Evaluation of best practices in traffic operations and safety : phase I : flashing LED stop sign and optical speed bars.

DOT National Transportation Integrated Search

2007-01-01

In a previous extensive review of overseas literature, researchers identified 42 traffic operations and safety technologies and practices that were not currently deployed in Virginia. These were evaluated for their potential application in Virginia, ...

Nighttime construction: evaluation of construction operations : final report.

DOT National Transportation Integrated Search

2004-05-01

The different aspects that should be considered in making decisions on nighttime construction operations are identified and investigated in light of the current state of knowledge and practice. A state-of-the-art review was conducted of the current p...

Hydrological Forecasting Practices in Brazil

NASA Astrophysics Data System (ADS)

Fan, Fernando; Paiva, Rodrigo; Collischonn, Walter; Ramos, Maria-Helena

2016-04-01

This work brings a review on current hydrological and flood forecasting practices in Brazil, including the main forecasts applications, the different kinds of techniques that are currently being employed and the institutions involved on forecasts generation. A brief overview of Brazil is provided, including aspects related to its geography, climate, hydrology and flood hazards. A general discussion about the Brazilian practices on hydrological short and medium range forecasting is presented. Detailed examples of some hydrological forecasting systems that are operational or in a research/pre-operational phase using the large scale hydrological model MGB-IPH are also presented. Finally, some suggestions are given about how the forecasting practices in Brazil can be understood nowadays, and what are the perspectives for the future.

Combustion and fires in low gravity

NASA Technical Reports Server (NTRS)

Friedman, Robert

1994-01-01

Fire safety always receives priority attention in NASA mission designs and operations, with emphasis on fire prevention and material acceptance standards. Recently, interest in spacecraft fire-safety research and development has increased because improved understanding of the significant differences between low-gravity and normal-gravity combustion suggests that present fire-safety techniques may be inadequate or, at best, non-optimal; and the complex and permanent orbital operations in Space Station Freedom demand a higher level of safety standards and practices. This presentation outlines current practices and problems in fire prevention and detection for spacecraft, specifically the Space Station Freedom's fire protection. Also addressed are current practices and problems in fire extinguishment for spacecraft.

Operations planning and analysis handbook for NASA/MSFC phase B development projects

NASA Technical Reports Server (NTRS)

Batson, Robert C.

1986-01-01

Current operations planning and analysis practices on NASA/MSFC Phase B projects were investigated with the objectives of (1) formalizing these practices into a handbook and (2) suggesting improvements. The study focused on how Science and Engineering (S&E) Operational Personnel support Program Development (PD) Task Teams. The intimate relationship between systems engineering and operations analysis was examined. Methods identified for use by operations analysts during Phase B include functional analysis, interface analysis methods to calculate/allocate such criteria as reliability, Maintainability, and operations and support cost.

Physical and Chemical Implications of Mid-Winter Pumping of Trunda Lakes - North Slope, Alaska

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

Hinzman, Larry D.; Lilly, Michael R.; Kane, Douglas L.

2005-09-30

Tundra lakes on the North Slope, Alaska, are an important resource for energy development and petroleum field operations. A majority of exploration activities, pipeline maintenance, and restoration activities take place on winter ice roads that depend on water availability at key times of the winter operating season. These same lakes provide important fisheries and ecosystem functions. In particular, overwintering habitat for fish is one important management concern. This study focused on the evaluation of winter water use in the current field operating areas to provide a better understanding of the current water use practices. It found that under the currentmore » water use practices, there were no measurable negative effects of winter pumping on the lakes studied and current water use management practices were appropriately conservative. The study did find many areas where improvements in the understanding of tundra lake hydrology and water usage would benefit industry, management agencies, and the protection of fisheries and ecosystems.« less

Investigating influences on current community pharmacy practice at micro, meso, and macro levels.

PubMed

Hermansyah, Andi; Sainsbury, Erica; Krass, Ines

The nature of Australian community pharmacy is continually evolving, raising the need to explore the current situation in order to understand the potential impact of any changes. Although community pharmacy has the potential to play a greater role in health care, it is currently not meeting this potential. To investigate the nature of the contemporary practice of community pharmacy in Australia and examine the potential missed opportunities for role expansion in health care. In-depth semi-structured interviews with a wide-range of key stakeholders within and beyond community pharmacy circles were conducted. Interviews were audio-recorded, transcribed verbatim and analyzed for emerging themes. Twenty-seven key informants across Eastern half of Australia were interviewed between December 2014 and August 2015. Several key elements of the current situation representing the social, economic and policy context of community pharmacy have been identified. These elements operate interdependently, influence micro, meso and macro levels of community pharmacy operation and are changing in the current climate. Community pharmacy has untapped potential in primary health care, but it has been slow to change to meet opportunities available in the current situation. As the current situation is complex, interrelated and dynamic with often unintended and unpredictable consequences, this paper suggests that policy makers to consider the micro, meso and macro levels of community pharmacy operation when making significant policy changes. The framework proposed in this study can be a helpful tool to analyze the processes operating at these three levels and their influences on practice. Copyright © 2016 Elsevier Inc. All rights reserved.

The Second Joint NASA/FAA/DOD Conference on Aging Aircraft. Pt. 1

NASA Technical Reports Server (NTRS)

Harris, Charles E. (Editor)

1999-01-01

The purpose of the Conference was to bring together world leaders in aviation safety research, aircraft design and manufacturing, fleet operation and aviation maintenance to disseminate information on current practices and advanced technologies that will assure the continued airworthiness of the aging aircraft in the military and commercial fleets. The Conference included reviews of current industry practices, assessments of future technology requirements, and status of aviation safety research. The Conference provided an opportunity for interactions among the key personnel in the research and technology development community, the original equipment manufacturers, commercial airline operators, military fleet operators, aviation maintenance, and aircraft certification and regulatory authorities. Conference participation was unrestricted and open to the international aviation community.

Perioperative management of trauma patients admitted on clopidogrel (Plavix). A survey of orthopaedic departments across the United Kingdom.

PubMed

Inman, Dominic S; Michla, Yusuf; Partington, Paul F

2007-05-01

Clopidogrel (Plavix) is an anti-platelet drug recommended as lifelong treatment by NICE for all patients following stroke, MI, and peripheral vascular disease. It is also indicated for short-term use following cardiac stent insertion. It irreversibly inhibits platelets for up to 7 days. Current recommendations are to stop treatment 7 days before elective surgery. Current evidence shows that delay to surgery more than 4 days in patients with hip fractures increases postoperative mortality. To determine current practice of orthopaedic surgeons in their management of patients taking clopidogrel admitted following a hip fracture to trauma units in the UK with respect to its peri-operative withdrawal and subsequent timing of surgery. To perform a review of the available literature and produce a suggested protocol for the peri-operative management of this rapidly increasing cohort of patients. National postal survey. Orthopaedic consultants representing each unit receiving trauma patients in the United Kingdom. There was a 57% response rate (139/244 UK trauma units). 41% (56) stop clopidogrel and operate immediately, 11% (15) stop clopidogrel for between 5 and 10 days pre-operatively, 10% (14) stop clopidogrel for 10 days preoperatively, 19% (26) continue clopidogrel and operate immediately, 19% (26) have another protocol. 15% (20) have written departmental guidelines. 2%(3) quoted published evidence for their practice. This study demonstrates that there are a wide variety of practices, largely based on anecdotal evidence. Most units (85%) have no formal guidelines. There is evidence in the cardiac literature of increased intra-operative bleeding in patients operated on while taking clopidogrel. There is likely to be an exponential rise in such patients presenting to trauma units and further research is required to guide best practice. Following review of the literature we propose an interim protocol for the withdrawal and resumption of clopidogrel peri-operatively in patients with hip fractures.

Freeway management and operations handbook

DOT National Transportation Integrated Search

1995-02-01

This paper: (1) describes current logistics practices as they are affected by truck size and weight limits; (2) examines how changes in truck size and weight limits might affect logistics practices; and (3) where possible, identifies research needed ...

The genesis of neurosurgery and the evolution of the neurosurgical operative environment: part I-prehistory to 2003.

PubMed

Liu, Charles Y; Apuzzo, Michael L J

2003-01-01

Despite its singular importance, little attention has been given to the neurosurgical operative environment in the scientific and medical literature. This article focuses attention on the development of neurosurgery and the parallel emergence of its operative setting. The operative environment has, to a large extent, defined the "state of the art and science" of neurosurgery, which is now undergoing rapid reinvention. During the course of its initial invention, major milestones in the development of neurosurgery have included the definition of anatomy, consolidation of a scientific basis, and incorporation of the practicalities of anesthesia and antisepsis and later operative technical adjuvants for further refinement of action and minimalism. The progress, previously long and laborious in emergence, is currently undergoing rapid evolution. Throughout its evolution, the discipline has assimilated the most effective tools of modernity into the operative environment, leading eventually to the entity known as the operating room. In the decades leading to the present, progressive minimalization of manipulation and the emergence of more refined operative definition with increasing precision are evident, with concurrent miniaturization of attendant computerized support systems, sensors, robotic interfaces, and imaging devices. These developments over time have led to the invention of neurosurgery and the establishment of the current state-of-the-art neurosurgical operating room as we understand it, and indeed, to a broader definition of the entity itself. To remain current, each neurosurgeon should periodically reconsider his or her personal operative environment and its functional design with reference to modernity of practice as currently defined.

Night-time road construction operations synthesis of practice.

DOT National Transportation Integrated Search

2008-05-01

report synthesizes existing literature on nighttime construction operations, identifies gaps in the current state of knowledge, and summarizes research in progress studies that are planned or underway. The literature review and synthesis found the fo...

Support surfaces for intraoperative prevention of pressure ulcers in patients undergoing surgery: a cost-effectiveness analysis.

PubMed

Pham, Ba'; Teague, Laura; Mahoney, James; Goodman, Laurie; Paulden, Mike; Poss, Jeff; Li, Jianli; Sikich, Nancy Joan; Lourenco, Rosemarie; Ieraci, Luciano; Carcone, Steven; Krahn, Murray

2011-07-01

Patients who undergo prolonged surgical procedures are at risk of developing pressure ulcers. Recent systematic reviews suggest that pressure redistribution overlays on operating tables significantly decrease the associated risk. Little is known about the cost effectiveness of using these overlays in a prevention program for surgical patients. Using a Markov cohort model, we evaluated the cost effectiveness of an intraoperative prevention strategy with operating table overlays made of dry, viscoelastic polymer from the perspective of a health care payer over a 1-year period. We simulated patients undergoing scheduled surgical procedures lasting ≥90 min in the supine or lithotomy position. Compared with the current practice of using standard mattresses on operating tables, the intraoperative prevention strategy decreased the estimated intraoperative incidence of pressure ulcers by 0.51%, corresponding to a number-needed-to-treat of 196 patients. The average cost of using the operating table overlay was $1.66 per patient. Compared with current practice, this intraoperative prevention strategy would increase slightly the quality-adjusted life days of patients and by decreasing the incidence of pressure ulcers, this strategy would decrease both hospital and home care costs for treating fewer pressure ulcers originated intraoperatively. The cost savings was $46 per patient, which ranged from $13 to $116 by different surgical populations. Intraoperative prevention was 99% likely to be more cost effective than the current practice. In patients who undergo scheduled surgical procedures lasting ≥90 min, this intraoperative prevention strategy could improve patients' health and save hospital costs. The clinical and economic evidence support the implementation of this prevention strategy in settings where it has yet to become current practice. Copyright © 2011 Mosby, Inc. All rights reserved.

The Second Joint NASA/FAA/DoD Conference on Aging Aircraft. Part 2

NASA Technical Reports Server (NTRS)

Harris, Charles E. (Editor)

1999-01-01

The purpose of the Conference was to bring together world leaders in aviation safety research, aircraft design and manufacturing, fleet operation and aviation maintenance to disseminate information on current practices and advanced technologies that will assure the continued airworthiness of the aging aircraft in the military and commercial fleets. The Conference included reviews of current industry practices, assessments of future technology requirements, and status of aviation safety research. The Conference provided an opportunity for interactions among the key personnel in the research and technology development community, the original equipment manufacturers, commercial airline operators, military fleet operators, aviation maintenance, and aircraft certification and regulatory authorities. Conference participation was unrestricted and open to the international aviation community. Appendix B contains the name and addresses of the 623 participants in the Conference.

Preliminary Report on Mission Design and Operations for Critical Events

NASA Technical Reports Server (NTRS)

Hayden, Sandra C.; Tumer, Irem

2005-01-01

Mission-critical events are defined in the Jet Propulsion Laboratory s Flight Project Practices as those sequences of events which must succeed in order to attain mission goals. These are dependent on the particular operational concept and design reference mission, and are especially important when committing to irreversible events. Critical events include main engine cutoff (MECO) after launch; engine cutoff or parachute deployment on entry, descent, and landing (EDL); orbital insertion; separation of payload from vehicle or separation of booster segments; maintenance of pointing accuracy for power and communication; and deployment of solar arrays and communication antennas. The purpose of this paper is to report on the current practices in handling mission-critical events in design and operations at major NASA spaceflight centers. The scope of this report includes NASA Johnson Space Center (JSC), NASA Goddard Space Flight Center (GSFC), and NASA Jet Propulsion Laboratory (JPL), with staff at each center consulted on their current practices, processes, and procedures.

The Effects of the Reverse Current Caused by the Series Compensation on the Current Differential Protection

PubMed Central

Tang, Cui; Yin, Xianggen; Qi, Xuanwei; Zhang, Zhe

2014-01-01

The series capacitor compensation is one of the key technologies in the EHV and UHV long distance power transmission lines. This paper analyzes the operation characteristics of the main protection combined with the engineering practice when the transmission line overcompensation due to the series compensation system is modified and analyzes the influence of the transition resistance and the system operation mode on the current differential protection. According to the simulation results, it presents countermeasure on improving the sensitivity of differential current protection. PMID:25247206

A review of the International Atomic Energy Agency (IAEA) international standards for tissue banks.

PubMed

Morales Pedraza, Jorge; Lobo Gajiwala, Astrid; Martinez Pardo, María Esther

2012-03-01

The IAEA International Standards for Tissue Banks published in 2003 were based on the Standards then currently in use in the USA and the European Union, among others, and reflect the best practices associated with the operation of a tissue bank. They cover legal, ethical and regulatory controls as well as requirements and procedures from donor selection and tissue retrieval to processing and distribution of finished tissue for clinical use. The application of these standards allows tissue banks to operate with the current good tissue practice, thereby providing grafts of high quality that satisfy the national and international demand for safe and biologically useful grafts. The objective of this article is to review the IAEA Standards and recommend new topics that could improve the current version.

Pre-operative patient teaching in an acute care ward in Hong Kong: a case study.

PubMed

Lee, David S; Chien, W T

2002-10-01

Many nurses have acknowledged that adequate pre-operative teaching can alleviate patients' anxiety, increase patient participation in their own care, and minimize post-operative complications. However, the organization and degree to which pre-operative patient teachingfeatured in nurses' practice varies in different acute care settings. A case study design was used to explore the practice of pre-operative teaching in a surgical ward of an acute general hospital in Hong Kong. Seventeen registered nurses working on the ward were interviewed and observed in order to explore how they conduct a pre-operative teaching program and the difficulties encountered by them in carrying out pre-operative teaching on this acute care setting. Thefindings of this study indicate that pre-operative teaching workshops are organized and conducted by nursesfrom the operating theatre, in the day surgery center. Ward nurses were not actively involved in this pre-operative teaching. The results of this study present some similarities to a study with the similar design in Australia. There are also issues unique to the Hong Kong context. This case study was to review Hong Kong nurses' current practices of pre-operative teaching and to understand the cultural, conceptual and managementfactors influencing the practice in pre-operative teaching.

The RICORDO approach to semantic interoperability for biomedical data and models: strategy, standards and solutions

PubMed Central

2011-01-01

Background The practice and research of medicine generates considerable quantities of data and model resources (DMRs). Although in principle biomedical resources are re-usable, in practice few can currently be shared. In particular, the clinical communities in physiology and pharmacology research, as well as medical education, (i.e. PPME communities) are facing considerable operational and technical obstacles in sharing data and models. Findings We outline the efforts of the PPME communities to achieve automated semantic interoperability for clinical resource documentation in collaboration with the RICORDO project. Current community practices in resource documentation and knowledge management are overviewed. Furthermore, requirements and improvements sought by the PPME communities to current documentation practices are discussed. The RICORDO plan and effort in creating a representational framework and associated open software toolkit for the automated management of PPME metadata resources is also described. Conclusions RICORDO is providing the PPME community with tools to effect, share and reason over clinical resource annotations. This work is contributing to the semantic interoperability of DMRs through ontology-based annotation by (i) supporting more effective navigation and re-use of clinical DMRs, as well as (ii) sustaining interoperability operations based on the criterion of biological similarity. Operations facilitated by RICORDO will range from automated dataset matching to model merging and managing complex simulation workflows. In effect, RICORDO is contributing to community standards for resource sharing and interoperability. PMID:21878109

Stormwater quality management in rail transportation--past, present and future.

PubMed

Vo, Phuong Tram; Ngo, Huu Hao; Guo, Wenshan; Zhou, John L; Listowski, Andrzej; Du, Bin; Wei, Qin; Bui, Xuan Thanh

2015-04-15

Railways currently play an important role in sustainable transportation systems, owing to their substantial carrying capacity, environmental friendliness and land-saving advantages. Although total pollutant emissions from railway systems are far less than that of automobile vehicles, the pollution from railway operations should not be underestimated. To date, both scientific and practical papers dealing with stormwater management for rail tracks have solely focused on its drainage function. Unlike roadway transport, the potential of stormwater pollution from railway operations is currently mishandled. There have been very few studies into the impact of its operations on water quality. Hence, upon the realisation on the significance of nonpoint source pollution, stormwater management priorities should have been re-evaluated. This paper provides an examination of past and current practices of stormwater management in the railway industry, potential sources of stormwater pollution, obstacles faced in stormwater management and concludes with strategies for future management directions. Copyright © 2015 Elsevier B.V. All rights reserved.

Assessment of training capacity in New Zealand general practices: a stocktake in the lower North Island and South Island.

PubMed

Murton, Samantha A; Pullon, Susan Rh

2017-09-22

General practices are providing clinically-based training for rapidly increasing numbers of medical (and other health professional) trainees. This study investigated capacity and intention of general practices to additionally teach junior doctors (now required to undertake community-based attachments by the New Zealand Medical Council) alongside current trainees in their service. A web-based/telephone survey of all general practices was developed and administered November 2015-April 2016. In the Otago study region (lower North Island, South Island), 463 currently operating practices were identified. (A companion Auckland-based study concurrently investigated the upper North Island.) Of the 280/463 (60%) responding practices, 93% (261/280) were currently taking health professional trainees, with 86% (241/280) taking at least one type of medical trainee. Practices indicate that 14% fewer of them will take undergraduate medical students than previously (199 practices down to 162), but more would take junior doctors (42 up to 79) and GP registrars (129 practices up to 142). Most practices in these regions already contribute to teaching. Practices indicated limitations in accommodating continued increases in numbers of trainees in the current poorly coordinated system. Improved support and training for practices is needed to enable practices to take more trainees of multiple types per practice, both concurrently and sequentially.

A comparative analysis of the dissemination of best practice measures for key populations.

PubMed

Lundy, Jennifer; Santangelo, Jennifer; Rogers, Patrick; Kuehn, Lynn; Christensen, Sharon; Bournique, Judy; Mekhjian, Hagop; Kamal, Jyoti

2008-11-06

In collaboration with the department of Quality and Operations Improvement, Clinical Applications and the Information Warehouse, we have leveraged available Information Warehouse data to build a Best Practice Compliance Measurement Dashboard. This tool combines information from our operating room charting system, our order entry system and coding information from the patient billing and management system to provide 'previous day', data on a patients current course of treatment.

Criteria for extending the operation periods of thermoelectric converters based on IV-VI compounds

NASA Astrophysics Data System (ADS)

Sadia, Yatir; Ohaion-Raz, Tsion; Ben-Yehuda, Ohad; Korngold, Meidad; Gelbstein, Yaniv

2016-09-01

The recent energy demands affected by the dilution of conventional energy resources and the growing awareness of environmental considerations, had positioned the research of renewable energy conversion methods in general and of thermoelectric direct conversion of thermal into electrical energies in particular, in the forefront of the currently active applicative sciences. IV-VI thermoelectric compounds (e.g. GeTe, PbTe and SnTe) and their alloys comprise some of the most efficient thermoelectric compositions ever reported. Yet a proper utilization of such materials in practical thermoelectric devices, still requires an overcoming the so-called technological "valley of death", including among others, transport properties' degradation, due to sublimation of volatile Te rich species, while being subjected to elevated temperatures for long periods of time. In an attempt to establish practical operation criteria for extending the operation periods of such thermoelectric converters, it is currently shown based on thermal gravimetric and metallurgical considerations that such harmful sublimation can be practically bridged over by limiting the maximal operating temperatures to the 410-430 °C range for GeTe rich alloys and to 510-530 °C for PbTe and SnTe rich alloys, depending of the thermoelectric leg's diameter.

Review article: practical current issues in perioperative patient safety.

PubMed

Eichhorn, John H

2013-02-01

This brief review provides an overview and, importantly, a context perspective of relevant current practical issues in perioperative patient safety. The dramatic improvement in anesthesia patient safety over the last 30 years was not initiated by electronic monitors but, rather, largely by a set of behaviours known as "safety monitoring" that were then made decidedly more effective by extending the human senses through electronic monitoring, for example, capnography and pulse oximetry. In the highly developed world, this current success is threatened by complacency and production pressure. In some areas of the developing/underdeveloped world, the challenge is implementing the components of anesthesia practice that will bring safety improvements to parallel the overall current success, for instance, applying the World Federation of Societies of Anaesthesiologists (WFSA) "International Standards for A Safe Practice of Anaesthesia". Generally, expanding the current success in safety involves many practical issues. System issues involve research, effective reporting mechanisms and analysis/broadcasting of results, perioperative communication (including "speaking up to power"), and checklists. Monitoring issues involve enforcing existing published monitoring standards and also recognizing the risk of danger to the patient from hypoventilation during procedural sedation and from postoperative intravenous pain medications. Issues of clinical care include medication errors in the operating room, cerebral hypoperfusion (especially in the head-up position), dangers of airway management, postoperative residual weakness from muscle relaxants, operating room fires, and risks specific in obstetric anesthesia. Recognition of the issues outlined here and empowerment of all anesthesia professionals, from the most senior professors and administrators to the newest practitioners, should help maintain, solidify, and expand the improvements in anesthesia and perioperative patient safety.

The Business Practices Course: Self-Study Learning Reengineered.

ERIC Educational Resources Information Center

Acovelli, Marianne; Nowakowski, Alan

1994-01-01

Describes an interactive multimedia Business Practices Course, developed to help reengineer point-of-need training for professional development, in which the learner conducts a business review of a company's current operations and makes recommendations to improve productivity and increase customer satisfaction. (six references) (LRW)

Analysis of environmental constraints on expanding reserves in current and future reservoirs in wetlands. Final report

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

Harder, B.J.

1995-03-01

Louisiana wetlands require careful management to allow exploitation of non-renewable resources without destroying renewable resources. Current regulatory requirements have been moderately successful in meeting this goal by restricting development in wetland habitats. Continuing public emphasis on reducing environmental impacts of resource development is causing regulators to reassess their regulations and operators to rethink their compliance strategies. We examined the regulatory system and found that reducing the number of applications required by going to a single application process and having a coherent map of the steps required for operations in wetland areas would reduce regulatory burdens. Incremental changes can be mademore » to regulations to allow one agency to be the lead for wetland permitting at minimal cost to operators. Operators need cost effective means of access that will reduce environmental impacts, decrease permitting time, and limit future liability. Regulators and industry must partner to develop incentive based regulations that can provide significant environmental impact reduction for minimal economic cost. In addition regulators need forecasts of future E&P trends to estimate the impact of future regulations. To determine future activity we attempted to survey potential operators when this approach was unsuccessful we created two econometric models of north and south Louisiana relating drilling activity, success ratio, and price to predict future wetland activity. Results of the econometric models indicate that environmental regulations have a small but statistically significant effect on drilling operations in wetland areas of Louisiana. We examined current wetland practices and evaluated those practices comparing environmental versus economic costs and created a method for ranking the practices.« less

Overview of practice management in child and adolescent psychiatry.

PubMed

Schreter, Robert K

2010-01-01

The manager of a psychiatric practice must create and direct a clinical delivery system, design and oversee the administrative services necessary to support the system, and guide the business operations that contribute to its success. Regardless of the size of the practice, the psychiatrist administrator must handle seven core administrative responsibilities and oversee individual functions and capabilities within each domain. These responsibilities include practice development, clinical services management, medical office operations, clinical management, information management, business management, and risk management. This article provides a roadmap for creating and sustaining successful clinical and administrative endeavors. It can also be used by existing practices as an audit instrument to provide a snapshot of current capabilities so that strengths as well as opportunities for continued growth can be identified.

Actual vs perceived performance debriefing in surgery: practice far from perfect.

PubMed

Ahmed, Maria; Sevdalis, Nick; Vincent, Charles; Arora, Sonal

2013-04-01

Performance feedback or debriefing in surgery is increasingly recognized as an essential means to optimize learning in the operating room (OR). However, there is a lack of evidence regarding the current practice and barriers to debriefing in the OR. Phase 1 consisted of semistructured interviews with surgical trainers and trainees to identify features of an effective debriefing and perceived barriers to debriefing. Phase 2 consisted of ethnographic observations of surgical cases to identify current practice and observed barriers to debriefing. Surgical trainers and trainees identified key features of effective debriefing with regard to the approach and content; however, these were not commonly identified in practice. Culture was recognized as a significant barrier to debriefing across both phases of the study. There is a disparity between what the surgical community views as effective debriefing and actual debriefing practices in the OR. Improvements to the current debriefing culture and practice within the field of surgery should be considered to facilitate learning from clinical practice. Copyright © 2013. Published by Elsevier Inc.

Mission operations management

NASA Technical Reports Server (NTRS)

Rocco, David A.

1994-01-01

Redefining the approach and philosophy that operations management uses to define, develop, and implement space missions will be a central element in achieving high efficiency mission operations for the future. The goal of a cost effective space operations program cannot be realized if the attitudes and methodologies we currently employ to plan, develop, and manage space missions do not change. A management philosophy that is in synch with the environment in terms of budget, technology, and science objectives must be developed. Changing our basic perception of mission operations will require a shift in the way we view the mission. This requires a transition from current practices of viewing the mission as a unique end product, to a 'mission development concept' built on the visualization of the end-to-end mission. To achieve this change we must define realistic mission success criteria and develop pragmatic approaches to achieve our goals. Custom mission development for all but the largest and most unique programs is not practical in the current budget environment, and we simply do not have the resources to implement all of our planned science programs. We need to shift our management focus to allow us the opportunity make use of methodologies and approaches which are based on common building blocks that can be utilized in the space, ground, and mission unique segments of all missions.

21 CFR 211.130 - Packaging and labeling operations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Packaging and Labeling Control § 211.130 Packaging and labeling operations. There shall be written procedures designed to... manufacture and control of the batch. (d) Examination of packaging and labeling materials for suitability and...

Evaluation of Project Processes in Relation to Transportation System Management and Operations (TSM&O)

DOT National Transportation Integrated Search

2018-01-01

This study was conducted to explore the current state-of-the-practice of Transportation Systems Management and Operations (TSM&O) in the Florida Department of Transportation (FDOT) and determine what would be required to mainstream TSM&O throughout t...

Succession planning.

PubMed

Catanzaro, Thomas E

2006-03-01

This article provides the reader with an appreciation of the diverse elements that go into a buy-sell, affiliation, or merger situation for veterinary practices. In the changing market place of American veterinary medicine, old paradigms no longer hold comfort. The generational differences are briefly explored herein as well as the new economic realities. A few examples are offered to illustrate just how much variability exists in the current business of veterinary medicine and the subsequent practice transitions needed to enhance value. Functioning models are explored, as well as affiliation and merger options. Practice valuation is discussed in general terms, referencing the cutting-edge factors. The six-point summary provides almost all practices a solid operational base for daily operations and succession planning.

Physiotherapy in upper abdominal surgery - what is current practice in Australia?

PubMed

Patman, Shane; Bartley, Alice; Ferraz, Allex; Bunting, Cath

2017-01-01

Upper abdominal surgery (UAS) has the potential to cause post-operative pulmonary complications (PPCs). In the absence of high-quality research regarding post-operative physiotherapy management, consensus-based best practice guidelines formulated by Hanekom et al. (2012) are available to clinicians providing recommendations for post-UAS treatment. Such best practice guidelines have recommended that physiotherapists should be using early mobilisation and respiratory intervention to minimise risk of PPCs. However, recent evidence supports the implementation of mobilisation as a standalone treatment in PPC prevention, though the diversity in literature poses questions regarding ideal current practice. This project aimed to document and report the assessment measures and interventions physiotherapists are utilising following UAS, establishing whether current management is reflective of best practice guidelines and recent evidence. An online survey was completed by 57 experienced Australian physiotherapists working with patients following UAS (35% survey response rate, 63% completion rate). On day one following UAS, when a patient's condition is not medically limited, most physiotherapists routinely mobilise. Additionally, routine chest treatment continues to be implemented, with only 23% ( n  = 11/47) of physiotherapists mobilising patients without accompanying specific respiratory intervention. Variability of screening tools used to identify post-operative patients at high risk of PPC development was evident. Patient-dependent factors such as 'fatigue' and 'non-compliance' were among those identified as barriers to treatment, all influencing the commencement of treatment. Physiotherapists indicated that early mobilisation away from the bedside was the preferred post-operative treatment within the UAS patient population. Many continue to perform routine respiratory interventions despite recent literature suggesting it may provide no additional benefit to preventing PPCs. Current intervention choice is reflective of guidelines [1], however, recent literature has called this into question and more research needs to be done to establish if these recommendations are the most effective at reducing PPCs. Continued research is necessary to promote translation of knowledge to ensure physiotherapists are mobilising patients day one post-UAS. Likewise, future work should focus on identification of barriers, the strategies used to overcome limitations and the creation of a reliable and validated screening tool to ensure appropriate prioritisation and allocation of physiotherapy resources within the UAS patient population.

Real-time observations of lithium battery reactions-operando neutron diffraction analysis during practical operation.

PubMed

Taminato, Sou; Yonemura, Masao; Shiotani, Shinya; Kamiyama, Takashi; Torii, Shuki; Nagao, Miki; Ishikawa, Yoshihisa; Mori, Kazuhiro; Fukunaga, Toshiharu; Onodera, Yohei; Naka, Takahiro; Morishima, Makoto; Ukyo, Yoshio; Adipranoto, Dyah Sulistyanintyas; Arai, Hajime; Uchimoto, Yoshiharu; Ogumi, Zempachi; Suzuki, Kota; Hirayama, Masaaki; Kanno, Ryoji

2016-06-30

Among the energy storage devices for applications in electric vehicles and stationary uses, lithium batteries typically deliver high performance. However, there is still a missing link between the engineering developments for large-scale batteries and the fundamental science of each battery component. Elucidating reaction mechanisms under practical operation is crucial for future battery technology. Here, we report an operando diffraction technique that uses high-intensity neutrons to detect reactions in non-equilibrium states driven by high-current operation in commercial 18650 cells. The experimental system comprising a time-of-flight diffractometer with automated Rietveld analysis was developed to collect and analyse diffraction data produced by sequential charge and discharge processes. Furthermore, observations under high current drain revealed inhomogeneous reactions, a structural relaxation after discharge, and a shift in the lithium concentration ranges with cycling in the electrode matrix. The technique provides valuable information required for the development of advanced batteries.

Real-time observations of lithium battery reactions—operando neutron diffraction analysis during practical operation

PubMed Central

Taminato, Sou; Yonemura, Masao; Shiotani, Shinya; Kamiyama, Takashi; Torii, Shuki; Nagao, Miki; Ishikawa, Yoshihisa; Mori, Kazuhiro; Fukunaga, Toshiharu; Onodera, Yohei; Naka, Takahiro; Morishima, Makoto; Ukyo, Yoshio; Adipranoto, Dyah Sulistyanintyas; Arai, Hajime; Uchimoto, Yoshiharu; Ogumi, Zempachi; Suzuki, Kota; Hirayama, Masaaki; Kanno, Ryoji

2016-01-01

Among the energy storage devices for applications in electric vehicles and stationary uses, lithium batteries typically deliver high performance. However, there is still a missing link between the engineering developments for large-scale batteries and the fundamental science of each battery component. Elucidating reaction mechanisms under practical operation is crucial for future battery technology. Here, we report an operando diffraction technique that uses high-intensity neutrons to detect reactions in non-equilibrium states driven by high-current operation in commercial 18650 cells. The experimental system comprising a time-of-flight diffractometer with automated Rietveld analysis was developed to collect and analyse diffraction data produced by sequential charge and discharge processes. Furthermore, observations under high current drain revealed inhomogeneous reactions, a structural relaxation after discharge, and a shift in the lithium concentration ranges with cycling in the electrode matrix. The technique provides valuable information required for the development of advanced batteries. PMID:27357605

Current good manufacturing practice in manufacturing, packaging, labeling, or holding operations for dietary supplements. Final rule.

PubMed

2007-06-25

The Food and Drug Administration (FDA) is issuing a final rule regarding current good manufacturing practice (CGMP) for dietary supplements. The final rule establishes the minimum CGMPs necessary for activities related to manufacturing, packaging, labeling, or holding dietary supplements to ensure the quality of the dietary supplement. The final rule is one of many actions related to dietary supplements that we are taking to promote and protect the public health.

Improvements in safety and recovery following cystectomy: reassessing the role of pre-operative bowel preparation and interventions to speed return of post-operative bowel function.

PubMed

Zaid, Harras B; Kaffenberger, Samuel D; Chang, Sam S

2013-04-01

For radical cystectomy, historical practice trends have favored the use of preoperative bowel preparations to reduce complications, including surgical site infections, ileus, and anastomotic leaks. However, emerging data has questioned this practice. Postoperative cystectomy care also remains in flux, as new pharmacologic agents that may potentiate earlier return of bowel function are studied. We review the current literature with regards to preoperative and postoperative cystectomy bowel management.

Mission Success and Environmental Protection: Orbital Debris Considerations

NASA Technical Reports Server (NTRS)

Johnson, Nicholas

2007-01-01

The current U.S. National Space Policy specifically calls on U.S. Government entities "to follow the United States Government Orbital Debris Mitigation Standard Practices, consistent with mission requirements and cost effectiveness, in the procurement and operation of spacecraft, launch services, and the operation of tests and experiments in space. Early assessment (pre-PDR) of orbital debris mitigation compliance is essential to minimize development impacts. Orbital debris mitigation practices today are the most effective means to protect the near-Earth space environment for future missions.

21 CFR 129.1 - Current good manufacturing practice.

Code of Federal Regulations, 2011 CFR

2011-04-01

... drinking water are in conformance with or are operated or administered in conformity with good manufacturing practice to assure that bottled drinking water is safe and that it has been processed, bottled...) FOOD FOR HUMAN CONSUMPTION PROCESSING AND BOTTLING OF BOTTLED DRINKING WATER General Provisions § 129.1...

An Examination of Safety and Health Practices in Agricultural Mechanics Education

ERIC Educational Resources Information Center

Threeton, Mark D.; Ewing, John C.

2017-01-01

Providing training of safe operations and behaviors in Agricultural Mechanics classrooms and laboratories is an important aspect of the agricultural education teaching and learning environment. The purpose of this survey research study was to examine current occupational safety and health practices within agricultural mechanics programs. The…

Building a Foundation on Sand: The Demise of Leaders Resulting from Toxic Followership

DTIC Science & Technology

2016-05-26

Toxic Followers, Prototype Theory, Mission Command, Operational Art , McClellan, Johnston, MacArthur, Powell, 16. SECURITY CLASSIFICATION OF: a. REPORT...structured and more vague problems. Using mission command throughout the Army facilitates leaders practicing operational art .2 Current US joint doctrine...defines operational art as the “use of creative thinking by commanders and staffs to design strategies, campaigns, and major operations and organize

Alertness management in flight operations - Strategic napping

NASA Technical Reports Server (NTRS)

Rosekind, Mark R.; Gander, Philippa H.; Dinges, David F.

1991-01-01

Strategic napping in two different flight operation environments is considered to illustrate its application as a fatigue countermeasure. Data obtained from commercial short-haul and long-haul operations demonstrated the utility and current practices of strategic napping. A preplanned cockpit nap acted as an acute 'safety valve' for the sleep loss, circadian disruption, and fatigue that occurs in long-haul flying.

Development of a National Item Bank for Tests of Driving Knowledge.

ERIC Educational Resources Information Center

Pollock, William T.; McDole, Thomas L.

Materials intended for driving knowledge test development use by operational licensing and education agencies were prepared. Candidate test items were developed, using literature and operational practice sources, to reflect current state-of-knowledge with respect to principles of safe, efficient driving, to legal regulations, and to traffic…

Orbital transfer vehicle launch operations study. Processing flows. Volume 3

NASA Technical Reports Server (NTRS)

1986-01-01

The Orbit Transfer Vehicle (OTV) processing flow and Resource Identification Sheets (RISs) for the ground based orbit transfer vehicle and for the space based orbit transfer vehicle are the primary source of information for the rest of the Kennedy Space Center (KSC) OTV Launch Operations Study. Work is presented which identifies KSC facility requirements for the OTV Program, simplifies or automates either flow though the application technology, revises test practices and identifies crew sizes or skills used. These flows were used as the primary point of departure from current operations and practices. Analyses results were documented by revising the appropriate RIS page.

Considering the health care entity C corporation conversion to tax pass-through entity status.

PubMed

Reilly, Robert F

2012-01-01

The double taxation of C corporation income from operations and from the ultimate sale of its assets makes the C corporation an inefficient tax status for many health care entities. At the time of this writing, the changes in the federal tax law that are scheduled to take effect in 2013 will increase this level of double-taxation inefficiency. The owners of a C corporation practice can avoid the C corporation status tax inefficiency by converting the practice to either (1) S corporation status or (2) LLC status. The conversion of the health care C corporation to an S corporation may be accomplished without a current tax cost. However, the conversion of a health care C corporation to an LLC status can result in a current tax at both the corporation level and the shareholder level. Nonetheless, the current conversion tax cost may be less than the future tax cost (1) of operating the practice as a C corporation and incurring double taxation at what may be higher tax rates or (2) of incurring the higher tax cost (or reduced price) on the ultimate disposition of the practice assets and the attendant double taxation of the appreciation in the value of the practice assets. Since individual income tax rates on qualifying dividends from C corporations and on capital gains are currently at very low rates, this may be a good time for C corporation practice owners to consider the costs and benefits of a conversion to either S corporation status or LLC status. The practice owners should consult with their accounting, legal, and valuation advisors in order to consider all of the costs and benefits of a possible corporate tax status conversion. An estimation of both the costs and benefits of the corporate tax status conversion depends on the concluded fair market values of the medical practice, dental practice, or other health care entity assets. And, that practice asset appraisal should encompass all of the practice assets, both tangible assets and intangible assets.

77 FR 48608 - Reports, Forms, and Record Keeping Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-14

... solving) courts known as DWI Courts and Hybrid DWI/Drug Courts to obtain an inventory of their current operational practices. All known operating DWI Courts and Hybrid DWI/ Drug Courts will be contacted by mail... the United States that are either designated DWI Courts (192) or else Hybrid DWI/Drug Courts (406) as...

Risk-Hedged Approach for Re-Routing Air Traffic Under Weather Uncertainty

NASA Technical Reports Server (NTRS)

Sadovsky, Alexander V.; Bilimoria, Karl D.

2016-01-01

This presentation corresponds to: our paper explores a new risk-hedged approach for re-routing air traffic around forecast convective weather. In this work, flying through a more likely weather instantiation is considered to pose a higher level of risk. Current operational practice strategically plans re-routes to avoid only the most likely (highest risk) weather instantiation, and then tactically makes any necessary adjustments as the weather evolves. The risk-hedged approach strategically plans re-routes by minimizing the risk-adjusted path length, incorporating multiple possible weather instantiations with associated likelihoods (risks). The resulting model is transparent and is readily analyzed for realism and treated with well-understood shortest-path algorithms. Risk-hedged re-routes are computed for some example weather instantiations. The main result is that in some scenarios, relative to an operational-practice proxy solution, the risk-hedged solution provides the benefits of lower risk as well as shorter path length. In other scenarios, the benefits of the risk-hedged solution are ambiguous, because the solution is characterized by a tradeoff between risk and path length. The risk-hedged solution can be executed in those scenarios where it provides a clear benefit over current operational practice.

An operational amplifier B1404UD1A-1 in the patch-clamp current-to-voltage converter.

PubMed

Korzun, A M; Rozinov, S V; Abashin, G I

1997-01-01

The applicability of the home-made operational amplifier B1404UD1A-1 in a patch-clamp current-to-voltage converter was analyzed. Its parameters (background noise, input bias current, and gain-bandwidth product) were estimated. Schematic solutions and practical recommendations for the use of this amplifier in a current-to-voltage converter were given. Based on the background noise and frequency parameters of the converter, we found that this device can be used for measuring ion channel currents with a high sensitivity and within a broad frequency range (0.055 pA, to 1 kHz; 0.4 pA, to 10 kHz). An example of the converter application in experiments is given.

Transition from child and adolescent to adult mental health services in the Republic of Ireland: an investigation of process and operational practice.

PubMed

McNamara, Niamh; McNicholas, Fiona; Ford, Tamsin; Paul, Moli; Gavin, Blanaid; Coyne, Imelda; Cullen, Walter; O'Connor, Karen; Ramperti, Nicolas; Dooley, Barbara; Barry, Siobhan; Singh, Swaran P

2014-08-01

Ensuring a seamless transition from child to adult mental health services poses challenges for services worldwide. This is an important process in the ongoing care of young people with mental illness; therefore, it is incumbent on all countries to probe their individual structures to assess the quality of mental health service delivery to this vulnerable cohort. To date, there have been no published studies on the transition from Child to Adult Mental Health Services in the Republic of Ireland. To this end, a nationwide survey of transition policies of community mental health teams in both services was conducted in order to compare best practice guidelines for transition with current process and experience in clinical practice. Structured interviews were conducted with 57 consultant psychiatrists (representing 32 CAMHS teams and 25 AMHS teams) to obtain information on annual transition numbers, existing transition policies and operational practice from the professional perspective. Numbers of young people considered suitable for transfer to adult services (M = 7.73, SD = 9.86, n = 25) were slightly higher than numbers who actually transferred (M = 4.50, SD = 3.33, n = 20). There is a lack of standardized practice nationwide regarding the service transition boundary, an absence of written transition policies and protocols, and minimal formal interaction between child and adult services. The findings suggest that there are critical gaps between current operational practice and best practice guidelines. Future studies will investigate the impact this has on the transition experiences of young people, their carers and health-care professionals. © 2013 Wiley Publishing Asia Pty Ltd.

Environmental Assessment: Proposed Automotive/Arts and Crafts Skills Center, Hill Air Force Base, Utah

DTIC Science & Technology

2010-10-14

Water regarding potential sources of t practices to ensure drinking water source protection. u ity design and operating standards would be based...center would not be constructed, and adequate facilities would not be provided. The existing facility would operate as it currently exists...would be properly handled during the construction process. Operational activities would generate the same types of waste as the existing facility

The Italian Expedition in the Russian Campaign 1941-43: A Pronounced Failure

DTIC Science & Technology

This monograph investigates the Italian Expedition in the Russian campaign during the Second World War from an operational perspective. It seeks to...identify those factors relevant for practicing operational art that caused the collapse of the Italian forces in 1943. Specifically, the monograph ...commands. The conclusion of the monograph depicts several lessons for current and future operational planners. The latter have to be ready to properly frame

Nonoperative management of blunt hepatic injury: an Eastern Association for the Surgery of Trauma practice management guideline.

PubMed

Stassen, Nicole A; Bhullar, Indermeet; Cheng, Julius D; Crandall, Marie; Friese, Randall; Guillamondegui, Oscar; Jawa, Randeep; Maung, Adrian; Rohs, Thomas J; Sangosanya, Ayodele; Schuster, Kevin; Seamon, Mark; Tchorz, Kathryn M; Zarzuar, Ben L; Kerwin, Andrew

2012-11-01

During the last century, the management of blunt force trauma to the liver has changed from observation and expectant management in the early part of the 1900s to mainly operative intervention, to the current practice of selective operative and nonoperative management. These issues were first addressed by the Eastern Association for the Surgery of Trauma in the Practice Management Guidelines for Nonoperative Management of Blunt Injury to the Liver and Spleen published online in 2003. Since that time, a large volume of literature on these topics has been published requiring a reevaluation of the previous Eastern Association for the Surgery of Trauma guideline. The National Library of Medicine and the National Institutes of Health MEDLINE database were searched using PubMed (http://www.pubmed.gov). The search was designed to identify English-language citations published after 1996 (the last year included in the previous guideline) using the keywords liver injury and blunt abdominal trauma. One hundred seventy-six articles were reviewed, of which 94 were used to create the current practice management guideline for the selective nonoperative management of blunt hepatic injury. Most original hepatic guidelines remained valid and were incorporated into the greatly expanded current guidelines as appropriate. Nonoperative management of blunt hepatic injuries currently is the treatment modality of choice in hemodynamically stable patients, irrespective of the grade of injury or patient age. Nonoperative management of blunt hepatic injuries should only be considered in an environment that provides capabilities for monitoring, serial clinical evaluations, and an operating room available for urgent laparotomy. Patients presenting with hemodynamic instability and peritonitis still warrant emergent operative intervention. Intravenous contrast enhanced computed tomographic scan is the diagnostic modality of choice for evaluating blunt hepatic injuries. Repeated imaging should be guided by a patient's clinical status. Adjunctive therapies like angiography, percutaneous drainage, endoscopy/endoscopic retrograde cholangiopancreatography and laparoscopy remain important adjuncts to nonoperative management of hepatic injuries. Despite the explosion of literature on this topic, many questions regarding nonoperative management of blunt hepatic injuries remain without conclusive answers in the literature.

40 CFR 424.22 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... technology currently available. 424.22 Section 424.22 Protection of Environment ENVIRONMENTAL PROTECTION... Covered Electric Furnaces and Other Smelting Operations With Wet Air Pollution Control Devices Subcategory... application of the best practicable control technology currently available. Except as provided in §§ 125.30...

The State of Knowledge of Outdoor Orientation Programs: Current Practices, Research, and Theory

ERIC Educational Resources Information Center

Bell, Brent J.; Gass, Michael A.; Nafziger, Christopher S.; Starbuck, J. David

2014-01-01

Outdoor orientation programs represent a prominent area of experiential education with over 25,000 participants annually. More than 191 outdoor orientation programs currently operate in the United States and Canada. The research examining outdoor orientation programs consists of 25 peer-reviewed published studies and 11 dissertations. A new theory…

40 CFR 424.22 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... technology currently available. 424.22 Section 424.22 Protection of Environment ENVIRONMENTAL PROTECTION... Covered Electric Furnaces and Other Smelting Operations With Wet Air Pollution Control Devices Subcategory... application of the best practicable control technology currently available. Except as provided in §§ 125.30...

40 CFR 424.22 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... technology currently available. 424.22 Section 424.22 Protection of Environment ENVIRONMENTAL PROTECTION... Covered Electric Furnaces and Other Smelting Operations With Wet Air Pollution Control Devices Subcategory... application of the best practicable control technology currently available. Except as provided in §§ 125.30...

40 CFR 424.22 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... technology currently available. 424.22 Section 424.22 Protection of Environment ENVIRONMENTAL PROTECTION... Covered Electric Furnaces and Other Smelting Operations With Wet Air Pollution Control Devices Subcategory... application of the best practicable control technology currently available. Except as provided in §§ 125.30...

40 CFR 424.22 - Effluent limitations guidelines representing the degree of effluent reduction attainable by the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... technology currently available. 424.22 Section 424.22 Protection of Environment ENVIRONMENTAL PROTECTION... Covered Electric Furnaces and Other Smelting Operations With Wet Air Pollution Control Devices Subcategory... application of the best practicable control technology currently available. Except as provided in §§ 125.30...

Bus Propulsion Alternatives Overview

DOT National Transportation Integrated Search

1982-04-01

The Urban Mass Transportation Administration (UMTA) is currently investigating propulsion alternatives which would conserve petroleum-based fuels and would be practical for use by U.S. transit operators. A discussion of these alternatives (electric p...

30 CFR 810.2 - Objective.

Code of Federal Regulations, 2013 CFR

2013-07-01

... practicable with mining operations; (e) Minimizing, to the extent possible using the best technology currently... threatened species and their critical habitats as determined by the Endangered Species Act of 1973 (16 U.S.C...

30 CFR 810.2 - Objective.

Code of Federal Regulations, 2011 CFR

2011-07-01

... practicable with mining operations; (e) Minimizing, to the extent possible using the best technology currently... threatened species and their critical habitats as determined by the Endangered Species Act of 1973 (16 U.S.C...

30 CFR 810.2 - Objective.

Code of Federal Regulations, 2014 CFR

2014-07-01

... practicable with mining operations; (e) Minimizing, to the extent possible using the best technology currently... threatened species and their critical habitats as determined by the Endangered Species Act of 1973 (16 U.S.C...

30 CFR 810.2 - Objective.

Code of Federal Regulations, 2012 CFR

2012-07-01

... practicable with mining operations; (e) Minimizing, to the extent possible using the best technology currently... threatened species and their critical habitats as determined by the Endangered Species Act of 1973 (16 U.S.C...

A review of current surgical practice in the operative treatment of proximal humeral fractures

PubMed Central

Jones, L. D.; Palmer, A. J. R.; Macnair, R. D.; Brewer, P. E.; Jayadev, C.; Wheelton, A. N.; Ball, D. E. J.; Nandra, R. S.; Aujla, R. S.; Sykes, A. E.; Carr, A. J.

2016-01-01

Objectives The PROximal Fracture of the Humerus: Evaluation by Randomisation (PROFHER) trial has recently demonstrated that surgery is non-superior to non-operative treatment in the management of displaced proximal humeral fractures. The objective of this study was to assess current surgical practice in the context of the PROFHER trial in terms of patient demographics, injury characteristics and the nature of the surgical treatment. Methods A total of ten consecutive patients undergoing surgery for the treatment of a proximal humeral fracture from each of 11 United Kingdom hospitals were retrospectively identified over a 15 month period between January 2014 and March 2015. Data gathered for the 110 patients included patient demographics, injury characteristics, mode of surgical fixation, the grade of operating surgeon and the cost of the surgical implants. Results A majority of the patients were female (66%, 73 of 110). The mean patient age was 62 years (range 18 to 89). A majority of patients met the inclusion criteria for the PROFHER trial (75%, 83 of 110). Plate fixation was the most common mode of surgery (68%, 75 patients), followed by intramedullary fixation (12%, 13 patients), reverse shoulder arthroplasty (10%, 11 patients) and hemiarthroplasty (7%, eight patients). The consultant was either the primary operating surgeon or supervising the operating surgeon in a large majority of cases (91%, 100 patients). Implant costs for plate fixation were significantly less than both hemiarthroplasty (p < 0.05) and reverse shoulder arthroplasty (p < 0.0001). Implant costs for intramedullary fixation were significantly less than plate fixation (p < 0.01), hemiarthroplasty (p < 0.0001) and reverse shoulder arthroplasty (p < 0.0001). Conclusions Our study has shown that the majority of a representative sample of patients currently undergoing surgical treatment for a proximal humeral fracture in these United Kingdom centres met the inclusion criteria for the PROFHER trial and that a proportion of these patients may, therefore, have been effectively managed non-operatively. Cite this article: Mr B. J. F. Dean. A review of current surgical practice in the operative treatment of proximal humeral fractures: Does the PROFHER trial demonstrate a need for change? Bone Joint Res 2016;5:178–184. DOI: 10.1302/2046-3758.55.2000596. PMID:27179004

A review of current surgical practice in the operative treatment of proximal humeral fractures: Does the PROFHER trial demonstrate a need for change?

PubMed

Dean, B J F; Jones, L D; Palmer, A J R; Macnair, R D; Brewer, P E; Jayadev, C; Wheelton, A N; Ball, D E J; Nandra, R S; Aujla, R S; Sykes, A E; Carr, A J

2016-05-01

The PROximal Fracture of the Humerus: Evaluation by Randomisation (PROFHER) trial has recently demonstrated that surgery is non-superior to non-operative treatment in the management of displaced proximal humeral fractures. The objective of this study was to assess current surgical practice in the context of the PROFHER trial in terms of patient demographics, injury characteristics and the nature of the surgical treatment. A total of ten consecutive patients undergoing surgery for the treatment of a proximal humeral fracture from each of 11 United Kingdom hospitals were retrospectively identified over a 15 month period between January 2014 and March 2015. Data gathered for the 110 patients included patient demographics, injury characteristics, mode of surgical fixation, the grade of operating surgeon and the cost of the surgical implants. A majority of the patients were female (66%, 73 of 110). The mean patient age was 62 years (range 18 to 89). A majority of patients met the inclusion criteria for the PROFHER trial (75%, 83 of 110). Plate fixation was the most common mode of surgery (68%, 75 patients), followed by intramedullary fixation (12%, 13 patients), reverse shoulder arthroplasty (10%, 11 patients) and hemiarthroplasty (7%, eight patients). The consultant was either the primary operating surgeon or supervising the operating surgeon in a large majority of cases (91%, 100 patients). Implant costs for plate fixation were significantly less than both hemiarthroplasty (p < 0.05) and reverse shoulder arthroplasty (p < 0.0001). Implant costs for intramedullary fixation were significantly less than plate fixation (p < 0.01), hemiarthroplasty (p < 0.0001) and reverse shoulder arthroplasty (p < 0.0001). Our study has shown that the majority of a representative sample of patients currently undergoing surgical treatment for a proximal humeral fracture in these United Kingdom centres met the inclusion criteria for the PROFHER trial and that a proportion of these patients may, therefore, have been effectively managed non-operatively.Cite this article: Mr B. J. F. Dean. A review of current surgical practice in the operative treatment of proximal humeral fractures: Does the PROFHER trial demonstrate a need for change? Bone Joint Res 2016;5:178-184. DOI: 10.1302/2046-3758.55.2000596. © 2016 Dean et al.

