific business plans and models for sustainability).In this article, the authors address these important strategic issues by sharing lessons learned from the design and implementation of an IM facility within an academic teaching hospital, the Brigham and Women's Hospital at Harvard Medical School; and review alternative options based on information about IM centers across the United States.The authors conclude that there is currently no consensus as to how integrative care models should be optimally organized, implemented, replicated, assessed, and funded. The time may be right for prospective research in "best practices" across emerging models of IM care nationally in an effort to standardize, refine, and replicate them in preparation for rigorous cost-effectiveness evaluations.

77 FR 8877 - ICD-9-CM Coordination and Maintenance (C&M) Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-15

... Coordination and Maintenance (C&M) Committee Meeting National Center for Health Statistics (NCHS... Coordination and Maintenance (C&M) Committee meeting. Time and Date: 9 a.m.-5:30 p.m., March 5, 2012. Place... entering the building. Attendees who wish to attend the ICD- 9-CM C&M meeting on March 5, 2012, must submit...

Analytical solution of the problem of a shock wave in the collapsing gas in Lagrangian coordinates

NASA Astrophysics Data System (ADS)

Kuropatenko, V. F.; Shestakovskaya, E. S.

2016-10-01

It is proposed the exact solution of the problem of a convergent shock wave and gas dynamic compression in a spherical vessel with an impermeable wall in Lagrangian coordinates. At the initial time the speed of cold ideal gas is equal to zero, and a negative velocity is set on boundary of the sphere. When t > t0 the shock wave spreads from this point into the gas. The boundary of the sphere will move under the certain law correlated with the motion of the shock wave. The trajectories of the gas particles in Lagrangian coordinates are straight lines. The equations determining the structure of the gas flow between the shock front and gas border have been found as a function of time and Lagrangian coordinate. The dependence of the entropy on the velocity of the shock wave has been found too. For Lagrangian coordinates the problem is first solved. It is fundamentally different from previously known formulations of the problem of the self-convergence of the self-similar shock wave to the center of symmetry and its reflection from the center, which was built up for the infinite area in Euler coordinates.

Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease

PubMed Central

Kaufman, Arthur; Powell, Wayne; Alfero, Charles; Pacheco, Mario; Silverblatt, Helene; Anastasoff, Juliana; Ronquillo, Francisco; Lucero, Ken; Corriveau, Erin; Vanleit, Betsy; Alverson, Dale; Scott, Amy

2010-01-01

The Agricultural Cooperative Extension Service model offers academic health centers methodologies for community engagement that can address the social determinants of disease. The University of New Mexico Health Sciences Center developed Health Extension Rural Offices (HEROs) as a vehicle for its model of health extension. Health extension agents are located in rural communities across the state and are supported by regional coordinators and the Office of the Vice President for Community Health at the Health Sciences Center. The role of agents is to work with different sectors of the community in identifying high-priority health needs and linking those needs with university resources in education, clinical service and research. Community needs, interventions, and outcomes are monitored by county health report cards. The Health Sciences Center is a large and varied resource, the breadth and accessibility of which are mostly unknown to communities. Community health needs vary, and agents are able to tap into an array of existing health center resources to address those needs. Agents serve a broader purpose beyond immediate, strictly medical needs by addressing underlying social determinants of disease, such as school retention, food insecurity, and local economic development. Developing local capacity to address local needs has become an overriding concern. Community-based health extension agents can effectively bridge those needs with academic health center resources and extend those resources to address the underlying social determinants of disease. PMID:20065282

Near-IR MCD of the nonheme ferrous active site in naphthalene 1,2-dioxygenase: correlation to crystallography and structural insight into the mechanism of Rieske dioxygenases.

PubMed

Ohta, Takehiro; Chakrabarty, Sarmistha; Lipscomb, John D; Solomon, Edward I

2008-02-06

Near-IR MCD and variable temperature, variable field (VTVH) MCD have been applied to naphthalene 1,2-dioxygenase (NDO) to describe the coordination geometry and electronic structure of the mononuclear nonheme ferrous catalytic site in the resting and substrate-bound forms with the Rieske 2Fe2S cluster oxidized and reduced. The structural results are correlated with the crystallographic studies of NDO and other related Rieske nonheme iron oxygenases to develop molecular level insights into the structure/function correlation for this class of enzymes. The MCD data for resting NDO with the Rieske center oxidized indicate the presence of a six-coordinate high-spin ferrous site with a weak axial ligand which becomes more tightly coordinated when the Rieske center is reduced. Binding of naphthalene to resting NDO (Rieske oxidized and reduced) converts the six-coordinate sites into five-coordinate (5c) sites with elimination of a water ligand. In the Rieske oxidized form the 5c sites are square pyramidal but transform to a 1:2 mixture of trigonal bipyramial/square pyramidal sites when the Rieske center is reduced. Thus the geometric and electronic structure of the catalytic site in the presence of substrate can be significantly affected by the redox state of the Rieske center. The catalytic ferrous site is primed for the O2 reaction when substrate is bound in the active site in the presence of the reduced Rieske site. These structural changes ensure that two electrons and the substrate are present before the binding and activation of O2, which avoids the uncontrolled formation and release of reactive oxygen species.

Identify involved agencies addressing safety when freight centers are planned and developed : project summary.

DOT National Transportation Integrated Search

2017-01-01

This project aimed to improve coordination and : cooperation among various entities in the : planning process for developing safer and more : efficient connections between intermodal : facilities and the highway network. Coordination : and cooperatio...

IGS Network Coordinator Report - 2002

NASA Technical Reports Server (NTRS)

Moore, Angelyn

2004-01-01

The IGS network is a set of permanent, continuously-operating, dual-frequency GPS stations operated by over 100 worldwide agencies. The dataset is pooled at IGS Data Centers for routine use by IGS Analysis Centers in creating precise IGS products, as well as free access by other analysts around the world. The IGS Central Bureau hosts the IGS Network Coordinator, who assures adherence to standards and provides information regarding the IGS network via the Central Bureau Information System website at http://igscb.jpl.nasa.gov.

PCMHs, ACOs, and medication management: lessons learned from early research partnerships.

PubMed

Schnur, Evan S; Adams, Alex J; Klepser, Donald G; Doucette, William R; Scott, David M

2014-02-01

The Patient Protection and Affordable Care Act has greatly accelerated the formation of team-based models of care delivery, primarily accountable care organizations (ACOs) and patient-centered medical homes (PCMHs).  Many have written about the need to incorporate medication management services into these systems in order to improve care and reduce total health care costs. Two primary ways of doing so have emerged: (1) an embedded model, whereby pharmacists are employed directly by a physician practice, or (2) a "virtual care team" model, whereby a PCMH or ACO develops an arrangement with external pharmacists in community settings to provide coordinated services.

Pulsed ENDOR Determination of Relative Orientation of g- and Molecular-Frames of Imidazole-Coordinated Heme Center of iNOS

PubMed Central

Astashkin, Andrei V.; Fan, Weihong; Elmore, Bradley O.; Guillemette, J. Guy; Feng, Changjian

2011-01-01

Mammalian nitric oxide synthase (NOS) is a flavo-hemoprotein that catalyzes the oxidation of L-arginine to nitric oxide. Information about the relative alignment of the heme and FMN domains of NOS is important for understanding the electron transfer between the heme and FMN centers, but no crystal structure data for NOS holoenzyme are available. In our previous work [Astashkin, A. V.; Elmore, B. O.; Fan, W.; Guillemette, J. G.; Feng, C. J. Am. Chem. Soc. 2010, 132, 12059–12067], the distance between the imidazole-coordinated low-spin Fe(III) heme and FMN semiquinone in a human inducible NOS (iNOS) oxygenase/FMN construct has been determined by pulsed electron paramagnetic resonance (EPR). The orientation of the Fe – FMN radius-vector, RFe-FMN, with respect to the heme g-frame was also determined. In the present study, pulsed electron-nuclear double resonance (ENDOR) investigation of the deuterons at carbons C2 and C5 in the deuterated coordinated imidazole was used to determine the relative orientation of the heme g- and molecular frames, from which RFe-FMN can be referenced to the heme molecular frame. Numerical simulations of the ENDOR spectra showed that the g-factor axis corresponding to the low-field EPR turning point is perpendicular to the heme plane, while the axis corresponding to the high-field turning point is in the heme plane and makes an angle of about 80° with the coordinated imidazole plane. The FMN-heme domain docking model obtained in the previous work was found to be in qualitative agreement with the combined experimental results of the two pulsed EPR works. PMID:21834532

New Mononuclear Cu(II) Complexes and 1D Chains with 4-Amino-4H-1,2,4-triazole

PubMed Central

Dîrtu, Marinela M.; Boland, Yves; Gillard, Damien; Tinant, Bernard; Robeyns, Koen; Safin, Damir A.; Devlin, Eamonn; Sanakis, Yiannis; Garcia, Yann

2013-01-01

The crystal structures of two mononuclear Cu(II) NH2trz complexes [Cu(NH2trz)4(H2O)](AsF6)2 (I) and [Cu(NH2trz)4(H2O)](PF6)2 (II) as well as two coordination polymers [Cu(μ2-NH2trz)2Cl]Cl·H2O (III) and [Cu(μ2-NH2trz)2Cl] (SiF6)0.5·1.5H2O (IV) are presented. Cationic 1D chains with bridging bis-monodentate μ2-coordinated NH2trz and bridging μ2-coordinated chloride ligands are present in III and IV. In these coordination polymers, the Cu(II) ions are strongly antiferromagnetically coupled with J = −128.4 cm−1 for III and J = −143 cm−1 for IV (H = −J∑SiSi+1), due to the nature of the bridges between spin centers. Inter-chain interactions present in the crystal structures were taken into consideration, as well as g factors, which were determined experimentally, for the quantitative modeling of their magnetic properties. PMID:24300095

A needs assessment of health information technology for improving care coordination in three leading patient-centered medical homes.

PubMed

Richardson, Joshua E; Vest, Joshua R; Green, Cori M; Kern, Lisa M; Kaushal, Rainu

2015-07-01

We investigated ways that patient-centered medical homes (PCMHs) are currently using health information technology (IT) for care coordination and what types of health IT are needed to improve care coordination. A multi-disciplinary team of researchers conducted semi-structured telephone interviews with 28 participants from 3 PCMHs in the United States. Participants included administrators and clinicians from PCMHs, electronic health record (EHR) and health information exchange (HIE) representatives, and policy makers. Participants identified multiple barriers to care coordination using current health IT tools. We identified five areas in which health IT can improve care coordination in PCMHs: 1) monitoring patient populations, 2) notifying clinicians and other staff when specific patients move across care settings, 3) collaborating around patients, 4) reporting activities, and 5) interoperability. To accomplish these tasks, many participants described using homegrown care coordination systems separate from EHRs. The participants in this study have resources, experience, and expertise with using health IT for care coordination, yet they still identified multiple areas for improvement. We hypothesize that focusing health IT development in the five areas we identified can enable more effective care coordination. Key findings from this work are that homegrown systems apart from EHRs are currently used to support care coordination and, also, that reporting tools are key components of care coordination. New health IT that enables monitoring, notifying, collaborating, reporting, and interoperability would enhance care coordination within PCMHs beyond what current health IT enables. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

77 FR 31358 - Disease, Disability, and Injury Prevention and Control Special Interest Projects (SIPs): Initial...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-25

... announced below concerns Coordinating Center for the Managing Epilepsy Well (MEW) Prevention Research Centers Network, SIP12-056, and Managing Epilepsy Well (MEW) Collaborating Center for Epilepsy Self... Managing Epilepsy Well (MEW) Prevention [[Page 31359

Patient-Centered Specialty Practice: Defining the Role of Specialists in Value-Based Health Care.

PubMed

Ward, Lawrence; Powell, Rhea E; Scharf, Michael L; Chapman, Andrew; Kavuru, Mani

2017-04-01

Health care is at a crossroads and under pressure to add value by improving patient experience and health outcomes and reducing costs to the system. Efforts to improve the care model in primary care, such as the patient-centered medical home, have enjoyed some success. However, primary care accounts for only a small portion of total health-care spending, and there is a need for policies and frameworks to support high-quality, cost-efficient care in specialty practices of the medical neighborhood. The Patient-Centered Specialty Practice (PCSP) model offers ambulatory-based specialty practices one such framework, supported by a formal recognition program through the National Committee for Quality Assurance. The key elements of the PCSP model include processes to support timely access to referral requests, improved communication and coordination with patients and referring clinicians, reduced unnecessary and duplicative testing, and an emphasis on continuous measurement of quality, safety, and performance improvement for a population of patients. Evidence to support the model remains limited, and estimates of net costs and value to practices are not fully understood. The PCSP model holds promise for promoting value-based health care in specialty practices. The continued development of appropriate incentives is required to ensure widespread adoption. Copyright © 2017. Published by Elsevier Inc.

The economics of patient-centered care.

PubMed

David, Guy; Saynisch, Philip A; Smith-McLallen, Aaron

2018-05-01

The Patient-Centered Medical Home (PCMH) is a widely-implemented model for improving primary care, emphasizing care coordination, information technology, and process improvements. However, its treatment as an undifferentiated intervention in policy evaluation obscures meaningful variation in implementation. This heterogeneity leads to contracting inefficiencies between insurers and practices and may account for mixed evidence on its success. Using a novel dataset we group practices into meaningful implementation clusters and then link these clusters with detailed patient claims data. We find implementation choice affects performance, suggesting that generally-unobserved features of primary care reorganization influence patient outcomes. Reporting these features may be valuable to insurers and their members. Copyright © 2018 Elsevier B.V. All rights reserved.

Measuring public health practice and outcomes in chronic disease: a call for coordination.

PubMed

Porterfield, Deborah S; Rogers, Todd; Glasgow, LaShawn M; Beitsch, Leslie M

2015-04-01

A strategic opportunity exists to coordinate public health systems and services researchers' efforts to develop local health department service delivery measures and the efforts of divisions within the Centers for Disease Control and Prevention's National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) to establish outcome indicators for public health practice in chronic disease. Several sets of outcome indicators developed by divisions within NCCDPHP and intended for use by state programs can be tailored to assess outcomes of interventions within smaller geographic areas or intervention settings. Coordination of measurement efforts could potentially allow information to flow from the local to the state to the federal level, enhancing program planning, accountability, and even subsequent funding for public health practice.

A method for topological analysis of high nuclearity coordination clusters and its application to Mn coordination compounds.

PubMed

Kostakis, George E; Blatov, Vladislav A; Proserpio, Davide M

2012-04-21

A novel method for the topological description of high nuclearity coordination clusters (CCs) was improved and applied to all compounds containing only manganese as a metal center, the data on which are collected in the CCDC (CCDC 5.33 Nov. 2011). Using the TOPOS program package that supports this method, we identified 539 CCs with five or more Mn centers adopting 159 topologically different graphs. In the present database all the Mn CCs are collected and illustrated in such a way that can be searched by cluster topological symbol and nuclearity, compound name and Refcode. The main principles for such an analysis are described herein as well as useful applications of this method.

Formation Flying Control of Multiple Spacecraft

NASA Technical Reports Server (NTRS)

Hadaegh, F. Y.; Lau, Kenneth; Wang, P. K. C.

1997-01-01

The problem of coordination and control of multiple spacecraft (MS) moving in formation is considered. Here, each MS is modeled by a rigid body with fixed center of mass. First, various schemes for generating the desired formation patterns are discussed, Then, explicit control laws for formation-keeping and relative attitude alignment based on nearest neighbor-tracking are derived. The necessary data which must be communicated between the MS to achieve effective control are examined. The time-domain behavior of the feedback-controlled MS formation for typical low-Earth orbits is studied both analytically and via computer simulation. The paper concludes with a discussion of the implementation of the derived control laws, and the integration of the MS formation coordination and control system with a proposed inter-spacecraft communication/computing network.

Macrocyclic metal complexes for metalloenzyme mimicry and sensor development.

PubMed

Joshi, Tanmaya; Graham, Bim; Spiccia, Leone

2015-08-18

Examples of proteins that incorporate one or more metal ions within their structure are found within a broad range of classes, including oxidases, oxidoreductases, reductases, proteases, proton transport proteins, electron transfer/transport proteins, storage proteins, lyases, rusticyanins, metallochaperones, sporulation proteins, hydrolases, endopeptidases, luminescent proteins, iron transport proteins, oxygen storage/transport proteins, calcium binding proteins, and monooxygenases. The metal coordination environment therein is often generated from residues inherent to the protein, small exogenous molecules (e.g., aqua ligands) and/or macrocyclic porphyrin units found, for example, in hemoglobin, myoglobin, cytochrome C, cytochrome C oxidase, and vitamin B12. Thus, there continues to be considerable interest in employing macrocyclic metal complexes to construct low-molecular weight models for metallobiosites that mirror essential features of the coordination environment of a bound metal ion without inclusion of the surrounding protein framework. Herein, we review and appraise our research exploring the application of the metal complexes formed by two macrocyclic ligands, 1,4,7-triazacyclononane (tacn) and 1,4,7,10-tetraazacyclododecane (cyclen), and their derivatives in biological inorganic chemistry. Taking advantage of the kinetic inertness and thermodynamic stability of their metal complexes, these macrocyclic scaffolds have been employed in the development of models that aid the understanding of metal ion-binding natural systems, and complexes with potential applications in biomolecule sensing, diagnosis, and therapy. In particular, the focus has been on "coordinatively unsaturated" metal complexes that incorporate a kinetically inert and stable metal-ligand moiety, but which also contain one or more weakly bound ligands, allowing for the reversible binding of guest molecules via the formation and dissociation of coordinate bonds. With regards to mimicking metallobiosites, examples are presented from our work on tacn-based complexes developed as simplified structural models for multimetallic enzyme sites. In particular, structural comparisons are made between multinuclear copper(II) complexes formed by such ligands and multicopper enzymes featuring type-2 and type-3 copper centers, such as ascorbate oxidase (AO) and laccase (Lc). Likewise, with the aid of relevant examples, we highlight the importance of cooperativity between either multiple metal centers or a metal center and a proximal auxiliary unit appended to the macrocyclic ligand in achieving efficient phosphate ester cleavage. Finally, the critical importance of the Zn(II)-imido and Zn(II)-phosphate interactions in Zn-cyclen-based systems for delivering highly sensitive electrochemical and fluorescent chemosensors is also showcased. The Account additionally highlights some of the factors that limit the performance of these synthetic nucleases and the practical application of the biosensors, and then identifies some avenues for the development of more effective macrocyclic constructs in the future.

42 CFR 423.466 - Timeframes for coordination of benefits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 423.466 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Coordination of Part D...) Retroactive claims adjustments, underpayment refunds, and overpayment recoveries. Whenever a sponsor receives...

Patient opinion regarding patient-centered medical home fundamentals.

PubMed

Wexler, Randell K; King, Dana E; Andrews, Mark

2012-04-01

Although conceptually there is agreement on how the Patient-Centered Medical Home (PCMH) should be organized, there is little information regarding which PCMH components are the most important to patients. An anonymous, voluntary survey was administered to patients at three US academic medical centers. Questions sought opinions regarding the National Committee for Quality Assurance's key components and essential elements of the PCMH. Analysis of the survey responses was conducted using SAS version 9.1. A total of 780 surveys were returned. Patients expressed believing strongly that the ability to coordinate care, help patients to manage their own disease, and track laboratory results were the most important aspects of a PCMH office. There were no differences in response to the survey according to age, sex, race, or site. Patients listed care coordination, patient self-management, and improved access to care as the top priority attributes of a PCMH. Patients were consistent in their opinions that care coordination, access, and patient self-management were the most important elements of a PCMH.

A one-dimensional nickel(II) coordination polymer containing 2,6-dipicolinate and dipyrido[3,2-a:2',3'-c]phenazine.

PubMed

Ma, Yi; Zhang, Li-Tian; Wang, Xiao-Fang; He, Yong-Ke; Han, Zheng-Bo

2007-12-01

A new coordination polymer, catena-poly[[(dipyrido[3,2-a:2',3'-c]phenazine-kappa(2)N,N')nickel(II)]-mu-2,6-dipicolinato-kappa(4)O(2),N,O(6):O(2')], [Ni(C7H3NO4)(C18H10N4)]n, exhibits a one-dimensional structure in which 2,6-dipicolinate acts as a bridging ligand interconnecting adjacent nickel(II) centers to form a chain structure. The asymmetric unit contains one Ni(II) center, one dipyrido[3,2-a:2',3'-c]phenazine ligand and one 2,6-dipicolinate ligand. Each Ni(II) center is six-coordinated and surrounded by three N atoms and three O atoms from one dipyrido[3,2-a:2',3'-c]phenazine ligand and two different 2,6-dipicolinate ligands, leading to a distorted octahedral geometry. Adjacent chains are linked by pi-pi stacking interactions and weak interactions to form a three-dimensional supramolecular network.

