Development of X-Ray Microcalorimeter Imaging Spectrometers for the X-Ray Surveyor Mission Concept

NASA Technical Reports Server (NTRS)

Bandler, Simon R.; Adams, Joseph S.; Chervenak, James A.; Datesman, Aaron M.; Eckart, Megan E.; Finkbeiner, Fred M.; Kelley, Richard L.; Kilbourne, Caroline A.; Betncourt-Martinez, Gabriele; Miniussi, Antoine R.;

The Large UV/Optical/Infrared Surveyor (LUVOIR): Decadal Mission Concept Technology Development Overview

NASA Technical Reports Server (NTRS)

Bolcar, Matthew R.

2017-01-01

The Large Ultraviolet / Optical / Infrared (LUVOIR) Surveyor is one of four large mission concept studies being developed by NASA for consideration in the 2020 Astrophysics Decadal Survey. LUVOIR will support a broad range of science objectives, including the direct imaging and spectral characterization of habitable exoplanets around sun-like stars, the study of galaxy formation and evolution, the epoch of reionization, star and planet formation, and the remote sensing of Solar System bodies. The LUVOIR Science and Technology Definition Team (STDT) has tasked a Technology Working Group (TWG), with more than 60 members from NASA centers, academia, industry, and international partners, with identifying technologies that enable or enhance the LUVOIR science mission. The TWG has identified such technologies in the areas of Coronagraphy, Ultra-Stable Opto-mechanical Systems, Detectors, Coatings, Starshades, and Instrument Components, and has completed a detailed assessment of the state-of-the-art. We present here a summary of this technology assessment effort, as well as the current progress in defining a technology development plan to mature these technologies to the required technology readiness level (TRL).

Origins Space Telescope: Interstellar Medium, Milky Way, and Nearby Galaxies

NASA Astrophysics Data System (ADS)

Battersby, Cara; Origins Space Telescope Study Team

2017-01-01

The Origins Space Telescope (OST) is the mission concept for the Far-Infrared Surveyor, a study in development by NASA in preparation for the 2020 Astronomy and Astrophysics Decadal Survey. Origins is planned to be a large aperture, actively-cooled telescope covering a wide span of the mid- to far-infrared spectrum. Its imagers and spectrographs will enable a variety of surveys of the sky that will discover and characterize the most distant galaxies, Milky-Way, exoplanets, and the outer reaches of our Solar system. Origins will enable flagship-quality general observing programs led by the astronomical community in the 2030s. The Science and Technology Definition Team (STDT) would like to hear your science needs and ideas for this mission. The team can be contacted at firsurveyor_info@lists.ipac.caltech.edu.This presentation will provide a summary of the science case related to the Interstellar Medium (ISM), the Milky Way, and Nearby Galaxies. Origins will enable a comprehensive view of magnetic fields, turbulence, and the multi-phase ISM; connecting physics at all scales, from galaxies to protostellar cores. With unprecedented sensitivity, Origins will measure and characterize the mechanisms of feedback from star formation and Active Galactic Nuclei (AGN) over cosmic time and trace the trail of water from interstellar clouds, to protoplanetary disks, to Earth itself in order to understand the abundance and availability of water for habitable planets.

Origins Space Telescope: Planet-forming disks and exoplanets

NASA Astrophysics Data System (ADS)

Pontoppidan, Klaus; Origins Space Telescope Study Team

2017-01-01

The Origins Space Telescope (OST) is the mission concept for the Far-Infrared Surveyor, a study in development by NASA in preparation for the 2020 Astronomy and Astrophysics Decadal Survey. Origins is planned to be a large aperture, actively-cooled telescope covering a wide span of the mid- to far-infrared spectrum. Its imagers and spectrographs will enable a variety of surveys of the sky that will discover and characterize the most distant galaxies, Milky-Way, exoplanets, and the outer reaches of our Solar system. Origins will enable flagship-quality general observing programs led by the astronomical community in the 2030s. The Science and Technology Definition Team (STDT) would like to hear your science needs and ideas for this mission. The team can be contacted at firsurveyor_info@lists.ipac.caltech.edu. This presentation will provide a summary of the science case related to planet formation and exoplanets. Leveraging orders of magnitude of improvements in sensitivity, the Origins Telescope will reveal the path of water from the interstellar medium to the inner regions of planet-forming disks, and determine the total masses of disks around stars across the stellar mass range out to distances of 500 pc. It will measure the temperatures and search for basic chemical ingredients for life on rocky planets. Beyond this, the Origins Telescope will open a vast discovery space in the general areas of star formation, protoplanetary and debris disks, and cool exoplanets in habitable zones.

Team X Report #1401: Exoplanet Coronagraph STDT Study 2013-06

NASA Technical Reports Server (NTRS)

Warfield, Keith

2013-01-01

This document is intended to stimulate discussion of the topic described. All technical and cost analyses are preliminary. This document is not a commitment to work, but is a precursor to a formal proposal if it generates sufficient mutual interest. The data contained in this document may not be modified in any way. Cost estimates described or summarized in this document were generated as part of a preliminary, first-order cost class identification as part of an early trade space study, are based on JPL-internal parametric cost modeling, assume a JPL in-house build, and do not constitute a commitment on the part of JPL or Caltech. JPL and Team X add cost reserves for development and operations. Unadjusted estimate totals and cost reserve allocations would be revised as needed in future more-detailed studies as appropriate for the specific cost-risks for a given mission concept.

Origins Space Telescope: Cosmology and Reionization

NASA Astrophysics Data System (ADS)

Vieira, Joaquin D.; Origins Space Telescope Study Team

2017-01-01

The Origins Space Telescope (OST) is the mission concept for the Far-Infrared Surveyor, a study in development by NASA in preparation for the 2020 Astronomy and Astrophysics Decadal Survey. Origins is planned to be a large aperture, actively-cooled telescope covering a wide span of the mid- to far-infrared spectrum. Its imagers and spectrographs will enable a variety of surveys of the sky that will discover and characterize the most distant galaxies, Milky-Way, exoplanets, and the outer reaches of our Solar system. Origins will enable flagship-quality general observing programs led by the astronomical community in the 2030s. The Science and Technology Definition Team (STDT) would like to hear your science needs and ideas for this mission. The team can be contacted at firsurveyor_info@lists.ipac.caltech.edu.A core science goal of the OST mission is to study the the cosmological history of star, galaxy, and structure formation into the epoch of reionization (EoR). OST will probe the birth of galaxies through warm molecular hydrogen emission during the cosmic dark ages. Utilizing the unique power of the infrared fine-structure emission lines, OST will trace the rise of metals from the first galaxies until today. It will quantify the dust enrichment history of the Universe, uncover its composition and physical conditions, reveal the first cosmic sources of dust, and probe the properties of the earliest star formation. OST will provide a detailed astrophysical probe into the condition of the intergalactic medium at z > 6 and the galaxies which dominate the epoch of reionization.

Origins Space Telescope: Cosmology and Reionization

NASA Astrophysics Data System (ADS)

Vieira, Joaquin Daniel; Origins Space Telescope

2018-01-01

The Origins Space Telescope (OST) is the mission concept for the Far-Infrared Surveyor, a study in development by NASA in preparation for the 2020 Astronomy and Astrophysics Decadal Survey. Origins is planned to be a large aperture, actively-cooled telescope covering a wide span of the mid- to far-infrared spectrum. Its imagers and spectrographs will enable a variety of surveys of the sky that will discover and characterize the most distant galaxies, Milky-Way, exoplanets, and the outer reaches of our Solar system. Origins will enable flagship-quality general observing programs led by the astronomical community in the 2030s. The Science and Technology Definition Team (STDT) would like to hear your science needs and ideas for this mission. The team can be contacted at firsurveyor_info@lists.ipac.caltech.edu.A core science goal of the OST mission is to study the the cosmological history of star, galaxy, and structure formation into the epoch of reionization (EoR). OST will probe the birth of galaxies through warm molecular hydrogen emission during the cosmic dark ages. Utilizing the unique power of the infrared fine-structure emission lines, OST will trace the rise of metals from the first galaxies until today. It will quantify the dust enrichment history of the Universe, uncover its composition and physical conditions, reveal the first cosmic sources of dust, and probe the properties of the earliest star formation. OST will provide a detailed astrophysical probe into the condition of the intergalactic medium at z > 6 and the galaxies which dominate the epoch of reionization.

The Large UV/Optical/Infrared Surveyor (LUVOIR): Decadal Mission concept design update

NASA Astrophysics Data System (ADS)

Bolcar, Matthew R.; Aloezos, Steve; Bly, Vincent T.; Collins, Christine; Crooke, Julie; Dressing, Courtney D.; Fantano, Lou; Feinberg, Lee D.; France, Kevin; Gochar, Gene; Gong, Qian; Hylan, Jason E.; Jones, Andrew; Linares, Irving; Postman, Marc; Pueyo, Laurent; Roberge, Aki; Sacks, Lia; Tompkins, Steven; West, Garrett

2017-09-01

In preparation for the 2020 Astrophysics Decadal Survey, NASA has commissioned the study of four large mission concepts, including the Large Ultraviolet / Optical / Infrared (LUVOIR) Surveyor. The LUVOIR Science and Technology Definition Team (STDT) has identified a broad range of science objectives including the direct imaging and spectral characterization of habitable exoplanets around sun-like stars, the study of galaxy formation and evolution, the epoch of reionization, star and planet formation, and the remote sensing of Solar System bodies. NASA's Goddard Space Flight Center (GSFC) is providing the design and engineering support to develop executable and feasible mission concepts that are capable of the identified science objectives. We present an update on the first of two architectures being studied: a 15- meter-diameter segmented-aperture telescope with a suite of serviceable instruments operating over a range of wavelengths between 100 nm to 2.5 μm. Four instruments are being developed for this architecture: an optical / near-infrared coronagraph capable of 10-10 contrast at inner working angles as small as 2 λ/D the LUVOIR UV Multi-object Spectrograph (LUMOS), which will provide low- and medium-resolution UV (100 - 400 nm) multi-object imaging spectroscopy in addition to far-UV imaging; the High Definition Imager (HDI), a high-resolution wide-field-of-view NUV-Optical-IR imager; and a UV spectro-polarimeter being contributed by Centre National d'Etudes Spatiales (CNES). A fifth instrument, a multi-resolution optical-NIR spectrograph, is planned as part of a second architecture to be studied in late 2017.

Computer Program Development Specification for IDAMST Operational Flight Program Application, Software Type B5. Addendum 1.

DTIC Science & Technology

1976-07-30

Interface Requirements 4 3.1.1.1 Interface Block Diagram 4 3.1.1.2 Detailed Interface Definition 7 3.1.1.2.1 Subsystems 7 3.1.1.2.2 Controls & Displays 11 r...116 3.2.3.2 Navigation Brute Force 121 3.2.3.3 Cargo Brute Force 125 3.2.3.4 Sensor Brute Force 129 3.2.3.5 Controls /Displays Brute Force 135 3.2.3.6...STD-T553 Multiplex Data Bus, with the avionic subsystems, flight * control system, the controls /displays, engine sensors, and airframe sensors. 3.1

Origins Space Telescope: Breaking the Confusion Limit

NASA Astrophysics Data System (ADS)

Wright, Edward L.; Origins Space Telescope Science and Technology Definition Team

2018-01-01

The Origins Space Telescope (OST) is the mission concept for the Far-Infrared Surveyor, one of the four science and technology definition studies of NASA Headquarters for the 2020 Astronomy and Astrophysics Decadal survey. Origins will enable flagship-quality general observing programs led by the astronomical community in the 2030s.OST will have a background-limited sensitivity for a background 27,000 times lower than the Herschel background caused by thermal emission from Herschel's warm telescope. For continuum observations the confusion limit in a diffraction-limited survey can be reached in very short integration times at longer far-infrared wavelengths. But the confusion limit can be pierced for both the nearest and the farthest objects to be observed by OST. For outer the Solar System the targets' motion across the sky will provide a clear signature in surveys repeated after an interval of days to months. This will provide a size-frequency distribution of TNOs that is not biased toward high albedo objects.For the distant Universe the first galaxies and the first metals will provide a third dimension of spectral information that can be measured with a long-slit, medium resolution spectrograph. This will allow 3Dmapping to measure source densities as a function of redshift. The continuum shape associated with sourcesat different redshifts can be derived from correlation analyses of these 3D maps.Fairly large sky areas can be scanned by moving the spacecraft at a constant angular rate perpendicular to the orientation of the long slit of the spectrograph, avoiding the high overhead of step-and-stare surveying with a large space observatory.We welcome you to contact the Science and Technology Definition Team (STDT) with your science needs and ideas by emailing us at ost_info@lists.ipac.caltech.edu

The Origins Space Telescope: Tracing the Signatures of Life and the Ingredients of Habitable Worlds

NASA Astrophysics Data System (ADS)

Pontoppidan, Klaus Martin; Bergin, Edwin; Kaltenegger, Lisa; Milam, Stefanie N.; Sandstrom, Karin; Stevenson, Kevin; Origins Space Telescope Science and Technology Definition Team

2018-01-01

The Origins Space Telescope (OST) is the mission concept for the Far-Infrared Surveyor, one of the four science and technology definition studies of NASA Headquarters for the 2020 Astronomy and Astrophysics Decadal survey.Planet-hunting programs such as TRAPPIST, MEarth, and NASA's Kepler Space Observatory have confirmed the first Earth-sized planets orbiting within the habitable zones of their host stars. However, only once these planets' atmospheres have been characterized can their potential for supporting life be ascertained. Along with any detections of bio-relevant constituents of exoplanetary atmospheres, additional questions emerge. How are volatile elements - carbon, nitrogen, oxygen and the hydrogen in water - critical for life, delivered to habitable planets? This was an inefficient process for the Earth, but is it similarly difficult to deliver volatiles to Earth-sized planets in the habitable zone around other stars?The OST will have the power to reveal the formation, evolution and potential existence of biospheres, using the many unique tracers of water, organics and nitrogen-bearing species that dominate the infrared wavelength regions (5-600 micron). Using improved infrared detector stability and its large collecting area, OST will obtain infrared transmission and thermal emission spectra of transiting, potentially habitable, planets between 5.5-20 micron. This will allow for definitive measurements of atmospheric biosignatures and related species, such as CH4, O3, and CO2, and will measure planetary temperatures. An actively cooled, 4K telescope will vastly improve current sensitivities to far-infrared molecular lines by more than 3 orders of magnitude. OST will consequently be able to spectrally survey at least 1000 protoplanetary disks around stars down to the hydrogen-burning limit, map their content of water, and measure their total gas masses using HD as a tracer. Finally, OST will trace water back to its origin in the dense interstellar medium, as well as the origin of Earth's water by measuring the D/H ratio in comets.We welcome you to contact the Science and Technology Definition Team (STDT) with your science needs and ideas by emailing us at ost_info@lists.ipac.caltech.edu

Origins Space Telescope: The Far Infrared Imager and Polarimeter FIP

NASA Astrophysics Data System (ADS)

Staguhn, Johannes G.; Chuss, David; Howard, Joseph; Meixner, Margaret; Vieira, Joaquin; Amatucci, Edward; Bradley, Damon; Carter, Ruth; Cooray, Asantha; Flores, Anel; Leisawitz, David; Moseley, Samuel Harvey; Wollack, Edward; Origins Space Telescope Study Team

2018-01-01

The Origins Space Telescope (OST)* is the mission concept for the Far-Infrared Surveyor, one of the four science and technology definition studies of NASA Headquarters for the 2020 Astronomy and Astrophysics Decadal survey. The current "concept 1", which envisions a cold (4K) 9m space telescope, includes 5 instruments, providing a wavelength coverage ranging from 6um and 667um. The achievable sensitivity of the observatory will provide three to four orders of magnitude of improvement in sensitivity over current observational capabilities, allowing to address a wide range of new and so far inaccessible scientific questions, ranging from bio-signatures on exo-planets to mapping primordial H_2 from the "dark ages" before the universe went through the phase of re-ionization.Here we present the Far Infrared Imager and Polarimeter (FIP) for OST. The cameral will cover four bands, 40um, 80um, 120um, and 240um. It will allow for differential polarimetry in those bands with the ability to observe two colors in polarimtery mode simultaneously, while all four bands can be observed simultaneously in total power mode. While the confusion limit will be reached in only 32ms at 240um, at 40um the source density on the sky is so low, that at the angular resolution of 1" of OST at this wavelength there will be no source confusion, even for the longest integration times. Science topics that can be addressed by FIP include but are not limited to galactic and extragalactic magnetic field studies, Deep Galaxy Surveys, and Outer Solar System objects..*Origins will enable flagship-quality general observing programs led by the astronomical community in the 2030s. We welcome you to contact the Science and Technology Definition Team (STDT) with your science needs and ideas by emailing us at ost_info@lists.ipac.caltech.edu

Mission Architecture and Technology Options for a Flagship Class Venus In Situ Mission

NASA Technical Reports Server (NTRS)

Balint, Tibor S.; Kwok, Johnny H.; Kolawa, Elizabeth A.; Cutts, James A.; Senske, David A.

2008-01-01

Venus, as part of the inner triad with Earth and Mars, represents an important exploration target if we want to learn more about solar system formation and evolution. Comparative planetology could also elucidate the differences between the past, present, and future of these three planets, and can help with the characterization of potential habitable zones in our solar system and, by extension, extrasolar systems. A long lived in situ Venus mission concept, called the Venus Mobile Explorer, was prominently featured in NASA's 2006 SSE Roadmap and supported in the community White Paper by the Venus Exploration Analysis Group (VEXAG). Long-lived in situ missions are expected to belong to the largest (Flagship) mission class, which would require both enabling and enhancing technologies beside mission architecture options. Furthermore, extreme environment mitigation technologies for Venus are considered long lead development items and are expected to require technology development through a dedicated program. To better understand programmatic and technology needs and the motivating science behind them, in this fiscal year (FY08) NASA is funding a Venus Flaghip class mission study, based on key science and technology drivers identified by a NASA appointed Venus Science and Technology Definition Team (STDT). These mission drivers are then assembled around a suitable mission architecture to further refine technology and cost elements. In this paper we will discuss the connection between the final mission architecture and the connected technology drivers from this NASA funded study, which - if funded - could enable a future Flagship class Venus mission and potentially drive a proposed Venus technology development program.

A Venus Flagship Mission: Exploring a World of Contrasts

NASA Astrophysics Data System (ADS)

Senske, D.; Bullock, M.; Balint, T.; Benz, A.; Campbell, B.; Chassefiere, E.; Colaprete, A.; Cutts, J.; Glaze, L.; Gorevan, S.; Grinspoon, D.; Hall, J.; Hasimoto, G.; Head, J.; Hunter, G.; Johnson, N.; Kiefer, W.; Kolawa, E.; Kremic, T.; Kwok, J.; Limaye, S.; Mackwell, S.; Marov, M.; Peterson, C.; Schubert, G.; Spilker, T.; Stofan, E.; Svedhem, H.; Titov, D.; Treiman, A.