Empirical Analysis of Green Supply Chain Management Practices in Indian Automobile Industry

NASA Astrophysics Data System (ADS)

Luthra, S.; Garg, D.; Haleem, A.

2014-04-01

Environmental sustainability and green environmental issues have an increasing popularity among researchers and supply chain practitioners. An attempt has been made to identify and empirically analyze green supply chain management (GSCM) practices in Indian automobile industry. Six main GSCM practices (having 37 sub practices) and four expected performance outcomes (having 16 performances) have been identified by implementing GSCM practices from literature review. Questionnaire based survey has been made to validate these practices and performance outcomes. 123 complete questionnaires were collected from Indian automobile organizations and used for empirical analysis of GSCM practices in Indian automobile industry. Descriptive statistics have been used to know current implementation status of GSCM practices in Indian automobile industry and multiple regression analysis has been carried out to know the impact on expected organizational performance outcomes by current GSCM practices adopted by Indian automobile industry. The results of study suggested that environmental, economic, social and operational performances improve with the implementation of GSCM practices. This paper may play an important role to understand various GSCM implementation issues and help practicing managers to improve their performances in the supply chain.

Selective nonoperative management of blunt splenic injury: an Eastern Association for the Surgery of Trauma practice management guideline.

PubMed

Stassen, Nicole A; Bhullar, Indermeet; Cheng, Julius D; Crandall, Marie L; Friese, Randall S; Guillamondegui, Oscar D; Jawa, Randeep S; Maung, Adrian A; Rohs, Thomas J; Sangosanya, Ayodele; Schuster, Kevin M; Seamon, Mark J; Tchorz, Kathryn M; Zarzuar, Ben L; Kerwin, Andrew J

2012-11-01

During the last century, the management of blunt force trauma to the spleen has changed from observation and expectant management in the early part of the 1900s to mainly operative intervention, to the current practice of selective operative and nonoperative management. These issues were first addressed by the Eastern Association for the Surgery of Trauma (EAST) in the Practice Management Guidelines for Non-operative Management of Blunt Injury to the Liver and Spleen published online in 2003. Since that time, a large volume of literature on these topics has been published requiring a reevaluation of the current EAST guideline. The National Library of Medicine and the National Institute of Health MEDLINE database was searched using Pub Med (www.pubmed.gov). The search was designed to identify English-language citations published after 1996 (the last year included in the previous guideline) using the keywords splenic injury and blunt abdominal trauma. One hundred seventy-six articles were reviewed, of which 125 were used to create the current practice management guideline for the selective nonoperative management of blunt splenic injury. There has been a plethora of literature regarding nonoperative management of blunt splenic injuries published since the original EAST practice management guideline was written. Nonoperative management of blunt splenic injuries is now the treatment modality of choice in hemodynamically stable patients, irrespective of the grade of injury, patient age, or the presence of associated injuries. Its use is associated with a low overall morbidity and mortality when applied to an appropriate patient population. Nonoperative management of blunt splenic injuries should only be considered in an environment that provides capabilities for monitoring, serial clinical evaluations, and has an operating room available for urgent laparotomy. Patients presenting with hemodynamic instability and peritonitis still warrant emergent operative intervention. Intravenous contrast enhanced computed tomographic scan is the diagnostic modality of choice for evaluating blunt splenic injuries. Repeat imaging should be guided by a patient's clinical status. Adjunctive therapies like angiography with embolization are increasingly important adjuncts to nonoperative management of splenic injuries. Despite the explosion of literature on this topic, many questions regarding nonoperative management of blunt splenic injuries remain without conclusive answers in the literature.

Variability in Accreditation Council for Graduate Medical Education Resident Case Log System practices among orthopaedic surgery residents.

PubMed

Salazar, Dane; Schiff, Adam; Mitchell, Erika; Hopkinson, William

2014-02-05

The Accreditation Council for Graduate Medical Education (ACGME) Resident Case Log System is designed to be a reflection of residents' operative volume and an objective measure of their surgical experience. All operative procedures and manipulations in the operating room, Emergency Department, and outpatient clinic are to be logged into the Resident Case Log System. Discrepancies in the log volumes between residents and residency programs often prompt scrutiny. However, it remains unclear if such disparities truly represent differences in operative experiences or if they are reflections of inconsistent logging practices. The purpose of this study was to investigate individual recording practices among orthopaedic surgery residents prior to August 1, 2011. Orthopaedic surgery residents received a questionnaire on case log practices that was distributed through the Council of Orthopaedic Residency Directors list server. Respondents were asked to respond anonymously about recording practices in different clinical settings as well as types of cases routinely logged. Hypothetical scenarios of common orthopaedic procedures were presented to investigate the differences in the Current Procedural Terminology codes utilized. Two hundred and ninety-eight orthopaedic surgery residents completed the questionnaire; 37% were fifth-year residents, 22% were fourth-year residents, 18% were third-year residents, 15% were second-year residents, and 8% were first-year residents. Fifty-six percent of respondents reported routinely logging procedures performed in the Emergency Department or urgent care setting. Twenty-two percent of participants routinely logged procedures in the clinic or outpatient setting, 20% logged joint injections, and only 13% logged casts or splints applied in the office setting. There was substantial variability in the Current Procedural Terminology codes selected for the seven clinical scenarios. There has been a lack of standardization in case-logging practices among orthopaedic surgery residents prior to August 1, 2011. ACGME case log data prior to this date may not be a reliable measure of residents' procedural experience.

Integrated Risk and Knowledge Management Program -- IRKM-P

NASA Technical Reports Server (NTRS)

Lengyel, David M.

2009-01-01

The NASA Exploration Systems Mission Directorate (ESMD) IRKM-P tightly couples risk management and knowledge management processes and tools to produce an effective "modern" work environment. IRKM-P objectives include: (1) to learn lessons from past and current programs (Apollo, Space Shuttle, and the International Space Station); (2) to generate and share new engineering design, operations, and management best practices through preexisting Continuous Risk Management (CRM) procedures and knowledge-management practices; and (3) to infuse those lessons and best practices into current activities. The conceptual framework of the IRKM-P is based on the assumption that risks highlight potential knowledge gaps that might be mitigated through one or more knowledge management practices or artifacts. These same risks also serve as cues for collection of knowledge particularly, knowledge of technical or programmatic challenges that might recur.

Evolution in practice: how has British neurosurgery changed in the last 10 years?

PubMed

Tarnaris, A; Arvin, B; Ashkan, K

2008-09-01

Neurosurgery is a fast-evolving surgical subspecialty driven by technological advances, socio-economic factors and patient expectations. In this study, we have compared the work-load volume in a single institution in the years of 1994 and 2004 and commented on the possible reasons for the changes and the impacts they may have for the future. A retrospective, log-book review of all operations performed in the years 1994 and 2004 in a single, tertiary, neurosurgical centre was performed. Neurosurgical practice has evolved over this period. Current practice has moved away from clipping of aneurysms and towards coil embolisation performed by interventional radiologists. Electrode stimulation of deep brain regions for movement disorders is the current practice, whereas 10 years ago the same disorders were dealt with by lesioning of the relevant regions. In spinal neurosurgery, instrumentation is increasingly favoured currently. In the field of neuro-oncology, current practice favours minimal access to the target area by the use of stereotactic localisation. Changes were most pronounced in the subspecialties of vascular, functional and spinal neurosurgery within this 10-year period. Knowledge of such dynamics is valuable in health resource management as well as planning for neurosurgical training programmes.

ISS Training Best Practices and Lessons Learned

NASA Technical Reports Server (NTRS)

Barshi, Immanuel; Dempsey, Donna L.

2017-01-01

Training our crew members for long duration exploration-class missions (LDEM) will have to be qualitatively and quantitatively different from current training practices. However, there is much to be learned from the extensive experience NASA has gained in training crew members for missions on board the International Space Station (ISS). Furthermore, the operational experience on board the ISS provides valuable feedback concerning training effectiveness. Keeping in mind the vast differences between current ISS crew training and training for LDEM, the needs of future crew members, and the demands of future missions, this ongoing study seeks to document current training practices and lessons learned. The goal of the study is to provide input to the design of future crew training that takes as much advantage as possible of what has already been learned and avoids as much as possible past inefficiencies. Results from this study will be presented upon its completion. By researching established training principles, examining future needs, and by using current practices in spaceflight training as test beds, this research project is mitigating program risks and generating templates and requirements to meet future training needs.

ISS Training Best Practices and Lessons Learned

NASA Technical Reports Server (NTRS)

Dempsey, Donna L.; Barshi, Immanuel

2018-01-01

Training our crew members for long-duration Deep Space Transport (DST) missions will have to be qualitatively and quantitatively different from current training practices. However, there is much to be learned from the extensive experience NASA has gained in training crew members for missions on board the International Space Station (ISS). Furthermore, the operational experience on board the ISS provides valuable feedback concerning training effectiveness. Keeping in mind the vast differences between current ISS crew training and training for DST missions, the needs of future crew members, and the demands of future missions, this ongoing study seeks to document current training practices and lessons learned. The goal of the study is to provide input to the design of future crew training that takes as much advantage as possible of what has already been learned and avoids as much as possible past inefficiencies. Results from this study will be presented upon its completion. By researching established training principles, examining future needs, and by using current practices in spaceflight training as test beds, this research project is mitigating program risks and generating templates and requirements to meet future training needs.

Automated Chromium Plating Line for Gun Barrels

DTIC Science & Technology

1979-09-01

consistent pretreatments and bath dwell times. Some of the advantages of automated processing include increased productivity (average of 20^) due to...when automated processing procedures’ are used. The current method of applying chromium electrodeposits to gun tubes is a manual, batch operation...currently practiced with rotary swaged gun tubes would substantially reduce the difficulties in automated processing . RECOMMENDATIONS

Transit Vehicle-to-Infrastructure (V2I) assessment study.

DOT National Transportation Integrated Search

2015-07-01

The United States Department of Transportation (USDOT) is engaged in assessing applications that realize the full potential of connected vehicles, travelers, and infrastructure to enhance current operational practices and transform future surface tra...

Criteria for extending the operation periods of thermoelectric converters based on IV-VI compounds

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

Sadia, Yatir, E-mail: yatttir@yahoo.com; Ohaion-Raz, Tsion; Ben-Yehuda, Ohad

The recent energy demands affected by the dilution of conventional energy resources and the growing awareness of environmental considerations, had positioned the research of renewable energy conversion methods in general and of thermoelectric direct conversion of thermal into electrical energies in particular, in the forefront of the currently active applicative sciences. IV-VI thermoelectric compounds (e.g. GeTe, PbTe and SnTe) and their alloys comprise some of the most efficient thermoelectric compositions ever reported. Yet a proper utilization of such materials in practical thermoelectric devices, still requires an overcoming the so-called technological “valley of death”, including among others, transport properties' degradation, duemore » to sublimation of volatile Te rich species, while being subjected to elevated temperatures for long periods of time. In an attempt to establish practical operation criteria for extending the operation periods of such thermoelectric converters, it is currently shown based on thermal gravimetric and metallurgical considerations that such harmful sublimation can be practically bridged over by limiting the maximal operating temperatures to the 410–430 °C range for GeTe rich alloys and to 510–530 °C for PbTe and SnTe rich alloys, depending of the thermoelectric leg's diameter. - Graphical abstract: Evaporation rate in the GeTe and PbTe system showing the measured evaporation rates and the maximal operating temperatures for different compositions. In addition, the microstructure after evaporation is shown for PbTe, TAGS-85, and doped Pb{sub 0.13}Ge{sub 087}Te. Display Omitted - Highlights: • Evaporation rates of GeTe and PbTe based thermoelectric compounds were determined. • A criterion for their maximum operating temperature was established. • The materials showed phase separations and off-stoichiometry compositions.« less

Eddy current probe response to open and closed surface flaws

NASA Technical Reports Server (NTRS)

Auld, B. A.; Muennemann, F.; Winslow, D. K.

1981-01-01

A general analysis of eddy current response to certain types of open and closed surface flaws is presented for both standard low-frequency and ferromagnetic-resonance (FMR) probes. It is shown analytically that for two-dimensional and three-dimensional surface flaws interrogated by a uniform probe field, the crack opening sensitivity increases with the operating frequency of the probe, this behavior being due to the Faraday induction effect. Experiments with low-frequency probes operating at or below 1 MHz and with the FMR probe operating at approximately 1000 MHz confirm this increase of the crack mouth opening displacement for practical situations where the probe field is not uniform in the vicinity of the flaw.

Ten ways for provider units to weather this economic downturn.

PubMed

Bernard, Amy

2009-05-01

The current economic recession challenges all continuing nursing education provider units to review operational practices and explore ways to maintain and ensure financial viability. Adjustments in programs are likely, as nurses seek more cost-effective ways of meeting their continuing education requirements. Further, employers are reducing staff and budgets. As a result, provider units need to reassess operations and refocus outcomes.

Atmospheric LiDAR coupled with point measurement air quality samplers to measure fineparticulate matter (PM) emissions from agricultural operations. Part 2 of the California 2007 - 2008 Tillage Campaigns: Spring 2008 Data Analysis

EPA Science Inventory

Concern with health effects resulting from PM10 exposure is drawing increased regulatory scrutiny and research toward local agricultural tillage operations. To investigate the control effectiveness of one of the current Conservation Management Practices (CMPs) written for agricul...

A Systematic Review and Critical Appraisal of Qualitative Metasynthetic Practice in Public Health to Develop a Taxonomy of Operations of Reciprocal Translation

ERIC Educational Resources Information Center

Melendez-Torres, G. J.; Grant, Sean; Bonell, Chris

2015-01-01

Introduction: Reciprocal translation, the understanding of one study's findings in terms of another's, is the foundation of most qualitative metasynthetic methods. In light of the proliferation of metasynthesis methods, the current review sought to create a taxonomy of operations of reciprocal translation using recently published qualitative…

Learning from Trending, Precursor Analysis, and System Failures

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

Youngblood, R. W.; Duffey, R. B.

2015-11-01

Models of reliability growth relate current system unreliability to currently accumulated experience. But “experience” comes in different forms. Looking back after a major accident, one is sometimes able to identify previous events or measurable performance trends that were, in some sense, signaling the potential for that major accident: potential that could have been recognized and acted upon, but was not recognized until the accident occurred. This could be a previously unrecognized cause of accidents, or underestimation of the likelihood that a recognized potential cause would actually operate. Despite improvements in the state of practice of modeling of risk and reliability,more » operational experience still has a great deal to teach us, and work has been going on in several industries to try to do a better job of learning from experience before major accidents occur. It is not enough to say that we should review operating experience; there is too much “experience” for such general advice to be considered practical. The paper discusses the following: 1. The challenge of deciding what to focus on in analysis of operating experience. 2. Comparing what different models of learning and reliability growth imply about trending and precursor analysis.« less

Can Rural Minimally Invasive Surgery Fellowships Provide Operative Experience Similar to Urban Programs?

PubMed

Ryan, James Patrick; Borgert, Andrew J; Kallies, Kara J; Carlson, Lea M; McCollister, Howard; Severson, Paul A; Kothari, Shanu N

2016-01-01

Operative experience in rural fellowship programs is largely unknown. The 2 of the most rural minimally invasive surgery (MIS)/bariatric fellowships are located in the upper Midwest. We hypothesized that these 2 programs would offer a similar operative experience to other U.S. programs in more urban locations. The 2011 to 2012 and 2012 to 2013 fellowship case logs from 2 rural Midwest programs were compared with case logs from 23 U.S. MIS/bariatric programs. All rural Midwest fellowship graduates completed a survey describing their fellowship experience and current practice. Statistical analysis included Wilcoxon rank-sum test. Setting included the 2 rural Midwest U.S. MIS/bariatric fellowship programs. Graduates from MIS/bariatric fellowship programs participated in the study. Mean volumes for bariatric, foregut, abdominal wall, small intestine, and hepatobiliary cases for rural Midwest fellows vs. other U.S. programs were 123.8 ± 23.7 vs. 150.2 ± 49.2 (p = 0.20); 44.3 ± 19.4 vs. 66.3 ± 35.5 (p = 0.18); 48.3 ± 28.0 vs. 57.9 ± 27.8 (p = 0.58); 11.3 ± 1.9 vs. 12.0 ± 8.7 (p = 0.58); and 55.0 ± 34.8 vs. 48.1 ± 42.6 (p = 0.63), respectively. Mean endoscopy volume was significantly higher among rural Midwest fellows (451.0 ± 395.2 vs. 99.7 ± 83.4; p = 0.05). All rural Midwest fellows reported an adequate number of cases as operating surgeon during fellowship. A total of 60% of fellows currently practice in a rural area. In all, 87% and 13% reported that their fellowship training was extremely or somewhat beneficial to their current practice, respectively. Rural MIS fellowship programs offer a similar operative experience to other U.S. programs. A greater volume of endoscopy cases was observed in rural Midwest fellowships. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Data Sharing to Improve Close Approach Monitoring and Safety of Flight

NASA Astrophysics Data System (ADS)

Chan, Joseph; DalBello, Richard; Hope, Dean; Wauthier, Pascal; Douglas, Tim; Inghram, Travis

2009-03-01

Individual satellite operators have done a good job of developing the internal protocols and procedures to ensure the safe operation of their fleets. However, data sharing among operators for close approach monitoring is conducted in an ad-hoc manner during relocations, and there is currently no standardized agreement among operators on the content, format, and distribution protocol for data sharing. Crowding in geostationary orbit, participation by new commercial actors, government interest in satellite constellations, and highly maneuverable spacecraft all suggest that satellite operators will need to begin a dialogue on standard communication protocols and procedure to improve situation awareness. We will give an overview of the current best practices among different operators for close approach monitoring and discuss the concept of an active data center to improve data sharing, conjunction monitoring, and avoidance among satellite operators. We will also report on the progress and lessons learned from a Data Center prototype conducted by several operators over a one year period.

Systems and context modeling approach to requirements analysis

NASA Astrophysics Data System (ADS)

Ahuja, Amrit; Muralikrishna, G.; Patwari, Puneet; Subhrojyoti, C.; Swaminathan, N.; Vin, Harrick

2014-08-01

Ensuring completeness and correctness of the requirements for a complex system such as the SKA is challenging. Current system engineering practice includes developing a stakeholder needs definition, a concept of operations, and defining system requirements in terms of use cases and requirements statements. We present a method that enhances this current practice into a collection of system models with mutual consistency relationships. These include stakeholder goals, needs definition and system-of-interest models, together with a context model that participates in the consistency relationships among these models. We illustrate this approach by using it to analyze the SKA system requirements.

Accounting for Induced Travel in Evaluation of Urban Highway Expansion

DOT National Transportation Integrated Search

2013-02-01

The US DOT sponsored Dynamic Mobility Applications (DMA) program seeks to identify, develop, and deploy applications that leverage the full potential of connected vehicles, travelers and infrastructure to enhance current operational practices and tra...

The unit field sanitation team: a square peg in a round hole.

PubMed

Bosetti, Timothy; Bridges, Davin

2009-01-01

Basic field sanitation and hygiene is a lost art in today's modern Army. Today, more than ever, there is a need for the unit field sanitation team (FST) to serve as advisors to unit commanders in the area of basic field sanitation and hygiene. Soldiers should know how to construct field latrines, construct waste disposal devices, conduct pest management and control activities, disinfect field water supplies, and practice personal hygiene under field conditions. The current unit FST concept is centered on company-sized formations operating in open terrain. This concept does not support current operations, transformed formations, rapidly changing doctrine, and the expeditionary nature of the Army. This article does not present a new concept, but rather a new look at an existing concept and practice based upon the lessons-learned and after-action reports from the Global War on Terrorism to support the Army in transformation during an era of persistent conflict.

Petition to request an exemption from 100 percent identity testing of dietary ingredients: Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements. Interim final rule.

PubMed

2007-06-25

The Food and Drug Administration (FDA) is issuing an interim final rule (IFR) that sets forth a procedure for requesting an exemption from the requirement in the final rule "Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements," published elsewhere in this issue of the Federal Register, that the manufacturer conduct at least one appropriate test or examination to verify the identity of any component that is a dietary ingredient. This IFR allows for submission to, and review by, FDA of an alternative to the required 100 percent identity testing of components that are dietary ingredients, provided certain conditions are met and establishes a requirement for retention of records relating to the FDA's response to an exemption request.

An Approach for Measuring Reductions in Operations, Maintenance, and Energy Costs: Baseline Measures of Construction Industry Practices for the National Construction Goals.

ERIC Educational Resources Information Center

Chapman, Robert E.; Rennison, Roderick

The Construction and Building Subcommittee of the National Science and Technology Council (NSTC) has established seven National Construction Goals for the construction industry and is developing baseline measures for current practices and progress with respect to each goal. This document provides a detailed set of baseline measures for the NSTC…

Proactive approaches for mold-free interior environments.

PubMed

Warsco, Katherine; Lindsey, Patricia F

2003-08-01

Interior design education and practice can contribute to the prevention of mold growth in indoor environments. The authors provide an overview of current thinking within the interior design educational and professional communities regarding proactive approaches to achieving mold-free building interiors, including identification of current best practices for the prevention of mold problems in buildings. They also discuss the development of certification programs. A review of recent literature points to the need for interior designers to be educated to specify the use of ecologically sound materials that support the health of building occupants. The authors present trade-offs between best practices for designing mold-free indoor environments (including considerations of cost, maintenance, and operation) and occupant comfort, health, and well-being.

[Current treatment of hepatic trauma].

PubMed

Silvio-Estaba, Leonardo; Madrazo-González, Zoilo; Ramos-Rubio, Emilio

2008-05-01

The therapeutic and diagnostic approach of liver trauma injuries (by extension, of abdominal trauma) has evolved remarkably in the last decades. The current non-surgical treatment in the vast majority of liver injuries is supported by the accumulated experience and optimal results in the current series. It is considered that the non-surgical treatment of liver injuries has a current rate of success of 83-100%, with an associated morbidity of 5-42%. The haemodynamic stability of the patient will determine the applicability of the non-surgical treatment. Arteriography with angioembolisation constitutes a key technical tool in the context of liver trauma. Patients with haemodynamic instability will need an urgent operation and can benefit from abdominal packing techniques, damage control and post-operative arteriography. The present review attempts to contribute to the current, global and practical management in the care of liver trauma.

Leadership development practices and hospital financial outcomes.

PubMed

Crowe, Daniel; Garman, Andrew N; Li, Chien-Ching; Helton, Jeff; Anderson, Matthew M; Butler, Peter

2017-08-01

Affordable Care Act legislation is requiring leaders in US health systems to adapt to new and very different approaches to improving operating performance. Research from other industries suggests leadership development can be a helpful component of organizational change strategies; however, there is currently very little healthcare-specific research available to guide design and deployment. The goal of this exploratory study is to examine potential relationships between specific leadership development practices and health system financial outcomes. Results from the National Center for Healthcare Leadership survey of leadership development practices were correlated with hospital and health system financial performance data from the 2013 Medicare Cost Reports. A general linear regression model, controlling for payer mix, case-mix index, and bed size, was used to assess possible relationships between leadership practices and three financial performance metrics: operating margin, days cash on hand, and debt to capitalization. Statistically significant associations were found between hospital-level operating margins and 5 of the 11 leadership practices as well as the composite score. Relationships at the health system level, however, were not statistically significant. Results provide preliminary evidence of an association between hospital financial performance and investments made in developing their leaders.

The virtual practice: using the residents' continuity clinic to teach practice management and systems-based practice.

PubMed

Perez, Jose A; Faust, Cheryl; Kenyon, Angie

2009-09-01

Education in systems-based practice is a required component of all postgraduate medical education programs in the United States. Competency in this area requires that trainees have an understanding of the health care system sufficient to provide optimal care to patients. Most trainees in residency programs have little understanding of the complexities and challenges of present-day practice in the current system of care and consider themselves unprepared to undertake this activity following completion of training. Training in practice management in residency programs has not been emphasized as an important component of systems-based practice. Historically, practice management training in residency programs has been done using a fully didactic model, and residents have expressed a desire to learn this skill by becoming more directly involved in the operations and management of a practice. The patient visit touches many aspects of the health care system, including clinic operations, insurance, quality, and finances. At our institution, we used the residents' continuity clinic practices as a vehicle to provide education in practice management and systems-based practice by creating a curriculum that included the residents' perceived gaps in knowledge regarding going into practice. This is known as the virtual practice. This curriculum is taught using data obtained from residents' practice to illustrate concepts in many areas, including primary practice operations, malpractice insurance, financial benchmarks, and career planning. Resident self-assessed knowledge of these areas increased after participating in the curriculum, and resident testimonials indicate satisfaction with the project. In addition, residents have become engaged and interested in how their effort translates into performance and how they participate in the health care system.

Study on the steady operating state of a micro-pulse electron gun.

PubMed

Kui, Zhou; Xiangyang, Lu; Shengwen, Quan; Jifei, Zhao; Xing, Luo; Ziqin, Yang

2014-09-01

Micro-pulse electron gun (MPG) employs the basic concept of multipacting to produce high-current and short-pulse electron beams from a radio-frequency (RF) cavity. The concept of MPG has been proposed for more than two decades. However, the unstable operating state of MPG vastly obstructs its practical applications. This paper presents a study on the steady operating state of a micro-pulse electron gun with theory and experiments. The requirements for the steady operating state are proposed through the analysis of the interaction between the RF cavity and the beam load. Accordingly, a MPG cavity with the frequency of 2856 MHz has been designed, constructed, and tested. Some primary experiments have been finished. Both the unstable and stable operating states of the MPG have been observed. The stable output beam current has been detected at about 3.8 mA. Further experimental study is under way now.

Single-incision Laparoscopic Surgery (SILS) in general surgery: a review of current practice.

PubMed

Froghi, Farid; Sodergren, Mikael Hans; Darzi, Ara; Paraskeva, Paraskevas

2010-08-01

Single-incision laparoscopic surgery (SILS) aims to eliminate multiple port incisions. Although general operative principles of SILS are similar to conventional laparoscopic surgery, operative techniques are not standardized. This review aims to evaluate the current use of SILS published in the literature by examining the types of operations performed, techniques employed, and relevant complications and morbidity. This review considered a total of 94 studies reporting 1889 patients evaluating 17 different general surgical operations. There were 8 different access techniques reported using conventional laparoscopic instruments and specifically designed SILS ports. There is extensive heterogeneity associated with operating methods and in particular ways of overcoming problems with retraction and instrumentation. Published complications, morbidity, and hospital length of stay are comparable to conventional laparoscopy. Although SILS provides excellent cosmetic results and morbidity seems similar to conventional laparoscopy, larger randomized controlled trials are needed to assess the safety and efficacy of this novel technique.

Current situation of oil refinery in Bulgaria

NASA Astrophysics Data System (ADS)

Vershkova, Elena; Petkova, Petinka; Grinkevich, Anastasia

2016-09-01

This article deals with the classification approach for oil refineries in international practices. Criteria of refinery estimation group, including its financial status estimation, have been investigated. The analysis object is “Lukoil Neftochim Bourgas” AD (LNCHB) activity. This company is a leading enterprise in Bulgaria. The analysis of LNCHB operating: energy intensity index; index of operating costs and return on investment index have been performed.

Forestry as a reclamation practice on strip mined lands in Kansas

Treesearch

Harold G. Gallaher; Gary G. Naughton

1980-01-01

A general description of the significance of coal strip mining in Kansas and the current efforts to reclaim spoil banks to forest uses. Landowner's objectives are shown to be the most limiting factor in forestry operations.

Choosing rural road investments to help reduce poverty

DOT National Transportation Integrated Search

2000-10-01

The paper examines how rural road investment projects should be selected when the specific objective is taken to be poverty reduction. After critically reviewing past and current practices, an attempt is made to develop an operational approach that i...

Delving into sensible measures to enhance the environmental performance of biohydrogen: A quantitative approach based on process simulation, life cycle assessment and data envelopment analysis.

PubMed

Martín-Gamboa, Mario; Iribarren, Diego; Susmozas, Ana; Dufour, Javier

2016-08-01

A novel approach is developed to evaluate quantitatively the influence of operational inefficiency in biomass production on the life-cycle performance of hydrogen from biomass gasification. Vine-growers and process simulation are used as key sources of inventory data. The life cycle assessment of biohydrogen according to current agricultural practices for biomass production is performed, as well as that of target biohydrogen according to agricultural practices optimised through data envelopment analysis. Only 20% of the vineyards assessed operate efficiently, and the benchmarked reduction percentages of operational inputs range from 45% to 73% in the average vineyard. The fulfilment of operational benchmarks avoiding irregular agricultural practices is concluded to improve significantly the environmental profile of biohydrogen (e.g., impact reductions above 40% for eco-toxicity and global warming). Finally, it is shown that this type of bioenergy system can be an excellent replacement for conventional hydrogen in terms of global warming and non-renewable energy demand. Copyright © 2016 Elsevier Ltd. All rights reserved.

Coordinate Measuring Machine Pit Artifact Inspection Procedure

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

Montano, Joshua D.

2012-07-31

The goal of this document is to outline a procedure for dimensional measurement of Los Alamos National Laboratory's CMM Pit Artifact. This procedure will be used by the Manufacturing Practice's Inspection Technology Subgroup of the Interagency Manufacturing Operations Group and Joint Operations Weapon Operations Group (IMOG/JOWOG 39) round robin participants. The intent is to assess the state of industry within the Nuclear Weapons Complex for measurements made on this type of part and find which current measurement strategies and techniques produce the best results.

Evolution in Practice: How has British Neurosurgery Changed in the Last 10 Years?

PubMed Central

Tarnaris, A; Arvin, B; Ashkan, K

2008-01-01

INTRODUCTION Neurosurgery is a fast-evolving surgical subspecialty driven by technological advances, socio-economic factors and patient expectations. In this study, we have compared the work-load volume in a single institution in the years of 1994 and 2004 and commented on the possible reasons for the changes and the impacts they may have for the future. PATIENTS AND METHODS A retrospective, log-book review of all operations performed in the years 1994 and 2004 in a single, tertiary, neurosurgical centre was performed. RESULTS Neurosurgical practice has evolved over this period. Current practice has moved away from clipping of aneurysms and towards coil embolisation performed by interventional radiologists. Electrode stimulation of deep brain regions for movement disorders is the current practice, whereas 10 years ago the same disorders were dealt with by lesioning of the relevant regions. In spinal neurosurgery, instrumentation is increasingly favoured currently. In the field of neuro-oncology, current practice favours minimal access to the target area by the use of stereotactic localisation. CONCLUSIONS Changes were most pronounced in the subspecialties of vascular, functional and spinal neurosurgery within this 10-year period. Knowledge of such dynamics is valuable in health resource management as well as planning for neurosurgical training programmes. PMID:18765031

A simulation system for Space Station extravehicular activity

NASA Technical Reports Server (NTRS)

Marmolejo, Jose A.; Shepherd, Chip

1993-01-01

America's next major step into space will be the construction of a permanently manned Space Station which is currently under development and scheduled for full operation in the mid-1990's. Most of the construction of the Space Station will be performed over several flights by suited crew members during an extravehicular activity (EVA) from the Space Shuttle. Once fully operational, EVA's will be performed from the Space Station on a routine basis to provide, among other services, maintenance and repair operations of satellites currently in Earth orbit. Both voice recognition and helmet-mounted display technologies can improve the productivity of workers in space by potentially reducing the time, risk, and cost involved in performing EVA. NASA has recognized this potential and is currently developing a voice-controlled information system for Space Station EVA. Two bench-model helmet-mounted displays and an EVA simulation program have been developed to demonstrate the functionality and practicality of the system.

Study of the cost/benefit tradeoffs for reducing the energy consumption of the commercial air transportation system

NASA Technical Reports Server (NTRS)

Hopkins, J. P.

1976-01-01

Practical means were assessed for achieving reduced fuel consumption in commercial air transportation. Five areas were investigated: current aircraft types, revised operational procedures, modifications to current aircraft, derivatives of current aircraft and new near-term fuel conservative aircraft. As part of a multiparticipant coordinated effort, detailed performance and operating cost data in each of these areas were supplied to the contractor responsible for the overall analysis of the cost/benefit tradeoffs for reducing the energy consumption of the domestic commercial air transportation system. A follow-on study was performed to assess the potential of an advanced turboprop transport aircraft concept. To provide a valid basis for comparison, an equivalent turbofan transport aircraft concept incorporating equal technology levels was also derived. The aircraft as compared on the basis of weight, size, fuel utilization, operational characteristics and costs.

[Concepts of development of the neurosurgical operative environment in the 21st century].

PubMed

Apuzzo, M; Liu, C

2002-01-01

The operative environment has to a large extent defines the "state of the art and science" of neurosurgery, which is now undergoing rapid reinvention. In order to remain current, each neurosurgeon should periodically reconsider their personal operative environment and its functional design with reference to modernity of practice as currently defined. Historical trends and their analysis offer predictive guides for development of such settings with an eye toward the future. Examination of technical developments in decade timeframes defines the progress in capability and need. Progressive minimalism of manipulation and the presence of operative definition with increasing precision are evident, with concurrent miniaturization of attendant computerized support systems, sensors, robotic interfaces, and imaging devices. These trends and developments offer the opportunity for simplificity of setting design with higher functionality as the desired endpoint.

Center for Navy Business Excellence: A Catalyst for Business Transformation

DTIC Science & Technology

2005-12-01

selecting priority strategic initiatives and milestones. Key participants in the strategic planning process are Global Marketing and Sales Group...the Global Marketing Operations Group. This Group works to ensure current, best research practices are tested and utilized; establishing research

21 CFR 110.80 - Processes and controls.

Code of Federal Regulations, 2010 CFR

2010-04-01

... HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD Production and Process Controls § 110.80 Processes and controls. All operations in the receiving, inspecting, transporting, segregating, preparing, manufacturing, packaging, and storing of food shall be conducted in...

Improving the effectiveness of traffic monitoring based on wireless location technology.

DOT National Transportation Integrated Search

2004-01-01

A fundamental requirement for effectively monitoring and operating transportation facilities is reliable, accurate data on traffic flow. The current state of the practice is to use networks of point detectors to gather information on traffic flow at ...

Signal Timing and Coordination Strategies Under Varying Traffic Demands

DOT National Transportation Integrated Search

2012-07-01

Current practice for signal timing and signal coordination is to develop and operate a limited number of predetermined time-of-day plans. Coordination plans are commonly developed for and based on weekday morning, mid-day, evening, and weekend peak p...

Aligning oversize/overweight permit fees with agency costs : critical issues.

DOT National Transportation Integrated Search

2013-08-01

This project provides an elementary analysis of issues and a proposed framework for the state to evaluate cost recovery options : due to OSOW operations. The authors provide a review of current permitting practices, provide a sampling of fee structur...

Aligning oversize/overweight fees with agency costs : critical issues.

DOT National Transportation Integrated Search

2013-08-01

This project provides an elementary analysis of issues and a proposed framework for the state to evaluate cost recovery options : due to OSOW operations. The authors provide a review of current permitting practices, provide a sampling of fee structur...

Optimization of Lyophilized Plasma for Use in Combat Casualties

DTIC Science & Technology

2015-01-01

respiratory distress syndrome and multiple organ failure in combat casualties. This model was developed at Oregon Health & Science University (OHSU) and...during the controlled hemorrhage to induce acidosis and coagulopathy. This reflects current civilian pre-hospital resuscitative practices. Operative

Air Quality Programs and Provisions of the Intermodal Surface Transportation Efficiency Act of 1991

DOT National Transportation Integrated Search

2012-11-01

The US DOT sponsored Dynamic Mobility Applications (DMA) program seeks to identify, develop, and deploy applications that leverage the full potential of connected vehicles, travelers and infrastructure to enhance current operational practices and tra...

Guide of good practices for occupational radiological protection in plutonium facilities

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

NONE

1998-06-01

This Technical Standard (TS) does not contain any new requirements. Its purpose is to provide guides to good practice, update existing reference material, and discuss practical lessons learned relevant to the safe handling of plutonium. the technical rationale is given to allow US Department of Energy (DOE) health physicists to adapt the recommendations to similar situations throughout the DOE complex. Generally, DOE contractor health physicists will be responsible to implement radiation protection activities at DOE facilities and DOE health physicists will be responsible for oversight of those activities. This guidance is meant to be useful for both efforts. This TSmore » replaces PNL-6534, Health Physics Manual of Good Practices for Plutonium Facilities, by providing more complete and current information and by emphasizing the situations that are typical of DOE`s current plutonium operations; safe storage, decontamination, and decommissioning (environmental restoration); and weapons disassembly.« less

Special Operations Forces Language and Culture Needs Assessment: General Use of Interpreters

DTIC Science & Technology

2010-11-04

strategic use of interpreters. This information can be used to examine and revise policies and everyday practice related to interpreter use, so that SOF...operators’ mission effectiveness can be improved. Examining the current state of interpreter use in the SOF community can highlight important...the other hand, those who received pre-deployment use of interpreter training found it effective. This training can teach SOF operators how to

Refactoring affordances in corporate wikis: a case for the use of mind maps

NASA Astrophysics Data System (ADS)

Puente, Gorka; Díaz, Oscar; Azanza, Maider

2015-11-01

The organisation of corporate wikis tends to deteriorate as time goes by. Rearranging categories, structuring articles and even moving sections among articles are cumbersome tasks in current wiki engines. This discourages the layman. But, it is the layman who writes the articles, knows the wiki content and detects refactoring opportunities. Our goal is to improve the refactoring affordances of current wiki engines by providing an alternative front-end tuned to refactoring. This is achieved by (1) surfacing the structure of the wiki corpus as a mind map, and (2) conducting refactoring as mind map reshaping. To this end, we introduce WikiWhirl, a domain-specific language for wiki refactoring. WikiWhirl is supported as an extension of FreeMind, a popular mind mapping tool. In this way, refactoring operations are intuitively conducted as actions upon mind map nodes. In a refactoring session a user imports the wiki structure as a FreeMind map; next, conducts the refactoring operations on the map, and finally, the effects are saved in the wiki database. The operational semantics of the WikiWhirl operations follow refactoring good practices (e.g., authorship preservation). Results from a controlled experiment suggest that WikiWhirl outperforms MediaWiki in three main affordance enablers: understandability, productivity and fulfillment of refactoring good practices.

Surgical residents' perception of competence and relevance of the clinical curriculum to future practice.

PubMed

Fronza, Jeffrey Scott; Prystowsky, Jay P; DaRosa, Debra; Fryer, Jonathan P

2012-01-01

General surgery residents maintain a case log throughout residency in order to achieve a targeted number of designated operations. Program directors must certify that each graduate is competent to enter general surgery practice without direct supervision. Our purpose was twofold, to determine: 1) graduates' perception of competence and relevance of specific operations to their practice; and 2) if case volume is related to competence. Six classes from a general surgery residency program (n=26) were surveyed one year after graduation. The survey was piloted and revised base on findings. It listed 67 operations encompassing all facets of general surgery. Each operation corresponded to two four-point scales (strongly agree to strongly disagree). One scale was headed with "I was well prepared to work-up, independently perform the operation, and effectively care for the patient post-operatively" and the other "This operation is relevant to my current practice profile". A linear regression analysis was utilized to study the relationship between total case volume and overall competence. An unpaired T-test was utilized to study the relationship between volume of specific operations and perceptions of competence. Twenty-two graduates completed the survey (85% response rate). All respondents felt prepared to perform 24% (16/67) of the operations. Fifty percent or more of respondents felt prepared to perform 91% (61/67) of the operations. Fifty percent or more did not feel competent performing the surgical treatment of necrotizing enterocolitis, orchiopexy, transhiatal esophagectomy, adrenalectomy, and open/endovascular abdominal aortic aneurysm repair. Twenty-six operations were felt to be irrelevant to the practice of 50% or more of graduates. No operation was unanimously felt to be relevant. For 12% of operations (8/67) at least 10% of graduates felt the operation was relevant to their practice but were not comfortable performing it. These operations (abdominoperineal resection, transanal excision of tumor, transhiatal esophagectomy, superficial inguinal lymph node dissection, right hepatectomy, whipple, colonoscopy, and adrenalectomy) were considered to be in need of educational improvement at a program level. After analyzing individual case logs, increased case volume only correlated with competence for esophagectomy (5 vs. 1 p = .014), EGD (32 vs. 9 p = .018), orchiopexy (2.5 vs. 0 p = .03), and adrenalectomy (3 vs. 1 p = .001). Total major operations performed did not correlate with overall competence (p = .12). As program directors must document graduates' competency they must do so with confidence. Our results suggest graduates to not feel competent performing many operations, and several are relevant to their practice. Competence in all aspects of general surgery may be unrealistic, even with robust volume. These findings might help in the restructuring curricula of residency. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Increasing smoke alarm operability through theory-based health education: a randomised trial

PubMed Central

Miller, Ted R; Bergen, Gwen; Ballesteros, Michael F; Bhattacharya, Soma; Gielen, Andrea Carlson; Sheppard, Monique S

2015-01-01

Background Although working smoke alarms halve deaths in residential fires, many households do not keep alarms operational. We tested whether theory-based education increases alarm operability. Methods Randomised multiarm trial, with a single arm randomly selected for use each day, in low-income neighbourhoods in Maryland, USA. Intervention arms: (1) Full Education combining a health belief module with a social-cognitive theory module that provided hands-on practice installing alarm batteries and using the alarm’s hush button; (2) Hands-on Practice social-cognitive module supplemented by typical fire department education; (3) Current Norm receiving typical fire department education only. Four hundred and thirty-six homes recruited through churches or by knocking on doors in 2005–2008. Followup visits checked alarm operability in 370 homes (85%) 1–3.5 years after installation. Main outcome measures: number of homes with working alarms defined as alarms with working batteries or hard-wired and number of working alarms per home. Regressions controlled for alarm status preintervention; demographics and beliefs about fire risks and alarm effectiveness. Results Homes in the Full Education and Practice arms were more likely to have a functioning smoke alarm at follow-up (OR=2.77, 95% CI 1.09 to 7.03) and had an average of 0.32 more working alarms per home (95% CI 0.09 to 0.56). Working alarms per home rose 16%. Full Education and Practice had similar effectiveness (p=0.97 on both outcome measures). Conclusions Without exceeding typical fire department installation time, installers can achieve greater smoke alarm operability. Hands-on practice is key. Two years after installation, for every three homes that received hands-on practice, one had an additional working alarm. Trial registration number http://www.clinicaltrials.gov number NCT00139126. PMID:25165090

Viable Short-Term Directed Energy Weapon Naval Solutions: A Systems Analysis of Current Prototypes

DTIC Science & Technology

2013-06-01

Background and Issues for Congress 2013). The current DDG-51 electrical plant consists of three Gas Turbine Generator Sets ( GTGs ) rated at 2500 kW each...the generator rating (currently 2500kW), the practice is to have a minimum of two GTGs on line at all times to ensure continuity of service should...there be a system fault, or casualty to one of the GTGs (Mahoney, et al. 2010). This operation of at least two generators at all times essentially

Current UK dental sedation practice and the 'National Institute for Health and Care Excellence' (NICE) guideline 112: sedation in children and young people.

PubMed

Coulthard, P; Craig, D; Holden, C; Robb, N D; Sury, M; Chopra, S; Holroyd, I

2015-04-24

Describe current dental sedation practice for under 19-year-olds in the UK and compare it with the recommendations of NICE guidance 112. Members of the Society for the Advancement of Anaesthesia in Dentistry and members of the Dental Sedation Teachers Group were invited to participate in an online survey. Two hundred and sixty-six dentists and doctors completed the survey. Eighty-two percent were operator and sedationist (operator-sedationist). Ninety-five percent provided written information and 94% obtained written consent. Eighty-four percent kept a written or electronic sedation record. Eighty-six percent complied with life support training expectations. Eighty-six percent had immediate access to resuscitation equipment. Sixty-seven percent of sedationists reported that treatment could not be completed under sedation for <10% of cases during the previous year. When sedation was unsuccessful, 61% said they would schedule general anaesthesia and 54.5% would schedule advanced sedation care. Forty-nine percent believed that a dentist was an appropriate person to provide advanced sedation for 12-18 years. Only 24% thought a dentist should provide advanced sedation for children<12 years, with 75% preferring an anaesthetist. The appropriate setting for advanced sedation was thought to be primary care by 33% and secondary care by 68%. We found good agreement between the current practice of sedation and the recommendations of the NICE guidance 112.

21 CFR 110.10 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-04-01

... CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General... contamination of food. The methods for maintaining cleanliness include, but are not limited to: (1) Wearing outer garments suitable to the operation in a manner that protects against the contamination of food...

The Emerging Professional: An Investigation into Teacher Education Students' Developing Conceptions of the Relationship between Theory and Classroom Practice before, during and after a Postgraduate Teaching Programme

ERIC Educational Resources Information Center

Knight, Rupert

2012-01-01

The role of theory in educational practice has long been seen as problematic (Pring 2004) and within initial teacher education (ITE) specifically, various models linking the two have been proposed (Korthagen 2010). In England, ITE is currently in a state of flux, with the majority of university-based postgraduate programmes operating partly at…

Feasibility study and preliminary design for fishing (TUNA) vessel fuel storage and distribution. Final report. Export trade information

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

NONE

1995-07-01

The report is divided into the following sections: (1) Introduction; (2) Conclusions and Recommendations; (3) Existing Conditions and Facilities for a Fuel Distribution Center; (4) Pacific Ocean Regional Tuna Fisheries and Resources; (5) Fishing Effort in the FSMEEZ 1992-1994; (6) Current Transshipping Operations in the Western Pacific Ocean; (7) Current and Probale Bunkering Practices of United States, Japanese, Koren, and Taiwanese Offshore-Based Vessels Operating in FSM and Adjacent Waters; (8) Shore-Based Fish-Handling/Processing; (9) Fuels Forecast; (10) Fuel Supply, Storage and Distribution; (11) Cost Estimates; (12) Economic Evaluation of Fuel Supply, Storage and Distribution.

Improving organ procurement practices in Michigan

PubMed Central

Lynch, RJ; Mathur, AK; Hundley, JC; Kubus, J; Pietroski, RE; Mattice, BJ; Punch, JD; Englesbe, MJ

2015-01-01

Travel to procure deceased donor organs is associated with risk to transplant personnel. In many instances, multiple teams are present for a given operation. We studied our statewide experience to determine how much excess travel this redundancy entails, and generated alternate models for organ recovery. We reviewed our organ procurement organization’s experience with deceased donor operations between 2002 and 2008. Travel was expressed as cumulative person-miles between procurement team origin and donor hospital. A model of minimal travel was created, using thoracic and abdominal teams from the closest in-state center. A second model involved transporting donors to a dedicated procurement facility. Travel distance was recalculated using these models, and mode and cost of travel extrapolated from current practices. In 654 thoracic and 1469 abdominal donors studied, mean travel for thoracic teams was 1066 person-miles, and for abdominal teams was 550 person-miles. The mean distance traveled by thoracic and abdominal organs was 223 miles and 142 miles, respectively. Both hypothetical models showed reductions in team travel and reliance on air transport, with favorable costs and organ transport times compared to historical data. In summary, we found significant inefficiency in current practice, which may be alleviated using new paradigms for donor procurement. PMID:19656129

The Puestow procedure: how I do it.

PubMed

Adams, David B

2013-06-01

The Puestow procedure, also called lateral pancreaticojejunostomy, has been the mainstay of surgical therapy for dilated duct chronic pancreatitis for decades. Principles that Puestow and Gillesby described in 1958 are pertinent to the modern conduct of this operation that is described with current practice guidelines.

Operations analysis (study 2.1). Payload designs for space servicing, addendum

NASA Technical Reports Server (NTRS)

Wolfe, R. R.

1974-01-01

Space replaceable units and payload configurations are revised to reflect increased levels of redundancy to be more consistent with current design practices. A reassessment of expendable payload design reliabilities was performed to provide a common basis for comparison with space serviceable configurations.

High-Security Fencing for Rail Right-of-way Applications : Current Use and Best Practices.

DOT National Transportation Integrated Search

2015-10-01

The Volpe Center investigated how high-security fencing is used to prevent right-of-way (ROW) trespassing at several urban transit and commuter rail agencies in the United States. Interviews, operations documentation, and site visits were used to gat...

Integrating Sensor Monitoring Technology into the Current Air Pollution Regulatory Support Paradigm: Practical Considerations

EPA Science Inventory

The US Environmental Protection Agency (EPA) along with state, local, and tribal governments operate Federal Reference Method (FRM) and Federal Equivalent Method (FEM) instruments to assess compliance with US air pollution standards designed to protect human and ecosystem health....

21 CFR 110.35 - Sanitary operations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... against contamination of food. (1) Food-contact surfaces used for manufacturing or holding low-moisture... HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD... for contamination. Only the following toxic materials may be used or stored in a plant where food is...

Management of occiput posterior position in the second stage of labor: a survey of midwifery practice in Australia.

PubMed

Phipps, Hala; de Vries, Brad; Jagadish, Ujvala; Hyett, Jon

2014-03-01

The management of the occiput posterior (OP) position has been controversial for many years. Manual rotation can be performed by midwives and could reduce cesarean sections and instrumental births. We aimed to determine current midwifery views, knowledge, and practice of manual rotation. A de-identified, self-reported questionnaire was e-mailed to all Australian College of Midwives full members (n = 3,997). Of 3,182 surveyed, 57 percent (1,817) responded, of whom 51 percent (920) were currently practicing midwifery. Seventy-seven percent of midwives thought that manual rotation at full dilatation was a valid intervention. Sixty-four percent stated the procedure was acceptable before instrumental delivery, but 30 percent were unsure. Most practicing midwives (93%) had heard of manual rotation, but only 18 percent had performed one in the last year. Midwives would support the routine performance of manual rotation for OP position if it reduced operative births from 68 to 50 percent and would support manual rotation for occiput transverse (OT) position if it reduced operative births from 39 to 25 percent. This study indicates that manual rotation is considered acceptable by most midwives in Australia, yet is only performed by a minority. Midwives would be willing to perform prophylactic manual rotation if it was known to facilitate normal vaginal births suggesting a scope to introduce this procedure into widespread clinical practice. © 2014, Copyright the Authors Journal compilation © 2014, Wiley Periodicals, Inc.

Practical Framework for an Electron Beam Induced Current Technique Based on a Numerical Optimization Approach

NASA Astrophysics Data System (ADS)

Yamaguchi, Hideshi; Soeda, Takeshi

2015-03-01

A practical framework for an electron beam induced current (EBIC) technique has been established for conductive materials based on a numerical optimization approach. Although the conventional EBIC technique is useful for evaluating the distributions of dopants or crystal defects in semiconductor transistors, issues related to the reproducibility and quantitative capability of measurements using this technique persist. For instance, it is difficult to acquire high-quality EBIC images throughout continuous tests due to variation in operator skill or test environment. Recently, due to the evaluation of EBIC equipment performance and the numerical optimization of equipment items, the constant acquisition of high contrast images has become possible, improving the reproducibility as well as yield regardless of operator skill or test environment. The technique proposed herein is even more sensitive and quantitative than scanning probe microscopy, an imaging technique that can possibly damage the sample. The new technique is expected to benefit the electrical evaluation of fragile or soft materials along with LSI materials.

Semiconductor diode laser material and devices with emission in visible region of the spectrum

NASA Technical Reports Server (NTRS)

Ladany, I.; Kressel, H.

1975-01-01

Two alloy systems, (AlGa)As and (InGa)P, were studied for their properties relevant to obtaining laser diode operation in the visible region of the spectrum. (AlGa)As was prepared by liquid-phase epitaxy (LPE) and (InGa)P was prepared both by vapor-phase epitaxy and by liquid-phase epitaxy. Various schemes for LPE growth were applied to (InGa)P, one of which was found to be capable of producing device material. All the InGaP device work was done using vapor-phase epitaxy. The most successful devices were fabricated in (AlGa)As using heterojunction structures. At room temperature, the large optical cavity design yielded devices lasing in the red (7000 A). Because of the relatively high threshold due to the basic band structure limitation in this alloy, practical laser diode operation is presently limited to about 7300 A. At liquid-nitrogen temperature, practical continuous-wave operation was obtained at a wavelength of 6500 to 6600 A, with power emission in excess of 50 mW. The lowest pulsed lasing wavelength is 6280 A. At 223 K, lasing was obtained at 6770 A, but with high threshold currents. The work dealing with CW operation at room temperature was successful with practical operation having been achieved to about 7800 A.

Best practice guidelines for the operation of a donor human milk bank in an Australian NICU.

PubMed

Hartmann, B T; Pang, W W; Keil, A D; Hartmann, P E; Simmer, K

2007-10-01

Until the establishment of the PREM Bank (Perron Rotary Express Milk Bank) donor human milk banking had not occurred in Australia for the past 20 years. In re-establishing donor human milk banking in Australia, the focus of the PREM Bank has been to develop a formal and consistent approach to safety and quality in processing during the operation of the human milk bank. There is currently no existing legislation in Australia that specifically regulates the operation of donor human milk banks. For this reason the PREM Bank has utilised existing and internationally recognised management practices for managing hazards during food production. These tools (specifically HACCP) have been used to guide the development of Standard Operating Procedures and Good Manufacturing Practice for the screening of donors and processing of donor human milk. Donor screening procedures are consistent with those recommended by other human milk banks operating internationally, and also consistent with the requirements for blood and tissue donation in Australia. Controlled documentation and record keep requirements have also been developed that allow complete traceability from individual donation to individual feed dispensed to recipient and maintain a record of all processing and storage conditions. These operational requirements have been developed to reduce any risk associated with feeding pasteurised donor human milk to hospitalised preterm or ill infants to acceptable levels.

Study on the steady operating state of a micro-pulse electron gun

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

Kui, Zhou; Xing, Luo; Institute of Applied Electronics, Chinese Academy of Engineering Physics, Mianyang 621900

Micro-pulse electron gun (MPG) employs the basic concept of multipacting to produce high-current and short-pulse electron beams from a radio-frequency (RF) cavity. The concept of MPG has been proposed for more than two decades. However, the unstable operating state of MPG vastly obstructs its practical applications. This paper presents a study on the steady operating state of a micro-pulse electron gun with theory and experiments. The requirements for the steady operating state are proposed through the analysis of the interaction between the RF cavity and the beam load. Accordingly, a MPG cavity with the frequency of 2856 MHz has been designed,more » constructed, and tested. Some primary experiments have been finished. Both the unstable and stable operating states of the MPG have been observed. The stable output beam current has been detected at about 3.8 mA. Further experimental study is under way now.« less

Workshop on Assurance for Autonomous Systems for Aviation

NASA Technical Reports Server (NTRS)

Brat, Guillaume; Davies, Misty; Giannakopoulou, Dimitra; Neogi, Natasha

2016-01-01

This report describes the workshop on Assurance for Autonomous Systems for Aviation that was held in January 2016 in conjunction with the SciTech 2016 conference held in San Diego, CA. The workshop explored issues related to assurance for autonomous systems and also the idea of trust in these systems. Specifically, we focused on discussing current practices for assurance of autonomy, identifying barriers specific to autonomy as related to assurance as well as operational scenarios demonstrating the need to address the barriers. Furthermore, attention was given to identifying verification techniques that may be applicable to autonomy, as well as discussing new research directions needed to address barriers, thereby involving potential shifts in current practices.