Integration and continuity of Care in health care network models for frail older adults

PubMed Central

Veras, Renato Peixoto; Caldas, Célia Pereira; da Motta, Luciana Branco; de Lima, Kenio Costa; Siqueira, Ricardo Carreño; Rodrigues, Renata Teixeira da Silva Vendas; Santos, Luciana Maria Alves Martins; Guerra, Ana Carolina Lima Cavaletti

2014-01-01

A detailed review was conducted of the literature on models evaluating the effectiveness of integrated and coordinated care networks for the older population. The search made use of the following bibliographic databases: Pubmed, The Cochrane Library, LILACS, Web of Science, Scopus and SciELO. Twelve articles on five different models were included for discussion. Analysis of the literature showed that the services provided were based on primary care, including services within the home. Service users relied on the integration of primary and hospital care, day centers and in-home and social services. Care plans and case management were key elements in care continuity. This approach was shown to be effective in the studies, reducing the need for hospital care, which resulted in savings for the system. There was reduced prevalence of functional loss and improved satisfaction and quality of life on the part of service users and their families. The analysis reinforced the need for change in the approach to health care for older adults and the integration and coordination of services is an efficient way of initiating this change. PMID:24897058

Modeling Real-Time Coordination of Distributed Expertise and Event Response in NASA Mission Control Center Operations

NASA Astrophysics Data System (ADS)

Onken, Jeffrey

This dissertation introduces a multidisciplinary framework for the enabling of future research and analysis of alternatives for control centers for real-time operations of safety-critical systems. The multidisciplinary framework integrates functional and computational models that describe the dynamics in fundamental concepts of previously disparate engineering and psychology research disciplines, such as group performance and processes, supervisory control, situation awareness, events and delays, and expertise. The application in this dissertation is the real-time operations within the NASA Mission Control Center in Houston, TX. This dissertation operationalizes the framework into a model and simulation, which simulates the functional and computational models in the framework according to user-configured scenarios for a NASA human-spaceflight mission. The model and simulation generates data according to the effectiveness of the mission-control team in supporting the completion of mission objectives and detecting, isolating, and recovering from anomalies. Accompanying the multidisciplinary framework is a proof of concept, which demonstrates the feasibility of such a framework. The proof of concept demonstrates that variability occurs where expected based on the models. The proof of concept also demonstrates that the data generated from the model and simulation is useful for analyzing and comparing MCC configuration alternatives because an investigator can give a diverse set of scenarios to the simulation and the output compared in detail to inform decisions about the effect of MCC configurations on mission operations performance.

Pediatric Care Coordination: Lessons Learned and Future Priorities.

PubMed

Cady, Rhonda G; Looman, Wendy S; Lindeke, Linda L; LaPlante, Bonnie; Lundeen, Barbara; Seeley, Amanda; Kautto, Mary E

2015-09-30

A fundamental component of the medical home model is care coordination. In Minnesota, this model informed design and implementation of the state's health care home (HCH) model, a key element of statewide healthcare reform legislation. Children with medical complexity (CMC) often require care from multiple specialists and community resources. Coordinating this multi-faceted care within the HCH is challenging. This article describes the need for specialized models of care coordination for CMC. Two models of care coordination for CMC were developed to address this challenge. The TeleFamilies Model of Pediatric Care Coordination uses an advanced practice registered nurse care (APRN) coordinator embedded within an established HCH. The PRoSPer Model of Pediatric Care Coordination uses a registered nurse/social worker care coordinator team embedded within a specialty care system. We describe key findings from implementation of these models, and conclude with lessons learned. Replication of the models is encouraged to increase the evidence base for care coordination for the growing population of children with medical complexities.

Frequency Agility Radar,

DTIC Science & Technology

1982-12-06

different model aircraft in different wave bands (P,L, S and X). Yet, the obtained results were relatively complex and it was not easy to find regularity...hertz for the S wave band . This type of narrow wave band signifies that the drift velocity of the target viewed in the reflection center is very low... Band of Airborne Radar With Pulse Width of 0.02)4 s and Grazing Angle of 470) Key: 1. Probability exceeding horizontal coordinates 2. Clutter section 3

Getting Down to Business: An Action Plan for Public-Private Disaster Response Coordination. The Report of the Business Response Task Force

DTIC Science & Technology

2007-01-01

gency Management Association ( NEMA ) to explore application of the Emergency Management Assistance Compact (EMAC) model to the task of identifying...organizations combined—are the norm . The challenge for government and the private sector is to ensure that donated goods and services from the latter...Association ( NEMA ). EOC – Emergency Operations Center – the central command and control facility responsible for carrying out emergency preparedness and

Qualitative mechanism models and the rationalization of procedures

NASA Technical Reports Server (NTRS)

Farley, Arthur M.

1989-01-01

A qualitative, cluster-based approach to the representation of hydraulic systems is described and its potential for generating and explaining procedures is demonstrated. Many ideas are formalized and implemented as part of an interactive, computer-based system. The system allows for designing, displaying, and reasoning about hydraulic systems. The interactive system has an interface consisting of three windows: a design/control window, a cluster window, and a diagnosis/plan window. A qualitative mechanism model for the ORS (Orbital Refueling System) is presented to coordinate with ongoing research on this system being conducted at NASA Ames Research Center.

Fermi problem in disordered systems

NASA Astrophysics Data System (ADS)

Menezes, G.; Svaiter, N. F.; de Mello, H. R.; Zarro, C. A. D.

2017-10-01

We revisit the Fermi two-atom problem in the framework of disordered systems. In our model, we consider a two-qubit system linearly coupled with a quantum massless scalar field. We analyze the energy transfer between the qubits under different experimental perspectives. In addition, we assume that the coefficients of the Klein-Gordon equation are random functions of the spatial coordinates. The disordered medium is modeled by a centered, stationary, and Gaussian process. We demonstrate that the classical notion of causality emerges only in the wave zone in the presence of random fluctuations of the light cone. Possible repercussions are discussed.

GPS Modeling and Analysis. Summary of Research: GPS Satellite Axial Ratio Predictions

NASA Technical Reports Server (NTRS)

Axelrad, Penina; Reeh, Lisa

2002-01-01

This report outlines the algorithms developed at the Colorado Center for Astrodynamics Research to model yaw and predict the axial ratio as measured from a ground station. The algorithms are implemented in a collection of Matlab functions and scripts that read certain user input, such as ground station coordinates, the UTC time, and the desired GPS (Global Positioning System) satellites, and compute the above-mentioned parameters. The position information for the GPS satellites is obtained from Yuma almanac files corresponding to the prescribed date. The results are displayed graphically through time histories and azimuth-elevation plots.

[Characteristics of the leadership of health center coordinators in the autonomous community of Murcia].

PubMed

Menárguez Puche, J F; Saturno Hernández, P J

1998-12-01

To describe the style and effectiveness (adaptability) of the leadership of coordinators of an autonomous community according to the model of leadership on the ground, analysing its relationship with the work environment. Observational crossover study. All the functioning teams in this community. Medical and nursing coordinators. Hersey and Blanchard's questionnaire on leadership on the ground was employed. This identifies 1) the predominant style (scoring for style 0-12). On the approach of the coordinator to personal relationships and/or task development, it identifies 4 points: direction, persuasion, participation, delegation. 2) Adaptability of the manager (ranging from +24 to -24), based on that the best choice between different options depends on the maturity of the group. To contrast work environment and leadership, a validated questionnaire, adapted to our milieu, was used. Overall reply rate (51 coordinators) was 89.4%. Analysis of styles was: persuasive 5.05 points (SD = 1.25), participatory 4.74 (SD 1.76), directive 1.2 (SD 1.11) and delegating 0.34 (SD 0.68). Adaptability scored 8.38 points (SD = 4.67), and was greater for the nursing coordinators (p < 0.002) without differences for type, place or teaching qualifications. The work environment, both overall and by dimensions, correlated with adaptability, although no relationship was found with leaders' styles. Leadership adaptability was quite high and greater in nursing. The most prevalent styles were the persuasive and the participatory, more efficacious in teams of average maturity. Theoretical effectiveness was positively related to a better work environment.

Synthesis and characterization of thorium(IV) sulfates.

PubMed

Knope, Karah E; Wilson, Richard E; Skanthakumar, S; Soderholm, L

2011-09-05

Three Th(IV) sulfates, two new and one previously reported, have been synthesized from aqueous solution. In all of the compounds, the sulfate anions coordinate the Th(4+) metal center(s) in a monodentate manner with Th-S distances of 3.7-3.8 Å. Th(SO(4))(2)(H(2)O)(7)·2(H(2)O) (1; P2(1)/m, a = 7.224(1) Å, b = 12.151(1) Å, c = 7.989(1) Å, ss =98.289(2)°) and Th(4)(SO(4))(7)(H(2)O)(7)(OH)(2)·H(2)O (2; Pnma, a = 18.139(2) Å, b = 11.173(1) Å, c = 14.391(2) Å) each contain 9-coordinate monomeric (1,2) and dimeric (2) Th(IV) cations in monocapped square antiprism geometry. Alternatively, Th(OH)(2)SO(4) (3; Pnma, a = 11.684(1) Å, b = 6.047(1) Å, c = 7.047(1) Å) is built from chains of hydroxo-bridged, 8-coordinate Th(4+) centers. Whereas 1 adopts a molecular structure, 2 and 3 both exhibit 3D architectures. Differences in the dimensionality and the topology of 1-3 are manifested in the local coordination environment about the Th(IV) centers, the formation of oligomeric Th(4+) species, and the extended connectivity of the sulfate ligands. Herein, we report the syntheses and characterization of 1-3 as well as the atomic correlations of 1 in solution, as determined by high-energy X-ray scattering (HEXS).

Paramagnetic 19F NMR and Electrospray Ionization Mass Spectrometric Studies of Substituted Pyridine Complexes of Chromium(III): Models for Potential Use of 19F NMR to Probe Cr(III)-Nucleotide Interaction1

PubMed Central

Rhodes, Nicholas R.; Belmore, Ken; Cassady, Carolyn J.; Vincent, John B.

2013-01-01

The synthesis and characterization of chromium basic carboxylate complexes, [Cr3(O2CR)6L3]+, containing trifluoroacetate, 3-fluoropyridine, 3-trifluoromethylpyridine, and 4-trifluoromethylpyridine are described. The substituted pyridine ligands are used as models of DNA bases to determine whether 19F NMR would be a potentially useful probe of the binding of Cr3+ to DNA. The 19F NMR resonances of the coordinated ligands, while broadened by delocalization of unpaired electron density from the S=3/2 chromic centers, are readily discernable, and the contact shifts are of sufficient magnitude that the signals from coordinated and free ligands can easily be differentiated. Thus, 19F NMR appears to be a potentially useful probe of the binding of Cr3+ to DNA containing F-labeled bases. Additionally, electrospray MS is shown to be a convenient method to establish the identity of chromium basic carboxylate assemblies. PMID:24222929

Electrostatically Embedded Many-Body Expansion for Neutral and Charged Metalloenzyme Model Systems.

PubMed

Kurbanov, Elbek K; Leverentz, Hannah R; Truhlar, Donald G; Amin, Elizabeth A

2012-01-10

The electrostatically embedded many-body (EE-MB) method has proven accurate for calculating cohesive and conformational energies in clusters, and it has recently been extended to obtain bond dissociation energies for metal-ligand bonds in positively charged inorganic coordination complexes. In the present paper, we present four key guidelines that maximize the accuracy and efficiency of EE-MB calculations for metal centers. Then, following these guidelines, we show that the EE-MB method can also perform well for bond dissociation energies in a variety of neutral and negatively charged inorganic coordination systems representing metalloenzyme active sites, including a model of the catalytic site of the zinc-bearing anthrax toxin lethal factor, a popular target for drug development. In particular, we find that the electrostatically embedded three-body (EE-3B) method is able to reproduce conventionally calculated bond-breaking energies in a series of pentacoordinate and hexacoordinate zinc-containing systems with an average absolute error (averaged over 25 cases) of only 0.98 kcal/mol.

Nitric oxide activation by distal redox modulation in tetranuclear iron nitrosyl complexes.

PubMed

de Ruiter, Graham; Thompson, Niklas B; Lionetti, Davide; Agapie, Theodor

2015-11-11

A series of tetranuclear iron complexes displaying a site-differentiated metal center was synthesized. Three of the metal centers are coordinated to our previously reported ligand, based on a 1,3,5-triarylbenzene motif with nitrogen and oxygen donors. The fourth (apical) iron center is coordinatively unsaturated and appended to the trinuclear core through three bridging pyrazolates and an interstitial μ4-oxide moiety. Electrochemical studies of complex [LFe3(PhPz)3OFe][OTf]2 revealed three reversible redox events assigned to the Fe(II)4/Fe(II)3Fe(III) (-1.733 V), Fe(II)3Fe(III)/Fe(II)2Fe(III)2 (-0.727 V), and Fe(II)2Fe(III)2/Fe(II)Fe(III)3 (0.018 V) redox couples. Combined Mössbauer and crystallographic studies indicate that the change in oxidation state is exclusively localized at the triiron core, without changing the oxidation state of the apical metal center. This phenomenon is assigned to differences in the coordination environment of the two metal sites and provides a strategy for storing electron and hole equivalents without affecting the oxidation state of the coordinatively unsaturated metal. The presence of a ligand-binding site allowed the effect of redox modulation on nitric oxide activation by an Fe(II) metal center to be studied. Treatment of the clusters with nitric oxide resulted in binding of NO to the apical iron center, generating a {FeNO}(7) moiety. As with the NO-free precursors, the three reversible redox events are localized at the iron centers distal from the NO ligand. Altering the redox state of the triiron core resulted in significant change in the NO stretching frequency, by as much as 100 cm(-1). The increased activation of NO is attributed to structural changes within the clusters, in particular, those related to the interaction of the metal centers with the interstitial atom. The differences in NO activation were further shown to lead to differential reactivity, with NO disproportionation and N2O formation performed by the more electron-rich cluster.

The first 24 hours of the World Trade Center attacks of 2001--the Centers for Disease Control and Prevention emergency phase response.

PubMed

Cruz, Miguel A; Burger, Ronald; Keim, Mark

2007-01-01

On 11 September 2001, terrorists hijacked two passenger planes and crashed them into the two towers of the World Trade Center (WTC) in New York City. These synchronized attacks were the largest act of terrorism ever committed on US soil. The impacts, fires, and subsequent collapse of the towers killed and injured thousands of people. Within minutes after the first plane crashed into the WTC, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, initiated one of the largest public health responses in its history. Staff of the CDC provided technical assistance on several key public health issues. During the acute phase of the event, CDC personnel assisted with: (1) assessing hospital capacity; (2) establishing injury and disease surveillance activities; (3) deploying emergency coordinators/liaisons to facilitate inter-agency coordination with the affected jurisdictions; and (4) arranging rapid delivery of emergency medical supplies, therapeutics, and personal protective equipment. This incident highlighted the need for adequate planning for all potential hazards and the importance of interagency and interdepartmental coordination in preparing for and responding to public health emergencies.

Increasing maternal healthcare use in Rwanda: implications for child nutrition and survival.

PubMed

Pierce, Hayley; Heaton, Tim B; Hoffmann, John

2014-04-01

Rwanda has made great progress in improving maternal utilization of health care through coordination of external aid and more efficient health policy. Using data from the 2005 and 2010 Rwandan Demographic and Health Surveys, we examine three related questions regarding the impact of expansion of health care in Rwanda. First, did the increased use of health center deliveries apply to women across varying levels of education, economic status, and area of residency? Second, did the benefits associated with being delivered at a health center diminish as utilization became more widespread? Finally, did inequality in child outcomes decline as a result of increased health care utilization? Propensity score matching was used to address the selectivity that arises when choosing to deliver at a hospital. In addition, the regression models include a linear model to predict child nutritional status and Cox regression to predict child survival. The analysis shows that the largest increases in delivery at a health center occur among less educated, less wealthy, and rural Rwandan women. In addition, delivery at a health center is associated with better nutritional status and survival and the benefit is not diminished following the dramatic increase in use of health centers. Finally, educational, economic and residential inequality in child survival and nutrition did not decline. Copyright © 2014 Elsevier Ltd. All rights reserved.

Patients' experiences in different models of community health centers in southern China.

PubMed

Wang, Harry H X; Wong, Samuel Y S; Wong, Martin C S; Wei, Xiao Lin; Wang, Jia Ji; Li, Donald K T; Tang, Jin Ling; Gao, Gemma Y; Griffiths, Sian M

2013-01-01

Current health care reforms in China have an overall goal of strengthening primary care through the establishment and expansion of primary care networks based on community health centers (CHCs). Implementation in urban areas has led to the emergence of different models of ownership and management. The objective of this study was to evaluate the primary care experiences of patients in the Pearl River Delta as measured by the Primary Care Assessment Tool (PCAT) and the relationships with ownership and management in the 3 different models we describe. This cross-sectional study was conducted on-site at CHCs in 3 cities within the Pearl River Delta, China, using a multistage cluster sampling method. A validated Mandarin Chinese version of the PCAT-Adult Edition (short version) was adopted to collect information from adult patients regarding their experiences with primary care sources. PCAT scores for individual primary care attributes and total primary care assessment scores were assessed with respect to sociodemographic characteristics, health characteristics, and health care service utilization across 3 primary care models. One thousand four hundred forty (1,440) primary care patients responded to the survey, for an overall response rate of 86.1%. Respondents gave government-owned and -managed CHCs the highest overall PCAT scores when compared with CHCs either managed by hospitals (95.18 vs 90.81; P = .005) or owned by private and social entities (95.18 vs 90.69; P =.007) as a result of better first-contact care (better first-contact utilization) and coordination of care (better service coordination and information system). Factors that were positively and significantly associated with higher overall assessment scores included the presence of a chronic condition (P <.001), having medical insurance (P = .006), and a self-reported good health status (P <.001). This study suggests that government-owned and -managed CHCs may be able to provide better first-contact care in terms of utilization and coordination of care, and may be better at solving the problem of underutilization of the CHCs as the first-contact point of care, one key problem facing the reforms in China.

Development of the Jackson Heart Study Coordinating Center

PubMed Central

Campbell-Jenkins, Brenda W.; Addison, Clifton C.; Young, Lavon; Anugu, Pramod; Wilson, Gregory; Sarpong, Daniel

2009-01-01

The public health burden caused by cardiovascular disease (CVD) continues to adversely affect individuals in terms of cost, life expectancy, medical, pharmaceutical and hospital care. This burden has been excessive in the case of African Americans. The objective of this paper is to chronicle the procedures and processes that were implemented in the development of the Jackson Heart Study Coordinating Center. The Jackson Heart Study (JHS) is a population-based investigation of traditional and emerging risk factors that predict progression to CVD among African Americans. In response to the struggle against CVD, the Jackson Heart Study has convened a professional, technical, and administrative staff with specific competence in the operation of a coordinating center to handle the wide variety of areas related to CVD studies. The Jackson Heart Study Coordinating Center (JHSCC) was created to assure validity of the JHS findings and provide the resources necessary to meet comprehensive statistical needs (planning, implementing and monitoring data analysis); data management (designing, implementing and managing data collection and quality control), and administrative support. The JHSCC began with a commitment to support study functions in order to increase participant recruitment, retention and safety, meet regulatory requirements, prepare progress reports, and facilitate effective communication with the community and between all JHS centers. The JHSCC facilitates the efforts of the JHS scientists through the development and implementation of the study protocol. The efforts of the JHSCC have resulted in the successful preparation of scientific reports and manuscripts for publication and presentation of study findings and results. In summary, the JHSCC has emerged as an effective research mechanism that serves as the driving force behind the Jackson Heart Study activities. PMID:19543408

Customizing for clients: developing a library liaison program from need to plan.

PubMed

Tennant, M R; Butson, L C; Rezeau, M E; Tucker, P J; Boyle, M E; Clayton, G

2001-01-01

Building on the experiences of librarian representatives to curriculum committees in the colleges of dentistry, medicine, and nursing, the Health Science Center Libraries (HSCL) Strategic Plan recommended the formation of a Library Liaison Work Group to create a formal Library Liaison Program to serve the six Health Science Center (HSC) colleges and several affiliated centers and institutes. The work group's charge was to define the purpose and scope of the program, identify models of best practice, and recommend activities for liaisons. The work group gathered background information, performed an environmental scan, and developed a philosophy statement, a program of liaison activities focusing on seven primary areas, and a forum for liaison communication. Hallmarks of the plan included intensive subject specialization (beyond collection development), extensive communication with users, and personal information services. Specialization was expected to promote competence, communication, confidence, comfort, and customization. Development of the program required close coordination with other strategic plan implementation teams, including teams for collection development, education, and marketing. This paper discusses the HSCL's planning process and the resulting Library Liaison Program. Although focusing on an academic health center, the planning process and liaison model may be applied to any library serving diverse, subject-specific user populations.

Customizing for clients: developing a library liaison program from need to plan*

PubMed Central

Tennant, Michele R.; Butson, Linda C.; Rezeau, Michelle E.; Tucker, Prudence J.; Boyle, Marian E.; Clayton, Greg

2001-01-01

Building on the experiences of librarian representatives to curriculum committees in the colleges of dentistry, medicine, and nursing, the Health Science Center Libraries (HSCL) Strategic Plan recommended the formation of a Library Liaison Work Group to create a formal Library Liaison Program to serve the six Health Science Center (HSC) colleges and several affiliated centers and institutes. The work group's charge was to define the purpose and scope of the program, identify models of best practice, and recommend activities for liaisons. The work group gathered background information, performed an environmental scan, and developed a philosophy statement, a program of liaison activities focusing on seven |primary areas, and a forum for liaison communication. Hallmarks of the plan included intensive subject specialization (beyond collection development), extensive communication with users, and personal information services. Specialization was expected to promote competence, communication, confidence, comfort, and customization. Development of the program required close coordination with other strategic plan implementation teams, including teams for collection development, education, and marketing. This paper discusses the HSCL's planning process and the resulting Library Liaison Program. Although focusing on an academic health center, the planning process and liaison model may be applied to any library serving diverse, subject-specific user populations. PMID:11209807

A coordinated PCP-Cardiologist Telemedicine Model (PCTM) in China's community hypertension care: study protocol for a randomized controlled trial.