2008-12-01

Results from past missions and the current Venus Express Mission show that Venus is a world of contrasts, providing clear science drivers for renewed exploration of this planet. In early 2008, NASA's Science Mission Directorate formed a Science and Technology Definition Team (STDT) to formulate science goals and objectives, mission architecture and a technology roadmap for a flagship class mission to Venus. This 3- to 4 billon mission, to launch in the post 2020 timeframe, should revolutionize our understanding of how climate works on terrestrial planets, including the close relationship between volcanism, tectonism, the interior, and the atmosphere. It would also more clearly elucidate the geologic history of Venus, including the existence and persistence of an ancient ocean. Achieving these objectives will provide a basis to understand the habitability of extra solar terrestrial planets. To address a broad range of science questions this mission will be composed of flight elements that include an orbiter that is highlighted by an interferometric SAR to provide surface topographic and image information at scales one to two orders of magnitude greater than that achieved by any previous spacecraft to Venus. Two balloons with a projected lifetime of weeks will probe the structure and dynamics of the atmosphere at an altitude of 50 to 70-km. In addition, two descent probes will collect data synergistic to that from the balloon and analyze the geochemistry of surface rocks over a period of hours. The technology road map focuses on key areas of science instruments and enabling engineering to provide greater in situ longevity in the hostile Venus environment.

Long-Lived Venus Lander Conceptual Design: How To Keep It Cool

NASA Technical Reports Server (NTRS)

Dyson, Ridger W.; Schmitz, Paul C.; Penswick, L. Barry; Bruder, Geoffrey A.

2009-01-01

Surprisingly little is known about Venus, our neighboring sister planet in the solar system, due to the challenges of operating in its extremely hot, corrosive, and dense environment. For example, after over two dozen missions to the planet, the longest-lived lander was the Soviet Venera 13, and it only survived two hours on the surface. Several conceptual Venus mission studies have been formulated in the past two decades proposing lander architectures that potentially extend lander lifetime. Most recently, the Venus Science and Technology Definition Team (STDT) was commissioned by NASA to study a Venus Flagship Mission potentially launching in the 2020- 2025 time-frame; the reference lander of this study is designed to survive for only a few hours more than Venera 13 launched back in 1981! Since Cytherean mission planners lack a viable approach to a long-lived surface architecture, specific scientific objectives outlined in the National Science Foundation Decadal Survey and Venus Exploration Advisory Group final report cannot be completed. These include: mapping the mineralogy and composition of the surface on a planetary scale determining the age of various rock samples on Venus, searching for evidence of changes in interior dynamics (seismometry) and its impact on climate and many other key observations that benefit with time scales of at least a full Venus day (Le. daylight/night cycle). This report reviews those studies and recommends a hybrid lander architecture that can survive for at least one Venus day (243 Earth days) by incorporating selective Stirling multi-stage active cooling and hybrid thermoacoustic power.

Somatosensory temporal discrimination is prolonged during migraine attacks.

PubMed

Boran, H Evren; Cengiz, Bülent; Bolay, Hayrunnisa

2016-01-01

Symptoms and signs of sensorial disturbances are characteristic features of a migraine headache. Somatosensory temporal discrimination measures the temporal threshold to perceive two separate somaesthetic stimuli as clearly distinct. This study aimed to evaluate somaesthetic perception in migraine patients by measuring the somatosensory temporal discrimination thresholds. The study included 12 migraine patients without aura and 12 volunteers without headache. Somatosensory temporal discrimination threshold (STDT) values were measured in the face (V3) and hands (C7) during a lateralized headache attack and the headache-free interictal period. The disease duration, pain intensity, phonophobia, photophobia, nausea, vomiting, and brush allodynia were also recorded during the migraine attack. STDT values were within normal limits and not different between the control group and the interictal period in migraine patients. Compared to the headache-free period, STDT values during the attack were significantly prolonged in the contralateral hand (C7) (155.7 ± 84.2 vs 40.6 ± 16.1 ms [P < .001]), ipsilateral hand (C7) (88.6 ± 51.3 vs 31.4 ± 14.2 ms [P < 0.001]), contralateral face (V3) (65.5 ± 35.4 vs 37.6 ± 22.2 ms [P = .006]) and ipsilateral face (V3) (104.1 ± 44.5 vs 37.5 ± 21.4 ms [P < 0.001]) according to the lateralization of the headache. Ictal STDT values of the contralateral hand and ipsilateral face were significantly increased compared to that of the ipsilateral hand and contralateral face (155.7 ± 84.2 ms vs 88.6 ± 5.1.3 ms [P = .001], 104.1 ± 44.5 ms vs 65.5 ± 35.4 ms [P = 0.001]). No allodynia was detected in the areas that were tested for somatosensory temporal discrimination. The visual analog scale scores were correlated with the somatosensory temporal discrimination thresholds of the contralateral hand (r = 0.602, P = .038), whereas no correlation was detected between the somatosensory temporal discrimination thresholds and disease duration, brush allodynia in the forehead, phonophobia, photophobia, nausea and vomiting. The study demonstrates for the first time that somatosensory temporal discrimination thresholds are elevated during migraine attacks. A transient disruption of the central processing of somaesthetic stimuli during the lateralized migraine attack may provide additional information to understand the mechanisms of the cognitive and sensory perception impairment associated with migraine headache and may have diagnostic value. © 2015 American Headache Society.

Status and Path Forward for the Large Ultraviolet Optical Infrared Surveyor (LUVOIR) Mission Concept Study

NASA Technical Reports Server (NTRS)

Crooke, Julie A.; Roberge, Aki; Domagal-Goldman, Shawn D.; Mandell, Avram M.; Bolcar, Matthew R.; Rioux, Norman M.; Perez, Mario R.; Smith, Erin C.

2016-01-01

In preparation of the 2020 Astrophysics Decadal Survey, National Aeronautics and Space Administration (NASA) has commenced a process for the astronomical community to study several large mission concepts leveraging the lessons learned from past Decadal Surveys. This will enable the Decadal Survey committee to make more informed recommendations to NASA on its astrophysics science and mission priorities with respect to cost and risk. Four astrophysics large mission concepts were identified. Each of them had a Science and Technology Definition Teem(STDT) chartered to produce scientifically compelling, feasible, and executable design reference mission (DRM)concepts to present to the 2020 Decadal Survey. In addition, The Aerospace Corporation will perform an independent cost and technical evaluation (CATE) of each of these mission concept studies in advance of the 2020 Decadal Survey by interacting with the STDTs to provide detailed technical details on certain areas for which deep dives are appropriate. This paper presents the status and path forward for one of the four large mission concepts, namely, the Large UltraViolet, Optical, InfraRed surveyor (LUVOIR).

Status and path forward for the large ultraviolet/optical/infrared surveyor (LUVOIR) mission concept study

NASA Astrophysics Data System (ADS)

Crooke, Julie A.; Roberge, Aki; Domagal-Goldman, Shawn D.; Mandell, Avi M.; Bolcar, Matthew R.; Rioux, Norman M.; Perez, Mario R.; Smith, Erin C.

2016-07-01

In preparation of the 2020 Astrophysics Decadal Survey, National Aeronautics and Space Administration (NASA) has commenced a process for the astronomical community to study several large mission concepts leveraging the lessons learned from past Decadal Surveys. This will enable the Decadal Survey committee to make more informed recommendations to NASA on its astrophysics science and mission priorities with respect to cost and risk. Four astrophysics large mission concepts were identified. Each of them had a Science and Technology Definition Teem (STDT) chartered to produce scientifically compelling, feasible, and executable design reference mission (DRM) concepts to present to the 2020 Decadal Survey. In addition, The Aerospace Corporation will perform an independent cost and technical evaluation (CATE) of each of these mission concept studies in advance of the 2020 Decadal Survey, by interacting with the STDTs to provide detailed technical details on certain areas for which "deep dives" are appropriate. This paper presents the status and path forward for one of the four large mission concepts, namely, the Large UltraViolet, Optical, InfraRed surveyor (LUVOIR).

Origins Space Telescope: HEterodyne Receiver for OST (HERO)

NASA Astrophysics Data System (ADS)

Bergin, Edwin; Wiedner, Martina; Laurens, Andre; Gerin, Maryvonne; HERO team, Origins Space Telescope Science and Technology Definition Team

2018-01-01

The Origins Space Telescope (OST) is a mission concept for the Far-Infrared Surveyor, one of the four science and technology definition studies selected by NASA HQ for the 2020 Astronomy and Astrophysics Decadal survey. The OST study will encompass two mission concepts (poster by A. Cooray). Concept 1 is an extremely versatile observatory with 5 science instruments, of which the HEterodyne Receivers for OST (HERO) is one.HERO’s main targets are high spectral resolution observations (Dl/l up to 107 or Dv = 0.03km/s) of water to follow its trail from cores to YSOs as well as H2O and HDO observations on comets to explore the origins of water. HERO will probe all neutral ISM phases using cooling lines ([CII], [OI]) and hydrides as probes of CO-dark H2 (CH, HF). HERO will reveal how molecular clouds and filaments form in the local ISM up to nearby galaxies. HERO will enable detailed understanding of feedback mechanisms : shocks, cosmic rays, UV induced feedback and will provide a map of the cosmic ray ionization rate in the Galaxy and nearby galaxies using molecular ions (ArH+, OH+, H3O+).In order to achieve these observational goals, HERO will cover an extremely wide frequency range from 468 to 2700 GHz (641 to 111microns) and a window around the OI line at 4563 to 4752GHz (66 to 63 microns). It will consist of very large focal plane arrays of 128 pixels between 900 - 2700 GHz and at 4.7 THz, and 32 pixels for the 468 to 900 GHz range. The instrument is exploiting Herschel/HIFI heritage, but will go well beyond HIFIs capacities. HERO’s large arrays require low dissipation and low power components. The HERO concept makes use of the latest cryogenic SiGe amplifier technology, as well as CMOS technology for the backends with 2 orders of magnitude lower power. Advances in Local Oscillator technology have also been taken into account and ambitious, but realistic assumptions have been made for future amplifier multiplier chains going up to 4.7 THz.Origins will enable flagship-quality general observing programs led by the astronomical community in the 2030s. We welcome you to contact the Science and Technology Definition Team (STDT) with your science needs and ideas by emailing us at ost_info@lists.ipac.caltech.edu

High frequency repetitive sensory stimulation improves temporal discrimination in healthy subjects.

PubMed

Erro, Roberto; Rocchi, Lorenzo; Antelmi, Elena; Palladino, Raffaele; Tinazzi, Michele; Rothwell, John; Bhatia, Kailash P

2016-01-01

High frequency electrical stimulation of an area of skin on a finger improves two-point spatial discrimination in the stimulated area, likely depending on plastic changes in the somatosensory cortex. However, it is unknown whether improvement also applies to temporal discrimination. Twelve young and ten elderly volunteers underwent the stimulation protocol onto the palmar skin of the right index finger. Somatosensory temporal discrimination threshold (STDT) was evaluated before and immediately after stimulation as well as 2.5h and 24h later. There was a significant reduction in somatosensory temporal threshold only on the stimulated finger. The effect was reversible, with STDT returning to the baseline values within 24h, and was smaller in the elderly than in the young participants. High frequency stimulation of the skin focally improves temporal discrimination in the area of stimulation. Given previous suggestions that the perceptual effects rely on plastic changes in the somatosensory cortex, our results are consistent with the idea that the timing of sensory stimuli is, at least partially, encoded in the primary somatosensory cortex. Such a protocol could potentially be used as a therapeutic intervention to ameliorate physiological decline in the elderly or in other disorders of sensorimotor integration. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Will the right Robin patient rise, please? Definitions and criteria during management of Robin sequence patients in the Netherlands and Belgium.

PubMed

Basart, Hanneke; Kruisinga, Frea H; Breugem, Corstiaan C; Don Griot, J Peter W; Hennekam, Raoul C; Van der Horst, Chantal M A M

2015-01-01

Robin Sequence (RS) is characterized by micrognathia and upper airway obstruction (UAO), with or without cleft palate, causing respiratory and feeding problems. Management options are: positioning; nasopharyngeal airway (NPA); tongue-lip adhesion (TLA); mandibular distraction (MDO); and tracheostomy. Controversy exists in literature regarding RS definition and management. Here we describe definitions, management strategies and criteria in opting for management strategies, used by Dutch and Belgian cleft teams. A specifically designed questionnaire was sent to members of all 16 Dutch and Belgian cleft teams. 14 cleft teams returned 35 questionnaires. All used micrognathia as definition criterion, 93.4% cleft palate, 51.5%glossoptosis and 45.7% UAO. Six different RS definitions were used; even within a single team >1 definition was used. All teams used different management strategies: all used positioning, 10 NPA, 6 TLA, 7 MDO, 8 tracheostomy, 5 refer patients with invasive treatment indication. Criteria in opting management modalities were: O2-saturation (89.3%), clinical presentation (86.2%), growth and feeding problems (69.0%), polysomnography (62.1%), and differed within teams. The Dutch and Belgian cleft teams use variable RS definitions, different management modalities and criteria in choosing management strategies. A single, strict definition and evidence-based management guidelines should be formulated for optimal patient care. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

15 CFR 270.2 - Definitions used in this part.

Code of Federal Regulations, 2013 CFR

2013-01-01

... INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS General § 270.2 Definitions used in this part. The following definitions are applicable to this part: Act. The National Construction Safety Team Act (Pub. L. 107-231, 116 Stat. 1471...

15 CFR 270.2 - Definitions used in this part.

Code of Federal Regulations, 2011 CFR

2011-01-01

... INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS General § 270.2 Definitions used in this part. The following definitions are applicable to this part: Act. The National Construction Safety Team Act (Pub. L. 107-231, 116 Stat. 1471...

15 CFR 270.2 - Definitions used in this part.

Code of Federal Regulations, 2012 CFR

2012-01-01

... INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS General § 270.2 Definitions used in this part. The following definitions are applicable to this part: Act. The National Construction Safety Team Act (Pub. L. 107-231, 116 Stat. 1471...

15 CFR 270.2 - Definitions used in this part.

Code of Federal Regulations, 2014 CFR

2014-01-01

... INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS General § 270.2 Definitions used in this part. The following definitions are applicable to this part: Act. The National Construction Safety Team Act (Pub. L. 107-231, 116 Stat. 1471...

15 CFR 270.2 - Definitions used in this part.

Code of Federal Regulations, 2010 CFR

2010-01-01

... INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS General § 270.2 Definitions used in this part. The following definitions are applicable to this part: Act. The National Construction Safety Team Act (Pub. L. 107-231, 116 Stat. 1471...

Pay dispersion and performance in teams.

PubMed

Bucciol, Alessandro; Foss, Nicolai J; Piovesan, Marco

2014-01-01

Extant research offers conflicting predictions about the effect of pay dispersion on team performance. We collected a unique dataset from the Italian soccer league to study the effect of intra-firm pay dispersion on team performance, under different definitions of what constitutes a "team". This peculiarity of our dataset can explain the conflicting evidence. Indeed, we also find positive, null, and negative effects of pay dispersion on team performance, using the same data but different definitions of team. Our results show that when the team is considered to consist of only the members who directly contribute to the outcome, high pay dispersion has a detrimental impact on team performance. Enlarging the definition of the team causes this effect to disappear or even change direction. Finally, we find that the detrimental effect of pay dispersion is due to worse individual performance, rather than a reduction of team cooperation.

Pay Dispersion and Performance in Teams

PubMed Central

Bucciol, Alessandro; Foss, Nicolai J.; Piovesan, Marco

2014-01-01

Extant research offers conflicting predictions about the effect of pay dispersion on team performance. We collected a unique dataset from the Italian soccer league to study the effect of intra-firm pay dispersion on team performance, under different definitions of what constitutes a “team”. This peculiarity of our dataset can explain the conflicting evidence. Indeed, we also find positive, null, and negative effects of pay dispersion on team performance, using the same data but different definitions of team. Our results show that when the team is considered to consist of only the members who directly contribute to the outcome, high pay dispersion has a detrimental impact on team performance. Enlarging the definition of the team causes this effect to disappear or even change direction. Finally, we find that the detrimental effect of pay dispersion is due to worse individual performance, rather than a reduction of team cooperation. PMID:25397615

48 CFR 9.601 - Definition.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Definition. 9.601 Section 9.601 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION ACQUISITION PLANNING CONTRACTOR QUALIFICATIONS Contractor Team Arrangements 9.601 Definition. Contractor team arrangement, as used...

48 CFR 9.601 - Definition.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Definition. 9.601 Section 9.601 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION ACQUISITION PLANNING CONTRACTOR QUALIFICATIONS Contractor Team Arrangements 9.601 Definition. Contractor team arrangement, as used...

48 CFR 9.601 - Definition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Definition. 9.601 Section 9.601 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION ACQUISITION PLANNING CONTRACTOR QUALIFICATIONS Contractor Team Arrangements 9.601 Definition. Contractor team arrangement, as used...

48 CFR 9.601 - Definition.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Definition. 9.601 Section 9.601 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION ACQUISITION PLANNING CONTRACTOR QUALIFICATIONS Contractor Team Arrangements 9.601 Definition. Contractor team arrangement, as used...

48 CFR 9.601 - Definition.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Definition. 9.601 Section 9.601 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION ACQUISITION PLANNING CONTRACTOR QUALIFICATIONS Contractor Team Arrangements 9.601 Definition. Contractor team arrangement, as used...

Novel Hybrid CMOS X-ray Detector Developments for Future Large Area and High Resolution X-ray Astronomy Missions

NASA Astrophysics Data System (ADS)

Falcone, Abe

In the coming years, X-ray astronomy will require new soft X-ray detectors that can be read very quickly with low noise and can achieve small pixel sizes over a moderately large focal plane area. These requirements will be present for a variety of X-ray missions that will attempt to address science that was highly ranked by the 2010 Decadal Survey, including missions with science that overlaps with that of IXO and Athena, as well as other missions addressing science topics beyond those of IXO and Athena. An X-ray Surveyor mission was recently chosen by NASA for study by a Science & Technology Definition Team (STDT) so it can be considered as an option for an upcom-ing flagship mission. A mission such as this was endorsed by the NASA long term planning document entitled "Enduring Quests, Daring Visions," and a detailed description of one possible reali-zation of such a mission has been referred to as SMART-X, which was described in a recent NASA RFI response. This provides an example of a future mission concept with these requirements since it has high X-ray throughput and excellent spatial resolution. We propose to continue to modify current active pixel sensor designs, in particular the hybrid CMOS detectors that we have been working with for several years, and implement new in-pixel technologies that will allow us to achieve these ambitious and realistic requirements on a timeline that will make them available to upcoming X-ray missions. This proposal is a continuation of our program that has been work-ing on these developments for the past several years. The first 3 years of the program led to the development of a new circuit design for each pixel, which has now been shown to be suitable for a larger detector array. The proposed activity for the next four years will be to incorporate this pixel design into a new design of a full detector array (2k×2k pixels with digital output) and to fabricate this full-sized device so it can be thoroughly tested and characterized.