Current good manufacturing practice in manufacturing, processing, packing, or holding of drugs; revision of certain labeling controls--FDA. Final rule.

PubMed

1993-08-03

The Food and Drug Administration (FDA) is amending the current good manufacturing practice (CGMP) regulations for human and veterinary drug products to revise certain labeling control provisions. Specifically, the final rule defines the term "gang-printed labeling," specifies conditions for the use of gang-printed or cut labeling, exempts manufacturers that employ automated 100-percent labeling inspection systems from CGMP labeling reconciliation requirements, and requires manufacturers to identify filled drug product containers that are set aside and held in an unlabeled condition for future labeling operations. These changes are intended to reduce the frequency of drug product mislabeling and associated drug product recalls.

21 CFR 111.16 - What are the requirements under this subpart C for written procedures?

Code of Federal Regulations, 2010 CFR

2010-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKAGING, LABELING, OR HOLDING OPERATIONS FOR DIETARY SUPPLEMENTS Physical Plant and Grounds... follow written procedures for cleaning the physical plant and for pest control. ...

21 CFR 111.16 - What are the requirements under this subpart C for written procedures?

Code of Federal Regulations, 2011 CFR

2011-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKAGING, LABELING, OR HOLDING OPERATIONS FOR DIETARY SUPPLEMENTS Physical Plant and Grounds... follow written procedures for cleaning the physical plant and for pest control. ...

Rescue Manual. Module 2.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Instructional Materials Lab.

This learner manual for rescuers covers the current techniques or practices required in the rescue service. The second of 10 modules contains 5 chapters: (1) patient care and handling techniques; (2) rescue carries and drags; (3) emergency vehicle operations; (4) self-contained breathing apparatus; and (5) protective clothing. Key points, an…

Rescue Manual. Module 6.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Instructional Materials Lab.

This learner manual for rescuers covers the current techniques or practices required in the rescue service. The sixth of 10 modules contains 4 chapters: (1) industrial rescue; (2) rescue from a confined space; (3) extrication from heavy equipment; and (4) rescue operations involving elevators. Key points, an introduction, and conclusion accompany…

Advances in dental materials.

PubMed

Fleming, Garry J P

2014-05-01

The dental market is replete with new resorative materials marketed on the basis of novel technological advances in materials chemistry, bonding capability or reduced operator time and/or technique sensitivity. This paper aims to consider advances in current materials, with an emphasis on their role in supporting contemporary clinical practice.

U.S. Transit Track Restraining Rail. Volume I : Study of Requirements and Practices

DOT National Transportation Integrated Search

1981-12-01

This report covers a study of restraining rails in transit track, which is part of the current research program of UMTA and was initiated: (1) to assist in the analysis, design, and maintenance and operation of transit track; (2) to compile guideline...

Optical-Fiber-Welding Machine

NASA Technical Reports Server (NTRS)

Goss, W. C.; Mann, W. A.; Goldstein, R.

1985-01-01

Technique yields joints with average transmissivity of 91.6 percent. Electric arc passed over butted fiber ends to melt them together. Maximum optical transmissivity of joint achieved with optimum choice of discharge current, translation speed, and axial compression of fibers. Practical welding machine enables delicate and tedious joining operation performed routinely.

The Marine Corps’ Warrior Ethos: Practicality for Today’s Operating Environment

DTIC Science & Technology

2013-03-01

warrior ethos if that ethos does not place value on all human life, adhere to core values and recognize the importance of leaders, at all levels ...Adherence to the warrior ethos is critical because in the current environment, small unit tactical actions have strategic level impacts. The current...entry- level training. Violations of the Marine Corps warrior ethos have occurred in recent conflicts. Exploration of these violations is vital to

Update - Concept of Operations for Integrated Model-Centric Engineering at JPL

NASA Technical Reports Server (NTRS)

Bayer, Todd J.; Bennett, Matthew; Delp, Christopher L.; Dvorak, Daniel; Jenkins, Steven J.; Mandutianu, Sanda

2011-01-01

The increasingly ambitious requirements levied on JPL's space science missions, and the development pace of such missions, challenge our current engineering practices. All the engineering disciplines face this growth in complexity to some degree, but the challenges are greatest in systems engineering where numerous competing interests must be reconciled and where complex system level interactions must be identified and managed. Undesired system-level interactions are increasingly a major risk factor that cannot be reliably exposed by testing, and natural-language single-viewpoint specifications areinadequate to capture and expose system level interactions and characteristics. Systems engineering practices must improve to meet these challenges, and the most promising approach today is the movement toward a more integrated and model-centric approach to mission conception, design, implementation and operations. This approach elevates engineering models to a principal role in systems engineering, gradually replacing traditional document centric engineering practices.

Shaping the operating room and perioperative systems of the future: innovating for improved competitiveness.

PubMed

Seim, Andreas R; Sandberg, Warren S

2010-12-01

To review the current state of anesthesiology for operative and invasive procedures, with an eye toward possible future states. Anesthesiology is at once a mature specialty and in a crisis--requiring breakthrough to move forward. The cost of care now approaches reimbursement, and outcomes as commonly measured approach perfection. Thus, the cost of further improvements seems ready to topple the field, just as the specialty is realizing that seemingly innocuous anesthetic choices have long-term consequences, and better practice is required. Anesthesiologists must create more headroom between costs and revenues in order to sustain the academic vigor and creativity required to create better clinical practice. We outline three areas in which technological and organizational innovation in anesthesiology can improve competitiveness and become a driving force in collaborative efforts to develop the operating rooms and perioperative systems of the future: increasing the profitability of operating rooms; increasing the efficiency of anesthesia; and technological and organizational innovation to foster improved patient flow, communication, coordination, and organizational learning.

Management system to a photovoltaic panel based on the measurement of short-circuit currents

NASA Astrophysics Data System (ADS)

Dordescu, M.

2016-12-01

This article is devoted to fundamental issues arising from operation in terms of increased energy efficiency for photovoltaic panel (PV). By measuring the current from functioning cage determine the current value prescribed amount corresponding to maximum power point results obtained by requiring proof of pregnancy with this method are the maximum energy possible, thus justifying the usefulness of this process very simple and inexpensive to implement in practice. The proposed adjustment method is much simpler and more economical than conventional methods that rely on measuring power cut.

Integrating research into operational practice

PubMed Central

Ross, Alastair

2015-01-01

Research and development can be classified into three categories: technology adoption, technology extension, and knowledge and technology creation. In general, technology adoption is embedded in operational forensic science laboratory practice but the latter two categories require partnerships with industry and/or academia both to conduct the research and implement the outcomes. In a 2012 survey, Australian and New Zealand forensic science laboratories identified a number of ‘roadblocks’ to undertaking research and operationalizing research outcomes. These included insufficient time and funding, a lack of in-house research experience and the absence of a tangible research culture. Allied to this is that, increasingly, forensic science research is conducted in a ‘commercial in confidence’ environment and the outcomes are not readily or cost-effectively available to be integrated into operational forensic science laboratories. The paper is predominantly reflective of the current situation in Australia and New Zealand PMID:26101286

A Bearingless Switched-Reluctance Motor for High Specific Power Applications

NASA Technical Reports Server (NTRS)

Choi, Benjamin B.; Siebert, Mark

2006-01-01

A 12-8 switched-reluctance motor (SRM) is studied in bearingless (or self-levitated) operation with coil currents limited to the linear region to avoid magnetic saturation. The required motoring and levitating currents are summed and go into a single motor coil per pole to obtain the highest power output of the motor by having more space for motor coil winding. Two controllers are investigated for the bearingless SRM operation. First, a model-based controller using the radial force, which is adjusted by a factor derived from finite element analysis, is presented. Then a simple and practical observation-based controller using a PD (proportional-derivative) control algorithm is presented. Both controllers were experimentally demonstrated to 6500 rpm. This paper reports the initial efforts toward eventual self levitation of a SRM operating into strong magnetic core saturation at liquid nitrogen temperature.

Diode laser operating on an atomic transition limited by an isotope ⁸⁷Rb Faraday filter at 780 nm.

PubMed

Tao, Zhiming; Hong, Yelong; Luo, Bin; Chen, Jingbiao; Guo, Hong

2015-09-15

We demonstrate an extended cavity Faraday laser system using an antireflection-coated laser diode as the gain medium and the isotope (87)Rb Faraday anomalous dispersion optical filter (FADOF) as the frequency selective device. Using this method, the laser wavelength works stably at the highest transmission peak of the isotope (87)Rb FADOF over the laser diode current from 55 to 140 mA and the temperature from 15°C to 35°C. Neither the current nor the temperature of the laser diode has significant influence on the output frequency. Compared with previous extended cavity laser systems operating at frequencies irrelevant to spectacular atomic transition lines, the laser system realized here provides a stable laser source with the frequency operating on atomic transitions for many practical applications.

Articulating current service development practices: a qualitative analysis of eleven mental health projects

PubMed Central

2014-01-01

Background The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. Methods Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. Results Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. Conclusions This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial. PMID:24438471

Articulating current service development practices: a qualitative analysis of eleven mental health projects.

PubMed

Jun, Gyuchan Thomas; Morrison, Cecily; Clarkson, P John

2014-01-17

The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial.

Energy management study: A proposed case of government building

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

Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount ofmore » energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.« less

Energy management study: A proposed case of government building

NASA Astrophysics Data System (ADS)

Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Baharum, Mohd Faizal

2015-05-01

Align with the current needs of the sustainable and green technology in Malaysian construction industry, this research is conducted to seek and identify opportunities to better manage energy use including the process of understand when, where, and how energy is used in a building. The purpose of this research is to provide a best practice guideline as a practical tool to assist construction industry in Malaysia to improve the energy efficiency of the office building during the post-production by reviewing the current practice of the building operation and maintenance in order to optimum the usage and reduce the amount of energy input into the building. Therefore, this paper will review the concept of maintenance management, current issue in energy management, and on how the research process will be conducted. There are several process involves and focuses on technical and management techniques such as energy metering, tracing, harvesting, and auditing based on the case study that will be accomplish soon. Accordingly, a case study is appropriate to be selected as a strategic research approach in which involves an empirical investigation of a particular contemporary phenomenon within its real life context using multiple sources of evidence for the data collection process. A Government office building will be selected as an appropriate case study for this research. In the end of this research, it will recommend a strategic approach or model in a specific guideline for enabling energy-efficient operation and maintenance in the office building.

21 CFR 111.23 - Under this subpart C, what records must you make and keep?

Code of Federal Regulations, 2010 CFR

2010-04-01

... HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKAGING, LABELING, OR HOLDING OPERATIONS FOR DIETARY SUPPLEMENTS Physical Plant and Grounds... of the written procedures for cleaning the physical plant and for pest control. (c) You must make and...

21 CFR 111.23 - Under this subpart C, what records must you make and keep?

Code of Federal Regulations, 2011 CFR

2011-04-01

... HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKAGING, LABELING, OR HOLDING OPERATIONS FOR DIETARY SUPPLEMENTS Physical Plant and Grounds... of the written procedures for cleaning the physical plant and for pest control. (c) You must make and...

21 CFR 111.27 - What requirements apply to the equipment and utensils that you use?

Code of Federal Regulations, 2010 CFR

2010-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKAGING, LABELING, OR HOLDING OPERATIONS FOR DIETARY SUPPLEMENTS Equipment and Utensils § 111... utensils that are of appropriate design, construction, and workmanship to enable them to be suitable for...

Signing and pavement marking for concurrent-flow high-occupancy-vehicle lanes : summary of current practice

DOT National Transportation Integrated Search

1997-01-01

Concurrent-flow lanes account for more than half of existing high-occupancy-vehicle (HOV) mileage in the United States. Traffic on this type of HOV lane operates in the same direction as the adjacent traffic, typically in the far-left lane. Limited n...

75 FR 59266 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations... submitted to the Office of Management and Budget (OMB) for review and clearance under the Paperwork...

75 FR 60463 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-30

...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment...: Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for... Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995. DATES: Fax...

77 FR 38769 - 97th Annual Meeting of the National Conference on Weights and Measures

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... testing equipment that comprise the regulatory control of commercial weighing and measuring devices. The... specifications to recognize current marketing practices of offering pre or post delivery discounts on fuel prices... proposal would allow device manufacturers greater flexibility in the design and operation of customer...

16 CFR 436.9 - Additional prohibitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... practice in violation of Section 5 of the Federal Trade Commission Act for any franchise seller covered by... a franchise from the franchisor or operated a franchise of the type offered by the franchisor. (2) Can provide an independent and reliable report about the franchise or the experiences of any current...

16 CFR 436.9 - Additional prohibitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... practice in violation of Section 5 of the Federal Trade Commission Act for any franchise seller covered by... a franchise from the franchisor or operated a franchise of the type offered by the franchisor. (2) Can provide an independent and reliable report about the franchise or the experiences of any current...

16 CFR 436.9 - Additional prohibitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... practice in violation of Section 5 of the Federal Trade Commission Act for any franchise seller covered by... a franchise from the franchisor or operated a franchise of the type offered by the franchisor. (2) Can provide an independent and reliable report about the franchise or the experiences of any current...

16 CFR 436.9 - Additional prohibitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... practice in violation of Section 5 of the Federal Trade Commission Act for any franchise seller covered by... a franchise from the franchisor or operated a franchise of the type offered by the franchisor. (2) Can provide an independent and reliable report about the franchise or the experiences of any current...

16 CFR 436.9 - Additional prohibitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... practice in violation of Section 5 of the Federal Trade Commission Act for any franchise seller covered by... a franchise from the franchisor or operated a franchise of the type offered by the franchisor. (2) Can provide an independent and reliable report about the franchise or the experiences of any current...

75 FR 78715 - Small Entity Compliance Guide: Current Good Manufacturing Practice in Manufacturing, Packaging...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0605..., or Holding Operations for Dietary Supplements; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of a...

Ethical Problems in the Practice of Organization Development.

ERIC Educational Resources Information Center

Wooten, Kevin C.; White, Louis P.

1983-01-01

This article discusses forces that affect the professional ethics of organizational development (OD). Both driving forces and restraining forces have influenced the current status of OD ethics. These forces have operated since the emergence of OD itself, and their fluctuating intensity results in the dynamic nature of the OD profession. (SSH)

21 CFR 110.20 - Plant and grounds.

Code of Federal Regulations, 2010 CFR

2010-04-01

... CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD Buildings and... operator shall be kept in a condition that will protect against the contamination of food. The methods for..., yards, and parking lots so that they do not constitute a source of contamination in areas where food is...

Prototype development and demonstration for response, emergency staging, communications, uniform management, and evacuation (R.E.S.C.U.M.E.) : information broker framework analysis.

DOT National Transportation Integrated Search

2015-03-01

Through the Dynamic Mobility Applications (DMA) Program, U.S. DOT desires to improve current operational practices and transform management of future surface transportation systems. The DMA program is designed to enhance deployment of emerging techno...

Four Pillars for Improving the Quality of Safety-Critical Software-Reliant Systems

DTIC Science & Technology

2013-04-01

Studies of safety-critical software-reliant systems developed using the current practices of build-then-test show that requirements and architecture ... design defects make up approximately 70% of all defects, many system level related to operational quality attributes, and 80% of these defects are

Public Employee Retirement Systems: The Structure and Politics of Teacher Pensions.

ERIC Educational Resources Information Center

Taylor, Suzanne Saunders

This book describes the operation of state and local government pension systems for teachers, explores the rationale behind current administrative and financial practices, and describes the interaction of special interest groups, pension professionals, and investment personnel with the administration of these systems. The pension systems in 23…

CrossTalk, The Journal of Defense Software Engineering. Volume 26, Number 2. March/April 2013

DTIC Science & Technology

2013-04-01

standards and best practices. “Software and hardware are at risk of being tam - pered with even before they are linked together in an operational system...because of their role in national and global security and the variety of valuable lessons learned and best practices they can provide because they are...Management. GAO said DoD’s efforts to implement SCRM can be a learning tool for others in the Federal government. DoD is currently imple- CrossTalk

Findings from a national needs assessment of American Indian/Alaska native child welfare programs.

PubMed

Leake, Robin; Potter, Cathryn; Lucero, Nancy; Gardner, Jerry; Deserly, Kathy

2012-01-01

The National Child Welfare Resource Center for Tribes, a member of the Children's Bureau Child Welfare Training and Technical Assistance Network, conducted a national needs assessment of tribal child welfare. This assessment explored current practices in tribal child welfare to identify unique systemic strengths and challenges. A culturally based, multi-method design yielded findings in five areas: tribal child welfare practice, foster care and adoption, the Indian Child Welfare Act, legal and judicial, and program operations.

Management practices associated with pain in cattle on western Canadian cow-calf operations: A mixed methods study.

PubMed

Moggy, M A; Pajor, E A; Thurston, W E; Parker, S; Greter, A M; Schwartzkopf-Genswein, K S; Campbell, J R; Windeyer, M C

2017-02-01

The implementation of on-farm pain mitigation strategies is dependent on feasibility and importance to producers. Currently, there is a lack of information regarding adoption of management practices associated with pain in cattle within the Canadian beef industry. The objective of this mixed methods study was to describe pain-associated practices implemented on farm and producer perceptions toward pain mitigation strategies. A questionnaire about calving management and calf processing was delivered to 109 cow-calf producers in western Canada. In addition, 15 respondents were purposively selected based on questionnaire responses to participate in individual semistructured, on-farm interviews. The prevalence of pain mitigation strategies used for dystocia and cesarean section by respondents were 46 and 100%, respectively. The majority of operations reported castrating and dehorning calves before 3 mo of age (95 and 89%, respectively). The majority of operations did not use pain mitigation strategies for castration and dehorning (90 and 85%, respectively). Branding was practiced by 57% of respondents, 4% of which used pain mitigation. Thematic content analysis revealed that producers' perception of pain were influenced by what they referred to as "common sense," relatability to cattle, visual evidence of pain, and age of the animal. Factors that influenced participant rationale for the implementation of pain mitigation practices included access to information and resources, age of the animal, benefit to the operation, cost and logistics, market demands, and personal conscience. Overall, management practices were generally in compliance with published Canadian guidelines. Results of this study may provide direction for future policy making, research, and extension efforts to encourage the adoption of pain mitigation strategies.

Voltage- and current-activated metal-insulator transition in VO2-based electrical switches: a lifetime operation analysis.

PubMed

Crunteanu, Aurelian; Givernaud, Julien; Leroy, Jonathan; Mardivirin, David; Champeaux, Corinne; Orlianges, Jean-Christophe; Catherinot, Alain; Blondy, Pierre

2010-12-01

Vanadium dioxide is an intensively studied material that undergoes a temperature-induced metal-insulator phase transition accompanied by a large change in electrical resistivity. Electrical switches based on this material show promising properties in terms of speed and broadband operation. The exploration of the failure behavior and reliability of such devices is very important in view of their integration in practical electronic circuits. We performed systematic lifetime investigations of two-terminal switches based on the electrical activation of the metal-insulator transition in VO 2 thin films. The devices were integrated in coplanar microwave waveguides (CPWs) in series configuration. We detected the evolution of a 10 GHz microwave signal transmitted through the CPW, modulated by the activation of the VO 2 switches in both voltage- and current-controlled modes. We demonstrated enhanced lifetime operation of current-controlled VO 2 -based switching (more than 260 million cycles without failure) compared with the voltage-activated mode (breakdown at around 16 million activation cycles). The evolution of the electrical self-oscillations of a VO 2 -based switch induced in the current-operated mode is a subtle indicator of the material properties modification and can be used to monitor its behavior under various external stresses in sensor applications.

Empowerment through agency-promoting dialogue: an explicit application of harm reduction theory to reframe HIV test counseling.

PubMed

Mattson, M

2000-01-01

The counseling that accompanies HIV testing can be an important prevention tool for encouraging people to practice safer sex to avoid AIDS, but there is scant research about how HIV test counseling operates in practice. This article critiques the current Centers for Disease Control and Prevention (CDC) protocol for HIV test counseling for not being genuinely client centered and ignoring the unique needs of clients and offers an alternative approach that adapts and explicitly applies the tenets of harm reduction theory (HRT). Excerpts from actual HIV test counseling sessions illustrate both the weaknesses in the current approach to HIV test counseling and project how the alternative theoretical perspective offered could provide counseling that encourages agency-promoting and empowering dialogue. The implications for the development of HRT as a health communication heuristic and a practical training and evaluation strategy are discussed along with limitations and future research directions.

Review of Current Data Exchange Practices: Providing Descriptive Data to Assist with Building Operations Decisions

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

Livingood, W.; Stein, J.; Considine, T.

Retailers who participate in the U.S. Department of Energy Commercial Building Energy Alliances (CBEA) identified the need to enhance communication standards. The means are available to collect massive numbers of buildings operational data, but CBEA members have difficulty transforming the data into usable information and energy-saving actions. Implementing algorithms for automated fault detection and diagnostics and linking building operational data to computerized maintenance management systems are important steps in the right direction, but have limited scalability for large building portfolios because the algorithms must be configured for each building.

New technologies for space avionics

NASA Technical Reports Server (NTRS)

Aibel, David W.; Dingus, Peter; Lanciault, Mark; Hurdlebrink, Debra; Gurevich, Inna; Wenglar, Lydia

1994-01-01

This report reviews a 1994 effort that continued 1993 investigations into issues associated with the definition of requirements, with the practice concurrent engineering and rapid prototyping in the context of the development of a prototyping of a next-generation reaction jet driver controller. This report discusses lessons learned, the testing of the current prototype, the details of the current design, and the nature and performance of a mathematical model of the life cycle of a pilot operated valve solenoid.

[Application of three-dimensional printing technique in orthopaedics].

PubMed

Luo, Qiang; Lau, Tak Wing; Fang, Xinshuo; Leung, Frankie

2014-03-01

To review the current progress of three-dimensional (3-D) printing technique in the clinical practice, its limitations and prospects. The recent publications associated with the clinical application of 3-D printing technique in the field of surgery, especially in orthopaedics were extensively reviewed. Currently, 3-D printing technique has been applied in orthopaedic surgery to aid diagnosis, make operative plans, and produce personalized prosthesis or implants. 3-D printing technique is a promising technique in clinical application.

United States Air and Space Power in the 21st Century: Strategic Appraisal

DTIC Science & Technology

2002-01-01

changes in current U.S. nuclear operational practice. It would require at the very least • suitable planning systems (e.g., near- real - time target...to increase real - time visibility into demands, inventories, and flows will likely be very valuable in this regard. Robust, well-stocked FSLs will...of the type of wholesale shift required. The current system is designed for heavy deployments with fairly long lead times . To sup- port Air

Mental Health Evaluations for Adolescents Prior to Bariatric Surgery: A Review of Existing Practices and a Specific Example of Assessment Procedures.

PubMed

Sysko, Robyn; Zandberg, Laurie J; Devlin, Michael J; Annunziato, Rachel A; Zitsman, Jeffrey L; Walsh, B Timothy

2013-06-01

Best practice guidelines for adolescents considering bariatric surgery recommend a pre-operative mental health evaluation. However, only general information about these assessments appears in the literature, which makes consistency of administration challenging. This review proposes a specific empirically-derived format for pre-surgical mental health evaluations and summarizes currently available data on the psychiatric functioning of adolescents seeking bariatric surgery. Studies of mental health evaluations for adults preparing for bariatric surgery are reviewed, as is the limited literature relevant to adolescent evaluations. A specific and detailed example of an evaluation (clinical interview, self-report questionnaires, cognitive assessment) used for younger patients at a major metropolitan hospital center is presented, followed by data from an initial group of adolescents completing this evaluation. 200 adolescents (n=139 female; age: 14-18 y, BMI: 35.4-83.3 kg/m 2 ) presenting for bariatric surgery. A notable subset of adolescents reported current Axis I conditions (31.5%) and current mental health treatment (29.5%), but reports of current illicit drug use (1.5%) and regular alcohol use (0.5%) were relatively rare. Procedures for using the completed evaluation and post-surgery monitoring of psychosocial issues are discussed. Adolescents considering weight loss surgery should receive comprehensive pre-surgical mental health evaluations, but additional data are needed to develop specific recommendations the use of these evaluations in post-operative care.

Service innovation management practices in the telecommunications industry: what does cross country analysis reveal?

PubMed

Rahman, Syed Abidur; Taghizadeh, Seyedeh Khadijeh; Ramayah, T; Ahmad, Noor Hazlina

2015-01-01

Service innovation management practice is currently being widely scrutinized mainly in the developed countries, where it has been initiated. The current study attempts to propose a framework and empirically validate and explain the service innovation practices for successful performance in the telecommunications industry of two developing countries, Malaysia and Bangladesh. The research framework proposes relationships among organisational culture, operating core (innovation process, cross-functional organisation, and implementation of tools/technology), competition-informed pricing, and performance. A total of 176 usable data from both countries are analysed for the purpose of the research. The findings show that organisational culture tends to be more influential on innovation process and cross-functional organisation in Malaysian telecommunication industry. In contrast, implementation of tools/technology plays a more instrumental role in competition-informed pricing practices in Bangladesh. This study revealed few differences in the innovation management practices between two developing countries. The findings have strategic implications for the service sectors in both the developing countries regarding implementation of innovative enterprises, especially in Bangladesh where innovation is the basis for survival. Testing the innovation management practices in the developing countries perhaps contains uniqueness in the field of innovation management.

Increasing smoke alarm operability through theory-based health education: a randomised trial.

PubMed

Miller, Ted R; Bergen, Gwen; Ballesteros, Michael F; Bhattacharya, Soma; Gielen, Andrea Carlson; Sheppard, Monique S

2014-12-01

Although working smoke alarms halve deaths in residential fires, many households do not keep alarms operational. We tested whether theory-based education increases alarm operability. Randomised multiarm trial, with a single arm randomly selected for use each day, in low-income neighbourhoods in Maryland, USA. Intervention arms: (1) Full Education combining a health belief module with a social-cognitive theory module that provided hands-on practice installing alarm batteries and using the alarm's hush button; (2) Hands-on Practice social-cognitive module supplemented by typical fire department education; (3) Current Norm receiving typical fire department education only. Four hundred and thirty-six homes recruited through churches or by knocking on doors in 2005-2008. Follow-up visits checked alarm operability in 370 homes (85%) 1-3.5 years after installation. number of homes with working alarms defined as alarms with working batteries or hard-wired and number of working alarms per home. Regressions controlled for alarm status preintervention; demographics and beliefs about fire risks and alarm effectiveness. Homes in the Full Education and Practice arms were more likely to have a functioning smoke alarm at follow-up (OR=2.77, 95% CI 1.09 to 7.03) and had an average of 0.32 more working alarms per home (95% CI 0.09 to 0.56). Working alarms per home rose 16%. Full Education and Practice had similar effectiveness (p=0.97 on both outcome measures). Without exceeding typical fire department installation time, installers can achieve greater smoke alarm operability. Hands-on practice is key. Two years after installation, for every three homes that received hands-on practice, one had an additional working alarm. http://www.clinicaltrials.gov number NCT00139126. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

High Resolution Modeling of Coastal Inundation: User Requirements and Current Practice, A Navy Perspective

DTIC Science & Technology

2007-07-27

often located at Within this paper the general role of in- period. These changes in the operational ret- the cusp of the land- sea interface where algo...vegetation, and sediment proper- summarizes the user requirements set forth NNS060820-01, www.news.navy.mil). Fur- ties. Since the Navy operational...role are dis- modeling the circulation and pollutant trans- bal, regional, and local systems with two pri- cussed below, port in estuarine and coastal

FLOWER IPv4/IPv6 Network Flow Summarization software

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

Nickless, Bill; Curtis, Darren; Christy, Jason

FLOWER was written as a refactoring/reimplementation of the existing Flo software used by the Cooperative Protection Program (CPP) to provide network flow summaries for analysis by the Operational Analysis Center (OAC) and other US Department of Energy cyber security elements. FLOWER is designed and tested to operate at 10 gigabits/second, nearly 10 times faster than competing solutions. FLOWER output is optimized for importation into SQL databases for categorization and analysis. FLOWER is written in C++ using current best software engineering practices.

Operant conditioning-based behavior modification: one approach to treating somatic disorders.

PubMed

LeBow, M D

1975-01-01

The applicability of behavior modification as a process for treating somatic difficulties is examined within the framework of measurement, modification, and evaluation. Illustrations of this process are presented throughout. In particular, the last section of the paper gives an example of a currently operative and multifaceted approach to the problem of obesity. Among the topics considered herein are the use of behavioral contracts that specify ameliorative weight reduction practices and the assessment as well as manipulation of eating speed.

Evaluation of Winter Operational Runway Friction Measurement Equipment, Procedures, and Research

NASA Technical Reports Server (NTRS)

1995-01-01

This document produced by the FAA/Industry Winter Runway Friction Measurement and Reporting Working Group, is designed to provide an overview of current information on the present guidance, practices, and procedures for reporting runway pavement surface conditions during winter operations at airports. It contains recommendations on the desirability of providing the best procedural consistency and standardization and discusses the available means to implement the guidance that will result in improved aviation safety at airports during hazardous winter conditions.

General surgery workloads and practice patterns in the United States, 2007 to 2009: a 10-year update from the American Board of Surgery.

PubMed

Valentine, R James; Jones, Andrew; Biester, Thomas W; Cogbill, Thomas H; Borman, Karen R; Rhodes, Robert S

2011-09-01

To assess changes in general surgery workloads and practice patterns in the past decade. Nearly 80% of graduating general surgery residents pursue additional training in a surgical subspecialty. This has resulted in a shortage of general surgeons, especially in rural areas. The purpose of this study is to characterize the workloads and practice patterns of general surgeons versus certified surgical subspecialists and to compare these data with those from a previous decade. The surgical operative logs of 4968 individuals recertifying in surgery 2007 to 2009 were reviewed. Data from 3362 (68%) certified only in Surgery (GS) were compared with 1606 (32%) with additional American Board of Medical Specialties certificates (GS+). Data from GS surgeons were also compared with data from GS surgeons recertifying 1995 to 1997. Independent variables were compared using factorial ANOVA. GS surgeons performed a mean of 533 ± 365 procedures annually. Women GS performed far more breast operations and fewer abdomen, alimentary tract and laparoscopic procedures compared to men GS (P < 0.001). GS surgeons recertifying at 10 years performed more abdominal, alimentary tract and laparoscopic procedures compared to those recertifying at 20 or 30 years (P < 0.001). Rural GS surgeons performed far more endoscopic procedures and fewer abdominal, alimentary tract, and laparoscopic procedures than urban counterparts (P < 0.001). The United States medical school graduates had similar workloads and distribution of operations to international medical graduates. Compared to 1995 to 1997, GS surgeons from 2007 to 2009 performed more procedures, especially endoscopic and laparoscopic. GS+ surgeons performed 15% to 33% of all general surgery procedures. GS practice patterns are heterogeneous; gender, age, and practice setting significantly affect operative caseloads. A substantial portion of general surgery procedures currently are performed by GS+ surgeons, whereas GS surgeons continue to perform considerable numbers of specialty operations. Reduced general surgery operative experience in GS+ residencies may negatively impact access to general surgical care. Similarly, narrowing GS residency operative experience may impair specialty operation access.

Radiological health risk evaluation of radium contaminated land: a real life implementation.

PubMed

Paridaens, J

2005-01-01

A plot of land, currently used for dairy farming, has been contaminated over the years with radium due to the operation of one of the world's largest radium production plants. Within the framework of a global remediation approach for the plant surroundings, the land owner needed advice for a future destination of the land. Therefore, the radium contamination was accurately mapped, and on the basis of its severity a practically feasible subdivision of the land into four plots was proposed. For all four plots, the radiological risk was evaluated for the current type of land use and for possible alternative types. Hence a clear and useable advice could be formulated to the authorities reconciling public health, economic and practical issues.

Circumcision of preschool boys in Baghdad, Iraq: prevalence, current practice and complications.

PubMed

Naji, Hussein; Mustafa, Rajaa

2013-03-01

Circumcision is probably one of the most ancient surgical operations and has been performed more than any other operation. The aim of this study is to assess the prevalence of circumcision in preschool boys and to present an overview of the current practices and complications in Baghdad, Iraq. A statistical survey was conducted at the Central Teaching Hospital for Children in Baghdad, Iraq during the period April 2003 to October 2004. The survey consisted of structured interviews with the accompanying parents while waiting for their children's routine appointments. A total of 4000 boys were included. 2443 (61%) were circumcised and the prevalence of circumcision increased from 18% at 6 months of age to reach 92% at 6 years. Only 180 (7.4%) boys had a medical reason while the rest were circumcised for religious reasons. Parents were the only determinant in deciding the time and place of religious circumcision. Circumcision was performed by a doctor in 732 (30%) boys, by a nurse in 1276 (52%) and by a traditional circumciser in 435 (18%). Post-operative complications were encountered in 209 (8.5%) boys. Circumcision is an important surgical procedure that should be performed by trained medical staff in medical institutions. Circumcision performed by medical professionals caused significantly less complications.

Are electronic medical records helpful for care coordination? Experiences of physician practices.

PubMed

O'Malley, Ann S; Grossman, Joy M; Cohen, Genna R; Kemper, Nicole M; Pham, Hoangmai H

2010-03-01

Policies promoting widespread adoption of electronic medical records (EMRs) are premised on the hope that they can improve the coordination of care. Yet little is known about whether and how physician practices use current EMRs to facilitate coordination. We examine whether and how practices use commercial EMRs to support coordination tasks and identify work-around practices have created to address new coordination challenges. Semi-structured telephone interviews in 12 randomly selected communities. Sixty respondents, including 52 physicians or staff from 26 practices with commercial ambulatory care EMRs in place for at least 2 years, chief medical officers at four EMR vendors, and four national thought leaders. Six major themes emerged: (1) EMRs facilitate within-office care coordination, chiefly by providing access to data during patient encounters and through electronic messaging; (2) EMRs are less able to support coordination between clinicians and settings, in part due to their design and a lack of standardization of key data elements required for information exchange; (3) managing information overflow from EMRs is a challenge for clinicians; (4) clinicians believe current EMRs cannot adequately capture the medical decision-making process and future care plans to support coordination; (5) realizing EMRs' potential for facilitating coordination requires evolution of practice operational processes; (6) current fee-for-service reimbursement encourages EMR use for documentation of billable events (office visits, procedures) and not of care coordination (which is not a billable activity). There is a gap between policy-makers' expectation of, and clinical practitioners' experience with, current electronic medical records' ability to support coordination of care. Policymakers could expand current health information technology policies to support assessment of how well the technology facilitates tasks necessary for coordination. By reforming payment policy to include care coordination, policymakers could encourage the evolution of EMR technology to include capabilities that support coordination, for example, allowing for inter-practice data exchange and multi-provider clinical decision support.

Managing Safety and Operations: The Effect of Joint Management System Practices on Safety and Operational Outcomes.

PubMed

Tompa, Emile; Robson, Lynda; Sarnocinska-Hart, Anna; Klassen, Robert; Shevchenko, Anton; Sharma, Sharvani; Hogg-Johnson, Sheilah; Amick, Benjamin C; Johnston, David A; Veltri, Anthony; Pagell, Mark

2016-03-01

The aim of this study was to determine whether management system practices directed at both occupational health and safety (OHS) and operations (joint management system [JMS] practices) result in better outcomes in both areas than in alternative practices. Separate regressions were estimated for OHS and operational outcomes using data from a survey along with administrative records on injuries and illnesses. Organizations with JMS practices had better operational and safety outcomes than organizations without these practices. They had similar OHS outcomes as those with operations-weak practices, and in some cases, better outcomes than organizations with safety-weak practices. They had similar operational outcomes as those with safety-weak practices, and better outcomes than those with operations-weak practices. Safety and operations appear complementary in organizations with JMS practices in that there is no penalty for either safety or operational outcomes.

Financial implications of nonoperative fracture care at an academic trauma center.

PubMed

Appleton, Paul; Chacko, Aron; Rodriguez, Edward K

2012-11-01

To determine if nonoperative fracture Current Procedural Technology codes generate a significant portion of annual revenues in an academic practice. Retrospective review of an orthopaedic trauma practice billings during fiscal year 2008. An urban level-1 trauma center. Outpatient clinic, and all consults, to the orthopaedic trauma service in the emergency room and hospital wards staffed by an attending traumatologist. An analysis was made of relative value units (RVUs) generated by operative and nonoperative care, separating the later into clinic, consults, and closed (nonoperative) fracture treatment. A total of 19,815 RVUs were generated by the trauma service during the 2008 fiscal year. Emergency department and ward consults generated 2176 (11%) of RVUs, whereas outpatient clinic generated an additional 1313 (7%) of RVUs. Nonoperative (closed) fracture care generated 2725 (14%) RVUs, whereas surgical procedures were responsible for the remaining 13,490 (68%) of RVUs. In terms of overall financial reimbursement, nonoperative management, consults, and office visits generated 31% of income for the trauma service. Although the largest financial contribution to a busy surgical practice is operative procedures, 1 must not overlook the important impact of nonoperative fracture care and consults. In our academic center, nearly one-third of all income was generated from nonsurgical procedures. In the current medical/financial climate, 1 must be diligent in optimizing the finances of trauma care to sustain an economically viable practice. Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

The Attitudes and Behaviors of Anaesthesiology and Reanimation Specialists in Anaesthesia Care Applications Outside the Operating Room in Turkey: A Survey Study

PubMed Central

Yıldız, Mehmet; İyilikçi, Leyla; Duru, Seden; Hancı, Volkan

2014-01-01

Objective We aimed to investigate the attitudes and behaviors of anaesthesiologists in “non-operating room anaesthesia” applications, which can be described as anaesthesia applications performed outside the operating room, and their reflection on practice all over Turkey. Methods Our study was conducted between November 5, 2012 and January 7, 2013 with the approval of the Research Ethics Board. Survey data were obtained through distributing printed questionnaires to be completed either by hand or via the web. The questionnaire consisted of 38 questions. The data obtained were analyzed with the Statistical Package for Social Sciences (SPSS) program. Results A total of 500 anaesthesiologists replied to our survey; 93% of anaesthesia specialists reported that there was a request that the anaesthesia and anaesthesia outside the operating room was given in their institution. Among anaesthesiologists, 56% reported that there were other sections that can provide sedation other than the anaesthesiology department in their institutions. Anaesthesia care team members; equipment; anaesthetic techniques; monitoring methods; and hypnotic, analgesic, and antagonist agents had statistically significant differences according to the participants’ institutions. Equipment used in the anaesthesia practice outside the operating room, anaesthesia, and monitoring methods had statistically significant differences according to geographical distribution (p<0.05). Conclusion Outside the operating room, anaesthesia practices and security measures are compliant with the standards set by the guidelines, the key to the prevention of complications. In our study, the current status of anaesthetic procedures outside the operating room in our country have been analyzed. PMID:27366420

Aboriginal Self-Government in Canada: Current Trends and Issues. Purich's Aboriginal Issues Series.

ERIC Educational Resources Information Center

Hylton, John H., Ed.

This book contains 13 chapters analyzing important practical issues that must be addressed as Aboriginal self-government becomes fully operational in Canada. These issues are related to social problems and policies, criminal justice, community services, education, employment and job training, finance, the land base of government, women's rights…

Perceived Uncertainty Sources in Wind Power Plant Design

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

Damiani, Rick R

This presentation for the Fourth Wind Energy Systems Engineering Workshop covers some of the uncertainties that still impact turbulent wind operation and how these affect design and structural reliability; identifies key sources and prioritization for R and D; and summarizes an analysis of current procedures, industry best practice, standards, and expert opinions.

Assessment of Learning during Library Instruction: Practices, Prevalence, and Preparation

ERIC Educational Resources Information Center

Sobel, Karen; Sugimoto, Cassidy R.

2012-01-01

Library instruction serves a critical function in the operation of the contemporary academic library environment. Librarians are asked to provide instruction and information literacy training using a range of tools and modes of delivery. The current literature presents an array of instruments used for assessing student learning and for delivering…

Women in Vocational Education. Project Baseline Supplemental Report.

ERIC Educational Resources Information Center

Steele, Marilyn

Reviewing the current status of women in vocational education, the study determines whether there is a cause-effect relationship between school practices and limited job options for women in the world of work. According to a review and analysis of available data, schools at all levels are operating separate vocational education programs for women.…

Implementing Schoolwide Positive Behavior Interventions and Supports in High Schools: Contextual Factors and Stages of Implementation

ERIC Educational Resources Information Center

Swain-Bradway, Jessica; Pinkney, Christopher; Flannery, K. Brigid

2015-01-01

Schoolwide positive behavior interventions and supports (SWPBIS) are an increasingly popular framework for school improvement practices, but many high schools are still lagging behind their elementary counterparts. High school leadership teams can struggle with merging the SWPBIS framework with current operations, and there are limited examples of…

77 FR 56251 - Aviation Rulemaking Advisory Committee (ARAC); New Task Assignment for the ARAC: Establishment of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-12

... with the Airman Certification Standards documents; and to propose knowledge test item bank questions... ensure that knowledge test item bank questions are consistent with both the Airman Certification... knowledge and risk management into each Area of Operation in the current Practical Test Standards documents...

The Design, Pedagogy and Practice of an Integrated Public Affairs Leadership Course

ERIC Educational Resources Information Center

Sandfort, Jodi; Gerdes, Kevin

2017-01-01

Current world events demand public affairs leadership training that generates among professionals a sense of capability, agency, and responsibility to engage in complex public problems. In this paper, we describe a unique course operated in the US focused on achieving these learning outcomes. It uses an unconventional schedule and course design…

Current knowledge on effects of forest silvicultural operations on carbon sequestration in southern forests

Treesearch

John D. Cason; Donald L. Grebner; Andrew J. Londo; Stephen C. Grado

2006-01-01

Incentive programs to reduce carbon dioxide (CO2) emissions are increasing in number with the growing threat of global warming. Terrestrial sequestration of CO2 through forestry practices on newly established forests is a potential mitigation tool for developing carbon markets in the United States. The extent of industrial...

40 CFR 434.72 - Effluent limitations attainable by the application of the best practicable control technology...

Code of Federal Regulations, 2010 CFR

2010-07-01

... currently available (BPT). (a) The operator must submit a site-specific Pollution Abatement Plan to the permitting authority for the pollution abatement area. The plan must be approved by the permitting authority and incorporated into the permit as an effluent limitation. The Pollution Abatement Plan must identify...

Thoughts on For-Profit Schools. Occasional Paper.

ERIC Educational Resources Information Center

Levin, Henry M.

Although the theory of the market is well understood, little is known about how for-profit schools will operate in practice. This paper considers why for-profit schooling has developed during the current period and not before (e.g., entrepreneurs must compete against heavily subsidized public schools, which limits their ability to charge prices…

Pediatric Hospital School Programming: An Examination of Educational Services for Students Who Are Hospitalized

ERIC Educational Resources Information Center

Steinke, Sarah M.; Elam, Megan; Irwin, Mary Kay; Sexton, Karen; McGraw, Anne

2016-01-01

This study aimed to define the current functions and operations of hospital school programs nationwide. A 56-item survey was disseminated to hospital teachers across the country to examine perceptions about their work, programs, and professional practice. Quantitative findings were analyzed using descriptive statistics at the individual…

Graduate Assistants: Students or Staff, Policy or Practice? The Current Legal Employment Status of Graduate Assistants

ERIC Educational Resources Information Center

Flora, Bethany H.

2007-01-01

In the US, graduate assistants are an integral part of a university's educational and operational climate. Graduate assistants provide teaching, research or administrative services to the educational enterprise in exchange for professional experience and a financial stipend. Recent strikes of graduate teaching assistants at New York University…

Research Leads: Current Practice, Future Prospects

ERIC Educational Resources Information Center

Riggall, Anna; Singer, Rachel

2015-01-01

This report was conceived as one of three publications that collectively provide a commentary on research awareness and research use within schools in England. This third report in the series presents findings from a small-scale, detailed study of teachers who are operating as their school's Research Lead. The small scale of the study is…

75 FR 35375 - Endangered and Threatened Wildlife and Plants; Designation of Critical Habitat for Roswell...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-22

... assessment makes appropriate assumptions regarding current practices and likely regulatory changes imposed as... unsuitable for the species from urban areas, agriculture, release of chemicals, and oil and gas operations... private lands with multiple land uses including expanding urban development. There are 378 natural gas and...

Family co-operation programme description.

PubMed

Peine, H A; Terry, T

1990-01-01

Current parenting practices indicate a continuing trend towards less family interaction. Institutional attempts to intervene with parents often fail. The 'Family Co-operation Programme' provides a tangible method for families and schools to work together in preventing alcohol and drug abuse, by utilising the positive influence of the home and strengthening family relationships. The Board of Education for the State of Utah has tested and is currently implementing a unique, low-cost, alternative to impact on the home. Utilising a K-12 alcohol/drug abuse school-based curriculum, the child, based on his/her inclass training, becomes the resource for family co-operation activities. These include training in coping skills, decision-making, resistance to peer persuasion, increased self-esteem and alcohol/drug information. Grade level materials go home with the child, who returns a requested parent evaluation. Data for over one thousand families show the positive impact of the activities.

Public health assessment for El Toro Marine Corps Air Station, Santa Ana, Orange County, California, Region 9. CERCLIS No. CA6170023208. Final report

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

Not Available

El Toro Marine Corps Air Station is in Orange County, California, near the city of Irvine. The Marine Corps established El Toro in 1943, and it currently serves as the center for marine aviation operations on the Pacific Coast. El Toro Marine Corps Air Station was proposed for listing on EPA's National Priorities List (NPL) in 1989 because past operations and disposal practices contaminated local groundwater. Agricultural farm workers and well operators are exposed to contaminants in groundwater through unintentional ingestion of contaminated groundwater, dermal contact with contaminated groundwater, and inhalation of aerosolized groundwater contaminants. Future exposure could occur throughmore » two potable water wells that are located 10 miles downgradient of the contaminant plume. At the current rate of contaminant migration, those wells will be affected in one and a half to five years.« less

Status quo and current trends of operating room management in Germany.

PubMed

Baumgart, André; Schüpfer, Guido; Welker, Andreas; Bender, Hans-Joachim; Schleppers, Alexander

2010-04-01

Ongoing healthcare reforms in Germany have required strenuous efforts to adapt hospital and operating room organizations to the needs of patients, new technological developments, and social and economic demands. This review addresses the major developments in German operating room management research and current practice. The introduction of the diagnosis-related group system in 2003 has changed the incentive structure of German hospitals to redesign their operating room units. The role of operating room managers has been gradually changing in hospitals in response to the change in the reimbursement system. Operating room managers are today specifically qualified and increasingly externally hired staff. They are more and more empowered with authority to plan and control operating rooms as profit centers. For measuring performance, common perioperative performance indicators are still scarcely implemented in German hospitals. In 2008, a concerted time glossary was established to enable consistent monitoring of operating room performance with generally accepted process indicators. These key performance indicators are a consistent way to make a procedure or case - and also the effectiveness of the operating room management - more transparent. In the presence of increasing financial pressure, a hospital's executives need to empower an independent operating room management function to achieve the hospital's economic goals. Operating room managers need to adopt evidence-based methods also from other scientific fields, for example management science and information technology, to further sustain operating room performance.

A 0.2 V Micro-Electromechanical Switch Enabled by a Phase Transition.

PubMed

Dong, Kaichen; Choe, Hwan Sung; Wang, Xi; Liu, Huili; Saha, Bivas; Ko, Changhyun; Deng, Yang; Tom, Kyle B; Lou, Shuai; Wang, Letian; Grigoropoulos, Costas P; You, Zheng; Yao, Jie; Wu, Junqiao

2018-04-01

Micro-electromechanical (MEM) switches, with advantages such as quasi-zero leakage current, emerge as attractive candidates for overcoming the physical limits of complementary metal-oxide semiconductor (CMOS) devices. To practically integrate MEM switches into CMOS circuits, two major challenges must be addressed: sub 1 V operating voltage to match the voltage levels in current circuit systems and being able to deliver at least millions of operating cycles. However, existing sub 1 V mechanical switches are mostly subject to significant body bias and/or limited lifetimes, thus failing to meet both limitations simultaneously. Here 0.2 V MEM switching devices with ≳10 6 safe operating cycles in ambient air are reported, which achieve the lowest operating voltage in mechanical switches without body bias reported to date. The ultralow operating voltage is mainly enabled by the abrupt phase transition of nanolayered vanadium dioxide (VO 2 ) slightly above room temperature. The phase-transition MEM switches open possibilities for sub 1 V hybrid integrated devices/circuits/systems, as well as ultralow power consumption sensors for Internet of Things applications. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Summary of performance data for technologies to control gaseous, odor, and particulate emissions from livestock operations: Air management practices assessment tool (AMPAT)

PubMed Central

Maurer, Devin L.; Koziel, Jacek A.; Harmon, Jay D.; Hoff, Steven J.; Rieck-Hinz, Angela M.; Andersen, Daniel S.

2016-01-01

The livestock and poultry production industry, regulatory agencies, and researchers lack a current, science-based guide and data base for evaluation of air quality mitigation technologies. Data collected from science-based review of mitigation technologies using practical, stakeholders-oriented evaluation criteria to identify knowledge gaps/needs and focuses for future research efforts on technologies and areas with the greatest impact potential is presented in the Literature Database tab on the air management practices tool (AMPAT). The AMPAT is web-based (available at www.agronext.iastate.edu/ampat) and provides an objective overview of mitigation practices best suited to address odor, gaseous, and particulate matter (PM) emissions at livestock operations. The data was compiled into Excel spreadsheets from a literature review of 265 papers was performed to (1) evaluate mitigation technologies performance for emissions of odor, volatile organic compounds (VOCs), ammonia (NH3), hydrogen sulfide (H2S), particulate matter (PM), and greenhouse gases (GHGs) and to (2) inform future research needs. PMID:27158660

Impact of rural training on physician work force: the role of postresidency education.

PubMed

Acosta, D A

2000-01-01

Many innovative strategies have been developed over the years to improve the recruitment and retention of physicians in the shortage areas of rural America. These strategies have met with varying success. Postresidency education, or fellowship training, for family physicians is yet another strategy that has been developed for the same purpose. Most applicants have been interested in obstetrical and rural health fellowship programs as a means for preparing for rural practice. This paper describes these programs (demographics, funding, applicant pool, curriculum) and reviews their graduate outcomes (practice location after matriculation, clinical privileges). Twenty-nine obstetrical and nine rural health fellowships are currently operational in the United States. Fellows who complete a rural health fellowship have a higher tendency to locate in rural settings. Almost all graduates from obstetrical and rural health programs attain general hospital privileges in family practice, including low-risk obstetrics. A significant number of graduates from both types of programs attain privileges in high-risk and operative obstetrics as well. Fellowship training can play an integral role in the preparation of family physicians for rural practice.

Spin filter and spin valve in ferromagnetic graphene

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

Song, Yu, E-mail: kwungyusung@gmail.com; Dai, Gang; Research Center for Microsystems and Terahertz, China Academy of Engineering Physics, Mianyang 621999

2015-06-01

We propose and demonstrate that a EuO-induced and top-gated graphene ferromagnetic junction can be simultaneously operated as a spin filter and a spin valve. We attribute such a remarkable result to a coexistence of a half-metal band and a common energy gap for opposite spins in ferromagnetic graphene. We show that both the spin filter and the spin valve can be effectively controlled by a back gate voltage, and they survive for practical metal contacts and finite temperature. Specifically, larger single spin currents and on-state currents can be reached with contacts with work functions similar to graphene, and the spinmore » filter can operate at higher temperature than the spin valve.« less

Development of an activity-based costing model to evaluate physician office practice profitability.

PubMed

Dugel, Pravin U; Tong, Kuo Bianchini

2011-01-01

Newer treatment regimens for age-related macular degeneration have significantly affected traditional and non-traditional retinal services across all types of practice settings around the country as they seek to find a balance among delivering best patient care, keeping operating costs under control, and maintaining profitability. A systematic retrospective review of a multi-city, multi-physician retinal practice's accounting system to obtain data on revenues, expenses, and profit. Data reviewed were from practice management systems to obtain claims level data on clinical procedures across 7 primary activity centers: non-laser surgery, laser surgery, office visits, optical coherence tomography (OCT), non-OCT diagnostics, drugs and drug injections, and research. All treated patients from a retina practice from January 1, 2005, to December 31, 2007. Retrospective claims data review from a multi-physician retina practice detailing Current Procedural Terminology and Healthcare Common Procedure Coding System procedures performed and billed, submitted charges, allowed charges, and net collections. Analyses were performed by an outside firm and verified by a risk advisory firm. Identifying practice efficiencies/inefficiencies as they relate to patient care. An elaborate analysis using activity-based costing (ABC) showed that increased office visits and OCT and non-OCT diagnostics had a significant negative impact on the practice's profit margins, whereas surgical procedures contributed to the majority of the practice's profit margins because of the lower operating costs associated with surgery. The practice was able to accommodate the demand in patient volume, medical retina services, and medical imaging with the advent of anti-vascular endothelial growth factor therapy and realized a seismic shift in operating costs. The practice attempted to deliver state-of-the-art patient care in a cost-effective manner, yet underwent a significant decline in its financial health. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Inter Annual Variability of the California Current System and Associated Biochemical Characteristics from Prolonged Data Series

DTIC Science & Technology

2016-06-01

onto the eastern north Pacific circulation has been studied for years, the effect of El Nino Modoki in the region is still unclear. The CCS is...ready for combat. The main mission of Third Fleet is to provide safe, effective , relevant training to ensure Sailors have the essential skills to...Fleet. Understanding our environment and ocean currents with in the CCS improves the Navy’s ability to practice operating safely and effectively along

Space Radiation Protection, Space Weather, and Exploration

NASA Technical Reports Server (NTRS)

Zapp, Neal; Rutledge, R.; Semones, E. J.; Johnson, A. S.; Guetersloh, S.; Fry, D.; Stoffle, N.; Lee, K.