PubMed

Xu, Lei; Fang, Wei-Yi; Zhu, Fu; Zhang, Hong-Guang; Liu, Kai

2017-05-25

Hypertension is a major risk factor for cardiovascular disease, and its control rate has remained low worldwide. Studies have found that telemonitoring blood pressure (BP) helped control hypertension in randomized controlled trials. However, little is known about its effect in a structured primary care model in which primary care physicians (PCPs) are partnering with cardiology specialists in electronic healthcare data sharing and medical interventions. This study aims to identify the effects of a coordinated PCP-cardiologist model that applies telemedicine tools to facilitate community hypertension control in China. Patients with hypertension receiving care at four community healthcare centers that are academically affiliated to Shanghai Chest Hospital, Shanghai JiaoTong University are eligible if they have had uncontrolled BP in the previous 3 months and access to mobile Internet. Study subjects are randomly assigned to three interventional groups: (1) usual care; (2) home-based BP telemonitor with embedded Global System for Mobile Communications (GSM) module and unlimited data plan, an app to access personal healthcare record and receive personalized lifestyle coaching contents, and proficiency training of their use; or (3) this plus coordinated PCP-cardiologist care in which PCPs and cardiologists share data via a secure CareLinker website to determine interventional approaches. The primary outcome is mean change in systolic blood pressure over a 12-month period. Secondary outcomes are changes of diastolic blood pressure, HbA1C, blood lipids, and medication adherence measured by the eight-item Morisky Medication Adherence Scale. This study will determine whether a coordinated PCP-Cardiologist Telemedicine Model that incorporates the latest telemedicine technologies will improve hypertension care. Success of the model would help streamline the present community healthcare processes and impact a greater number of patients with uncontrolled hypertension. ClinicalTrials.gov, NCT02919033 . Registered on 23 September 2016.

Comparison of five-axis milling and rapid prototyping for implant surgical templates.

PubMed

Park, Ji-Man; Yi, Tae-Kyoung; Koak, Jai-Young; Kim, Seong-Kyoon; Park, Eun-Jin; Heo, Seong-Joo

2014-01-01

This study aims to compare and evaluate the accuracy of surgical templates fabricated using coordinate synchronization processing with five-axis milling and design-related processing with rapid prototyping (RP). Master phantoms with 10 embedded gutta-percha cylinders hidden under artificial gingiva were fabricated and imaged using cone beam computed tomography. Vectors of the hidden cylinders were extracted and transferred to those of the planned implants through reverse engineering using virtual planning software. An RP-produced template was fabricated by stereolithography in photopolymer at the RP center according to planned data. Metal sleeves were bonded after holes were bored (group RP). For the milled template, milling coordinates were synchronized using the conversion process for the coordinate synchronization platform located on the model's bottom. Metal bushings were set on holes milled on the five-axis milling machine, on which the model was fixed through the coordinate synchronization plate, and the framework was constructed on the model using orthodontic resin (group CS). A computed tomography image was taken with templates firmly fixed on models using anchor pins (RP) or anchor screws (CS). The accuracy was analyzed via reverse engineering. Differences between the two groups were compared by repeated measures two-factor analysis. From the reverse-engineered image of the template on the experimental model, RP-produced templates showed significantly larger deviations than did milled surgical guides. Maximum deviations of the group RP were 1.58 mm (horizontal), 1.68 mm (vertical), and 8.51 degrees (angular); those of the group CS were 0.68 mm (horizontal), 0.41 mm (vertical), and 3.23 degrees (angular). A comparison of milling and RP template production methods showed that a vector-milled surgical guide had significantly smaller deviations than did an RP-produced template. The accuracy of computer-guided milled surgical templates was within the safety margin of previous studies.

34 CFR 412.3 - What activities may the Secretary fund?

Code of Federal Regulations, 2011 CFR

2011-07-01

... VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION NATIONAL NETWORK FOR CURRICULUM COORDINATION IN... provides grants, cooperative agreements, or contracts to six regional curriculum coordination centers (CCCs... accessible by electronic means; (3) Provide leadership and technical assistance in the design, development...

Automotive Energy Efficiency Program - Presented Papers at the Contractors Coordination Meeting, January 15-17, 1975

DOT National Transportation Integrated Search

1975-06-01

This volume contains working papers presented at the Contractors Coordination Meeting of the Automotive Energy Efficiency Program held at the DOT Transportation Systems Center, January 15-17, 1975. This program is the Federal Government's major effor...

Automotive Energy Efficiency Program : Papers Presented at the Project Coordination Meeting, November 4-6, 1975

DOT National Transportation Integrated Search

1976-06-01

This volume contains working papers presented at the Contractors Coordination Meeting of the Automotive Energy Efficiency Program held at the DOT Transportation Systems Center, January 15-17, 1975. This program is the Federal Government's major effor...

Origins of the different metal preferences of Escherichia coli peptide deformylase and Bacillus thermoproteolyticus thermolysin: a comparative quantum mechanical/molecular mechanical study.

PubMed

Dong, Minghui; Liu, Haiyan

2008-08-21

The Escherichia coli peptide deformylase (PDF) and Bacillus thermoproteolyticus thermolysin (TLN) are two representative metal-requiring peptidases having remarkably similar active centers but distinctively different metal preferences. Zinc is a competent catalytic cofactor for TLN but not for PDF. Reaction pathways and the associated energetics for both enzymes were determined using combined semiempirical and ab initio quantum mechanical/molecular mechanical modeling, without presuming reaction coordinates. The results confirmed that both enzymes catalyze via the same chemical steps, and reproduced their different preferences for zinc or iron as competent cofactors. Further analyses indicated that different feasibility of the nucleophilic attack step leads to different metal preferences of the two enzymes. In TLN, the substrate is strongly activated and can serve as the fifth coordination ligand of zinc prior to the chemical steps. In PDF, the substrate carbonyl is activated by the chemical step itself, and becomes the fifth coordination partner of zinc only in a later stage of the nucleophilic attack. These leads to a much more difficult nucleophilic attack in PDF than in TLN. Different from some earlier suggestions, zinc has no difficulty in accepting an activated substrate as the fifth ligand to switch from tetra- to penta-coordination in either PDF or TLN. When iron replaces zinc, its stronger interaction with the hydroxide ligand may lead to higher activation barrier in TLN. In PDF, the stronger interactions of iron with ligands allow iron-substrate coordination to take place either before or at a very early stage of the chemical step, leading to effective catalysis. Our calculations also show combined semiempirical and ab initio quantum mechanical modeling can be efficient approaches to explore complicated reaction pathways in enzyme systems.

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

Johnston, Ryne C.; Zhou, Jing; Smith, Jeremy C.

In redox processes in complex transition metal-containing species are often intimately associated with changes in ligand protonation states and metal coordination number. Moreover, a major challenge is therefore to develop consistent computational approaches for computing pH-dependent redox and ligand dissociation properties of organometallic species. Reduction of the Co center in the vitamin B12 derivative aquacobalamin can be accompanied by ligand dissociation, protonation, or both, making these properties difficult to compute accurately. We examine this challenge here by using density functional theory and continuum solvation to compute Co ligand binding equilibrium constants (Kon/off), pKas and reduction potentials for models of aquacobalaminmore » in aqueous solution. We consider two models for cobalamin ligand coordination: the first follows the hexa, penta, tetra coordination scheme for Co III, Co II, and Co I species, respectively, and the second model features saturation of each vacant axial coordination site on Co II and Co I species with a single, explicit water molecule to maintain six directly interacting ligands or water molecules in each oxidation state. Comparing these two coordination schemes in combination with five dispersion-corrected density functionals, we find that the accuracy of the computed properties is largely independent of the scheme used, but including only a continuum representation of the solvent yields marginally better results than saturating the first solvation shell around Co throughout. PBE performs best, displaying balanced accuracy and superior performance overall, with RMS errors of 80 mV for seven reduction potentials, 2.0 log units for five pK as and 2.3 log units for two log K on/off values for the aquacobalamin system. Furthermore, we find that the BP86 functional commonly used in corrinoid studies suffers from erratic behavior and inaccurate descriptions of Co axial ligand binding, leading to substantial errors in predicted pK as and K on/off values. Finally, these findings demonstrate the effectiveness of the present approach for computing electrochemical and thermodynamic properties of a complex transition metal-containing cofactor.« less

Facilitators and Barriers to Care Coordination in Patient-centered Medical Homes (PCMHs) from Coordinators’ Perspectives

PubMed Central

Friedman, Asia; Howard, Jenna; Shaw, Eric K.; Cohen, Deborah J.; Shahidi, Laleh; Ferrante, Jeanne M.

2016-01-01

Background Care coordinators are increasingly featured in patient-centered medical home (PCMH) projects, yet little research examines how coordinators themselves define and experience their role. This is the first study describing experiences of care coordinators across the US from their own perspectives. Methods This qualitative study used a 5-month private, online discussion forum to gather data from 25 care coordinators from PCMH practices representing diversity in practice size, setting, and type. Participants answered questions and interacted with one another, creating an online social learning collaborative while allowing for data collection for research. Results Coordinators identified barriers and facilitators in their work at the organization/system level, the interpersonal level, and the individual level. Some factors emerged as both barriers and facilitators, including the functionality of clinical information technology; the availability of community resources; interactions with clinicians and other health care facilities; interactions with patients; and self-care practices for mental health and wellness. Colocation and full integration into practices were other key facilitators, whereas excessive case loads and data management responsibilities were felt to be important barriers. Conclusions While all the barriers and facilitators were important to performing coordinators’ roles, relationship building materialized as key to effective care coordination, whether with clinicians, patients, or outside organizations. We discuss implications for practice and provide suggestions for further research. PMID:26769881

Accountable care organization readiness and academic medical centers.

PubMed

Berkowitz, Scott A; Pahira, Jennifer J

2014-09-01

As academic medical centers (AMCs) consider becoming accountable care organizations (ACOs) under Medicare, they must assess their readiness for this transition. Of the 253 Medicare ACOs prior to 2014, 51 (20%) are AMCs. Three critical components of ACO readiness are institutional and ACO structure, leadership, and governance; robust information technology and analytic systems; and care coordination and management to improve care delivery and health at the population level. All of these must be viewed through the lens of unique AMC mission-driven goals.There is clear benefit to developing and maintaining a centralized internal leadership when it comes to driving change within an ACO, yet there is also the need for broad stakeholder involvement. Other important structural features are an extensive primary care foundation; concomitant operation of a managed care plan or risk-bearing entity; or maintaining a close relationship with post-acute-care or skilled nursing facilities, which provide valuable expertise in coordinating care across the continuum. ACOs also require comprehensive and integrated data and analytic systems that provide meaningful population data to inform care teams in real time, promote quality improvement, and monitor spending trends. AMCs will require proven care coordination and management strategies within a population health framework and deployment of an innovative workforce.AMC core functions of providing high-quality subspecialty and primary care, generating new knowledge, and training future health care leaders can be well aligned with a transition to an ACO model. Further study of results from Medicare-related ACO programs and commercial ACOs will help define best practices.

Unlocking information for coordination of care in Australia: a qualitative study of information continuity in four primary health care models

PubMed Central

2013-01-01

Background Coordination of care is considered a key component of patient-centered health care systems, but is rarely defined or operationalised in health care policy. Continuity, an aspect of coordination, is the patient’s experience of care over time, and is often described in terms of three dimensions: information, relational and management continuity. With the current health policy focus on both the use of information technology and care coordination, this study aimed to 1) explore how information continuity supports coordination and 2) investigate conditions required to support information continuity. Methods Four diverse Australian primary health care initiatives were purposively selected for inclusion in the study. Each has improved coordination as an aim or fundamental principle. Each organization was asked to identify practitioners, managers and decision makers who could provide insight into the use of information for care coordination to participate in the study. Using in-depth semi-structured interviews, we explored four questions covering the scope and use of information, the influence of governance, data ownership and confidentiality and the influence of financial incentives and quality improvement on information continuity and coordination. Data were thematically analyzed using NVivo 8. Results The overall picture that emerged across all four cases was that whilst accessibility and continuity of information underpin effective care, they are not sufficient for coordination of care for complex conditions. Shared information reduced unnecessary repetition and provided health professionals with the opportunity to access records of care from other providers, but participants described their role in coordination in terms of the active involvement of a person in care rather than the passive availability of information. Complex issues regarding data ownership and confidentiality often hampered information sharing. Successful coordination in each case was associated with responsiveness to local rather than system level factors. Conclusions The availability of information is not sufficient to ensure continuity for the patient or coordination from the systems perspective. Policy directed at information continuity must give consideration to the broader ‘fit’ with management and relational continuity and provide a broad base that allows for local responsiveness in order for coordination of care to be achieved. PMID:23497291

Unlocking information for coordination of care in Australia: a qualitative study of information continuity in four primary health care models.

PubMed

Banfield, Michelle; Gardner, Karen; McRae, Ian; Gillespie, James; Wells, Robert; Yen, Laurann

2013-03-13

Coordination of care is considered a key component of patient-centered health care systems, but is rarely defined or operationalised in health care policy. Continuity, an aspect of coordination, is the patient's experience of care over time, and is often described in terms of three dimensions: information, relational and management continuity. With the current health policy focus on both the use of information technology and care coordination, this study aimed to 1) explore how information continuity supports coordination and 2) investigate conditions required to support information continuity. Four diverse Australian primary health care initiatives were purposively selected for inclusion in the study. Each has improved coordination as an aim or fundamental principle. Each organization was asked to identify practitioners, managers and decision makers who could provide insight into the use of information for care coordination to participate in the study. Using in-depth semi-structured interviews, we explored four questions covering the scope and use of information, the influence of governance, data ownership and confidentiality and the influence of financial incentives and quality improvement on information continuity and coordination. Data were thematically analyzed using NVivo 8. The overall picture that emerged across all four cases was that whilst accessibility and continuity of information underpin effective care, they are not sufficient for coordination of care for complex conditions. Shared information reduced unnecessary repetition and provided health professionals with the opportunity to access records of care from other providers, but participants described their role in coordination in terms of the active involvement of a person in care rather than the passive availability of information. Complex issues regarding data ownership and confidentiality often hampered information sharing. Successful coordination in each case was associated with responsiveness to local rather than system level factors. The availability of information is not sufficient to ensure continuity for the patient or coordination from the systems perspective. Policy directed at information continuity must give consideration to the broader 'fit' with management and relational continuity and provide a broad base that allows for local responsiveness in order for coordination of care to be achieved.

Jason-2 systematic error analysis in the GPS derived orbits

NASA Astrophysics Data System (ADS)

Melachroinos, S.; Lemoine, F. G.; Zelensky, N. P.; Rowlands, D. D.; Luthcke, S. B.; Chinn, D. S.

2011-12-01

Several results related to global or regional sea level changes still too often rely on the assumption that orbit errors coming from station coordinates adoption can be neglected in the total error budget (Ceri et al. 2010). In particular Instantaneous crust-fixed coordinates are obtained by adding to the linear ITRF model the geophysical high-frequency variations. In principle, geocenter motion should also be included in this computation, in order to reference these coordinates to the center of mass of the whole Earth. This correction is currently not applied when computing GDR orbits. Cerri et al. (2010) performed an analysis of systematic errors common to all coordinates along the North/South direction, as this type of bias, also known as Z-shift, has a clear impact on MSL estimates due to the unequal distribution of continental surface in the northern and southern hemispheres. The goal of this paper is to specifically study the main source of errors which comes from the current imprecision in the Z-axis realization of the frame. We focus here on the time variability of this Z-shift, which we can decompose in a drift and a periodic component due to the presumably omitted geocenter motion. A series of Jason-2 GPS-only orbits have been computed at NASA GSFC, using both IGS05 and IGS08. These orbits have been shown to agree radially at less than 1 cm RMS vs our SLR/DORIS std0905 and std1007 reduced-dynamic orbits and in comparison with orbits produced by other analysis centers (Melachroinos et al. 2011). Our GPS-only JASON-2 orbit accuracy is assessed using a number of tests including analysis of independent SLR and altimeter crossover residuals, orbit overlap differences, and direct comparison to orbits generated at GSFC using SLR and DORIS tracking, and to orbits generated externally at other centers. Tests based on SLR-crossover residuals provide the best performance indicator for independent validation of the NASA/GSFC GPS-only reduced dynamic orbits. Reduced dynamic versus dynamic orbit differences are used to characterize the remaining force model error and TRF instability. At first, we quantify the effect of a North/South displacement of the tracking reference points for each of the three techniques. We then compare these results to the study of Morel and Willis (2005) and Ceri et al. (2010). We extend the analysis to the most recent Jason-2 cycles. We evaluate the GPS vs SLR & DORIS orbits produced using the GEODYN.

Rapid Model Fabrication and Testing for Aerospace Vehicles

NASA Technical Reports Server (NTRS)

Buck, Gregory M.

2000-01-01

Advanced methods for rapid fabrication and instrumentation of hypersonic wind tunnel models are being developed and evaluated at NASA Langley Research Center. Rapid aeroheating model fabrication and measurement techniques using investment casting of ceramic test models and thermographic phosphors are reviewed. More accurate model casting techniques for fabrication of benchmark metal and ceramic test models are being developed using a combination of rapid prototype patterns and investment casting. White light optical scanning is used for coordinate measurements to evaluate the fabrication process and verify model accuracy to +/- 0.002 inches. Higher-temperature (<210C) luminescent coatings are also being developed for simultaneous pressure and temperature mapping, providing global pressure as well as global aeroheating measurements. Together these techniques will provide a more rapid and complete experimental aerodynamic and aerothermodynamic database for future aerospace vehicles.

Patient Engagement in ACO Practices and Patient-reported Outcomes Among Adults With Co-occurring Chronic Disease and Mental Health Conditions.

PubMed

Ivey, Susan L; Shortell, Stephen M; Rodriguez, Hector P; Wang, Yue Emily

2018-05-12

Accountable care organizations (ACOs) have increased their use of patient activation and engagement strategies, but it is unknown whether they achieve better outcomes for patients with comorbid chronic physical and mental health conditions. To assess the extent to which practices with patient-centered cultures, greater shared decision-making strategies, and better coordination among team members have better patient-reported outcomes (PROs) for patients with diabetes and/or cardiovascular and comorbid mental health diagnoses. Sixteen practices randomly selected from top and bottom quartiles of a 39-item patient activation/engagement implementation survey of primary care team members (n=411) to assess patient-centered culture, shared decision-making, and relational coordination among team members. These data were linked to survey data on patient engagement and on emotional, physical, and social patient-reported health outcomes. Adult patients (n=606) with diabetes, cardiovascular, and comorbid mental health conditions who had at least 1 visit at participating primary care practices of 2 ACOs. Depression/anxiety, physical functioning, social functioning; patient-centered culture, patient activation/engagement implementation, relational coordination. Patients receiving care from practices with high patient-centered cultures reported better physical functioning (0.025) and borderline better emotional functioning (0.059) compared with less patient-centered practices. More activated patients reported better PROs, with higher activation levels partially mediating the relationship of patient-centered culture and better PROs. ACO patients with comorbid physical and mental health diagnoses report better physical functioning when practices have patient-centered cultures. More activated/engaged patients report better patient emotional, physical, and social health outcomes.

Facile synthesis of 2D Zn(II) coordination polymer and its crystal structure, selective removal of methylene blue and molecular simulations

NASA Astrophysics Data System (ADS)

Sezer, Güneş Günay; Yeşilel, Okan Zafer; Şahin, Onur; Arslanoğlu, Hasan; Erucar, İlknur

2017-09-01

A new coordination polymer {[Zn(μ3-ppda)(H2O)(μ-bpa)Zn(μ-ppda)(μ-bpa)]·4H2O}n (1) (ppda = 1,4-phenylenediacetate, bpa = 1,2-bis(4-pyridyl)ethane) has been synthesized by microwave-assisted reaction and characterized by elemental analysis, IR spectroscopy, single-crystal and powder X-ray diffractions. The asymmetric unit of 1 consists of two Zn(II) ions, two bpa ligands, two ppda ligands, one coordinated and four non-coordinated water molecules. In 1, ppda2- anions are linked the adjacent Zn(II) centers to generate 1D double-stranded chains. These chains are connected into 2D sheets by the bridging bpa ligands. Atomically detailed modeling was performed to compute single and binary component adsorption isotherms of H2, CO2, CH4 and N2 in complex 1. Results showed that 1 exhibits a high adsorption selectivity towards CO2 due to its high affinity for CO2. Results of this study will be helpful to guide the microwave-assisted reaction of coordination polymers to design promising adsorbents for gas storage and gas separation applications. The luminescent property of 1 and the selective removal of dyes in 1 have been also discussed. Results showed that 1 can be a potential candidate for luminescence applications and can selectively adsorb methylene blue (MB) dye molecules.

National Center on Sleep Disorders Research

MedlinePlus

... for Updates The National Center on Sleep Disorders Research (NCSDR) Located within the National Heart, Lung, and ... key functions: research, training, technology transfer, and coordination. Research Sleep disorders span many medical fields, requiring multidisciplinary ...

Center for Computing Research Summer Research Proceedings 2015.

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

Bradley, Andrew Michael; Parks, Michael L.

2015-12-18

The Center for Computing Research (CCR) at Sandia National Laboratories organizes a summer student program each summer, in coordination with the Computer Science Research Institute (CSRI) and Cyber Engineering Research Institute (CERI).

Controlled coordination in vanadium(V) dimethylhydrazido compounds.