32 CFR 60.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... COMMAND ASSISTANCE TEAM (FACAT) § 60.3 Definitions. Unless otherwise noted, these terms and their.... FACAT. A multidisciplinary team composed of specially trained and experienced individuals who are on...

Does the Reliability of Reporting in Injury Surveillance Studies Depend on Injury Definition?

PubMed

Cross, Matthew; Williams, Sean; Kemp, Simon P T; Fuller, Colin; Taylor, Aileen; Brooks, John; Trewartha, Grant; Stokes, Keith

2018-03-01

Choosing an appropriate definition for injury in injury surveillance studies is essential to ensure a balance among reporting reliability, providing an accurate representation of injury risk, and describing the nature of the clinical demand. To provide guidance on the choice of injury definition for injury surveillance studies by comparing within- and between-team variability in injury incidence with >24-hour and >7-day time-loss injury definitions in a large multiteam injury surveillance study. Cohort study (diagnosis); Level of evidence, 2. Injury data were reported for 2248 professional rugby union players from 15 Premiership Rugby clubs over 12 seasons. Within-team percentage coefficient of variation and mean between-team standard deviation (expressed as a percentage coefficient of variation) in injury incidence rates (injuries per 1000 player match hours) were calculated. For both variables, a comparison was made between >24-hour and >7-day injury incidence rates in terms of the magnitude of the observed effects. The overall mean incidence across the population with a >24-hour time-loss injury definition was approximately double the reported incidence with the >7-day definition. There was a 10% higher between-team variation in match injury incidence rates with the >24-hour time-loss definition versus the >7-day definition. There was a likely higher degree of between-team variation in match injury incidence rates with a >24-hour time-loss definition than with a >7-day definition of injury. However, in professional sports settings, it is likely that the benefits of using a more inclusive definition of injury (improved understanding of clinical demand and the appropriate and accurate reporting of injury risk) outweigh the small increase in variation in reporting consistency.

Does the Reliability of Reporting in Injury Surveillance Studies Depend on Injury Definition?

PubMed Central

Cross, Matthew; Williams, Sean; Kemp, Simon P.T.; Fuller, Colin; Taylor, Aileen; Brooks, John; Trewartha, Grant; Stokes, Keith

2018-01-01

Background: Choosing an appropriate definition for injury in injury surveillance studies is essential to ensure a balance among reporting reliability, providing an accurate representation of injury risk, and describing the nature of the clinical demand. Purpose: To provide guidance on the choice of injury definition for injury surveillance studies by comparing within- and between-team variability in injury incidence with >24-hour and >7-day time-loss injury definitions in a large multiteam injury surveillance study. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Injury data were reported for 2248 professional rugby union players from 15 Premiership Rugby clubs over 12 seasons. Within-team percentage coefficient of variation and mean between-team standard deviation (expressed as a percentage coefficient of variation) in injury incidence rates (injuries per 1000 player match hours) were calculated. For both variables, a comparison was made between >24-hour and >7-day injury incidence rates in terms of the magnitude of the observed effects. Results: The overall mean incidence across the population with a >24-hour time-loss injury definition was approximately double the reported incidence with the >7-day definition. There was a 10% higher between-team variation in match injury incidence rates with the >24-hour time-loss definition versus the >7-day definition. Conclusion: There was a likely higher degree of between-team variation in match injury incidence rates with a >24-hour time-loss definition than with a >7-day definition of injury. However, in professional sports settings, it is likely that the benefits of using a more inclusive definition of injury (improved understanding of clinical demand and the appropriate and accurate reporting of injury risk) outweigh the small increase in variation in reporting consistency. PMID:29581994

Cognitive Aids for Role Definition (CARD) to improve interprofessional team crisis resource management: An exploratory study.

PubMed

Renna, Tania Di; Crooks, Simone; Pigford, Ashlee-Ann; Clarkin, Chantalle; Fraser, Amy B; Bunting, Alexandra C; Bould, M Dylan; Boet, Sylvain

2016-09-01

This study aimed to assess the perceived value of the Cognitive Aids for Role Definition (CARD) protocol for simulated intraoperative cardiac arrests. Sixteen interprofessional operating room teams completed three consecutive simulated intraoperative cardiac arrest scenarios: current standard, no CARD; CARD, no CARD teaching; and CARD, didactic teaching. Each team participated in a focus group interview immediately following the third scenario; data were transcribed verbatim and qualitatively analysed. After 6 months, participants formed eight new teams randomised to two groups (CARD or no CARD) and completed a retention intraoperative cardiac arrest simulation scenario. All simulation sessions were video recorded and expert raters assessed team performance. Qualitative analysis of the 16 focus group interviews revealed 3 thematic dimensions: role definition in crisis management; logistical issues; and the "real life" applicability of CARD. Members of the interprofessional team perceived CARD very positively. Exploratory quantitative analysis found no significant differences in team performance with or without CARD (p > 0.05). In conclusion, qualitative data suggest that the CARD protocol clarifies roles and team coordination during interprofessional crisis management and has the potential to improve the team performance. The concept of a self-organising team with defined roles is promising for patient safety.

Team Learning in Teacher Teams: Team Entitativity as a Bridge between Teams-in-Theory and Teams-in-Practice

ERIC Educational Resources Information Center

Vangrieken, Katrien; Dochy, Filip; Raes, Elisabeth

2016-01-01

This study aimed to investigate team learning in the context of teacher teams in higher vocational education. As teacher teams often do not meet all criteria included in theoretical team definitions, the construct "team entitativity" was introduced. Defined as the degree to which a group of individuals possesses the quality of being a…

Defining Role in the New Classroom Teams.

ERIC Educational Resources Information Center

Thomas, Gary

1991-01-01

Interviews with four teachers, one parent, one assistant, and two ancillary helpers found that classroom teams possess little structure with minimal role definition. Participants erect defenses against the lack of definition and use a process termed "fraternity" to get along with one another and camouflage uncertainties and tensions. (SK)

Definitional ceremonies: narrative practices for psychologists to inform interdisciplinary teams' understanding of children's spirituality in pediatric settings.

PubMed

Moore, Kelsey; Talwar, Victoria; Moxley-Haegert, Linda

2015-03-01

In pediatric settings, parents and children often seek spiritual and religious support from their healthcare provider, as they try to find meaning in their illness. Narrative practices, such as definitional ceremonies, can provide a unique framework for psychologists to explore children's spirituality and its role in the midst of illness. In addition, definitional ceremonies can be used as a means for psychologists to inform interdisciplinary teams' understanding of children's spirituality and its relevance in pediatric treatment settings. In this article, our objectives are to (a) provide a brief overview of the literature on children's spirituality, (b) review some of the literature on childhood cancer patients' spirituality, (c) highlight the importance of whole-person care for diverse pediatric patients, and (d) introduce definitional ceremonies as appropriate narrative practices that psychologists can use to both guide their therapy and inform interdisciplinary teams' understanding of children's spirituality. © The Author(s) 2015.

A Simulation Study of Four Real-Time Heuristic Algorithms for Multiple Missile Missile Evasion: A Game Theoretic Approach

DTIC Science & Technology

1979-06-01

DIMENSION ACD (1OO,2) 6 LOGICAL FRIED, FLAGI, FLA62 I INTEQEI CUTIME a COMMON /AMP/ TO,QOSU,ALFAO,CLO,oOJ,L0,G, MRU ,CO1 ,c02,C03, 9 1 RHO,DjEIACLAFUSw,DU1...ARS11c’Ii+TE:TI/jiK11 STDT14G’COSGAM/V1) 56 U 1 =A IAN (AR G 1 ti9 TESTzAoS(THEDTI) YQ IF( TESI GSE. JNRESII) LF1m 91 1 R K 1 1 7 E T *V1 -CvS G AAJ( S IN

From problem solving to problem definition: scrutinizing the complex nature of clinical practice.

PubMed

Cristancho, Sayra; Lingard, Lorelei; Regehr, Glenn

2017-02-01

In medical education, we have tended to present problems as being singular, stable, and solvable. Problem solving has, therefore, drawn much of medical education researchers' attention. This focus has been important but it is limited in terms of preparing clinicians to deal with the complexity of the 21st century healthcare system in which they will provide team-based care for patients with complex medical illness. In this paper, we use the Soft Systems Engineering principles to introduce the idea that in complex, team-based situations, problems usually involve divergent views and evolve with multiple solution iterations. As such we need to shift the conversation from (1) problem solving to problem definition, and (2) from a problem definition derived exclusively at the level of the individual to a definition derived at the level of the situation in which the problem is manifested. Embracing such a focus on problem definition will enable us to advocate for novel educational practices that will equip trainees to effectively manage the problems they will encounter in complex, team-based healthcare.

Team-Based Care: A Concept Analysis.

PubMed

Baik, Dawon

2017-10-01

The purpose of this concept analysis is to clarify and analyze the concept of team-based care in clinical practice. Team-based care has garnered attention as a way to enhance healthcare delivery and patient care related to quality and safety. However, there is no consensus on the concept of team-based care; as a result, the lack of common definition impedes further studies on team-based care. This analysis was conducted using Walker and Avant's strategy. Literature searches were conducted using PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO, with a timeline from January 1985 to December 2015. The analysis demonstrates that the concept of team-based care has three core attributes: (a) interprofessional collaboration, (b) patient-centered approach, and (c) integrated care process. This is accomplished through understanding other team members' roles and responsibilities, a climate of mutual respect, and organizational support. Consequences of team-based care are identified with three aspects: (a) patient, (b) healthcare professional, and (c) healthcare organization. This concept analysis helps better understand the characteristics of team-based care in the clinical practice as well as promote the development of a theoretical definition of team-based care. © 2016 Wiley Periodicals, Inc.

Common Factors of High Performance Teams

ERIC Educational Resources Information Center

Jackson, Bruce; Madsen, Susan R.

2005-01-01

Utilization of work teams is now wide spread in all types of organizations throughout the world. However, an understanding of the important factors common to high performance teams is rare. The purpose of this content analysis is to explore the literature and propose findings related to high performance teams. These include definition and types,…

24 CFR 3282.7 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... or appliance which is built in as an integral part of the manufactured home during the manufacturing... (paragraph ff). (q) Joint monitoring team means a monitoring inspection team composed of personnel provided...

24 CFR 3282.7 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... or appliance which is built in as an integral part of the manufactured home during the manufacturing... (paragraph ff). (q) Joint monitoring team means a monitoring inspection team composed of personnel provided...

24 CFR 3282.7 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... or appliance which is built in as an integral part of the manufactured home during the manufacturing... (paragraph ff). (q) Joint monitoring team means a monitoring inspection team composed of personnel provided...

24 CFR 3282.7 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... or appliance which is built in as an integral part of the manufactured home during the manufacturing... monitoring team means a monitoring inspection team composed of personnel provided by the various State...

Fuzzy Analysis in Creative Problem Solving.

ERIC Educational Resources Information Center

Carey, Russell L.

1984-01-01

"Diagraming Analysis of a Fuzzy Technique" (DAFT) is a model rectifying two problems associated with Future Problem Solving Bowl activities, namely problem definition by teams and evaluation of team responses. (MC)

5 CFR 451.102 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Definitions. Award means something bestowed or an action taken to recognize and reward individual or team..., performance goals, measurement systems, award formulas, or payout schedules. Award program means the specific...

Emergence of Confucianism from Teachers' Definitions of Guidance and Discipline in Hong Kong Secondary Schools

ERIC Educational Resources Information Center

Hue, Ming-Tak

2007-01-01

Teachers in Hong Kong, as elsewhere, are concerned with students' misbehaviour. In secondary schools two teams of teachers, a guidance team and a discipline team, deal with it. This article examines how teachers make sense of their caring work and strategies for behaviour management. Taking an interactionist perspective, the framework suggested by…

The Definition and Measurement of Small Military Unit Team Functions. Final Report, July 1980-October 1981.

ERIC Educational Resources Information Center

Shiflett, Samuel; And Others

A study was undertaken to improve the measurement of small team performance within the Army. A provisional taxonomy of team-level performance functions was field-validated; criteria and measures of the functions were developed; and their reliability was examined. The provisional taxonomy, used for observing Army field training exercises, was used…

What is the role of a specialist regional mesothelioma multidisciplinary team meeting? A service evaluation of one tertiary referral centre in the UK.

PubMed

Bibby, Anna C; Williams, Katie; Smith, Sarah; Bhatt, Nidhi; Maskell, Nick A

2016-09-08

Multidisciplinary team meetings are standard care for cancer in the UK and Europe. Professional bodies recommend that mesothelioma cases should be discussed at specialist multidisciplinary team meetings. However, no evidence exists exploring the role of the specialist mesothelioma multidisciplinary team meeting. To evaluate the clinical activity of 1 specialist mesothelioma multidisciplinary team meeting and to determine how often a definitive diagnosis was made, whether the core requirements of the meeting were met and whether there was any associated benefit or detriment. A service evaluation using routinely collected data from 1 specialist mesothelioma multidisciplinary team meeting in a tertiary referral hospital in the South-West of England. All cases discussed between 1/1/2014 and 31/12/2015. The primary outcome measure was whether a definitive diagnosis was made. Secondary outcomes included whether treatment advice was offered, information on clinical trials provided or further investigations suggested. Additional benefits of the multidisciplinary team meeting and time taken from referral to outcome were also collected. A definitive diagnosis was reached in 171 of 210 cases discussed (81%). Mesothelioma was diagnosed in 153/210 (73%). Treatment advice was provided for 127 of 171 diagnostic cases (74%) and further investigations suggested for all 35 non-diagnostic cases. 86/210 cases (41%) were invited to participate in a trial, of whom 43/86 (50%) subsequently enrolled. Additional benefits included the avoidance of postmortem examination if the coroner was satisfied with the multidisciplinary team decision. The overall process from referral to outcome dispatch was <2 weeks in 75% of cases. This specialist mesothelioma multidisciplinary team meeting was effective at making diagnoses and providing recommendations for further investigations or treatment. The core requirements of a specialist mesothelioma multidisciplinary team meeting were met. The process was timely, with most outcomes returned within 2 weeks of referral. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Thermosphere-ionosphere-mesosphere energetics and dynamics (TIMED). The TIMED mission and science program report of the science definition team. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

1991-01-01

A Science Definition Team was established in December 1990 by the Space Physics Division, NASA, to develop a satellite program to conduct research on the energetics, dynamics, and chemistry of the mesosphere and lower thermosphere/ionosphere. This two-volume publication describes the TIMED (Thermosphere-Ionosphere-Mesosphere, Energetics and Dynamics) mission and associated science program. The report outlines the scientific objectives of the mission, the program requirements, and the approach towards meeting these requirements.

30 CFR 254.6 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... Pipeline means pipe and any associated equipment, appurtenance, or building used or intended for use in the... with “discharge” for the purposes of this part. Spill management team means the trained persons... for directing and coordinating response operations. Spill-response operating team means the trained...

30 CFR 254.6 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... Pipeline means pipe and any associated equipment, appurtenance, or building used or intended for use in the... with “discharge” for the purposes of this part. Spill management team means the trained persons... for directing and coordinating response operations. Spill-response operating team means the trained...

30 CFR 254.6 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... Pipeline means pipe and any associated equipment, appurtenance, or building used or intended for use in the... with “discharge” for the purposes of this part. Spill management team means the trained persons... for directing and coordinating response operations. Spill-response operating team means the trained...

NASA in-house Commercially Developed Space Facility (CDSF) study report. Volume 1: Concept configuration definition

NASA Technical Reports Server (NTRS)

Deryder, L. J.; Chiger, H. D.; Deryder, D. D.; Detweiler, K. N.; Dupree, R. L.; Gillespie, V. P.; Hall, J. B.; Heck, M. L.; Herrick, D. C.; Katzberg, S. J.

1989-01-01

The results of a NASA in-house team effort to develop a concept definition for a Commercially Developed Space Facility (CDSF) are presented. Science mission utilization definition scenarios are documented, the conceptual configuration definition system performance parameters qualified, benchmark operational scenarios developed, space shuttle interface descriptions provided, and development schedule activity was assessed with respect to the establishment of a proposed launch date.

Targeted Research and Technology Within NASA's Living With a Star Program

NASA Technical Reports Server (NTRS)

Hesse, Michael

2003-01-01

NASA's Living With a Star (LWS) initiative is a systematic, goal-oriented research program targeting those aspects of the Sun-Earth system that affect society. The Targeted Research and Technology (TR&T) component of LWS provides the theory, modeling, and data analysis necessary to enable an integrated, system-wide picture of Sun-Earth connection science with societal relevance. Recognizing the central and essential role that TR&T would have for the success of the LWS initiative, the LWS Science Architecture Team (SAT) recommended that a Science Definition Team (SDT), with the same status as a flight mission definition team, be formed to design and coordinate a TR&T program having prioritized goals and objectives that focused on practical societal benefits. This report details the SDT recommendations for the TR&T program.

Sexual Assault Policies and Consent Definitions: A Nationally Representative Investigation of U.S. Colleges and Universities

ERIC Educational Resources Information Center

Graham, Laurie M.; Treves-Kagan, Sarah; Magee, Erin P.; DeLong, Stephanie M.; Ashley, Olivia S.; Macy, Rebecca J.; Martin, Sandra L.; Moracco, Kathryn E.; Bowling, J. Michael

2017-01-01

Campus sexual assault (SA) policies and sexual consent definitions have not been widely studied. The study team conducted a nationally representative review of college and university websites (n = 995), assessing the prevalence of publicly accessible online policies and definitions and examining associations with school characteristics. A content…

Devising a consensus definition and framework for non-technical skills in healthcare to support educational design: A modified Delphi study.

PubMed

Gordon, Morris; Baker, Paul; Catchpole, Ken; Darbyshire, Daniel; Schocken, Dawn

2015-01-01

Non-technical skills are a subset of human factors that focus on the individual and promote safety through teamwork and awareness. There is no widely adopted competency- or outcome-based framework for non-technical skills training in healthcare. The authors set out to devise such a framework using a modified Delphi approach. An exhaustive list of published and team suggested items was presented to the expert panel for ranking and to propose a definition. In the second round, a focused list was presented, as well as the proposed definition elements. The finalised framework was sent to the panel for review. Sixteen experts participated. The final framework consists of 16 competencies for all and eight specific competencies for team leaders. The consensus definition describes non-technical skills as "a set of social (communication and team work) and cognitive (analytical and personal behaviour) skills that support high quality, safe, effective and efficient inter-professional care within the complex healthcare system". The authors have produced a new competency framework, through the works of an International expert panel, which is not discipline specific that can be used by curriculum developers, educational innovators and clinical teachers to support developments in the field.