2008-01-01

Management of crew exposure to radiation is a major concern for manned spaceflight -- and will be even more important for the modern concept of longer-duration exploration. The inherent protection afforded to astronauts by the magnetic field of the Earth in Low Earth Orbit (LEO) makes operations on the space shuttle or space station very different from operations during an exploration mission. In order to experience significant radiation-derived Loss of Mission (LOM) or Loss of Crew (LOC) risk for LEO operations, one is almost driven to dictate extreme duration or to dictate an extreme sequence of solar activity. Outside of the geo-magnetosphere, however, this scenario changes dramatically. Exposures to the same event on the ISS and on the surface of the Moon may differ by multiple orders of magnitude. This change in magnitude, coupled with the logistical constraints present in implementing any practical operational mitigation make situational awareness with regard to space weather a limiting factor for our ability to conduct exploration operations. With these differences in risk to crew, vehicle and mission in mind, we present the status of the efforts currently underway as the required development to enable exploration operations. The changes in the operating environment as crewed operations begin to stretch away from the Earth are changing the way we think about the lines between "research" and "operations". The real, practical work to enable a permanent human presence away from Earth has already begun.

Prognostics and Health Management of Wind Turbines -- Current Status and Future Opportunities

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

Sheng, Shuangwen

The global wind industry has seen tremendous growth during the past two decades. However, the industry is challenged by premature component failures, which lead to increased turbine downtime and subsequently, cost of energy for wind power. To mitigate the impacts from these failures, the wind industry has been exploring various areas for improvements ranging from product design, new materials or lubricants, to operation and maintenance (O&M) practices. Condition-based maintenance or prognostics and health management (PHM) has been explored as one enabling technology for improving O&M practices. This chapter provides a brief overview of wind turbine PHM with a focus onmore » operational data mining and condition monitoring of drivetrains. Some future research and development opportunities in wind turbine PHM are also briefly discussed.« less

Documentation: Records and Reports.

PubMed

Akers, Michael J

2017-01-01

This article deals with documentation to include the beginning of documentation, the requirements of Good Manufacturing Practice reports and records, and the steps that can be taken to minimize Good Manufacturing Practice documentation problems. It is important to remember that documentation for 503a compounding involves the Formulation Record, Compounding Record, Standard Operating Procedures, Safety Data Sheets, etc. For 503b outsourcing facilities, compliance with Current Good Manufacturing Practices is required, so this article is applicable to them. For 503a pharmacies, one can see the development and modification of Good Manufacturing Practice and even observe changes as they are occurring in 503a documentation requirements and anticipate that changes will probably continue to occur. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

Cost effectiveness of the U.S. Geological Survey's stream-gaging program in Illinois

USGS Publications Warehouse

Mades, D.M.; Oberg, K.A.

1984-01-01

Data uses and funding sources were identified for 138 continuous-record discharge-gaging stations currently (1983) operated as part of the stream-gaging program in Illinois. Streamflow data from five of those stations are used only for regional hydrology studies. Most streamflow data are used for defining regional hydrology, defining rainfall-runoff relations, flood forecasting, regulating navigation systems, and water-quality sampling. Based on the evaluations of data use and of alternative methods for determining streamflow in place of stream gaging, no stations in the 1983 stream-gaging program should be deactivated. The current budget (in 1983 dollars) for operating the 138-station program is $768,000 per year. The average standard error of instantaneous discharge for the current practice for visiting the gaging stations is 36.5 percent. Missing stage record accounts for one-third of the 36.5 percent average standard error. (USGS)

Room temperature current injection polariton light emitting diode with a hybrid microcavity.

PubMed

Lu, Tien-Chang; Chen, Jun-Rong; Lin, Shiang-Chi; Huang, Si-Wei; Wang, Shing-Chung; Yamamoto, Yoshihisa

2011-07-13

The strong light-matter interaction within a semiconductor high-Q microcavity has been used to produce half-matter/half-light quasiparticles, exciton-polaritons. The exciton-polaritons have very small effective mass and controllable energy-momentum dispersion relation. These unique properties of polaritons provide the possibility to investigate the fundamental physics including solid-state cavity quantum electrodynamics, and dynamical Bose-Einstein condensates (BECs). Thus far the polariton BEC has been demonstrated using optical excitation. However, from a practical viewpoint, the current injection polariton devices operating at room temperature would be most desirable. Here we report the first realization of a current injection microcavity GaN exciton-polariton light emitting diode (LED) operating under room temperature. The exciton-polariton emission from the LED at photon energy 3.02 eV under strong coupling condition is confirmed through temperature-dependent and angle-resolved electroluminescence spectra.

Co-Operative Advances in Behavioral Health and Performance Research and Operations

NASA Technical Reports Server (NTRS)

VanderArk, Stephen T.; Leveton, Lauren B.

2011-01-01

In organizations that engage in both operations and applied research, with operational needs guiding research questions and research informing improved operations, the ideal goal is a synergy of ideas and information. In reality, this ideal synergy is often lacking. Real-time operational needs driving day-to-day decisions, lack of communication, lag time in getting research advances plugged into operations can cause both areas to suffer from this gap between operations and research. At Johnson Space Center, the Behavior Health and Performance group (BHP) strives to bridge this gap by following a Human Research Program framework: Expectations of future operational needs identify the knowledge gaps; the gaps in turn guide research leading to a product that is transitioned into operations. Thus, the direction those of us in research take is in direct response to current and future needs of operations. Likewise, those of us in operations actively seek knowledge that is supported by evidence-based research. We make an ongoing effort to communicate across the research and operations gap by working closely with each other and making a conscious effort to keep each other informed. The objective of the proposed panel discussion is to demonstrate through the following presentations the results of a successful collaboration between research and operations and to provide ASMA members with more practical knowledge and strategies for building these bridges to serve our field of practice well. The panel will consist of six presenters from BHP operations, internal BHP research, and external research instigated by BHP who together represent the entire BHP Research Transition to Operations Framework

The Value of Biomedical Simulation Environments to Future Human Space Flight Missions

NASA Technical Reports Server (NTRS)

Mulugeta, Lealem; Myers, Jerry G.; Skytland, Nicholas G.; Platts, Steven H.

2010-01-01

With the ambitious goals to send manned missions to asteroids and onto Mars, substantial work will be required to ensure the well being of the men and women who will undertake these difficult missions. Unlike current International Space Station or Shuttle missions, astronauts will be required to endure long-term exposure to higher levels of radiation, isolation and reduced gravity. These new operation conditions will pose health risks that are currently not well understood and perhaps unanticipated. Therefore, it is essential to develop and apply advanced tools to predict, assess and mitigate potential hazards to astronaut health. NASA s Digital Astronaut Project (DAP) is working to develop and apply computational models of physiologic response to space flight operation conditions over various time periods and environmental circumstances. The collective application and integration of well vetted models assessing the physiology, biomechanics and anatomy is referred to as the Digital Astronaut. The Digital Astronaut simulation environment will serve as a practical working tool for use by NASA in operational activities such as the prediction of biomedical risks and functional capabilities of astronauts. In additional to space flight operation conditions, DAP s work has direct applicability to terrestrial biomedical research by providing virtual environments for hypothesis testing, experiment design, and to reduce animal/human testing. A practical application of the DA to assess pre and post flight responses to exercise is illustrated and the difficulty in matching true physiological responses is discussed.

Introducing guidelines into clinical practice.

PubMed

Fowkes, F G; Roberts, C J

1984-04-01

The impetus for guidelines of practice has been accelerated by a worldwide trend towards insurance based systems of health care. In the past it has been the tradition for the clinician to order all the diagnostic procedures that conceivably might help to clarify what is wrong with a patient, or what course of treatment should be followed. This traditional view ignores the stubborn economic reality that resources are finite and that it is no longer possible to be both endlessly generous and continually fair. Making judgements about the need for, and value of, services now forms an important part of coping with this problem. Clinical practice has to strive to be as safe as possible and to produce a given benefit at a socially acceptable cost. Guidelines are recommendations, preferably developed by clinicians themselves, which describe how and when individual clinical activities should be offered in order to achieve these objectives. Utilisation review of current practice is a valuable source of information for the development of guidelines. In the United Kingdom the Royal College of Radiologists attempted to do this in connection with the use of pre-operative chest X-rays. In 1979 they published the findings of a multicentre review of 10,619 consecutive cases of elective non-cardiopulmonary surgery undertaken in 8 centres throughout the United Kingdom. Substantial variations were found in national practice. Use of pre-operative chest X-rays varied from 11.5% of patients in one centre to 54.2% of patients in another centre. The study also found that the chest X-ray report did not seem to have much influence on the decision to operate nor on the decision to use inhalation anaesthesia. The College study failed to find "any evidence at all for the effectiveness of pre-operative chest X-ray when used routinely" and it was estimated that even if the procedure was 10% effective the costs of avoiding one death would be approximately 1 million pounds. These findings provided the impetus for the College to develop guidelines for the use of pre-operative chest X-rays in hospitals in the United Kingdom. Creating a change in clinical practice through the introduction of guidelines is a three stage process: Stage I: introducing the idea of a change in practice. Stage II: introduction of guidelines into clinical practice. Stage III: sustained implementation of guidelines in clinical practice.(ABSTRACT TRUNCATED AT 400 WORDS)

Recognizing the Operating Hand and the Hand-Changing Process for User Interface Adjustment on Smartphones †

PubMed Central

Guo, Hansong; Huang, He; Huang, Liusheng; Sun, Yu-E

2016-01-01

As the size of smartphone touchscreens has become larger and larger in recent years, operability with a single hand is getting worse, especially for female users. We envision that user experience can be significantly improved if smartphones are able to recognize the current operating hand, detect the hand-changing process and then adjust the user interfaces subsequently. In this paper, we proposed, implemented and evaluated two novel systems. The first one leverages the user-generated touchscreen traces to recognize the current operating hand, and the second one utilizes the accelerometer and gyroscope data of all kinds of activities in the user’s daily life to detect the hand-changing process. These two systems are based on two supervised classifiers constructed from a series of refined touchscreen trace, accelerometer and gyroscope features. As opposed to existing solutions that all require users to select the current operating hand or confirm the hand-changing process manually, our systems follow much more convenient and practical methods and allow users to change the operating hand frequently without any harm to the user experience. We conduct extensive experiments on Samsung Galaxy S4 smartphones, and the evaluation results demonstrate that our proposed systems can recognize the current operating hand and detect the hand-changing process with 94.1% and 93.9% precision and 94.1% and 93.7% True Positive Rates (TPR) respectively, when deciding with a single touchscreen trace or accelerometer-gyroscope data segment, and the False Positive Rates (FPR) are as low as 2.6% and 0.7% accordingly. These two systems can either work completely independently and achieve pretty high accuracies or work jointly to further improve the recognition accuracy. PMID:27556461

Recognizing the Operating Hand and the Hand-Changing Process for User Interface Adjustment on Smartphones.

PubMed

Guo, Hansong; Huang, He; Huang, Liusheng; Sun, Yu-E

2016-08-20

As the size of smartphone touchscreens has become larger and larger in recent years, operability with a single hand is getting worse, especially for female users. We envision that user experience can be significantly improved if smartphones are able to recognize the current operating hand, detect the hand-changing process and then adjust the user interfaces subsequently. In this paper, we proposed, implemented and evaluated two novel systems. The first one leverages the user-generated touchscreen traces to recognize the current operating hand, and the second one utilizes the accelerometer and gyroscope data of all kinds of activities in the user's daily life to detect the hand-changing process. These two systems are based on two supervised classifiers constructed from a series of refined touchscreen trace, accelerometer and gyroscope features. As opposed to existing solutions that all require users to select the current operating hand or confirm the hand-changing process manually, our systems follow much more convenient and practical methods and allow users to change the operating hand frequently without any harm to the user experience. We conduct extensive experiments on Samsung Galaxy S4 smartphones, and the evaluation results demonstrate that our proposed systems can recognize the current operating hand and detect the hand-changing process with 94.1% and 93.9% precision and 94.1% and 93.7% True Positive Rates (TPR) respectively, when deciding with a single touchscreen trace or accelerometer-gyroscope data segment, and the False Positive Rates (FPR) are as low as 2.6% and 0.7% accordingly. These two systems can either work completely independently and achieve pretty high accuracies or work jointly to further improve the recognition accuracy.

Practicing for Mars: The International Space Station (ISS) as a Testbed

NASA Technical Reports Server (NTRS)

Korth, David H.

2014-01-01

Allows demonstration and development of exploration capabilities to help accomplish future missions sooner with less risk to crew and mission Characteristics of ISS as a testbed High fidelity human operations platform in LEO: Continuously operating habitat and active laboratory. High fidelity systems. Astronauts as test subjects. Highly experienced ground operations teams. Offers a controlled test environment.: Consequences to systems performance and decision making not offered in ground analogs International participation. Continuously improving system looking for new technology and ideas to improve operations. Technology Demos & Critical Systems Maturation. Human Health and Performance. Operations Simulations and Techniques. Exploration prep testing on ISS has been ongoing since 2012. Number of tests increasing with each ISS expedition. One Year Crew Expedition starting in Spring 2015. ROSCOSMOS and NASA are partnering on the Participating Crew are Mikhail Kornienko and Scott Kelly Majority of testing is an extension of current Human Biomedical Research investigations Plan for extending & expanding upon current operations techniques and tech demo studies ESA 10 Day Mission in Fall 2015 ESA astronaut focus on testing exploration technologies Many more opportunities throughout the life of ISS! 4/24/2014 david.h.korth@nasa.gov 4 Exploration testing

Analysis of Regulatory Guidance for Health Monitoring

NASA Technical Reports Server (NTRS)

Munns, Thomas E.; Beard, Richard E.; Culp, Aubrey M.; Murphy, Dennis A.; Kent, Renee M.; Cooper, Eric G. (Technical Monitor)

2000-01-01

The purpose of this study was to assess the connection between current FAA regulations and the incorporation of Health Management (HM) systems into commercial aircraft. To address the overall objectives ARINC: (1) investigated FAA regulatory guidance, (2) investigated airline maintenance practices, (3) systematically identified regulations and practices that would be affected or could act as barriers to the introduction of HM technology, and (4) assessed regulatory and operational tradeoffs that should be considered for implementation. The assessment procedure was validated on a postulated structural HM capability for the B757 horizontal stabilizer.

Funds Flow in the Era of Value-Based Health Care.

PubMed

Itri, Jason N; Mithqal, Ayman; Krishnaraj, Arun

2017-06-01

Health care reform is creating significant challenges for hospital systems and academic medical centers (AMCs), requiring a new operating model to adapt to declining reimbursement, diminishing research funding, market consolidation, payers' focus on higher quality and lower cost, and greater cost sharing by patients. Maintaining and promoting the triple mission of clinical care, research, and education will require AMCs to be system-based with strong alignment around governance, operations, clinical care, and finances. Funds flow is the primary mechanism whereby an AMC maintains the triple mission through alignment of the hospital, physician practices, school of medicine, undergraduate university, and other professional schools. The purpose of this article is to discuss challenges with current funds flow models, impact of funds flow on academic and private practice radiology groups, and strategies that can increase funds flow to support radiology practices achieving clinical, research, and teaching missions in the era of value-based health care. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

How shift scheduling practices contribute to fatigue amongst freight rail operating employees: Findings from Canadian accident investigations.

PubMed

Rudin-Brown, Christina M; Harris, Sarah; Rosberg, Ari

2018-02-01

Canada's freight rail system moves 70% of the country's surface goods and almost half of all exports (RAC, 2016). These include dangerous goods. Anonymous survey of freight rail operating employees conducted by the Teamsters Canada Rail Conference (TCRC, 2014) revealed that many do not report getting enough sleep because of their work schedules, and that fatigue may be affecting their performance at work. Besides general impairments in attention and cognitive functioning, fatigue in railway operating employees slows reaction time to safety alarms and impairs conformance to train operating requirements. Shift scheduling practices can contribute to sleep-related fatigue by restricting sleep opportunities, requiring extended periods of wakefulness and by disrupting daily (circadian) rhythms. The primary goal of accident investigation is to identify causal and contributing factors so that similar occurrences can be prevented. A database search of Transportation Safety Board (TSB) rail investigation reports published in the 21-year period from 1995 to 2015 identified 18 that cited sleep-related fatigue of freight rail operating employees as a causal, contributing, or risk finding. This number represents about 20% of TSB rail investigations from the same period in which a human factors aspect of freight train activities was a primary cause. Exploration of accident themes suggests that management of fatigue and shift scheduling in the freight rail industry is a complex issue that is often not conducive to employee circadian rhythms and sleep requirements. It also suggests that current shift scheduling and fatigue management practices may be insufficient to mitigate the associated safety risk. Railway fatigue management systems that are based on the principles of modern sleep science are needed to improve scheduling practices and mitigate the ongoing safety risk. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

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

Nixon, J.D., E-mail: j.nixon@kingston.ac.uk; Wright, D.G.; Dey, P.K.

Highlights: • We evaluate operational municipal solid waste incinerators in the UK. • The supply chain of four case study plants are examined and compared in detail. • Technical, financial and operational data has been gathered for the four plants. • We suggest the best business practices for waste incinerators. • Appropriate strategy choices are the major difficulties for waste to energy plants. - Abstract: The uptake in Europe of Energy from Waste (EfW) incinerator plants has increased rapidly in recent years. In the UK, 25 municipal waste incinerators with energy recovery are now in operation; however, their waste supplymore » chains and business practices vary significantly. With over a hundred more plant developments being considered it is important to establish best business practices for ensuring efficient environmental and operational performance. By reviewing the 25 plants we identify four suitable case study plants to compare technologies (moving grate, fluidised bed and rotary kiln), plant economics and operations. Using data collected from annual reports and through interviews and site visits we provide recommendations for improving the supply chain for waste incinerators and highlight the current issues and challenges faced by the industry. We find that plants using moving grate have a high availability of 87–92%. However, compared to the fluidised bed and rotary kiln, quantities of bottom ash and emissions of hydrogen chloride and carbon monoxide are high. The uptake of integrated recycling practices, combined heat and power, and post incineration non-ferrous metal collections needs to be increased among EfW incinerators in the UK. We conclude that one of the major difficulties encountered by waste facilities is the appropriate selection of technology, capacity, site, waste suppliers and heat consumers. This study will be of particular value to EfW plant developers, government authorities and researchers working within the sector of waste management.« less

Blood transfusion practice in a rural hospital in Northern Ghana, Damongo, West Gonja District.

PubMed

Kubio, Chrysantus; Tierney, Geraldine; Quaye, Theophilus; Nabilisi, James Wewoli; Ziemah, Callistus; Zagbeeb, Sr Mary; Shaw, Sandra; Murphy, William G

2012-10-01

Blood transfusion in rural sub-Saharan Africa presents special challenges. Transfusions are primarily given for emergencies--life-threatening blood loss or anemia; blood is usually collected from family or replacement donors; and facilities to store an adequate reserve in a hospital bank are constrained. We report the everyday and organizational practices in a medium-sized district hospital in Northern Ghana. Information and data on blood transfusion practices at West Gonja Hospital, Damongo, were available from the laboratory reports, from day books and workbooks, and from direct observation in the following four areas: blood collection and blood donors; blood donation testing; blood storage and logistics; and clinical transfusion practice, adverse events, and follow-up. The hospital serves a rural community of 86,000. In 2009, a total of 719 units of whole blood were collected, a rate of 8.36 units per 1000 population. All donors were family or replacement donors. Positivity rates for infectious disease markers were 7.5% (64/853) for hepatitis B surface antigen, 6.1% (50/819) for hepatitis C virus, 3.9% (33/846) for human immunodeficiency virus, and 4.7% (22/468) for syphilis. Supply of laboratory materials was sometimes problematic, especially for temperature-critical materials. Difficulties in sample labeling, storage of blood and laboratory supplies, and disposal of waste were also incurred by operational, material, and financial constraints. Follow-up for outcomes of transfusion is not currently feasible. The operational, demographic, and financial environment pertaining in a rural hospital in Northern Ghana differs substantially from that in which much of current blood transfusion practice and technology evolved. Considerable effort and innovation will be needed to address successfully the challenges posed. © 2012 American Association of Blood Banks.

The peri-operative management of anti-platelet therapy in elective, non-cardiac surgery.

PubMed

Alcock, Richard F; Naoum, Chris; Aliprandi-Costa, Bernadette; Hillis, Graham S; Brieger, David B

2013-07-31

Cardiovascular complications are important causes of morbidity and mortality in patients undergoing elective non-cardiac surgery, with adverse cardiac outcomes estimated to occur in approximately 4% of all patients. Anti-platelet therapy withdrawal may precede up to 10% of acute cardiovascular syndromes, with withdrawal in the peri-operative setting incompletely appraised. The aims of our study were to determine the proportion of patients undergoing elective non-cardiac surgery currently prescribed anti-platelet therapy, and identify current practice in peri-operative management. In addition, the relationship between management of anti-platelet therapy and peri-operative cardiac risk was assessed. We evaluated consecutive patients attending elective non-cardiac surgery at a major tertiary referral centre. Clinical and biochemical data were collected and analysed on patients currently prescribed anti-platelet therapy. Peri-operative management of anti-platelet therapy was compared with estimated peri-operative cardiac risk. Included were 2950 consecutive patients, with 516 (17%) prescribed anti-platelet therapy, primarily for ischaemic heart disease. Two hundred and eighty nine (56%) patients had all anti-platelet therapy ceased in the peri-operative period, including 49% of patients with ischaemic heart disease and 46% of patients with previous coronary stenting. Peri-operative cardiac risk score did not influence anti-platelet therapy management. Approximately 17% of patients undergoing elective non-cardiac surgery are prescribed anti-platelet therapy, the predominant indication being for ischaemic heart disease. Almost half of all patients with previous coronary stenting had no anti-platelet therapy during the peri-operative period. The decision to cease anti-platelet therapy, which occurred commonly, did not appear to be guided by peri-operative cardiac risk stratification. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Toward the way forward: the national children's disaster mental health concept of operations.

PubMed

Schreiber, Merritt; Pfefferbaum, Betty; Sayegh, Lisa

2012-06-01

Although increasing evidence suggests that children are at particular risk from disasters and evidence-based practices have been developed to triage and treat them effectively, no strategy or concept of operations linking best practices for disaster response is currently in place. To our knowledge, this report describes the first effort to address this critical gap and outlines a triage-driven children's disaster mental health incident response strategy for seamless preparedness, response, and recovery elements that can be used now. The national children's disaster mental health concept of operations (NCDMH CONOPS) details the essential elements needed for an interoperable, coordinated response for the mental health needs of children by local communities, counties, regions, and states to better meet the needs of children affected by disasters and terrorism incidents. This CONOPS for children proposes the use of an evidence-based, rapid triage system to provide a common data metric to incident response and recovery action and to rationally align limited resources to those at greater need in a population-based approach.

Shear Ram Verification Test Protocol (VTP) Best Practices

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

Lindley, Roy A.; Braun, Joseph C.

A blowout preventer (BOP) is a critical component used on subsea oil and gas wells during drilling, completion, and workover operations on the U. S. outer continental shelf (OCS). The purpose of the BOP is to seal oil and gas wells, and in the case of an emergency well-control event, to prevent the uncontrolled release of hydrocarbons. One of the most important components of the BOP is the hydraulically operated blind shear ram (BSR) that shears drilling-related components, such as drill pipes, casings, tubings, and wire-related tools that may have been placed in the well. In addition to shearing thesemore » components, the BSR must form a seal to keep hydrocarbons within the well bore, even when under the highest well-fluid pressures expected. The purpose of this document is for Argonne National Laboratory (ANL) to provide an independent view, based on current regulations, and best practices for testing and confirming the operability and suitability of BSRs under realistic (or actual) well conditions.« less

Theoretical and practical considerations for teaching diagnostic electronic-nose technologies to clinical laboratory technicians

Treesearch

Alphus D. Wilson

2012-01-01

The rapid development of new electronic technologies and instruments, utilized to perform many current clinical operations in the biomedical field, is changing the way medical health care is delivered to patients. The majority of test results from laboratory analyses, performed with these analytical instruments often prior to clinical examinations, are frequently used...

The Integration of Health and Counseling Services on College Campuses: Is There a Risk in Maintaining Student Patients' Privacy?

ERIC Educational Resources Information Center

Davenport, Robin G.

2017-01-01

The formation of integrated centers on college campuses that combine health services and counseling provide clear advantages for students. There is currently no "best practices" model that informs integrated centers' operational procedures. The "continuity of care" requirement of medical providers can conflict with the strict…

From Theoretical Language to the Interstices of Daily Practice: Reducing Competency Stripping through Transformative Teaching and Learning

ERIC Educational Resources Information Center

Pasque, Penny A.; Kuntz, Aaron M.

2013-01-01

As a part of the next generation of critical qualitative scholars, we hope to challenge the current connections (or lack thereof) between methodological paradigms and lived action in order to achieve marked social change. Yet we operate within institutionalised boundaries and an academic culture that does not often encourage critical…

The Atlanta Urban Debate League: Exploring the Making of a Critical Literacy Space

ERIC Educational Resources Information Center

Cridland-Hughes, Susan

2016-01-01

The Atlanta Urban Debate League was established in 1985 as an after school program focused on providing debate outreach to high school students in the Atlanta public schools. Still in operation today, volunteers work with current students in public middle and high schools in Atlanta, supporting students as they practice reading, writing, speaking…

Establish Best Practices for Supervision of Instructors

DTIC Science & Technology

2012-09-01

633. Christen, W. L., & Murphy, T. J. (1987). Inservice training and peer evaluation: An integrated program for faculty development. NASSP...describes the current state of instructional supervision in Special Operations Forces (SOF) initial acquisition training (IAT) language schools. This...leadership and Command Language Program Managers (CLPMs) related to selection, training , and resourcing. Finally, specific recommendations are provided for

Ethical Issues and Codes of Ethics: Views of Adult Education Practitioners in Canada and the United States.

ERIC Educational Resources Information Center

Gordon, Wanda; Sork, Thomas J.

2001-01-01

Replicating an Indiana study, 261 responses from British Columbia adult educators revealed a high degree of support for codes of ethics and identified ethical dilemmas in practice. Half currently operated under a code. Responses to whether codes should have a regulatory function were mixed. (Contains 44 references.) (SK)

Public High School Principals' Perceptions of Academic Reform. Center for Education Statistics Bulletin.

ERIC Educational Resources Information Center

Center for Education Statistics (ED/OERI), Washington, DC.

A survey of public high school principals asked which policies, programs, and practices designed to improve learning were currently in operation at their schools, and whether these policies were instituted or substantially strengthened in the past 5 years. These policies reflect the school-level recommendations for education reform made in "A…

The visual arts in Northern Ireland hospitals.

PubMed Central

Cromie, H.

1995-01-01

Since 1989 there has been a burgeoning of the visual arts in Northern Ireland hospitals. This paper compares the three organisational models for hospital arts currently operating within the Province and in an overview discusses ways to coordinate working practice for future development of the visual arts in local hospitals. Images Fig 1 Fig 2 Fig 3 PMID:8533183

Mapping the Growth of Statewide Voucher Programs in the United States. Informing Policy and Improving Practice. Policy Brief

ERIC Educational Resources Information Center

Cierniak, Katherine; Stewart, Molly; Ruddy, Anne-Maree

2015-01-01

This brief focuses solely on currently operating statewide, general education voucher programs which have income eligibility requirements. In this brief, students in a general education program refer to students whose education is not guided by an Individualized Education Program (IEP). The term general education (classroom, curriculum, setting)…

Teacher Education and Critical Inquiry: The Use of Activity Theory in Exploring Alternative Understandings of Language and Literature

ERIC Educational Resources Information Center

Doecke, Brenton; Kostogriz, Alex

2005-01-01

This article explores the challenges of espousing a critical pedagogy within the managerial climate that presently shapes teacher education. Current discourses of professionalism are incommensurate with an understanding of the way that literacy practices are grounded in the social worlds in which both school and university students operate. Such…

Why Can't a Teacher Be More like a Scientist? Science, Pseudoscience and the Art of Teaching

ERIC Educational Resources Information Center

Carter, Mark; Wheldall, Kevin

2008-01-01

In this article, the authors argue the case for scientific evidenced-based practice in education. They consider what differentiates science from pseudoscience and what sources of information teachers typically regard as reliable. The What Works Clearinghouse is discussed with reference to certain limitations of its current operation. Given the…

Identifying Governance Best Practices in Systems-of-Systems Acquisition

DTIC Science & Technology

2014-02-08

Acquisition Governance ................................................ 28  Figure 3.  Harvest Hercules Airborne Weapons Kit System Components ...... 39 ...acquisition poses considerable challenges that the current Department of Defense (DoD) acquisition governance structure was not necessarily designed to...specify the warship it needed along with the design , construction, and outfitting of the ship. The Navy managed and performed production operations and

Mental Health Evaluations for Adolescents Prior to Bariatric Surgery: A Review of Existing Practices and a Specific Example of Assessment Procedures

PubMed Central

Sysko, Robyn; Zandberg, Laurie J.; Devlin, Michael J.; Annunziato, Rachel A.; Zitsman, Jeffrey L.; Walsh, B. Timothy

2013-01-01

Objective Best practice guidelines for adolescents considering bariatric surgery recommend a pre-operative mental health evaluation. However, only general information about these assessments appears in the literature, which makes consistency of administration challenging. This review proposes a specific empirically-derived format for pre-surgical mental health evaluations and summarizes currently available data on the psychiatric functioning of adolescents seeking bariatric surgery. Design Studies of mental health evaluations for adults preparing for bariatric surgery are reviewed, as is the limited literature relevant to adolescent evaluations. A specific and detailed example of an evaluation (clinical interview, self-report questionnaires, cognitive assessment) used for younger patients at a major metropolitan hospital center is presented, followed by data from an initial group of adolescents completing this evaluation. Subjects 200 adolescents (n=139 female; age: 14–18 y, BMI: 35.4–83.3 kg/m2) presenting for bariatric surgery. Results A notable subset of adolescents reported current Axis I conditions (31.5%) and current mental health treatment (29.5%), but reports of current illicit drug use (1.5%) and regular alcohol use (0.5%) were relatively rare. Procedures for using the completed evaluation and post-surgery monitoring of psychosocial issues are discussed. Conclusions Adolescents considering weight loss surgery should receive comprehensive pre-surgical mental health evaluations, but additional data are needed to develop specific recommendations the use of these evaluations in post-operative care. PMID:24073019

Macro Trends and the Future of Public Health Practice.

PubMed

Erwin, Paul Campbell; Brownson, Ross C

2017-03-20

Public health practice in the twenty-first century is in a state of significant flux. Several macro trends are impacting the current practice of governmental public health and will likely have effects for many years to come. These macro trends are described as forces of change, which are changes that affect the context in which the community and its public health system operate. This article focuses on seven such forces of change: the Patient Protection and Affordable Care Act, public health agency accreditation, climate change, health in all policies, social media and informatics, demographic transitions, and globalized travel. Following the description of each of these, this article then turns to possible approaches to measuring, tracking, and understanding the impact of these forces of change on public health practice, including the use of evidence-based public health, practice-based research, and policy surveillance.

Research on Parallel Three Phase PWM Converters base on RTDS

NASA Astrophysics Data System (ADS)

Xia, Yan; Zou, Jianxiao; Li, Kai; Liu, Jingbo; Tian, Jun

2018-01-01

Converters parallel operation can increase capacity of the system, but it may lead to potential zero-sequence circulating current, so the control of circulating current was an important goal in the design of parallel inverters. In this paper, the Real Time Digital Simulator (RTDS) is used to model the converters parallel system in real time and study the circulating current restraining. The equivalent model of two parallel converters and zero-sequence circulating current(ZSCC) were established and analyzed, then a strategy using variable zero vector control was proposed to suppress the circulating current. For two parallel modular converters, hardware-in-the-loop(HIL) study based on RTDS and practical experiment were implemented, results prove that the proposed control strategy is feasible and effective.

The cost analysis of cemented versus cementless total hip replacement operations on the NHS.

PubMed

Kallala, R; Anderson, P; Morris, S; Haddad, F S

2013-07-01

In a time of limited resources, the debate continues over which types of hip prosthesis are clinically superior and more cost-effective. Orthopaedic surgeons increasingly need robust economic evidence to understand the full value of the operation, and to aid decision making on the 'package' of procedures that are available and to justify their practice beyond traditional clinical preference. In this paper we explore the current economic debate about the merits of cemented and cementless total hip replacement, an issue that continues to divide the orthopaedic community.

Clinical Space Medicine Products as Developed by the Medical Operations Support Team (MOST)

NASA Technical Reports Server (NTRS)

Polk, James D.; Doerr, Harold K.; Hurst, Victor W., IV; Schmid, Josef

2007-01-01

Medical Operations Support Team (MOST) is introducing/integrating teaching practices associated with high fidelity human patient simulation into the NASA culture, in particular, into medical training sessions and medical procedure evaluations. Current/Future Products iclude: a) Development of Sub-optimal Airway Protocols for the International Space Station (ISS) using the ILMA; b) Clinical Core Competency Training for NASA Flight Surgeons (FS); c) Post-Soyuz Landing Clinical Training for NASA FS; d) Experimental Integrated Training for Astronaut Crew Medical Officers and NASA FS; and e) Private Clinical Refresher Training.

Continuous-wave dual-wavelength operation of a distributed feedback laser diode with an external cavity using a volume Bragg grating

NASA Astrophysics Data System (ADS)

Zheng, Yujin; Sekine, Takashi; Kurita, Takashi; Kato, Yoshinori; Kawashima, Toshiyuki

2018-03-01

We demonstrate continuous-wave dual-wavelength operation of a broad-area distributed feedback (DFB) laser diode with a single external-cavity configuration. This high-power DFB laser has a narrow bandwidth (<0.29 nm) and was used as a single-wavelength source. A volume Bragg grating was used as an output coupler for the external-cavity DFB laser to output another stable wavelength beam with a narrow bandwidth of 0.27 nm. A frequency difference for dual-wavelength operation of 0.88 THz was achieved and an output power of up to 415 mW was obtained. The external-cavity DFB laser showed a stable dual-wavelength operation over the practical current and temperature ranges.

Software Development Standard Processes (SDSP)

NASA Technical Reports Server (NTRS)

Lavin, Milton L.; Wang, James J.; Morillo, Ronald; Mayer, John T.; Jamshidian, Barzia; Shimizu, Kenneth J.; Wilkinson, Belinda M.; Hihn, Jairus M.; Borgen, Rosana B.; Meyer, Kenneth N.;

The Hierarchy of Control in the Epidemic of Farm Injury.

PubMed

Dosman, James; Hagel, Louise; King, Nathan; Koehncke, Niels; Kirychuk, Shelley; Trask, Catherine; Neudorf, Joshua; Day, Lesley; Voaklander, Donald; Pickett, William

2015-01-01

The application of the hierarchy of control (HOC) is a well-established approach to hazard reduction in industrial workplaces. However, it has not been generally applied in farm workplaces. The objective was to determine current practices of farmers in the context of a modified HOC, and the effect of these practices on farm injury outcomes. A self-reported mail survey of 1196 Saskatchewan farm operations was conducted in 2013. Selected survey questions were used as proxy measures of the farm owner-operator's practices relevant to each of the six steps of increasing importance in a modified HOC: (1) hazard identification; (2) risk assessment; (3) personal protection; (4) administrative controls; (5) engineering controls; and (6) elimination of the hazard. Analysis used basic descriptive statistics and logistic regression to examine associations of interest. When four of the six HOC steps were adhered to, there was a significant protective effect: odds ratio (OR) = 0.32 (95% confidence interval [CI]: 0.14-0.74) for any injury and OR = 0.27 (95% CI: 0.07-0.99) for serious injury in the overall study population. For farm owner-operators utilizing four of the six steps in the modified HOC, there was a significant protective effect for any injury (OR = 0.30, 95% CI: 0.11-0.83). Although there is a considerable absence of use of elements of the HOC among farm operators, for farmers who adhere to these steps, there is a significant reduction in their risk for injury. Prevention strategies that embrace the practice of these principles may be effective in the control of farm workplace injury.

Rapid prototyping, astronaut training, and experiment control and supervision: distributed virtual worlds for COLUMBUS, the European Space Laboratory module

NASA Astrophysics Data System (ADS)

Freund, Eckhard; Rossmann, Juergen

2002-02-01

In 2004, the European COLUMBUS Module is to be attached to the International Space Station. On the way to the successful planning, deployment and operation of the module, computer generated and animated models are being used to optimize performance. Under contract of the German Space Agency DLR, it has become IRF's task to provide a Projective Virtual Reality System to provide a virtual world built after the planned layout of the COLUMBUS module let astronauts and experimentators practice operational procedures and the handling of experiments. The key features of the system currently being realized comprise the possibility for distributed multi-user access to the virtual lab and the visualization of real-world experiment data. Through the capabilities to share the virtual world, cooperative operations can be practiced easily, but also trainers and trainees can work together more effectively sharing the virtual environment. The capability to visualize real-world data will be used to introduce measured data of experiments into the virtual world online in order to realistically interact with the science-reference model hardware: The user's actions in the virtual world are translated into corresponding changes of the inputs of the science reference model hardware; the measured data is than in turn fed back into the virtual world. During the operation of COLUMBUS, the capabilities for distributed access and the capabilities to visualize measured data through the use of metaphors and augmentations of the virtual world may be used to provide virtual access to the COLUMBUS module, e.g. via Internet. Currently, finishing touches are being put to the system. In November 2001 the virtual world shall be operational, so that besides the design and the key ideas, first experimental results can be presented.

Radiology applications of financial accounting.

PubMed

Leibenhaut, Mark H

2005-03-01

A basic knowledge of financial accounting can help radiologists analyze business opportunities and examine the potential impacts of new technology or predict the adverse consequences of new competitors entering their service area. The income statement, balance sheet, and cash flow statement are the three basic financial statements that document the current financial position of the radiology practice and allow managers to monitor the ongoing financial operations of the enterprise. Pro forma, or hypothetical, financial statements can be generated to predict the financial impact of specific business decisions or investments on the profitability of the practice. Sensitivity analysis, or what-if scenarios, can be performed to determine the potential impact of changing key revenue, investment, operating cost or financial assumptions. By viewing radiology as both a profession and a business, radiologists can optimize their use of scarce economic resources and maximize the return on their financial investments.

Protecting the GEO Environment: Policies and Practices

NASA Technical Reports Server (NTRS)

Johnson, Nicholas L.; McKay, Gordon A. (Technical Monitor)

1999-01-01

The geosynchronous orbital regime has long been recognized as a unique space resource, dictating special measures to ensure its continuing use for future generations. During the past 20 years a variety of national and international policies have been developed to preserve this environment. A review of current practices involving the deployment and disposal of geosynchronous spacecraft, associated upper stages and apogee kick motors, and geosynchronous orbit transfer objects indicates both positive and negative trends. Most spacecraft operators are indeed performing end-of-mission maneuvers, but the boost altitudes normally fall short of policy guidelines. Russia, a major operator in geosynchronous orbit, maneuvers only 1 in 3 spacecraft out of the region, while China has never refired a spacecraft above GEO. The viability of voluntary protection measures for this regime depends upon the responsible actions of the aerospace community as a whole.

A comparison of surgical assisting in a prepaid group practice and a community hospital.

PubMed

Lewit, E M; Bentkover, J D; Bentkover, S H; Watkins, R N; Hughes, E F

1980-09-01

Previous studies of the work loads and time utilization of general surgeons in two different practice settings suggested that paraprofessional surgical assistants (SAs) could reduce surgeon assisting time and perhaps increase productivity. In order to further assess the potential advantage of using SAs as surgical assistants, the present study examines assisting patterns in a prepaid group practice where SAs are used and in a community hospital where only physicians are available to assist. In the prepaid group practice, 87 per cent of general surgical procedures were performed with an assistant; in the c ommunity hospital, 67 per cent of general surgical procedures were performed with an assistant. General practitioners also were found to assist in the community hospital; family practice residents, medical students and "others" also assisted in prepaid group. In both settings, the propensity to use an assistant was positively correlated with operative complexity. On operations of greatest complexity, surgeons were most likely to act as first assistants. The use of SAs was not usually associated with operative sessions longer than when surgeons assisted, except on operations of high complexity. In the prepaid group, SAs also frequently assisted on orthopedic surgery, neurosurgery and obstetrics-gynecology, only occasionally on otolaryngology and plastic surgery, and never on ophthalmology. It appears that in organizations such as a prepaid group practice, where mechanisms for sharing resources exist and incentives are provided to minimize the total cost of surgery, the utilization of SAs might be associated with cost savings. At present, organizational and financial barriers exist to the introduction of paraprofessionals as surgical assistants. It is difficult to advocate the modification of these barriers to facilitate the training and large-scale introduction of this new group of paraprofessionals in the current surgical market where there may already be an excess supply of surgeons.

Landmine policy in the near-term: a framework for technology analysis and action

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

Eimerl, D., LLNL

1997-08-01

Any effective solution to the problem of leftover landmines and other post-conflict unexploded ordnance (UXO) must take into account the real capabilities of demining technologies and the availability of sufficient resources to carry out demining operations. Economic and operational factors must be included in analyses of humanitarian demining. These factors will provide a framework for using currently available resources and technologies to complete this task in a time frame that is both practical and useful. Since it is likely that reliable advanced technologies for demining are still several years away, this construct applies to the intervening period. It may alsomore » provide a framework for utilizing advanced technologies as they become available. This study is an economic system model for demining operations carried out by the developed nations that clarifies the role and impact of technology on the economic performance and viability of these operations. It also provides a quantitative guide to assess the performance penalties arising from gaps in current technology, as well as the potential advantages and desirable features of new technologies that will significantly affect the international community`s ability to address this problem. Implications for current and near-term landmine and landmine technology policies are drawn.« less

Enhancing links between visual short term memory, visual attention and cognitive control processes through practice: An electrophysiological insight.

PubMed

Fuggetta, Giorgio; Duke, Philip A

2017-05-01

The operation of attention on visible objects involves a sequence of cognitive processes. The current study firstly aimed to elucidate the effects of practice on neural mechanisms underlying attentional processes as measured with both behavioural and electrophysiological measures. Secondly, it aimed to identify any pattern in the relationship between Event-Related Potential (ERP) components which play a role in the operation of attention in vision. Twenty-seven participants took part in two recording sessions one week apart, performing an experimental paradigm which combined a match-to-sample task with a memory-guided efficient visual-search task within one trial sequence. Overall, practice decreased behavioural response times, increased accuracy, and modulated several ERP components that represent cognitive and neural processing stages. This neuromodulation through practice was also associated with an enhanced link between behavioural measures and ERP components and with an enhanced cortico-cortical interaction of functionally interconnected ERP components. Principal component analysis (PCA) of the ERP amplitude data revealed three components, having different rostro-caudal topographic representations. The first component included both the centro-parietal and parieto-occipital mismatch triggered negativity - involved in integration of visual representations of the target with current task-relevant representations stored in visual working memory - loaded with second negative posterior-bilateral (N2pb) component, involved in categorising specific pop-out target features. The second component comprised the amplitude of bilateral anterior P2 - related to detection of a specific pop-out feature - loaded with bilateral anterior N2, related to detection of conflicting features, and fronto-central mismatch triggered negativity. The third component included the parieto-occipital N1 - related to early neural responses to the stimulus array - which loaded with the second negative posterior-contralateral (N2pc) component, mediating the process of orienting and focusing covert attention on peripheral target features. We discussed these three components as representing different neurocognitive systems modulated with practice within which the input selection process operates. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Cholesterol Point-of-Care Testing for Community Pharmacies: A Review of the Current Literature.

PubMed

Haggerty, Lauren; Tran, Deanna

2017-08-01

To summarize the literature on cholesterol point-of-care tests (POCTs). This article would serve as a resource to assist community pharmacists in developing cholesterol point-of-care (POC) pharmacy services. A literature search was performed in MEDLINE Ovid, PubMed, EMBASE, and Cochrane database using the following medical subject headings (MeSH) terms: point-of-care test, cholesterol, blood chemical analysis, rapid testing, collaborative practice, community pharmacy, and ambulatory care. Additional resources including device manufacturer web sites were summarized to supplement the current literature. All human research articles, review articles, meta-analyses, and abstracts published in English through September 1, 2014, were considered. A total of 36 articles were applicable for review. Information was divided into the following categories to be summarized: devices, pharmacists' impact, and operational cost for the pharmacy. The current literature suggests that POCTs in community pharmacies assist with patient outcomes by providing screenings and referring patients with dyslipidemia for further evaluation. The majority of studies on cholesterol POC devices focused on accuracy, revealing the need for further studies to develop best practices and practice models with successful reimbursement. Accuracy, device specifications, required supplies, and patient preference should be considered when selecting a POC device for purchase.

Space Radiation Protection, Space Weather, and Exploration

NASA Technical Reports Server (NTRS)

Zapp, Neal; Fry, Dan; Lee, Kerry

2010-01-01

Management of crew exposure to radiation is a major concern for manned spaceflight and will be even more important for the modern concept of longer-duration exploration. The inherent protection afforded to astronauts by the magnetic field of the Earth in Low Earth Orbit (LEO) makes operations on the space shuttle or space station very different from operations during a deep space exploration mission. In order to experience significant radiation-derived Loss of Mission (LOM) or Loss of Crew (LOC) risk for LEO operations, one is almost driven to dictate extreme duration or to dictate an extreme sequence of solar activity. Outside of the geo-magnetosphere, however, this scenario changes dramatically. Exposures to the same event on the ISS and on the surface of the Moon may differ by multiple orders of magnitude. This change in magnitude, coupled with the logistical constraints present in implementing any practical operational mitigation make situational awareness with regard to space weather a limiting factor for our ability to conduct exploration operations. With these differences in risk to crew, vehicle and mission in mind, we present the status of the efforts currently underway as the required development to enable exploration operations. The changes in the operating environment as crewed operations begin to stretch away from the Earth are changing the way we think about the lines between research and operations . The real, practical work to enable a permanent human presence away from Earth has already begun

Why don't Practitioners use Reservoir Optimization Methods? Results from a Survey of UK Water Managers

NASA Astrophysics Data System (ADS)

Dobson, B.; Pianosi, F.; Wagener, T.

2016-12-01

Extensive scientific literature exists on the study of how operation decisions in water resource systems can be made more effectively through the use of optimization methods. However, to the best of the authors' knowledge, there is little in the literature on the implementation of these optimization methods by practitioners. We have performed a survey among UK reservoir operators to assess the current state of method implementation in practice. We also ask questions to assess the potential for implementation of operation optimization. This will help academics to target industry in their current research, identify any misconceptions in industry about the area and open new branches of research for which there is an unsatisfied demand. The UK is a good case study because the regulatory framework is changing to impose "no build" solutions for supply issues, as well as planning across entire water resource systems rather than individual components. Additionally there is a high appetite for efficiency due to the water industry's privatization and most operators are part of companies that control multiple water resources, increasing the potential for cooperation and coordination.

Self-excitation of microwave oscillations in plasma-assisted slow-wave oscillators by an electron beam with a movable focus

NASA Astrophysics Data System (ADS)

Bliokh, Yu. P.; Nusinovich, G. S.; Shkvarunets, A. G.; Carmel, Y.

2004-10-01

Plasma-assisted slow-wave oscillators (pasotrons) operate without external magnetic fields, which makes these devices quite compact and lightweight. Beam focusing in pasotrons is provided by ions, which appear in the device due to the impact ionization of a neutral gas by beam electrons. Typically, the ionization time is on the order of the rise time of the beam current. This means that, during the rise of the current, beam focusing by ions becomes stronger. Correspondingly, a beam of electrons, which was initially diverging radially due to the self-electric field, starts to be focused by ions, and this focus moves towards the gun as the ion density increases. This feature makes the self-excitation of electromagnetic (em) oscillations in pasotrons quite different from practically all other microwave sources where em oscillations are excited by a stationary electron beam. The process of self-excitation of em oscillations has been studied both theoretically and experimentally. It is shown that in pasotrons, during the beam current rise the amount of current entering the interaction space and the beam coupling to the em field vary. As a result, the self-excitation can proceed faster than in conventional microwave sources with similar operating parameters such as the operating frequency, cavity quality-factor and the beam current and voltage.

Information Warfare and the Principles of War.

DTIC Science & Technology

1997-02-07

information dominance , control of ’cyberspace’ or the ’Infosphere’ and Information Warfare. Some argue that Information Warfare (IW) is just a repackaging of old concepts and current practices, while others contend it is the next Revolution in Military Affairs (RMA). The question that needs to be addressed is; can IW achieve strategic and operational military objectives on its on merit? A way to answer this questions is to analyze IW against our current doctrine. Using the principles of war as a framework, does IW fit (or can it be employed) in the

Contaminated waste incinerator modification study. Final report

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

Wolf, F.

1995-08-01

An explosive waste incinerator (EWI) can be installed in the existing Badger AAP Contaminated Waste Processor (CWP). An engineering evaluation of installing a rotary kiln furnace to dispose of waste energetic material has shown the installation to be possible. An extensive literature search was completed to develop the known proven methods of energetic waste disposal. Current incineration practice including thermal treatment alternatives was investigated. Existing and new equipment was reviewed for adequacy. Current CWP operations and hazardous waste to be disposed of were determined. Comparisons were made with other AAP`s EWI.

Robotic surgery for rectal cancer: A systematic review of current practice

PubMed Central

Mak, Tony Wing Chung; Lee, Janet Fung Yee; Futaba, Kaori; Hon, Sophie Sok Fei; Ngo, Dennis Kwok Yu; Ng, Simon Siu Man

2014-01-01

AIM: To give a comprehensive review of current literature on robotic rectal cancer surgery. METHODS: A systematic review of current literature via PubMed and Embase search engines was performed to identify relevant articles from january 2007 to november 2013. The keywords used were: “robotic surgery”, “surgical robotics”, “laparoscopic computer-assisted surgery”, “colectomy” and “rectal resection”. RESULTS: After the initial screen of 380 articles, 20 papers were selected for review. A total of 1062 patients (male 64.0%) with a mean age of 61.1 years and body mass index of 24.9 kg/m2 were included in the review. Out of 1062 robotic-assisted operations, 831 (78.2%) anterior and low anterior resections, 132 (12.4%) intersphincteric resection with coloanal anastomosis, 98 (9.3%) abdominoperineal resections and 1 (0.1%) Hartmann’s operation were included in the review. Robotic rectal surgery was associated with longer operative time but with comparable oncological results and anastomotic leak rate when compared with laparoscopic rectal surgery. CONCLUSION: Robotic colorectal surgery has continued to evolve to its current state with promising results; feasible surgical option with low conversion rate and comparable short-term oncological results. The challenges faced with robotic surgery are for more high quality studies to justify its cost. PMID:24936229

A Practical Study of the 66kV Fault Current Limiter (FCL) System with Rectifier

NASA Astrophysics Data System (ADS)

Tokuda, Noriaki; Matsubara, Yoshio; Yuguchi, Kyosuke; Ohkuma, Takeshi; Hobara, Natsuro; Takahashi, Yoshihisa

A fault current limiter (FCL) is extensively expected to suppress fault current, particularly required for trunk power systems heavily connected high-voltage transmission lines, such as 500kV class power system which constitutes the nucleus of the electric power system. By installing such FCL in the power system, the system interconnection is possible without the need to raise the capacity of the circuit breakers, and facilities can be configured for efficiency, among other benefits. For these reasons, fault current limiters based on various principles of operation have been developed both in Japan and abroad. In this paper, we have proposed a new type of FCL system, consisting of solid-state diodes, DC coil and bypass AC coil, and described the specification of distribution power system and 66kV model at the island power system and the superconducting cable power system. Also we have made a practical study of 66kV class, which is the testing items and the future subjects of the rectifier type FCL system.

Orthopaedic Resident Practice Management and Health Policy Education: Evaluation of Experience and Expectations.

PubMed

Stautberg Iii, Eugene F; Romero, Jose; Bender, Sean; DeHart, Marc

2018-04-11

Introduction Practice management and health policy have generally not been considered integral to orthopaedic resident education. Our objective was to evaluate residents' current experience and knowledge, formal training, and desire for further education in practice management and health policy. Methods We developed a 29-question survey that was divided into three sections: practice management, initial employment opportunity, and health policy. Within each section, questions were directed at a resident's current experience and knowledge, formal training, and interest in further education. The survey was distributed at the end of the academic year through an Internet-based survey tool (www.surveymonkey.com) to orthopaedic residents representing multiple programs and all postgraduate years. Results The survey was distributed to 121 residents representing eight residency programs. Of those, 87 residents responded, resulting in a 72% response rate. All postgraduate years were represented. Regarding practice management, 66% had "no confidence" or "some confidence" in coding clinical encounters. When asked if practice models, finance management, and coding should be taught in residency, 95%, 93%, and 97% responded "yes," respectively. When evaluating first employment opportunities, the three most important factors were location, operating room block time, and call. Regarding health policy, 28% were "moderately familiar" or "very familiar" with the Physician Payments Sunshine Act, and 72% were "not familiar" or "somewhat familiar" with bundled payments for arthroplasty. Finally, when asked if yearly lectures in political activities would enhance resident education, 90% responded "yes." Discussion and conclusion Regarding practice management, the survey suggests that current orthopaedic residents are not familiar with basic topics, do not receive formal training, and want further education. The survey suggests that residents also receive minimal training in health policy. Residents feel that health policy will be important in their careers, and they would benefit from formal training in residency.

Many-objective reservoir policy identification and refinement to reduce institutional myopia in water management

NASA Astrophysics Data System (ADS)

Giuliani, Matteo; Herman, Jonathan D.; Castelletti, Andrea; Reed, Patrick M.