PubMed

Sakuramoto, Takashi; Moriuchi, Toshiyuki; Hirao, Toshikazu

2016-11-01

The vanadium(V) dimethylhydrazido compounds were structurally characterized to elucidate the effect of the alkoxide ligands in the coordination environment of vanadium(V) hydrazido center. The single-crystal X-ray structure determination of the vanadium(V) dimethylhydrazido compound with isopropoxide ligands revealed a dimeric structure with the V(1)-N(1) distance of 1.680(5)Å, in which each vanadium atom is coordinated in a distorted trigonal-bipyramidal geometry (τ 5 =0.81) with the hydrazido and bridging isopropoxide ligands in the apical positions. On the contrary, nearly tetrahedral arrangement around the vanadium metal center (τ 4 =0.06) with the V(1)-N(1) distance of 1.660(2)Å was observed in the vanadium(V) dimethylhydrazido compound with tert-butoxide ligands. The introduction of the 2,2',2″-nitrilotriethoxide ligand led to a pseudo-trigonal-bipyramidal geometry (τ 5 =0.92) at the vanadium center with the V(1)-N(1) distance of 1.691(5)Å, wherein vanadium atom is pulled out of the plane formed by the nitrilotriethoxide oxygen atoms in the direction of the hydrazido nitrogen. The coordination from the apical ligand in the vanadium(V) dimethylhydrazido compound was found to result in the longer V(1)-N(1) distance. Copyright © 2016 Elsevier Inc. All rights reserved.

Innovation in organ transplantation: A meeting report.

PubMed

Fishman, Jay A; Greenwald, Melissa

2018-05-09

This workshop targeted opportunities to stimulate transformative innovation in organ transplantation. Participants reached consensus regarding the following: (1) Mechanisms are needed to improve the coordination of policy and oversight activities, given overlapping responsibilities for transplantation and clinical investigation among federal agencies. Innovative clinical trials span traditional administrative boundaries and include stakeholders with diverse interests. Participants identified the need for a governmental interagency working group to coordinate nationwide transplant-related activities. (2) Improvements are required in clinical metrics for transplantation, with alignment of performance goals across transplantation organizations and any development of data requirements being consistent with those goals. Database coordination among clinical centers, organ procurement organizations, regulatory agencies, and payers would facilitate research and better inform policy. New data requirements should provide actionable insights into clinical performance. (3) Innovative research seen as potentially adversely affecting Program-Specific Reports may reduce centers' participation. Cutting-edge research requires mitigation of risk-aversive behaviors created by reporting of clinical outcomes data. Participants proposed a new review process in advance of implementation of clinical trials to guide "carve-outs" of transplant center outcomes data from Program-Specific Reports. Clinical transplantation will be advanced by the development of a shared and comprehensive research agenda to facilitate coordination of research and policy. © 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.

Structural and process factors affecting the implementation of antimicrobial resistance prevention and control strategies in U.S. hospitals.

PubMed

Chou, Ann F; Yano, Elizabeth M; McCoy, Kimberly D; Willis, Deanna R; Doebbeling, Bradley N

2008-01-01

To address increases in the incidence of infection with antimicrobial-resistant pathogens, the National Foundation for Infectious Diseases and Centers for Disease Control and Prevention proposed two sets of strategies to (a) optimize antibiotic use and (b) prevent the spread of antimicrobial resistance and control transmission. However, little is known about the implementation of these strategies. Our objective is to explore organizational structural and process factors that facilitate the implementation of National Foundation for Infectious Diseases/Centers for Disease Control and Prevention strategies in U.S. hospitals. We surveyed 448 infection control professionals from a national sample of hospitals. Clinically anchored in the Donabedian model that defines quality in terms of structural and process factors, with the structural domain further informed by a contingency approach, we modeled the degree to which National Foundation for Infectious Diseases and Centers for Disease Control and Prevention strategies were implemented as a function of formalization and standardization of protocols, centralization of decision-making hierarchy, information technology capabilities, culture, communication mechanisms, and interdepartmental coordination, controlling for hospital characteristics. Formalization, standardization, centralization, institutional culture, provider-management communication, and information technology use were associated with optimal antibiotic use and enhanced implementation of strategies that prevent and control antimicrobial resistance spread (all p < .001). However, interdepartmental coordination for patient care was inversely related with antibiotic use in contrast to antimicrobial resistance spread prevention and control (p < .0001). Formalization and standardization may eliminate staff role conflict, whereas centralized authority may minimize ambiguity. Culture and communication likely promote internal trust, whereas information technology use helps integrate and support these organizational processes. These findings suggest concrete strategies for evaluating current capabilities to implement effective practices and foster and sustain a culture of patient safety.

Thiol-functionalization of metal-organic framework by a facile coordination-based postsynthetic strategy and enhanced removal of Hg2+ from water.

PubMed

Ke, Fei; Qiu, Ling-Guang; Yuan, Yu-Peng; Peng, Fu-Min; Jiang, Xia; Xie, An-Jian; Shen, Yu-Hua; Zhu, Jun-Fa

2011-11-30

The presence of coordinatively unsaturated metal centers in metal-organic frameworks (MOFs) provides an accessible way to selectively functionalize MOFs through coordination bonds. In this work, we describe thiol-functionalization of MOFs by choosing a well known three-dimensional (3D) Cu-based MOF, i.e. [Cu(3)(BTC)(2)(H(2)O)(3)](n) (HKUST-1, BTC=benzene-1,3,5-tricarboxylate), by a facile coordination-based postsynthetic strategy, and demonstrate their application for removal of heavy metal ion from water. A series of [Cu(3)(BTC)(2)](n) samples stoichiometrically decorated with thiol groups has been prepared through coordination bonding of coordinatively unsaturated metal centers in HKUST-1 with -SH group in dithioglycol. The obtained thiol-functionalized samples were characterized by powder X-ray diffraction, scanning electron microscope, energy dispersive X-ray spectroscopy, infrared spectroscopy, and N(2) sorption-desorption isothermal. Significantly, the thiol-functionalized [Cu(3)(BTC)(2)](n) exhibited remarkably high adsorption affinity (K(d)=4.73 × 10(5)mL g(-1)) and high adsorption capacity (714.29 mg g(-1)) for Hg(2+) adsorption from water, while the unfunctionalized HKUST-1 showed no adsorption of Hg(2+) under the same condition. Copyright © 2011 Elsevier B.V. All rights reserved.

A set of new transition metal-based coordination complexes dependent upon Hpztza ligand (Hpztza=2-(5-(pyrazin-2-yl)-2H-tetrazol-2-yl) acetic acid)

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

Yang Jie; Shen Lei; Yang Gaowen, E-mail: ygwsx@126.com

2012-02-15

Reaction of MCl{sub 2}{center_dot}4H{sub 2}O (M=Zn, Cd, Mn, Co, Ni) with 2-(5-(pyrazin-2-yl)-2H-tetrazol-2-yl) acetic acid (Hpztza) yielded a set of new M(II)/pztza complexes, [Cd(pztza){sub 2}(H{sub 2}O){sub 6}]{center_dot}3H{sub 2}O{center_dot}(Hpztza) (1), [M(pztza){sub 2}(H{sub 2}O){sub 2}; M=Cd(2), Zn(7), Mn(9)], [Cd(pztza){sub 2}]{center_dot}2(CH{sub 3}OH) (3), [Co(pztza){sub 2}(H{sub 2}O){sub 2}]{center_dot}6H{sub 2}O (4), [Co(pztza)(H{sub 2}O)Cl] (6) and [M(pztza){sub 2}(H{sub 2}O){sub 2}]{center_dot}2H{sub 2}O [M=Co(5), Zn(8), Ni(10)]. These compounds were structurally characterized by elemental analysis, IR spectroscopy and X-ray single-crystal diffraction. Complex 1 featured a mononuclear structure, complexes 4, 5, 7, 8, 10 showed 1D chains and complexes 2, 3, 6, 9 displayed 2D layer structures. Furthermore, the luminescence propertiesmore » of 1-10 were investigated at room temperature in the solid state. - Graphical abstract: Ten new coordination polymers with 2-(5-(pyrazin-2-yl)-2H-tetrazol-2-yl) acetic acid (Hpztza) ligand have been synthesized and their structures have been characterized. All of the complexes show photoluminescence at room temperature. Highlights: Black-Right-Pointing-Pointer Ten novel transition metal-based coordination complexes with 2-(5-(pyrazin-2-yl)-2H-tetrazol-2-yl) acetic acid (Hpztza) are reported. Black-Right-Pointing-Pointer Complexes 1-10 are described as mononuclear structure, 1D and 2D frameworks with diverse architecture. Black-Right-Pointing-Pointer Six coordination complexes show emission at room temperature in the solid state.« less

Persistent four-coordinate iron-centered radical stabilized by π-donation† †Electronic supplementary information (ESI) available: Experimental, crystallographic, computational details, and crystal data for 2, 4, 5 and 8. CCDC 1057111–1057113 and 1425703. For ESI and crystallographic data in CIF or other electronic format see DOI: 10.1039/c5sc02601f Click here for additional data file. Click here for additional data file.

PubMed Central

Ishida, Shintaro; Hirakawa, Fumiya; Shiota, Yoshihito; Yoshizawa, Kazunari; Kanegawa, Shinji; Sato, Osamu; Nagashima, Hideo

2016-01-01

Dinuclear iron carbonyl complex 2, which contains an elongated unsupported Fe–Fe bond, was synthesized by the reaction between Fe2(CO)9 and phosphinyl radical 1. Thermal Fe–Fe bond homolysis led to the generation of a four-coordinate carbonyl-based iron-centered radical, 3, which is stabilized by π-donation. Complex 3 exhibited high reactivity toward organic radicals to form diamagnetic five-coordinate Fe(ii) complexes. PMID:28758000

Facilitating primary care provider use in a patient-centered medical home intervention study for chronic hemodialysis patients.

PubMed

Chukwudozie, Ifeanyi Beverly; Fitzgibbon, Marian L; Schiffer, Linda; Berbaum, Michael; Gilmartin, Cheryl; David, Pyone; Ekpo, Eson; Fischer, Michael J; Porter, Anna C; Aziz-Bradley, Alana; Hynes, Denise M

2018-05-23

Patients with chronic kidney disease have a high disease burand may benefit from primary care services and care coord A medical home model with direct access to primary care services is one approach that may address this need, yet has not been examined. As a substudy of the Patient-Centered Outcomes Research Institute (PCORI) patient-centered medical home for kidney disease (PCMH-KD) health system intervention study, we examined the uptake of free primary care physician (PCP) services. The PCORI PCMH-KD study was an initial step toward integrating PCPs, a nurse coordinator, a pharmacist, and community health workers (CHWs) within the health care delivery team. Adult chronic hemodialysis (CHD) at two urban dialysis centers were enrolled in the intervention. We examined trends and factors associated with the use of the PCMH-KD PCP among two groups of patients based on their report of having a regular physician for at least six months (established-PCP) or not (no-PCP). Of the 173 enrolled patients, 91 (53%) patients had at least one visit with the PCMH-KD PCP. The rate of visits was higher in those in the no-PCP group compared with those in the established-PCP group (62% vs. 41%, respectively). Having more visits with the CHW was positively associated with having a visit with the PCMH-KD PCPs for both groups. Embedded CHWs within the care team played a role in facilithe uptake of PCMH-KD PCP. Lessons from this health system intervention can inform future approaches on the integration of PCPs and care coordination for CHD patients.

Gravity Influences the Visual Representation of Object Tilt in Parietal Cortex

PubMed Central

Angelaki, Dora E.

2014-01-01

Sensory systems encode the environment in egocentric (e.g., eye, head, or body) reference frames, creating inherently unstable representations that shift and rotate as we move. However, it is widely speculated that the brain transforms these signals into an allocentric, gravity-centered representation of the world that is stable and independent of the observer's spatial pose. Where and how this representation may be achieved is currently unknown. Here we demonstrate that a subpopulation of neurons in the macaque caudal intraparietal area (CIP) visually encodes object tilt in nonegocentric coordinates defined relative to the gravitational vector. Neuronal responses to the tilt of a visually presented planar surface were measured with the monkey in different spatial orientations (upright and rolled left/right ear down) and then compared. This revealed a continuum of representations in which planar tilt was encoded in a gravity-centered reference frame in approximately one-tenth of the comparisons, intermediate reference frames ranging between gravity-centered and egocentric in approximately two-tenths of the comparisons, and in an egocentric reference frame in less than half of the comparisons. Altogether, almost half of the comparisons revealed a shift in the preferred tilt and/or a gain change consistent with encoding object orientation in nonegocentric coordinates. Through neural network modeling, we further show that a purely gravity-centered representation of object tilt can be achieved directly from the population activity of CIP-like units. These results suggest that area CIP may play a key role in creating a stable, allocentric representation of the environment defined relative to an “earth-vertical” direction. PMID:25339732

Evaluation of vertical coordinate and vertical mixing algorithms in the HYbrid-Coordinate Ocean Model (HYCOM)

NASA Astrophysics Data System (ADS)

Halliwell, George R.

Vertical coordinate and vertical mixing algorithms included in the HYbrid Coordinate Ocean Model (HYCOM) are evaluated in low-resolution climatological simulations of the Atlantic Ocean. The hybrid vertical coordinates are isopycnic in the deep ocean interior, but smoothly transition to level (pressure) coordinates near the ocean surface, to sigma coordinates in shallow water regions, and back again to level coordinates in very shallow water. By comparing simulations to climatology, the best model performance is realized using hybrid coordinates in conjunction with one of the three available differential vertical mixing models: the nonlocal K-Profile Parameterization, the NASA GISS level 2 turbulence closure, and the Mellor-Yamada level 2.5 turbulence closure. Good performance is also achieved using the quasi-slab Price-Weller-Pinkel dynamical instability model. Differences among these simulations are too small relative to other errors and biases to identify the "best" vertical mixing model for low-resolution climate simulations. Model performance deteriorates slightly when the Kraus-Turner slab mixed layer model is used with hybrid coordinates. This deterioration is smallest when solar radiation penetrates beneath the mixed layer and when shear instability mixing is included. A simulation performed using isopycnic coordinates to emulate the Miami Isopycnic Coordinate Ocean Model (MICOM), which uses Kraus-Turner mixing without penetrating shortwave radiation and shear instability mixing, demonstrates that the advantages of switching from isopycnic to hybrid coordinates and including more sophisticated turbulence closures outweigh the negative numerical effects of maintaining hybrid vertical coordinates.

REACT Real-Time Emergency Action Coordination Tool

NASA Technical Reports Server (NTRS)

2004-01-01

Recently the Emergency Management Operations Center (EMOC) of St. Tammany Parish turned to the Technology Development and Transfer Office (TDTO) of NASA's Stennis Space Center (SSC) for help in combating the problems associated with water inundation. Working through a Dual-Use Development Agreement the Technology Development and Transfer Office, EMOC and a small geospatial applications company named Nvision provided the parish with a new front-line defense. REACT, Real-time Emergency Action coordination Tool is a decision support system that integrates disparate information to enable more efficient decision making by emergency management personnel.

Workforce Investment Act: Coordination between TANF Programs and One-Stop Centers Is Increasing, but Challenges Remain. Statement of Sigurd R. Nilsen, Director, Education, Workforce, and Income Security Issues [to the] Subcommittee on 21st Century Competitiveness, Committee on Education and the Workforce, House of Representatives.

ERIC Educational Resources Information Center

Nilsen, Sigurd R.

The General Accounting Office assessed the extent to which states were coordinating their Temporary Assistance for Needy Families (TANF) services with their one-stop centers. Data were gathered through the following activities: (1) an autumn 2001 survey of workforce development agency officials in all 50 states and a similar survey conducted in…

NAPNAP Position Statement. Position Statement on Pediatric Health Care/Medical Home: Key Issues on Care Coordination, Transitions, and Leadership.

PubMed

2016-01-01

The National Association of Pediatric Nurse Practitioners (NAPNAP) affirms that the delivery of children's health care should be family-centered, accessible, comprehensive, coordinated, culturally appropriate, compassionate, and focused on the overall well-being of children and families. All qualified pediatric health care providers should collaborate in providing health care services for children in pediatric health care/medical homes. Interventions must address the concepts of family-centered partnerships, community-based systems, and transitional care from pediatric to adult services.

75 FR 9914 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-04

... national centers' initiatives, performance, and achievements. Influenza Coordination Unit (CVA4). The mission of the Influenza Coordination Unit (ICU) is to synchronize all aspects of CDC's pandemic influenza... Diseases on pandemic influenza preparedness and response activities, assisting the Director and Deputy...

77 FR 72985 - Health Information Technology: Revisions to the 2014 Edition Electronic Health Record...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-07

... Technology: Revisions to the 2014 Edition Electronic Health Record Certification Criteria; and Medicare and... National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services... National Coordinator for Health Information Technology, Attention: Steven Posnack, Hubert H. Humphrey...

Composite system in rotationally invariant noncommutative phase space

NASA Astrophysics Data System (ADS)

Gnatenko, Kh. P.; Tkachuk, V. M.

2018-03-01

Composite system is studied in noncommutative phase space with preserved rotational symmetry. We find conditions on the parameters of noncommutativity on which commutation relations for coordinates and momenta of the center-of-mass of composite system reproduce noncommutative algebra for coordinates and momenta of individual particles. Also, on these conditions, the coordinates and the momenta of the center-of-mass satisfy noncommutative algebra with effective parameters of noncommutativity which depend on the total mass of the system and do not depend on its composition. Besides, it is shown that on these conditions the coordinates in noncommutative space do not depend on mass and can be considered as kinematic variables, the momenta are proportional to mass as it has to be. A two-particle system with Coulomb interaction is studied and the corrections to the energy levels of the system are found in rotationally invariant noncommutative phase space. On the basis of this result the effect of noncommutativity on the spectrum of exotic atoms is analyzed.

2,5-dimethylthiophene coordination to three metal centers in (. eta. sup 4 ,S-. mu. sub 3 -2,5-Me sub 2 T)(IrCp sup * )(Mo(CO) sub 2 Cp) sub 2

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

Chen, Jiabi; Angelici, R.J.

1990-03-01

The reaction of Cp{sup *}Ir({eta}{sup 4}-2,5-Me{sub 2}T), where {eta}{sup 4}-2,5-Me{sub 2}T is 2,5-dimethylthiophene coordinated through the four ring carbons, with Cp(CO){sub 2}Mo{triple bond}Mo(CO){sub 2}Cp gives ({eta}{sup 4},S-{mu}{sub 3}-2,5-Me{sub 2}T)(IrCp{sup *})(Mo(CO){sub 2}Cp){sub 2}, in which the bridging thiophene is {eta}{sup 4}-coordinated to the Ir and bonded via the sulfur to both Mo atoms. The same product is obtained from the ring-opened isomer of Cp{sup *}Ir(2,5-Me{sub 2}T). The structure of the product, which is the first example of a thiophene coordinated to three metal centers, was established by X-ray crystallography.

Workforce Investment Act: Coordination of TANF Services through One-Stops Has Increased Despite Challenges. Testimony before the Subcommittee on Employment, Safety, and Training, Committee on Health, Education, Labor, and Pensions, U.S. Senate. Statement of Sigurd R. Nilsen, Director, Education, Workforce, and Income Security Issues.

ERIC Educational Resources Information Center

Nilsen, Sigurd R.

Coordination between Temporary Assistance for Needy Families (TANF)-related programs and Workforce Investment Act of 1998 (WIA)'s one-stop centers increased since spring 2000, when WIA was first implemented. Nearly all states reported some coordination between the programs at either the state or the local level. Most often, coordination took one…

47 CFR 25.272 - General inter-system coordination procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the system control center, and those responsible for long term engineering and technical design issues... network control center which will have the responsibility to monitor space-to-Earth transmissions in its... the licensee is authorized to transmit, contact telephone numbers for the control center of the earth...

Election Information/Issues Analysis Center.

ERIC Educational Resources Information Center

Institute for Political/Legal Education, Sewell, NJ.

Procedures for establishing a student-run election information and issue analysis center at the high school level are presented. The purpose of the election information center is to provide the student population with an awareness of candidate's views and to coordinate volunteer activities of students in a campaign. Student personnel include a…

76 FR 35227 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alternative Medicine Special Emphasis Panel, NIH-HMO Collaboratory Coordinating Center (U54). Date: July 14... Scientific Review, National Center for Complementary, and Alternative Medicine, NIH, 6707 Democracy Blvd...

77 FR 31862 - National Center for Complementary & Alternative Medicine; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-30

... Complementary & Alternative Medicine; Notice of Closed Meetings Pursuant to section 10(d) of the Federal... Alternative Medicine Special Emphasis Panel; HCS Collaboratory Coordinating Center (U54). Date: July 9, 2012... Scientific Review, National Center for Complementary and Alternative Medicine, NIH, 6707 Democracy Blvd...

Exploring Nonoffending Caregiver Satisfaction with a Children's Advocacy Center

ERIC Educational Resources Information Center

Bonach, Kathryn; Mabry, J. Beth; Potts-Henry, Candice

2010-01-01

This study is a case evaluation research report on one Children's Advocacy Center that provides a coordinated response to allegations of child maltreatment, particularly sexual abuse. The data come from a mailed survey of nonoffending caregivers measuring their satisfaction with services provided through the Children's Advocacy Center. The results…

Southern Rural Development Center Annual Progress Report, 1996.

ERIC Educational Resources Information Center

Southern Rural Development Center, Mississippi State, MS.

This annual report of the Southern Rural Development Center (SRDC) describes the agency's extension and research activities from October 1, 1995, to October 1, 1996. SRDC is one of four regional centers coordinating rural development research and extension education programs cooperatively with the land-grant institutions. SRDC cooperates with 29…

THE EDUCATIONAL DIAGNOSTIC AND PLANNING CENTER.