5 CFR 451.102 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Definitions. Award means something bestowed or an action taken to recognize and reward individual or team... to, employee incentives which are based on predetermined criteria such as productivity standards, performance goals, measurement systems, award formulas, or payout schedules. Award program means the specific...

5 CFR 451.102 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Definitions. Award means something bestowed or an action taken to recognize and reward individual or team... to, employee incentives which are based on predetermined criteria such as productivity standards, performance goals, measurement systems, award formulas, or payout schedules. Award program means the specific...

5 CFR 451.102 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Definitions. Award means something bestowed or an action taken to recognize and reward individual or team... to, employee incentives which are based on predetermined criteria such as productivity standards, performance goals, measurement systems, award formulas, or payout schedules. Award program means the specific...

5 CFR 250.301 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Definitions. 250.301 Section 250.301 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL MANAGEMENT IN... agency's management team. This includes anyone with supervisory or managerial duties. Managers are those...

En Route Critical Care: Evolving, Improving & Advancing Capabilities

DTIC Science & Technology

2011-01-26

Neonatal Intensive Care – Burn Team – Acute Lung Team 18 2011 MHS Conference OCONUS Medical Center/ASF INTRA-THEATER INTER-THEATER Theater...MASF, FST Theater Hospital Care Forward Resuscitative Care 68W, PA, FS, PJ, 4N, RN, SOFME/SOCCET, CCATT Battalion Aid Station SABC/TCCC US Medical...Lvl-II/Forward Surgical Teams Damage Control Surgery/ Resuscitation Lvl-III/CSH, EMEDS, EMF Theater Hospitals Definitive Care GOAL: Maintain

Joint IKI/ROSCOSMOS - NASA Science Definition Team and concept mission to Venus based on Venera-D

NASA Astrophysics Data System (ADS)

Zasova, L.; Senske, D.; Economou, T.; Eismont, N.; Esposito, L.; Gerasimov, M.; Gorinov, D.; Ignatiev, N.; Ivanov, M.; Jessup, K. Lea; Khatuntsev, I.; Korablev, O.; Kremic, T.; Limaye, S.; Lomakin, I.; Martynov, A.; Ocampo, A.; Vaisberg, O.; Burdanov, A.

2017-09-01

NASA and IKI/Roscosmos established in 2015 a Joint Science Definition Team (JSDT), a key task of which was to codify the synergy between the goals of Venera-D with those of NASA. In addition, the JSDT studied potential NASA provided mission augmentations (experiments /elements) that could to fill identified science gaps. The first report to NASA - IKI/Roscosmos was provided in January 2017. The baseline Venera-D concept includes two elements, and orbiter and a lander, with potential contributions consisting of an aerial platform/balloon, small long-lived surface stations or a sub-satellite.

Targeted Research and Technology Within NASA's Living With a Star Program

NASA Technical Reports Server (NTRS)

Antiochos, Spiro; Baker, Kile; Bellaire, Paul; Blake, Bern; Crowley, Geoff; Eddy, Jack; Goodrich, Charles; Gopalswamy, Nat; Gosling, Jack; Hesse, Michael

2004-01-01

Targeted Research & Technology (TR&T) NASA's Living With a Star (LWS) initiative is a systematic, goal-oriented research program targeting those aspects of the Sun-Earth system that affect society. The Targeted Research and Technology (TR&T) component of LWS provides the theory, modeling, and data analysis necessary to enable an integrated, system-wide picture of Sun-Earth connection science with societal relevance. Recognizing the central and essential role that TR&T would have for the success of the LWS initiative, the LWS Science Architecture Team (SAT) recommended that a Science Definition Team (SDT), with the same status as a flight mission definition team, be formed to design and coordinate a TR&T program having prioritized goals and objectives that focused on practical societal benefits. This report details the SDT recommendations for the TR&T program.

Establishment of heart teams in Portugal.

PubMed

Sousa Uva, M; Leite Moreira, A; Gavina, C; Pereira, H; Lopes, M G

2014-01-01

Whenever several therapeutic options exist, multidisciplinary decision-making is beneficial for the patient and for society at large. The main obstacles to the establishment of heart teams in Portugal are organizational and logistical. Implementing a heart team approach entails definition of the situations requiring multidisciplinary discussion, creation of clear lines of communication, written protocols and obtaining patient informed consent. The European Society of Cardiology guidelines define the clinical scenarios where intervention of the heart team is recommended. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Customized Assessment Group Initiative: A Complementary Approach to Students' Learning

ERIC Educational Resources Information Center

Akindayomi, Akinloye

2015-01-01

This study, conducted in a US setting, examines the importance of group dynamics that emphasize cooperative team building through the proposed grouping strategy called Customized Assessment Group Initiative (CAGI). CAGI is a student grouping strategy designed to operationalize the mutual accountability concept central to the definition of teams by…

IDC Reengineering Phase 2 Project Scope.

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

Harris, James M.

This report provides a brief description of the scope of the IDC Reengineering Phase 2 project. It describes the goals and objectives of reengineering, the system definition, and the technical scope of the system. REVISIONS Version Date Author/Team Revision Description Authorized by 1.0 9/25/2014 SNL IDC Reengineering Team Unlimited Release for I2 M. Harris 1.1 28/01/2015 IDC Reengineering Team Align with previous IDC scope document E. Tomuta.

The Impact of an Antimicrobial Utilization Program on Antimicrobial Use at a Large Teaching Hospital: A Randomized Controlled Trial

PubMed Central

Camins, Bernard C.; King, Mark D.; Wells, Jane B.; Googe, Heidi L.; Patel, Manish; Kourbatova, Ekaterina V.; Blumberg, Henry M.

2009-01-01

Background Multidisciplinary antimicrobial utilization teams (AUT) have been proposed as a mechanism for improving antimicrobial use, but data on their efficacy remain limited. Objective To determine the impact of an AUT on antimicrobial use at a teaching hospital. Design Randomized controlled intervention trial. Setting A 953-bed public university-affiliated urban teaching hospital. Patients Patients who were prescribed selected antimicrobial agents (piperacillin-tazobactam, levofloxacin, or vancomycin) by internal medicine ward teams. Intervention Twelve internal medicine teams were randomized monthly: 6 teams to intervention group (academic detailing by the AUT), and 6 teams to a control group given indication-based guidelines for prescription of broad spectrum antimicrobials (standard of care) during a 10-month study period. Measurements Proportion of appropriate empiric, definitive (therapeutic), and end antimicrobial (overall) usage. Results A total of 784 new prescriptions of piperacillin-tazobactam, levofloxacin, and vancomycin were reviewed. The proportion of appropriate antimicrobial prescriptions written by the intervention teams was significantly higher than prescribed by the control teams: 82% vs. 73% for empiric (RR=1.14, 95% CI 1.04–1.24), 82% vs. 43% for definitive (RR=1.89, 95% CI 1.53–2.33), and 94% vs. 70% for end antimicrobial usage (RR=1.34, 95% CI 1.25–1.43). In a multivariate analysis, teams that received feedback from the AUT alone (aRR=1.37, 95% CI 1.27–1.48) or from both the AUT and the ID consult service (aRR=2.28, 95% CI 1.64–3.19) were significantly more likely to prescribe end antimicrobial usage appropriately compared to control teams. Conclusions A multidisciplinary AUT which provides feedback to prescribing physicians was an effective method in improving antimicrobial use. PMID:19712032

An engineering database management system for spacecraft operations

NASA Technical Reports Server (NTRS)

Cipollone, Gregorio; Mckay, Michael H.; Paris, Joseph

1993-01-01

Studies at ESOC have demonstrated the feasibility of a flexible and powerful Engineering Database Management System in support for spacecraft operations documentation. The objectives set out were three-fold: first an analysis of the problems encountered by the Operations team in obtaining and managing operations documents; secondly, the definition of a concept for operations documentation and the implementation of prototype to prove the feasibility of the concept; and thirdly, definition of standards and protocols required for the exchange of data between the top-level partners in a satellite project. The EDMS prototype was populated with ERS-l satellite design data and has been used by the operations team at ESOC to gather operational experience. An operational EDMS would be implemented at the satellite prime contractor's site as a common database for all technical information surrounding a project and would be accessible by the cocontractor's and ESA teams.

Can We All Fit? Squeezing in Better Support With Fewer People

ERIC Educational Resources Information Center

Jung, Lee Ann

2005-01-01

Individualized Family Service Plan (IFSP) teams are by definition comprised of professionals from a variety of disciplines who are trained to determine recommendations for the services they deliver. Research indicates that when more people are on the IFSP team, families may feel less supported, and diminished child outcomes can result. However,…

The Use of Team-Building Activities to Build a Better Resident.

PubMed

Ireland, James D; Deloney, Linda A; Renfroe, Shyann; Jambhekar, Kedar

We implemented team building activities to build a better resident during our orientation process and we have refined the choice of activities each year since. Resident satisfaction with their team building actives provided feedback to improve the following years' experience. While there is no definite way to demonstrate the effectiveness of our team building initiative, our expectation is it will improve the residency experience and work environment, and ultimately, result in better patient care. We focus on five aspects of team building - personal history sharing, creativity and imagination, common bonds, cooperation, and shared experience. The purpose of this paper is to recommend activities in each of these areas based on our experience. Published by Elsevier Inc.

Wide Field Infrared Survey Telescope [WFIRST]: Telescope Design and Simulated Performance

NASA Technical Reports Server (NTRS)

Goullioud, R.; Content, D. A.; Kuan, G. M.; Moore, J. D.; Chang, Z.; Sunada, E. T.; Villalvazo, J.; Hawk, J. P.; Armani, N. V.; Johnson, E. L.;

Comparison of Military and Business Culture and Their Impact in Cross-Cultural Teams

DTIC Science & Technology

2004-06-01

Comparing Military and Business Leadership .................................................37 Table 8. Organizational Culture Propositions...to Kotter’s definitions, business leadership will be addressed. In a market culture, team leaders tend to be hard-driving competitors and...organizational change (Manning and Robinson, 2002). A great deal of management literature focuses on business leadership as being successful at

Has Technology Been Considered? A Guide for IEP Teams. CASE/TAM Assistive Technology Policy and Practice Series.

ERIC Educational Resources Information Center

Chambers, A. C.

This guide compiles information essential to a working knowledge of assistive technology for children with disabilities. It addresses the definition of assistive technology and provides information on laws which direct the provision of assistive technology. The manual provides a framework to guide the Individualized Education Program (IEP) team as…

Cooperative Trust Games

DTIC Science & Technology

2013-01-01

the more widely recognized competitive (non-cooperative) game theory. Cooperative game theory focuses on what groups of self-interested agents can...provides immediate justification for using non-cooperative game theory as the basis for modeling the purely competitive agents. 2.4. Superadditive...the competitive and altruistic contributions of the subset team. Definition: Given a payoff function ( ) in a subset team game , the total marginal

A status of the Turbine Technology Team activities

NASA Technical Reports Server (NTRS)

Griffin, Lisa W.

1992-01-01

The recent activities of the Turbine Technology Team of the Consortium for Computational Fluid Dynamics (CFD) Application in Propulsion Technology is presented. The team consists of members from the government, industry, and universities. The goal of this team is to demonstrate the benefits to the turbine design process attainable through the application of CFD. This goal is to be achieved by enhancing and validating turbine design tools for improved loading and flowfield definition and loss prediction, and transferring the advanced technology to the turbine design process. In order to demonstrate the advantages of using CFD early in the design phase, the Space Transportation Main Engine (STME) turbines for the National Launch System (NLS) were chosen on which to focus the team's efforts. The Turbine Team activities run parallel to the STME design work.

Error or "act of God"? A study of patients' and operating room team members' perceptions of error definition, reporting, and disclosure.

PubMed

Espin, Sherry; Levinson, Wendy; Regehr, Glenn; Baker, G Ross; Lingard, Lorelei

2006-01-01

Calls abound for a culture change in health care to improve patient safety. However, effective change cannot proceed without a clear understanding of perceptions and beliefs about error. In this study, we describe and compare operative team members' and patients' perceptions of error, reporting of error, and disclosure of error. Thirty-nine interviews of team members (9 surgeons, 9 nurses, 10 anesthesiologists) and patients (11) were conducted at 2 teaching hospitals using 4 scenarios as prompts. Transcribed responses to open questions were analyzed by 2 researchers for recurrent themes using the grounded-theory method. Yes/no answers were compared across groups using chi-square analyses. Team members and patients agreed on what constitutes an error. Deviation from standards and negative outcome were emphasized as definitive features. Patients and nurse professionals differed significantly in their perception of whether errors should be reported. Nurses were willing to report only events within their disciplinary scope of practice. Although most patients strongly advocated full disclosure of errors (what happened and how), team members preferred to disclose only what happened. When patients did support partial disclosure, their rationales varied from that of team members. Both operative teams and patients define error in terms of breaking the rules and the concept of "no harm no foul." These concepts pose challenges for treating errors as system failures. A strong culture of individualism pervades nurses' perception of error reporting, suggesting that interventions are needed to foster collective responsibility and a constructive approach to error identification.

"RAPID" team triage: one hospital's approach to patient-centered team triage.

PubMed

Shea, Sheila Sanning; Hoyt, K Sue

2012-01-01

Patients who present to the emergency department want definitive care by a health care provider who can perform an initial assessment, initiate treatment, and implement a disposition plan. The traditional "nurse triage" model often creates barriers to the process of rapidly evaluating patients. Therefore, innovative strategies must be explored to improve the time of patient arrival to the time seen by a qualified provider in order to complete a thorough medical screening examination. One such approach is a rapid team triage system that provides a patient-centered process. This article describes the implementation of a rapid team triage model in an urban community hospital.

Imaging Exoplanets with the Exo-S Starshade Mission: Baseline Design

NASA Astrophysics Data System (ADS)

Cady, Eric; Lisman, Doug; Martin, Stefan; Scharf, Daniel; Shaklan, Stuart; Trabert, Rachel; Webb, David; Exo-S Science; Technology Definition Team, Exoplanet Program Probe Study Design Team

2015-01-01

Starshades suppress on-axis starlight to enable the direct imaging of exoplanets with non-specialized space telescopes of variable size. Even relatively small, commercially available telescopes are capable of imaging Earth-like planets in the habitable zone, and larger telescopes provide the capability to characterize planet atmospheres with increasing spectral resolution. We detail two options developed by the STDT for probe-class starshade missions (Exo-S): a co-launch of a starshade with a dedicated 1.1m telescope, and a standalone starshade to augment an existing large telescope such as WFIRST-AFTA. For these concepts, we describe the optical and mechanical design, the formation flying system, and the augmentations required to make a telescope 'starshade-ready'. We also lay out typical design reference missions for each and their scientific yield, and show both concepts have the capability to image terrestrial exoplanets orbiting nearby stars.

The Role of a Multidimensional Concept of Trust in the Performance of Global Virtual Teams

NASA Technical Reports Server (NTRS)

Bodensteiner, Nan Muir; Stecklein, Jonette M.

2002-01-01

This paper focuses on the concept of trust as an important ingredient of effective global virtual team performance. Definitions of trust and virtual teams are presented. The concept of trust is developed from its unilateral application (trust, absence of trust) to a multidimensional concept including cognitive and affective components. The special challenges of a virtual team are then discussed with particular emphasis on how a multidimensional concept of trust impacts these challenges. Propositions suggesting the multidimensional concept of trust moderates the negative impacts of distance, cross cultural and organizational differences, the effects of electronically mediated communication, reluctance to share information and a lack of hi story/future on the performance of virtual teams are stated. The paper concludes with recommendations and a set of techniques to build both cognitive and affective trust in virtual teams.

Three images of interdisciplinary team meetings.

PubMed

Crepeau, E B

1994-08-01

Teams are an essential aspect of health care today, especially in rehabilitation or chronic illness where the course of care is frequently long, complex, and unpredictable. The coordinative function of teams and their interdisciplinary aspects are thought to improve patient care because team members bring their unique professional skills together to address patient problems. This coordination is enacted through the team meeting, which typically results in an integrated care plan. This professional image of team meetings is explicit and addresses the description and provision of care as objective and rational activities. In contrast, the constructed and ritualistic images of health care team meetings are implicit and concern the less objective and rational aspects of planning care. The constructed image pertains to the definitional activity of team members as they try to understand patient troubles and achieve consensus. This process involves the individual clinical reasoning of team members and the collective reasoning of the group. The ritualistic image is that aspect of team meetings in which the team affirms and reaffirms its collective identity. Drawing from field research of geropsychiatric team meetings, this article defines and explicates these images, focusing on the constructed and ritualistic aspects of team meetings and the influence of these images on group function.

The Mental Health Team: Evaluation From a Professional Viewpoint. A Qualitative Study.

PubMed

Pileño, María Elena; Morillo, Javier; Morillo, Andrea; Losa-Iglesias, Marta

2018-04-01

Health care institutions include workers who must operate in accordance with the requirements of the position, even though there are psychosocial influences that can affect the stability of the worker. To analyze the organizational culture of the team of professionals who work in the mental health network. A qualitative methodology was used to assess a sample of 55 mental health professionals who have been practicing for at least 5years. "Team" was the overall topic. The subtopics within "Team" were: getting along in the unit, getting along with the patient, personal resources for dealing with patients, adaptive resources of team members and, resources that the team uses in their group activities. It was observed that the team does not work with a common objective and needs an accepted leader to manage the group. The definition and acceptance of roles can result in conflict. By increasing the skill level of each worker, the multidisciplinary team would be more collaborative. Copyright © 2017 Elsevier Inc. All rights reserved.

Global positioning systems (GPS) and microtechnology sensors in team sports: a systematic review.