2014-05-01

Current water reservoir operating policies are facing growing water demands as well as increasing uncertainties associated with a changing climate. However, policy inertia and myopia strongly limit the possibility of adapting current water reservoir operations to the undergoing change. Historical agreements and regulatory constraints limit the rate that reservoir operations are innovated and creates policy inertia, where water institutions are unlikely to change their current practices in absence of dramatic failures. Yet, no guarantee exists that historical management policies will not fail in coming years. In reference to policy myopia, although it has long been recognized that water reservoir systems are generally framed in heterogeneous socio-economic contexts involving a myriad of conflicting, non-commensurable operating objectives, the broader understanding of the multi-objective consequences of current operating rules as well as their vulnerability to hydroclimatic uncertainties is severely limited. This study proposes a decision analytic framework to overcome both policy inertia and myopia in complex river basin management contexts. The framework combines reservoir policy identification, many-objective optimization under uncertainty, and visual analytics to characterize current operations and discover key tradeoffs between alternative policies for balancing evolving demands and system uncertainties. The approach is demonstrated on the Conowingo Dam, located within the Lower Susquehanna River, USA. The Lower Susquehanna River is an interstate water body that has been subject to intensive water management efforts due to the system's competing demands from urban water supply, atomic power plant cooling, hydropower production, and federally regulated environmental flows. The proposed framework initially uses available streamflow observations to implicitly identify the current but unknown operating policy of Conowingo Dam. The quality of the identified baseline policy was validated by its ability to replicate historical release dynamics. Starting from this baseline policy, we then combine evolutionary many-objective optimization with visual analytics to discover new operating policies that better balance the tradeoffs within the Lower Susquehanna. Results confirm that the baseline operating policy, which only considers deterministic historical inflows, significantly overestimates the reliability of the reservoir's competing demands. The proposed framework removes this bias by successfully identifying alternative reservoir policies that are more robust to hydroclimatic uncertainties, while also better addressing the tradeoffs across the Conowingo Dam's multi-sector services.

Medical robotics: the impact on perioperative nursing practice.

PubMed

Francis, Paula; Winfield, Howard N

2006-04-01

Robotic technology and the increased use of minimally invasive surgery approaches is altering the environment in which operating room personnel work and affecting how nurses must care for patients. An understanding of the history of robotics, current applications of the technology, and perioperative nursing responsibilities is needed to assure quality patient care in the wake of continued advances in technology.

A Creatively Creative Taxonomy on Creativity: A New Model of Creativity and Other Novel Forms of Behavior.

ERIC Educational Resources Information Center

Stahl, Robert J.

Some of the most used, misused, and abused terms in contemporary education are the words "create,""creative," and "creativity." One way of understanding creativity is to reject the current practice of assuming that creative behavior is directly caused by some special kind of mental operation called "creative thinking." What can be accepted is the…

Response: Hermeneutics and Accountable Practice--Lessons from the History of Social Work

ERIC Educational Resources Information Center

Lorenz, Walter

2012-01-01

Central to this article are two concerns: It seeks to demonstrate that social work theories and methods always need to be evaluated with reference to the social policy context in which they operate and in which they might assume unintended functions. It further proposes that the dominance of a positivist epistemology in the current surge for…

National Institutes of Health-Sponsored Clinical Islet Transplantation Consortium Phase 3 Trial: Manufacture of a Complex Cellular Product at Eight Processing Facilities.

PubMed

Ricordi, Camillo; Goldstein, Julia S; Balamurugan, A N; Szot, Gregory L; Kin, Tatsuya; Liu, Chengyang; Czarniecki, Christine W; Barbaro, Barbara; Bridges, Nancy D; Cano, Jose; Clarke, William R; Eggerman, Thomas L; Hunsicker, Lawrence G; Kaufman, Dixon B; Khan, Aisha; Lafontant, David-Erick; Linetsky, Elina; Luo, Xunrong; Markmann, James F; Naji, Ali; Korsgren, Olle; Oberholzer, Jose; Turgeon, Nicole A; Brandhorst, Daniel; Chen, Xiaojuan; Friberg, Andrew S; Lei, Ji; Wang, Ling-Jia; Wilhelm, Joshua J; Willits, Jamie; Zhang, Xiaomin; Hering, Bernhard J; Posselt, Andrew M; Stock, Peter G; Shapiro, A M James; Chen, Xiaojuan

2016-11-01

Eight manufacturing facilities participating in the National Institutes of Health-sponsored Clinical Islet Transplantation (CIT) Consortium jointly developed and implemented a harmonized process for the manufacture of allogeneic purified human pancreatic islet (PHPI) product evaluated in a phase 3 trial in subjects with type 1 diabetes. Manufacturing was controlled by a common master production batch record, standard operating procedures that included acceptance criteria for deceased donor organ pancreata and critical raw materials, PHPI product specifications, certificate of analysis, and test methods. The process was compliant with Current Good Manufacturing Practices and Current Good Tissue Practices. This report describes the manufacturing process for 75 PHPI clinical lots and summarizes the results, including lot release. The results demonstrate the feasibility of implementing a harmonized process at multiple facilities for the manufacture of a complex cellular product. The quality systems and regulatory and operational strategies developed by the CIT Consortium yielded product lots that met the prespecified characteristics of safety, purity, potency, and identity and were successfully transplanted into 48 subjects. No adverse events attributable to the product and no cases of primary nonfunction were observed. © 2016 by the American Diabetes Association.

National Institutes of Health–Sponsored Clinical Islet Transplantation Consortium Phase 3 Trial: Manufacture of a Complex Cellular Product at Eight Processing Facilities

PubMed Central

Balamurugan, A.N.; Szot, Gregory L.; Kin, Tatsuya; Liu, Chengyang; Czarniecki, Christine W.; Barbaro, Barbara; Bridges, Nancy D.; Cano, Jose; Clarke, William R.; Eggerman, Thomas L.; Hunsicker, Lawrence G.; Kaufman, Dixon B.; Khan, Aisha; Lafontant, David-Erick; Linetsky, Elina; Luo, Xunrong; Markmann, James F.; Naji, Ali; Korsgren, Olle; Oberholzer, Jose; Turgeon, Nicole A.; Brandhorst, Daniel; Chen, Xiaojuan; Friberg, Andrew S.; Lei, Ji; Wang, Ling-jia; Wilhelm, Joshua J.; Willits, Jamie; Zhang, Xiaomin; Hering, Bernhard J.; Posselt, Andrew M.; Stock, Peter G.; Shapiro, A.M. James

2016-01-01

Eight manufacturing facilities participating in the National Institutes of Health–sponsored Clinical Islet Transplantation (CIT) Consortium jointly developed and implemented a harmonized process for the manufacture of allogeneic purified human pancreatic islet (PHPI) product evaluated in a phase 3 trial in subjects with type 1 diabetes. Manufacturing was controlled by a common master production batch record, standard operating procedures that included acceptance criteria for deceased donor organ pancreata and critical raw materials, PHPI product specifications, certificate of analysis, and test methods. The process was compliant with Current Good Manufacturing Practices and Current Good Tissue Practices. This report describes the manufacturing process for 75 PHPI clinical lots and summarizes the results, including lot release. The results demonstrate the feasibility of implementing a harmonized process at multiple facilities for the manufacture of a complex cellular product. The quality systems and regulatory and operational strategies developed by the CIT Consortium yielded product lots that met the prespecified characteristics of safety, purity, potency, and identity and were successfully transplanted into 48 subjects. No adverse events attributable to the product and no cases of primary nonfunction were observed. PMID:27465220

Drug product distribution systems and departmental operations.

PubMed

Hynniman, C E

1991-10-01

Technologies affecting institutional pharmacy practice and the operation of pharmacy departments are reviewed, future developments are outlined, and implications of these developments for pharmacy education are proposed. Computer technology, especially as applied to areas such as artificial intelligence, online information databases, electronic bulletin boards, hospital information systems, and point-of-care systems, will have a strong impact on pharmacy practice and management in the 1990s. Other areas in which growth is likely to be active include bar-code technology, robotics, and automated drug dispensing. The applications of these technologies are described, with particular attention placed on the effects of increased automation on the drug-dispensing function. Technological advances may effect marked reductions in dispensing and medication errors; questions concerning the cost-effectiveness of these new systems remain to be answered. These advances also create new opportunities for clinical involvement by pharmacists; however, a fundamental understanding of computer systems is essential. Current practitioners can benefit from attending seminars, participating in users' groups, and keeping current with the computer literature. Many students now acquire the needed skills in computer laboratories and in the classroom. Technological advances will offer the opportunity for pharmacists to expand their clinical role.

Transfer path analysis: Current practice, trade-offs and consideration of damping

NASA Astrophysics Data System (ADS)

Oktav, Akın; Yılmaz, Çetin; Anlaş, Günay

2017-02-01

Current practice of experimental transfer path analysis is discussed in the context of trade-offs between accuracy and time cost. An overview of methods, which propose solutions for structure borne noise, is given, where assumptions, drawbacks and advantages of methods are stated theoretically. Applicability of methods is also investigated, where an engine induced structure borne noise of an automobile is taken as a reference problem. Depending on this particular problem, sources of measurement errors, processing operations that affect results and physical obstacles faced in the application are analysed. While an operational measurement is common in all stated methods, when it comes to removal of source, or the need for an external excitation, discrepancies are present. Depending on the chosen method, promised outcomes like independent characterisation of the source, or getting information about mounts also differ. Although many aspects of the problem are reported in the literature, damping and its effects are not considered. Damping effect is embedded in the measured complex frequency response functions, and it is needed to be analysed in the post processing step. Effects of damping, reasons and methods to analyse them are discussed in detail. In this regard, a new procedure, which increases the accuracy of results, is also proposed.

Airborne Precision Spacing (APS) Dependent Parallel Arrivals (DPA)

NASA Technical Reports Server (NTRS)

Smith, Colin L.

2012-01-01

The Airborne Precision Spacing (APS) team at the NASA Langley Research Center (LaRC) has been developing a concept of operations to extend the current APS concept to support dependent approaches to parallel or converging runways along with the required pilot and controller procedures and pilot interfaces. A staggered operations capability for the Airborne Spacing for Terminal Arrival Routes (ASTAR) tool was developed and designated as ASTAR10. ASTAR10 has reached a sufficient level of maturity to be validated and tested through a fast-time simulation. The purpose of the experiment was to identify and resolve any remaining issues in the ASTAR10 algorithm, as well as put the concept of operations through a practical test.

The Need for Integrating the Back End of the Nuclear Fuel Cycle in the United States of America

DOE PAGES

Bonano, Evaristo J.; Kalinina, Elena A.; Swift, Peter N.

2018-02-26

Current practice for commercial spent nuclear fuel management in the United States of America (US) includes storage of spent fuel in both pools and dry storage cask systems at nuclear power plants. Most storage pools are filled to their operational capacity, and management of the approximately 2,200 metric tons of spent fuel newly discharged each year requires transferring older and cooler fuel from pools into dry storage. In the absence of a repository that can accept spent fuel for permanent disposal, projections indicate that the US will have approximately 134,000 metric tons of spent fuel in dry storage by mid-centurymore » when the last plants in the current reactor fleet are decommissioned. Current designs for storage systems rely on large dual-purpose (storage and transportation) canisters that are not optimized for disposal. Various options exist in the US for improving integration of management practices across the entire back end of the nuclear fuel cycle.« less

The Need for Integrating the Back End of the Nuclear Fuel Cycle in the United States of America

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

Bonano, Evaristo J.; Kalinina, Elena A.; Swift, Peter N.

Current practice for commercial spent nuclear fuel management in the United States of America (US) includes storage of spent fuel in both pools and dry storage cask systems at nuclear power plants. Most storage pools are filled to their operational capacity, and management of the approximately 2,200 metric tons of spent fuel newly discharged each year requires transferring older and cooler fuel from pools into dry storage. In the absence of a repository that can accept spent fuel for permanent disposal, projections indicate that the US will have approximately 134,000 metric tons of spent fuel in dry storage by mid-centurymore » when the last plants in the current reactor fleet are decommissioned. Current designs for storage systems rely on large dual-purpose (storage and transportation) canisters that are not optimized for disposal. Various options exist in the US for improving integration of management practices across the entire back end of the nuclear fuel cycle.« less

Risk Importance Measures in the Designand Operation of Nuclear Power Plants

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

Vrbanic I.; Samanta P.; Basic, I

This monograph presents and discusses risk importance measures as quantified by the probabilistic risk assessment (PRA) models of nuclear power plants (NPPs) developed according to the current standards and practices. Usually, PRA tools calculate risk importance measures related to a single ?basic event? representing particular failure mode. This is, then, reflected in many current PRA applications. The monograph focuses on the concept of ?component-level? importance measures that take into account different failure modes of the component including common-cause failures (CCFs). In opening sections the roleof risk assessment in safety analysis of an NPP is introduced and discussion given of ?traditional?,more » mainly deterministic, design principles which have been established to assign a level of importance to a particular system, structure or component. This is followed by an overview of main risk importance measures for risk increase and risk decrease from current PRAs. Basic relations which exist among the measures are shown. Some of the current practical applications of risk importancemeasures from the field of NPP design, operation and regulation are discussed. The core of the monograph provides a discussion on theoreticalbackground and practical aspects of main risk importance measures at the level of ?component? as modeled in a PRA, starting from the simplest case, single basic event, and going toward more complexcases with multiple basic events and involvements in CCF groups. The intent is to express the component-level importance measures via theimportance measures and probabilities of the underlying single basic events, which are the inputs readily available from a PRA model andits results. Formulas are derived and discussed for some typical cases. The formulas and their results are demonstrated through some practicalexamples, done by means of a simplified PRA model developed in and run by RiskSpectrum? tool, which are presented in the appendices. The monograph concludes with discussion of limitations of the use of risk importance measures and a summary of component-level importance cases evaluated.« less

High-Potential Metalless Nanocarbon Foam Supercapacitors Operating in Aqueous Electrolyte.

PubMed

Liu, Chueh; Li, Changling; Ahmed, Kazi; Mutlu, Zafer; Lee, Ilkeun; Zaera, Francisco; Ozkan, Cengiz S; Ozkan, Mihrimah

2018-04-01

Light-weight graphite foam decorated with carbon nanotubes (dia. 20-50 nm) is utilized as an effective electrode without binders, conductive additives, or metallic current collectors for supercapacitors in aqueous electrolyte. Facile nitric acid treatment renders wide operating potentials, high specific capacitances and energy densities, and long lifespan over 10 000 cycles manifested as 164.5 and 111.8 F g -1 , 22.85 and 12.58 Wh kg -1 , 74.6% and 95.6% capacitance retention for 2 and 1.8 V, respectively. Overcharge protection is demonstrated by repetitive cycling between 2 and 2.5 V for 2000 cycles without catastrophic structural demolition or severe capacity fading. Graphite foam without metallic strut possessing low density (≈0.4-0.45 g cm -3 ) further reduces the total weight of the electrode. The thorough investigation of the specific capacitances and coulombic efficiencies versus potential windows and current densities provides insights into the selection of operation conditions for future practical devices. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Creative employee scheduling in the health information management department.

PubMed

Hyde, C S

1998-02-01

What effect do schedules have on employees and department activities? Negative effects such as backlogs, poor employee morale, and absenteeism may be due to scheduling practices currently in place. The value of effective employee scheduling practices may be seen in areas of improved productivity. The process of developing schedules should include assessing department areas, understanding operational needs, choosing an option, and implementation. Finding a schedule that meets the needs of managers as well as those of the employees is rewarding. It is a win-win situation, and the benefits can yield increased productivity, decreased turnover, and higher morale.

European guidelines for workplace drug testing in oral fluid.

PubMed

Brcak, Michaela; Beck, Olof; Bosch, Tessa; Carmichael, Duncan; Fucci, Nadia; George, Claire; Piper, Mark; Salomone, Alberto; Schielen, Wim; Steinmeyer, Stefan; Taskinen, Sanna; Weinmann, Wolfgang

2018-03-01

These guidelines for Legally Defensible Workplace Drug Testing have been prepared and updated by the European Workplace Drug Testing Society (EWDTS). The European Guidelines are designed to establish best practice procedures whilst allowing individual countries to operate within the requirements of national customs and legislation. The EWDTS recommends that all European laboratories that undertake legally defensible workplace drug testing should use these guidelines as a template for accreditation. These guidelines are relevant to laboratory-based testing only. These guidelines follow current best practices and are constantly under review. Copyright © 2017 John Wiley & Sons, Ltd.

ADX - Advanced Divertor and RF Tokamak Experiment

NASA Astrophysics Data System (ADS)

Greenwald, Martin; Labombard, Brian; Bonoli, Paul; Irby, Jim; Terry, Jim; Wallace, Greg; Vieira, Rui; Whyte, Dennis; Wolfe, Steve; Wukitch, Steve; Marmar, Earl

2015-11-01

The Advanced Divertor and RF Tokamak Experiment (ADX) is a design concept for a compact high-field tokamak that would address boundary plasma and plasma-material interaction physics challenges whose solution is critical for the viability of magnetic fusion energy. This device would have two crucial missions. First, it would serve as a Divertor Test Tokamak, developing divertor geometries, materials and operational scenarios that could meet the stringent requirements imposed in a fusion power plant. By operating at high field, ADX would address this problem at a level of power loading and other plasma conditions that are essentially identical to those expected in a future reactor. Secondly, ADX would investigate the physics and engineering of high-field-side launch of RF waves for current drive and heating. Efficient current drive is an essential element for achieving steady-state in a practical, power producing fusion device and high-field launch offers the prospect of higher efficiency, better control of the current profile and survivability of the launching structures. ADX would carry out this research in integrated scenarios that simultaneously demonstrate the required boundary regimes consistent with efficient current drive and core performance.

NIOSH testimony to DOL on the Occupational Safety And Health Administration's proposed rule on occupational exposure to asbestos, tremolite, anthophyllite, and actinolite by J. D. Millar, January 24, 1991

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

Not Available

1991-01-24

The testimony contains the comments of NIOSH regarding the proposed rule on occupational exposure to asbestos (1332214), tremolite (14567738), anthophyllite (17068789) and actinolite (77536664) exposures. NIOSH supports OSHA in proposing changes to the existing asbestos standard to minimize the risk of asbestos related diseases in workers. The current standard is insufficient to protect the health of workers exposed to asbestos, and the proposed changes represent a prudent and necessary approach to accomplish this goal. Specific topics addressed in the testimony include exposure limits for asbestos; methods for sampling and analysis of airborne fibers; use of time weighted averages to measuremore » exposure; use of engineering controls, good work practices and personal protective equipment; use of engineering controls and work practices for brake and clutch repair and service; required use of specific work practices during maintenance of vinyl asbestos floor tile; housekeeping; definitions of small scale and short duration operations; exemption of roofing operations from the requirement for negative pressure enclosures; communication among employers and owners; regulated areas for asbestos removal, maintenance, demolition, and renovation operations; use of glove bags; definition of competent person; and notification to OSHA and method of notification.« less

Outcome of renal transplantation with and without intra-operative diuretics.

PubMed

Hanif, F; Macrae, A N; Littlejohn, M G; Clancy, M J; Murio, E

2011-01-01

This paper presents an e-survey of current clinical practice of use of intra-operative diuretics during renal transplantation in the United Kingdom and a study to compare outcome of renal transplants carried out with or without intra-operative diuretics in our centre. An e-mail questionnaire to renal transplant surgeons exploring their practice of renal transplantation with or without intra-operative diuretics, the type of a diuretic/s if used and the relevant doses. An observational study comparing the outcome of renal transplant recipients, group no-diuretics (GND, n = 80) carried out from 2004 to 2008 versus group diuretics (GD n = 69) renal transplant recipients who received intra-operative diuretics over a one year period is presented. Outcome measures were incidence of delayed graft function and a comparison of graft survival in both groups. Forty surgeons answered from 18 transplant centres with a response rate of 67%. 13 surgeons do not use diuretics. Mannitol is used by 10/40, Furosemide 6/40 and 11 surgeons use a combination of both. In comparative study there was no significant overall difference in one year graft survival of GD versus GND (N = 65/69, 94% and 75/80, 94% respectively, p = 0.08) and the incidence of delayed graft function was also comparable (16/69, 23% and 21/80, 26% respectively, p = 0.07). The donor characteristics in both groups were comparable. The study showed variation in clinical practice on the use of intra-operative diuretics in renal transplantation and it did not demonstrate that the use of diuretics can improve renal graft survival. Copyright © 2011 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Screening the use of informed consent forms prior to procedures involving operative dentistry: ethical aspects

PubMed Central

Graziele Rodrigues, Livia; De Souza, João Batista; De Torres, Erica Miranda; Ferreira Silva, Rhonan

2017-01-01

Background. The present study aimed to screen the knowledge and attitudes of dentists toward the use of informed consent forms prior to procedures involving operative dentistry. Methods. A research tool containing questions (questionnaire) regarding the use of informed consent forms was developed. The questionnaire consisted of seven questions structured to screen the current practice in operative dentistry towards the use of informed consent forms. Results. The questionnaires were distributed among 731 dentists, of which 179 returned them with answers. Sixty-seven dentists reported not using informed consent forms. The main reasons for not using informed consent forms were: having a complete dental record signed by the patient (67.2%) and having a good relation with patients (43.6%). The dentists who reported using informed consent forms revealed that they obtained them from other dentists and made their own modifications (35.9%). Few dentists revealed contacting lawyers (1.7%) and experts in legal dentistry (0.9%) for the development of their informed consent forms. Conclusion. A high number of dentists working in the field of operative dentistry behave according to the ethical standards in the clinical practice, becoming unprotected against ethical and legal actions. PMID:28413600

EHRs in primary care practices: benefits, challenges, and successful strategies.

PubMed

Goetz Goldberg, Debora; Kuzel, Anton J; Feng, Lisa Bo; DeShazo, Jonathan P; Love, Linda E

2012-02-01

To understand the current use of electronic health records (EHRs) in small primary care practices and to explore experiences and perceptions of physicians and staff toward the benefits, challenges, and successful strategies for implementation and meaningful use of advanced EHR functions. Qualitative case study of 6 primary care practices in Virginia. We performed surveys and in-depth interviews with clinicians and administrative staff (N = 38) and observed interpersonal relations and use of EHR functions over a 16-month period. Practices with an established EHR were selected based on a maximum variation of quality activities, location, and ownership. Physicians and staff report increased efficiency in retrieving medical records, storing patient information, coordination of care, and office operations. Costs, lack of knowledge of EHR functions, and problems transforming office operations were barriers reported for meaningful use of EHRs. Major disruption to patient care during upgrades and difficulty utilizing performance tracking and quality functions were also reported. Facilitators for adopting and using advanced EHR functions include team-based care, adequate technical support, communication and training for employees and physicians, alternative strategies for patient care during transition, and development of new processes and work flow procedures. Small practices experience difficulty with implementation and utilization of advanced EHR functions. Federal and state policies should continue to support practices by providing technical assistance and financial incentives, grants, and/or loans. Small practices should consider using regional extension center services and reaching out to colleagues and other healthcare organizations with similar EHR systems for advice and guidance.

An assessment of nitrogen-based manure application rates on 39 U.S. swine operations.

PubMed

Lory, John A; Massey, Raymond E; Zulovich, Joseph M; Hoehne, John A; Schmidt, Amy M; Carlson, Marcia S; Fulhage, Charles D

2004-01-01

Water quality concerns and revised regulations are changing how confined animal feeding operations manage manure. Devising acceptable and feasible changes in manure practices requires a full understanding of the forces shaping current manure management decisions. Previous theoretical models have shown that a wide range of factors influence the lowest cost solution for manure management. We used a mechanistic model to characterize the manure management practices on 39 swine operations (20 unagitated lagoon and 19 slurry operations) in five states (Iowa, Missouri, North Carolina, Oklahoma, and Pennsylvania). Information was collected from each operation about animal numbers, feed and water use, manure handling and storage characteristics, field locations, crop rotation, fertilizer need, and equipment inventory and usage. Collected data were used as input and to validate results from a mechanistic model that determined acres required for manure application, manure application rate, time required for manure application, value of manure, and costs of manure management. The 39 farms had a mean of 984 animal units (AU) per operation, 18.2 AU ha(-1) (7.4 AU acre(-1)), and manure application costs of dollar 10.49 AU(-1) yr(-1). Significant factors affecting manure management included operation size, manure handling system, state, and ownership structure. Larger operations had lower manure management costs (r2 = 0.32). Manure value potentially exceeded manure application costs on 58% of slurry and 15% of lagoon operations. But 38% of slurry operations needed to apply manure off the farm whereas all lagoon operations had sufficient land for N-based manure management. Manure management was a higher percentage of gross income on contract operations compared with independents (P < 0.01). This research emphasized the importance of site-specific factors affecting manure management decisions and the economics of U.S. swine operations.

Facilitators and barriers in expanding scope of practice: findings from a national survey of Irish nurses and midwives.

PubMed

Fealy, Gerard M; Rohde, Daniela; Casey, Mary; Brady, Anne-Marie; Hegarty, Josephine; Kennedy, Catriona; McNamara, Martin; O'Reilly, Pauline; Prizeman, Geraldine

2015-12-01

The aim was to examine current scope of practice among nurses and midwives in Ireland. The objectives were to describe practitioners' self-reported facilitators and barriers to expanding scope of practice and to develop a scope of practice barriers scale. Regulatory authorities permit practice expansion, so long as it falls within accepted parameters of scope of practice. Enduring difficulties in relation to scope of practice include the difficulty of balancing practice restriction with practice expansion. A postal survey design was used to examine registered nurses' and midwives' current scope of practice, including their experiences of facilitators and barriers to expanding practice. A stratified random sample of registered nurses and midwives in Ireland was surveyed using the Scope-QB, a 19-item self-report scope of practice barriers scale. Based on a sample of 1010 respondents, the self-reported perceived barriers to practice expansion included fear of legal consequences, time restrictions and lack of remuneration. Professional satisfaction, patients' needs, organisational support and having access to continuing professional education were perceived as facilitators of practice expansion. Older nurses and midwives as well as nurses and midwives holding more senior promotional grades, such as clinical nurse manager grades, perceived fewer barriers than their younger and more junior counterparts. Nurses and midwives continue to experience difficulties in relation to expanding their practice. Practitioners can operate to optimal scope of practice when practitioner-centred and workplace-based circumstances are optimal. The optimal circumstances for practice expansion exist when the facilitators of practice expansion outweigh the barriers. Given the critical role that nurses and midwives play in modern health services, it is important that they are empowered and enabled to expand their practice and to work to full scope of practice when patient needs and service requirements warrant it. © 2015 John Wiley & Sons Ltd.

Who controls the uses of organs after death? Law in the books, law in practice and the view of the people.

PubMed

Naffine, Ngaire; Richards, Bernadette; de Lacey, Sheryl; Braunack-Mayer, Annette; Rogers, Wendy

2012-12-01

The conventional wisdom is that we are free to dispose of our organs at death and that they will be employed according to our wishes. However, this reflects neither the formal law nor medical practice. This article explores the theory underlying the principle of self-determination after death. It presents an overview of Australian law and the way that the law is interpreted in clinical practice. It then presents the results of a community survey on organ disposition, and identifies a gap between community expectations and the current operation of Australian law. It concludes with some specific recommendations for development of the law to align it more closely with contemporary community views.

A Framework of Working Across Disciplines in Early Design and R&D of Large Complex Engineered Systems

NASA Technical Reports Server (NTRS)

McGowan, Anna-Maria Rivas; Papalambros, Panos Y.; Baker, Wayne E.

2015-01-01

This paper examines four primary methods of working across disciplines during R&D and early design of large-scale complex engineered systems such as aerospace systems. A conceptualized framework, called the Combining System Elements framework, is presented to delineate several aspects of cross-discipline and system integration practice. The framework is derived from a theoretical and empirical analysis of current work practices in actual operational settings and is informed by theories from organization science and engineering. The explanatory framework may be used by teams to clarify assumptions and associated work practices, which may reduce ambiguity in understanding diverse approaches to early systems research, development and design. The framework also highlights that very different engineering results may be obtained depending on work practices, even when the goals for the engineered system are the same.

Forecast of jet engine exhaust emissions for future high altitude commercial aircraft

NASA Technical Reports Server (NTRS)

Grobman, J.; Ingebo, R. D.

1974-01-01

Projected minimum levels of engine exhaust emissions that may be practicably achievable for future commercial aircraft operating at high altitude cruise conditions are presented. The forecasts are based on: (1) current knowledge of emission characteristics of combustors and augmentors; (2) the current status of combustion research in emission reduction technology; (3) predictable trends in combustion systems and operating conditions as required for projected engine designs that are candidates for advanced subsonic or supersonic commercial aircraft. Results are presented for cruise conditions in terms of an emission index, g pollutant/kg fuel. Two sets of engine exhaust emission predictions are presented: the first, based on an independent NASA study and the second, based on the consensus of an ad hoc committee composed of industry, university, and government representatives. The consensus forecasts are in general agreement with the NASA forecasts.

Forecast of jet engine exhaust emissions for future high altitude commercial aircraft

NASA Technical Reports Server (NTRS)

Grobman, J.; Ingebo, R. D.

1974-01-01

Projected minimum levels of engine exhaust emissions that may be practicably achievable for future commercial aircraft operating at high altitude cruise conditions are presented. The forecasts are based on: (1) current knowledge of emission characteristics of combustors and augmentors; (2) the current status of combustion research in emission reduction technology; and (3) predictable trends in combustion systems and operating conditions as required for projected engine designs that are candidates for advanced subsonic or supersonic commercial aircraft. Results are presented for cruise conditions in terms of an emission index, g pollutant/kg fuel. Two sets of engine exhaust emission predictions are presented: the first, based on an independent NASA study and the second, based on the consensus of an ad hoc committee composed of industry, university, and government representatives. The consensus forecasts are in general agreement with the NASA forecasts.

A Review of Hydrazine Sensors: The State of the Art

NASA Technical Reports Server (NTRS)

Meneghelli, B. J.

2004-01-01

Several types of sensors have been developed over the past few years that quantify the vapor concentrations of the hydrazines. These sensor s are able to detect concentrations as low as 10 parts per billion (ppb) up to several parts per million (ppm). The scope of this review wi ll be focused on those sensors that are most current in the marketpla ce as either leak detectors or personnel monitors. Some technical information on the theory of operations of each hydrazine detector will a lso be included. The review will highlight current operations that utilize hydrazine sensors including the Kennedy Space Center (KSC), the United States Air Force (USAF) at Cape Canaveral Air Station (CCAS), USAF F-16 facilities. The orientation of the review will be towards giving users usable practical information on hydrazine sensors.

Process Analytical Technology (PAT): batch-to-batch reproducibility of fermentation processes by robust process operational design and control.

PubMed

Gnoth, S; Jenzsch, M; Simutis, R; Lübbert, A

2007-10-31

The Process Analytical Technology (PAT) initiative of the FDA is a reaction on the increasing discrepancy between current possibilities in process supervision and control of pharmaceutical production processes and its current application in industrial manufacturing processes. With rigid approval practices based on standard operational procedures, adaptations of production reactors towards the state of the art were more or less inhibited for long years. Now PAT paves the way for continuous process and product improvements through improved process supervision based on knowledge-based data analysis, "Quality-by-Design"-concepts, and, finally, through feedback control. Examples of up-to-date implementations of this concept are presented. They are taken from one key group of processes in recombinant pharmaceutical protein manufacturing, the cultivations of genetically modified Escherichia coli bacteria.

Solutions Network Formulation Report. Improving NOAA's Tides and Currents Through Enhanced Data Inputs from NASA's Ocean Surface Topography Mission

NASA Technical Reports Server (NTRS)

Guest, DeNeice C.

2006-01-01

The Nation uses water-level data for a variety of practical purposes, including hydrography, nautical charting, maritime navigation, coastal engineering, and tsunami and storm surge warnings (NOAA, 2002; Digby et al., 1999). Long-term applications include marine boundary determinations, tidal predictions, sea-level trend monitoring, oceanographic research, and climate research. Accurate and timely information concerning sea-level height, tide, and ocean current is needed to understand their impact on coastal management, disaster management, and public health. Satellite altimeter data products are currently used by hundreds of researchers and operational users to monitor ocean circulation and to improve scientists understanding of the role of the oceans in climate and weather. The NOAA (National Oceanic and Atmospheric Administration) National Ocean Service has been monitoring sea-level variations for many years (NOAA, 2006). NOAA s Tides & Currents DST (decision support tool, managed by the Center for Operational Oceanographic Products and Services, is the portal to a vast collection of oceanographic and meteorological data (historical and real-time), predictions, and nowcasts and forecasts. This report assesses the capacity of NASA s satellite altimeter data to meet societal decision support needs through incorporation into NOAA s Tides & Currents.

A Best Practice for Developing Availability Guarantee Language in Photovoltaic (PV) O&M Agreements.

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

Klise, Geoffrey Taylor; Balfour, John

This document outlines the foundation for developing language that can be utilized in an Equipment Availability Guarantee, typically included in an O&M services agreement between a PV system or plant owner and an O&M services provider, or operator. Many of the current PV O&M service agreement Availability Guarantees are based on contracts used for traditional power generation, which create challenges for owners and operators due to the variable nature of grid-tied photovoltaic generating technologies. This report documents language used in early PV availability guarantees and presents best practices and equations that can be used to more openly communicate how themore » reliability of the PV system and plant equipment can be expressed in an availability guarantee. This work will improve the bankability of PV systems by providing greater transparency into the equipment reliability state to all parties involved in an O&M services contract.« less

Budgeting for Solar PV Plant Operations & Maintenance: Practices and Pricing.

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

Enbar, Nadav; Weng, Dean; Klise, Geoffrey Taylor

2016-01-01

With rising grid interconnections of solar photovoltaic (PV) systems, greater attention is being trained on lifecycle performance, reliability, and project economics. Expected to meet production thresholds over a 20-30 year timeframe, PV plants require a steady diet of operations and maintenance (O&M) oversight to meet contractual terms. However, industry best practices are only just beginning to emerge, and O&M budgets—given the arrangement of the solar project value chain—appear to vary widely. Based on insights from in-depth interviews and survey research, this paper presents an overview of the utility-scale PV O&M budgeting process along with guiding rationales, before detailing perspectives onmore » current plant upkeep activities and price points largely in the U.S. It concludes by pondering potential opportunities for improving upon existing O&M budgeting approaches in ways that can benefit the industry at-large.« less

Budgeting for Solar PV Plant Operations & Maintenance: Practices and Pricing.

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

Enbar, Nadav; Weng, Dean; Klise, Geoffrey Taylor

2015-12-01

With rising grid interconnections of solar photovoltaic (PV) systems, greater attention is being trained on lifecycle performance, reliability, and project economics. Expected to meet production thresholds over a 20-30 year timeframe, PV plants require a steady diet of operations and maintenance (O&M) oversight to meet contractual terms. However, industry best practices are only just beginning to emerge, and O&M budgets—given the arrangement of the solar project value chain—appear to vary widely. Based on insights from in-depth interviews and survey research, this paper presents an overview of the utility-scale PV O&M budgeting process along with guiding rationales, before detailing perspectives onmore » current plant upkeep activities and price points largely in the U.S. It concludes by pondering potential opportunities for improving upon existing O&M budgeting approaches in ways that can benefi t the industry at-large.« less

Use of psychological decompression in military operational environments.

PubMed

Hughes, Jamie G H Hacker; Earnshaw, N Mark; Greenberg, Neil; Eldridge, Rod; Fear, Nicola T; French, Claire; Deahl, Martin P; Wessely, Simon

2008-06-01

This article reviews the use of psychological decompression as applied to troops returning from active service in operational theaters. Definitions of the term are considered and a brief history is given. Current policies and practices are described and the question of mandatory decompression is considered. Finally, the evidence base for the efficacy of decompression is examined and some conclusions are drawn. This article highlights variations in the definition and practice of decompression and its use. Although there is, as yet, no evidence that decompression works, there is also no evidence to the contrary. Given the lack of knowledge as to the balance of risks and benefits of decompression and the absence of any definitive evidence that decompression is associated with improved mental health outcomes or that lack of decompression is associated with the reverse, it is argued that the use of decompression should remain a matter for discretion.

An Independent Scientific Assessment of Well Stimulation in California Volume I

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

Jane C.S. Long; Laura C. Feinstein; Birkholzer, Jens

In 2013, the California Legislature passed Senate Bill 4 (SB 4), setting the framework for regulation of well stimulation technologies in California, including hydraulic fracturing. SB 4 also requires the California Natural Resources Agency to conduct an independent scientific study of well stimulation technologies in California to assess current and potential future practices, including the likelihood that well stimulation technologies could enable extensive new petroleum production in the state, evaluate the impacts of well stimulation technologies and the gaps in data that preclude this understanding, identify risks associated with current practices, and identify alternative practices which might limit these risks.more » The study is issued in three volumes. This document, Volume I, provides the factual basis describing well stimulation technologies, how and where operators deploy these technologies for oil and gas production in California, and where they might enable production in the future. Volume II discusses how well stimulation affects water, the atmosphere, seismic activity, wildlife and vegetation, traffic, light and noise levels; it will also explore human health hazards, and identify data gaps and alternative practices. Volume III presents case studies to assess environmental issues and qualitative« less

[Error prevention through management of complications in urology: standard operating procedures from commercial aviation as a model].

PubMed

Kranz, J; Sommer, K-J; Steffens, J

2014-05-01

Patient safety and risk/complication management rank among the current megatrends in modern medicine, which has undoubtedly become more complex. In time-critical, error-prone and difficult situations, which often occur repeatedly in everyday clinical practice, guidelines are inappropriate for acting rapidly and intelligently. With the establishment and consistent use of standard operating procedures like in commercial aviation, a possible strategic approach is available. These medical aids to decision-making - quick reference cards - are short, optimized instructions that enable a standardized procedure in case of medical claims.

Developing and Implementing Health and Sustainability Guidelines for Institutional Food Service123

PubMed Central

Kimmons, Joel; Jones, Sonya; McPeak, Holly H.; Bowden, Brian

2012-01-01

Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability. PMID:22585909

Developing and implementing health and sustainability guidelines for institutional food service.

PubMed

Kimmons, Joel; Jones, Sonya; McPeak, Holly H; Bowden, Brian

2012-05-01

Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability of the food system. Institutional guidelines assist staff, managers, and vendors in aligning the food environment at food service venues with healthier and more sustainable choices and practices. Guideline specifics and their effective implementation depend on the size, culture, nature, and management structure of an institution and the individuals affected. They may be applied anywhere food is sold, served, or consumed. Changing institutional food service practice requires comprehensive analysis, engagement, and education of all relevant stakeholders including institutional management, members of the food supply chain, and customers. Current examples of food service guidelines presented here are the HHS and GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which translate evidence-based recommendations on health and sustainability into institutional food service practices and are currently being implemented at the federal level. Developing and implementing guidelines has the potential to improve long-term population health outcomes while simultaneously benefitting the food system. Nutritionists, public health practitioners, and researchers should consider working with institutions to develop, implement, and evaluate food service guidelines for health and sustainability.

Practice Patterns Regarding Multidisciplinary Cancer Management and Suggestions for Further Refinement: Results from a National Survey in Korea.

PubMed

Lee, Yun-Gyoo; Oh, Sukjoong; Kimm, Heejin; Koo, Dong-Hoe; Kim, Do Yeun; Kim, Bong-Seog; Lee, Seung-Sei

2017-10-01

This study was conducted to explore the process and operation of a cancer multidisciplinary team (MDT) after the reimbursement decision in Korea, and to identify ways to overcome the major barriers to effective and sustainable MDTs. Approximately 1,000 cancer specialists, including medical oncologists, surgical oncologists, radiation oncologists, pathologists, and radiologists in general hospitals in Koreawere invited to complete the survey. The questionnaire covered the following topics: organizational structure of MDTs, candidates for consulting, the clinical decision-making initiative, and responsibility for dealing with legal disputes. We collected a total of 179 responses (18%) from physicians at institutions where an MDT approach was active. A surgical oncologist (91%), internist (90%),radiologist (89%),radiation oncologist (86%), pathologist (71%), and trainees (20%) regularly participated in MDT operations. Approximately 55% of respondents stated that MDTs met regularly. In cases of a split opinion, the physician in charge (69%) or chairperson (17%) made the final decision, and most (86%) stated they followed the final decision. About 15% and 32% of respondents were "very satisfied" and "satisfied," respectively, with the current MDT's operations. Among 38 institutional representatives, 34% responded that the MDT operation became more active and 18% stated an MDT was newly implemented after the reimbursement decision. The reimbursement decision invigorated MDT operations in almost half of eligible hospitals. Dissatisfaction regarding current MDTs was over 50%, and the high discordance rates regarding risk sharing suggest that it is necessary to revise the current system of MDTs.

Proposal on a sustainable strategy to avoid point source pollution of water with plant protection products.

PubMed

Mestdagh, Inge; Bonicelli, Bernard; Laplana, Ramon; Roettele, Manfred

2009-01-01

Based on the results and lessons learned from the TOPPS project (Training the Operators to prevent Pollution from Point Sources), a proposal on a sustainable strategy to avoid point source pollution from Plant Protection Products (PPPs) was made. Within this TOPPS project (2005-2008), stakeholders were interviewed and research and analysis were done in 6 pilot catchment areas (BE, FR, DE, DK, IT, PL). Next, there was a repeated survey on operators' perception and opinion to measure changes resulting from TOPPS activities and good and bad practices were defined based on the Best Management Practices (risk analysis). Aim of the proposal is to suggest a strategy considering the differences between countries which can be implemented on Member State level in order to avoid PPP pollution of water through point sources. The methodology used for the up-scaLing proposal consists of the analysis of the current situation, a gap analysis, a consistency analysis and organisational structures for implementation. The up-scaling proposal focuses on the behaviour of the operators, on the equipment and infrastructure available with the operators. The proposal defines implementation structures to support correct behaviour through the development and updating of Best Management Practices (BMPs) and through the transfer and the implementation of these BMPs. Next, the proposal also defines requirements for the improvement of equipment and infrastructure based on the defined key factors related to point source pollution. It also contains cost estimates for technical and infrastructure upgrades to comply with BMPs.

Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room: a randomized controlled trial.

PubMed

Palter, Vanessa N; Grantcharov, Teodor P

2014-03-01

The purpose of this study was to investigate whether individualized deliberate practice on a virtual reality (VR) simulator results in improved technical performance in the operating room. Training on VR simulators has been shown to improve technical performance in the operating room (OR). Currently described VR curricula consist of trainees practicing the same tasks until expert proficiency is reached. It has yet to be investigated whether the individualized deliberate practice, where curricula tasks vary depending on prior levels of technical proficiency, would translate into the OR. This single-blinded prospective trial randomized 16 novice surgical residents to a deliberate practice (DP) group and a conventional residency training group. Both groups performed a laparoscopic cholecystectomy in the OR that was video-recorded. Technical performance of DP group residents in the OR was assessed using 3 validated assessment tools. A score of less than 60% on any component of the assessment tool resulted in the trainee practicing a specific task on the VR simulator. The DP group practiced on the simulator as per their individualized schedule. Both groups then performed another laparoscopic cholecystectomy. A blinded expert assessed the OR recordings using a validated global rating scale. Although both groups had similar technical abilities preintervention [DP: median score, 13.5 (9.3-15.0); control: median score, 14.5 (9.3-17.8); P = 0.45], the DP residents had a superior technical performance postintervention [DP: median score, 17.0 (15.3-18.5); control: median score, 12.5 (7.5-14.0); P = 0.03]. Of 8 DP residents, 6 practiced 5 basic VR tasks (median 1 trial to pass), and 7 of 8 practiced 2 advanced tasks (median 4 trials to pass). A curriculum of deliberate individualized practice on a VR simulator improves technical performance in the OR. This has implications to greatly improve the feasibility of implementing simulation-based curricula in residency training programs, rather then having them being limited to research protocols.

Managers’ perspectives: practical experience and challenges associated with variable-density operations and uneven-aged management

Treesearch

Kurtis E. Steele

2013-01-01

Variable-density thinning has received a lot of public attention in recent years and has subsequently become standard language in most of the Willamette National Forest’s timber management projects. Many techniques have been tried, with varying on-the-ground successes. To accomplish variable-density thinning, the McKenzie River Ranger District currently uses...

Department of Defense Best Management Practices for Munitions Constituents on Operational Ranges

DTIC Science & Technology

2014-04-01

website for updates on currently funded plant-based mitigation projects. Key Resources: Best EPH, Smith JC, Ringelberg DB. 2009. Phytoremediation of...Bruce N. 2012. Sustainable Range Management of RDX and TNT by Phytoremediation with Engineered Plants. SERDP Project ER-1498 Fact Sheet. Schnoor...J. 2011. Phytoremediation for the Containment and Treatment of Energetic and Propellant Material Releases on Testing and Training Ranges. SERDP

Marines in the Interagency: Are We in the Right Places?

DTIC Science & Technology

2012-05-01

Fellows Program for fellowships at U.S. businesses were very logistics-best-practice focused (product distribution, supply chain management , shipping...for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and...manpower management system to better identify what interagency organization(s) has Marines assigned; 3) Formalize current billets with the Department of

Vacuum pumps and systems: A review of current practice

NASA Technical Reports Server (NTRS)

Giles, Stuart

1986-01-01

A review of the fundamental characteristics of the many types of vacuum pumps and vacuum pumping systems is given. The optimum pumping range, relative cost, performance limitations, maintenance problems, system operating costs and similar subjects are discussed. Experiences from the thin film deposition, chemical processing, material handling, food processing and other industries, as well as space simulation are used to support conclusions and recommendations.

Development and implementation of the Good Neighbor Agreement (GNA) practice in the USA sustainable mining development.

NASA Astrophysics Data System (ADS)

Masaitis, Alexandra

2014-05-01

New economic, environmental and social challenges for the mining industry in the USA show the need to implement "responsible" mining practices that include improved community involvement. Conflicts which occur in the US territory and with US mining companies around the world are now common between the mining proponents, NGO's and communities. These conflicts can sometimes be alleviated by early development of modes of communication, and a formal discussion format that allows airing of concerns and potential resolution of problems. One of the methods that can formalize this process is to establish a Good Neighbor Agreement (GNA), which deals specifically with challenges in relationships between mining operations and the local communities. It is a new practice related to mining operations that are oriented toward social needs and concerns of local communities that arise during the normal life of a mine, which can achieve sustainable mining practices. The GNA project being currently developed at the University of Nevada, USA in cooperation with the Newmont Mining Corporation has a goal of creating an open company/community dialog that will help identify and address sociological and environmental concerns associated with mining. Discussion: The Good Neighbor Agreement currently evolving will address the following: 1. Identify spheres of possible cooperation between mining companies, government organizations, and NGO's. 2. Provide an economically viable mechanism for developing a partnership between mining operations and the local communities that will increase mining industry's accountability and provide higher levels of confidence for the community that a mine is operated in a safe and sustainable manner. Implementation of the GNA can help identify and evaluate conflict criteria in mining/community relationships; determine the status of concerns; determine the role and responsibilities of stakeholders; analyze problem resolution feasibility; maintain the community involvement and support through economic benefits and environmental safeguards; develop options for the concerns resolution. Difficulties in establishing the GNA standards include lack of insurance/bonding policies, and by the lack of audit and monitoring that could determine the level of exposure of the local community and the environment to the contaminants released at the mine sites. Since many problems of mines can occur during closure and post-closure, GNA's should address those issues also. The goal of the GNA is to have open access for the public to the safety, health, and environmental information pertaining to the mining operation, as well as to educate the local communities about mining practices that promote mutual acknowledgment of the need to build a relationship amenable to each other's needs. Frequent conflicts between mining companies and surrounding communities lead to work disruptions or even mine closures and show the necessity of a less confrontational approach to environmental and social justice. The Good Neighbor Agreement is a unique way to provide the benefits for the both mining operations and local community to provide a mechanism for risk redaction and communication that offer the potential to protect both mining and community interests.

Advancing the state of the art in healthcare strategic planning.

PubMed

Zuckerman, Alan M

2006-01-01

A recent survey of the state of strategic planning among healthcare organizations indicates that planners and executives believe that healthcare strategic planning practices are effective and provide the appropriate focus and direction for their organizations. When compared to strategic planning practices employed outside of the healthcare field, however, most healthcare strategic planning processes have not evolved to the more advanced, state-of-the-art levels of planning being used successfully outside of healthcare. While organizations that operate in stable markets may be able to survive using basic strategic planning practices, the volatile healthcare market demands that providers be nimble competitors with advanced, ongoing planning processes that drive growth and organizational effectiveness. What should healthcare organizations do to increase the rigor and sophistication of their strategic planning practices? This article identifies ten current healthcare strategic planning best practices and recommends five additional innovative approaches from pathbreaking companies outside of healthcare that have used advanced strategic planning practices to attain high levels of organizational success.

High Pulse Repetition Rate, Eye Safe, Visible Wavelength Lidar Systems: Design, Results and Potential

NASA Technical Reports Server (NTRS)

Spinhirne, James; Berkoff, Timothy; Welton, Elsworth; Campbell, James; OCStarr, David (Technical Monitor)

2002-01-01

In 1993 the first of the eye safe visible wavelength lidar systems known now as Micro Pulse Lidar (MPL) became operational. Since that time there have been several dozen of these systems produced and applied for full time profiling of atmospheric cloud and aerosol structure. There is currently an observational network of MPL sites to support global climate research. In the course of application of these instruments there have been significant improvements in understanding, design and performance of the systems. There are addition potential and applications beyond current practice for the high repetition rate, eye safe designs. The MPL network and the current capability, design and future potential of MPL systems are described.

Guidelines for computer security in general practice.

PubMed

Schattner, Peter; Pleteshner, Catherine; Bhend, Heinz; Brouns, Johan

2007-01-01

As general practice becomes increasingly computerised, data security becomes increasingly important for both patient health and the efficient operation of the practice. To develop guidelines for computer security in general practice based on a literature review, an analysis of available information on current practice and a series of key stakeholder interviews. While the guideline was produced in the context of Australian general practice, we have developed a template that is also relevant for other countries. Current data on computer security measures was sought from Australian divisions of general practice. Semi-structured interviews were conducted with general practitioners (GPs), the medical software industry, senior managers within government responsible for health IT (information technology) initiatives, technical IT experts, divisions of general practice and a member of a health information consumer group. The respondents were asked to assess both the likelihood and the consequences of potential risks in computer security being breached. The study suggested that the most important computer security issues in general practice were: the need for a nominated IT security coordinator; having written IT policies, including a practice disaster recovery plan; controlling access to different levels of electronic data; doing and testing backups; protecting against viruses and other malicious codes; installing firewalls; undertaking routine maintenance of hardware and software; and securing electronic communication, for example via encryption. This information led to the production of computer security guidelines, including a one-page summary checklist, which were subsequently distributed to all GPs in Australia. This paper maps out a process for developing computer security guidelines for general practice. The specific content will vary in different countries according to their levels of adoption of IT, and cultural, technical and other health service factors. Making these guidelines relevant to local contexts should help maximise their uptake.

Are paediatric operations evidence based? A prospective analysis of general surgery practice in a teaching paediatric hospital.

PubMed

Zani-Ruttenstock, Elke; Zani, Augusto; Bullman, Emma; Lapidus-Krol, Eveline; Pierro, Agostino

2015-01-01

Paediatric surgical practice should be based upon solid scientific evidence. A study in 1998 (Baraldini et al., Pediatr Surg Int) indicated that only a quarter of paediatric operations were supported by the then gold standard of evidence based medicine (EBM) which was defined by randomized controlled trials (RCTs). The aim of the current study was to re-evaluate paediatric surgical practice 16 years after the previous study in a larger cohort of patients. A prospective observational study was performed in a tertiary level teaching hospital for children. The study was approved by the local research ethics board. All diagnostic and therapeutic procedures requiring a general anaesthetic carried out over a 4-week period (24 Feb 2014-22 Mar 2014) under the general surgery service or involving a general paediatric surgeon were included in the study. Pubmed and EMBASE were used to search in the literature for the highest level of evidence supporting the recorded procedures. Evidence was classified according to the Oxford Centre for Evidence Based Medicine (OCEBM) 2009 system as well as according to the classification used by Baraldini et al. Results was compared using Χ (2) test. P < 0.05 was considered statistically significant. During the study period, 126 operations (36 different types) were performed on 118 patients. According to the OCEBM classification, 62 procedures (49 %) were supported by systematic reviews of multiple homogeneous RCTs (level 1a), 13 (10 %) by individual RCTs (level 1b), 5 (4 %) by systematic reviews of cohort studies (level 2a), 11 (9 %) by individual cohort studies, 1 (1 %) by systematic review of case-control studies (level 3a), 14 (11 %) by case-control studies (level 3b), 9 (7 %) by case series (type 4) and 11 procedures (9 %) were based on expert opinion or deemed self-evident interventions (type 5). High level of evidence (OCEBM level 1a or 1b or level I according to Baraldini et al. PSI 1998) supported 75 (60 %) operations in the current study compared to 18 (26 %) in the study of 1998 (P < 0.0001). The present study shows that nowadays a remarkable number of paediatric surgical procedures are supported by high level of evidence. Despite this improvement in evidence-based paediatric surgical practice, more than a third of the procedures still lack sufficient evidence-based literature support. More RCTs are warranted to support and direct paediatric surgery practice according to the principals of EBM.

Taking a traditional web site to patient portal technology.

PubMed

Labow, Kimberly

2010-01-01

In this era of consumer-driven healthcare, consumers (your current and potential patients) seek healthcare information on the Internet. If your practice doesn't have a Web site, or has one that's static and uninformative, you won't be found, and the patient will move on to the next practice Web site. Why? Because only the most graphically appealing, informative, and patient-centered Web sites will drive patients to your practice. Patients are demanding improved communication with their physician. A practice Web site is a start, but the adoption of a fully functional, interactive Web site with patient portal solutions will not only improve patient-to-provider relationships but will also give the patient access to your practice from anywhere, at any time of the day. Furthermore, these solutions can help practices increase efficiencies and revenue, while reducing operating costs. With the American Recovery and Reinvestment Act of 2009 and other incentives for healthcare information technology adoption, the time is right for your practice to consider implementing technology that will bring considerable value to your practice and also increase patient satisfaction.

The cryogenic wind tunnel for high Reynolds number testing. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Kilgore, R. A.

1974-01-01

Experiments performed at the NASA Langley Research Center in a cryogenic low-speed continuous-flow tunnel and in a cryogenic transonic continuous-flow pressure tunnel have demonstrated the predicted changes in Reynolds number, drive power, and fan speed with temperature, while operating with nitrogen as the test gas. The experiments have also demonstrated that cooling to cryogenic temperatures by spraying liquid nitrogen directly into the tunnel circuit is practical and that tunnel temperature can be controlled within very close limits. Whereas most types of wind tunnel could operate with advantage at cryogenic temperatures, the continuous-flow fan-driven tunnel is particularly well suited to take full advantage of operating at these temperatures. A continuous-flow fan-driven cryogenic tunnel to satisfy current requirements for test Reynolds number can be constructed and operated using existing techniques. Both capital and operating costs appear acceptable.