ERIC Educational Resources Information Center

STOREY, GEORGE

THIS REPORT BRIEFLY DESCRIBES THE EDUCATIONAL DIAGNOSTIC AND PLANNING CENTER FUNDED UNDER TITLE III OF THE 1965 ELEMENTARY AND SECONDARY EDUCATION ACT. THE CENTER IS RESPONSIBLE FOR THE COORDINATION OF DIAGNOSTIC AND EDUCATIONAL RESOURCES FOR UNDERACHIEVING OR OTHERWISE ATYPICAL PUPILS WHO ARE POTENTIAL DROPOUTS BECAUSE OF A PARTICULAR BEHAVIOR OR…

Optical Properties of Nickel(ii) and Radiation Defects in Magnesium-Fluoride and Manganese-Fluoride

NASA Astrophysics Data System (ADS)

Feuerhelm, Leonard Norman

1980-12-01

Scope and Method of Study. A study has been made of the radiation defects in pure MgF(,2) by observating the polarized absorption, luminescence, and excitation spectra in electron-irradiated MgF(,2). Additionally, studies of the absorption, emission, excitation, and temperature dependence of the lifetimes of transitions in nickel-doped MgF(,2) and MnF(,2) have been accomplished, as well as the observation of radiation effects on these crystals. Findings and Conclusions. The absorption band at about 320 nm in irradiated MgF(,2) is identified to be due to the F(,2)(D(,2h)) center, and to have an emission at about 450 nm. Analysis of the temperature dependence of this band indicates a dominant phonon mode of 255 cm(' -1) for the excited state. The F(,2)(C(,1)) center is identified with an absorption of about 360 nm and an emission of 410 nm. An absorption peak at 300 nm, for which no corresponding emission has been found, is tentatively identified to be the F(,3)-center, and to have a dominant phonon mode of 255 cm('-1). The temperature dependence of the lifetimes of transitions in nickel-doped MgF(,2) have been analyzed by the quantum mechanical single configuration coordinate model of Struck and Fonger, and a complete configuration coordinate model has been made for this crystal. Similar studies have been made in MnF(,2):Ni, but energy transfer between Mn('2+) ions and Ni('2+) ions prevents completion of the complete model. Energy transfer in this crystal was studied, with the finding that a gain of about 2 in luminescence output was possible for excitation in the visible region (400-600 nm) as compared with MgF(,2):Ni. The effects of radiation upon the Ni('2+) transitions in these crystals were studied with the finding that no observable change occurred in the Ni('2+) transitions with radiation, although other radiation effects were noted in the crystal.

Evaluating community health centers' adoption of a new global capitation payment (eCHANGE) study protocol.

PubMed

Angier, H; O'Malley, J P; Marino, M; McConnell, K J; Cottrell, E; Jacob, R L; Likumahuwa-Ackman, S; Heintzman, J; Huguet, N; Bailey, S R; DeVoe, J E

2017-01-01

Primary care patient-centered medical homes (PCMHs) are an effective healthcare delivery model. Evidence regarding the most effective payment models for increased coordination efforts is sparse. This protocol paper describes the evaluation of an Alternative Payment Methodology (APM) implemented in a subset of Oregon community health centers (CHCs), using a prospective matched observational design. The APM is a primary care payment reform intervention that changed Oregon's Medicaid payment for several CHCs from fee-for-service reimbursement to a per-member-per-month capitated payment. We will implement a difference-in-difference analytic approach to evaluate pre-post APM changes between intervention and control groups, including: 1) clinic-level outcomes, 2) patient-level clinical outcomes, and 3) patient-level econometric outcomes. Findings from the project will be of national significance, as there is a need for evidence regarding how novel payment methods might enhance PCMH capabilities and support their capacity to produce better quality and outcomes. If this capitated payment method is proven effective, study findings will inform dissemination of similar APMs nationwide. Copyright © 2016 Elsevier Inc. All rights reserved.

KSC-65P-0205

NASA Image and Video Library

1965-11-06

CAPE KENNEDY, Fla. -- At Cape Kennedy Air Force Station in Florida, a thrust augmented improved Delta lifts off with a three hundred eighty five pound geodetic Explorer spacecraft, designated GEOS-A. The spacecraft contains five geodetic instrumentation systems to provide simultaneous measurements that scientists require to establish a more precise model of the Earth's gravitational field, and to map a world coordinate system relating points on, or near the surface to the common center of mass. This will be the first launch for the improved Delta second stage. Photo Credit: NASA

Terrain Referenced Navigation Using SIFT Features in LiDAR Range-Based Data

DTIC Science & Technology

2014-12-26

14 2.5 Geocentric and geodetic representation of the same point on Earth’s surface. . . 16 2.6 Difference between datum provided ellipsoid height h and...also called a geocentric system, in that its origin is coincident with the calculated center of the earth. 8 2.1.3.2 Local Navigation Frame. The local...utilizing them. 2.2.1.1 Ellipsoid Earth Models. While geocentric ECEF coordinates are useful to describe a point on or inside the earth they can be cumbersome

Learning to Fly: The Wright Brothers' Adventure. A Guide for Educators and Students with Activities in Aeronautics

NASA Technical Reports Server (NTRS)

Benson, T.; Galica, C.; McCredie, P.; Storm, R.

2003-01-01

This guide was produced by the NASA Glenn Research Center Office of Educational Programs in Cleveland, OH, and the NASA Aerospace Educational Coordinating Committee. It includes activity modules for students, including the history of the Wright Brothers and their family in Dayton, Ohio and flight experimentation in Kitty Hawk, North Carolina. Student activities such as building models of the Wright Brothers glider and writing press releases of the initial flight are included.

An Investigation of the Flow Physics of Acoustic Liners by Direct Numerical Simulation

NASA Technical Reports Server (NTRS)

Watson, Willie R. (Technical Monitor); Tam, Christopher

2004-01-01

This report concentrates on reporting the effort and status of work done on three dimensional (3-D) simulation of a multi-hole resonator in an impedance tube. This work is coordinated with a parallel experimental effort to be carried out at the NASA Langley Research Center. The outline of this report is as follows : 1. Preliminary consideration. 2. Computation model. 3. Mesh design and parallel computing. 4. Visualization. 5. Status of computer code development. 1. Preliminary Consideration.

NASA Lewis Research Center's Program on Icing Research

NASA Technical Reports Server (NTRS)

Reinmann, J. J.; Shaw, R. J.; Olsen, W. A., Jr.

1982-01-01

The helicopter and general aviation, light transport, and commercial transport aircraft share common icing requirements: highly effective, lightweight, low power consuming deicing systems, and detailed knowledge of the aeropenalties due to ice on aircraft surfaces. To meet current and future needs, NASA has a broadbased icing research program which covers both research and engineering applications, and is well coordinated with the FAA, DOD, universities, industry, and some foreign governments. Research activity in ice protection systems, icing instrumentation, experimental methods, analytical modeling, and in-flight research are described.

Pennsylvania safe routes to school program.

DOT National Transportation Integrated Search

2010-10-21

In October 2007, the Center for Nutrition and Activity promotion at Penn State Hershey Children's Hospital (Center) began working under contract with the Pennsylvania Deaprtment of Transportation )PennDOT) to develop, coordinate, and administer the n...

Station Coordinates Combination Status and Contribution to ITRF2005

NASA Astrophysics Data System (ADS)

Ferland, R.

2007-12-01

Under the auspices of the International GNSS Service (IGS), the Reference Frame Working Group combines at Natural Resources Canada (NRCan) an accurate and consistent set of station coordinates, velocities and Earth Rotation Parameters (ERP) that are updated weekly. The consistency of these parameters is ensured by simultaneously combining them using their full variance-covariance information. The IGS Analysis Centers (ACs) (cod, emr, esa, gfz, jpl, mit, ngs, sio) provide the solutions used in the IGS weekly combination. The Global Network Associates Analysis Centers (GNAAC) (mit, ncl) also generate weekly combined solutions that include consistent station coordinates and ERPs. Those GNAAC solutions are used for comparisons and quality control of the IGS weekly solution. In recent weeks each AC has been contributing between about 50 and 250 station coordinates estimates. The combined product currently approaches 300 stations. Of those, between 40 and 110 are used for the current IGS reference frame realization of the ITRF2005 in each AC solution. The quality of the AC station coordinates solutions has improved significantly since they have started contributing in early 1996. This is due to the densification of the network of stations along with gradual improvements in station hardware and processing software. For recent solutions, the estimated noise (std. dev.) level between the AC weekly solutions and the different combined solutions varies between 1-3mm horizontally and 2-10mm vertically. More details about the statistics, their evolution and differences between the ACs will be presented. IGS weekly station coordinates and ERP combined products have also been contributed to the ITRF2005. Those weekly solutions were all recombined from the original AC contributions, going back to the beginning of 1996. The recombined solutions were edited for known problems (e.g. incorrect antenna heights and outliers). Several stations with short time span were also removed. A list of station coordinates discontinuities was also prepared, in collaboration with several individuals and contributed to the IERS. Since November 5, 2006 (GPS week 1400), the IGS has implemented a realization of ITRF2005. It includes mainly the change from relative to absolute antenna phase centers and an update of the selected reference frame stations for the new realization. An expected change of scale from about 3 ppb to -0.7 ppb caused by the phase center shift was observed.

Developing a reversible rapid coordinate transformation model for the cylindrical projection

NASA Astrophysics Data System (ADS)

Ye, Si-jing; Yan, Tai-lai; Yue, Yan-li; Lin, Wei-yan; Li, Lin; Yao, Xiao-chuang; Mu, Qin-yun; Li, Yong-qin; Zhu, De-hai

2016-04-01

Numerical models are widely used for coordinate transformations. However, in most numerical models, polynomials are generated to approximate "true" geographic coordinates or plane coordinates, and one polynomial is hard to make simultaneously appropriate for both forward and inverse transformations. As there is a transformation rule between geographic coordinates and plane coordinates, how accurate and efficient is the calculation of the coordinate transformation if we construct polynomials to approximate the transformation rule instead of "true" coordinates? In addition, is it preferable to compare models using such polynomials with traditional numerical models with even higher exponents? Focusing on cylindrical projection, this paper reports on a grid-based rapid numerical transformation model - a linear rule approximation model (LRA-model) that constructs linear polynomials to approximate the transformation rule and uses a graticule to alleviate error propagation. Our experiments on cylindrical projection transformation between the WGS 84 Geographic Coordinate System (EPSG 4326) and the WGS 84 UTM ZONE 50N Plane Coordinate System (EPSG 32650) with simulated data demonstrate that the LRA-model exhibits high efficiency, high accuracy, and high stability; is simple and easy to use for both forward and inverse transformations; and can be applied to the transformation of a large amount of data with a requirement of high calculation efficiency. Furthermore, the LRA-model exhibits advantages in terms of calculation efficiency, accuracy and stability for coordinate transformations, compared to the widely used hyperbolic transformation model.

A Simple Method for Drawing Chiral Mononuclear Octahedral Metal Complexes

ERIC Educational Resources Information Center

Mohamadou, Aminou; Haudrechy, Arnaud

2008-01-01

Octahedral transition-metal complexes are involved in a number of reactions and octahedral coordination geometry, frequently observed for metallic centers, includes important topographical stereochemistry. Depending on the number and nature of different ligands, octahedral coordination units with at least two different monodentate ligands give…

78 FR 2276 - National Institute of Mental Health; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-10

... U.S.C. App.), notice is hereby given of an Interagency Autism Coordinating Committee (IACC) meeting.... Name of Committee: Interagency Autism Coordinating Committee (IACC). Type of meeting: Open Meeting...: Metro accessible--Medical Center Metro Station Contact Person: Ms. Lina Perez, Office of Autism Research...

Coordinated Management of Academic Health Centers.

PubMed

Balser, Jeffrey R; Stead, William W

2017-01-01

Academic health centers (AHCs) are the nation's primary resource for healthcare discovery, innovation, and training. US healthcare revenue growth has declined sharply since 2009, and is forecast to remain well below historic levels for the foreseeable future. As the cost of education and research at nearly all AHCs is heavily subsidized through large transfers from clinical care margins, our institutions face a mounting crisis. Choices centering on how to increase the cost-effectiveness of the AHC enterprise require unprecedented levels of alignment to preserve an environment that nurtures creativity. Management processes require governance models that clarify decision rights while harnessing the talents and the intellectual capital of a large, diverse enterprise to nimbly address unfamiliar organizational challenges. This paper describes key leadership tactics aimed at propelling AHCs along this journey - one that requires from all leaders a commitment to resilience, optimism, and willingness to embrace change.

Mapping Applications Center, National Mapping Division, U.S. Geological Survey

USGS Publications Warehouse

,

1996-01-01

The Mapping Applications Center (MAC), National Mapping Division (NMD), is the eastern regional center for coordinating the production, distribution, and sale of maps and digital products of the U.S. Geological Survey (USGS). It is located in the John Wesley Powell Federal Building in Reston, Va. The MAC's major functions are to (1) establish and manage cooperative mapping programs with State and Federal agencies; (2) perform new research in preparing and applying geospatial information; (3) prepare digital cartographic data, special purpose maps, and standard maps from traditional and classified source materials; (4) maintain the domestic names program of the United States; (5) manage the National Aerial Photography Program (NAPP); (6) coordinate the NMD's publications and outreach programs; and (7) direct the USGS mapprinting operations.

How Interplanetary Scintillation Data Can Improve Modeling of Coronal Mass Ejection Propagation

NASA Astrophysics Data System (ADS)

Taktakishvili, A.; Mays, M. L.; Manoharan, P. K.; Rastaetter, L.; Kuznetsova, M. M.

2017-12-01

Coronal mass ejections (CMEs) can have a significant impact on the Earth's magnetosphere-ionosphere system and cause widespread anomalies for satellites from geosynchronous to low-Earth orbit and produce effects such as geomagnetically induced currents. At the NASA/GSFC Community Coordinated Modeling Center we have been using ensemble modeling of CMEs since 2012. In this presnetation we demonstrate that using of interplanetary scintillation (IPS) observations from the Ooty Radio Telescope facility in India can help to track CME propagaion and improve ensemble forecasting of CMEs. The observations of the solar wind density and velocity using IPS from hundreds of distant sources in ensemble modeling of CMEs can be a game-changing improvement of the current state of the art in CME forecasting.

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

Shearer, J.; Callan, P; Amie, J

Nitrile hydratases (NHases) are non-heme Fe{sup III} or non-corrin Co{sup III} containing metalloenzymes that possess an N{sub 2}S{sub 3} ligand environment with nitrogen donors derived from amidates and sulfur donors derived from cysteinates. A closely related enzyme is thiocyanate hydrolase (SCNase), which possesses a nearly identical active-site coordination environment as CoNHase. These enzymes are redox inactive and perform hydrolytic reactions; SCNase hydrolyzes thiocyanate anions while NHase converts nitriles into amides. Herein an active CoNHase metallopeptide mimic, [Co{sup III}NHase-m1] (NHase-m1 = AcNH-CCDLP-CGVYD-PA-COOH), that contains Co{sup III} in a similar N{sub 2}S{sub 3} coordination environment as CoNHase is reported. [Co{sup III}NHase-m1] wasmore » characterized by electrospray ionization-mass spectrometry (ESI-MS), gel-permeation chromatography (GPC), Co K-edge X-ray absorption spectroscopy (Co-S: 2.21 {angstrom}; Co-N: 1.93 {angstrom}), vibrational, and optical spectroscopies. We find that [Co{sup III}NHase-m1] will perform the catalytic conversion of acrylonitrile into acrylamide with up to 58 turnovers observed after 18 h at 25 C (pH 8.0). FTIR data used in concert with calculated vibrational data (mPWPW91/aug-cc-TZVPP) demonstrates that the active form of [Co{sup III}NHase-m1] has a ligated SO{sub 2} (? = 1091 cm{sup -1}) moiety and a ligated protonated SO(H) (? = 928 cm{sup -1}) moiety; when only one oxygenated cysteinate ligand (i.e., a mono-SO{sub 2} coordination motif) or the bis-SO{sub 2} coordination motif are found within [Co{sup III}NHase-m1] no catalytic activity is observed. Calculations of the thermodynamics of ligand exchange (B3LYP/aug-cc-TZVPP) suggest that the reason for this is that the SO{sub 2}/SO(H) equatorial ligand motif promotes both water dissociation from the Co{sup III}-center and nitrile coordination to the Co{sup III}-center. In contrast, the under- or overoxidized motifs will either strongly favor a five coordinate Co{sup III}-center or strongly favor water binding to the Co{sup III}-center over nitrile binding.« less

Care coordination between specialty care and primary care: a focus group study of provider perspectives on strong practices and improvement opportunities

PubMed Central

Kim, Bo; Lucatorto, Michelle A; Hawthorne, Kara; Hersh, Janis; Myers, Raquel; Elwy, A Rani; Graham, Glenn D

2015-01-01

Care coordination between the specialty care provider (SCP) and the primary care provider (PCP) is a critical component of safe, efficient, and patient-centered care. Veterans Health Administration conducted a series of focus groups of providers, from specialty care and primary care clinics at VA Medical Centers nationally, to assess 1) what SCPs and PCPs perceive to be current practices that enable or hinder effective care coordination with one another and 2) how these perceptions differ between the two groups of providers. A qualitative thematic analysis of the gathered data validates previous studies that identify communication as being an important enabler of coordination, and uncovers relationship building between specialty care and primary care (particularly through both formal and informal relationship-building opportunities such as collaborative seminars and shared lunch space, respectively) to be the most notable facilitator of effective communication between the two sides. Results from this study suggest concrete next steps that medical facilities can take to improve care coordination, using as their basis the mutual understanding and respect developed between SCPs and PCPs through relationship-building efforts. PMID:25653538

Care coordination between specialty care and primary care: a focus group study of provider perspectives on strong practices and improvement opportunities.

PubMed

Kim, Bo; Lucatorto, Michelle A; Hawthorne, Kara; Hersh, Janis; Myers, Raquel; Elwy, A Rani; Graham, Glenn D

2015-01-01

Care coordination between the specialty care provider (SCP) and the primary care provider (PCP) is a critical component of safe, efficient, and patient-centered care. Veterans Health Administration conducted a series of focus groups of providers, from specialty care and primary care clinics at VA Medical Centers nationally, to assess 1) what SCPs and PCPs perceive to be current practices that enable or hinder effective care coordination with one another and 2) how these perceptions differ between the two groups of providers. A qualitative thematic analysis of the gathered data validates previous studies that identify communication as being an important enabler of coordination, and uncovers relationship building between specialty care and primary care (particularly through both formal and informal relationship-building opportunities such as collaborative seminars and shared lunch space, respectively) to be the most notable facilitator of effective communication between the two sides. Results from this study suggest concrete next steps that medical facilities can take to improve care coordination, using as their basis the mutual understanding and respect developed between SCPs and PCPs through relationship-building efforts.

Honors

NASA Astrophysics Data System (ADS)

2013-11-01

The recently released list of 2013-2014 Fulbright Scholars includes 9 AGU members working on diverse topics. They include Michael Coe, senior scientist/coordinator of the Amazon group at the Woods Hole Research Center, whose topic is "Agricultural expansion in the Brazilian Cerrado and consequences for the water cycle"; Benjamin Crosby, associate professor, Department of Geosciences, Idaho State University, on the topic "Taking the pulse of Chilean rivers: Enhancing educational and academic opportunities in a time of rapid change"; David Fitzjarrald, senior research associate, Atmospheric Sciences Research Center, State University of New York at Albany, on the topic "Landscape heterogeneity and Amazonian mesoclimate: Fostering critical understanding of observations and model output"; and Syed Hasan, professor of geology, Department of Geosciences, University of Missouri-Kansas City, who will be teaching courses in waste management.

KSC-99pp0975

NASA Image and Video Library

1999-07-19

KENNEDY SPACE CENTER, FLA. -- Mrs. Lalitha Chandrasekhar (left), wife of the late Indian-American Nobel Laureate Subrahmanyan Chandrasekhar, poses with a model of the Chandra X-ray Observatory and the winners of the contest to rename the telescope in the TRW Media Hospitality Tent at the NASA Press Site at KSC. The winners of the contest are Jatila van der Veen (center), academic coordinator and lecturer, Physics Dept., University of Santa Barbara, Calif., and Tyrel Johnson (right), high school student, Laclede, Idaho. The name "Chandra," a shortened version of Chandrasekhar's name which he preferred among friends and colleagues, was chosen to honor the Nobel Laureate. "Chandra" also means "Moon" or "luminous" in Sanskrit. The observatory is scheduled to be launched aboard Columbia on Space Shuttle mission STS-93

Coordination and Data Management of the International Arctic Buoy Programme (IABP)

DTIC Science & Technology

1999-09-30

Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor 1013 NE 40th Street Polar Science Center...Coordination of the IABP falls into the categories of information, resource management, and meeting planning. Information is primarily distributed via a...These data and other research products of the IABP are available on the World Wide Web at http://iabp.apl.washington.edu/. WORK COMPLETED Our recent

Coordination and Data Management of the International Arctic Buoy Programme (IABP)

DTIC Science & Technology

2000-09-30

Coordination and Data Management of the International Arctic Buoy Programme ( IABP ) Ignatius G. Rigor 1013 NE 40th Street Polar Science Center...Coordination of the IABP falls into the categories of information, resource management, and meeting planning. Information is primarily distributed via a monthly...data and other research products of the IABP are available on the World Wide Web at http://iabp.apl.washington.edu/. Report Documentation Page Form

A Study of Patient Satisfaction in the Pediatrics Clinic at Water Reed Army Medical Center

DTIC Science & Technology

1992-08-01

Coordinated Care Program set forth by the Assistant Secretary of Defense for Health Affairs, Dr. Mendez , (January, 1992): "The Coordinated Care Program...William Walker, MC, Chief, Pediatric Clinic; CPT Kurt Allebach, MS, Administrator, Department of Pediatrics; Ms Carol Tross, Nursing Supervisor...of Defense moves to Coordinated Care with mandatory enrollment ( Mendez , 1992). The impact on this research may be an overestimation of the true level

Improvement of Coordination in the Multi-National Military Coordination Center of the Nepal Army in Respond to Disasters

DTIC Science & Technology

2017-06-09

primary question. This thesis has used the case study research methodology with Capability-Based Assessment (CBA) approach. My engagement in this...protected by more restrictions in their home countries, in which case further publication or sale of copyrighted images is not permissible...effective coordinating mechanism. The research follows the case study method utilizing the Capability Based Analysis (CBA) approach to scrutinize the

Using "Functional" Target Coordinates of the Subthalamic Nucleus to Assess the Indirect and Direct Methods of the Preoperative Planning: Do the Anatomical and Functional Targets Coincide?