PubMed

Cummins, Cloe; Orr, Rhonda; O'Connor, Helen; West, Cameron

2013-10-01

Use of Global positioning system (GPS) technology in team sport permits measurement of player position, velocity, and movement patterns. GPS provides scope for better understanding of the specific and positional physiological demands of team sport and can be used to design training programs that adequately prepare athletes for competition with the aim of optimizing on-field performance. The objective of this study was to conduct a systematic review of the depth and scope of reported GPS and microtechnology measures used within individual sports in order to present the contemporary and emerging themes of GPS application within team sports. A systematic review of the application of GPS technology in team sports was conducted. We systematically searched electronic databases from earliest record to June 2012. Permutations of key words included GPS; male and female; age 12-50 years; able-bodied; and recreational to elite competitive team sports. The 35 manuscripts meeting the eligibility criteria included 1,276 participants (age 11.2-31.5 years; 95 % males; 53.8 % elite adult athletes). The majority of manuscripts reported on GPS use in various football codes: Australian football league (AFL; n = 8), soccer (n = 7), rugby union (n = 6), and rugby league (n = 6), with limited representation in other team sports: cricket (n = 3), hockey (n = 3), lacrosse (n = 1), and netball (n = 1). Of the included manuscripts, 34 (97 %) detailed work rate patterns such as distance, relative distance, speed, and accelerations, with only five (14.3 %) reporting on impact variables. Activity profiles characterizing positional play and competitive levels were also described. Work rate patterns were typically categorized into six speed zones, ranging from 0 to 36.0 km·h⁻¹, with descriptors ranging from walking to sprinting used to identify the type of activity mainly performed in each zone. With the exception of cricket, no standardized speed zones or definitions were observed within or between sports. Furthermore, speed zone criteria often varied widely within (e.g. zone 3 of AFL ranged from 7 to 16 km·h⁻¹) and between sports (e.g. zone 3 of soccer ranged from 3.0 to <13 km·h⁻¹ code). Activity descriptors for a zone also varied widely between sports (e.g. zone 4 definitions ranged from jog, run, high velocity, to high-intensity run). Most manuscripts focused on the demands of higher intensity efforts (running and sprint) required by players. Body loads and impacts, also summarized into six zones, showed small variations in descriptions, with zone criteria based upon grading systems provided by GPS manufacturers. This systematic review highlights that GPS technology has been used more often across a range of football codes than across other team sports. Work rate pattern activities are most often reported, whilst impact data, which require the use of microtechnology sensors such as accelerometers, are least reported. There is a lack of consistency in the definition of speed zones and activity descriptors, both within and across team sports, thus underscoring the difficulties encountered in meaningful comparisons of the physiological demands both within and between team sports. A consensus on definitions of speed zones and activity descriptors within sports would facilitate direct comparison of the demands within the same sport. Meta-analysis from systematic review would also be supported. Standardization of speed zones between sports may not be feasible due to disparities in work rate pattern activities.

Teamharmony: Employing Matchmaking Algorithms to Team-Building

DTIC Science & Technology

2017-12-01

Army1 A. HUMAN CHEMISTRY Within groups of people , there exists the powerful social phenomenon known as human chemistry. Although many definitions...which occur when two or more people interact, and cause the resulting relationship to be positively cohesive or toxic. Much like the weather, human...use experiential intuition when staffing teams. Apart from SOF units, there are no systems in place to gauge psychological makeup. Figure 2

Enhancing Team Composition in Professional Networks: Problem Definitions and Fast Solutions

PubMed Central

Li, Liangyue; Tong, Hanghang; Cao, Nan; Ehrlich, Kate; Lin, Yu-Ru; Buchler, Norbou

2017-01-01

In this paper, we study ways to enhance the composition of teams based on new requirements in a collaborative environment. We focus on recommending team members who can maintain the team’s performance by minimizing changes to the team’s skills and social structure. Our recommendations are based on computing team-level similarity, which includes skill similarity, structural similarity as well as the synergy between the two. Current heuristic approaches are one-dimensional and not comprehensive, as they consider the two aspects independently. To formalize team-level similarity, we adopt the notion of graph kernel of attributed graphs to encompass the two aspects and their interaction. To tackle the computational challenges, we propose a family of fast algorithms by (a) designing effective pruning strategies, and (b) exploring the smoothness between the existing and the new team structures. Extensive empirical evaluations on real world datasets validate the effectiveness and efficiency of our algorithms. PMID:29104408

Towards a practical definition of professional behaviour.

PubMed

Rogers, Wendy; Ballantyne, Angela

2010-04-01

Professionalism remains a challenging part of the medical curriculum to define, teach and evaluate. We suggest that one way to meet these challenges is to clarify the definition of professionalism and distinguish this from medical ethics. Our analysis is two staged. First, we reviewed influential definitions of professionalism and separated elements relating to (a) ethico-legal competencies, (b) clinical competence and (c) professionalism. In reference to professionalism, we then distinguished between aspirational virtues/values and specific behaviours. From these, we develop a working definition of medical professional behaviour consisting of six domains of behaviour: responsibility; relationships with and respect for patients; probity and honesty; self awareness and capacity for reflection; collaboration and team work; and care of colleagues. Second, we tested this working definition against empirical data concerning disciplinary action against practising doctors using (a) sources in the literature and (b) an original analysis of complaints received by the Medical Board of South Australia. Our empirical analysis supports the relevance of four of the six potential domains: responsibility; relationships with and respect for patients; probity and honesty; self awareness and capacity for reflection. There are additional reasons for retaining 'collaboration and team work' in the medical professional behaviour curriculum but 'care of colleagues' may be better addressed in the ethico-legal curriculum. Our definition of professional behaviour is consistent with the theoretical literature, captures behaviours that predict future complaints against practitioners and is consistent with current complaints about professionalism in South Australian practitioners. This definition can further the teaching and assessing of professional behaviour in medical schools.

Towards a definition of neurodisability: a Delphi survey.

PubMed

Morris, Christopher; Janssens, Astrid; Tomlinson, Richard; Williams, Jane; Logan, Stuart

2013-12-01

The aim of this study was to develop, systematically, a consensus-based definition for 'neurodisability' that is meaningful to health professionals and parents of children with neurological conditions. A multidisciplinary group of health professionals was recruited through child development teams and professional societies in the UK; several parents of children with neurological conditions worked with the research team. Professionals participated in three rounds of a Delphi survey. Participants rated their agreement with a proposed definition in each round, and feedback was used to refine the definition. Finally, a perspective was sought from international experts. Responses to the three rounds were as follows: round 1,245 out of 290 (84.4%); round 2,242 out of 300 (80.6%); and round 3,237 out of 297 (79.7%). Agreement with the proposed definition was extremely high in every round (89.0%, 90.1%, and 93.6% respectively). The final version of the definition was widely endorsed among professionals, parents, and a small number of international colleagues. The final definition is as follows: 'Neurodisability describes a group of congenital or acquired long-term conditions that are attributed to impairment of the brain and/or neuromuscular system and create functional limitations. A specific diagnosis may not be identified. Conditions may vary over time, occur alone or in combination, and include a broad range of severity and complexity. The impact may include difficulties with movement, cognition, hearing and vision, communication, emotion, and behaviour'. An agreed definition of neurodisability will be useful for conducting research or clinical evaluations with people affected by neurological problems. © 2013 Crown copyright. Developmental Medicine and Child Neurology © 2013 Mac Keith Press. This article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland.

Addressing the paradox of the team innovation process: A review and practical considerations.

PubMed

Thayer, Amanda L; Petruzzelli, Alexandra; McClurg, Caitlin E

2018-01-01

Facilitating team innovation is paramount to promoting progress in the science, technology, engineering, and math fields, as well as advancing national health, safety, prosperity, and welfare. However, innovation teams face a unique set of challenges due to the novelty and uncertainty that is core to the definition of innovation, as well as the paradoxical nature of idea generation and idea implementation processes. These and other challenges must be overcome for innovation teams to realize their full potential for producing change. The purpose of this review is, thus, to provide insight into the unique context that these teams function within and provide an integrative, evidence-based, and practically useful, organizing heuristic that focuses on the most important considerations for facilitating team innovation. Finally, we provide practical guidance for psychologists, organizations, practitioners, scientists, educators, policymakers, and others who employ teams to produce novel, innovative solutions to today's problems. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

50 CFR 660.502 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... symmetricus), and market squid (Loligo opelescens). Coastal Pelagic Species Management Team (CPSMT) means the... fishing for CPS for the purposes of conversion into fish flour, fish meal, fish scrap, fertilizer, fish...

42 CFR 484.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., treatment and drugs administered and the patient's reaction, and any changes in physical or emotional... health team, that summarizes facts about care furnished and the patient's response during a given period...

Person-Centered Care: A Definition and Essential Elements.

PubMed

2016-01-01

Improving healthcare safety, quality, and coordination, as well as quality of life, are important aims of caring for older adults with multiple chronic conditions and/or functional limitations. Person-centered care is an approach to meeting these aims, but there are no standardized, agreed-upon parameters for delivering such care. The SCAN Foundation charged a team from the American Geriatrics Society (AGS) in collaboration with a research and clinical team from the Keck School of Medicine of the University of Southern California to provide the evidence base to support a definition of person-centered care and its essential elements. An interprofessional panel of experts in person-centered care principles and practices that the AGS convened developed this statement. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

High definition in minimally invasive surgery: a review of methods for recording, editing, and distributing video.

PubMed

Kelly, Christopher R; Hogle, Nancy J; Landman, Jaime; Fowler, Dennis L

2008-09-01

The use of high-definition cameras and monitors during minimally invasive procedures can provide the surgeon and operating team with more than twice the resolution of standard definition systems. Although this dramatic improvement in visualization offers numerous advantages, the adoption of high definition cameras in the operating room can be challenging because new recording equipment must be purchased, and several new technologies are required to edit and distribute video. The purpose of this review article is to provide an overview of the popular methods for recording, editing, and distributing high-definition video. This article discusses the essential technical concepts of high-definition video, reviews the different kinds of equipment and methods most often used for recording, and describes several options for video distribution.

Ares Launch Vehicles Lean Practices Case Study

NASA Technical Reports Server (NTRS)

Doreswamy, Rajiv; Self, Timothy A.

2007-01-01

The Ares launch vehicles team, managed by the Ares Projects Office (APO) at NASA Marshall Space Flight Center, has completed the Ares I Crew Launch Vehicle System Requirements Review and System Definition Review and early design work for the Ares V Cargo Launch Vehicle. This paper provides examples of how Lean Manufacturing, Kaizen events, and Six Sigma practices are helping APO deliver a new space transportation capability on time and within budget, while still meeting stringent technical requirements. For example, Lean philosophies have been applied to numerous process definition efforts and existing process improvement activities, including the Ares I-X test flight Certificate of Flight Readiness (CoFR) process, risk management process, and review board organization and processes. Ares executives learned Lean practices firsthand, making the team "smart buyers" during proposal reviews and instilling the team with a sense of what is meant by "value-added" activities. Since the goal of the APO is to field launch vehicles at a reasonable cost and on an ambitious schedule, adopting Lean philosophies and practices will be crucial to the Ares Project's long-term SUCCESS.

Teaching Bioethics from an Interdisciplinary Perspective.

ERIC Educational Resources Information Center

Singleton, Rivers, Jr.; Brock, D. Heyward

1982-01-01

Outlines an interdisciplinary workshop in bioethics for secondary teachers taught by a team consisting of a scientist, a philosopher, and a literary critic. Discusses definitions, topics, reading selections, problems, and value. (DC)

A Genesis breakup and burnup analysis in off-nominal Earth return and atmospheric entry

NASA Technical Reports Server (NTRS)

Salama, Ahmed; Ling, Lisa; McRonald, Angus

2005-01-01

The Genesis project conducted a detailed breakup/burnup analysis before the Earth return to determine if any spacecraft component could survive and reach the ground intact in case of an off-nominal entry. In addition, an independent JPL team was chartered with the responsibility of analyzing several definitive breakup scenarios to verify the official project analysis. This paper presents the analysis and results of this independent team.

[Psymobile and the phenomenon of the hikikomori].

PubMed

Chauliac, Nicolas; Depraz, Pierre; Pacaut-Troncin, Michèle; Straub, Sylvie; Terra, Jean-Louis

2015-01-01

By its very nature, the Psymobile team is often called on to visit young adults who remain confined at home but who have no diagnosed psychiatric conditions. The team has consequently become interested in the Japanese concept of hikikomori, a notion which appeared in the 1990s and which has since spread across the world. This concept still arouses some amount of discussion regarding its aetiology, its precise definition and its relevance outside Japan.

Interdisciplinary Team Communication.

ERIC Educational Resources Information Center

Thorsheim, Mary Jo

1979-01-01

To assist in the development of a shared language for therapists and teachers serving handicapped children, the article offers a glossary of terms used by occupational and physical therapists. Definitions of 30 terms are given. (SBH)

10 CFR 1046.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... educational institution, manufacturing plant, laboratory, office building or other area utilized by the DOE or....” Special response team member. A security police officer who has been selected to be part of a unit...

The DISAM Journal of International Security Assistance Management. Volume 23, Number 3, Summer 2001

DTIC Science & Technology

2001-01-01

of subjects from enemy troop movements to control of an airborne armada. They enable commanders to cut through the fog of war and achieve decisive...and various engineers to begin the requirements definition and FMS acquisition process. The focus of the NAVAIDS Country Study Team is to: The DISAM...and recommendations process, and definitions are provided. The modernization recommendations of this report usually play an

Activities conducted during the definition phase of the outer planets missions program

NASA Technical Reports Server (NTRS)

1972-01-01

The activities are described of the Meteoroid Science Team for the definition phase of the outer planet missions. Studies reported include: (1) combined zodiacal experiment for the Grand Tour Missions of the outer planets, (2) optical transmission of a honeycomb panel and its effectiveness as a particle impact surface, (3) element identification data from the combined zodiacal OPGT experiment and (4) development of lightweight thermally stable mirrors.

10 CFR 1046.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., laboratory, office building or other area utilized by the DOE or its contractors or subcontractors for the..., previously referred to as a “security inspector.” Special response team member. A security police officer who...

10 CFR 1046.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., laboratory, office building or other area utilized by the DOE or its contractors or subcontractors for the..., previously referred to as a “security inspector.” Special response team member. A security police officer who...

10 CFR 1046.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., laboratory, office building or other area utilized by the DOE or its contractors or subcontractors for the..., previously referred to as a “security inspector.” Special response team member. A security police officer who...

Managers and the new definition of quality.

PubMed

Chilgren, Allison A

2008-01-01

The manager, particularly the mid-level manager, has a vital role in the success of any healthcare organization, especially in the realm of patient perception of quality. To patients, "quality" means how well a service was delivered, not how technically superior the actual service or clinical component turned out. This definition of quality can also be referred to as patient satisfaction. Managers, with help of an integrative team, can develop quality processes geared toward patient expectations by doing a number of things, including the following: clearly identify outcomes, and empower employees to achieve those goals; form an integrated quality development team to establish quality metrics; build in cultural competence into quality processes; and align the organization's mission to the overall quality program. With a successful quality program, managers can expect a considerable return on investment, satisfied patients and staff, and improved clinical outcomes.

Sexual Harassment in the Navy.

DTIC Science & Technology

1980-12-01

a team in order to make the U.S. Navy the best in the world. Invidious attitudes such as racism and sexism cripple team effectiveness. 30 V...SEXUAL HARASSMENT SEXUAL DISCRIMINATION SEXISM SEXIST ATTITUDES IN THE WORK ENVIRONMENT 20. Auti*ACT (Coniefia l- an a e 041110 mit0010411 4041 14MEI110tp...7- II. DEFINITION OF SEXUAL HARASSMENT What is sexual harassment? It is a form of sexism ? Stories about the infamous "casting couches" of Hollywood

5 CFR 250.301 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... in 5 U.S.C. 105. Executives are members of the Senior Executive Service or equivalent. Leaders are an... leave. Team leaders are those who provide employees with day-to-day guidance in work projects, but do...

The Practice of Strategic Planning in the Organization of the Future

DTIC Science & Technology

1989-06-07

or go into steady decline. Books and articles abound offering a variety of prescriptions to deal with the phenomena of continually shrinking markets ...organizations continue to view themselves as external boundary spanners, market strategists, or acquisitioners divorced from the internal culture of the...management team, to act a- guardians of the process. A simple set of definition.s was selected and agreed upon. The onlN imperatives in term-selection were

[Acute respiratory distress syndrome: a review of the Berlin definition].

PubMed

de Luis Cabezón, N; Sánchez Castro, I; Bengoetxea Uriarte, U X; Rodrigo Casanova, M P; García Peña, J M; Aguilera Celorrio, L

2014-01-01

Acute Respiratory Distress Syndrome (ARDS) is due to many causes. The absence of a universal definition up until now has led to a series of practical problems for a definitive diagnosis. The incidences of ARDS and Acute Lung Injury (ALI) vary widely in the current literature. The American-European Consensus Conference definition has been applied since its publication in 1994 and has helped to improve knowledge about ARDS. However, 18 years later, in 2011, the European Intensive Medicine Society, requested a team of international experts to meet in Berlin to review the ARDS definition. The purpose of the Berlin definition is not to use it as a prognostic tool, but to improve coherence between research and clinical practice. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

James Webb Space Telescope (JWST) Optical Telescope Element (OTE) Development Status

NASA Technical Reports Server (NTRS)

Feinberg, Lee D.

2004-01-01

The James Webb Space Telescope (JWST) Optical Telescope Element (OTE) is a segmented, cryogenic telescope scheduled for launch in 2011. In September of 2002, NASA selected prime contractor Northrop Grumman Space Technology (NGST) to build the observatory including management of the OTE. NGST is teamed with subcontractors Ball Aerospace, Alliant Techsystems (ATK). and Kodak. The team has completed several significant design, technology, architecture definition, and manufacturing milestones in the past year that are summarized in this paper.

Magnetometer instrument team studies for the definition phase of the outer planets grand tour

NASA Technical Reports Server (NTRS)

Coleman, P. J., Jr.

1972-01-01

The objectives of magnetic field investigations on missions to the outer planets were defined as well as an instrumentation system, a program of studies and instrument development tasks was proposed for the mission definition phase of the Outer Planets Grand Tour project. A report on the status of this program is given. Requirements were also established for the spacecraft and the mission which would insure their compatibility with the magnetic field investigation proposed for the outer planets missions and developed figures of merit for encounter trajectories. The spacecraft-instrumentation interface and the on-board data handling system were defined in various reports by the Project Team and in the reports by the Science Steering Group. The defining program for exploring the outer planets within the more restrictive constraints of the Mariner Jupiter-Saturn project included defining a limited magnetic field investigation.

Quality Interaction Between Mission Assurance and Project Team Members

NASA Technical Reports Server (NTRS)

Kwong-Fu, Helenann H.; Wilson, Robert K.

2006-01-01

Mission Assurance independent assessments started during the development cycle and continued through post launch operations. In operations, Health and Safety of the Observatory is of utmost importance. Therefore, Mission Assurance must ensure requirements compliance and focus on process improvements required across the operational systems including new/modified products, tools, and procedures. The deployment of the interactive model involves three objectives: Team member Interaction, Good Root Cause Analysis Practices, and Risk Assessment to avoid reoccurrences. In applying this model, we use a metric based measurement process and was found to have the most significant effect, which points to the importance of focuses on a combination of root cause analysis and risk approaches allowing the engineers the ability to prioritize and quantify their corrective actions based on a well-defined set of root cause definitions (i.e. closure criteria for problem reports), success criteria and risk rating definitions.