78 FR 16051 - Vehicle/Track Interaction Safety Standards; High-Speed and High Cant Deficiency Operations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-13

...FRA is amending the Track Safety Standards and Passenger Equipment Safety Standards to promote the safe interaction of rail vehicles with the track over which they operate under a variety of conditions at speeds up to 220 m.p.h. The final rule revises standards for track geometry and safety limits for vehicle response to track conditions, enhances vehicle/track qualification procedures, and adds flexibility for permitting high cant deficiency train operations through curves at conventional speeds. The rule accounts for a range of vehicle types that are currently in operation, as well as vehicle types that may likely be used in future high-speed or high cant deficiency rail operations, or both. The rule is based on the results of simulation studies designed to identify track geometry irregularities associated with unsafe wheel/rail forces and accelerations, thorough reviews of vehicle qualification and revenue service test data, and consideration of international practices.

Cognitive architectures: choreographing the dance of mental operations with the task environment.

PubMed

Gray, Wayne D

2008-06-01

In this article, I present the ideas and trends that have given rise to the use of cognitive architectures in human factors and provide a cognitive engineering-oriented taxonomy of these architectures and a snapshot of their use for cognitive engineering. Architectures of cognition have had a long history in human factors but a brief past. The long history entails a 50-year preamble, whereas the explosion of work in the current decade reflects the brief past. Understanding this history is key to understanding the current and future prospects for applying cognitive science theory to human factors practice. The review defines three formative eras in cognitive engineering research: the 1950s, 1980s, and now. In the first era, the fledging fields of cognitive science and human factors emphasized characteristics of the dancer the limited capacity or bounded rationality view of the mind, and the ballroom, the task environment. The second era emphasized the dance (i.e., the dynamic interaction between mental operations and task environment). The third era has seen the rise of cognitive architectures as tools for choreographing the dance of mental operations within the complex environments posed by human factors practice. Hybrid architectures present the best vector for introducing cognitive science theories into a renewed engineering-based human factors. The taxonomy provided in this article may provide guidance on when and whether to apply a cognitive science or a hybrid architecture to a human factors issue.

Commercial mortgages: An underutilized channel for scaling energy efficiency investments?

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

Mathew, Paul; Wallace, Nancy; Alschuler, Elena

2016-02-01

Commercial mortgages currently do not fully account for energy factors in underwriting and valuation, particularly as it relates to the impact of energy costs and volatility on an owner’s net operating income. As a consequence, energy efficiency is not properly valued and energy risks are not properly assessed and mitigated. Commercial mortgages are a large lever and could be a significant channel for scaling energy efficiency investments. A pilot analysis of loans with different mortgage contract structures and locations showed that when energy cost volatility was included in mortgage valuation, a 20% reduction in energy use resulted in a 1.3%more » average increase in mortgage value. This suggests that the explicit inclusion of energy use and volatility in mortgage valuation can send a strong price signal that financially rewards and values energy efficiency in commercial properties. This paper presents findings from a scoping study addressing energy factors in commercial mortgages. First, we present a review of current practices as it relates to incorporating energy factors into commercial mortgage underwriting and valuation. Next, we detail the impacts of energy factors on property values, net operating income and mortgage valuation. Building operational practices alone can result in energy use variations from -17% to 87%. Finally, we present a set of proposed interventions to properly address energy factors in commercial mortgages, based on extensive discussions with stakeholders including mortgage originators, underwriters, building owners and regulators.« less

[A project to improve the validity rate for nursing staff operating single door autoclave sterilizers].

PubMed

Chen, Chun-Hung; Li, Cheng-Chang; Chou, Chuan-Yu; Chen, Shu-Hwa

2009-08-01

This project was designed to improve the low validity rate for nurses responsible to operate single door autoclave sterilizers in the operating room. By investigating the current status, we found that the nursing staff validity rate of cognition on the autoclave sterilizer was 85%, and the practice operating check validity rate was only 80%. Such was due to a lack of in-service education. Problems with operation included: 1. Unsafe behaviors - not following standard procedure, lacking relevant operating knowledge and absence of a check form; 2. Unsafe environment - the conveying steam piping was typically not covered and lacked operation marks. Recommended improvement measures included: 1. holding in-service education; 2. generating an operation procedure flow chart; 3. implementing obstacle eliminating procedures; 4. covering piping to prevent fire and burns; 5. performing regular checks to ensure all procedures are followed. Following intervention, nursing staff cognition rose from 85% to 100%, while the operation validity rate rose from 80% to 100%. These changes ensure a safer operating room environment, and helps facilities move toward a zero accident rate in the healthcare environment.

Operation Sun Beam, Shots Little Feller I, II and Johnie Boy. Project officers report. Project 6. 6. Electromagnetic measurements

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

Henderson, W.D.; Livingston, P.M.; Rutter, R.L.

Of considerable interest from both a physical and practical viewpoint is the coupling of electromagnetic energy from a nuclear explosion into various electrical systems in the vicinity of the burst. A series of electromagnetic measurements were made on Shots Little Feller I, Little Feller II, and Johnie Boy. It is clear from the records that radiation shielding must be given closer consideration in future tests. Due to equipment failure and radiation inactivation, only the Johnie Boy dynamic current measurement and the passive peak current indicators on all three events are interpretable.

The NASA broad-specification fuels combustion technology program: An assessment of phase 1 test results

NASA Technical Reports Server (NTRS)

Fear, J. S.

1983-01-01

An assessment is made of the results of Phase 1 screening testing of current and advanced combustion system concepts using several broadened-properties fuels. The severity of each of several fuels-properties effects on combustor performance or liner life is discussed, as well as design techniques with the potential to offset these adverse effects. The selection of concepts to be pursued in Phase 2 refinement testing is described. This selection takes into account the relative costs and complexities of the concepts, the current outlook on pollutant emissions control, and practical operational problems.

Aerospace Concurrent Engineering Design Teams: Current State, Next Steps and a Vision for the Future

NASA Technical Reports Server (NTRS)

Hihn, Jairus; Chattopadhyay, Debarati; Karpati, Gabriel; McGuire, Melissa; Borden, Chester; Panek, John; Warfield, Keith

2011-01-01

Over the past sixteen years, government aerospace agencies and aerospace industry have developed and evolved operational concurrent design teams to create novel spaceflight mission concepts and designs. These capabilities and teams, however, have evolved largely independently. In today's environment of increasingly complex missions with limited budgets it is becoming readily apparent that both implementing organizations and today's concurrent engineering teams will need to interact more often than they have in the past. This will require significant changes in the current state of practice. This paper documents the findings from a concurrent engineering workshop held in August 2010 to identify the key near term improvement areas for concurrent engineering capabilities and challenges to the long-term advancement of concurrent engineering practice. The paper concludes with a discussion of a proposed vision for the evolution of these teams over the next decade.

An Optical Fiber Sensor and Its Application in UAVs for Current Measurements

PubMed Central

Delgado, Felipe S.; Carvalho, João P.; Coelho, Thiago V. N.; Dos Santos, Alexandre B.

2016-01-01

In this paper, we propose and experimentally investigate an optical sensor based on a novel combination of a long-period fiber grating (LPFG) with a permanent magnet to measure electrical current in unmanned aerial vehicles (UAVs). The proposed device uses a neodymium magnet attached to the grating structure, which suffers from an electromagnetic force produced when the current flows in the wire of the UAV engine. Therefore, it causes deformation on the sensor and thus, different shifts occur in the resonant bands of the transmission spectrum of the LPFG. Finally, the results show that it is possible to monitor electrical current throughout the entire operating range of the UAV engine from 0 A to 10 A in an effective and practical way with good linearity, reliability and response time, which are desirable characteristics in electrical current sensing. PMID:27801798

A novel comparison of Møller and Compton electron-beam polarimeters

DOE PAGES

Magee, J. A.; Narayan, A.; Jones, D.; ...

2017-01-19

We have performed a novel comparison between electron-beam polarimeters based on Moller and Compton scattering. A sequence of electron-beam polarization measurements were performed at low beam currents (more » $<$ 5 $$\\mu$$A) during the $$Q_{\\rm weak}$$ experiment in Hall C at Jefferson Lab. These low current measurements were bracketed by the regular high current (180 $$\\mu$$A) operation of the Compton polarimeter. All measurements were found to be consistent within experimental uncertainties of 1% or less, demonstrating that electron polarization does not depend significantly on the beam current. This result lends confidence to the common practice of applying Moller measurements made at low beam currents to physics experiments performed at higher beam currents. Here, the agreement between two polarimetry techniques based on independent physical processes sets an important benchmark for future precision asymmetry measurements that require sub-1% precision in polarimetry.« less

A novel comparison of Møller and Compton electron-beam polarimeters

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

Magee, J. A.; Narayan, A.; Jones, D.

We have performed a novel comparison between electron-beam polarimeters based on Moller and Compton scattering. A sequence of electron-beam polarization measurements were performed at low beam currents (more » $<$ 5 $$\\mu$$A) during the $$Q_{\\rm weak}$$ experiment in Hall C at Jefferson Lab. These low current measurements were bracketed by the regular high current (180 $$\\mu$$A) operation of the Compton polarimeter. All measurements were found to be consistent within experimental uncertainties of 1% or less, demonstrating that electron polarization does not depend significantly on the beam current. This result lends confidence to the common practice of applying Moller measurements made at low beam currents to physics experiments performed at higher beam currents. Here, the agreement between two polarimetry techniques based on independent physical processes sets an important benchmark for future precision asymmetry measurements that require sub-1% precision in polarimetry.« less

49 CFR 240.125 - Criteria for testing knowledge.

Code of Federal Regulations, 2010 CFR

2010-10-01

... practices for the safe operation of trains. (c) The testing methods selected by the railroad shall be: (1) Designed to examine a person's knowledge of the railroad's rules and practices for the safe operation of...) Personal safety practices; (ii) Operating practices; (iii) Equipment inspection practices; (iv) Train...

Research to Operations: The Critical Transition

NASA Technical Reports Server (NTRS)

Fogarty, Jennifer A.

2009-01-01

Space Life Sciences Directorate (SLSD) specializes in transitioning technology and knowledge to medical operations. This activity encompasses funding a spectrum of research and technology efforts, such as understanding fundamental biological mechanisms altered by microgravity and executing technology watches for state of the art diagnostic imaging equipment. This broad spectrum approach to fulfilling the need to protect crewmember health and performance during long and short duration missions to the International Space Station, moon and Mars is made possible by having a line of site between research and operations. Currently, SLSD's line of site is articulated in a transition to medical practice (TMP) process. This process is designed to shepherd information and knowledge gained through fundamental and mechanistic research toward the development of an operational solution such as a pre-flight selection criteria; an in-flight countermeasure, monitoring capability or treatment; or a post-flight reconditioning program. The TMP process is also designed to assist with the customization of mature hardware or technology for NASA specific use. The benefits of this process are that the concept of operational usability is interjected early in the research, design, or acquisition phase, and stakeholders are involved early to identify requirements and also periodically asked to assess requirements compliance of research or technology development project. Currently a device known as the actiwatch is being assessed for the final transition to operational use. Specific examples of research to operations transition success help to illustrate the process and bolster communication between the research and medical operations communities.

Geospace monitoring for space weather research and operation

NASA Astrophysics Data System (ADS)

Nagatsuma, Tsutomu

2017-10-01

Geospace, a space surrounding the Earth, is one of the key area for space weather. Because geospace environment dynamically varies depending on the solar wind conditions. Many kinds of space assets are operating in geospace for practical purposes. Anomalies of space assets are sometimes happened because of space weather disturbances in geospace. Therefore, monitoring and forecasting of geospace environment is very important tasks for NICT's space weather research and development. To monitor and to improve forecasting model, fluxgate magnetometers and HF radars are operated by our laboratory, and its data are used for our research work, too. We also operate real-time data acquisition system for satellite data, such as DSCOVR, STEREO, and routinely received high energy particle data from Himawari-8. Based on these data, we are monitoring current condition of geomagnetic disturbances, and that of radiation belt. Using these data, we have developed empirical models for relativistic electron flux at GEO and inner magnetosphere. To provide userfriendly information , we are trying to develop individual spacecraft anomaly risk estimation tool based on combining models of space weather and those of spacecraft charging, Current status of geospace monitoring, forecasting, and research activities are introduced.

Using a High-Performance Planning Model to Increase Levels of Functional Effectiveness Within Professional Development.

PubMed

Winter, Peggi

2016-01-01

Nursing professional practice models continue to shape how we practice nursing by putting families and members at the heart of everything we do. Faced with enormous challenges around healthcare reform, models create frameworks for practice by unifying, uniting, and guiding our nurses. The Kaiser Permanente Practice model was developed to ensure consistency for nursing practice across the continuum. Four key pillars support this practice model and the work of nursing: quality and safety, leadership, professional development, and research/evidence-based practice. These four pillars form the foundation that makes transformational practice possible and aligns nursing with Kaiser Permanente's mission. The purpose of this article is to discuss the pillar of professional development and the components of the Nursing Professional Development: Scope and Standards of Practice model (American Nurses Association & National Nursing Staff Development Organization, 2010) and place them in a five-level development framework. This process allowed us to identify the current organizational level of practice, prioritize each nursing professional development component, and design an operational strategy to move nursing professional development toward a level of high performance. This process is suggested for nursing professional development specialists.

The personal receiving document management and the realization of email function in OAS

NASA Astrophysics Data System (ADS)

Li, Biqing; Li, Zhao

2017-05-01

This software is an independent software system, suitable for small and medium enterprises, contains personal office, scientific research project management and system management functions, independently run in relevant environment, and to solve practical needs. This software is an independent software system, using the current popular B/S (browser/server) structure and ASP.NET technology development, using the Windows 7 operating system, Microsoft SQL Server2005 Visual2008 and database as a development platform, suitable for small and medium enterprises, contains personal office, scientific research project management and system management functions, independently run in relevant environment, and to solve practical needs.

Experience of Application of Liquid Lubricating Materials during Wide Strip Hot Rolling

NASA Astrophysics Data System (ADS)

Platov, S. I.; Dema, R. R.; Kharchenko, M. V.; Amirov, R. N.

2017-12-01

The paper presents the results of the scientific and practical research of roller systems operation at feed of liquid lubricating materials through the example of the wide strip hot rolling Mill-2000 at PAO MMK. The experiments proved that application of lubricating materials leads to decrease of energy-power parameters of the process by 12 to 15 %, and reduction of work roll wear by 10 to 12%. The practical results of the study are developed recommendations on determination of consumption-volumetric parameters of the supplied lubricating material depending on rheological and geometrical parameters of the rolled strip and current wear of work rolls.

Practical results from a mathematical analysis of guard patrols

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

Indusi, Joseph P.

1978-12-01

Using guard patrols as a primary detection mechanism is not generally viewed as a highly efficient detection method when compared to electronic means. Many factors such as visibility, alertness, and the space-time coincidence of guard and adversary presence all have an effect on the probability of detection. Mathematical analysis of the guard patrol detection problem is related to that of classical search theory originally developed for naval search operations. The results of this analysis tend to support the current practice of using guard forces to assess and respond to previously detected intrusions and not as the primary detection mechanism. 6more » refs.« less

The Richard C. Schneider Lecture. New dimensions of neurosurgery in the realm of high technology: possibilities, practicalities, realities.

PubMed

Apuzzo, M L

1996-04-01

Fueled by a buoyant economy, popular attitudes and demands, and parallel progress in transferable technical and biological areas, neurosurgery has enjoyed a remarkable quarter of a century of progress. Developmental trends in the discipline have included the following: 1) a refinement of preoperative definition of the structural substrate, 2) miniaturization of operative corridors, 3) reduction of operative trauma, 4) increased effectiveness at the target site, and 5) incorporation of improved technical adjuvants and physical operative tools into treatment protocols. In particular, the computer has become a formidable ally in diagnostic and surgical events. Trends in technical development indicate that we are entering an exciting era of advanced surgery of the human cerebrum, which is heralded by the following: 1) current developments in areas of imaging, sensors, and visualization; 2) new devices for localization and navigation; 3) new capabilities for action at the target point; and 4) innovative concepts related to advanced operative venues. Imaging has provided structurally based surgical maps, which now are being given the new dimension of function in complex and integrated formats for preoperative planning and intraoperative tactical direction. Cerebral localization and navigation based on these advances promise to provide further refinement to the field of stereotactic neurosurgery, as linked systems are superseded by more flexible nonlinked methodologies in functionally defined volume-oriented navigational databases. Target point action now includes not only ablative capabilities through micro-operative methods and the use of stereotactically directed high-energy forms but also the emergence of restorative capabilities through applications of principles of genetic engineering in the areas of molecular and cellular neurosurgery. Complex, dedicated, and self-contained operative venues will be required to optimize the emergence and development of these computer-oriented micro/stereotactic capabilities, which appear to be unavoidably required as locales for the practice and development of virtual reality-based stations for operative rehearsal, simulation, training, and, ultimately, enhancement of operative events through robotic interfaces. Primary impetus for progress has relied upon new combinations of technologies, disciplines, and industries. Philosophical and practical problems include the spectrum of availability of these methods to the population at large, the training of individuals to properly administer these methods, defining the acceptable envelope of expertise, and maintaining suitable delivery and progress while containing spiraling costs. Advanced neurological surgery and the use and development of high-technology adjuvants require a robust economy that has a populace willing to invest in the luxury of such developments. The current socioeconomic situation is fragile from the standpoint of both economics and attitudes of the patients and health care providers, with diversion of economic resources, redistribution of funding bases, modification of patient referrals, practice styles, and service attitudes undermining progress. Economic pressures have brought high-technology methods under great scrutiny regarding their effectiveness and cost-effectiveness. Reform proposals have specifically targeted technology-oriented services, and the Office of Technology Assessment has recommended increasing the use of managed care providers who look to information on cost-effectiveness and clinical practice guidelines to establish efficient management strategies and issue "report cards." Although the premise is laudable and "gimmickry" needs to be identified, it might be argued that such scrutiny and control might be overbearing and overused, impeding appropriate delivery and progress.

Special Forces Medical Sergeants' perceptions and beliefs regarding their current medical sustainment program: implications for the field.

PubMed

Wilson, Ramey L; DeZee, Kent J

2014-01-01

Special Forces Medical Sergeants (SFMS) are trained to provide trauma and medical care in support of military operations and diplomatic missions throughout the world with indirect physician oversight. This study assessed their perceptions of the current program designed to sustain their medical skills. An Internet-based survey was developed using the constructs of the Theory of Reasoned Action/Planned Behavior and validated through survey best practices. Of the 334 respondents, 92.8% had deployed at least once as an SFMS. Respondents reported spending 4 hours per week sustaining their medical skills and were highly confident that they could perform their duties on a no-notice deployment. On a 5-point, Likert-type response scale, SFMS felt that only slight change is needed to the Special Operations Medical Skills Sustainment Course (mean: 2.17; standard deviation [SD]: 1.05), while moderate change is needed to the Medical Proficiency Training (mean: 2.82; SD: 1.21) and nontrauma modules (mean: 3.02; SD: 1.22). Respondents desire a medical sustainment program that is provided by subject matter experts, involves actual patient care, incorporates new technology, uses hands-on simulation, and is always available. SFMS are challenged to sustain their medical skills in the current operational environment, and barriers to medical training should be minimized to facilitate sustainment training. Changes to the current medical sustainment program should incorporate operator-level perspectives to ensure acceptability and utility but must be balanced with organizational realities. Improving the medical sustainment program will prepare SFMS for the challenges of future missions. 2014.

Training simulator for retinal laser photocoagulation: a new approach for surgeons' apprenticeships

NASA Astrophysics Data System (ADS)

Dubois, Patrick; Meseure, Philippe; Peugnet, Frederic; Rouland, Jean-Francois

1998-06-01

Retinal laser photocoagulation is a current practice in many eye diseases therapy. Its mastering requires a specific training usually made on actual patients with some risks. The authors present a new device aimed to deliver a complete training separated from the therapeutic practice. This training simulator is built around the actual instrument to comply with the required realism. The instrumental functionalities of the device give the residents the same operating conditions as in the actual practice. The eye fundus visualization is simulated by virtual images, based on actual fundus pictures. They are computed at the rate of 10-12 frames/second according to the adjustments and manipulations of the 3-mirror lens made by the operator. All the pictures are combined in a fundus database planned to collect a wide variety of pathologies. The pedagogical functionalities are gathered in the user's interface. The two major guidelines of the developed software was to achieve an easy to use interface and to enforce no 'school dependent' rules of valuation. This new pedagogical instrument runs on PC micro-computers which allows a low- cost technology and could provide a practical training to retinal photocoagulation without the patient. A clinical validation of its pedagogical efficiency is submitted in another abstract.

Best practicable means (BPM) and as low as reasonably practicable (ALARP) in action at Sellafield.

PubMed

Morley, Bob

2004-03-01

Operators within the UK nuclear industry are required to employ 'best practicable means' (BPM) to control and minimise radioactive discharges. The requirement for the use of BPM is in order to ensure that doses from discharges are as low as reasonably practicable (ALARP). This facet is increasingly becoming the principal feature of discharge authorisations issued by the Environment Agencies under the Radioactive Substances Act, 1993 (RSA 93), which are enforceable by law. It is important to state at the outset, however, that scientific assessments to date indicate that there are no expectations of environmental harm from authorised discharges, even where those discharges have historically been up to two orders of magnitude higher than current levels. There is also no evidence to indicate that foreseeable future discharges from the Sellafield site will make any contribution to environmental harm.

A flight test of laminar flow control leading-edge systems

NASA Technical Reports Server (NTRS)

Fischer, M. C.; Wright, A. S., Jr.; Wagner, R. D.

1983-01-01

NASA's program for development of a laminar flow technology base for application to commercial transports has made significant progress since its inception in 1976. Current efforts are focused on development of practical reliable systems for the leading-edge region where the most difficult problems in applying laminar flow exist. Practical solutions to these problems will remove many concerns about the ultimate practicality of laminar flow. To address these issues, two contractors performed studies, conducted development tests, and designed and fabricated fully functional leading-edge test articles for installation on the NASA JetStar aircraft. Systems evaluation and performance testing will be conducted to thoroughly evaluate all system capabilities and characteristics. A simulated airline service flight test program will be performed to obtain the operational sensitivity, maintenance, and reliability data needed to establish that practical solutions exist for the difficult leading-edge area of a future commercial transport employing laminar flow control.

Power-Efficient, High-Current-Density, Long-Life Thermionic Cathode Developed for Microwave Amplifier Applications

NASA Technical Reports Server (NTRS)

Wintucky, Edwin G.

2002-01-01

A power-efficient, miniature, easily manufactured, reservoir-type barium-dispenser thermionic cathode has been developed that offers the significant advantages of simultaneous high electron-emission current density (>2 A/sq cm) and very long life (>100,000 hr of continuous operation) when compared with the commonly used impregnated-type barium-dispenser cathodes. Important applications of this cathode are a wide variety of microwave and millimeter-wave vacuum electronic devices, where high output power and reliability (long life) are essential. We also expect it to enable the practical development of higher purveyance electron guns for lower voltage and more reliable device operation. The low cathode heater power and reduced size and mass are expected to be particularly beneficial in traveling-wave-tube amplifiers (TWTA's) for space communications, where future NASA mission requirements include smaller onboard spacecraft systems, higher data transmission rates (high frequency and output power) and greater electrical efficiency.

The WLCG Messaging Service and its Future

NASA Astrophysics Data System (ADS)

Cons, Lionel; Paladin, Massimo

2012-12-01

Enterprise messaging is seen as an attractive mechanism to simplify and extend several portions of the Grid middleware, from low level monitoring to experiments dashboards. The production messaging service currently used by WLCG includes four tightly coupled brokers operated by EGI (running Apache ActiveMQ and designed to host the Grid operational tools such as SAM) as well as two dedicated services for ATLAS-DDM and experiments dashboards (currently also running Apache ActiveMQ). In the future, this service is expected to grow in numbers of applications supported, brokers and technologies. The WLCG Messaging Roadmap identified three areas with room for improvement (security, scalability and availability/reliability) as well as ten practical recommendations to address them. This paper describes a messaging service architecture that is in line with these recommendations as well as a software architecture based on reusable components that ease interactions with the messaging service. These two architectures will support the growth of the WLCG messaging service.

Mechanisms Involved in Nematode Control by Endophytic Fungi.

PubMed

Schouten, Alexander

2016-08-04

Colonization of plants by particular endophytic fungi can provide plants with improved defenses toward nematodes. Evidently, such endophytes can be important in developing more sustainable agricultural practices. The mechanisms playing a role in this quantitative antagonism are poorly understood but most likely multifactorial. This knowledge gap obstructs the progress regarding the development of endophytes or endophyte-derived constituents into biocontrol agents. In part, this may be caused by the fact that endophytic fungi form a rather heterogeneous group. By combining the knowledge of the currently characterized antagonistic endophytic fungi and their effects on nematode behavior and biology with the knowledge of microbial competition and induced plant defenses, the various mechanisms by which this nematode antagonism operates or may operate are discussed. Now that new technologies are becoming available and more accessible, the currently unresolved mechanisms can be studied in greater detail than ever before.

Liquid Rocket Engine Turbopump Rotating-shaft Seals

NASA Technical Reports Server (NTRS)

Burcham, R. E.; Keller, R. B., Jr. (Editor)

1978-01-01

A monograph is organized and presents, for effective use in design, the significant experience and knowledge accumulated in development and operational programs to date. It reviews and assesses current practices, and from them establishes firm guidance for achieving greater consistency in design, increased reliability in the end product, and greater efficiency in the design effort. The monograph is divided into two major sections: state of the art and design criteria.

An Improved NDE (Non-Destructive Evaluation) Capability for Aerospace Components.

DTIC Science & Technology

1984-12-21

proposed design will use the scintillator/fiber-optic Reticon detector which was investigated in the eperimental studies discussed above. The x rays...practical operation. Experimental studies of a microfocal x-ray source and the SFRD pinpointed current proklems and capabilities. A conceptual design ...authors would like to acknowledge the following important contributions to this effort: Chuck Isaacson for his help in the design and implementation of

Close-Spaced High Temperature Knudsen Flow.

DTIC Science & Technology

1986-07-15

work~was a study of discharge processes in Knudsen mode (collisionless), thermionic energy converters. Areas of research involve’mechanisms for reducing ...power densities. The mechanisms/we have chosen to study are: reduction of space-charge through a very close interelectrode gap (less than 10 microns...In order to operate at practical current densities, the effect of electron space charge must be reduced . This can be done through very close

SHI(EL)DS: A Novel Hardware-Based Security Backplane to Enhance Security with Minimal Impact to System Operation

DTIC Science & Technology

2008-03-01

executables. The current roadblock to detecting Type I Malware consistantly is the practice of legitimate software , such as antivirus programs, using this... Software Security Systems . . 31 3.2.2 Advantages of Hardware . . . . . . . . . . . . . 32 3.2.3 Trustworthiness of Information . . . . . . . . . 33...Towards a Hardware Security Backplane . . . . . . . . . 42 IV. Review of State of the Art Computer Security Solutions . . . . . 46 4.1 Software

Thromboprophylaxis among Australasian colorectal surgeons.

PubMed

Smart, Philip; Burbury, Kate; Lingaratnam, Senthil; Lynch, A Craig; Mackay, John; Heriot, Alexander

2013-09-01

Thromboembolism is a common cause of morbidity and mortality in patients with colorectal cancer, but thromboprophylaxis (TP) is underutilized. Current guidelines do not make specific recommendations for colorectal cancer patients and provide minimal guidance for the ambulatory setting, although emerging evidence suggests TP may be warranted during chemoradiotherapy or in the extended post-operative phase. A survey of Australasian colorectal surgeons was therefore performed to assess current TP practice and attitudes. An online survey was sent to 204 surgeons who were members of the Colorectal Surgical Society of Australia and New Zealand. One hundred twenty-eight surgeons (63%) completed the survey. Most surgeons consult available guidelines, and where recommendations are made, current practice is in line with them. Lack of data, lack of ownership, logistical issues and an absence of guideline recommendations currently prevent surgeons from instituting TP in the neoadjuvant treatment period. Fifty-four per cent of surgeons currently prescribe TP after hospital discharge; those that do not, cite logistical issues as the main constraint. More data on thromboembolism risk during various treatment phases are required and should be promulgated in tumour-specific guidelines. Logistical barriers to adopting TP in the ambulatory setting should be addressed. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Operational momentum in large-number addition and subtraction by 9-month-olds.

PubMed

McCrink, Koleen; Wynn, Karen

2009-08-01

Recent studies on nonsymbolic arithmetic have illustrated that under conditions that prevent exact calculation, adults display a systematic tendency to overestimate the answers to addition problems and underestimate the answers to subtraction problems. It has been suggested that this operational momentum results from exposure to a culture-specific practice of representing numbers spatially; alternatively, the mind may represent numbers in spatial terms from early in development. In the current study, we asked whether operational momentum is present during infancy, prior to exposure to culture-specific representations of numbers. Infants (9-month-olds) were shown videos of events involving the addition or subtraction of objects with three different types of outcomes: numerically correct, too large, and too small. Infants looked significantly longer only at those incorrect outcomes that violated the momentum of the arithmetic operation (i.e., at too-large outcomes in subtraction events and too-small outcomes in addition events). The presence of operational momentum during infancy indicates developmental continuity in the underlying mechanisms used when operating over numerical representations.

How do strategic decisions and operative practices affect operating room productivity?

PubMed

Peltokorpi, Antti

2011-12-01

Surgical operating rooms are cost-intensive parts of health service production. Managing operating units efficiently is essential when hospitals and healthcare systems aim to maximize health outcomes with limited resources. Previous research about operating room management has focused on studying the effect of management practices and decisions on efficiency by utilizing mainly modeling approach or before-after analysis in single hospital case. The purpose of this research is to analyze the synergic effect of strategic decisions and operative management practices on operating room productivity and to use a multiple case study method enabling statistical hypothesis testing with empirical data. 11 hypotheses that propose connections between the use of strategic and operative practices and productivity were tested in a multi-hospital study that included 26 units. The results indicate that operative practices, such as personnel management, case scheduling and performance measurement, affect productivity more remarkably than do strategic decisions that relate to, e.g., units' size, scope or academic status. Units with different strategic positions should apply different operative practices: Focused hospital units benefit most from sophisticated case scheduling and parallel processing whereas central and ambulatory units should apply flexible working hours, incentives and multi-skilled personnel. Operating units should be more active in applying management practices which are adequate for their strategic orientation.

Design and Operation of an Electrochemical Methanol Concentration Sensor for Direct Methanol Fuel Cell Systems

NASA Technical Reports Server (NTRS)

Narayanan, S. R.; Valdez, T. I.; Chun, W.

2000-01-01

The development of a 150-Watt packaged power source based on liquid feed direct methanol fuel cells is being pursued currently at the Jet propulsion Laboratory for defense applications. In our studies we find that the concentration of methanol in the fuel circulation loop affects the electrical performance and efficiency the direct methanol fuel cell systems significantly. The practical operation of direct methanol fuel cell systems, therefore, requires accurate monitoring and control of methanol concentration. The present paper reports on the principle and demonstration of an in-house developed electrochemical sensor suitable for direct methanol fuel cell systems.

The Coming Paradigm-Shift in Maintenance: From Metals to Composites

NASA Technical Reports Server (NTRS)

Hobbs, Alan; Brasil, Connie; Kanki, Barbara

2009-01-01

The purpose of this study is to examine the current maintenance practices of airline operators in the detection and repair of damage to composite structures, with the aim of learning lessons that will be applicable to the maintenance of future advanced composite airplanes. A process map was created to capture the events and activities that occur from the moment a damage event occurs, through damage detection, assessment and repair. The study is identifying areas where operational risks may negatively impact the process, where personnel are required to make judgments in the absence of procedural guidance, and areas where future tools or techniques may be of assistance.

Relationship between operational variables, fundamental physics and foamed cement properties in lab and field generated foamed cement slurries

DOE PAGES

Glosser, D.; Kutchko, B.; Benge, G.; ...

2016-03-21

Foamed cement is a critical component for wellbore stability. The mechanical performance of a foamed cement depends on its microstructure, which in turn depends on the preparation method and attendant operational variables. Determination of cement stability for field use is based on laboratory testing protocols governed by API Recommended Practice 10B-4 (API RP 10B-4, 2015). However, laboratory and field operational variables contrast considerably in terms of scale, as well as slurry mixing and foaming processes. Here in this paper, laboratory and field operational processes are characterized within a physics-based framework. It is shown that the “atomization energy” imparted by themore » high pressure injection of nitrogen gas into the field mixed foamed cement slurry is – by a significant margin – the highest energy process, and has a major impact on the void system in the cement slurry. There is no analog for this high energy exchange in current laboratory cement preparation and testing protocols. Quantifying the energy exchanges across the laboratory and field processes provides a basis for understanding relative impacts of these variables on cement structure, and can ultimately lead to the development of practices to improve cement testing and performance.« less

A Path to Planetary Protection Requirements for Human Exploration: A Literature Review and Systems Engineering Approach

NASA Technical Reports Server (NTRS)

Johnson, James E.; Conley, Cassie; Siegel, Bette

2015-01-01

As systems, technologies, and plans for the human exploration of Mars and other destinations beyond low Earth orbit begin to coalesce, it is imperative that frequent and early consideration is given to how planetary protection practices and policy will be upheld. While the development of formal planetary protection requirements for future human space systems and operations may still be a few years from fruition, guidance to appropriately influence mission and system design will be needed soon to avoid costly design and operational changes. The path to constructing such requirements is a journey that espouses key systems engineering practices of understanding shared goals, objectives and concerns, identifying key stakeholders, and iterating a draft requirement set to gain community consensus. This paper traces through each of these practices, beginning with a literature review of nearly three decades of publications addressing planetary protection concerns with respect to human exploration. Key goals, objectives and concerns, particularly with respect to notional requirements, required studies and research, and technology development needs have been compiled and categorized to provide a current 'state of knowledge'. This information, combined with the identification of key stakeholders in upholding planetary protection concerns for human missions, has yielded a draft requirement set that might feed future iteration among space system designers, exploration scientists, and the mission operations community. Combining the information collected with a proposed forward path will hopefully yield a mutually agreeable set of timely, verifiable, and practical requirements for human space exploration that will uphold international commitment to planetary protection.

Laparoscopic Pediatric Inguinal Hernia Repair: Overview of "True Herniotomy" Technique and Review of Current Evidence.

PubMed

Feehan, Brendan P; Fromm, David S

2017-05-01

Inguinal hernia repair is one of the most commonly performed operations in the pediatric population. While the majority of pediatric surgeons routinely use laparoscopy in their practices, a relatively small number prefer a laparoscopic inguinal hernia repair over the traditional open repair. This article provides an overview of the three port laparoscopic technique for inguinal hernia repair, as well as a review of the current evidence with respect to visualization and identification of hernias, recurrence rates, operative times, complication rates, postoperative pain, and cosmesis. The laparoscopic repair presents a viable alternative to open repair and offers a number of benefits over the traditional approach. These include superior visualization of the relevant anatomy, ability to assess and repair a contralateral hernia, lower rates of metachronous hernia, shorter operative times in bilateral hernia, and the potential for lower complication rates and improved cosmesis. This is accomplished without increasing recurrence rates or postoperative pain. Further research comparing the different approaches, including standardization of techniques and large randomized controlled trials, will be needed to definitively determine which is superior. Copyright© South Dakota State Medical Association.

Surgical simulation in orthopaedic skills training.

PubMed

Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

2012-07-01

Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated.

Non-operative management of a complete anterior cruciate ligament injury in an English Premier League football player with return to play in less than 8 weeks: applying common sense in the absence of evidence

PubMed Central

Weiler, Richard; Monte-Colombo, Mathew; Mitchell, Adam; Haddad, Fares

2015-01-01

This case report illustrates and discusses the non-operative management of a complete anterior cruciate ligament (ACL) injury in an English Premier League football player, his return to play within 8 weeks and problem-free follow-up at 18 months post injury. When non-operative verses surgical ACL reconstruction is considered there are many fundamental gaps in our knowledge and currently, at elite level, there are no cases in cutting sports within the literature to guide these decisions. When the norm is for all professional footballers to be recommended surgery, it will be very challenging when circumstances and patient autonomy dictate a conservative approach, where prognosis, end points and risk are unclear and assumed to be high. This case challenges current dogma and provides a starting point for much needed debate about best practice, treatment options, research direction and not just at the elite level of sport. PMID:25917066

Looking for Skeletons in the Data Centre `Cupboard': How Repository Certification Can Help

NASA Astrophysics Data System (ADS)

Sorvari, S.; Glaves, H.

2017-12-01

There has been a national geoscience repository at the British Geological Survey (or one of its previous incarnations) almost since its inception in 1835. This longevity has resulted in vast amounts of analogue material and, more recently, digital data some of which has been collected by our scientists but much more has been acquired either through various legislative obligations or donated from various sources. However, the role and operation of the UK National Geoscience Data Centre (NGDC) in the 21st Century is very different to that of the past, with new systems and procedures dealing with predominantly digital data. A web-based ingestion portal allows users to submit their data directly to the NGDC while online services provide discovery and access to data and derived products. Increasingly we are also required to implement an array of standards e.g. ISO, OGC, W3C, best practices e.g. FAIR and legislation e.g. EU INSPIRE Directive; whilst at the same time needing to justifying our very existence to our funding agency and hosting organisation. External pressures to demonstrate that we can be recognised as a trusted repository by researchers, various funding agencies, publishers and other related entities have forced us to look at how we function, and to benchmark our operations against those of other organisations and current relevant standards such as those laid down by different repository certification processes. Following an assessment of the various options, the WDS/DSA certification process was selected as the most appropriate route for accreditation of NGDC as a trustworthy repository. It provided a suitable framework for reviewing the current systems, procedures and best practices. Undertaking this process allowed us to identify where the NGDC already has robust systems in place and where there were gaps and deficiencies in current practices. The WDS/DSA assessment process also helped to reinforce best practice throughout the NGDC and demonstrated that many of the recognised and required procedures and standards for recognition as a trusted repository were already in place, even if they were not always followed!

Congenital cardiac surgery fellowship training: A status update.

PubMed

Kogon, Brian; Karamlou, Tara; Baumgartner, William; Merrill, Walter; Backer, Carl

2016-06-01

In 2007, congenital cardiac surgery became a recognized fellowship by the Accreditation Council of Graduate Medical Education (ACGME) and leads to board certification through the American Board of Thoracic Surgery (ABTS). We highlight the strengths and weaknesses in the current system of accredited training. Data were collected from program directors, the ACGME, and the ABTS. In addition, surveys were sent to training program graduates. Topics included program accreditation status, number of fellows trained per year and per program, match results, fellow operative experience, fellow satisfaction, and post-fellowship employment status. There are twelve active accredited fellowship programs, and 44 trainees have completed accredited training. Each active program has trained a median of 3 fellows (range: 0-7). Operative logs were obtained from 38 of 44 (86%) graduates. The median number of total cases (minimum 75) was 136 (range: 75-236). For complex neonates (minimum 5), the median number of cases was 6 (range: 2-17). Some fellows failed to meet the minimum requirements. Thirty-six (82%) graduates responded to the survey; most were satisfied with their overall operative experience, but less with their neonatal operative experience. Of this total, 84% are currently practicing congenital cardiac surgery, and 74% secured jobs prior to completing their residency. Since 2007, congenital cardiac surgery training has been accredited by the ACGME. In general, the training is uniform, the operative experience is robust, and the fellows are satisfied. Although shortcomings remain, this study highlights the many strengths of the current system. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Test Rack Development for Extended Operation of Advanced Stirling Convertors at NASA Glenn Research Center

NASA Technical Reports Server (NTRS)

Dugala, Gina M.

2010-01-01

The U.S. Department of Energy, Lockheed Martin Space Systems Company, Sunpower Inc., and NASA Glenn Research Center (GRC) have been developing an Advanced Stirling Radioisotope Generator (ASRG) for use as a power system on space science missions. This generator will make use of free-piston Stirling convertors to achieve higher conversion efficiency than with currently available alternatives. One part of NASA GRC's support of ASRG development includes extended operation testing of Advanced Stirling Convertors (ASCs) developed by Sunpower Inc. and GRC. The ASC consists of a free-piston Stirling engine integrated with a linear alternator. NASA GRC has been building test facilities to support extended operation of the ASCs for several years. Operation of the convertors in the test facility provides convertor performance data over an extended period of time. One part of the test facility is the test rack, which provides a means for data collection, convertor control, and safe operation. Over the years, the test rack requirements have changed. The initial ASC test rack utilized an alternating-current (AC) bus for convertor control; the ASRG Engineering Unit (EU) test rack can operate with AC bus control or with an ASC Control Unit (ACU). A new test rack is being developed to support extended operation of the ASC-E2s with higher standards of documentation, component selection, and assembly practices. This paper discusses the differences among the ASC, ASRG EU, and ASC-E2 test racks.

Independent variations of applied voltage and injection current for controlling the quantum-confined Stark effect in an InGaN/GaN quantum-well light-emitting diode.

PubMed

Chen, Horng-Shyang; Liu, Zhan Hui; Shih, Pei-Ying; Su, Chia-Ying; Chen, Chih-Yen; Lin, Chun-Han; Yao, Yu-Feng; Kiang, Yean-Woei; Yang, C C

2014-04-07

A reverse-biased voltage is applied to either device in the vertical configuration of two light-emitting diodes (LEDs) grown on patterned and flat Si (110) substrates with weak and strong quantum-confined Stark effects (QCSEs), respectively, in the InGaN/GaN quantum wells for independently controlling the applied voltage across and the injection current into the p-i-n junction in the lateral configuration of LED operation. The results show that more carrier supply is needed in the LED of weaker QCSE to produce a carrier screening effect for balancing the potential tilt in increasing the forward-biased voltage, when compared with the LED of stronger QCSE. The small spectral shift range in increasing injection current in the LED of weaker QCSE is attributed not only to the weaker QCSE, but also to its smaller device resistance such that a given increment of applied voltage leads to a larger increment of injection current. From a viewpoint of practical application in LED operation, by applying a reverse-biased voltage in the vertical configuration, the applied voltage and injection current in the lateral configuration can be independently controlled by adjusting the vertical voltage for keeping the emission spectral peak fixed.

Flying Unmanned Aircraft: A Pilot's Perspective

NASA Technical Reports Server (NTRS)

Pestana, Mark E.

2011-01-01

The National Aeronautics and Space Administration (NASA) is pioneering various Unmanned Aircraft System (UAS) technologies and procedures which may enable routine access to the National Airspace System (NAS), with an aim for Next Gen NAS. These tools will aid in the development of technologies and integrated capabilities that will enable high value missions for science, security, and defense, and open the door to low-cost, extreme-duration, stratospheric flight. A century of aviation evolution has resulted in accepted standards and best practices in the design of human-machine interfaces, the displays and controls of which serve to optimize safe and efficient flight operations and situational awareness. The current proliferation of non-standard, aircraft-specific flight crew interfaces in UAS, coupled with the inherent limitations of operating UAS without in-situ sensory input and feedback (aural, visual, and vestibular cues), has increased the risk of mishaps associated with the design of the "cockpit." The examples of current non- or sub- standard design features range from "annoying" and "inefficient", to those that are difficult to manipulate or interpret in a timely manner, as well as to those that are "burdensome" and "unsafe." A concerted effort is required to establish best practices and standards for the human-machine interfaces, for the pilot as well as the air traffic controller. In addition, roles, responsibilities, knowledge, and skill sets are subject to redefining the terms, "pilot" and "air traffic controller", with respect to operating UAS, especially in the Next-Gen NAS. The knowledge, skill sets, training, and qualification standards for UAS operations must be established, and reflect the aircraft-specific human-machine interfaces and control methods. NASA s recent experiences flying its MQ-9 Ikhana in the NAS for extended duration, has enabled both NASA and the FAA to realize the full potential for UAS, as well as understand the implications of current limitations. Ikhana is a Predator-B/Reaper UAS, built by General Atomics, Aeronautical Systems, Inc., and modified for research. Since 2007, the aircraft has been flown seasonally with a wing-mounted pod containing an infrared scanner, utilized to provide real-time wildfire geo-location data to various fire-fighting agencies in the western U.S. The multi-agency effort included an extensive process to obtain flight clearance from the FAA to operate under special provisions, given that UAS in general do not fully comply with current airspace regulations (e.g. sense-and-avoid requirements).

"The difference is in the tomato at the end": Understanding the motivations and practices of cannabis growers operating within Belgian Cannabis Social Clubs.

PubMed

Pardal, Mafalda

2018-03-11

In Belgium, Cannabis Social Clubs (CSCs) collectively organize the cultivation and distribution of cannabis for the personal use of their members. In this paper we seek to improve understanding of the motivations and practices of cannabis growers operating within CSCs, shedding light on the cultivation process. We draw on data gathered through face-to-face semi-structured interviews with the directors of seven active Belgian CSCs (n = 21) and CSC growers (n = 23). These data are complemented by additional fieldwork and a review of policies relating to CSCs', including bylaws and growing protocols. The Belgian CSCs rely on single and multiple in-house grower arrangements. Most CSC growers had been cultivating cannabis prior to joining their current CSC, albeit growing in different contexts (non-commercial and commercial). The CSC growers discussed both ideological and pragmatic motives for operating within a CSC. Cultivation took place indoors and followed organic practices. Despite their small-scale (20 plants on average), the grow sites used specialized equipment. The growers reported receiving financial compensation to cover production costs. This paper offers new insights into a particular sector of domestic cannabis cultivation - CSC growers and their practices within those collectives - which has not been studied previously. The Belgian CSCs have decentralized production among small-scale grow sites, at a size comparable to that found in other small-scale cultivation studies. In terms of motivations and practices, CSC growers share some features typically ascribed to small-scale cannabis cultivators. At the same time, CSC growers seemed particularly engaged with the CSC model and willing to adhere to the (self-)regulated practices developed by the organizations. This had implications for the way cultivation was organized and for the role of the grower within the CSC. Copyright © 2018 Elsevier B.V. All rights reserved.

Minimally invasive surgery fellowship graduates: Their demographics, practice patterns, and contributions.

PubMed

Park, Adrian E; Sutton, Erica R H; Heniford, B Todd

2015-12-01

Fellowship opportunities in minimally invasive surgery, bariatric, gastrointestinal, and hepatobiliary arose to address unmet training needs. The large cohort of non-Accreditation Council for Graduate Medical Education -accredited fellowship graduates (NACGMEG) has been difficult to track. In this, the largest survey of graduates to date, our goal was to characterize this unique group's demographics and professional activities. A total of 580 NACGMEG were surveyed covering 150 data points: demographics, practice patterns, academics, lifestyle, leadership, and maintenance of certification. Of 580 previous fellows, 234 responded. Demographics included: average age 37 years, 84% male, 75% in urban settings, 49% in purely academic practice, and 58% in practice <5 years. They averaged 337 operating room cases/year (approximately 400/year for private practice vs 300/year for academic). NACGMEG averaged 100 flexible endoscopies/year (61 esophagogastroduodenoscopies, 39 colon). In the past 24 months, 60% had submitted abstracts to a national meeting, and 54% submitted manuscripts to peer-reviewed journals. Subset analyses revealed relevant relationships. There was high satisfaction (98%) that their fellowship experience met expectations; 78% termed their fellowships, versus 50% for residencies, highly pertinent to their current practices. 63% of previous fellows occupy local leadership roles, and most engage in maintenance of certification activities. Fellowship alumnae appear to be productive contributors to American surgery. They are clinically and academically active, believe endoscopy is important, have adopted continuous learning, and most assume work leadership roles. The majority acknowledge their fellowship training as having met expectations and uniquely equipping them for their current practice. Copyright © 2015 Elsevier Inc. All rights reserved.

Current issues in billing and coding in interventional pain medicine.

PubMed

Manchikanti, L

2000-10-01

Interventional pain management is a dynamic field with changes occurring on a daily basis, not only with technology but also with regulations that have a substantial financial impact on practices. Regulations are imposed not only by the federal government and other regulatory agencies, and also by a multitude of other payors, state governments and medical boards. Documentation of medical necessity with coding that correlates with multiple components of the patient's medical record, operative report, and billing statement is extremely important. Numerous changes which have occurred in the practice of interventional pain management in the new millennium continue to impact the financial viability of interventional pain practices along with patient access to these services. Thus, while complying with regulations of billing, coding and proper, effective, and ethical practice of pain management, it is also essential for physicians to understand financial aspects and the impact of various practice patterns. This article provides guidelines which are meant to provide practical considerations for billing and coding of interventional techniques in the management of chronic pain based on the current state of the art and science of interventional pain management. Hence, these guidelines do not constitute inflexible treatment, coding, billing or documentation recommendations. It is expected that a provider will establish a plan of care on a case-by-case basis taking into account an individual patient's medical condition, personal needs, and preferences, along with physician's experience and in a similar manner, billing and coding practices will be developed. Based on an individual patient's needs, treatment, billing and coding, different from what is outlined here is not only warranted but essential.

Claus sulfur recovery unit startups

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

Parnell, D.C.

1973-08-01

Because of the recent emphasis on reducing sulfur emissions to the atmosphere, Claus-type sulfur recovery units are becoming more prevalent throughout the industry. Many plants, including refinery, chemical, and natural gasoline units, are being required to install Claus sulfur recovery facilities to meet pollution requirements. Although Claus units in some cases cannot alone meet the most rigid air pollution codes currently being enforced, they are still the most economical and practical method for recovering about 94 to 97% of the sulfur from hydrogen sulfide rich gases. For best operation and longer service life, proper startup and shutdown procedures for thesemore » sulfur recovery units should be followed. On all startups and shutdowns, these units require considerable operator attention; improper operation during these critical phases can affect overall plant efficiency.« less

[Virtual surgical education: experience with medicine and surgery students].

PubMed

Bonavina, Luigi; Mozzi, Enrico; Peracchia, Alberto

2003-01-01

The use of virtual reality simulation is currently being proposed within programs of postgraduate surgical education. The simple tasks that make up an operative procedure can be repeatedly performed until satisfactory execution is achieved, and the errors can be corrected by means of objective assessment. The aim of this study was to evaluate the applicability and the results of structured practice with the LapSim laparoscopic simulator used by undergraduate medical students. A significant reduction in operative time and errors was noted in several tasks (navigation, clipping, etc.). Although the transfer of technical skills to the operating room environment remains to be demonstrated, our research shows that this type of teaching is applicable to undergraduate medical students and in future may become a useful tool for selecting individuals for surgical residency programs.

High-density magnetoresistive random access memory operating at ultralow voltage at room temperature.

PubMed

Hu, Jia-Mian; Li, Zheng; Chen, Long-Qing; Nan, Ce-Wen

2011-11-22

The main bottlenecks limiting the practical applications of current magnetoresistive random access memory (MRAM) technology are its low storage density and high writing energy consumption. Although a number of proposals have been reported for voltage-controlled memory device in recent years, none of them simultaneously satisfy the important device attributes: high storage capacity, low power consumption and room temperature operation. Here we present, using phase-field simulations, a simple and new pathway towards high-performance MRAMs that display significant improvements over existing MRAM technologies or proposed concepts. The proposed nanoscale MRAM device simultaneously exhibits ultrahigh storage capacity of up to 88 Gb inch(-2), ultralow power dissipation as low as 0.16 fJ per bit and room temperature high-speed operation below 10 ns.

High-density magnetoresistive random access memory operating at ultralow voltage at room temperature

PubMed Central

Hu, Jia-Mian; Li, Zheng; Chen, Long-Qing; Nan, Ce-Wen

2011-01-01

The main bottlenecks limiting the practical applications of current magnetoresistive random access memory (MRAM) technology are its low storage density and high writing energy consumption. Although a number of proposals have been reported for voltage-controlled memory device in recent years, none of them simultaneously satisfy the important device attributes: high storage capacity, low power consumption and room temperature operation. Here we present, using phase-field simulations, a simple and new pathway towards high-performance MRAMs that display significant improvements over existing MRAM technologies or proposed concepts. The proposed nanoscale MRAM device simultaneously exhibits ultrahigh storage capacity of up to 88 Gb inch−2, ultralow power dissipation as low as 0.16 fJ per bit and room temperature high-speed operation below 10 ns. PMID:22109527

Establishing a master's degree programme in bioinformatics: challenges and opportunities.

PubMed

Sahinidis, N V; Harandi, M T; Heath, M T; Murphy, L; Snir, M; Wheeler, R P; Zukoski, C F

2005-12-01

The development of the Bioinformatics MS degree program at the University of Illinois, the challenges and opportunities associated with such a process, and the current structure of the program is described. This program has departed from earlier University practice in significant ways. Despite the existence of several interdisciplinary programs at the University, a few of which grant degrees, this is the first interdisciplinary program that grants degrees and formally recognises departmental specialisation areas. The program, which is not owned by any particular department but by the Graduate College itself, is operated in a franchise-like fashion via several departmental concentrations. With four different colleges and many more departments involved in establishing and operating the program, the logistics of the operation are of considerable complexity but result in significant interactions across the entire campus.

Survey of US fuel ethanol plants.

PubMed

Saunders, J A; Rosentrater, K A

2009-07-01

The ethanol industry is growing in response to increased consumer demands for fuel as well as the renewable fuel standard. Corn ethanol processing creates the following products: 1/3 ethanol, 1/3 distillers grains, and 1/3 carbon dioxide. As the production of ethanol increases so does the generation of its coproducts, and viable uses continually need to be developed. A survey was mailed to operational US ethanol plants to determine current practices. It inquired about processes, equipment used, end products, and desired future directions for coproducts. Results indicated that approximately one-third of plant managers surveyed expressed a willingness to alter current drying time and temperature if it could result in a higher quality coproduct. Other managers indicated hesitation, based on lack of economic incentives, potential cost and return, and capital required. Respondents also reported the desire to use their coproducts in some of the following products: fuels, extrusion, pellets, plastics, and human food applications. These results provide a snapshot of the industry, and indicate that operational changes to the current production of DDGS must be based upon the potential for positive economic returns.

Advanced Launch System (ALS) actuation and power systems impact operability and cost

NASA Technical Reports Server (NTRS)

Sundberg, Gale R.

1990-01-01

To obtain the Advanced Launch System (ALS) primary goals of reduced costs and improved operability, there must be significant reductions in the launch operations and servicing requirements relative to current vehicle designs and practices. One of the primary methods for achieving these goals is by using vehicle electrical power system and controls for all actuation and avionics requirements. A brief status review of the ALS and its associated Advanced Development Program is presented to demonstrate maturation of those technologies that will help meet the overall operability and cost goals. The electric power and actuation systems are highlighted as a specific technology ready not only to meet the stringent ALS goals (cryogenic field valves and thrust vector controls with peak power demands to 75 hp), but also those of other launch vehicles, military and civilian aircraft, lunar/Martian vehicles, and a multitude of commercial applications.