PubMed

Rabie, Ahmed; Verhagen Metman, Leo; Slavin, Konstantin V

2016-12-21

To answer the question of whether the anatomical center of the subthalamic nucleus (STN), as calculated indirectly from stereotactic atlases or by direct visualization on magnetic resonance imaging (MRI), corresponds to the best functional target. Since the neighboring red nucleus (RN) is well visualized on MRI, we studied the relationships of the final target to its different borders. We analyzed the data of 23 PD patients (46 targets) who underwent bilateral frame-based STN deep brain stimulation (DBS) procedure with microelectrode recording guidance. We calculated coordinates of the active contact on DBS electrode on postoperative MRI, which we referred to as the final "functional/optimal" target. The coordinates calculated by the atlas-based "indirect" and "direct" methods, as well as the coordinates of the different RN borders were compared to these final coordinates. The mean ± SD of the final target coordinates was 11.7 ± 1.5 mm lateral (X), 2.4 ± 1.5 mm posterior (Y), and 6.1 ± 1.7 mm inferior to the mid-commissural point (Z). No significant differences were found between the "indirect" X, Z coordinates and those of the final targets. The "indirect" Y coordinate was significantly posterior to Y of the final target, with mean difference of 0.6 mm ( p = 0.014). No significant differences were found between the "direct" X, Y, and Z coordinates and those of the final targets. The functional STN target is located in direct proximity to its anatomical center. During preoperative targeting, we recommend using the "direct" method, and taking into consideration the relationships of the final target to the mid-commissural point (MCP) and the different RN borders.

Ping-Pong Energy Transfer in a Boron Dipyrromethane Containing Pt(II)-Schiff Base Complex: Synthesis, Photophysical Studies, and Anti-Stokes Shift Increase in Triplet-Triplet Annihilation Upconversion.

PubMed

Razi, Syed S; Koo, Yun Hee; Kim, Woojae; Yang, Wenbo; Wang, Zhijia; Gobeze, Habtom; D'Souza, Francis; Zhao, Jianzhang; Kim, Dongho

2018-05-07

A boron dipyrromethane (BDP)-containing Pt(II)-Schiff base complex (Pt-BDP), showing ping-pong singlet-triplet energy transfer, was synthesized, and the detailed photophysical properties were investigated using various steady-state and time-resolved transient spectroscopies. Femtosecond/nanosecond transient absorption spectroscopies demonstrated that, upon selective excitation of the BDP unit in Pt-BDP at 490 nm, Förster resonance energy transfer from the BDP unit to the Pt(II) coordination center occurred (6.7 ps), accompanied by an ultrafast intersystem crossing at the Pt(II) coordination center (<1 ps) and triplet-triplet energy transfer back to the BDP moiety (148 ps). These processes generated a triplet state localized at BDP, and the lifetime was 103.2 μs, much longer than the triplet-state lifetime of Pt-Ph (3.5 μs), a complex without the BDP moiety. Finally, Pt-BDP was used as a triplet photosensitizer for triplet-triplet annihilation (TTA) upconversion through selective excitation of the BDP unit or the Pt(II) coordination center at lower excitation energy. An upconversion quantum yield of up to 10% was observed with selective excitation of the BDP moiety, and a large anti-Stokes shift of 0.65 eV was observed upon excitation of the lower-energy band of the Pt(II) coordination center. We propose that using triplet photosensitizers with the ping-pong energy-transfer process may become a useful method for increasing the anti-Stokes shift of TTA upconversion.

Coordinate metrology of a primary surface composite panel from the Large Millimeter Telescope

NASA Astrophysics Data System (ADS)

Gale, David M.; Lucero Álvarez, Maribel; Cabrera Cuevas, Lizeth; Leon-Huerta, Andrea; Arizmendi Reyes, Edgar; Icasio Hernández, Octavio; Castro Santos, David; Hernández Ríos, Emilio; Tecuapetla Sosa, Esteban; Tzile Torres, Carlos; Viliesid Alonso, Miguel

2016-07-01

The Large Millimeter Telescope (LMT) is a single-dish fully-steerable radio telescope presently operating with a 32.5 m parabolic primary reflector, in the process of extension to 50 m. The project is managed by the Instituto Nacional de Astrofísica, Óptica y Electrónica (INAOE) in México, and the University of Massachusetts Amherst, USA. A laminated surface panel from the LMT primary reflector has been subjected to a surface measurement assay at Mexico's National Metrology Center (CENAM). Data obtained using a coordinate measuring machine and laser tracker owned by CENAM is compared with measurements using an identical model laser tracker and the photogrammetry technique, the latter systems owned and operated by the LMT. All measurements were performed within the controlled metrology environment at CENAM. The measurement exercise is intended to prepare the groundwork for converting this spare surface panel into a calibrated work-piece. The establishment of a calibrated work-piece provides quality assurance for metrology through measurement traceability. It also simplifies the evaluation of measurement uncertainty for coordinate metrology procedures used by the LMT project during reflector surface qualification.

Coordinated Analysis of Age, Sex, and Education Effects on Change in MMSE Scores

PubMed Central

2013-01-01

Objectives. We describe and compare the expected performance trajectories of older adults on the Mini-Mental Status Examination (MMSE) across six independent studies from four countries in the context of a collaborative network of longitudinal studies of aging. A coordinated analysis approach is used to compare patterns of change conditional on sample composition differences related to age, sex, and education. Such coordination accelerates evaluation of particular hypotheses. In particular, we focus on the effect of educational attainment on cognitive decline. Method. Regular and Tobit mixed models were fit to MMSE scores from each study separately. The effects of age, sex, and education were examined based on more than one centering point. Results. Findings were relatively consistent across studies. On average, MMSE scores were lower for older individuals and declined over time. Education predicted MMSE score, but, with two exceptions, was not associated with decline in MMSE over time. Conclusion. A straightforward association between educational attainment and rate of cognitive decline was not supported. Thoughtful consideration is needed when synthesizing evidence across studies, as methodologies adopted and sample characteristics, such as educational attainment, invariably differ. PMID:23033357

Coordinated analysis of age, sex, and education effects on change in MMSE scores.

PubMed

Piccinin, Andrea M; Muniz-Terrera, Graciela; Clouston, Sean; Reynolds, Chandra A; Thorvaldsson, Valgeir; Deary, Ian J; Deeg, Dorly J H; Johansson, Boo; Mackinnon, Andrew; Spiro, Avron; Starr, John M; Skoog, Ingmar; Hofer, Scott M

2013-05-01

We describe and compare the expected performance trajectories of older adults on the Mini-Mental Status Examination (MMSE) across six independent studies from four countries in the context of a collaborative network of longitudinal studies of aging. A coordinated analysis approach is used to compare patterns of change conditional on sample composition differences related to age, sex, and education. Such coordination accelerates evaluation of particular hypotheses. In particular, we focus on the effect of educational attainment on cognitive decline. Regular and Tobit mixed models were fit to MMSE scores from each study separately. The effects of age, sex, and education were examined based on more than one centering point. Findings were relatively consistent across studies. On average, MMSE scores were lower for older individuals and declined over time. Education predicted MMSE score, but, with two exceptions, was not associated with decline in MMSE over time. A straightforward association between educational attainment and rate of cognitive decline was not supported. Thoughtful consideration is needed when synthesizing evidence across studies, as methodologies adopted and sample characteristics, such as educational attainment, invariably differ.

Early Results of Medicare's Bundled Payment Initiative for a 90-Day Total Joint Arthroplasty Episode of Care.

PubMed

Iorio, Richard; Clair, Andrew J; Inneh, Ifeoma A; Slover, James D; Bosco, Joseph A; Zuckerman, Joseph D

2016-02-01

In 2011 Medicare initiated a Bundled Payment for Care Improvement (BPCI) program with the goal of introducing a payment model that would "lead to higher quality, more coordinated care at a lower cost to Medicare." A Model 2 bundled payment initiative for Total Joint Replacement (TJR) was implemented at a large, tertiary, urban academic medical center. The episode of care includes all costs through 90 days following discharge. After one year, data on 721 Medicare primary TJR patients were available for analysis. Average length of stay (LOS) was decreased from 4.27 days to 3.58 days (Median LOS 3 days). Discharges to inpatient facilities decreased from 71% to 44%. Readmissions occurred in 80 patients (11%), which is slightly lower than before implementation. The hospital has seen cost reduction in the inpatient component over baseline. Early results from the implementation of a Medicare BPCI Model 2 primary TJR program at this medical center demonstrate cost-savings. IV economic and decision analyses-developing an economic or decision model. Copyright © 2016 Elsevier Inc. All rights reserved.

A fluorescence resonance energy transfer-derived structure of a quantum dot-protein bioconjugate nanoassembly

PubMed Central

Medintz, I. L.; Konnert, J. H.; Clapp, A. R.; Stanish, I.; Twigg, M. E.; Mattoussi, H.; Mauro, J. M.; Deschamps, J. R.

2004-01-01

The first generation of luminescent semiconductor quantum dot (QD)-based hybrid inorganic biomaterials and sensors is now being developed. It is crucial to understand how bioreceptors, especially proteins, interact with these inorganic nanomaterials. As a model system for study, we use Rhodamine red-labeled engineered variants of Escherichia coli maltose-binding protein (MBP) coordinated to the surface of 555-nm emitting CdSe-ZnS core–shell QDs. Fluorescence resonance energy transfer studies were performed to determine the distance from each of six unique MBP-Rhodamine red dye-acceptor locations to the center of the energy-donating QD. In a strategy analogous to a nanoscale global positioning system determination, we use the intraassembly distances determined from the fluorescence resonance energy transfer measurements, the MBP crystallographic coordinates, and a least-squares approach to determine the orientation of the MBP relative to the QD surface. Results indicate that MBP has a preferred orientation on the QD surface. The refined model is in agreement with other evidence, which indicates coordination of the protein to the QD occurs by means of its C-terminal pentahistidine tail, and the size of the QD estimated from the model is in good agreement with physical measurements of QD size. The approach detailed here may be useful in determining the orientation of proteins in other hybrid protein–nanoparticle materials. To our knowledge, this is the first structural model of a hybrid luminescent QD-protein receptor assembly elucidated by using spectroscopic measurements in conjunction with crystallographic and other data. PMID:15210939

Towards the Next Generation of Space Environment Prediction Capabilities.

NASA Astrophysics Data System (ADS)

Kuznetsova, M. M.

2015-12-01

Since its establishment more than 15 years ago, the Community Coordinated Modeling Center (CCMC, http://ccmc.gsfc.nasa.gov) is serving as an assess point to expanding collection of state-of-the-art space environment models and frameworks as well as a hub for collaborative development of next generation space weather forecasting systems. In partnership with model developers and international research and operational communities the CCMC integrates new data streams and models from diverse sources into end-to-end space weather impacts predictive systems, identifies week links in data-model & model-model coupling and leads community efforts to fill those gaps. The presentation will highlight latest developments, progress in CCMC-led community-wide projects on testing, prototyping, and validation of models, forecasting techniques and procedures and outline ideas on accelerating implementation of new capabilities in space weather operations.

Great Help for Older Americans | NIH MedlinePlus the Magazine

MedlinePlus

... that may prevent or delay disability. Claude D. Pepper Older American Independence Centers (OAICs) University of California ... Wake Forest University P.I. Stephen Kritchevsky, PhD Pepper Coordinating Center Kevin High, MD University of Florida ...

Uncovering the Local Magnesium Environment in the Metal–Organic Framework Mg 2 (dobpdc) Using 25 Mg NMR Spectroscopy

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

Xu, Jun; Blaakmeer, E. S. Merijn; Lipton, Andrew S.

The incorporation of N,N'-dimethylethylenediamine into an expanded MOF-74 framework has yielded a material (mmen-Mg2(dobpdc)) exhibiting “step-shaped” CO2 adsorption isotherms. The coordination of mmen at the Mg open metal center is essential for the unique cooperative adsorption mechanism elucidated for this material. Despite its importance for carbon capture, there is as yet no experimental structure determination available for the underlying metal– organic framework Mg2(dobpdc). Our 25Mg solid-state NMR data unravel the local Mg environments in several Mg2(dobpdc) samples, unambiguously confirming the formation of fivecoordinate Mg centers in the activated material and six-coordinate Mg centers in the solvent- or diamine-loaded samples, suchmore » as mmen-Mg2(dobpdc). A fraction of the Mg centers are locally disordered due to the framework deformation accompanied by the guest distributions and dynamics.« less

AXAF Coordinate Transformation at XRCF

NASA Technical Reports Server (NTRS)

He, Helen; McDowell, Jonathan; Conroy, Maureen

1997-01-01

Coordinate transformation between focal plane and detector pixel systems must be handled carefully at the X-ray Calibration Facility (XRCF) as it will be during flight. The High Resolution Mirror Assembly (HRMA) X-ray Detection System (HXDS) stage dithers, and the five-axis mount (FAM) attachment points underwent various types of motion during testing. At the XRCF when the FAM moved, the Science Instrument Module (SIM) travel direction was not necessarily aligned with the mirror axis motion, and, in addition, an arbitrary position offset had to be calibrated. Misalignment from the mirror axis was assessed by measuring its displacement from the boresight configuration of the default FAM frame, and the HXDS stage was monitored for motion from the default FAM reference point. Mirror position, prescribed in a mirror modal coordinate system, was measured in HRMA pitch and yaw axes. Prior to corrections for dithering and FAM movement, the coordinate data at XRCF also had to be corrected for possible misalignments of the mirror mount relative to XRCF and the default FAM axes due to the movement of the FAM feet. Those misalignments were processed in terms of yaw-pitch-roll Euler angles in the mirror nodal coordinate, and in the default FAM frame, respectively. An AXAF Science Center (ASC) coordinate library, pixlib, has been built to support these coordinate transformations and was used during x-ray calibration at the George C. Marshall Space Flight Center, Huntsville, AL. The design and implementation of this library will be discussed.

X-ray crystal structure and theoretical study of a new dinuclear Cu(II) complex with two different geometry centers bridged with an oxo group

NASA Astrophysics Data System (ADS)

Golbedaghi, Reza; Azimi, Saeid; Molaei, Atefeh; Hatami, Masoud; Notash, Behrouz

2017-10-01

A new Schiff base ligand HL, 1,3-bis(2-((Z)-(2-aminoethylimino)methyl)phenoxy)ethylene di amine, has been synthesized from the reaction of a new aldehyde and ethylenediamine. After preparation the Schiff base, a new dinuclear Cu(II) complex with two different geometry for each metal ion was synthesized. Single crystal X-ray structure analysis of the complex Cu(II) showed that the complex is binuclear and all nitrogen and oxygen atoms of ligand (N4O3) are coordinated to two Cu(II) center ions. The crystal structure studying shows, a perchlorate ion has been coordinated to the two Cu(II) metal centers as bridged and another perchlorate coordinated to the one of Cu(II) ion as terminal. However, two interesting structures square pyramidal and distorted octahedral Cu(II) ions are bridged asymmetrically by a perchlorate ion and oxygen of hydroxyl group of Schiff base ligand. In addition, we had a theoretical study to have a comparison of experimental and theoretical results we determined the HOMO and LUMO orbitals.

Mishap Investigation Team (MIT) - Barksdale AFB, Louisiana

NASA Technical Reports Server (NTRS)

Stepaniak, Philip

2005-01-01

The Shuttle Program is organized to support a Shuttle mishap using the resources of the MIT. The afternoon of Feb. 1, 2003, the MIT deployed to Barksdale AFB. This location became the investigative center and interim storage location for crewmembers received from the Lufkin Disaster Field Office (DFO). Working under the leadership of the MIT Lead, the medical team executed a short-term plan that included search, recovery, and identification including coordination with the Armed Forces Institute of Pathology Temporary operations was set up at Barksdale Air Force Base for two weeks. During this time, coordination with the DFO field recovery teams, AFIP personnel, and the crew surgeons was on going. In addition, the crewmember families and NASA management were updated daily. The medical team also dealt with public reports and questions concerning biological and chemical hazards, which were coordinated with SPACEHAB, Inc., Kennedy Space Center (KSC) Medical Operations and the Johnson Space Center (JSC) Space Medicine office. After operations at Barksdale were concluded the medical team transitioned back to Houston and a long-term search, recovery and identification plan was developed.

77 FR 33605 - Privacy Act of 1974: Implementation of Exemptions; Department of Homeland Security Office of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-07

... operations center for the Department of Homeland Security.'' Through the NOC, OPS provides real-time...-003 Operations Collection, Planning, Coordination, Reporting, Analysis, and Fusion System of Records... System of Records.'' The DHS/OPS-003 Operations Collection, Planning, Coordination, Reporting, Analysis...

77 FR 43096 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Diabetes Mellitus...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-23

... meeting will focus on ``Diabetes, Dementia, and Alzheimer's Disease.'' Any member of the public interested... Diabetes and Digestive and Kidney Diseases; Notice of Diabetes Mellitus Interagency Coordinating Committee... Coordinating Committee, National Institute of Diabetes and Digestive and Kidney Diseases, 31 Center Drive...

77 FR 52218 - Amendment of Class E Airspace; Montgomery, AL, Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... airspace in the Montgomery, AL, area. The corrected coordinates for Maxwell AFB and Wetumpka Municipal... amendments. FOR FURTHER INFORMATION CONTACT: John Fornito, Operations Support Group, Eastern Service Center..., the FAA found that the geographic coordinates of Maxwell AFB and Wetumpka Municipal Airport need to be...

75 FR 82405 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-30

... and Regulatory Affairs, to reflect the establishment of a new Federal Coordinated Health Care Office... Health Care Office (FCQ).'' (3) Under Part F, CMS, FC. 20 Functions, change the title of the Office of... Center for Medicare and Medicaid Innovation (FCP): Federal Coordinated Health Care Office (FCQ) Manages...

42 CFR 431.636 - Coordination of Medicaid with the Children's Health Insurance Program (CHIP).

Code of Federal Regulations, 2010 CFR

2010-10-01

... Insurance Program (CHIP). 431.636 Section 431.636 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...'s Health Insurance Program (CHIP). (a) Statutory basis. This section implements— (1) Section 2102(b... coordination between a State child health program and other public health insurance programs. (b) Obligations...

42 CFR 422.66 - Coordination of enrollment and disenrollment through MA organizations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... through MA organizations. 422.66 Section 422.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Eligibility, Election, and Enrollment § 422.66 Coordination of enrollment and disenrollment through MA organizations. (a) Enrollment. An individual who wishes to elect an MA plan offered by an MA organization may...

42 CFR 422.66 - Coordination of enrollment and disenrollment through MA organizations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... through MA organizations. 422.66 Section 422.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Eligibility, Election, and Enrollment § 422.66 Coordination of enrollment and disenrollment through MA organizations. (a) Enrollment. An individual who wishes to elect an MA plan offered by an MA organization may...

42 CFR 422.66 - Coordination of enrollment and disenrollment through MA organizations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... through MA organizations. 422.66 Section 422.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Eligibility, Election, and Enrollment § 422.66 Coordination of enrollment and disenrollment through MA organizations. (a) Enrollment. An individual who wishes to elect an MA plan offered by an MA organization may...

Annual Report of Indian Education in Montana. Johnson-O'Malley Activities, Fiscal Year 1975.

ERIC Educational Resources Information Center

Montana State Office of the Superintendent of Public Instruction, Helena.

In fiscal year 1975, Montana's Johnson-O'Malley (JOM) funds provided services for 6,869 eligible Indian students. JOM funds provided transportation, boarding homes, home-school coordinators, cultural enrichment programs, nurse coordinators, study centers, consultation service, writing projects, summer programs, special teachers, and workshops for…

34 CFR 364.26 - What are the requirements for cooperation, coordination, and working relationships?

Code of Federal Regulations, 2010 CFR

2010-07-01

... EDUCATION STATE INDEPENDENT LIVING SERVICES PROGRAM AND CENTERS FOR INDEPENDENT LIVING PROGRAM: GENERAL... 34 Education 2 2010-07-01 2010-07-01 false What are the requirements for cooperation, coordination, and working relationships? 364.26 Section 364.26 Education Regulations of the Offices of the...

34 CFR 364.26 - What are the requirements for cooperation, coordination, and working relationships?

Code of Federal Regulations, 2011 CFR

2011-07-01

... EDUCATION STATE INDEPENDENT LIVING SERVICES PROGRAM AND CENTERS FOR INDEPENDENT LIVING PROGRAM: GENERAL... 34 Education 2 2011-07-01 2010-07-01 true What are the requirements for cooperation, coordination, and working relationships? 364.26 Section 364.26 Education Regulations of the Offices of the...

42 CFR 412.612 - Coordination of the collection of patient assessment data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Coordination of the collection of patient assessment data. 412.612 Section 412.612 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL...

75 FR 32942 - National Toxicology Program (NTP); NTP Interagency Center for the Evaluation of Alternative...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-10

... Progress Report of the Interagency Coordinating Committee on the Validation of Alternative Methods (ICCVAM... of the Biennial Progress Report 2008-2009: Interagency Coordinating Committee on the Validation of...) 919-541-0947, (e-mail) [email protected] . FOR FURTHER INFORMATION CONTACT: Dr. William S. Stokes...