Understanding Teamwork in the Provision of Cancer Care: Highlighting the Role of Trust.

PubMed

Lazzara, Elizabeth H; Keebler, Joseph R; Day, Soosi; DiazGranados, Deborah; Pan, Minggui; King, Michael A; Tu, Shin-Ping

2016-11-01

Team science research has indicated that trust is a critical variable of teamwork, contributing greatly to a team's performance. Trust has long been examined in health care with research focusing on the development of trust by patients with their health care practitioners. Studies have indicated that trust is linked to patient satisfaction, adherence to treatment, continuity of care, and improved outcomes. We explore the construct of trust using a case example of a patient who received a surgical procedure for a precancerous polyp. We apply the principle of trust to the case as well as present the literature on trust and key definitions for understanding trust. Additionally, we apply the definitions presented to the specific case example by highlighting moments where trust is developed or violated. Lastly, we offer insights to health care practitioners on the development of trust in their own patient interactions to improve care.

Patient safety incidents in hospice care: observations from interdisciplinary case conferences.

PubMed

Oliver, Debra Parker; Demiris, George; Wittenberg-Lyles, Elaine; Gage, Ashley; Dewsnap-Dreisinger, Mariah L; Luetkemeyer, Jamie

2013-12-01

In the home hospice environment, issues arise every day presenting challenges to the safety, care, and quality of the dying experience. The literature pertaining to the safety challenges in this environment is limited. The study explored two research questions; 1) What types of patient safety incidents occur in the home hospice setting? 2) How many of these incidents are recognized by the hospice staff and/or the patient or caregiver as a patient safety incident? Video-recordings of hospice interdisciplinary team case conferences were reviewed and coded for patient safety incidents. Patient safety incidents were defined as any event or circumstance that could have resulted or did result in unnecessary harm to the patient or caregiver, or that could have resulted or did result in a negative impact on the quality of the dying experience for the patient. Codes for categories of patient safety incidents were based on the International Classification for Patient Safety. The setting for the study included two rural hospice programs in one Midwestern state in the United States. One hospice team had two separately functioning teams, the second hospice had three teams. 54 video-recordings were reviewed and coded. Patient safety incidents were identified that involved issues in clinical process, medications, falls, family or caregiving, procedural problems, documentation, psychosocial issues, administrative challenges and accidents. This study distinguishes categories of patient safety events that occur in home hospice care. Although the scope and definition of potential patient safety incidents in hospice is unique, the events observed in this study are similar to those observed with in other settings. This study identifies an operating definition and a potential classification for further research on patient safety incidents in hospice. Further research and consensus building of the definition of patient safety incidents and patient safety incidents in this setting is recommended.

Fission Surface Power System Initial Concept Definition

NASA Technical Reports Server (NTRS)

2010-01-01

Under the NASA Exploration Technology Development Program (ETDP) and in partnership with the Department of Energy (DOE), NASA has embarked on a project to develop Fission Surface Power (FSP) technology. The primary goals of the project are to 1) develop FSP concepts that meet expected surface power requirements at reasonable cost with added benefits over other options, 2) establish a hardwarebased technical foundation for FSP design concepts and reduce overall development risk, 3) reduce the cost uncertainties for FSP and establish greater credibility for flight system cost estimates, and 4) generate the key products to allow NASA decision-makers to consider FSP as a preferred option for flight development. The FSP project was initiated in 2006 as the Prometheus Program and the Jupiter Icy Moons Orbiter (JIMO) mission were phased-out. As a first step, NASA Headquarters commissioned the Affordable Fission Surface Power System Study to evaluate the potential for an affordable FSP development approach. With a cost-effective FSP strategy identified, the FSP team evaluated design options and selected a Preliminary Reference Concept to guide technology development. Since then, the FSP Preliminary Reference Concept has served as a point-of-departure for several NASA mission architecture studies examining the use of nuclear power and has provided the foundation for a series of "Pathfinder" hardware tests. The long-term technology goal is a Technology Demonstration Unit (TDU) integrated system test using full-scale components and a non-nuclear reactor simulator. The FSP team consists of Glenn Research Center (GRC), Marshall Space Flight Center (MSFC) and the DOE National Laboratories at Los Alamos (LANL), Idaho (INL), Oak Ridge (ORNL), and Sandia (SNL). The project is organized into two main elements: Concept Definition and Risk Reduction. Under Concept Definition, the team performs trade studies, develops analytical tools, and formulates system concepts. Under Risk Reduction the team develops hardware prototypes and conducts laboratory-based testing.

Surveillance versus clinical adjudication: differences persist with new ventilator-associated event definition.

PubMed

McMullen, Kathleen M; Boyer, Anthony F; Schoenberg, Noah; Babcock, Hilary M; Micek, Scott T; Kollef, Marin H

2015-06-01

The National Healthcare Safety Network (NHSN) has recently supported efforts to shift surveillance away from ventilator-associated pneumonia to ventilator-associated events (VAEs) to decrease subjectivity in surveillance and minimize concerns over clinical correlation. The goals of this study were to compare the results of an automated surveillance strategy using the new VAE definition with a prospectively performed clinical application of the definition. All patients ventilated for ≥2 days in a medical and surgical intensive care unit were evaluated by 2 methods: retrospective surveillance using an automated algorithm combined with manual chart review after the NHSN's VAE methodology and prospective surveillance by pulmonary physicians in collaboration with the clinical team administering care to the patient at the bedside. Overall, a similar number of events were called by each method (69 vs 67). Of the 1,209 patients, 56 were determined to have VAEs by both methods (κ = .81, P = .04). There were 24 patients considered to be a VAE by only 1 of the methods. Most discrepancies were the result of clinical disagreement with the NHSN's VAE methodology. There was good agreement between the study teams. Awareness of the limitations of the surveillance definition for VAE can help infection prevention personnel in discussions with critical care partners about optimal use of these data. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Rosetta mission operations for landing

NASA Astrophysics Data System (ADS)

Accomazzo, Andrea; Lodiot, Sylvain; Companys, Vicente

2016-08-01

The International Rosetta Mission of the European Space Agency (ESA) was launched on 2nd March 2004 on its 10 year journey to comet Churyumov-Gerasimenko and has reached it early August 2014. The main mission objectives were to perform close observations of the comet nucleus throughout its orbit around the Sun and deliver the lander Philae to its surface. This paper describers the activities at mission operations level that allowed the landing of Philae. The landing preparation phase was mainly characterised by the definition of the landing selection process, to which several parties contributed, and by the definition of the strategy for comet characterisation, the orbital strategy for lander delivery, and the definition and validation of the operations timeline. The definition of the landing site selection process involved almost all components of the mission team; Rosetta has been the first, and so far only mission, that could not rely on data collected by previous missions for the landing site selection. This forced the teams to include an intensive observation campaign as a mandatory part of the process; several science teams actively contributed to this campaign thus making results from science observations part of the mandatory operational products. The time allocated to the comet characterisation phase was in the order of a few weeks and all the processes, tools, and interfaces required an extensive planning an validation. Being the descent of Philae purely ballistic, the main driver for the orbital strategy was the capability to accurately control the position and velocity of Rosetta at Philae's separation. The resulting operations timeline had to merge this need of frequent orbit determination and control with the complexity of the ground segment and the inherent risk of problems when doing critical activities in short times. This paper describes the contribution of the Mission Control Centre (MOC) at the European Space Operations Centre (ESOC) to this mission phase and the lessons learned that can be derived from this experience.

5 CFR 430.203 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... aspect of individual, team, or organizational performance that is not a critical or non-critical element..., or organizational performance, exclusive of a critical element, that is used in assigning a summary... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERFORMANCE MANAGEMENT...

Family Advocacy Command Assistance Team

DTIC Science & Technology

1989-02-03

treatment in a Medical Treatment Facility is authorized. 2. Child Abuse /Neglect. The physical injury, sexual maltreatment, emotional maltreatment, deprivation...of abusive behavior within the definition of child abuse that includes the rape, molestation, prostitution, or other such form of sexual exploitation

49 CFR 110.20 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS AND OIL TRANSPORTATION HAZARDOUS MATERIALS PUBLIC SECTOR... necessary to train public sector emergency response and preparedness teams, enabling them to comply with..., town, township, local public authority (including any public and Indian housing agency under the United...

Maritime Navigation/Communications Program. Volume 2. Requirements Definitions Statement.

DOT National Transportation Integrated Search

1987-04-01

A Maritime Administration/Transportation Systems Center team has been conducting a program to study navigation and communication systems on the Great Lakes and St. Lawrence River with the objective of defining technologies and systems that have the p...

The Geospace Mission Definition Team report

NASA Astrophysics Data System (ADS)

Kintner, P.; Spann, J.

The Geospace Mission Definition Team (GMDT) is the portion of the Living With a Star (LWS) Program that has been charged by NASA to examine how the Geospace environment responds to solar variability. The goal is to provide science recommendations that guide NASA in the formulation of Geospace missions. The GMDT's first meeting with September 10, 2001 and has met on four subsequent dates. The top level space weather effects were initially defined by the LWS Science Architecture Team (SAT). From these effects the GMDT has distilled general objectives and specific objectives. These objectives have been prioritized and compelling science questions have been identified that are required to address the objectives. A set of candidate missions has been defined with minimum, baseline, and augmentation measurements identified. The priority science questions focus on two broad areas: (1) ionospheric variability, especially at mid-latitudes, that affects navigation and communications and (2) the source, acceleration mechanisms, and sinks of the radiation belts that degrade satellite lifetimes, produce surface charging, and threaten manned space flight. In addition the measurements required for understanding ionospheric variability will also address science issues associated with thermospheric satellite drag and orbital prediction. Candidate missions to address these science focii have been developed and studied. The team concludes that it is possible to address the compelling science questions with a cost effective program that yields major advances in our understanding of space weather science, that inspires and validates better ionospheric and magnetospheric models, and that will enable operational advances mitigating the societal impacts of space weather.

The importance of team functioning to natural resource planning outcomes.

PubMed

Stern, Marc J; Predmore, S Andrew

2012-09-15

In its recent history, the U.S. Forest Service is among many federal land management agencies struggling with questions concerning why its planning procedures are sometimes inefficient, perform poorly in the eyes of the public, and fail to deliver outputs that advance agency mission. By examining a representative sample of National Environmental Policy Act (NEPA) processes conducted by the agency between 2007 and 2009, we provide new insights into what drives outcomes in these planning processes. We examined team leaders' perceptions of the following outcomes: achievement of agency goals and NEPA mandates, process efficiency, public relations, and team outcomes. The most consistently important predictors of positive outcomes were team harmony and a clearly empowered team leader. Other factors, such as perceptions of the use of best science, a clear and unambiguous purpose and need, team turnover (personnel changes during the process), extra-agency engagement, and intra-agency relations, were also important, but played a less consistent role. The findings suggest the importance of empowering team leaders and team members through enhancing elements of discretion, responsibility, clear role definition, collaborative interdisciplinary deliberation, and perceived self-efficacy. The results also suggest the importance of genuine concern and respect for participating publics and effective inter-agency coordination. Copyright © 2012 Elsevier Ltd. All rights reserved.

The first 3 minutes: Optimising a short realistic paediatric team resuscitation training session.

PubMed

McKittrick, Joanne T; Kinney, Sharon; Lima, Sally; Allen, Meredith

2018-01-01

Inadequate resuscitation leads to death or brain injury. Recent recommendations for resuscitation team training to complement knowledge and skills training highlighted the need for development of an effective team resuscitation training session. This study aimed to evaluate and revise an interprofessional team training session which addressed roles and performance during provision of paediatric resuscitation, through incorporation of real-time, real team simulated training episodes. This study was conducted applying the principles of action research. Two cycles of data collection, evaluation and refinement of a 30-40 minute resuscitation training session for doctors and nurses occurred. Doctors and nurses made up 4 groups of training session participants. Their responses to the training were evaluated through thematic analysis of rich qualitative data gathered in focus groups held immediately after each training session. Major themes included the importance of realism, teamwork, and reflective learning. Findings informed important training session changes. These included; committed in-situ training; team diversity; realistic resources; role flexibility, definition and leadership; increased debriefing time and the addition of a team goal. In conclusion, incorporation of interprofessional resuscitation training which addresses team roles and responsibilities into standard medical and nursing training will enhance preparedness for participation in paediatric resuscitation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Integrating pharmacists into primary care teams: barriers and facilitators.

PubMed

Jorgenson, Derek; Laubscher, Tessa; Lyons, Barry; Palmer, Rebecca

2014-08-01

This study evaluated the barriers and facilitators that were experienced as pharmacists were integrated into 23 existing primary care teams located in urban and rural communities in Saskatchewan, Canada. Qualitative design using data from one-on-one telephone interviews with pharmacists, physicians and nurse practitioners from the 23 teams that integrated a new pharmacist role. Four researchers from varied backgrounds used thematic analysis of the interview transcripts to determine key themes. The research team met on multiple occasions to agree on the key themes and received written feedback from an external auditor and two of the original interviewees. Seven key themes emerged describing the barriers and facilitators that the teams experienced during the pharmacist integration: (1) relationships, trust and respect; (2) pharmacist role definition; (3) orientation and support; (4) pharmacist personality and professional experience; (5) pharmacist presence and visibility; (6) resources and funding; and (7) value of the pharmacist role. Teams from urban and rural communities experienced some of these challenges in unique ways. Primary care teams that integrated a pharmacist experienced several common barriers and facilitators. The negative impact of these barriers can be mitigated with effective planning and support that is individualized for the type of community where the team is located. © 2013 Royal Pharmaceutical Society.

A System Approach to Advanced Practice Clinician Standardization and High Reliability.

PubMed

Okuno-Jones, Susan; Siehoff, Alice; Law, Jennifer; Juarez, Patricia

Advanced practice clinicians (APCs) are an integral part of the health care team. Opportunities exist within Advocate Health Care to standardize and optimize APC practice across the system. To enhance the role and talents of APCs, an approach to role definition and optimization of practice and a structured approach to orientation and evaluation are shared. Although in the early stages of development, definition and standardization of accountabilities in a framework to support system changes are transforming the practice of APCs.

Project on Elite Athlete Commitment (PEAK): IV. identification of new candidate commitment sources in the sport commitment model.

PubMed

Scanlan, Tara K; Russell, David G; Scanlan, Larry A; Klunchoo, Tatiana J; Chow, Graig M

2013-10-01

Following a thorough review of the current updated Sport Commitment Model, new candidate commitment sources for possible future inclusion in the model are presented. They were derived from data obtained using the Scanlan Collaborative Interview Method. Three elite New Zealand teams participated: amateur All Black rugby players, amateur Silver Fern netball players, and professional All Black rugby players. An inductive content analysis of these players' open-ended descriptions of their sources of commitment identified four unique new candidate commitment sources: Desire to Excel, Team Tradition, Elite Team Membership, and Worthy of Team Membership. A detailed definition of each candidate source is included along with example quotes from participants. Using a mixed-methods approach, these candidate sources provide a basis for future investigations to test their viability and generalizability for possible expansion of the Sport Commitment Model.

38 CFR 59.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... program must provide individualized care delivered by an interdisciplinary health care team and support... domiciliary or nursing home buildings, the expansion, remodeling, or alteration of existing buildings for the... provision of initial equipment for any such buildings. Domiciliary care means providing shelter, food, and...

38 CFR 59.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... program must provide individualized care delivered by an interdisciplinary health care team and support... domiciliary or nursing home buildings, the expansion, remodeling, or alteration of existing buildings for the... provision of initial equipment for any such buildings. Domiciliary care means providing shelter, food, and...

38 CFR 59.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... program must provide individualized care delivered by an interdisciplinary health care team and support... domiciliary or nursing home buildings, the expansion, remodeling, or alteration of existing buildings for the... provision of initial equipment for any such buildings. Domiciliary care means providing shelter, food, and...

38 CFR 59.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... program must provide individualized care delivered by an interdisciplinary health care team and support... domiciliary or nursing home buildings, the expansion, remodeling, or alteration of existing buildings for the... provision of initial equipment for any such buildings. Domiciliary care means providing shelter, food, and...

38 CFR 59.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... program must provide individualized care delivered by an interdisciplinary health care team and support... domiciliary or nursing home buildings, the expansion, remodeling, or alteration of existing buildings for the... provision of initial equipment for any such buildings. Domiciliary care means providing shelter, food, and...

Athlete leadership: a review of the theoretical, measurement, and empirical literature.

PubMed

Loughead, Todd M

2017-08-01

Athlete leadership is defined as an athlete who occupies a formal or informal leadership role within a team and influences team members to achieve a common objective. The area of athlete leadership has been shaped by theories and measurement tools from organizational and sport coaching literatures. The present article describes the conceptual developments within athlete leadership by providing an operational definition of this construct, followed by the theories and measurement tools used to examine athlete leadership. Finally, the present paper describes both qualitative and quantitative research that has emerged over the last decade. The results suggest the importance of this source of leadership within sport teams. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

A Team Approach to the Development of Gamma Ray and x Ray Remote Sensing and in Situ Spectroscopy for Planetary Exploration Missions

NASA Technical Reports Server (NTRS)

Trombka, J. I.; Floyd, S.; Ruitberg, A.; Evans, L.; Starr, R.; Metzger, A.; Reedy, R.; Drake, D.; Moss, C.; Edwards, B.

1993-01-01

An important part of the investigation of planetary origin and evolution is the determination of the surface composition of planets, comets, and asteroids. Measurements of discrete line X-ray and gamma ray emissions from condensed bodies in space can be used to obtain both qualitative and quantitative elemental composition information. The Planetary Instrumentation Definition and Development Program (PIDDP) X-Ray/Gamma Ray Team has been established to develop remote sensing and in situ technologies for future planetary exploration missions.

Life sciences payload definition and integration study, task C and D. Volume 2: Payload definition, integration, and planning studies

NASA Technical Reports Server (NTRS)

1973-01-01

The Life Sciences Payload Definition and Integration Study was composed of four major tasks. Tasks A and B, the laboratory definition phase, were the subject of prior NASA study. The laboratory definition phase included the establishment of research functions, equipment definitions, and conceptual baseline laboratory designs. These baseline laboratories were designated as Maxi-Nom, Mini-30, and Mini-7. The outputs of Tasks A and B were used by the NASA Life Sciences Payload Integration Team to establish guidelines for Tasks C and D, the laboratory integration phase of the study. A brief review of Tasks A and B is presented provide background continuity. The tasks C and D effort is the subject of this report. The Task C effort stressed the integration of the NASA selected laboratory designs with the shuttle sortie module. The Task D effort updated and developed costs that could be used by NASA for preliminary program planning.