Advanced Launch System (ALS): Electrical actuation and power systems improve operability and cost picture

NASA Technical Reports Server (NTRS)

Sundberg, Gale R.

1990-01-01

To obtain the Advanced Launch System (ALS) primary goals of reduced costs and improved operability, there must be significant reductions in the launch operations and servicing requirements relative to current vehicle designs and practices. One of the primary methods for achieving these goals is by using vehicle electrical power system and controls for all actuation and avionics requirements. A brief status review of the ALS and its associated Advanced Development Program is presented to demonstrate maturation of those technologies that will help meet the overall operability and cost goals. The electric power and actuation systems are highlighted as a specific technology ready not only to meet the stringent ALS goals (cryogenic field valves and thrust vector controls with peak power demands to 75 hp), but also those of other launch vehicles, military and civilian aircraft, lunar/Martian vehicles, and a multitude of commercial applications.

Advanced launch system (ALS) - Electrical actuation and power systems improve operability and cost picture

NASA Technical Reports Server (NTRS)

Sundberg, Gale R.

1990-01-01

To obtain the Advanced Launch System (ALS) primary goals of reduced costs and improved operability, there must be significant reductions in the launch operations and servicing requirements relative to current vehicle designs and practices. One of the primary methods for achieving these goals is by using vehicle electrrical power system and controls for all aviation and avionics requirements. A brief status review of the ALS and its associated Advanced Development Program is presented to demonstrate maturation of those technologies that will help meet the overall operability and cost goals. The electric power and actuation systems are highlighted as a sdpecific technology ready not only to meet the stringent ALS goals (cryogenic field valves and thrust vector controls with peak power demands to 75 hp), but also those of other launch vehicles, military ans civilian aircraft, lunar/Martian vehicles, and a multitude of comercial applications.

Lock hopper values for coal gasification plant service

NASA Technical Reports Server (NTRS)

Schoeneweis, E. F.

1977-01-01

Although the operating principle of the lock hopper system is extremely simple, valve applications involving this service for coal gasification plants are likewise extremely difficult. The difficulties center on the requirement of handling highly erosive pulverized coal or char (either in dry or slurry form) combined with the requirement of providing tight sealing against high-pressure (possibly very hot) gas. Operating pressures and temperatures in these applications typically range up to 1600 psi (110bar) and 600F (316C), with certain process requirements going even higher. In addition, and of primary concern, is the need for reliable operation over long service periods with the provision for practical and economical maintenance. Currently available data indicate the requirement for something in the order of 20,000 to 30,000 open-close cycles per year and a desire to operate at least that long without valve failure.

Scorecard cardiovascular medicine. Its impact and future directions.

PubMed

Topol, E J; Califf, R M

1994-01-01

Public release of operator-specific data for cardiovascular procedures has set a new precedent, introducing the "scorecard" era. Justification exists for public disclosure, but the mechanics of appropriate data release are complex from a clinical, statistical, and logistic standpoint. Scorecard medicine may appropriately promote regionalization of medical centers and consolidation of services, but unless the process is directed effectively, it may impair the development of new treatments because of a more restrictive clinical practice environment. We propose revamping our current system to facilitate rapid and accurate access to outcome data in the local practice environment so that improvement in practice occurs on a voluntary basis rather than in response to punitive restrictions. A rational plan needs to be developed for dealing with high-risk patients, perhaps through compensation in regression models used to calculate expected outcomes, and for the start-up of novice physicians. Special provisions are needed to promote clinical research. Before procedures are done, it would be ideal to provide a full disclosure informed consent, whereby the physician reports operator-specific data and the patient's decision-making process is facilitated. Overall, appropriate implementation of scorecards could ultimately lead to a substantial improvement in the quality of U.S. cardiovascular medicine.

Operational Dynamic Configuration Analysis

NASA Technical Reports Server (NTRS)

Lai, Chok Fung; Zelinski, Shannon

2010-01-01

Sectors may combine or split within areas of specialization in response to changing traffic patterns. This method of managing capacity and controller workload could be made more flexible by dynamically modifying sector boundaries. Much work has been done on methods for dynamically creating new sector boundaries [1-5]. Many assessments of dynamic configuration methods assume the current day baseline configuration remains fixed [6-7]. A challenging question is how to select a dynamic configuration baseline to assess potential benefits of proposed dynamic configuration concepts. Bloem used operational sector reconfigurations as a baseline [8]. The main difficulty is that operational reconfiguration data is noisy. Reconfigurations often occur frequently to accommodate staff training or breaks, or to complete a more complicated reconfiguration through a rapid sequence of simpler reconfigurations. Gupta quantified a few aspects of airspace boundary changes from this data [9]. Most of these metrics are unique to sector combining operations and not applicable to more flexible dynamic configuration concepts. To better understand what sort of reconfigurations are acceptable or beneficial, more configuration change metrics should be developed and their distribution in current practice should be computed. This paper proposes a method to select a simple sequence of configurations among operational configurations to serve as a dynamic configuration baseline for future dynamic configuration concept assessments. New configuration change metrics are applied to the operational data to establish current day thresholds for these metrics. These thresholds are then corroborated, refined, or dismissed based on airspace practitioner feedback. The dynamic configuration baseline selection method uses a k-means clustering algorithm to select the sequence of configurations and trigger times from a given day of operational sector combination data. The clustering algorithm selects a simplified schedule containing k configurations based on stability score of the sector combinations among the raw operational configurations. In addition, the number of the selected configurations is determined based on balance between accuracy and assessment complexity.

Fibromyalgia syndrome care of Iraq- and Afghanistan-deployed Veterans in Veterans Health Administration.

PubMed

Mohanty, April F; Helmer, Drew A; Muthukutty, Anusha; McAndrew, Lisa M; Carter, Marjorie E; Judd, Joshua; Garvin, Jennifer H; Samore, Matthew H; Gundlapalli, Adi V

2016-01-01

Little is known regarding fibromyalgia syndrome (FMS) care among Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn (OIF/OEF/OND) Veterans. Current recommendations include interdisciplinary, team-based combined care approaches and limited opioid use. In this study of OIF/OEF/OND Veterans who accessed Veterans Health Administration services between 2002 and 2012, we hypothesized that combined care (defined as at least 4 primary care visits/yr with visits to mental health and/or rheumatology) versus <4 primary care visits/yr only would be associated with lower risk of at least 2 opioid prescriptions 12 mo following an FMS diagnosis. Using generalized linear models with a log-link, the Poisson family, and robust standard errors, we estimated risk ratios (RRs) and 95% confidence intervals (CIs). We found that 1% of Veterans had at least 2 FMS diagnoses (International Classification of Diseases-9th Revision-Clinical Modification code 729.1) or at least 1 FMS diagnosis by rheumatology. Veterans with (vs without) FMS were more likely to be female, older, Hispanic, and never/currently married. Combined primary, mental health, and rheumatology care was associated with at least 2 opioid prescriptions (RR [95% CI] for males 2.2 [1.1-4.4] and females 2.8 [0.4-18.6]). Also, combined care was associated with at least 2 nonopioid pain-related prescriptions, a practice supported by evidence-based clinical practice guidelines. In tandem, these results provide mixed evidence of benefit of combined care for FMS. Future studies of healthcare encounter characteristics, care coordination, and benefits for Veterans with FMS are needed.

ReDirection: Options for Policy and Practice in Adult Literacy in Washington State. Goals and Outcomes. A Series of Discussion Papers for the Adult Education Advisory Council.

ERIC Educational Resources Information Center

Fish, Susan; Sampson, Lynne

This discussion paper endeavors to inform decision makers about the goals and outcomes for adult basic education in Washington State. It first examines the current goals operating in adult literacy programs in the state, concluding that, although there may appear to be agreement about the very general purposes of literacy education in the state,…

[The discussion of superconducting MRI magnet transformation without LHe].

PubMed

Yu, Huixian

2014-01-01

In this paper, from the current situation of the domestic use of superconducting MRI, on liquid helium supply and demand crisis in the market, the significance of the transformation without LHe of the superconducting MRI magnet was explained, and according to the enterprise's production process, a number of operating without liquid helium transformation practice and ideas were raised, important value orientation for the domestic manufacture and use of superconducting MRI was provided.

Simulators for training in ultrasound guided procedures.

PubMed

Farjad Sultan, Syed; Shorten, George; Iohom, Gabrielle

2013-06-01

The four major categories of skill sets associated with proficiency in ultrasound guided regional anaesthesia are 1) understanding device operations, 2) image optimization, 3) image interpretation and 4) visualization of needle insertion and injection of the local anesthetic solution. Of these, visualization of needle insertion and injection of local anaesthetic solution can be practiced using simulators and phantoms. This survey of existing simulators summarizes advantages and disadvantages of each. Current deficits pertain to the validation process.

High Current Density Cathodes for Future Vacuum Electronics Applications

DTIC Science & Technology

2008-05-30

Tube - device for generating high levels of RF power DARPA Defense Advanced Research Agency PBG Photonic band gap W- Band 75-111 GHz dB Decibels GHz...Extended interaction klystron 1. Introduction All RF vacuum electron sources require a high quality electron beam for efficient operation. Research on...with long life. Pres- ently, only thermionic dispenser cathodes are practical for high power RF sources. Typical thermi- onic cathodes consists of a

Department of Defense Enterprise Architecture Transition Strategy, Version 2.0

DTIC Science & Technology

2008-02-29

the DoD CIO Enterprise Architecture Congruence Community of Practice Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting ...Directorate for Information Operations and Reports , 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware...does not display a currently valid OMB control number. 1. REPORT DATE 29 FEB 2008 2. REPORT TYPE 3. DATES COVERED 00-00-2008 to 00-00-2008 4

Research and design of logistical information system based on SOA

NASA Astrophysics Data System (ADS)

Zhang, Bo

2013-03-01

Through the study on the existing logistics information systems and SOA technology, based on the current situation of enterprise logistics management and business features, this paper puts forward a SOA-based logistics system design program. This program is made in the WCF framework, with the combination of SOA and the actual characteristics of logistics enterprises, is simple to realize, easy to operate, and has strong expansion characteristic, therefore has high practical value.

Survey of Current Doctrine, Training, and Special Considerations for Military Operations on Urbanized Terrain (MOUT).

DTIC Science & Technology

1983-11-01

Securing and fortifying (a) Doors (b) Hallways (c) Stairs (d) Windows (e) Floors (f) Ceilings 3 (g) Unoccupied rooms (h) Basements (i) Upper floors...observed, the instructors were interviewed, and training K was assessed through administration of a multiple-choice test and a Perception of Training...instructing clearing procedures. It would provide the opportunity to both critique and practice, using one structure. A Perception of Training

Boussinesq Modeling for Inlets, Harbors & Structures (Bouss-2D)

DTIC Science & Technology

2014-10-27

subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 27...work applications. It may be used from deep to shallow water to simulate the nonlinear wave processes of interest in the open coast, nearshore zone...design, and operation of coastal navigation and flooding projects. It provides key engineering estimates for coastal and hydraulic engineering practice

40 CFR 63.11550 - What are my standards and management practices?

Code of Federal Regulations, 2013 CFR

2013-07-01

... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

40 CFR 63.11550 - What are my standards and management practices?

Code of Federal Regulations, 2012 CFR

2012-07-01

... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

40 CFR 63.11550 - What are my standards and management practices?

Code of Federal Regulations, 2011 CFR

2011-07-01

... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

40 CFR 63.11550 - What are my standards and management practices?

Code of Federal Regulations, 2014 CFR

2014-07-01

... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

40 CFR 63.11550 - What are my standards and management practices?

Code of Federal Regulations, 2010 CFR

2010-07-01

... of the management practices that they must follow. You may use your standard operating procedures as the management practices plan provided the standard operating procedures include the required... my standards and management practices? (a) If you own or operate new or existing affected sources at...

A ubiquitous reflective e-portfolio architecture.

PubMed

Forte, Marcos; de Souza, Wanderley L; da Silva, Roseli F; do Prado, Antonio F; Rodrigues, Jose F

2013-11-01

In nurse and in medicine courses, the use of reflective portfolios as a pedagogical tool is becoming a common practice; in the last years, this practice has gradually migrated from paper-based to electronic-based portfolios. Current approaches for reflective e-portfolios, however, do not widely operate at outdoor sites, where data networks are limited or nonexistent. Considering that many of the activities related to nurse and medicine courses relate to professional practices conducted in such conditions, these network shortcomings restrict the adoption of e-portfolios. The present study describes the requirements specification, design, implementation, and evaluation of the Ubiquitous Reflective E-Portfolio Architecture, a solution proposed to support the development of systems based on mobile and wired access for both online and offline operation. We have implemented a prototype named Professional Practice Module to evaluate the Ubiquitous Reflective E-Portfolio Architecture; the module was based on requirements observed during the professional practice, the paper-based portfolio in use, and related learning meetings in the Medicine Course of a Brazilian University. The evaluation of the system was carried out with a learning group of 2nd year students of the medicine course, who answered to extensive evaluation questionnaires. The prototype proved to be operational in the activities of the professional practice of the Medicine Course object of the study, including homework tasks, patient care, data sharing, and learning meetings. It also demonstrated to be versatile with respect to the availability of the computer network that, many times, was not accessible. Moreover, the students considered the module useful and easy to use, but pointed out difficulties about the keyboard and the display sizes of the netbook devices, and about their operational system. Lastly, most of the students declared preference for the electronic Professional Practice Module in internal and in group activities, and for the paper-based version while in patient attendance. There is evidence that the environment where the professional practice takes place influences the usage of the e-portfolio. Mobile devices were able to support students in their professional practice; however, these devices present characteristics that must be judiciously selected, otherwise, they may limit the execution of important tasks. The main shortcoming identified during the evaluation tests was about the use of the module, and of the access device, during patient attendance. For this reason, we have envisioned a new version of the Professional Practice Module that shall follow a twofold requisite: by one side, it will include all the features of the module, to be used at the university or in the students' homes; from the other side, it will include only the features that are essential for the practice of patient attendance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Cast Stone Formulation for Nuclear Waste Immobilization at Higher Sodium Concentrations

DOE PAGES

Fox, Kevin; Cozzi, Alex; Roberts, Kimberly; ...

2014-11-01

Low activity radioactive waste at U.S. Department of Energy sites can be immobilized for permanent disposal using cementitious waste forms. This study evaluated waste forms produced with simulated wastes at concentrations up to twice that of currently operating processes. The simulated materials were evaluated for their fresh properties, which determine processability, and cured properties, which determine waste form performance. The results show potential for greatly reducing the volume of material. Fresh properties were sufficient to allow for processing via current practices. Cured properties such as compressive strength meet disposal requirements. Leachability indices provide an indication of expected long-term performance.

Sterilization processes. Meeting the demands of today's health care technology.

PubMed

Crow, S

1993-09-01

Universal Precautions dictate sterilization for all invasive equipment that break the blood barrier; however, current methods of sterilization, such as steam and ethylene oxide gas (ETO), are not compatible with many of the delicate, heat-sensitive surgical instruments used in modern health care. In addition, traditional sterilization methods are often too time consuming for practical use in the operating room. Clearly, new sterilization processes need to be developed. In this article, the criteria modern sterilization processes must meet and how some manufacturers plan to meet this challenge are discussed. In addition, the pros and cons of using peracetic acid (the newest sterilization process currently available) are examined.

Alternative scenarios: harnessing mid-level providers and evidence-based practice in primary dental care in England through operational research.

PubMed

Wanyonyi, Kristina L; Radford, David R; Harper, Paul R; Gallagher, Jennifer E

2015-09-15

In primary care dentistry, strategies to reconfigure the traditional boundaries of various dental professional groups by task sharing and role substitution have been encouraged in order to meet changing oral health needs. The aim of this research was to investigate the potential for skill mix use in primary dental care in England based on the undergraduate training experience in a primary care team training centre for dentists and mid-level dental providers. An operational research model and four alternative scenarios to test the potential for skill mix use in primary care in England were developed, informed by the model of care at a primary dental care training centre in the south of England, professional policy including scope of practice and contemporary evidence-based preventative practice. The model was developed in Excel and drew on published national timings and salary costs. The scenarios included the following: "No Skill Mix", "Minimal Direct Access", "More Prevention" and "Maximum Delegation". The scenario outputs comprised clinical time, workforce numbers and salary costs required for state-funded primary dental care in England. The operational research model suggested that 73% of clinical time in England's state-funded primary dental care in 2011/12 was spent on tasks that may be delegated to dental care professionals (DCPs), and 45- to 54-year-old patients received the most clinical time overall. Using estimated National Health Service (NHS) clinical working patterns, the model suggested alternative NHS workforce numbers and salary costs to meet the dental demand based on each developed scenario. For scenario 1:"No Skill Mix", the dentist-only scenario, 81% of the dentists currently registered in England would be required to participate. In scenario 2: "Minimal Direct Access", where 70% of examinations were delegated and the primary care training centre delegation patterns for other treatments were practised, 40% of registered dentists and eight times the number of dental therapists currently registered would be required; this would save 38% of current salary costs cf. "No Skill Mix". Scenario 3: "More Prevention", that is, the current model with no direct access and increasing fluoride varnish from 13.1% to 50% and maintaining the same model of delegation as scenario 2 for other care, would require 57% of registered dentists and 4.7 times the number of dental therapists. It would achieve a 1% salary cost saving cf. "No Skill Mix". Scenario 4 "Maximum Delegation" where all care within dental therapists' jurisdiction is delegated at 100%, together with 50% of restorations and radiographs, suggested that only 30% of registered dentists would be required and 10 times the number of dental therapists registered; this scenario would achieve a 52% salary cost saving cf. "No Skill Mix". Alternative scenarios based on wider expressed treatment need in national primary dental care in England, changing regulations on the scope of practice and increased evidence-based preventive practice suggest that the majority of care in primary dental practice may be delegated to dental therapists, and there is potential time and salary cost saving if the majority of diagnostic tasks and prevention are delegated. However, this would require an increase in trained DCPs, including role enhancement, as part of rebalancing the dental workforce.

Deep Submarine Tailings Disposal (DSTP) the Proposed Use of Submarine Canyons and Artificial Turbidity Currents for the Disposal of Mine Waste: Current Practice, Future Plans, and Cumulative Impacts.

NASA Astrophysics Data System (ADS)

Young, R.; Moran, R.

2015-12-01

The wastes from mining operations ( tailings) have been disposed of in the fluvial environment (riverine disposal) and in nearshore marine environments for much of the last century. The scale of modern mining operations has led to increasing use of steep slopes and submarine canyons for deposition of these wastes at depths of 2000m - 4000m. Current mine disposal operations in Indonesia and Papua New Guinea which use Deep Sea Tailings Placement (DSTP) release volumes between 5000 tpd and 160,000 tpd. Planning is underway by the"Consortium," an industry and government group in Chile which would deposit mine waste of 1M tpd into the Humbolt Current Large Marine Ecosystem (HCLME) which provides nearly 20% of the fish biomass harvested on a sustainable basis worldwide. Underwater pipelines discharge tailings as a slurry to create a continuous artificial turbidity current with particle size distribtions (PSD's) ranging from sand to clay sized fractions. Potential problems arise from benthic smothering, angular particulate uptake by benthic organisms, and from the bioaccumulation of a complex of heavy metals by both benthic and pelagic species. While much is known about the binding of copper and other toxic heavy metals in a reducing environment, little has been done to consider the implications of ocean dumping where 1% of tailings discharged may consist of unrecovered heavy metals. Synergistic cumulative impacts to just the HCLME from the dumping of the more than 3M tpy of reactive metals in these tailings sediments remains unknown and poses substantial risks. DSTP assumes a stable deep sea depositional environment but upwelling currents and plume shear may make this hard to accomplish.

Microbial fuel cells as an alternative energy source: current status.

PubMed

Javed, Muhammad Mohsin; Nisar, Muhammad Azhar; Ahmad, Muhammad Usman; Yasmeen, Nighat; Zahoor, Sana

2018-06-22

Microbial fuel cell (MFC) technology is an emerging area for alternative renewable energy generation and it offers additional opportunities for environmental bioremediation. Recent scientific studies have focused on MFC reactor design as well as reactor operations to increase energy output. The advancement in alternative MFC models and their performance in recent years reflect the interests of scientific community to exploit this technology for wider practical applications and environmental benefit. This is reflected in the diversity of the substrates available for use in MFCs at an economically viable level. This review provides an overview of the commonly used MFC designs and materials along with the basic operating parameters that have been developed in recent years. Still, many limitations and challenges exist for MFC development that needs to be further addressed to make them economically feasible for general use. These include continued improvements in fuel cell design and efficiency as well scale-up with economically practical applications tailored to local needs.

Removal site evaluation report for the Isotope Facilities at Oak Ridge National Laboratory, Oak Ridge, Tennessee

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

NONE

This removal site evaluation (RmSE) report of the Isotope Facilities at Oak Ridge National Laboratory (ORNL) was prepared to provide the Environmental Restoration Program with information necessary to evaluate whether hazardous and/or radiological contaminants in and around the Isotopes Facility pose a substantial risk to human health or the environment and if remedial site evaluations (RSEs) or removal actions are required. The scope of the project included: (1) a review of historical evidence regarding operations and use of the facility; (2) interviews with facility personnel concerning current and past operating practices; (3) a site inspection; and (4) identification of hazardmore » areas requiring maintenance, removal, or remedial actions. The results of RmSE indicate that no substantial risks exist from contaminants present in the Isotope Facilities because adequate controls and practices exist to protect human health and the environment. The recommended correction from the RmSE are being conducted as maintenance actions; accordingly, this RmSE is considered complete and terminated.« less

Evaluation of Iron Loss in Interior Permanent Magnet Synchronous Motor with Consideration of Rotational Field

NASA Astrophysics Data System (ADS)

Ma, Lei; Sanada, Masayuki; Morimoto, Shigeo; Takeda, Yoji; Kaido, Chikara; Wakisaka, Takeaki

Loss evaluation is an important issue in the design of electrical machines. Due to the complicate structure and flux distribution, it is difficult to predict the iron loss in the machines exactly. This paper studies the iron loss in interior permanent magnet synchronous motors based on the finite element method. The iron loss test data of core material are used in the fitting of the hysteresis and eddy current loss constants. For motors in practical operation, additional iron losses due to the appearance of rotation of flux density vector and harmonic flux density distribution makes the calculation data deviates from the measured ones. Revision is made to account for these excess iron losses which exist in the practical operating condition. Calculation results show good consistence with the experimental ones. The proposed method provides a possible way to predict the iron loss of the electrical machine with good precision, and may be helpful in the selection of the core material which is best suitable for a certain machine.

Challenges to replicating evidence-based research in real-world settings: training African-American peers as patient navigators for colon cancer screening.

PubMed

Sly, Jamilia R; Jandorf, Lina; Dhulkifl, Rayhana; Hall, Diana; Edwards, Tiffany; Goodman, Adam J; Maysonet, Elithea; Azeez, Sulaiman

2012-12-01

Many cancer-prevention interventions have demonstrated effectiveness in diverse populations, but these evidenced-based findings slowly disseminate into practice. The current study describes the process of disseminating and replicating research (i.e., peer patient navigation for colonoscopy screening) in real-world settings. Two large metropolitan hospitals collaborated to replicate a peer patient navigation model within their existing navigation systems. Six African-American peer volunteers were recruited and trained to navigate patients through colonoscopy scheduling and completion. Major challenges included: (1) operating within multiple institutional settings; (2) operating within nonacademic/research infrastructures; (3) integrating into an established navigation system; (4) obtaining support of hospital staff without overburdening; and (5) competing priorities and time commitments. Bridging the gap between evidence-based research and practice is critical to eliminating many cancer health disparities; therefore, it is crucial that researchers and practitioners continue to work to achieve both diffusion and fusion of evidence-based findings. Recommendations for addressing these challenges are discussed.

Measuring the burden of herpes zoster and post herpetic neuralgia within primary care in rural Crete, Greece

PubMed Central

2011-01-01

Background Research has indicated that general practitioners (GPs) have good clinical judgment in regards to diagnosing and managing herpes zoster (HZ) within clinical practice in a country with limited resources for primary care and general practice. The objective of the current study was to assess the burden of HZ and post herpetic neuralgia (PHN) within rural general practices in Crete, Greece. Methods The current study took place within a rural setting in Crete, Greece during the period of November 2007 to November 2009 within the catchment area in which the Cretan Rural Practice-based Research Network is operating. In total 19 GP's from 14 health care units in rural Crete were invited to participate, covering a total turnover patient population of approximately 25, 000 subjects. For the purpose of this study an electronic record database was constructed and used as the main tool for monitoring HZ and PHN incidence. Stress related data was also collected with the use of the Short Anxiety Screening Test (SAST). Results The crude incidence rate of HZ was 1.4/1000 patients/year throughout the entire network of health centers and satellite practices, while among satellite practices alone it was calculated at 1.3/1000 patients/year. Additionally, the standardised incidence density within satellite practices was calculated at 1.6/1000 patients/year. In regards to the stress associated with HZ and PHN, the latter were found to have lower levels of anxiety, as assessed through the SAST score (17.4 ± 3.9 vs. 21.1 ± 5.7; p = 0.029). Conclusions The implementation of an electronic surveillance system was feasible so as to measure the burden of HZ and PHN within the rural general practice setting in Crete. PMID:22145678

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

Glosser, D.; Kutchko, B.; Benge, G.

Foamed cement is a critical component for wellbore stability. The mechanical performance of a foamed cement depends on its microstructure, which in turn depends on the preparation method and attendant operational variables. Determination of cement stability for field use is based on laboratory testing protocols governed by API Recommended Practice 10B-4 (API RP 10B-4, 2015). However, laboratory and field operational variables contrast considerably in terms of scale, as well as slurry mixing and foaming processes. Here in this paper, laboratory and field operational processes are characterized within a physics-based framework. It is shown that the “atomization energy” imparted by themore » high pressure injection of nitrogen gas into the field mixed foamed cement slurry is – by a significant margin – the highest energy process, and has a major impact on the void system in the cement slurry. There is no analog for this high energy exchange in current laboratory cement preparation and testing protocols. Quantifying the energy exchanges across the laboratory and field processes provides a basis for understanding relative impacts of these variables on cement structure, and can ultimately lead to the development of practices to improve cement testing and performance.« less

The new Waste Law: Challenging opportunity for future landfill operation in Indonesia.

PubMed

Meidiana, Christia; Gamse, Thomas

2011-01-01

The Waste Law No. 18/2008 Article 22 and 44 require the local governments to run environmentally sound landfill. Due to the widespread poor quality of waste management in Indonesia, this study aimed to identify the current situation by evaluating three selected landfills based on the ideal conditions of landfill practices, which are used to appraise the capability of local governments to adapt to the law. The results indicated that the local governments have problems of insufficient budget, inadequate equipment, uncollected waste and unplanned future landfill locations. All of the selected landfills were partially controlled landfills with open dumping practices predominating. In such inferior conditions the implementation of sanitary landfill is not necessarily appropriate. The controlled landfill is a more appropriate solution as it offers lower investment and operational costs, makes the selection of a new landfill site unnecessary and can operate with a minimum standard of infrastructure and equipment. The sustainability of future landfill capacity can be maintained by utilizing the old landfill as a profit-oriented landfill by implementing a landfill gas management or a clean development mechanism project. A collection fee system using the pay-as-you-throw principle could increase the waste income thereby financing municipal solid waste management.

NASA's Hall Thruster Program

NASA Technical Reports Server (NTRS)

Jankovsky, Robert S.; Jacobson, David T.; Rawlin, Vincent K.; Mason, Lee S.; Mantenieks, Maris A.; Manzella, David H.; Hofer, Richard R.; Peterson, Peter Y.

2001-01-01

NASA's Hall thruster program has base research and focused development efforts in support of the Advanced Space Transportation Program, Space-Based Program, and various other programs. The objective of the base research is to gain an improved understanding of the physical processes and engineering constraints of Hall thrusters to enable development of advanced Hall thruster designs. Specific technical questions that are current priorities of the base effort are: (1) How does thruster life vary with operating point? (2) How can thruster lifetime and wear rate be most efficiently evaluated? (3) What are the practical limitations for discharge voltage as it pertains to high specific impulse operation (high discharge voltage) and high thrust operation (low discharge voltage)? (4) What are the practical limits for extending Hall thrusters to very high input powers? and (5) What can be done during thruster design to reduce cost and integration concerns? The objective of the focused development effort is to develop a 50 kW-class Hall propulsion system, with a milestone of a 50 kW engineering model thruster/system by the end of program year 2006. Specific program wear 2001 efforts, along with the corporate and academic participation, are described.

From Hydroclimatic Prediction to Negotiated and Risk Managed Water Allocation and Reservoir Operation (Invited)

NASA Astrophysics Data System (ADS)

Lall, U.

2013-12-01

The availability of long lead climate forecasts that can in turn inform streamflow, agricultural, ecological and municipal/industrial and energy demands provides an opportunity for innovations in water resources management that go beyond the current practices and paradigms. In a practical setting, managers seek to meet registered demands as well as they can. Pricing mechanisms to manage demand are rarely invoked. Drought restrictions and operations are implemented as needed, and pressures from special interest groups are sometimes accommodated through a variety of processes. In the academic literature, there is a notion that demand curves for different sectors could be established and used for "optimal management". However, the few attempts to implement such ideas have invariably failed as elicitation of demand elasticity and socio-political factors is imperfect at best. In this talk, I will focus on what is worth predicting and for whom and how operational risks for the water system can be securitized while providing a platform for priced and negotiated allocation of the resources in the presence of imperfect forecasts. The possibility of a national or regional market for water contracts as part of the framework is explored, and its potential benefits and pitfalls identified.

Putting social impact assessment to the test as a method for implementing responsible tourism practice

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

McCombes, Lucy, E-mail: l.mccombes@leedsbeckett.ac.uk; Vanclay, Frank, E-mail: frank.vanclay@rug.nl; Evers, Yvette, E-mail: y.evers@tft-earth.org

The discourse on the social impacts of tourism needs to shift from the current descriptive critique of tourism to considering what can be done in actual practice to embed the management of tourism's social impacts into the existing planning, product development and operational processes of tourism businesses. A pragmatic approach for designing research methodologies, social management systems and initial actions, which is shaped by the real world operational constraints and existing systems used in the tourism industry, is needed. Our pilot study with a small Bulgarian travel company put social impact assessment (SIA) to the test to see if itmore » could provide this desired approach and assist in implementing responsible tourism development practice, especially in small tourism businesses. Our findings showed that our adapted SIA method has value as a practical method for embedding a responsible tourism approach. While there were some challenges, SIA proved to be effective in assisting the staff of our test case tourism business to better understand their social impacts on their local communities and to identify actions to take. - Highlights: • Pragmatic approach is needed for the responsible management of social impacts of tourism. • Our adapted Social impact Assessment (SIA) method has value as a practical method. • SIA can be embedded into tourism businesses existing ‘ways of doing things’. • We identified challenges and ways to improve our method to better suit small tourism business context.« less

Today's minimal requirements for a practical dental office infection control and exposure control program.

PubMed

Terezhalmy, G T; Gitto, C A

1998-10-01

The current climate in society regarding infectious diseases in general, and herpes, hepatitis, and HIV infections in particular, dictates that today's dental practices must use effective infection control techniques. The Occupational Safety and Health Administration continues to inspect, cite, and fine health care facilities. More states are implementing regulations concerning the operation of health care facilities. Patients are becoming more sophisticated in their scrutinizing of the dental and medical professions' approach to asepsis. Media coverage of exposure incidents is becoming more intense. All these factors leave dentists no choice; they must implement appropriate infection control techniques. The life-time cost of effective infection control is far less than one malpractice settlement. Implementation of an effective infection control program to promote dental asepsis can be cost-effective. In addition, it can be a practice builder.

Simulator Network Project Report: A tool for improvement of teaching materials and targeted resource usage in Skills Labs

PubMed Central

Damanakis, Alexander; Blaum, Wolf E.; Stosch, Christoph; Lauener, Hansjörg; Richter, Sabine; Schnabel, Kai P.

2013-01-01

During the last decade, medical education in the German-speaking world has been striving to become more practice-oriented. This is currently being achieved in many schools through the implementation of simulation-based instruction in Skills Labs. Simulators are thus an essential part of this type of medical training, and their acquisition and operation by a Skills Lab require a large outlay of resources. Therefore, the Practical Skills Committee of the Medical Education Society (GMA) introduced a new project, which aims to improve the flow of information between the Skills Labs and enable a transparent assessment of the simulators via an online database (the Simulator Network). PMID:23467581

Product-based Safety Certification for Medical Devices Embedded Software.

PubMed

Neto, José Augusto; Figueiredo Damásio, Jemerson; Monthaler, Paul; Morais, Misael

2015-01-01

Worldwide medical device embedded software certification practices are currently focused on manufacturing best practices. In Brazil, the national regulatory agency does not hold a local certification process for software-intensive medical devices and admits international certification (e.g. FDA and CE) from local and international industry to operate in the Brazilian health care market. We present here a product-based certification process as a candidate process to support the Brazilian regulatory agency ANVISA in medical device software regulation. Center of Strategic Technology for Healthcare (NUTES) medical device embedded software certification is based on a solid safety quality model and has been tested with reasonable success against the Class I risk device Generic Infusion Pump (GIP).

Design of a national distributed health data network.

PubMed

Maro, Judith C; Platt, Richard; Holmes, John H; Strom, Brian L; Hennessy, Sean; Lazarus, Ross; Brown, Jeffrey S

2009-09-01

A distributed health data network is a system that allows secure remote analysis of separate data sets, each comprising a different medical organization's or health plan's records. Distributed health data networks are currently being planned that could cover millions of people, permitting studies of comparative clinical effectiveness, best practices, diffusion of medical technologies, and quality of care. These networks could also support assessment of medical product safety and other public health needs. Distributed network technologies allow data holders to control all uses of their data, which overcomes many practical obstacles related to confidentiality, regulation, and proprietary interests. Some of the challenges and potential methods of operation of a multipurpose, multi-institutional distributed health data network are described.

Integrating emerging earth science technologies into disaster risk management: an enterprise architecture approach

NASA Astrophysics Data System (ADS)

Evans, J. D.; Hao, W.; Chettri, S. R.

2014-12-01

Disaster risk management has grown to rely on earth observations, multi-source data analysis, numerical modeling, and interagency information sharing. The practice and outcomes of disaster risk management will likely undergo further change as several emerging earth science technologies come of age: mobile devices; location-based services; ubiquitous sensors; drones; small satellites; satellite direct readout; Big Data analytics; cloud computing; Web services for predictive modeling, semantic reconciliation, and collaboration; and many others. Integrating these new technologies well requires developing and adapting them to meet current needs; but also rethinking current practice to draw on new capabilities to reach additional objectives. This requires a holistic view of the disaster risk management enterprise and of the analytical or operational capabilities afforded by these technologies. One helpful tool for this assessment, the GEOSS Architecture for the Use of Remote Sensing Products in Disaster Management and Risk Assessment (Evans & Moe, 2013), considers all phases of the disaster risk management lifecycle for a comprehensive set of natural hazard types, and outlines common clusters of activities and their use of information and computation resources. We are using these architectural views, together with insights from current practice, to highlight effective, interrelated roles for emerging earth science technologies in disaster risk management. These roles may be helpful in creating roadmaps for research and development investment at national and international levels.

Practice Guidelines for Operative Performance Assessments.

PubMed

Williams, Reed G; Kim, Michael J; Dunnington, Gary L

2016-12-01

To provide recommended practice guidelines for assessing single operative performances and for combining results of operative performance assessments into estimates of overall operative performance ability. Operative performance is one defining characteristic of surgeons. Assessment of operative performance is needed to provide feedback with learning benefits to surgical residents in training and to assist in making progress decisions for residents. Operative performance assessment has been a focus of investigation over the past 20 years. This review is designed to integrate findings of this research into a set of recommended operative performance practices. Literature from surgery and from other pertinent research areas (psychology, education, business) was reviewed looking for evidence to inform practice guideline development. Guidelines were created along with a conceptual and scientific foundation for each guideline. Ten guidelines are provided for assessing individual operative performances and 10 are provided for combing data from individual operative performances into overall judgments of operative performance ability. The practice guidelines organize available information to be immediately useful to program directors, to support surgical training, and to provide a conceptual framework upon which to build as the base of pertinent knowledge expands through future research and development efforts.

Fully Disposable Manufacturing Concepts for Clinical and Commercial Manufacturing and Ballroom Concepts.

PubMed

Boedeker, Berthold; Goldstein, Adam; Mahajan, Ekta

2017-11-04

The availability and use of pre-sterilized disposables has greatly changed the methods used in biopharmaceuticals development and production, particularly from mammalian cell culture. Nowadays, almost all process steps from cell expansion, fermentation, cell removal, and purification to formulation and storage of drug substances can be carried out in disposables, although there are still limitations with single-use technologies, particularly in the areas of pretesting and quality control of disposables, bag and connections standardization and qualification, extractables and leachables (E/L) validation, and dependency on individual vendors. The current status of single-use technologies is summarized for all process unit operations using a standard mAb process as an example. In addition, current pros and cons of using disposables are addressed in a comparative way, including quality control and E/L validation.The continuing progress in developing single-use technologies has an important impact on manufacturing facilities, resulting in much faster, less expensive and simpler plant design, start-up, and operation, because cell culture process steps are no longer performed in hard-piped unit operations. This leads to simpler operations in a lab-like environment. Overall it enriches the current landscape of available facilities from standard hard-piped to hard-piped/disposables hybrid to completely single-use-based production plants using the current segregation and containment concept. At the top, disposables in combination with completely and functionally closed systems facilitate a new, revolutionary design of ballroom facilities without or with much less segregation, which enables us to perform good manufacturing practice manufacturing of different products simultaneously in unclassified but controlled areas.Finally, single-use processing in lab-like shell facilities is a big enabler of transferring and establishing production in emergent countries, and this is described in more detail in 7. Graphical Abstract.

Bidirectional associations in multiplication memory: conditions of negative and positive transfer.

PubMed

Campbell, Jamie I D; Robert, Nicole D

2008-05-01

A variety of experimental evidence indicates that the memory representation for multiplication facts (e.g., 6 x 9 = 54) incorporates bidirectional links with a forward association from factors to product and a reverse association from product to factors. Surprisingly, the authors did not find evidence in Experiment 1 of facilitative transfer-of-practice from multiplication (6 x 9 = ?) to factoring (54 = ? x ?); in fact, multiplication practice produced item-specific interference with factoring. Similarly, the authors found no evidence in Experiment 2 that repetition of specific factoring problems (54 = ? x ?) facilitated performance of corresponding multiplication problems (6 x 9 = ?). In Experiment 3, participants practiced both multiplication and factoring and presented facilitative transfer in both directions. Thus, bidirectional facilitation occurred if both operations were practiced, but interference occurred when only one operation was practiced. We propose that this seemingly paradoxical behavior occurs because it is adaptive for the bidirectional retrieval structure to retain operational flexibility in the context of practicing both operations, whereas it is adaptive to specialize the memory representation for the practiced operation (i.e., factoring or multiplication) when only one operation is practiced.

Application of ERTS-1 data to the protection and management of New Jersey's coastal environment

NASA Technical Reports Server (NTRS)

Yunghans, R. S. (Principal Investigator); Feinberg, E. B.; Stitt, J. A.; Mairs, R. L.; Wobber, F. J.; Macomber, R. T.; Stanczuk, D. T.; Thibult, D.

1974-01-01

The author has identified the following significant results. Quasi-operational information products for coastal zone management have been prepared using ERTS-1 imagery and collateral aerial photography. These products were applied to the practical regulation, protection, and management of New Jersey's coastal environment. Procedures were developed for the operational use of ERTS-1 data products within New Jersey's Department of Environmental Protection. Successful analysis and product preparation for operational needs centered on four major coastal resource problem areas: (1) detection of environmental changes in coastal areas, (2) siting of ocean outfalls, (3) monitoring of offshore waste disposal, and (4) calculation of recession rates along the Atlantic Shore. The utility and monetary benefits derived from ERTS and aircraft imagery for each problem area have been determined. The NJDEP estimates the possibility of $620,000 yearly savings through the use of an operational ERTS system and a one-time savings of $2.8 million on current or planned projects if a truly operational ERTS type satellite were available.

Increasing operational command and control security by the implementation of device independent quantum key distribution

NASA Astrophysics Data System (ADS)

Bovino, Fabio Antonio; Messina, Angelo

2016-10-01

In a very simplistic way, the Command and Control functions can be summarized as the need to provide the decision makers with an exhaustive, real-time, situation picture and the capability to convey their decisions down to the operational forces. This two-ways data and information flow is vital to the execution of current operations and goes far beyond the border of military operations stretching to Police and disaster recovery as well. The availability of off-the shelf technology has enabled hostile elements to endanger the security of the communication networks by violating the traditional security protocols and devices and hacking sensitive databases. In this paper an innovative approach based to implementing Device Independent Quantum Key Distribution system is presented. The use of this technology would prevent security breaches due to a stolen crypto device placed in an end-to-end communication chain. The system, operating with attenuated laser, is practical and provides the increasing of the distance between the legitimate users.

Evaluation of a commercial system for CAMAC-based control of the Chalk River Laboratories tandem-accelerator-superconducting-cyclotron complexcomplex

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

Greiner, B.F.; Caswell, D.J.; Slater, W.R.

1992-04-01

This paper discusses the control system of the Tandem Accelerator Superconducting Cyclotron (TASCC) of AECL Research at its Chalk River Laboratories which is presently based on a PDP-11 computer and the IAS operating system. The estimated expense of a custom conversion of the system to a current, equivalent operating system is prohibitive. The authors have evaluated a commercial control package from VISTA Control Systems based on VAX microcomputers and the VMS operating system. Vsystem offers a modern, graphical operator interface, an extensive software toolkit for configuration of the system and a multi-feature data-logging capability, all of which far surpass themore » functionality of the present control system. However, the implementation of some familiar, practical features that TASCC operators find to be essential has proven to be challenging. The assessment of Vsystem, which is described in terms of presently perceived strengths and weaknesses, is, on balance, very positive.« less

Analysis of the current rib support practices and techniques in U.S. coal mines

PubMed Central

Mohamed, Khaled M.; Murphy, Michael M.; Lawson, Heather E.; Klemetti, Ted

2016-01-01

Design of rib support systems in U.S. coal mines is based primarily on local practices and experience. A better understanding of current rib support practices in U.S. coal mines is crucial for developing a sound engineering rib support design tool. The objective of this paper is to analyze the current practices of rib control in U.S. coal mines. Twenty underground coal mines were studied representing various coal basins, coal seams, geology, loading conditions, and rib control strategies. The key findings are: (1) any rib design guideline or tool should take into account external rib support as well as internal bolting; (2) rib bolts on their own cannot contain rib spall, especially in soft ribs subjected to significant load—external rib control devices such as mesh are required in such cases to contain rib sloughing; (3) the majority of the studied mines follow the overburden depth and entry height thresholds recommended by the Program Information Bulletin 11-29 issued by the Mine Safety and Health Administration; (4) potential rib instability occurred when certain geological features prevailed—these include draw slate and/or bone coal near the rib/roof line, claystone partings, and soft coal bench overlain by rock strata; (5) 47% of the studied rib spall was classified as blocky—this could indicate a high potential of rib hazards; and (6) rib injury rates of the studied mines for the last three years emphasize the need for more rib control management for mines operating at overburden depths between 152.4 m and 304.8 m. PMID:27648341

Peri-procedural protocols for interventional pain management techniques: a survey of US pain centers.

PubMed

Ahmed, Shihab U; Tonidandel, William; Trella, Jason; Martin, Nicole M; Chang, Yuchiao

2005-04-01

Interventional techniques are now an integral part of chronic pain management. As new procedures are arising at a rapid pace, decisions regarding patient safety and comfort are becoming more challenging. No peri-procedural consensus protocol currently addresses issues such as 1. nulla per os (NPO) status, 2. sedation, 3. monitoring, or 4. recovery. In establishing safety guidelines for interventional pain procedures, the knowledge of current peri-procedural protocols is required. To survey interventional pain practices and to obtain current peri-procedural protocols. We faxed a one-page questionnaire to 105 United States pain practices identified using the directory of the American Pain Society. Fifty-seven academic and private pain practices (54%) responded and were included in the analysis. Monitoring devices such as electrocardiogram (EKG), blood pressure, and pulse oximetry are not universally employed for cervical or lumbar spinal procedures. Even procedures that are often performed by anesthesiologists in operating rooms, such as Bier blocks, are not monitored in a uniform manner when performed in pain clinics. Establishment of intravenous access for procedures also varies among practitioners. Most (72%) practices had treated patients with vasovagal reactions over the past 12 months, but only 42% had simulated cardiac arrests to prepare for these situations. While various trends in peri-procedural care are observable, standards of care are not well established. In order to minimize complications associated with interventional pain management techniques, the pain management community should agree on safety guidelines for all procedures, much as these advocated by the American Society of Anesthesiology for surgical anesthetic care.

Learning to doctor: tinkering with visibility in residency training.

PubMed

Wallenburg, Iris; Bont, Antoinette; Heineman, Maas-Jan; Scheele, Fedde; Meurs, Pauline

2013-05-01

Medical doctors in teaching hospitals aim to serve the two central goals of patient care and medical training. Whereas patient care asks for experience, expertise and close supervision, medical training requires space to practise and the 'invisibility' of medical residents. Yet current reforms in postgraduate medical training point to an increasing emphasis on the measurable visibility of residents. Drawing on an ethnographic study of gynaecology training in The Netherlands, this article demonstrates that in daily clinical routines multiple practices of residents' visibility (visibilities) coexist. The article lists four visibilities: staging residents, negotiating supervision, playing the invisibility game and filming surgical operations. The article shows how attending physicians and medical residents tinker with these visibilities in daily clinical work to provide good care while enacting learning space, highlighting the increasing importance of visualising technologies in clinical work. Moreover, the article contributes to traditional sociological accounts on medical education, shifting the focus from medical education as a social institution to the practices of medical training itself. Such a focus on practice helps to gain an understanding of how the current reform challenges clinicians' educational activities. © 2012 The Authors. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

An optimization framework for workplace charging strategies

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

Huang, Yongxi; Zhou, Yan

2015-03-01

The workplace charging (WPC) has been recently recognized as the most important secondary charging point next to residential charging for plug-in electric vehicles (PEVs). The current WPC practice is spontaneous and grants every PEV a designated charger, which may not be practical or economic when there are a large number of PEVs present at workplace. This study is the first research undertaken that develops an optimization framework for WPC strategies to satisfy all charging demand while explicitly addressing different eligible levels of charging technology and employees’ demographic distributions. The optimization model is to minimize the lifetime cost of equipment, installations,more » and operations, and is formulated as an integer program. We demonstrate the applicability of the model using numerical examples based on national average data. The results indicate that the proposed optimization model can reduce the total cost of running a WPC system by up to 70% compared to the current practice. The WPC strategies are sensitive to the time windows and installation costs, and dominated by the PEV population size. The WPC has also been identified as an alternative sustainable transportation program to the public transit subsidy programs for both economic and environmental advantages.« less

Estimating the Effects of Climate Change on Federal Hydropower and Power Marketing

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

Sale, Michael J; Kao, Shih-Chieh; Uria Martinez, Rocio

The U.S. Department of Energy is currently preparing an assessment of the effects of climate change on federal hydropower, as directed by Congress in Section 9505 of the Secure Water Act of 2009 (P.L. 111-11). This paper describes the assessment approach being used in a Report to Congress currently being prepared by Oak Ridge National Laboratory. The 9505 assessment will examine climate change effects on water available for hydropower operations and the future power supplies marketed from federal hydropower projects. It will also include recommendations from the Power Marketing Administrations (PMAs) on potential changes in operation or contracting practices thatmore » could address these effects and risks of climate change. Potential adaption and mitigation strategies will also be identified. Federal hydropower comprises approximately half of the U.S. hydropower portfolio. The results from the 9505 assessment will promote better understanding among federal dam owners/operators of the sensitivity of their facilities to water availability, and it will provide a basis for planning future actions that will enable adaptation to climate variability and change. The end-users of information are Congressional members, their staff, the PMAs and their customers, federal dam owners/operators, and the DOE Water Power Program.« less

Variation in Perfusion Strategies for Neonatal and Infant Aortic Arch Repair: Contemporary Practice in the STS Congenital Heart Surgery Database.

PubMed

Meyer, David B; Jacobs, Jeffrey P; Hill, Kevin; Wallace, Amelia S; Bateson, Brian; Jacobs, Marshall L

2016-09-01

Regional cerebral perfusion (RCP) is used as an adjunct or alternative to deep hypothermic circulatory arrest (DHCA) for neonates and infants undergoing aortic arch repair. Clinical studies have not demonstrated clear superiority of either strategy, and multicenter data regarding current use of these strategies are lacking. We sought to describe the variability in contemporary practice patterns for use of these techniques. The Society of Thoracic Surgeons Congenital Heart Surgery Database (2010-2013) was queried to identify neonates and infants whose index operation involved aortic arch repair with cardiopulmonary bypass. Perfusion strategy was classified as isolated DHCA, RCP (with less than or equal to ten minutes of DHCA), or mixed (RCP with more than ten minutes of DHCA). Data were analyzed for the entire cohort and stratified by operation subgroups. Overall, 4,523 patients (105 centers) were identified; median age seven days (interquartile range: 5.0-13.0). The most prevalent perfusion strategy was RCP (43%). Deep hypothermic circulatory arrest and mixed perfusion accounted for 32% and 16% of cases, respectively. In all, 59% of operations involved some period of RCP. Regional cerebral perfusion was the most prevalent perfusion strategy for each operation subgroup. Neither age nor weight was associated with perfusion strategy, but reoperations were less likely to use RCP (31% vs 45%, P < .001). The combined duration of RCP and DHCA in the RCP group was longer than the DHCA time in the DHCA group (45 vs 36 minutes, P < .001). There is considerable variability in practice regarding perfusion strategies for arch repair in neonates and infants. In contemporary practice, RCP is the most prevalent perfusion strategy for these procedures. Use of DHCA is also common. Further investigation is warranted to ascertain possible relative merits of the various perfusion techniques. © The Author(s) 2016.

Best Practices for Operations of Satellite Constellations

NASA Technical Reports Server (NTRS)

Howard, Joseph; Oza, Dipak; Smith, Danford S.

2006-01-01

This paper presents the best practices used by several commercial and government operators of satellite constellations. These best practices were identified through a series of seminars and discussions held at NASA Goddard Space Flight Center (GSFC). The best practices are arrived through many years of experience and improvements made in the operations procedures and the operational systems with the primary drivers as mission safety and cost effectiveness. This paper discusses the operational aspects associated with how different organizations manage complexities of constellation operations. For the purposes of this paper, satellite constellations are groups of similar spacecraft with more than one spacecraft needed to fully accomplish the constellation's mission

Texas entry-year agriculture teachers' perceptions, practices, and preparation regarding safety and health in agricultural education.

PubMed

Hubert, D J; Ullrich, D R; Murphy, T H; Lindner, J R

2001-08-01

The purpose of this study was to gather benchmark data for the assessment of the knowledge, attitudes, and perceptions regarding agricultural safety issues and curricula held by Texas agricultural teachers with less than two full years of teaching experience (entry-year teachers). Seventy-four of 118 well-distributed teachers responded to this survey. Researchers concluded that more females were entering a traditionally male-dominated field. Overall, teachers addressed safety within units of instruction rather than as separate units. The most useful forms of new teaching resources that this group of teachers would like to see produced were safety videos and study guides, and class demonstration/simulation activities. There was a significant difference in rankings between teachers less than 26 years old and teachers more than 26 years old regarding the usefulness of transparencies as a new teaching resource (F = 5.00, p = 0.0268). Few teachers were currently CPR and first aid certified, even though most had received training and completed a general safety and/or health related course while in college. Teachers generally agreed philosophically with most practices and exhibited personal beliefs consistent with proper safety preparedness and practice in agricultural settings. However, many of these teachers failed to practice what was expected of safe tractor operators, such as wearing safety belts and allowing younger drivers to operate the equipment.

Implications of leading crop production practices on environmental quality and human health.

PubMed

Udeigwe, Theophilus K; Teboh, Jasper M; Eze, Peter N; Stietiya, M Hashem; Kumar, Vipan; Hendrix, James; Mascagni, Henry J; Ying, Teng; Kandakji, Tarek

2015-03-15

Globally, much weight is currently being placed on agriculture to provide food for the growing population as well as feedstock for the bioenergy industry. Unfortunately, the intensification of agricultural operations to satisfy these growing needs has been associated with a number of environmental and human health risks. A review of publications on the subject was conducted and emphasis was placed on articles focusing on agriculture, environment, and public health as well as their interactions. Supporting information was also gathered from publications of various agricultural and environmental agencies. Agricultural practices with potential negative implications on the environment and human health were identified broadly as: (a) utilization of biosolids and animal manures, (b) use of agricultural chemicals, (c) management of post-harvest residue, (d) irrigation, and (e) tillage operations. Soil, water, and air contamination by nutrients, heavy metals, pathogens, and pesticides, as well as air contamination by particulate matters, noxious gases, and pathogens were among the leading environmental impacts. Some of the human-health impacts identified included neurological and reproductive defects, cardiovascular risks, cancers and other diseases (of kidney, liver, lung, and skin), skin allergies, gastroenteritis, and methemoglobinemia. Continual awareness on the impacts of the reviewed agricultural practices on environmental quality and human health and the implementation of experimentally-backed best management practices in agricultural systems remain indispensable. Copyright © 2014 Elsevier Ltd. All rights reserved.

Feasibility and costs of phosphorus application limits on 39 U.S. swine operations.

PubMed

Lory, John A; Massey, Raymond E; Zulovich, Joseph M; Hoehne, John A; Schmidt, Amy M; Carlson, Marcia S; Fulhage, Charles D

2004-01-01

Concerns about manure P and water quality have prompted new regulations imposing P limits on land application of manure. Previous research established that P limits increase land needs for animal feeding operations. We evaluated the effect of N, annual P, and rotation P limits on the feasibility of manure management. A mechanistic model characterized manure management practices on 39 swine operations (20 unagitated lagoon and 19 slurry operations) in five states (Iowa, Missouri, North Carolina, Oklahoma, and Pennsylvania). Extensive information collected from each operation was used to determine effects of manure storage type, ownership structure, and application limits on attributes of manure management. Phosphorus limits had substantially greater effect on slurry operations, increasing land needs 250% (0.3 hectares per animal unit [AU]) and time for manure application 24% (2.5 min AU(-1)) for rotation P limits and 41% (4.4 min AU(-1)) for annual P limits. Annual P limits were infeasible for current land application equipment on two operations and had the greatest effect on time and costs because they required all but three slurry operations to reduce discharge rate. We recommend implementing rotation P limits (not to exceed crop N need) to minimize time effects, allow most farmers to use their current manure application methods, and allow manure to fulfill crop N and P needs in the year of application. Phosphorus limits increased potential manure value but would require slurry operations to recover at least 61% of manure value through manure sales. Phosphorus limits are likely to shape the U.S. swine industry through differential effects on the various sectors of the swine industry.