47 CFR 25.272 - General inter-system coordination procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... network control center which will have the responsibility to monitor space-to-Earth transmissions in its system. This would indirectly monitor uplink earth station transmissions in its system and to coordinate.... (c) The transmitting earth station licensee shall provide the operator(s) of the satellites, on which...

47 CFR 25.272 - General inter-system coordination procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... network control center which will have the responsibility to monitor space-to-Earth transmissions in its system. This would indirectly monitor uplink earth station transmissions in its system and to coordinate.... (c) The transmitting earth station licensee shall provide the operator(s) of the satellites, on which...

Service line structure and decision-maker attention in three health systems: Implications for patient-centered care.

PubMed

Louis, Christopher J; Clark, Jonathan R; Gray, Barbara; Brannon, Diane; Parker, Victoria

2017-06-15

Scholars have noted a disconnect between the level at which structure is typically examined (the organization) and the level at which the relevant coordination takes place (service delivery). Accordingly, our understanding of the role structure plays in care coordination is limited. In this article, we explore service line structure, with an aim of advancing our understanding of the role service line structure plays in producing coordinated, patient-centered care. We do so by giving special attention to the cognitive roots of patient-centeredness. Our exploratory study relied on comparative case studies of the breast cancer service lines in three health systems. Nonprobability discriminative snowball sampling was used to identify the final sample of key informants. We employed a grounded approach to analyzing and interpreting the data. We found substantial variation across the three service lines in terms of their structure. We also found corresponding variation across the three case sites in terms of where informant attention was primarily focused in the process of coordinating care. Drawing on the attention-based view of the firm, our results draw a clear connection between structural characteristics and the dominant focus of attention (operational tactics, provider roles and relationships, or patient needs and engagement) in health care service lines. Our exploratory results suggest that service line structures influence attention in two ways: (a) by regulating the type and intensity of the problems facing service line participants and (b) by encouraging (or discouraging) a shared purpose around patient needs. Patient-centered attention-a precursor to coordinated, patient-centered care-depends on the internal choices organizations make around service line structure. Moreover, a key task for organizational and service line leaders is to structure service lines to create a context that minimizes distractions and enables care providers to focus their attention on the needs of their patients.

Development and Monitoring the Key Performance Indicators of the Quality of Care for Patients with Cleft Lips/Palates at Srinagarind Hospital.

PubMed

Mongkhonthawornchai, Siriporn; Pradubwong, Suteera; Augsornwan, Darawan; Pathumwiwatana, Pornpen; Sroyhin, Waranya; Pongpagatip, Sumalee; Wongkham, Jamras; Wachirapakorn, Jantira; Lao-unka, Kesorn; Mucnamporn, Tippawan; Chowchuen, Bowornsilp

2015-08-01

Congenital deformities, such as cleft lips and/or cleft palates (CLP), have high incidences in the Northeast of Thailand. These birth defects can affect patient's quality of life. CLP patients need crucial and long-term treatments by a multidisciplinary team starting from prenatal stage to late adulthood. Patients and their families should involve in their own care, and their care objectives should correspond with healthcare providers. Besides the clinical outcome of interdisciplinary team, key performance indicators (KPIs) need to be developed in the hospital service unit in order to improve quality of care and treatment outcomes. 1) to establish KPIs in hospital service units, and 2) to develop the information system to collect, analysis and improve the quality of CLP care. A nurse coordinator was appointed in the Tawanchai Center to coordinate care. The three periods were conducted for the nurse coordinator to work with nine service units in Srinagarind Hospital for consensus on both qualitative and quantitative data to be used as service unit quality measurement. Thirty one KPIs from nine service units were established, collected and analyzed during a four-month period in 2014. The 20 KPIs achieved the unit targets. Two PKIs of the rates of complication with anesthesia during/after surgery in the first 24 hours and the rates of patient/caregiver's satisfaction in acquiring information from the officer were improving. There were 11 KPIs that did not achieve the targets. The coordinator nurse of the Tawanchai Center discussed with the service unit for the cause and how to improve the outcome. The monitoring KPIs will lead to improvement of outcome for better patient quality as well as benchmarking with other hospitals of Cleft Center. The KPIs from hospital service units with the monitoring and analysis of information by the nurse coordinator will enhance and lead to improvement of the quality of the patients and family centered care process.

76 FR 44302 - Upper Rio Grande Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-25

..., Colorado. Written comments should be sent to Mike Blakeman, San Luis Valley Public Lands Center, 1803 West... received at the San Luis Valley Public Lands Center, 1803 West U.S. Highway 160, Monte Vista, CO 81144. FOR FURTHER INFORMATION CONTACT: Mike Blakeman, RAC Coordinator, USDA, San Luis Valley Public Lands Center...

42 CFR 485.916 - Condition of participation: Treatment team, person-centered active treatment plan, and...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Condition of participation: Treatment team, person... Health Centers (CMHCs) § 485.916 Condition of participation: Treatment team, person-centered active treatment plan, and coordination of services. The CMHC must designate an interdisciplinary treatment team...

Mental Health Professionals in Children's Advocacy Centers: Is There Role Conflict?

ERIC Educational Resources Information Center

Cross, Theodore P.; Fine, Janet E.; Jones, Lisa M.; Walsh, Wendy A.

2012-01-01

Two recent chapters in professional books have criticized children's advocacy centers for creating role conflict for mental health professionals because of their work with criminal justice and child protection professionals in children's advocacy centers as part of a coordinated response to child abuse. This article argues that these critiques…

Coordination-Driven Dimerization of Zinc Chlorophyll Derivatives Possessing a Dialkylamino Group.

PubMed

Watanabe, Hiroaki; Kamatani, Yusuke; Tamiaki, Hitoshi

2017-04-04

Zinc chlorophyll derivatives Zn-1-3 possessing a tertiary amino group at the C3 1 position have been synthesized through reductive amination of methyl pyropheophorbide-d obtained from naturally occurring chlorophyll-a. In a dilute CH 2 Cl 2 solution as well as in a dilute 10 %(v/v) CH 2 Cl 2 /hexane solution, Zn-1 possessing a dimethylamino group at the C3 1 position showed red-shifted UV/Vis absorption and intensified exciton-coupling circular dichroism (CD) spectra at room temperature owing to its dimer formation via coordination to the central zinc by the 3 1 -N atom of the dimethylamino group. However, Zn-2/3 bearing 3 1 -ethylmethylamino/diethylamino groups did not. The difference was dependent on the steric factor of the substituents in the tertiary amino group, where an increase of the carbon numbers on the N atom reduced the intermolecular N⋅⋅⋅Zn coordination. UV/Vis, CD, and 1 H NMR spectroscopic analyses including DOSY measurements revealed that Zn-1 formed closed-type dimers via an opened dimer by single-to-double axial coordination with an increase in concentration and a temperature decrease in CH 2 Cl 2 , while Zn-2/3 gave open and flexible dimers in a concentrated CH 2 Cl 2 solution at low temperature. The supramolecular closed dimer structures of Zn-1 were estimated by molecular modelling calculations, which showed these structures were promising models for the chlorophyll dimer in a photosynthetic reaction center. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

The Use of the Regional Navy Coastal Ocean Model (RNCOM) by the US Navy in Operational Oceanography

NASA Astrophysics Data System (ADS)

Rayburn, J. T.

2016-02-01

The operational RNCOM is a 1/30° resolution nested model run daily by the Naval Oceanographic Office (NAVOCEANO), Stennis Space Center, Mississippi. Operational RNCOM areas are used in combination with the Global HYbrid Coordinate Ocean Model (HYCOM) to provide full global model coverage with enhanced resolution for temperature, salinity, currents in key areas. This talk will discuss two aspects of RNCOM. First, it will focus on how the model is configured. As a nested model, issues to consider include the source of boundary condition, boundary placement, and observational inputs. Secondly, this talk will focus on the strengths and weaknesses RNCOM demonstrates in accurately characterizing ocean condition with respect to HYCOM and how this regional model's output is used by NAVOCEANO Ocean Forecasters to develop operational forecasts.

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

PubMed

Ellis, Horace; Alexander, Vinette

2016-06-01

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

Synthesis, structure, and DNA cleavage properties of copper(II) complexes of 1,4,7-triazacyclononane ligands featuring pairs of guanidine pendants.

PubMed

Tjioe, Linda; Joshi, Tanmaya; Brugger, Joël; Graham, Bim; Spiccia, Leone

2011-01-17

Two new ligands, L(1) and L(2), have been prepared via N-functionalization of 1,4,7-triazacyclononane (tacn) with pairs of ethyl- or propyl-guanidine pendants, respectively. The X-ray crystal structure of [CuL(1)](ClO4)2 (C1) isolated from basic solution (pH 9) indicates that a secondary amine nitrogen from each guanidine pendants coordinates to the copper(II) center in addition to the nitrogen atoms in the tacn macrocycle, resulting in a five-coordinate complex with intermediate square-pyramidal/trigonal bipyramidal geometry. The guanidines adopt an unusual coordination mode in that their amine nitrogen nearest to the tacn macrocycle binds to the copper(II) center, forming very stable five-membered chelate rings. A spectrophotometric pH titration established the pK(app) for the deprotonation and coordination of each guanidine group to be 3.98 and 5.72, and revealed that [CuL(1)](2+) is the only detectable species present in solution above pH ∼ 8. The solution speciation of the CuL(2) complex (C2) is more complex, with at least 5 deprotonation steps over the pH range 4-12.5, and mononuclear and binuclear complexes coexisting. Analysis of the spectrophotometric data provided apparent deprotonation constants, and suggests that solutions at pH ∼ 7.5 contain the maximum proportion of polynuclear complexes. Complex C1 exhibits virtually no cleavage activity toward the model phosphate diesters, bis(p-nitrophenyl)phosphate (BNPP) and 2-hydroxypropyl-p-nitrophenyl phosphate (HPNPP), while C2 exhibits moderate activity. For C2, the respective kobs values measured at pH 7.0 (7.24 (± 0.08) × 10(-5) s(-1) (BNPP at 50 °C) and 3.2 (± 0.3) × 10(-5) s(-1) (HPNPP at 25 °C)) are 40- and 10-times faster than [Cu(tacn)(OH2)2](2+) complex. Both complexes cleave supercoiled pBR 322 plasmid DNA, indicating that the guanidine pendants of [CuL(1)](2+) may have been displaced from the copper coordination sphere to allow for DNA binding and subsequent cleavage. The rate of DNA cleavage by C2 is twice that measured for [Cu(tacn)(OH2)2](2+), suggesting some degree of cooperativity between the copper center and guanidinium pendants in the hydrolysis of the phosphate ester linkages of DNA. A predominantly hydrolytic cleavage mechanism was confirmed through experiments performed either in the presence of various radical scavengers or under anaerobic conditions.

78 FR 46860 - Proposed Waiver and Extension of the Project Period for the Technical Assistance Coordination Center

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... funded centers, professional organizations, and other stakeholders to collaborate, solve problems...; (b) maintaining a Web site that houses tools that TA&D Network projects have developed or can use in...

Metropolitan transportation management center concepts of operation : a cross-cutting study : improving transportation network efficiency

DOT National Transportation Integrated Search

1999-10-01

The implementor and operator of a regional transportation management center (TMC) face a challenging task. Operators of TMCsthe primary point of coordination for managing transportation resourcestypically control millions of dollars of intellig...

Oral Health Integration Into a Pediatric Practice and Coordination of Referrals to a Colocated Dental Home at a Federally Qualified Health Center.

PubMed

Sengupta, Nandini; Nanavati, Sonal; Cericola, Maria; Simon, Lisa

2017-10-01

We have integrated preventive oral health measures into preventive care visits for children at a federally qualified health center in Boston, Massachusetts. The program, started in 2015, covers 3400 children and has increased universal caries risk screening in primary care to 85%, fluoride varnish application rates to 80%, and referrals to a dental home to 35%. We accomplished this by minimizing pressures on providers' workflow, empowering medical assistants to lead the initiative, and utilizing data-driven improvement strategies, alongside colocated coordinated care.

Coordinating Council. Seventh Meeting: Acquisitions

NASA Technical Reports Server (NTRS)

1992-01-01

The theme for this NASA Scientific and Technical Information Program Coordinating Council meeting was Acquisitions. In addition to NASA and the NASA Center for AeroSpace Information (CASI) presentations, the report contains fairly lengthy visuals about acquisitions at the Defense Technical Information Center. CASI's acquisitions program and CASI's proactive acquisitions activity were described. There was a presentation on the document evaluation process at CASI. A talk about open literature scope and coverage at the American Institute of Aeronautics and Astronautics was also given. An overview of the STI Program's Acquisitions Experts Committee was given next. Finally acquisitions initiatives of the NASA STI program were presented.

Coordination Structure and Fragmentation Chemistry of the Tripositive Lanthanide-Thio-Diglycolamide Complexes.

PubMed

Chen, Xiuting; Li, Qingnuan; Gong, Yu

2017-12-14

Tripositive Ln(TMTDA) 3 3+ complexes (Ln = La-Lu except Pm, TMTDA = tetramethyl 3-thio-diglycolamide) were observed in the gas phase by electrospray ionization of LnCl 3 and TMTDA mixtures. Collision-induced dissociation (CID) was employed to investigate their fragmentation chemistry, which revealed the influence of metal center as well as ligand on the ligated complexes. Ln(TMTDA) 2 (TMTDA-45) 3+ resulting from C carbonyl -N bond cleavage of TMTDA and hydrogen transfer was the major CID product for all Ln(TMTDA) 3 3+ except Eu(TMTDA) 3 3+ , which predominantly formed charge-reducing product Eu II (TMTDA) 2 2+ via electron transfer from TMTDA to Eu 3+ . Density functional theory calculations on the structure of La(TMTDA) 3 3+ and Lu(TMTDA) 3 3+ revealed that Ln 3+ was coordinated by six O carbonyl atoms from three neutral TMTDA ligands, and both complexes possessed C 3h symmetry. The S ether atom deviating from the ligand plane was not coordinated to the metal center. On the basis of the CID results of Ln(TMTDA) 3 3+ , Ln(TMGA) 3 3+ , and Ln(TMOGA) 3 3+ , the fragmentation chemistry associated with the ligand depends on the coordination mode, while the redox chemistry of these tripositive ions is related to the nature of both metal centers and diamide ligands.

The Wmo Global Atmosphere Watch Programme: Global Framework for Atmospheric Composition Observations and Analysis

NASA Astrophysics Data System (ADS)

Tarasova, O. A.; Jalkanen, L.

2010-12-01

The WMO Global Atmosphere Watch (GAW) Programme is the only existing long-term international global programme providing an international coordinated framework for observations and analysis of the chemical composition of the atmosphere. GAW is a partnership involving contributors from about 80 countries. It includes a coordinated global network of observing stations along with supporting facilities (Central Facilities) and expert groups (Scientific Advisory Groups, SAGs and Expert Teams, ETs). Currently GAW coordinates activities and data from 27 Global Stations and a substantial number of Regional and Contributing Stations. Station information is available through the GAW Station Information System GAWSIS (http://gaw.empa.ch/gawsis/). There are six key groups of variables which are addressed by the GAW Programme, namely: ozone, reactive gases, greenhouse gases, aerosols, UV radiation and precipitation chemistry. GAW works to implement integrated observations unifying measurements from different platforms (ground based in situ and remote, balloons, aircraft and satellite) supported by modeling activities. GAW provides data for ozone assessments, Greenhouse Gas Bulletins, Ozone Bulletins and precipitation chemistry assessments published on a regular basis and for early warnings of changes in the chemical composition and related physical characteristics of the atmosphere. To ensure that observations can be used for global assessments, the GAW Programme has developed a Quality Assurance system. Five types of Central Facilities dedicated to the six groups of measurement variables are operated by WMO Members and form the basis of quality assurance and data archiving for the GAW global monitoring network. They include Central Calibration Laboratories (CCLs) that host primary standards (PS), Quality Assurance/Science Activity Centres (QA/SACs), World Calibration Centers (WCCs), Regional Calibration Centers (RCCs), and World Data Centers (WDCs) with responsibility for archiving and access to GAW data. Education, training, workshops, comparison campaigns, station audits/visits and twinning are also provided to build capacities in atmospheric sciences in Member countries.

Long-term observations of tropospheric ozone: GAW Measurement Guidelines

NASA Astrophysics Data System (ADS)

Tarasova, Oksana; Galbally, Ian E.; Schultz, Martin G.

2013-04-01

The Global Atmosphere Watch (GAW) Programme of the World Meteorological Organization (WMO) coordinates long-term observations of the chemical composition and physical properties of the atmosphere which are relevant for understanding of atmospheric chemistry and climate change. Atmospheric observations of reactive gases (tropospheric ozone, carbon monoxide, volatile organic compounds and nitrogen oxides) coordinated by the GAW Programme complement local and regional scale air quality monitoring efforts. As part of the GAW quality assurance (QA) system detailed measurement guidelines for atmospheric trace species are developed by international expert teams at irregular intervals. The most recent report focuses on continuous in-situ measurements of ozone in the troposphere, performed in particular at continental or island sites with altitudes ranging from sea level to mountain tops. Data Quality Objectives (DQOs) are defined for different applications of the data (e.g. trend analysis and verification of global model forecasts). These DQOs include a thorough discussion of the tolerable level of measurement uncertainty and data completeness. The guidelines present the best practices and practical arrangements adopted by the GAW Programme in order to enable the GAW station network to approach or achieve the defined tropospheric ozone DQOs. The document includes information on the selection of station and measurement locations, required skills and training of staff, recommendations on the measurement technique and the necessary equipment to perform highest quality measurements, rules for conducting the measurements, preparing the data and archiving them, and more. Much emphasis is given to discussions about how to ensure the quality of the data through tracing calibrations back to primary standards, proper calibration and data analysis, etc. In the GAW Programme the QA system is implemented through Central Facilities (Central Calibration Laboratories, World and Regional Calibration Centers and World Data Centers), Scientific Advisory Groups and GAW Training and Education Center. These bodies support primary standards, provide calibration and data archiving facilities, coordinate comparison campaigns, perform stations audit, provide documentation and training of personnel.

Developing an academic health department in Northeast Tennessee: a sustainable approach through student leadership.

PubMed

Brooks, Billy; Blackley, David; Masters, Paula; May, Andrew Stephen; Mayes, Gary; Williams, Christian; Pack, Robert

2014-01-01

In an effort to bridge the gap between public health practice and academia, the Health Resources and Services Administration-funded Tennessee Public Health Training Center (LIFEPATH) has supported establishment of an academic health department (AHD) involving the East Tennessee State University College of Public Health (COPH) and the Sullivan County Regional Health Department (SCRHD). The SCRHD identified a need to increase internal capacity to conduct ongoing community health assessment and community-centered practice. Similarly, the COPH recognized the need to expand evidence-based practice implementation and evaluation opportunities for public health students. Personnel from the SCRHD, LIFEPATH, and the COPH developed a formal AHD agreement during the summer of 2012 and launched the program the subsequent fall semester. One aspect of the COPH/SCRHD/LIFEPATH model that addresses financial barriers experienced by other AHDs is the competitive awarding of the coordinator position to a doctor of public health student from the COPH, demonstrating investment in the model by the college. The doctor of public health student gains leadership experience through project management, coordination of the local health council, and day-to-day facilitation of undergraduate and master's student interns. The SCRHD benefits from the formal academic background of graduate-level interns dedicated to working in the community. This AHD framework offers an opportunity for doctoral-level students to develop practical leadership skills in a health department while enhancing the capacity of the SCRHD and the COPH to serve their community and stakeholders.

The Pediatric Emergency Care Applied Research Network Registry: A Multicenter Electronic Health Record Registry of Pediatric Emergency Care.

PubMed

Deakyne Davies, Sara J; Grundmeier, Robert W; Campos, Diego A; Hayes, Katie L; Bell, Jamie; Alessandrini, Evaline A; Bajaj, Lalit; Chamberlain, James M; Gorelick, Marc H; Enriquez, Rene; Casper, T Charles; Scheid, Beth; Kittick, Marlena; Dean, J Michael; Alpern, Elizabeth R

2018-04-01

 Electronic health record (EHR)-based registries allow for robust data to be derived directly from the patient clinical record and can provide important information about processes of care delivery and patient health outcomes.  A data dictionary, and subsequent data model, were developed describing EHR data sources to include all processes of care within the emergency department (ED). ED visit data were deidentified and XML files were created and submitted to a central data coordinating center for inclusion in the registry. Automated data quality control occurred prior to submission through an application created for this project. Data quality reports were created for manual data quality review.  The Pediatric Emergency Care Applied Research Network (PECARN) Registry, representing four hospital systems and seven EDs, demonstrates that ED data from disparate health systems and EHR vendors can be harmonized for use in a single registry with a common data model. The current PECARN Registry represents data from 2,019,461 pediatric ED visits, 894,503 distinct patients, more than 12.5 million narrative reports, and 12,469,754 laboratory tests and continues to accrue data monthly.  The Registry is a robust harmonized clinical registry that includes data from diverse patients, sites, and EHR vendors derived via data extraction, deidentification, and secure submission to a central data coordinating center. The data provided may be used for benchmarking, clinical quality improvement, and comparative effectiveness research. Schattauer.

Limits on same-day billing in Medicaid hinders integration of behavioral health into the medical home model.