A proposed approach may help systematic reviews retain needed expertise while minimizing bias from nonfinancial conflicts of interest.

PubMed

Viswanathan, Meera; Carey, Timothy S; Belinson, Suzanne E; Berliner, Elise; Chang, Stephanie M; Graham, Elaine; Guise, Jeanne-Marie; Ip, Stanley; Maglione, Margaret A; McCrory, Douglas C; McPheeters, Melissa; Newberry, Sydne J; Sista, Priyanka; White, C Michael

2014-11-01

Groups such as the Institute of Medicine emphasize the importance of attention to financial conflicts of interest. Little guidance exists, however, on managing the risk of bias for systematic reviews from nonfinancial conflicts of interest. We sought to create practical guidance on ensuring adequate clinical or content expertise while maintaining independence of judgment on systematic review teams. Workgroup members built on existing guidance from international and domestic institutions on managing conflicts of interest. We then developed practical guidance in the form of an instrument for each potential source of conflict. We modified the Institute of Medicine's definition of conflict of interest to arrive at a definition specific to nonfinancial conflicts. We propose questions for funders and systematic review principal investigators to evaluate the risk of nonfinancial conflicts of interest. Once risks have been identified, options for managing conflicts include disclosure followed by no change in the systematic review team or activities, inclusion on the team along with other members with differing viewpoints to ensure diverse perspectives, exclusion from certain activities, and exclusion from the project entirely. The feasibility and utility of this approach to ensuring needed expertise on systematic reviews and minimizing bias from nonfinancial conflicts of interest must be investigated. Copyright © 2014 Elsevier Inc. All rights reserved.

Challenges in defining 'palliative care' for the purposes of clinical trials.

PubMed

Bausewein, Claudia; Higginson, Irene J

2012-12-01

Palliative care has become part of mainstream medicine with increasing evidence about the effectiveness of specialist palliative care (SPC) on patient and family outcomes. Comparison of studies testing SPC interventions is challenging as types of interventions and reporting of components of the intervention vary. In consequence, study results are difficult to interpret. There is a continuous lack of clarity in palliative care definitions. For clinical trials, multidisciplinary care, supportive care documentation, symptom assessment and symptom management are suggested as key domains. In recent studies testing palliative care as an intervention SPC physicians and palliative care nurses were core members of multiprofessional teams, but integration of other team members varied. Management of symptoms and psychosocial issues were central to SPC with various other areas described. Services were delivered by hospital and community support teams, in palliative care units, outpatient clinics and hospital. Cost information was only provided by a few studies. Due to the lack of an agreed definition of palliative care and heterogeneity in reporting of components of an SPC intervention comparison of studies remains challenging. Key aspects of palliative care interventions are incurable disease, multidisciplinary approach, focus on symptom management including standardized assessment, psychosocial and family support, and (advance) care planning. Detailed information about all aspects of the intervention should be provided.

El Paso's Organizational Development Model

ERIC Educational Resources Information Center

de los Santos, Gilberto

1975-01-01

The success of El Paso Community College (Texas) is attributed to its early definition of instructional thrusts including: systematizing and individualizing instruction; increasing awareness, sensitivity, and appreciation of the culture of the students; development of staff bilingual capabilities; development of staff teams versed in management by…

A systematic review of team formulation in clinical psychology practice: Definition, implementation, and outcomes.

PubMed

Geach, Nicole; Moghaddam, Nima G; De Boos, Danielle

2018-06-01

Team formulation is promoted by professional practice guidelines for clinical psychologists. However, it is unclear whether team formulation is understood/implemented in consistent ways - or whether there is outcome evidence to support the promotion of this practice. This systematic review aimed to (1) synthesize how team formulation practice is defined and implemented by practitioner psychologists and (2) analyse the range of team formulation outcomes in the peer-reviewed literature. Seven electronic bibliographic databases were searched in June 2016. Eleven articles met inclusion criteria and were quality assessed. Extracted data were synthesized using content analysis. Descriptions of team formulation revealed three main forms of instantiation: (1) a structured, consultation approach; (2) semi-structured, reflective practice meetings; and (3) unstructured/informal sharing of ideas through routine interactions. Outcome evidence linked team formulation to a range of outcomes for staff teams and service users, including some negative outcomes. Quality appraisal identified significant issues with evaluation methods; such that, overall, outcomes were not well-supported. There is weak evidence to support the claimed beneficial outcomes of team formulation in practice. There is a need for greater specification and standardization of 'team formulation' practices, to enable a clearer understanding of any relationships with outcomes and implications for best-practice implementations. Under the umbrella term of 'team formulation', three types of practice are reported: (1) highly structured consultation; (2) reflective practice meetings; and (3) informal sharing of ideas. Outcomes linked to team formulation, including some negative outcomes, were not well evidenced. Research using robust study designs is required to investigate the process and outcomes of team formulation practice. © 2017 The British Psychological Society.

The Difficult Airway Society 'ADEPT' guidance on selecting airway devices: the basis of a strategy for equipment evaluation.

PubMed

Pandit, J J; Popat, M T; Cook, T M; Wilkes, A R; Groom, P; Cooke, H; Kapila, A; O'Sullivan, E

2011-08-01

Faced with the concern that an increasing number of airway management devices were being introduced into clinical practice with little or no prior evidence of their clinical efficacy or safety, the Difficult Airway Society formed a working party (Airway Device Evaluation Project Team) to establish a process by which the airway management community within the profession could itself lead a process of formal device/equipment evaluation. Although there are several national and international regulations governing which products can come on to the market and be legitimately sold, there has hitherto been no formal professional guidance relating to how products should be selected (i.e. purchased). The Airway Device Evaluation Project Team's first task was to formulate such advice, emphasising evidence-based principles. Team discussions led to a definition of the minimum level of evidence needed to make a pragmatic decision about the purchase or selection of an airway device. The Team concluded that this definition should form the basis of a professional standard, guiding those with responsibility for selecting airway devices. We describe how widespread adoption of this professional standard can act as a driver to create an infrastructure in which the required evidence can be obtained. Essential elements are that: (i) the Difficult Airway Society facilitates a coherent national network of research-active units; and (ii) individual anaesthetists in hospital trusts play a more active role in local purchasing decisions, applying the relevant evidence and communicating their purchasing decisions to the Difficult Airway Society. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

Simulated Family Therapy: A Classroom Demonstration

ERIC Educational Resources Information Center

Banyard, Victoria L.; Fernald, Peter S.

2002-01-01

In this article, we describe a demonstration and discussion of an initial family therapy interview simulated by 4 student volunteers. Several concepts and principles fundamental to family therapy are illustrated: interview stages, one-person definition of a problem, systemic perspective, clear generation line, unified executive team, disengaged…

5 CFR 430.203 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... aspect of individual, team, or organizational performance that is not a critical or non-critical element..., are useful for purposes such as communicating performance expectations and serving as the basis for granting awards. Such elements may include, but are not limited to, objectives, goals, program plans, work...

Space Focus Lead Report

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

Reeves, Geoffrey D.

The Space Focus team is tasked with the definition of the Space Focused Science Topics, and with the review and ranking of the CSES proposals received in all the program areas. This is achieved by dedicated meetings or a series of informal discussions and/or e-mail reviews.

42 CFR 484.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... provides services within a portion of the total geographic area served by the parent agency. The branch..., treatment and drugs administered and the patient's reaction, and any changes in physical or emotional... health team, that summarizes facts about care furnished and the patient's response during a given period...

76 FR 35481 - NASA Advisory Council; Science Committee; Astrophysics Subcommittee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-17

... Update. --Research and Analysis Update. --Wide-Field Infrared Survey Telescope Science Definition Team... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 11-054] NASA Advisory Council; Science... Subcommittee of the NASA Advisory Council (NAC). This subcommittee reports to the Science Committee of the NAC...

Challenges and Approaches to Make Multidisciplinary Team Meetings Interoperable - The KIMBo Project.

PubMed

Krauss, Oliver; Holzer, Karl; Schuler, Andreas; Egelkraut, Reinhard; Franz, Barbara

2017-01-01

Multidisciplinary team meetings (MDTMs) are already in use for certain areas in healthcare (e.g. treatment of cancer). Due to the lack of common standards and accessibility for the applied IT systems, their potential is not yet completely exploited. Common requirements for MDTMs shall be identified and aggregated into a process definition to be automated by an application architecture utilizing modern standards in electronic healthcare, e.g. HL7 FHIR. To identify requirements, an extensive literature review as well as semi-structured expert interviews were conducted. Results showed, that interoperability and flexibility in terms of the process are key requirements to be addressed. An architecture blueprint as well as an aggregated process definition were derived from the insights gained. To evaluate the feasibility of identified requirements, methods of explorative prototyping in software engineering were used. MDTMs will become an important part of modern and future healthcare but the need for standardization in terms of interoperability is imminent.

Masters Athletes: Exemplars of Successful Aging?

PubMed

Geard, David; Reaburn, Peter R J; Rebar, Amanda L; Dionigi, Rylee A

2017-07-01

Global population aging has raised academic interest in successful aging to a public policy priority. Currently there is no consensus regarding the definition of successful aging. However, a synthesis of research shows successful aging can be defined as a late-life process of change characterized by high physical, psychological, cognitive, and social functioning. Masters athletes systematically train for, and compete in, organized forms of team and individual sport specifically designed for older adults. Masters athletes are often proposed as exemplars of successful aging. However, their aging status has never been examined using a comprehensive multidimensional successful aging definition. Here, we examine the successful aging literature, propose a successful aging definition based on this literature, present evidence which suggests masters athletes could be considered exemplars of successful aging according to the proposed definition, and list future experimental research directions.

Organizing for teamwork in healthcare: an alternative to team training?

PubMed

Rydenfält, Christofer; Odenrick, Per; Larsson, Per Anders

2017-05-15

Purpose The purpose of this paper is to explore how organizational design could support teamwork and to identify organizational design principles that promote successful teamwork. Design/methodology/approach Since traditional team training sessions take resources away from production, the alternative approach pursued here explores the promotion of teamwork by means of organizational design. A wide and pragmatic definition of teamwork is applied: a team is considered to be a group of people that are set to work together on a task, and teamwork is then what they do in relation to their task. The input - process - output model of teamwork provides structure to the investigation. Findings Six teamwork enablers from the healthcare team literature - cohesion, collaboration, communication, conflict resolution, coordination, and leadership - are discussed, and the organizational design measures required to implement them are identified. Three organizational principles are argued to facilitate the teamwork enablers: team stability, occasions for communication, and a participative and adaptive approach to leadership. Research limitations/implications The findings could be used as a foundation for intervention studies to improve team performance or as a framework for evaluation of existing organizations. Practical implications By implementing these organizational principles, it is possible to achieve many of the organizational traits associated with good teamwork. Thus, thoughtful organization for teamwork can be used as an alternative or complement to the traditional team training approach. Originality/value With regards to the vast literature on team training, this paper offers an alternative perspective on how to improve team performance in healthcare.

System design from mission definition to flight validation

NASA Technical Reports Server (NTRS)

Batill, S. M.

1992-01-01

Considerations related to the engineering systems design process and an approach taken to introduce undergraduate students to that process are presented. The paper includes details on a particular capstone design course. This course is a team oriented aircraft design project which requires the students to participate in many phases of the system design process, from mission definition to validation of their design through flight testing. To accomplish this in a single course requires special types of flight vehicles. Relatively small-scale, remotely piloted vehicles have provided the class of aircraft considered in this course.

An interferometer for high-resolution optical surveillance from geostationary orbit

NASA Astrophysics Data System (ADS)

Bonino, L.; Bresciani, F.; Piasini, G.; Flebus, C.; Lecat, J.-H.; Roose, S.; Pisani, M.; Cabral, A.; Rebordão, J.; Proença, C.; Costal, J.; Lima, P. U.; Loix, N.; Musso, F.

2017-11-01

The activities described in this paper have been developed in the frame of the EUCLID CEPA 9 RTP 9.9 "High Resolution Optical Satellite Sensor" project of the WEAO Research Cell. They have been focused on the definition of an interferometric instrument optimised for the high-resolution optical surveillance from geostationary orbit (GEO) by means of the synthetic aperture technique, and on the definition and development of the related enabling technologies. In this paper we describe the industrial team, the selected mission specifications and overview of the whole design and manufacturing activities performed.

36 CFR 906.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... site under The Pennsylvania Avenue Plan—1974, as amended, and The Planning and Design Objectives, Controls, and Standards of the Corporation (36 CFR part 920 et seq.). (f) Development team means the group... means an opportunity set aside and committed for the sole involvement of a woman, minority group member...

36 CFR 906.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... site under The Pennsylvania Avenue Plan—1974, as amended, and The Planning and Design Objectives, Controls, and Standards of the Corporation (36 CFR part 920 et seq.). (f) Development team means the group... means an opportunity set aside and committed for the sole involvement of a woman, minority group member...

36 CFR 906.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... site under The Pennsylvania Avenue Plan—1974, as amended, and The Planning and Design Objectives, Controls, and Standards of the Corporation (36 CFR part 920 et seq.). (f) Development team means the group... means an opportunity set aside and committed for the sole involvement of a woman, minority group member...

36 CFR 906.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... site under The Pennsylvania Avenue Plan—1974, as amended, and The Planning and Design Objectives, Controls, and Standards of the Corporation (36 CFR part 920 et seq.). (f) Development team means the group... means an opportunity set aside and committed for the sole involvement of a woman, minority group member...

36 CFR 908.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Developer means a Person or team of Persons that has received preliminary approval for a development...) of this rule. (d) Newly developed space means any leaseable part of a new building in the Development Area upon which construction was commenced after October 27, 1972 or an existing building in the...

36 CFR 908.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Developer means a Person or team of Persons that has received preliminary approval for a development...) of this rule. (d) Newly developed space means any leaseable part of a new building in the Development Area upon which construction was commenced after October 27, 1972 or an existing building in the...

36 CFR 908.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Developer means a Person or team of Persons that has received preliminary approval for a development...) of this rule. (d) Newly developed space means any leaseable part of a new building in the Development Area upon which construction was commenced after October 27, 1972 or an existing building in the...

36 CFR 908.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Developer means a Person or team of Persons that has received preliminary approval for a development...) of this rule. (d) Newly developed space means any leaseable part of a new building in the Development Area upon which construction was commenced after October 27, 1972 or an existing building in the...

33 CFR 155.4025 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... another, when the vessel's own transfer equipment is not working. External firefighting teams means... vessel, or damage to the marine environment. Marine firefighting pre-fire plan means a plan that outlines... scene, at a safe distance from the vessel or on the vessel, who can determine the steps needed to...

NORSTAR Project: Norfolk public schools student team for acoustical research

NASA Technical Reports Server (NTRS)

Fortunato, Ronald C.

1987-01-01

Development of the NORSTAR (Norfolk Public Student Team for Acoustical Research) Project includes the definition, design, fabrication, testing, analysis, and publishing the results of an acoustical experiment. The student-run program is based on a space flight organization similar to the Viking Project. The experiment will measure the scattering transfer of momentum from a sound field to spheres in a liquid medium. It is hoped that the experimental results will shed light on a difficult physics problem - the difference in scattering cross section (the overall effect of the sound wave scattering) for solid spheres and hollow spheres of differing wall thicknesses.

Definition and Management of Borderline Resectable Pancreatic Cancer.

PubMed

Denbo, Jason W; Fleming, Jason B

2016-12-01

Patients with localized pancreatic ductal adenocarcinoma seek potentially curative treatment, but this group represents a spectrum of disease. Patients with borderline resectable primary tumors are a unique subset whose successful therapy requires a care team with expertise in medical care, imaging, surgery, medical oncology, and radiation oncology. This team must identify patients with borderline tumors then carefully prescribe and execute a combined treatment strategy with the highest possibility of cure. This article addresses the issues of clinical evaluation, imaging techniques, and criteria, as well as multidisciplinary treatment of patients with borderline resectable pancreatic ductal adenocarcinoma. Copyright © 2016 Elsevier Inc. All rights reserved.

Definitions in use by the visible and near-infrared, and thermal working groups

NASA Technical Reports Server (NTRS)

Bruegge, Carol J.; Miller, ED; Martin, Bob; Kieffer, Hugh H.; Palmer, James M.

1992-01-01

The Calibration Advisory Panel (CAP) is composed of calibration experts from each of the Earth Observing System (EOS) instruments, science investigation, and cross-calibration teams. These members come from a variety of institutions and backgrounds. In order to facilitate an exchange of ideas, and assure a common basis for communication, it was desirable to assemble this list of definitions. These definitions were developed for use by the visible and near-infrared working group, and the thermal infrared working group. Where necessary or appropriate, deviations from these for specific instruments or other sensor types are given in the individual calibration plans. The definitions contained in this document are derived, wherever possible, from definitions accepted by international and national metrological commissions including the United States National Institute of Standards and Technology (NIST), the International Bureau of Weights and Measures (BIPM), the International Electrotechnical Commission (IEC), the International Organization for Standardization (ISO), and the International Organization of Legal Metrology (OIML).

36 CFR § 906.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... site under The Pennsylvania Avenue Plan—1974, as amended, and The Planning and Design Objectives, Controls, and Standards of the Corporation (36 CFR part 920 et seq.). (f) Development team means the group... means an opportunity set aside and committed for the sole involvement of a woman, minority group member...

A Multidimensional Model for the Identification of Dual-Exceptional Learners

ERIC Educational Resources Information Center

Al-Hroub, Anies

2013-01-01

This research takes mathematics as a model for investigating the definitions, identification, classification and characteristics of a group of gifted student related to the notion of "dual-exceptionality". An extensive process using qualitative and quantitative methods was conducted by a multidisciplinary team to develop and implement a…

36 CFR § 908.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Developer means a Person or team of Persons that has received preliminary approval for a development...) of this rule. (d) Newly developed space means any leaseable part of a new building in the Development Area upon which construction was commenced after October 27, 1972 or an existing building in the...

Using Problem-Based Learning to Enhance Team and Player Development in Youth Soccer

ERIC Educational Resources Information Center

Hubball, Harry; Robertson, Scott

2004-01-01

Problem-based learning (PBL) is a coaching and teaching methodology that develops knowledge, abilities, and skills. It also encourages participation, collaborative investigation, and the resolution of authentic, "ill-structured" problems through the use of problem definition, teamwork, communication, data collection, decision-making,…

Tag Team Public Speaking

ERIC Educational Resources Information Center

Brigance, Linda Czuba

2004-01-01

Designing and presenting a speech is a solitary task. By definition, public speaking involves one person speaking to a group, which sets it apart from other types of communication situations, such as interpersonal and small group communication. Due to the inherently individualistic nature of assignments in the basic course, students rarely profit…

Invited Reaction: Developing Emotional Intelligence (EI) Abilities through Team-Based Learning

ERIC Educational Resources Information Center

Leimbach, Michael P.; Maringka, Jane

2010-01-01

The preceding article (Clarke, 2010) examines an important and interesting question; that is, under what conditions can learning contribute to the development of emotional intelligence (EI)? Despite the controversy surrounding the definition and construct of EI, its prevalence for the human resources development (HRD) field and its implications…

Evidence-Based Practice for Outpatient Clinical Teams

ERIC Educational Resources Information Center

Hamilton, John D.