Update on combat psychiatry: from the battle front to the home front and back again.

PubMed

Ritchie, Elspeth Cameron

2007-12-01

The U.S. military has long emphasized the principles of prevention and early intervention in preparing for and treating those afflicted by the psychological wounds of war. This article opens with lessons learned by the U.S. military through wartime during the past century. Current practice in the military's employment of stress control teams is reviewed. Updates in the military efforts in Operation Iraqi Freedom and Operation Enduring Freedom to prevent and to limit psychological casualties are stressed. Misconduct has occurred in this conflict; future steps to reduce aberrant behavior by soldiers are discussed. The challenges of reintegration at home, by both healthy and wounded soldiers, are highlighted.

Jet engine exhaust emissions of high altitude commercial aircraft projected to 1990

NASA Technical Reports Server (NTRS)

Grobman, J.; Ingebo, R. D.

1974-01-01

Projected minimum levels of engine exhaust emissions that may be practicably achievable for future commercial aircraft operating at high-altitude cruise conditions are presented. The forecasts are based on:(1) current knowledge of emission characteristics of combustors and augmentors; (2) the status of combustion research in emission reduction technology; and (3) predictable trends in combustion systems and operating conditions as required for projected engine designs that are candidates for advanced subsonic or supersonic commercial aircraft fueled by either JP fuel, liquefied natural gas, or hydrogen. Results are presented for cruise conditions in terms of both an emission index (g constituent/kg fuel) and an emission rate (g constituent/hr).

Liquid rocket booster study. Volume 2, book 3, appendices 2-5: PPIP, transition plan, AMOS plan, and environmental analysis

NASA Technical Reports Server (NTRS)

1988-01-01

This Preliminary Project Implementation Plan (PPIP) was used to examine the feasibility of replacing the current Solid Rocket Boosters on the Space Shuttle with Liquid Rocket Boosters (LRBs). The need has determined the implications of integrating the LRB with the Space Transportation System as the earliest practical date. The purpose was to identify and define all elements required in a full scale development program for the LRB. This will be a reference guide for management of the LRB program, addressing such requirement as design and development, configuration management, performance measurement, manufacturing, product assurance and verification, launch operations, and mission operations support.

Site remediation techniques in India: a review

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

Anomitra Banerjee; Miller Jothi

India is one of the developing countries operating site remediation techniques for the entire nuclear fuel cycle waste for the last three decades. In this paper we intend to provide an overview of remediation methods currently utilized at various hazardous waste sites in India, their advantages and disadvantages. Over the years the site remediation techniques have been well characterized and different processes for treatment, conditioning and disposal are being practiced. Remediation Methods categorized as biological, chemical or physical are summarized for contaminated soils and environmental waters. This paper covers the site remediation techniques implemented for treatment and conditioning of wastelandsmore » arising from the operation of nuclear power plant, research reactors and fuel reprocessing units. (authors)« less

Federal role in dental public health: dental care for special populations.

PubMed

Reifel, Nancy

2005-07-01

California is home to more than 70 dental clinics operated or funded by the U.S. government. They operate on annual appropriations from Congress to serve a specific population and regulations that specify the type of dental services provided are usually promulgated at the national level. Dental clinics have the challenge of creating a program that delivers high-quality care within these financial and programmatic constraints. In California, U.S. government appropriations are the main source of funding dental clinics of immigration services, the Veterans Administration, the Bureau of Prisons, the Coast Guard, and American Indian clinics. The evolution and current practices of these five dental public health programs are described.

Management practices associated with stress in cattle on western Canadian cow-calf operations: A mixed methods study.

PubMed

Moggy, M A; Pajor, E A; Thurston, W E; Parker, S; Greter, A M; Schwartzkopf-Genswein, K S; Campbell, J R; Windeyer, M C

2017-04-01

Handling, weaning, and euthanasia are some of the most stressful practices performed on cow-calf operations. Although strategies to minimize stress exist, their use on western Canadian cow-calf operations is unknown. The objectives were to describe current stress-associated practices on western Canadian cow-calf operations, describe producer and operation demographics associated with the use of nonabrupt weaning methods, and explore producer perceptions toward these practices. A questionnaire focusing on stressful management practices was delivered to 109 cow-calf producers in western Canada. Fifteen respondents were purposively selected for individual interviews. The majority of producers reported calves less than 1 wk of age were handled by manual restraint (87%) and those older than 1 wk of age were handled using a cattle squeeze or table. Most producers performed abrupt weaning (70%). Interviewees often mentioned that cost and logistics were major factors in deciding on a weaning strategy. Pasture availability and facilities were viewed as constraints toward the adoption of a nonabrupt weaning method. Animal stress was considered, as producers expressed concern that nonabrupt weaning methods may cause increased stress because of the additional handling required. Producers conveyed that animal age was a major factor that impacted weaning stress and that improved animal performance might motivate them to adopt a nonabrupt weaning strategy. Producers also expressed reluctance to change previously successful traditional approaches. Of respondents, 13% did not euthanize cattle on farm and 8% did not confirm death. Producers interviewed reported that the decision to euthanize cattle on farm was difficult and that veterinary advice was often considered. Factors that influenced their decision to euthanize included the animal's likelihood of recovery and degree of pain and distress. Finally, producers explained that they considered whether the animal was salvageable and able to be transported. Identification of common methods of handling provides focus for future research to determine optimal handling strategies. Identified barriers to nonabrupt weaning may be addressed through research, extension, or policy to encourage the adoption of weaning methods that could improve animal welfare. Confirmation of death after euthanasia was identified as an area that needs to be addressed by producer education to minimize animal stress during on-farm euthanasia.

Reconstruction and systemization of the methodologies for strategic environmental assessment in Taiwan

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

Liou, M.-L.; Yeh, S.-C.; Yu, Y.-H.

2006-03-15

This paper discusses the current SEA procedures and assessment methodologies, aiming to propose strategies that can lead to effective improvement in a newly industrialized Asian country, Taiwan. Institutional and practical problems with regard to the regulations and tools of SEA in Taiwan are compared to those in other countries. According to the research results, it is suggested that extra evaluation processes should be incorporated into the current assessment procedures to improve their scientific validity and integrity. Moreover, it is also suggested that the sustainability appraisal approaches be included in the SEA framework. In this phase, revised evaluation indicators associated withmore » corresponding targets can be the first attempt for modifying the SEA system. It is believed that these can promote the operability in practice and also lead the whole assessment procedures to a direction closer to sustainable development. The trails that Taiwan has followed can help other countries that are going to adopt SEA to find a more effective and efficient way to follow.« less

Research gaps related to forest management and stream sediment in the United States.

PubMed

Anderson, Christopher J; Lockaby, B Graeme

2011-02-01

Water quality from forested landscapes tends to be very high but can deteriorate during and after silvicultural activities. Practices such as forest harvesting, site preparation, road construction/use, and stream crossings have been shown to contribute sediment, nutrients, and other pollutants to adjacent streams. Although advances in forest management accompanied with Best Management Practices (BMPs) have been very effective at reducing water quality impacts from forest operations, projected increases in demand for forest products may result in unintended environmental degradation. Through a review of the pertinent literature, we identified several research gaps related to water yield, aquatic habitat, sediment source and delivery, and BMP effectiveness that should be addressed for streams in the United States to better understand and address the environmental ramifications of current and future levels of timber production. We explored the current understanding of these topics based on relevant literature and the possible implications of increased demand for forest products in the United States.

A comparative assessment of waste incinerators in the UK.

PubMed

Nixon, J D; Wright, D G; Dey, P K; Ghosh, S K; Davies, P A

2013-11-01

The uptake in Europe of Energy from Waste (EfW) incinerator plants has increased rapidly in recent years. In the UK, 25 municipal waste incinerators with energy recovery are now in operation; however, their waste supply chains and business practices vary significantly. With over a hundred more plant developments being considered it is important to establish best business practices for ensuring efficient environmental and operational performance. By reviewing the 25 plants we identify four suitable case study plants to compare technologies (moving grate, fluidised bed and rotary kiln), plant economics and operations. Using data collected from annual reports and through interviews and site visits we provide recommendations for improving the supply chain for waste incinerators and highlight the current issues and challenges faced by the industry. We find that plants using moving grate have a high availability of 87-92%. However, compared to the fluidised bed and rotary kiln, quantities of bottom ash and emissions of hydrogen chloride and carbon monoxide are high. The uptake of integrated recycling practices, combined heat and power, and post incineration non-ferrous metal collections needs to be increased among EfW incinerators in the UK. We conclude that one of the major difficulties encountered by waste facilities is the appropriate selection of technology, capacity, site, waste suppliers and heat consumers. This study will be of particular value to EfW plant developers, government authorities and researchers working within the sector of waste management. Copyright © 2013 Elsevier Ltd. All rights reserved.

Transatlantic Current. Number 7. October 2012. Building Future Transatlantic Interoperability Around a Robust NATO Response Force

DTIC Science & Technology

2012-10-01

inss short, multinational skills have reached an all time high, though there is more road ahead than already traveled . However, this accrued wealth of...training centers such as the bilateral U.S.- Romanian Joint Task Force– East at Kogalniceanu Airbase Romania. Stand up a U.S. Corps Forward Element in...which facilitates practical cooperation downstream, either within NATO or in any coalition operations. Increase U.S. and Allied Exchange Students

Use or abuse of computers in the workplace.

PubMed

Gregg, Robert E

2007-01-01

Is your computer system about to become your next liability by the misuse of computers in the workplace? "E-discovery" reveals evidence of harassment, discrimination, defamation, and more. Yet employees also sue when the employer improperly intercepts electronic messages the employees claim were "private." Employers need to be aware of the issues of use, misuse, and rights to properly monitor and control the electronic system. Learn the current issues, legal trends, and practical pointers for your electronic operations.

Research in Intelligent Automata (Phase I)

DTIC Science & Technology

1964-04-29

results , major practical problems will not be overlooked, costs of real solutions may be assessed, and the operating models can also serve a major purpose...demonstration(s). In any case , the total cost of the equipments in these categories should be held to only a small fraction of the cost of all of the...number of factors , including ( I) Storage capaci ty required (2) Response time required (3) Current avai labi Ii ty and cost of associa ti ve

US Interagency Regional Foreign Policy Implementation: A Survey of Current Practice and an Analysis of Options for Improvement

DTIC Science & Technology

2014-06-01

Culture 143 Congressional Support and Legislation 144 What If There Is No Appetite for Interagency Reform? 148 Appendix Interagency Reform at the... environmental disasters. Humanitarian and military operations will often depend on access rights in many different countries.”3 As US foreign policy...dination. However, because the JIACG is located in one agency (the DOD) and has no presidential directive or legislative sanction, other agencies are

Design Guidelines and Criteria for User/Operator Transactions with Battlefield Automated Systems. Volume 5. Background Literature

DTIC Science & Technology

1981-02-01

the machine . ARI’s efforts in this area focus on human perfor- mance problems related to interactions with command and control centers, and on issues...improvement of the user- machine interface. Lacking consistent design principles, current practice results in a fragmented and unsystematic approach to system...complexity in the user- machine interface of BAS, ARI supported this effort for develop- me:nt of an online language for Army tactical intelligence

Bringing High-Rate, CO2-Based Microbial Electrosynthesis Closer to Practical Implementation through Improved Electrode Design and Operating Conditions.

PubMed

Jourdin, Ludovic; Freguia, Stefano; Flexer, Victoria; Keller, Jurg

2016-02-16

The enhancement of microbial electrosynthesis (MES) of acetate from CO2 to performance levels that could potentially support practical implementations of the technology must go through the optimization of key design and operating conditions. We report that higher proton availability drastically increases the acetate production rate, with pH 5.2 found to be optimal, which will likely suppress methanogenic activity without inhibitor addition. Applied cathode potential as low as -1.1 V versus SHE still achieved 99% of electron recovery in the form of acetate at a current density of around -200 A m(-2). These current densities are leading to an exceptional acetate production rate of up to 1330 g m(-2) day(-1) at pH 6.7. Using highly open macroporous reticulated vitreous carbon electrodes with macropore sizes of about 0.6 mm in diameter was found to be optimal for achieving a good balance between total surface area available for biofilm formation and effective mass transfer between the bulk liquid and the electrode and biofilm surface. Furthermore, we also successfully demonstrated the use of a synthetic biogas mixture as carbon dioxide source, yielding similarly high MES performance as pure CO2. This would allow this process to be used effectively for both biogas quality improvement and conversion of the available CO2 to acetate.

Clinical guidelines and practice: in search of the truth.

PubMed

Kereiakes, Dean J; Antman, Elliott M

2006-09-19

Data from randomized clinical trials, non-randomized studies, and registries, as well as expert panel consensus are appropriately weighted and woven into the context of clinical practice guidelines. Recent guidelines for the care of patients with ischemic heart disease have emphasized both risk stratification and early coronary angiography with revascularization of patients with high-risk indicators. Advances in our understanding of the pathogenesis of acute coronary syndromes and the dynamics of therapeutic innovation (improvement in catheter-based technologies and adjunctive pharmacotherapy) mandate the timely update and revision of practice guidelines. We believe that the weight of evidence remains clearly in support of an early invasive treatment strategy based on risk stratification. Arguments regarding treatment strategy (invasive vs. conservative) are misguided, and greater focus should be placed on improving the treatment-risk paradox demonstrated in clinical practice as well as on strategies to enhance current guideline compliance and utilization. Interest exists in establishing regional centers of excellence for care of patients with acute ischemic heart disease, analogous to the regionalized approach already established for patients with trauma or stroke. This approach is supported by data that demonstrate an inverse relationship between both institutional and operator procedural volumes and mortality, as well as by existing constraints in resources such as specialized nurses and subspecialty-trained physicians. It is appropriate at this time to briefly review specific aspects of the American College of Cardiology/American Heart Association practice guidelines and the current process of care for acute ischemic heart disease.

Incorporation of quality updates for JPSS CGS Products

NASA Astrophysics Data System (ADS)

Cochran, S.; Grant, K. D.; Ibrahim, W.; Brueske, K. F.; Smit, P.

2016-12-01

NOAA's next-generation environmental satellite, the Joint Polar Satellite System (JPSS) replaces the current Polar-orbiting Operational Environmental Satellites (POES). JPSS satellites carry sensors which collect meteorological, oceanographic, climatological, and solar-geophysical observations of the earth, atmosphere, and space. The first JPSS satellite was launched in 2011 and is currently NOAA's primary operational polar satellite. The JPSS ground system is the Common Ground System (CGS), and provides command, control, and communications (C3) and data processing (DP). A multi-mission system, CGS provides combinations of C3/DP for numerous NASA, NOAA, DoD, and international missions. In preparation for the next JPSS satellite, CGS improved its multi-mission capabilities to enhance mission operations for larger constellations of earth observing satellites with the added benefit of streamlining mission operations for other NOAA missions. This paper will discuss both the theoretical basis and the actual practices used to date to identify, test and incorporate algorithm updates into the CGS processing baseline. To provide a basis for this support, Raytheon developed a theoretical analysis framework, and the application of derived engineering processes, for the maintenance of consistency and integrity of remote sensing operational algorithm outputs. The framework is an abstraction of the operationalization of the science-grade algorithm (Sci2Ops) process used throughout the JPSS program. By combining software and systems engineering controls, manufacturing disciplines to detect and reduce defects, and a standard process to control analysis, an environment to maintain operational algorithm maturity is achieved. Results of the use of this approach to implement algorithm changes into operations will also be detailed.

Methods and Tools for Product Quality Maintenance in JPSS CGS

NASA Astrophysics Data System (ADS)

Cochran, S.; Smit, P.; Grant, K. D.; Jamilkowski, M. L.

2015-12-01

NOAA's next-generation environmental satellite, the Joint Polar Satellite System (JPSS) replaces the current Polar-orbiting Operational Environmental Satellites (POES). JPSS satellites carry sensors which collect meteorological, oceanographic, climatological, and solar-geophysical observations of the earth, atmosphere, and space. The first JPSS satellite was launched in 2011 and is currently NOAA's primary operational polar satellite. The JPSS ground system is the Common Ground System (CGS), and provides command, control, and communications (C3) and data processing (DP). A multi-mission system, CGS provides combinations of C3/DP for numerous NASA, NOAA, DoD, and international missions. In preparation for the next JPSS satellite, CGS improved its multi-mission capabilities to enhance mission operations for larger constellations of earth observing satellites with the added benefit of streamlining mission operations for other NOAA missions. This paper will discuss both the theoretical basis and the actual practices used to date to identify, test and incorporate algorithm updates into the CGS processing baseline. To provide a basis for this support, Raytheon developed a theoretical analysis framework, and the application of derived engineering processes, for the maintenance of consistency and integrity of remote sensing operational algorithm outputs. The framework is an abstraction of the operationalization of the science-grade algorithm (Sci2Ops) process used throughout the JPSS program. By combining software and systems engineering controls, manufacturing disciplines to detect and reduce defects, and a standard process to control analysis, an environment to maintain operational algorithm maturity is achieved. Results of the use of this approach to implement algorithm changes into operations will also be detailed.

Accounting for human neurocognitive function in the design and evaluation of 360 degree situational awareness display systems

NASA Astrophysics Data System (ADS)

Metcalfe, Jason S.; Mikulski, Thomas; Dittman, Scott

2011-06-01

The current state and trajectory of development for display technologies supporting information acquisition, analysis and dissemination lends a broad informational infrastructure to operators of complex systems. The amount of information available threatens to outstrip the perceptual-cognitive capacities of operators, thus limiting their ability to effectively interact with targeted technologies. Therefore, a critical step in designing complex display systems is to find an appropriate match between capabilities, operational needs, and human ability to utilize complex information. The present work examines a set of evaluation parameters that were developed to facilitate the design of systems to support a specific military need; that is, the capacity to support the achievement and maintenance of real-time 360° situational awareness (SA) across a range of complex military environments. The focal point of this evaluation is on the reciprocity native to advanced engineering and human factors practices, with a specific emphasis on aligning the operator-systemenvironment fit. That is, the objective is to assess parameters for evaluation of 360° SA display systems that are suitable for military operations in tactical platforms across a broad range of current and potential operational environments. The approach is centered on five "families" of parameters, including vehicle sensors, data transmission, in-vehicle displays, intelligent automation, and neuroergonomic considerations. Parameters are examined under the assumption that displays designed to conform to natural neurocognitive processing will enhance and stabilize Soldier-system performance and, ultimately, unleash the human's potential to actively achieve and maintain the awareness necessary to enhance lethality and survivability within modern and future operational contexts.

Building Consensus: Development of Best Practice Guidelines on Wrong Level Surgery in Spinal Deformity.

PubMed

Vitale, Michael; Minkara, Anas; Matsumoto, Hiroko; Albert, Todd; Anderson, Richard; Angevine, Peter; Buckland, Aaron; Cho, Samuel; Cunningham, Matthew; Errico, Thomas; Fischer, Charla; Kim, Han Jo; Lehman, Ronald; Lonner, Baron; Passias, Peter; Protopsaltis, Themistocles; Schwab, Frank; Lenke, Lawrence

Consensus-building using the Delphi and nominal group technique. To establish best practice guidelines using formal techniques of consensus building among a group of experienced spinal deformity surgeons to avert wrong-level spinal deformity surgery. Numerous previous studies have demonstrated that wrong-level spinal deformity occurs at a substantial rate, with more than half of all spine surgeons reporting direct or indirect experience operating on the wrong levels. Nevertheless, currently, guidelines to avert wrong-level spinal deformity surgery have not been developed. The Delphi process and nominal group technique were used to formally derive consensus among 16 fellowship-trained spine surgeons. Surgeons were surveyed for current practices, presented with the results of a systematic review, and asked to vote anonymously for or against item inclusion during three iterative rounds. Agreement of 80% or higher was considered consensus. Items near consensus (70% to 80% agreement) were probed in detail using the nominal group technique in a facilitated group meeting. Participants had a mean of 13.4 years of practice (range: 2-32 years) and 103.1 (range: 50-250) annual spinal deformity surgeries, with a combined total of 24,200 procedures. Consensus was reached for the creation of best practice guidelines (BPGs) consisting of 17 interventions to avert wrong-level surgery. A final checklist consisting of preoperative and intraoperative methods, including standardized vertebral-level counting and optimal imaging criteria, was supported by 100% of participants. We developed consensus-based best practice guidelines for the prevention of wrong-vertebral-level surgery. This can serve as a tool to reduce the variability in preoperative and intraoperative practices and guide research regarding the effectiveness of such interventions on the incidence of wrong-level surgery. Level V. Copyright © 2017 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

Electric thruster research

NASA Technical Reports Server (NTRS)

Kaufman, H. R.; Robinson, R. S.

1982-01-01

It has been customary to assume that ions flow nearly equally in all directions from the ion production region within an electron-bombardment discharge chamber. In general, the electron current through a magnetic field can alter the electron density, and hence the ion density, in such a way that ions tend to be directed away from the region bounded by the magnetic field. When this mechanism is understood, it becomes evident that many past discharge chamber designs have operated with a preferentially directed flow of ions. Thermal losses were calculated for an oxide-free hollow cathode. At low electron emissions, the total of the radiation and conduction losses agreed with the total discharge power. At higher emissions, though, the plasma collisions external to the cathode constituted an increasingly greater fraction of the discharge power. Experimental performance of a Hall-current thruster was adversely affected by nonuniformities in the magnetic field, produced by the cathode heating current. The technology of closed-drift thrusters was reviewed. The experimental electron diffusion in the acceleration channel was found to be within about a factor of 3 of the Bohm value for the better thruster designs at most operating conditions. Thruster efficiencies of about 0.5 appear practical for the 1000 to 2000 s range of specific impulse. Lifetime information is limited, but values of several thousands of hours should be possible with anode layer thrusters operated or = to 2000 s.

Space Weather Status for Exploration Radiation Protection

NASA Technical Reports Server (NTRS)

Fry, Dan J.; Lee, Kerry; Zapp, Neal; Barzilla, Janet; Dunegan, Audrey; Johnson, Steve; Stoffle, Nicholas

2011-01-01

Management of crew exposure to radiation is a major concern for manned spaceflight and will be even more important for the modern concept of longer-duration exploration. The inherent protection afforded to astronauts by the magnetic field of the Earth in Low Earth Orbit (LEO) makes operations on the space shuttle or space station very different from operations during an exploration mission. In order to experience significant radiation-derived Loss of Mission (LOM) or Loss of Crew (LOC) risk for LEO operations, one is almost driven to dictate extreme duration or to dictate an extreme sequence of solar activity. Outside of the geo-magnetosphere, however, this scenario changes dramatically. Exposures to the same event on the ISS and in free space, for example, may differ by orders of magnitude. This change in magnitude, coupled with the logistical constraints present in implementing any practical operational mitigation make situational awareness with regard to space weather a limiting factor for the ability to conduct exploration operations. We present a current status of developing operational concepts for manned exploration and expectations for asset viability and available predictive and characterization toolsets.

Planning low-carbon electricity systems under uncertainty considering operational flexibility and smart grid technologies.

PubMed

Moreno, Rodrigo; Street, Alexandre; Arroyo, José M; Mancarella, Pierluigi

2017-08-13

Electricity grid operators and planners need to deal with both the rapidly increasing integration of renewables and an unprecedented level of uncertainty that originates from unknown generation outputs, changing commercial and regulatory frameworks aimed to foster low-carbon technologies, the evolving availability of market information on feasibility and costs of various technologies, etc. In this context, there is a significant risk of locking-in to inefficient investment planning solutions determined by current deterministic engineering practices that neither capture uncertainty nor represent the actual operation of the planned infrastructure under high penetration of renewables. We therefore present an alternative optimization framework to plan electricity grids that deals with uncertain scenarios and represents increased operational details. The presented framework is able to model the effects of an array of flexible, smart grid technologies that can efficiently displace the need for conventional solutions. We then argue, and demonstrate via the proposed framework and an illustrative example, that proper modelling of uncertainty and operational constraints in planning is key to valuing operationally flexible solutions leading to optimal investment in a smart grid context. Finally, we review the most used practices in power system planning under uncertainty, highlight the challenges of incorporating operational aspects and advocate the need for new and computationally effective optimization tools to properly value the benefits of flexible, smart grid solutions in planning. Such tools are essential to accelerate the development of a low-carbon energy system and investment in the most appropriate portfolio of renewable energy sources and complementary enabling smart technologies.This article is part of the themed issue 'Energy management: flexibility, risk and optimization'. © 2017 The Author(s).

Cervical bracing practices after degenerative cervical surgery: a survey of cervical spine research society members.

PubMed

Lunardini, David J; Krag, Martin H; Mauser, Nathan S; Lee, Joon Y; Donaldson, William H; Kang, James D

2018-05-21

Context: Prior studies have shown common use of post-operative bracing, despite advances in modern day instrumentation rigidity and little evidence of brace effectiveness. To document current practice patterns of brace use after degenerative cervical spine surgeries among members of the Cervical Spine Research Society (CSRS), to evaluate trends, and to identify areas of further study. A questionnaire survey METHODS: A 10 question survey was sent to members of the Cervical Spine Research Society to document current routine bracing practices after various common degenerative cervical spine surgical scenarios, including fusion and non-fusion procedures. The overall bracing rate was 67%. This included 8.4% who used a hard collar in each scenario. Twenty-two percent of surgeons never used a hard collar, while 34% never used a soft collar, and 3.6% (3 respondents) did not use a brace in any surgical scenario. Bracing frequency for specific surgical scenarios varied from 39% after foraminotomy to 88% after multi-level corpectomy with anterior & posterior fixation. After one, two and three level anterior cervical discectomy & fusion (ACDF), bracing rates were 58%, 65% and 76% for an average of 3.3, 4.3 and 5.3 weeks, respectively. After single level corpectomy, 77% braced for an average of 6.2 weeks. After laminectomy and fusion, 72% braced for an average of 5.4 weeks. Significant variation persists among surgeons on the type and length of post-operative brace usage after cervical spine surgeries. Overall rates of bracing have not changed significantly with time. Given the lack evidence in the literature to support bracing, reconsidering use of a brace after certain surgeries may be warranted. Copyright © 2018. Published by Elsevier Inc.

Cost analysis of percutaneous fixation of hand fractures in the main operating room versus the ambulatory setting.

PubMed

Gillis, Joshua A; Williams, Jason G

2017-08-01

To date, there have been no studies identifying the cost differential for performing closed reduction internal fixation (CRIF) of hand fractures in the operating room (OR) versus an ambulatory setting. Our goal was to analyse the cost and efficiency of performing CRIF in these two settings and to investigate current practice trends in Canada. A detailed analysis of the costs involved both directly and indirectly in the CRIF of a hand fracture was conducted. Hospital records were used to calculate efficiency. A survey was distributed to practicing plastic surgeons across Canada regarding their current practice of managing hand fractures. In an eight-hour surgical block we are able to perform five CRIF in the OR versus eight in an ambulatory setting. The costs of performing a CRIF in the OR under local anaesthetic, not including surgeon compensation, is $461.27 Canadian (CAD) compared to $115.59 CAD in the ambulatory setting, a 299% increase. The use of a regional block increases the cost to $665.49 CAD, a 476% increase. The main barrier to performing CRIFs in an outpatient setting is the absence of equipment necessary to perform these cases effectively, based on survey results. The use of the OR for CRIF of hand fractures is associated with a significant increase in cost and hospital resources with decreased efficiency. For appropriately selected hand fractures, CRIF in an ambulatory setting is less costly and more efficient compared to the OR and resources should be allocated to facilitate CRIF in this setting. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

1T1R Nonvolatile Memory with Al/TiO₂/Au and Sol-Gel-Processed Insulator for Barium Zirconate Nickelate Gate in Pentacene Thin Film Transistor.

PubMed

Lee, Ke-Jing; Chang, Yu-Chi; Lee, Cheng-Jung; Wang, Li-Wen; Wang, Yeong-Her

2017-12-09

A one-transistor and one-resistor (1T1R) architecture with a resistive random access memory (RRAM) cell connected to an organic thin-film transistor (OTFT) device is successfully demonstrated to avoid the cross-talk issues of only one RRAM cell. The OTFT device, which uses barium zirconate nickelate (BZN) as a dielectric layer, exhibits favorable electrical properties, such as a high field-effect mobility of 5 cm²/Vs, low threshold voltage of -1.1 V, and low leakage current of 10 -12 A, for a driver in the 1T1R operation scheme. The 1T1R architecture with a TiO₂-based RRAM cell connected with a BZN OTFT device indicates a low operation current (10 μA) and reliable data retention (over ten years). This favorable performance of the 1T1R device can be attributed to the additional barrier heights introduced by using Ni (II) acetylacetone as a substitute for acetylacetone, and the relatively low leakage current of a BZN dielectric layer. The proposed 1T1R device with low leakage current OTFT and excellent uniform resistance distribution of RRAM exhibits a good potential for use in practical low-power electronic applications.

Proactive detection of bones in poultry processing

NASA Astrophysics Data System (ADS)

Daley, W. D. R.; Stewart, John

2009-05-01

Bones continue to be a problem of concern for the poultry industry. Most further processed products begin with the requirement for raw material with minimal bones. The current process for generating deboned product requires systems for monitoring and inspecting the output product. The current detection systems are either people palpitating the product or X-ray systems. The current performance of these inspection techniques are below the desired levels of accuracies and are costly. We propose a technique for monitoring bones that conduct the inspection operation in the deboning the process so as to have enough time to take action to reduce the probability that bones will end up in the final product. This is accomplished by developing active cones with built in illumination to backlight the cage (skeleton) on the deboning line. If the bones of interest are still on the cage then the bones are not in the associated meat. This approach also allows for the ability to practice process control on the deboning operation to keep the process under control as opposed to the current system where the detection is done post production and does not easily present the opportunity to adjust the process. The proposed approach shows overall accuracies of about 94% for the detection of the clavicle bones.

Miles In Trail (MIT) Restrictions: A Perspective

NASA Technical Reports Server (NTRS)

Kopardekar, Parimal; Green, Steven; Roherty, Tom; Aston, John

2003-01-01

Miles-in-trail restrictions are issued to meet the airport and/or airspace capacity. The purpose of this paper is to review the currently practiced miles-in-trail operations for traffic flow management at a typical en route Air Traffic Control Center. The paper describes roles and considerations of both traffic management coordinators and the controllers in planning, coordination, execution, and monitoring of miles-in-trail restrictions. The paper addresses the type of decisions that traffic management coordinators must make and the different information required to plan and monitor miles-in-trail restrictions. The implications of miles-in-trail restrictions on controller workload are also addressed. Using the Cleveland center as an example, the paper also identified some challenging traffic situations that required miles-in-trail restrictions on a regular basis. The paper is expected to benefit the research and development community as it provides the current challenges in traffic flow management and strengths and weakness of miles-in-trail operations.

Coordinated Science Campaign Scheduling for Sensor Webs

NASA Technical Reports Server (NTRS)

Edgington, Will; Morris, Robert; Dungan, Jennifer; Williams, Jenny; Carlson, Jean; Fleming, Damian; Wood, Terri; Yorke-Smith, Neil

2005-01-01

Future Earth observing missions will study different aspects and interacting pieces of the Earth's eco-system. Scientists are designing increasingly complex, interdisciplinary campaigns to exploit the diverse capabilities of multiple Earth sensing assets. In addition, spacecraft platforms are being configured into clusters, trains, or other distributed organizations in order to improve either the quality or the coverage of observations. These simultaneous advances in the design of science campaigns and in the missions that will provide the sensing resources to support them offer new challenges in the coordination of data and operations that are not addressed by current practice. For example, the scheduling of scientific observations for satellites in low Earth orbit is currently conducted independently by each mission operations center. An absence of an information infrastructure to enable the scheduling of coordinated observations involving multiple sensors makes it difficult to execute campaigns involving multiple assets. This paper proposes a software architecture and describes a prototype system called DESOPS (Distributed Earth Science Observation Planning and Scheduling) that will address this deficiency.

Strategic analytics: towards fully embedding evidence in healthcare decision-making.

PubMed

Garay, Jason; Cartagena, Rosario; Esensoy, Ali Vahit; Handa, Kiren; Kane, Eli; Kaw, Neal; Sadat, Somayeh

2015-01-01

Cancer Care Ontario (CCO) has implemented multiple information technology solutions and collected health-system data to support its programs. There is now an opportunity to leverage these data and perform advanced end-to-end analytics that inform decisions around improving health-system performance. In 2014, CCO engaged in an extensive assessment of its current data capacity and capability, with the intent to drive increased use of data for evidence-based decision-making. The breadth and volume of data at CCO uniquely places the organization to contribute to not only system-wide operational reporting, but more advanced modelling of current and future state system management and planning. In 2012, CCO established a strategic analytics practice to assist the agency's programs contextualize and inform key business decisions and to provide support through innovative predictive analytics solutions. This paper describes the organizational structure, services and supporting operations that have enabled progress to date, and discusses the next steps towards the vision of embedding evidence fully into healthcare decision-making. Copyright © 2014 Longwoods Publishing.

Performance study of galactic cosmic ray shield materials

NASA Technical Reports Server (NTRS)

Kim, Myung-Hee Y.; Wilson, John W.; Thibeault, Sheila A.; Nealy, John E.; Badavi, Francis F.; Kiefer, Richard L.

1994-01-01

The space program is faced with two difficult radiation protection issues for future long-term operations. First, retrofit of shield material or conservatism in shield design is prohibitively expensive and often impossible. Second, shielding from the cosmic heavy ions is faced with limited knowledge on the physical properties and biological responses of these radiations. The current status of space shielding technology and its impact on radiation health is discussed herein in terms of conventional protection practice and a test biological response model. The impact of biological response on the selection of optimum materials for cosmic ray shielding is presented in terms of the transmission characteristics of the shield material. Although the systematics of nuclear cross sections are able to demonstrate the relation of exposure risk to shield-material composition, the current uncertainty in-nuclear cross sections will not allow an accurate evaluation of risk reduction. This paper presents a theoretical study of risk-related factors and a pilot experiment to study the effectiveness of choice of shield materials to reduce the risk in space operations.

Atmospheric/Space Environment Support Lessons Learned Regarding Aerospace Vehicle Design and Operations

NASA Technical Reports Server (NTRS)

Vaughan, William W.; Anderson, B. Jeffrey

2005-01-01

In modern government and aerospace industry institutions the necessity of controlling current year costs often leads to high mobility in the technical workforce, "one-deep" technical capabilities, and minimal mentoring for young engineers. Thus, formal recording, use, and teaching of lessons learned are especially important in the maintenance and improvement of current knowledge and development of new technologies, regardless of the discipline area. Within the NASA Technical Standards Program Website http://standards.nasa.gov there is a menu item entitled "Lessons Learned/Best Practices". It contains links to a large number of engineering and technical disciplines related data sets that contain a wealth of lessons learned information based on past experiences. This paper has provided a small sample of lessons learned relative to the atmospheric and space environment. There are many more whose subsequent applications have improved our knowledge of the atmosphere and space environment, and the application of this knowledge to the engineering and operations for a variety of aerospace programs.

Transient analysis of an HTS DC power cable with an HVDC system

NASA Astrophysics Data System (ADS)

Dinh, Minh-Chau; Ju, Chang-Hyeon; Kim, Jin-Geun; Park, Minwon; Yu, In-Keun; Yang, Byeongmo

2013-11-01

The operational characteristics of a superconducting DC power cable connected to a highvoltage direct current (HVDC) system are mainly concerned with the HVDC control and protection system. To confirm how the cable operates with the HVDC system, verifications using simulation tools are needed. This paper presents a transient analysis of a high temperature superconducting (HTS) DC power cable in connection with an HVDC system. The study was conducted via the simulation of the HVDC system and a developed model of the HTS DC power cable using a real time digital simulator (RTDS). The simulation was performed with some cases of short circuits that may have caused system damage. The simulation results show that during the faults, the quench did not happen with the HTS DC power cable because the HVDC controller reduced some degree of the fault current. These results could provide useful data for the protection design of a practical HVDC and HTS DC power cable system.

The feasibility of introducing advanced minimally invasive surgery into surgical practice

PubMed Central

Birch, Daniel W.; Misra, Monali; Farrokhyar, Forough

2007-01-01

Background This study investigates the feasibility of performing advanced minimally invasive surgery (MIS) in a nonspecialized practice environment. Methods We conducted a cross-sectional survey of all community general surgeons currently practising in Ontario. Results Few community surgeons perform a high volume (> 10 procedures per yr) of advanced MIS. Most (70%) believe it is important to acquire additional skills in advanced MIS. The most appropriate methods for learning advanced MIS are believed to be expert mentoring (79.7%), courses (77.2%) and a colleague mentor (63.9%). A total of 57.6% of respondents have attended a course in MIS while in practice, and most have access to a reasonable variety of instrumentation. Respondents believe that 57.6% of assistants, 54.8% of nurses and 43.4% of anaesthetists are relatively inexperienced with advanced MIS. Barriers to establishing advanced MIS include limited operating room access (50%), resources or equipment (45.2%) and limited expert mentoring (43.6%). Surgeons with less than 10 years of practice found lack of trained nursing staff (7.9% v. 4.2%, p = 0.01) and experienced assistants (12% v. 6.2%, p = 0.008) to be more important barriers than did those with over 10 years of practice, respectively. Conclusion Most general surgeons working in Ontario are self-taught with respect to MIS skills, and few perform a high volume of advanced MIS. Only one-half of all respondents have access to skilled MIS operating room nurses, surgical assistants or anesthesiology. Despite this, general surgeons perceive the greatest barriers to introducing advanced MIS procedures to be limited access to operating rooms, resources or equipment and limited mentoring. This study has shown that the role of the surgical team in advanced MIS may be underestimated by many general surgeons. These data have important implications in training general surgeons and in incorporating additional advanced MIS procedures into the armamentarium of general surgeons. PMID:17897513

Verbal autopsy: current practices and challenges.

PubMed Central

Soleman, Nadia; Chandramohan, Daniel; Shibuya, Kenji

2006-01-01

Cause-of-death data derived from verbal autopsy (VA) are increasingly used for health planning, priority setting, monitoring and evaluation in countries with incomplete or no vital registration systems. In some regions of the world it is the only method available to obtain estimates on the distribution of causes of death. Currently, the VA method is routinely used at over 35 sites, mainly in Africa and Asia. In this paper, we present an overview of the VA process and the results of a review of VA tools and operating procedures used at demographic surveillance sites and sample vital registration systems. We asked for information from 36 field sites about field-operating procedures and reviewed 18 verbal autopsy questionnaires and 10 cause-of-death lists used in 13 countries. The format and content of VA questionnaires, field-operating procedures, cause-of-death lists and the procedures to derive causes of death from VA process varied substantially among sites. We discuss the consequences of using varied methods and conclude that the VA tools and procedures must be standardized and reliable in order to make accurate national and international comparisons of VA data. We also highlight further steps needed in the development of a standard VA process. PMID:16583084

Post-operative ventricular flow dynamics following atrioventricular valve surgical and device therapies: A review.

PubMed

Nguyen, Yen Ngoc; Ismail, Munirah; Kabinejadian, Foad; Tay, Edgar Lik Wui; Leo, Hwa Liang

2018-04-01

Intra-ventricular flow dynamics has recently emerged as an important evaluation and diagnosis tool in different cardiovascular conditions. The formation of vortex pattern during the cardiac cycle has been suggested to play important epigenetic and energy-modulation roles in cardiac remodelling, adaptations and mal-adaptations. In this new perspective, flow alterations due to different cardiovascular procedures can affect the long-term outcome of those procedures. Especially, repairs and replacements performed on atrioventricular valves are likely to exert direct impact on intra-ventricular flow pattern. In this review, current consensus around the roles of vortex dynamics in cardiac function is discussed. An overview of physiological vortex patterns found in healthy left and right ventricles as well as post-operative ventricular flow phenomenon owing to different atrioventricular valvular procedures are reviewed, followed by the summary of different vortex identification schemes used to characterise intraventricular flow. This paper also emphasises on future research directions towards a comprehensive understanding of intra-cardiac flow and its clinical relevance. The knowledge could encourage more effective pre-operative planning and better outcomes for current clinical practices. Copyright © 2018. Published by Elsevier Ltd.

Promoting leadership and management in Australian general practice nursing: what will it take?

PubMed

Halcomb, Elizabeth J; Davidson, Patricia M; Patterson, Elizabeth

2008-10-01

This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting. Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty. The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns. There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession.

Robotic assembly and maintenance of future space stations based on the ISS mission operations experience

NASA Astrophysics Data System (ADS)

Rembala, Richard; Ower, Cameron

2009-10-01

MDA has provided 25 years of real-time engineering support to Shuttle (Canadarm) and ISS (Canadarm2) robotic operations beginning with the second shuttle flight STS-2 in 1981. In this capacity, our engineering support teams have become familiar with the evolution of mission planning and flight support practices for robotic assembly and support operations at mission control. This paper presents observations on existing practices and ideas to achieve reduced operational overhead to present programs. It also identifies areas where robotic assembly and maintenance of future space stations and space-based facilities could be accomplished more effectively and efficiently. Specifically, our experience shows that past and current space Shuttle and ISS assembly and maintenance operations have used the approach of extensive preflight mission planning and training to prepare the flight crews for the entire mission. This has been driven by the overall communication latency between the earth and remote location of the space station/vehicle as well as the lack of consistent robotic and interface standards. While the early Shuttle and ISS architectures included robotics, their eventual benefits on the overall assembly and maintenance operations could have been greater through incorporating them as a major design driver from the beginning of the system design. Lessons learned from the ISS highlight the potential benefits of real-time health monitoring systems, consistent standards for robotic interfaces and procedures and automated script-driven ground control in future space station assembly and logistics architectures. In addition, advances in computer vision systems and remote operation, supervised autonomous command and control systems offer the potential to adjust the balance between assembly and maintenance tasks performed using extra vehicular activity (EVA), extra vehicular robotics (EVR) and EVR controlled from the ground, offloading the EVA astronaut and even the robotic operator on-orbit of some of the more routine tasks. Overall these proposed approaches when used effectively offer the potential to drive down operations overhead and allow more efficient and productive robotic operations.

Good manufacturing practices for medicinal products for human use.

PubMed

Gouveia, Bruno G; Rijo, Patrícia; Gonçalo, Tânia S; Reis, Catarina P

2015-01-01

At international and national levels, there are public and private organizations, institutions and regulatory authorities, who work and cooperate between them and with Pharmaceutical Industry, in order to achieve a consensus of the guidelines and laws of the manufacturing of medicinal products for human use. This article includes an explanation of how operate and cooperate these participants, between them and expose the current regulations, following the line of European Community/European Economic Area, referencing, wherever appropriate, the practiced guidelines, outside of regulatory action of space mentioned. In this way, it is intended to achieve quality, security and effectiveness exceptional levels in the manufacturing of health products. Good Manufacturing Practice aim the promotion of the human health and consequently, to the improvement of quality of life. For achieve the proposed objectives, it is necessary to ensure the applicability of the presented concepts and show the benefits arising from this applicability.

Reasoning and Data Representation in a Health and Lifestyle Support System.

PubMed

Hanke, Sten; Kreiner, Karl; Kropf, Johannes; Scase, Marc; Gossy, Christian

2017-01-01

Case-based reasoning and data interpretation is an artificial intelligence approach that capitalizes on past experience to solve current problems and this can be used as a method for practical intelligent systems. Case-based data reasoning is able to provide decision support for experts and clinicians in health systems as well as lifestyle systems. In this project we were focusing on developing a solution for healthy ageing considering daily activities, nutrition as well as cognitive activities. The data analysis of the reasoner followed state of the art guidelines from clinical practice. Guidelines provide a general framework to guide clinicians, and require consequent background knowledge to become operational, which is precisely the kind of information recorded in practice cases; cases complement guidelines very well and helps to interpret them. It is expected that the interest in case-based reasoning systems in the health.

Practical application of remote sensing in agriculture

NASA Technical Reports Server (NTRS)

Phelps, R. A.

1975-01-01

Remote sensing program imagery from several types of platforms, from light aircraft to the LANDSAT (ERTS) satellites, have been utilized during the past few years, with preference for inexpensive imagery over expensive magnetic tapes. Emphasis has been on practical application of remote sensing data to increase crop yield by decreasing plant stress, disease, weeds and undesirable insects and by improving irrigation. Imagery obtained from low altitudes via aircraft provides the necessary resolution and complements but does not replace data from high altitude aircraft, Gemini and Apollo spacecraft, Skylab space station and LANDSAT satellites. Federal government centers are now able to supply imagery within about thirty days from data of order. Nevertheless, if the full potential of space imagery in practical agricultural operations is to be realized, the time span from date of imaging to user application needs to be shortened from the current several months to not more than two weeks.

Investment in workforce health: exploring the implications for workforce safety climate and commitment.

PubMed

Mearns, Kathryn; Hope, Lorraine; Ford, Michael T; Tetrick, Lois E

2010-09-01

The relationship between investment in employee health and non-health outcomes has received little research attention. Drawing from social exchange and climate theory, the current study uses a multilevel approach to examine the implications of worksite health investment for worksite safety and health climate and employee safety compliance and commitment to the worksite. Data were collected from 1932 personnel working on 31 offshore installations operating in UK waters. Installation medics provided corporate workforce health investment details for 20 of these installations. The findings provide support for a strong link between health investment practices and worksite safety and health climate. The results also found a relationship between health investment practices and organizational commitment among employees. These results suggest that health investment practices are associated with committed workforces and climates that reflect a priority on health and safety. 2009 Elsevier Ltd. All rights reserved.

Good manufacturing practices for medicinal products for human use

PubMed Central

Gouveia, Bruno G.; Rijo, Patrícia; Gonçalo, Tânia S.; Reis, Catarina P.

2015-01-01

At international and national levels, there are public and private organizations, institutions and regulatory authorities, who work and cooperate between them and with Pharmaceutical Industry, in order to achieve a consensus of the guidelines and laws of the manufacturing of medicinal products for human use. This article includes an explanation of how operate and cooperate these participants, between them and expose the current regulations, following the line of European Community/European Economic Area, referencing, wherever appropriate, the practiced guidelines, outside of regulatory action of space mentioned. In this way, it is intended to achieve quality, security and effectiveness exceptional levels in the manufacturing of health products. Good Manufacturing Practice aim the promotion of the human health and consequently, to the improvement of quality of life. For achieve the proposed objectives, it is necessary to ensure the applicability of the presented concepts and show the benefits arising from this applicability. PMID:25883511

[Tensions between the (il)legal and the (il)legitimate in professional health practices regarding women who seek abortion].

PubMed

López Gómez, Alejandra

2016-01-01

The implementation of a pre- and post-abortion health care strategy, adopted in 2004 in Uruguay within a restrictive legal context prior to the decriminalization of abortion in 2012, opened a window of opportunity to link women facing unwanted pregnancies and abortion to health services in order to prevent unsafe abortion practices. This article looks into the tensions generated by the change of focus from maternal-child health to health and sexual and reproductive rights, and how those tensions operate. Using semi-structured interviews and focus groups, the practices and perception and assessment frameworks of professionals in their care of women facing unwanted pregnancy and abortion in the National Integrated Health System in Montevideo are analyzed. The results offer insights into some of the barriers and difficulties that can currently be observed in the implementation of the new law.

A climate-compatible approach to development practice by international humanitarian NGOs.

PubMed

Clarke, Matthew; de Cruz, Ian

2015-01-01

If current climate-change predictions prove accurate, non-linear change, including potentially catastrophic change, is possible and the environments in which international humanitarian NGOs operate will change figuratively and literally. This paper proposes that a new approach to development is required that takes changing climate into account. This 'climate-compatible approach' to development is a bleak shift from some of the current orthodox positions and will be a major challenge to international humanitarian NGOs working with the most vulnerable. However, it is necessary to address the challenges and context such NGOs face, and the need to be resilient and adaptive to these changes. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Psychiatric nurses' beliefs, attitudes, and perceived barriers about medical emergency teams.

PubMed

Herisko, Camellia; Puskar, Kathryn; Mitchell, Ann M

2013-10-01

A literature review of nurses' attitudes, beliefs, and barriers regarding the medical emergency team (MET) process is limited to medical hospitals. How psychiatric nurses view the MET process and their prior experiences with METs are important because they are often the ones assessing the need for, and then calling, the MET. This article examines psychiatric nurses' attitudes, beliefs, and barriers toward the MET process in a 310-bed psychiatric hospital that is part of an urban academic medical center. Through the use of key informant interviews, nurses were asked for their feedback and input regarding the current MET practices. The results may be useful in improving the current operating system.

Optimizing Geothermal Drilling: Oil and Gas Technology Transfer

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

Denninger, Kate; Eustes, Alfred; Visser, Charles

There is a significant amount of financial risk associated with geothermal drilling. This study of drilling operations seeks opportunities to improve upon current practices and technologies. The scope of this study included analyzing 21 geothermal wells and 21 oil and gas wells. The goal was to determine a 'Perfect Well' using historical data to compare the best oil and gas well to the best geothermal well. Unfortunately, limitations encountered in the study included missing data (bit records, mud information, etc.) and poor data collection practices An online software database was used to format drilling data to IADC coded daily drillingmore » reports and generate figures for analysis. Six major issues have been found in geothermal drilling operations. These problems include lost circulation, rig/ equipment selection, cementing, penetration rate, drilling program, and time management. As a result of these issues, geothermal drilling averaged 56.4 days longer than drilling comparable oil and gas wells in the wells in this study. Roughly $13.9 million was spent on non-productive time in the 21 geothermal wells, compared with only $1.3 million in the oil and gas wells, assuming a cost of $50,000 per day. Comparable events such as drilling the same sized hole, tripping in/out, cementing, and running the same size casing took substantially less time in the oil and gas wells. Geothermal wells were drilled using older and/or less advanced technology to depths less than 10,000 feet, while oil and gas wells reached 12,500 feet faster with purpose built rigs. A new approach is now underway that will optimize drilling programs throughout the drilling industry using Mechanical Specific Energy (MSE) as a tool to realize efficient drilling processes. Potential improvements for current geothermal operations are: the use of electronic records, real time services, and official glossary terms to describe rig operations, and advanced drilling rigs/technology.« less

A perverse quality incentive in surgery: implications of reimbursing surgeons less for doing laparoscopic surgery.

PubMed

Fader, Amanda N; Xu, Tim; Dunkin, Brian J; Makary, Martin A

2016-11-01

Surgery is one of the highest priced services in health care, and complications from surgery can be serious and costly. Recently, advances in surgical techniques have allowed surgeons to perform many common operations using minimally invasive methods that result in fewer complications. Despite this, the rates of open surgery remain high across multiple surgical disciplines. This is an expert commentary and review of the contemporary literature regarding minimally invasive surgery practices nationwide, the benefits of less invasive approaches, and how minimally invasive compared with open procedures are differentially reimbursed in the United States. We explore the incentive of the current surgeon reimbursement fee schedule and its potential implications. A surgeon's preference to perform minimally invasive compared with open surgery remains highly variable in the U.S., even after adjustment for patient comorbidities and surgical complexity. Nationwide administrative claims data across several surgical disciplines demonstrates that minimally invasive surgery utilization in place of open surgery is associated with reduced adverse events and cost savings. Reducing surgical complications by increasing adoption of minimally invasive operations has significant cost implications for health care. However, current U.S. payment structures may perversely incentivize open surgery and financially reward physicians who do not necessarily embrace newer or best minimally invasive surgery practices. Utilization of minimally invasive surgery varies considerably in the U.S., representing one of the greatest disparities in health care. Existing physician payment models must translate the growing body of research in surgical care into physician-level rewards for quality, including choice of operation. Promoting safe surgery should be an important component of a strong, value-based healthcare system. Resolving the potentially perverse incentives in paying for surgical approaches may help address disparities in surgical care, reduce the prevalent problem of variation, and help contain health care costs.

Liquid rocket pressure regulators, relief valves, check valves, burst disks, and explosive valves. [design techniques and practices

NASA Technical Reports Server (NTRS)

1973-01-01

The development of and operational programs for effective use in design are presented for liquid rocket pressure regulators, relief valves, check valves, burst disks, and explosive valves. A review of the total design problem is presented, and design elements are identified which are involved in successful design. Current technology pertaining to these elements is also described. Design criteria are presented which state what rule or standard must be imposed on each essential design element to assure successful design. These criteria serve as a checklist of rules for a project manager to use in guiding a design or in assessing its adequacy. Recommended practices are included which state how to satisfy each of the criteria.

Waste management practices in the Gulf of Suez - Egypt

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

Ghzaly, S.M.; Binegar, J.S.

1996-12-31

The Gulf of Suez Petroleum Company (GUPCO) is the largest offshore oil producing company in Egypt. GUPCO currently produces 400,000 BOPD from over 350 wells supported by 87 offshore producing platforms. As a leader of the Egyptian petroleum industry, GUPCO established within its strategies and goals a separate category covering safety, health and Protection of the environment. This step was recognized and emphasized the importance of GUPCO`s role in protecting the Egyptian environment while producing oil and natural gas. This paper discusses the existing waste management practices of the Gulf of Suez Petroleum Company which were put into place tomore » protect the Egyptian environment in the Gulf of Suez-Egypt and GUPCO`s associated operations.« less

Monitoring autocorrelated process: A geometric Brownian motion process approach

NASA Astrophysics Data System (ADS)

Li, Lee Siaw; Djauhari, Maman A.

2013-09-01

Autocorrelated process control is common in today's modern industrial process control practice. The current practice of autocorrelated process control is to eliminate the autocorrelation by using an appropriate model such as Box-Jenkins models or other models and then to conduct process control operation based on the residuals. In this paper we show that many time series are governed by a geometric Brownian motion (GBM) process. Therefore, in this case, by using the properties of a GBM process, we only need an appropriate transformation and model the transformed data to come up with the condition needs in traditional process control. An industrial example of cocoa powder production process in a Malaysian company will be presented and discussed to illustrate the advantages of the GBM approach.