PubMed

Roby, Dylan H; Jones, Erynne E

2016-02-01

The potential expansion of insurance coverage through the Patient Protection and Affordable Care Act of 2010 can facilitate the reduction of access barriers and improved quality for behavioral health care. More than 5 million of the newly insured are expected to have mental health and substance use disorders. In addition, state and federal efforts to integrate behavioral and medical health needs through patient-centered medical home models and innovations in payment strategies provide an unprecedented opportunity to use federal financial support to improve not only access to care, but also improve quality through active care coordination, use of interdisciplinary teams, colocating services, and engaging in warm hand-offs between providers in the same setting. These potential advances are hindered in 24 different states because of Medicaid payment policy, with 7 explicitly limiting the ability to reimburse for physical health and behavioral health services on the same day for all providers. Without the ability for providers to be reimbursed for different services on the same day to improve behavioral and medical health care coordination, these states could be limited in their ability to improve care via patient-centered approaches and interdisciplinary team-based care that would involve physicians, clinical psychologists, psychiatrists, and other mental health professionals. Limits on same-day billing in Medicaid programs could impact up to 36.7 million people in 24 states, which is approximately 52.6% of all Medicaid enrollees. (c) 2016 APA, all rights reserved).

Science Archives in the 21st Century: A NASA LAMBDA Report

NASA Technical Reports Server (NTRS)

Butterworth, P.; Greason, M.

2007-01-01

Lambda is a thematic data center that focuses on serving the cosmic microwave background (CMB) research community. LAMBDA is an active archive for NASA's Cosmic Background Explorer (COBE) and Wilkinson Microwave Anisotropy Probe (WMAP) mission data sets. In addition, LAMBDA provides analysis software, on-line tools, relevant ancillary data and important web links. LAMBDA also tries to preserve the most important ground-based and suborbital CMB data sets. CMB data is unlike other astrophysical data, consisting of intrinsically diffuse surface brightness photometry with a signal contrast of the order 1 part in 100,000 relative to the uniform background. Because of the extremely faint signal levels, the signal-to-noise ratio is relatively low and detailed instrument-specific knowledge of the data is essential. While the number of data sets being produced is not especially large, those data sets are becoming large and complex. That tendency will increase when the many polarization experiments currently being deployed begin producing data. The LAMBDA experience supports many aspects of the NASA data archive model developed informally over the last ten years-that small focused data centers are often more effective than larger more ambitious collections, for example; that data centers are usually best run by active scientists; that it can be particularly advantageous if those scientists are leaders in the use of the archived data sets; etc. LAMBDA has done some things so well that they might provide lessons for other archives. A lot of effort has been devoted to developing a simple and consistent interface to data sets, for example; and serving all the documentation required via simple 'more' pages and longer explanatory supplements. Many of the problems faced by LAMBDA will also not surprise anyone trying to manage other space science data. These range from persuading mission scientists to provide their data as quickly as possible, to dealing with a high volume of nuisance (spam) messages. Because so many data center problems and solutions are common across individual data centers and disciplines it would be very valuable to establish some new systems of communication - such as informal email lists for administrators and developers. But resources are very limited, so new timeconsuming and inefficient mechanisms - like too-frequent and too-structured meetingsshould be avoided. Although there are great advantages to being small, agile and independent, there are also some areas where science data centers within and without NASA could be better coordinated - for the assignment of persistent identifiers; to encourage the early adoption of useful standards and technologies; etc. Some super-structure to facilitate such coordination might be beneficial as long as it doesn't begin to control the other work of the archives, and become a "methodology police". In this respect the CCSDS "Reference Model for an Open Archive Information System" is a little worrying. It may be that the closer a data center gets to following such a detailed prescription, the less effective it will become. It is much better to have an informal coordination process than a bureaucratic straight-jacket.

A break-even analysis for dementia care collaboration: Partners in Dementia Care.

PubMed

Morgan, Robert O; Bass, David M; Judge, Katherine S; Liu, C F; Wilson, Nancy; Snow, A Lynn; Pirraglia, Paul; Garcia-Maldonado, Maurilio; Raia, Paul; Fouladi, N N; Kunik, Mark E

2015-06-01

Dementia is a costly disease. People with dementia, their families, and their friends are affected on personal, emotional, and financial levels. Prior work has shown that the "Partners in Dementia Care" (PDC) intervention addresses unmet needs and improves psychosocial outcomes and satisfaction with care. We examined whether PDC reduced direct Veterans Health Administration (VHA) health care costs compared with usual care. This study was a cost analysis of the PDC intervention in a 30-month trial involving five VHA medical centers. Study subjects were veterans (N = 434) 50 years of age and older with dementia and their caregivers at two intervention (N = 269) and three comparison sites (N = 165). PDC is a telephone-based care coordination and support service for veterans with dementia and their caregivers, delivered through partnerships between VHA medical centers and local Alzheimer's Association chapters. We tested for differences in total VHA health care costs, including hospital, emergency department, nursing home, outpatient, and pharmacy costs, as well as program costs for intervention participants. Covariates included caregiver reports of veterans' cognitive impairment, behavior problems, and personal care dependencies. We used linear mixed model regression to model change in log total cost post-baseline over a 1-year follow-up period. Intervention participants showed higher VHA costs than usual-care participants both before and after the intervention but did not differ significantly regarding change in log costs from pre- to post-baseline periods. Pre-baseline log cost (p ≤ 0.001), baseline cognitive impairment (p ≤ 0.05), number of personal care dependencies (p ≤ 0.01), and VA service priority (p ≤ 0.01) all predicted change in log total cost. These analyses show that PDC meets veterans' needs without significantly increasing VHA health care costs. PDC addresses the priority area of care coordination in the National Plan to Address Alzheimer's Disease, offering a low-cost, structured, protocol-driven, evidence-based method for effectively delivering care coordination.

NOAA SWPC / NASA CCMC Space Weather Modeling Assessment Project: Toward the Validation of Advancements in Heliospheric Space Weather Prediction Within WSA-Enlil

NASA Astrophysics Data System (ADS)

Adamson, E. T.; Pizzo, V. J.; Biesecker, D. A.; Mays, M. L.; MacNeice, P. J.; Taktakishvili, A.; Viereck, R. A.

2017-12-01

In 2011, NOAA's Space Weather Prediction Center (SWPC) transitioned the world's first operational space weather model into use at the National Weather Service's Weather and Climate Operational Supercomputing System (WCOSS). This operational forecasting tool is comprised of the Wang-Sheeley-Arge (WSA) solar wind model coupled with the Enlil heliospheric MHD model. Relying on daily-updated photospheric magnetograms produced by the National Solar Observatory's Global Oscillation Network Group (GONG), this tool provides critical predictive knowledge of heliospheric dynamics such as high speed streams and coronal mass ejections. With the goal of advancing this predictive model and quantifying progress, SWPC and NASA's Community Coordinated Modeling Center (CCMC) have initiated a collaborative effort to assess improvements in space weather forecasts at Earth by moving from a single daily-updated magnetogram to a sequence of time-dependent magnetograms to drive the ambient inputs for the WSA-Enlil model as well as incorporating the newly developed Air Force Data Assimilative Photospheric Flux Transport (ADAPT) model. We will provide a detailed overview of the scope of this effort and discuss preliminary results from the first phase focusing on the impact of time-dependent magnetogram inputs to the WSA-Enlil model.

Intelligent multiagent coordination based on reinforcement hierarchical neuro-fuzzy models.

PubMed

Mendoza, Leonardo Forero; Vellasco, Marley; Figueiredo, Karla

2014-12-01

This paper presents the research and development of two hybrid neuro-fuzzy models for the hierarchical coordination of multiple intelligent agents. The main objective of the models is to have multiple agents interact intelligently with each other in complex systems. We developed two new models of coordination for intelligent multiagent systems, which integrates the Reinforcement Learning Hierarchical Neuro-Fuzzy model with two proposed coordination mechanisms: the MultiAgent Reinforcement Learning Hierarchical Neuro-Fuzzy with a market-driven coordination mechanism (MA-RL-HNFP-MD) and the MultiAgent Reinforcement Learning Hierarchical Neuro-Fuzzy with graph coordination (MA-RL-HNFP-CG). In order to evaluate the proposed models and verify the contribution of the proposed coordination mechanisms, two multiagent benchmark applications were developed: the pursuit game and the robot soccer simulation. The results obtained demonstrated that the proposed coordination mechanisms greatly improve the performance of the multiagent system when compared with other strategies.

Introducing a 2-His-1-Glu Nonheme Iron Center into Myoglobin Confers Nitric Oxide Reductase Activity

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

Lin, Y.W.; Robinson, H.; Yeung, N.

2010-07-28

A conserved 2-His-1-Glu metal center, as found in natural nonheme iron-containing enzymes, was engineered into sperm whale myoglobin by replacing Leu29 and Phe43 with Glu and His, respectively (swMb L29E, F43H, H64, called Fe{sub B}Mb(-His)). A high resolution (1.65 {angstrom}) crystal structure of Cu(II)-CN?-Fe{sub B}Mb(-His) was determined, demonstrating that the unique 2-His-1-Glu metal center was successfully created within swMb. The Fe{sub B}Mb(-His) can bind Cu, Fe, or Zn ions, with both Cu(I)-Fe{sub B}Mb(-His) and Fe(II)-Fe{sub B}Mb(-His) exhibiting nitric oxide reductase (NOR) activities. Cu dependent NOR activity was significantly higher than that of Fe in the same metal binding site. EPRmore » studies showed that the reduction of NO to N{sub 2}O catalyzed by these two enzymes resulted in different intermediates; a five-coordinate heme-NO species was observed for Cu(I)-Fe{sub B}Mb(-His) due to the cleavage of the proximal heme Fe-His bond, while Fe(II)-Fe{sub B}Mb(-His) remained six-coordinate. Therefore, both the metal ligand, Glu29, and the metal itself, Cu or Fe, play crucial roles in NOR activity. This study presents a novel protein model of NOR and provides insights into a newly discovered member of the NOR family, gNOR.« less

A new mapping function in table-mounted eye tracker

NASA Astrophysics Data System (ADS)

Tong, Qinqin; Hua, Xiao; Qiu, Jian; Luo, Kaiqing; Peng, Li; Han, Peng

2018-01-01

Eye tracker is a new apparatus of human-computer interaction, which has caught much attention in recent years. Eye tracking technology is to obtain the current subject's "visual attention (gaze)" direction by using mechanical, electronic, optical, image processing and other means of detection. While the mapping function is one of the key technology of the image processing, and is also the determination of the accuracy of the whole eye tracker system. In this paper, we present a new mapping model based on the relationship among the eyes, the camera and the screen that the eye gazed. Firstly, according to the geometrical relationship among the eyes, the camera and the screen, the framework of mapping function between the pupil center and the screen coordinate is constructed. Secondly, in order to simplify the vectors inversion of the mapping function, the coordinate of the eyes, the camera and screen was modeled by the coaxial model systems. In order to verify the mapping function, corresponding experiment was implemented. It is also compared with the traditional quadratic polynomial function. And the results show that our approach can improve the accuracy of the determination of the gazing point. Comparing with other methods, this mapping function is simple and valid.

Ground target geolocation based on digital elevation model for airborne wide-area reconnaissance system

NASA Astrophysics Data System (ADS)

Qiao, Chuan; Ding, Yalin; Xu, Yongsen; Xiu, Jihong

2018-01-01

To obtain the geographical position of the ground target accurately, a geolocation algorithm based on the digital elevation model (DEM) is developed for an airborne wide-area reconnaissance system. According to the platform position and attitude information measured by the airborne position and orientation system and the gimbal angles information from the encoder, the line-of-sight pointing vector in the Earth-centered Earth-fixed coordinate frame is solved by the homogeneous coordinate transformation. The target longitude and latitude can be solved with the elliptical Earth model and the global DEM. The influences of the systematic error and measurement error on ground target geolocation calculation accuracy are analyzed by the Monte Carlo method. The simulation results show that this algorithm can improve the geolocation accuracy of ground target in rough terrain area obviously. The geolocation accuracy of moving ground target can be improved by moving average filtering (MAF). The validity of the geolocation algorithm is verified by the flight test in which the plane flies at a geodetic height of 15,000 m and the outer gimbal angle is <47°. The geolocation root mean square error of the target trajectory is <45 and <7 m after MAF.

On the molecular basis of the activity of the antimalarial drug chloroquine: EXAFS-assisted DFT evidence of a direct Fe-N bond with free heme in solution

NASA Astrophysics Data System (ADS)

Macetti, Giovanni; Rizzato, Silvia; Beghi, Fabio; Silvestrini, Lucia; Lo Presti, Leonardo

2016-02-01

4-aminoquinoline antiplasmodials interfere with the biocrystallization of the malaria pigment, a key step of the malaria parasite metabolism. It is commonly believed that these drugs set stacking π···π interactions with the Fe-protoporphyrin scaffold of the free heme, even though the details of the heme:drug recognition process remain elusive. In this work, the local coordination of Fe(III) ions in acidic solutions of hematin at room temperature was investigated by extended x-ray absorption fine structure (EXAFS) spectroscopy in the 4.0-5.5 pH range, both in the presence and in the absence of the antimalarial drug chloroquine. EXAFS results were complemented by DFT simulations in polarizable continuum media to model solvent effects. We found evidence that a complex where the drug quinoline nitrogen is coordinated with the iron center might coexist with formerly proposed adduct geometries, based on stacking interactions. Charge-assisted hydrogen bonds among lateral chains of the two molecules play a crucial role in stabilizing this complex, whose formation is favored by the presence of lipid micelles. The direct Fe-N bond could reversibly block the axial position in the Fe 1st coordination shell in free heme, acting as an inhibitor for the crystallization of the malaria pigment without permanently hampering the catalytic activity of the redox center. These findings are discussed in the light of possible implications on the engineering of drugs able to thwart the adaptability of the malaria parasite against classical aminoquinoline-based therapies.

Redox reactions of [FeFe]-hydrogenase models containing an internal amine and a pendant phosphine.

PubMed

Zheng, Dehua; Wang, Mei; Chen, Lin; Wang, Ning; Sun, Licheng

2014-02-03

A diiron dithiolate complex with a pendant phosphine coordinated to one of the iron centers, [(μ-SCH2)2N(CH2C6H4-o-PPh2){Fe2(CO)5}] (1), was prepared and structurally characterized. The pendant phosphine is dissociated together with a CO ligand in the presence of excess PMe3, to afford [(μ-SCH2)2N(CH2C6H4-o-PPh2){Fe(CO)2(PMe3)}2] (2). Redox reactions of 2 and related complexes were studied in detail by in situ IR spectroscopy. A series of new Fe(II)Fe(I) ([3](+) and [6](+)), Fe(II)Fe(II) ([4](2+)), and Fe(I)Fe(I) (5) complexes relevant to Hox, Hox(CO), and Hred states of the [FeFe]-hydrogenase active site were detected. Among these complexes, the molecular structures of the diferrous complex [4](2+) with the internal amine and the pendant phosphine co-coordinated to the same iron center and the triphosphine diiron complex 5 were determined by X-ray crystallography. To make a comparison, the redox reactions of an analogous complex, [(μ-SCH2)2N(CH2C6H5){Fe(CO)2(PMe3)}2] (7), were also investigated by in situ IR spectroscopy in the absence or presence of extrinsic PPh3, which has no influence on the oxidation reaction of 7. The pendant phosphine in the second coordination sphere makes the redox reaction of 2 different from that of its analogue 7.

Youth services in Ethiopia.

PubMed

Meredith, P

1990-12-01

Departing from the usual family planning education format in teenage counseling, the IPPF is funding youth centers providing contraception as well as education in Ethiopia, Kenya, Togo, Tunisia, and Turkey. The development concern is for a cost efficient and effective center with minimal criticism. 2 experimental Mexican models were used in the Ethiopian youth centers. Both models utilize young adult coordinators who supervise young promoters, however each operates differently. Mexican staff trained their African counterparts and a detailed project manual will be available soon. The Ethiopian youth centers utilizing NGO's and the private sector have been permitted freedom from central control. Alarming statistics include: 20.8% of pregnancies are teenaged; 20.8% of hospital reported abortions are teenaged; the contraceptive prevalence rate is 2%; population increased by 3% per year with the average children per woman of 7.5. Addis Ababa's youth project provides services to mostly zone 5 school aged adolescents who are informed and eager to purchase condoms, although they are not able to purchase them commercially. Revolutionary Ethiopian Youth Association (REYA) with its 200,000 membership, is increasing its contribution to expanding the network of promoters. Promoters are used to register those receiving free condoms, but the recommendation to cease this practice of registration is in, and replace it with the sale of 50 US cents per condom.

A coordination theory for intelligent machines

NASA Technical Reports Server (NTRS)

Wang, Fei-Yue; Saridis, George N.

1990-01-01

A formal model for the coordination level of intelligent machines is established. The framework of the coordination level investigated consists of one dispatcher and a number of coordinators. The model called coordination structure has been used to describe analytically the information structure and information flow for the coordination activities in the coordination level. Specifically, the coordination structure offers a formalism to (1) describe the task translation of the dispatcher and coordinators; (2) represent the individual process within the dispatcher and coordinators; (3) specify the cooperation and connection among the dispatcher and coordinators; (4) perform the process analysis and evaluation; and (5) provide a control and communication mechanism for the real-time monitor or simulation of the coordination process. A simple procedure for the task scheduling in the coordination structure is presented. The task translation is achieved by a stochastic learning algorithm. The learning process is measured with entropy and its convergence is guaranteed. Finally, a case study of the coordination structure with three coordinators and one dispatcher for a simple intelligent manipulator system illustrates the proposed model and the simulation of the task processes performed on the model verifies the soundness of the theory.

Research Nurse | Center for Cancer Research

Cancer.gov

We are looking for a Research Nurse (Accrual Site Coordinator) to join our neuro-oncology clinical team to help us provide administrative and coordination support for the Brain Tumor Trials Collaborative (BTTC). Duties include, but are not limited to, monitoring and overseeing activities pertaining to clinical protocols and administrative operations supporting the BTTC, with

42 CFR 431.625 - Coordination of Medicaid with Medicare part B.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-living increases under title II of the Act; (iv) Beneficiaries of foster care maintenance payments or... 42 Public Health 4 2012-10-01 2012-10-01 false Coordination of Medicaid with Medicare part B. 431.625 Section 431.625 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...

42 CFR 431.625 - Coordination of Medicaid with Medicare part B.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Coordination of Medicaid with Medicare part B. 431.625 Section 431.625 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... available in State expenditures for Medicare Part B premiums for Medicaid recipients unless the recipients...

42 CFR 431.625 - Coordination of Medicaid with Medicare part B.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-living increases under title II of the Act; (iv) Beneficiaries of foster care maintenance payments or... 42 Public Health 4 2014-10-01 2014-10-01 false Coordination of Medicaid with Medicare part B. 431.625 Section 431.625 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...

42 CFR 431.625 - Coordination of Medicaid with Medicare part B.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Coordination of Medicaid with Medicare part B. 431.625 Section 431.625 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... available in State expenditures for Medicare Part B premiums for Medicaid recipients unless the recipients...

42 CFR 431.625 - Coordination of Medicaid with Medicare part B.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-living increases under title II of the Act; (iv) Beneficiaries of foster care maintenance payments or... 42 Public Health 4 2013-10-01 2013-10-01 false Coordination of Medicaid with Medicare part B. 431.625 Section 431.625 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...

Partners in Dementia Care: A Care Coordination Intervention for Individuals with Dementia and Their Family Caregivers

ERIC Educational Resources Information Center

Judge, Katherine S.; Bass, David M.; Snow, A. Lynn; Wilson, Nancy L.; Morgan, Robert; Looman, Wendy J.; McCarthy, Catherine; Kunik, Mark E.

2011-01-01

Purpose: This article provides a detailed description of a telephone-based care coordination intervention, Partners in Dementia Care (PDC), for veterans with dementia and their family caregivers. Essential features of PDC included (a) formal partnerships between Veterans Affairs (VA) medical centers and Alzheimer's Association Chapters; (b) a…

42 CFR 431.635 - Coordination of Medicaid with Special Supplemental Food Program for Women, Infants, and Children...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Coordination of Medicaid with Special Supplemental Food Program for Women, Infants, and Children (WIC). 431.635 Section 431.635 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE...

42 CFR 431.635 - Coordination of Medicaid with Special Supplemental Food Program for Women, Infants, and Children...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Coordination of Medicaid with Special Supplemental Food Program for Women, Infants, and Children (WIC). 431.635 Section 431.635 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE...

42 CFR 431.635 - Coordination of Medicaid with Special Supplemental Food Program for Women, Infants, and Children...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Coordination of Medicaid with Special Supplemental Food Program for Women, Infants, and Children (WIC). 431.635 Section 431.635 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE...

42 CFR 422.66 - Coordination of enrollment and disenrollment through MA organizations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... through MA organizations. 422.66 Section 422.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES..., Election, and Enrollment § 422.66 Coordination of enrollment and disenrollment through MA organizations. (a) Enrollment. An individual who wishes to elect an MA plan offered by an MA organization may make or change his...

42 CFR 422.66 - Coordination of enrollment and disenrollment through MA organizations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... through MA organizations. 422.66 Section 422.66 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES..., Election, and Enrollment § 422.66 Coordination of enrollment and disenrollment through MA organizations. (a) Enrollment. An individual who wishes to elect an MA plan offered by an MA organization may make or change his...

78 FR 57264 - Final Waiver and Extension of the Project Period for the Technical Assistance Coordination Center

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-18

...: 84.326Z.] Final Waiver and Extension of the Project Period for the Technical Assistance Coordination... project period. SUMMARY: The Secretary waives the requirements in the Education Department General Administrative Regulations that generally prohibit project periods exceeding five years and extensions of project...

42 CFR 431.636 - Coordination of Medicaid with the Children's Health Insurance Program (CHIP).

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Coordination of Medicaid with the Children's Health Insurance Program (CHIP). 431.636 Section 431.636 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...'s Health Insurance Program (CHIP). (a) Statutory basis. This section implements— (1) Section 2102(b...