2006-01-01

This column focuses on evidence-based practice (EBP) within multidisciplinary outpatient settings, but first provides some definitions. Besides EBP (Burns and Hoagwood, 2005; Guyatt and Rennie, 2002), there are also evidence-based medicine (EBM; March et al., 2005), evidence-based service (EBS; Chorpita et al., 2002), and evidence-based treatment…

Team Training for Command and Control Systems. Volume II. Recommendations for Research Program.

DTIC Science & Technology

1982-04-01

between individual and group goals and how they are set, the roles of hedonistic individual orientation and altruistic commitment to a group, and... boredom . They are not intended to be definitive, comprehensive, nor exhaustive. They are also not mutually exclusive and other partitionings of the

Sustainable interprofessional teamwork needs a team-friendly healthcare system: Experiences from a collaborative Dutch programme.

PubMed

van Dijk-de Vries, Anneke; van Dongen, Jerôme Jean Jacques; van Bokhoven, Marloes Amantia

2017-03-01

The significance of effective interprofessional teamwork to improve the quality of care has been widely recognised. Effective interprofessional teamwork calls on good collaboration between professionals and patients, coordination between professionals, and the development of teamwork over time. Effective development of teams also requires support from the wider organisational context. In a Dutch village, healthcare professionals work closely together, and mutual consultations as well as interprofessional meetings take place on a regular basis. The network was created as a precondition for sustainable interprofessional teamwork in elderly care. However, several external barriers were experienced regarding the supportive structure and cooperative attitude of the healthcare insurer and municipality. The aim of the article is to examine these experience-based issues regarding internal organisation, perspective, and definition of effective teamwork. Complicating factors refer to finding the right key figures, and the different perspectives on team development and team effectiveness. Our conclusion is that the organisation of healthcare insurance companies needs to implement fundamental changes to facilitate an interprofessional care approach. Furthermore, municipalities should work on their vision of the needs and benefits of a fruitful collaboration with interprofessional healthcare teams. The challenge for healthcare teams is to learn to speak the language of external partners. To support the development of interprofessional teams, external parties need to recognise and trust in a shared aim to provide quality of care in an efficient and effective way.

Europa Explorer Operational Scenarios Development

NASA Technical Reports Server (NTRS)

Lock, Robert E.; Pappalardo, Robert T.; Clark, Karla B.

2008-01-01

In 2007, NASA conducted four advanced mission concept studies for outer planets targets: Europa, Ganymede, Titan and Enceladus. The studies were conducted in close cooperation with the planetary science community. Of the four, the Europa Explorer Concept Study focused on refining mission options, science trades and implementation details for a potential flagship mission to Europa in the 2015 timeframe. A science definition team (SDT) was appointed by NASA to guide the study. A JPL-led engineering team worked closely with the science team to address 3 major focus areas: 1) credible cost estimates, 2) rationale and logical discussion of radiation risk and mitigation approaches, and 3) better definition and exploration of science operational scenario trade space. This paper will address the methods and results of the collaborative process used to develop Europa Explorer operations scenarios. Working in concert with the SDT, and in parallel with the SDT's development of a science value matrix, key mission capabilities and constraints were challenged by the science and engineering members of the team. Science goals were advanced and options were considered for observation scenarios. Data collection and return strategies were tested via simulation, and mission performance was estimated and balanced with flight and ground system resources and science priorities. The key to this successful collaboration was a concurrent development environment in which all stakeholders could rapidly assess the feasibility of strategies for their success in the full system context. Issues of science and instrument compatibility, system constraints, and mission opportunities were treated analytically and objectively leading to complementary strategies for observation and data return. Current plans are that this approach, as part of the system engineering process, will continue as the Europa Explorer Concept Study moves toward becoming a development project.

Philosophy and conceptual framework: collectively structuring nursing care systematization.

PubMed

Schmitz, Eudinéia Luz; Gelbcke, Francine Lima; Bruggmann, Mario Sérgio; Luz, Susian Cássia Liz

2017-03-30

To build the Nursing Philosophy and Conceptual Framework that will support the Nursing Care Systematization in a hospital in southern Brazil with the active participation of the institution's nurses. Convergent Care Research Data collection took place from July to October 2014, through two workshops and four meetings, with 42 nurses. As a result, the nursing philosophy and conceptual framework were created and the theory was chosen. Data analysis was performed based on Morse and Field. The philosophy involves the following beliefs: team nursing; team work; holistic care; service excellence; leadership/coordination; interdisciplinary team commitment. The conceptual framework brings concepts such as: human being; nursing; nursing care, safe care. The nursing theory defined was that of Wanda de Aguiar Horta. As a contribution, it brought the construction of the institutions' nursing philosophy and conceptual framework, and the definition of a nursing theory.

The European general practice research network presents the translations of its comprehensive definition of multimorbidity in family medicine in ten European languages.

PubMed

Le Reste, Jean Yves; Nabbe, Patrice; Rivet, Charles; Lygidakis, Charilaos; Doerr, Christa; Czachowski, Slawomir; Lingner, Heidrun; Argyriadou, Stella; Lazic, Djurdjica; Assenova, Radost; Hasaganic, Melida; Munoz, Miquel Angel; Thulesius, Hans; Le Floch, Bernard; Derriennic, Jeremy; Sowinska, Agnieska; Van Marwijk, Harm; Lietard, Claire; Van Royen, Paul

2015-01-01

Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review. To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research. Forward translation of the EGPRN's definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teams to ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached. 229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved. A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care.

The European General Practice Research Network Presents the Translations of Its Comprehensive Definition of Multimorbidity in Family Medicine in Ten European Languages

PubMed Central

Le Reste, Jean Yves; Nabbe, Patrice; Rivet, Charles; Lygidakis, Charilaos; Doerr, Christa; Czachowski, Slawomir; Lingner, Heidrun; Argyriadou, Stella; Lazic, Djurdjica; Assenova, Radost; Hasaganic, Melida; Munoz, Miquel Angel; Thulesius, Hans; Le Floch, Bernard; Derriennic, Jeremy; Sowinska, Agnieska; Van Marwijk, Harm; Lietard, Claire; Van Royen, Paul

2015-01-01

Background Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review. Objective To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research. Method Forward translation of the EGPRN’s definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teams to ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached Results 229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved. Conclusion A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care. PMID:25607642

'The trial is owned by the team, not by an individual': a qualitative study exploring the role of teamwork in recruitment to randomised controlled trials in surgical oncology.

PubMed

Strong, Sean; Paramasivan, Sangeetha; Mills, Nicola; Wilson, Caroline; Donovan, Jenny L; Blazeby, Jane M

2016-04-26

Challenges exist in recruitment to trials involving interventions delivered by different clinical specialties. Collaboration is required between clinical specialty and research teams. The aim of this study was to explore how teamwork influences recruitment to a multicentre randomised controlled trial (RCT) involving interventions delivered by different clinical specialties. Semi-structured interviews were conducted in three centres with a purposeful sample of members of the surgical, oncology and research teams recruiting to a feasibility RCT comparing definitive chemoradiotherapy with chemoradiotherapy and surgery for oesophageal squamous cell carcinoma. Interviews explored factors known to influence healthcare team effectiveness and were audio-recorded and thematically analysed. Sampling, data collection and analysis were undertaken iteratively and concurrently. Twenty-one interviews were conducted. Factors that influenced how team working impacted upon trial recruitment were centred on: (1) the multidisciplinary team (MDT) meeting, (2) leadership of the trial, and (3) the recruitment process. The weekly MDT meeting was reported as central to successful recruitment and formed the focus for creating a 'study team', bringing together clinical and research teams. Shared study leadership positively influenced healthcare professionals' willingness to participate. Interviewees perceived their clinical colleagues to have strong treatment preferences which led to scepticism regarding whether the treatments were being described to patients in a balanced manner. This study has highlighted a number of aspects of team functioning that are important for recruitment to RCTs that span different clinical specialties. Understanding these issues will aid the production of guidance on team-relevant issues that should be considered in trial management and the development of interventions that will facilitate teamwork and improve recruitment to these challenging RCTs. International Standard Randomised Controlled Trial Number (ISRCTN): ISRCTN89052791 .

Interventional valve surgery: building a team and working together.

PubMed

Ruel, Marc; Dickie, Sean; Chow, Benjamin J W; Labinaz, Marino

2010-01-01

Transcatheter aortic valve implantation (TAVI) is a new modality that may change the therapeutic landscape in the management of aortic valve stenosis. Despite the excellent results of surgical aortic valve replacement, TAVI has the potential to revolutionize the treatment of elderly and high-risk patients with aortic stenosis. It therefore constitutes a new reality that cardiac surgeons have to acknowledge. As TAVI indications and techniques become better defined, the importance of a team approach to the implementation and performance of TAVI is becoming increasingly evident. The surgeon has a crucial role to play in the introduction, development, and sustainability of TAVI at any institution. In this article, we discuss the procedural technique involved in TAVI, as well as the cardiologist and heart surgeon individualities and team dynamics. We make a case for judicious team-based adoption of TAVI technologies, considering that evidence-based and health economics data are not yet available. We also illustrate how a team approach may lead to improved outcomes, better patient and institutional acceptance, and a better definition of the therapeutic niche of TAVI modalities, amid the excellent results of conventional aortic valve replacement surgery. Copyright © 2010 Elsevier Inc. All rights reserved.

Remedial training for the radiology resident: a template for optimization of the learning plan.

PubMed

Mar, Colin; Chang, Silvia; Forster, Bruce

2015-02-01

All radiology residency programs should strive for the early identification of individuals in need of remedial training and have an approach ready to address this situation. This article provides a template for a step-by-step approach which is team based. It includes definition of the learning or performance issues, creation of suitable learning objectives and learning plan, facilitation of feedback and assessment, and definition of outcomes. Using such a template will assist the resident in returning to the path toward a safe and competent radiologist. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Intelligent resources for satellite ground control operations

NASA Technical Reports Server (NTRS)

Jones, Patricia M.

1994-01-01

This paper describes a cooperative approach to the design of intelligent automation and describes the Mission Operations Cooperative Assistant for NASA Goddard flight operations. The cooperative problem solving approach is being explored currently in the context of providing support for human operator teams and also in the definition of future advanced automation in ground control systems.

HRM Practices in Public and Private Universities of Pakistan: A Comparative Study

ERIC Educational Resources Information Center

Iqbal, Muhammad Zafar; Arif, Muhammad Irfan; Abbas, Furrakh

2011-01-01

The purpose of this study was to compare the HRM practices of public and private universities in Punjab province of Pakistan. The data for the study was collected through a questionnaire comprising 30 items mainly related to job definition, training and development, compensation, team work, employee's participation and performance appraisal. The…

Business planning. Reasons, definitions, and elements.

PubMed

Cardamone, Michael A; Shaver, Mark; Werthman, Ronald

2004-04-01

The Johns Hopkins Hospital and Health System has developed a centralized business planning structure that provides for creativity while incorporating a system of checks and balances. Combining standardization with flexibility allows for customization and variability. Using a team approach, the organization allows key players to contribute their experience and expertise to the planning for each new project.

Optimal UAV Path Planning for Tracking a Moving Ground Vehicle with a Gimbaled Camera

DTIC Science & Technology

2014-03-27

micro SD card slot to record all video taken at 1080P resolution. This feature allows the team to record the high definition video taken by the...Inequality constraints 64 h=[]; %Equality constraints 104 Bibliography 1. “ DIY Drones: Official ArduPlane Repository”, 2013. URL https://code

Three Is a Crowd? No Way--Three Is a Team! Collaborative Consultation Techniques for Educators.

ERIC Educational Resources Information Center

Wilber, Mary M. Jensen

This paper presents specific strategies to assist collaborative consultation efforts by educators of students with disabilities. First, a definition of collaborative consultation is offered and advantages of this approach identified. Next, essential skills and strategies to gain acceptance and establish credibility in collaborative situations are…

Business Plan for the Southwest Regional Spaceport: Executive Summary

NASA Technical Reports Server (NTRS)

1997-01-01

A proposal for a commercial, full-service launch, tracking, and recovery complex for Reusable Launch Vehicles in New Mexico is presented. Vision, mission, business definition, competitive advantages, and business approach are formulated. Management plan and team structure are detailed, and anticipated market is described. Finance and marketing plans are presented. Financial analysis is performed.

Supporting Collaboration with Technology: Does Shared Cognition Lead to Co-Regulation in Medicine?

ERIC Educational Resources Information Center

Lajoie, Susanne P.; Lu, Jingyan

2012-01-01

The theoretical distinctions between metacognition, self-regulation and self-regulated learning are often blurred which makes the definition of co-regulation in group learning situations even more difficult. We have started to explore co-regulation in the context of decision making in simulated emergencies where medical teams work together to…

Final Report and Recommendations to Secretary Cobey from The Environmental Education Team.

ERIC Educational Resources Information Center

North Carolina State Dept. of Environment, Health, and Natural Resources, Raleigh.

This report discusses the effectiveness of current educational efforts in the state of North Carolina, identifies opportunities for new or expanded activity, and recommends a plan of action. The first section discusses the definition of environmental education and reasons why environmental education is needed. The second section discusses three…

Project-Method Fit: Exploring Factors That Influence Agile Method Use

ERIC Educational Resources Information Center

Young, Diana K.

2013-01-01

While the productivity and quality implications of agile software development methods (SDMs) have been demonstrated, research concerning the project contexts where their use is most appropriate has yielded less definitive results. Most experts agree that agile SDMs are not suited for all project contexts. Several project and team factors have been…

A Bridge over Troubled Water: Facility Needs for Inclusive Classrooms.

ERIC Educational Resources Information Center

Pierce, Judy; And Others

1993-01-01

Focuses on ways to meet the facility needs of students with disabilities in inclusive classrooms. Provides a definition of inclusion; discusses some processes to design school environments that support a side range of student needs; and presents a process that will enable facility planning teams to move all students from self-contained classrooms…

Success in Student-Faculty/Staff SoTL Partnerships: Motivations, Challenges, Power, and Definitions

ERIC Educational Resources Information Center

Acai, Anita; Akesson, Bree; Allen, Meghan; Chen, Victoria; Mathany, Clarke; McCollum, Brett; Spencer, Jennifer; Verwoord, Roselynn E. M.

2017-01-01

Partnerships with students are considered one of the principles of good Scholarship of Teaching and Learning (SoTL) practice. However, not all partnerships are equally successful. What characteristics are common to successful partnerships and what preparatory elements can lead toward more successful partnerships? In this article, our team of…

BOREAS AFM-04 Twin Otter Aircraft Flux Data

NASA Technical Reports Server (NTRS)

MacPherson, J. Ian; Hall, Forrest G. (Editor); Knapp, David E. (Editor); Desjardins, Raymond L.; Smith, David E. (Technical Monitor)

2000-01-01

The BOREAS AFM-5 team collected and processed data from the numerous radiosonde flights during the project. The goals of the AFM-05 team were to provide large-scale definition of the atmosphere by supplementing the existing AES aerological network, both temporally and spatially. This data set includes basic upper-air parameters collected from the network of upper-air stations during the 1993, 1994, and 1996 field campaigns over the entire study region. The data are contained in tabular ASCII files. The data files are available on a CD-ROM (see document number 20010000884) or from the Oak Ridge National Laboratory (ORNL) Distributed Active Archive Center (DAAC).

Model Based Definition

NASA Technical Reports Server (NTRS)

Rowe, Sidney E.

2010-01-01

In September 2007, the Engineering Directorate at the Marshall Space Flight Center (MSFC) created the Design System Focus Team (DSFT). MSFC was responsible for the in-house design and development of the Ares 1 Upper Stage and the Engineering Directorate was preparing to deploy a new electronic Configuration Management and Data Management System with the Design Data Management System (DDMS) based upon a Commercial Off The Shelf (COTS) Product Data Management (PDM) System. The DSFT was to establish standardized CAD practices and a new data life cycle for design data. Of special interest here, the design teams were to implement Model Based Definition (MBD) in support of the Upper Stage manufacturing contract. It is noted that this MBD does use partially dimensioned drawings for auxiliary information to the model. The design data lifecycle implemented several new release states to be used prior to formal release that allowed the models to move through a flow of progressive maturity. The DSFT identified some 17 Lessons Learned as outcomes of the standards development, pathfinder deployments and initial application to the Upper Stage design completion. Some of the high value examples are reviewed.

The MSFC Collaborative Engineering Process for Preliminary Design and Concept Definition Studies

NASA Technical Reports Server (NTRS)

Mulqueen, Jack; Jones, David; Hopkins, Randy

2011-01-01

This paper describes a collaborative engineering process developed by the Marshall Space Flight Center's Advanced Concepts Office for performing rapid preliminary design and mission concept definition studies for potential future NASA missions. The process has been developed and demonstrated for a broad range of mission studies including human space exploration missions, space transportation system studies and in-space science missions. The paper will describe the design team structure and specialized analytical tools that have been developed to enable a unique rapid design process. The collaborative engineering process consists of integrated analysis approach for mission definition, vehicle definition and system engineering. The relevance of the collaborative process elements to the standard NASA NPR 7120.1 system engineering process will be demonstrated. The study definition process flow for each study discipline will be will be outlined beginning with the study planning process, followed by definition of ground rules and assumptions, definition of study trades, mission analysis and subsystem analyses leading to a standardized set of mission concept study products. The flexibility of the collaborative engineering design process to accommodate a wide range of study objectives from technology definition and requirements definition to preliminary design studies will be addressed. The paper will also describe the applicability of the collaborative engineering process to include an integrated systems analysis approach for evaluating the functional requirements of evolving system technologies and capabilities needed to meet the needs of future NASA programs.

Hydropower application of confined space regulations

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

Franseen, H.W.

1995-12-31

OSHA`s {open_quotes}Permit Required Confined Space{close_quotes} rules, 1910.146, became effective April 15, 1993. Their rules define a {open_quotes}confined space{close_quotes} and {open_quotes}permit required confined space{close_quotes}; provide general requirements for those entering the confined space, for the attendant and entry supervisor; define what a confined space program and permit system should be; and describe training requirements and rescue considerations. Tapoco Inc., began preparing confined space procedures in 1992 using Alcoa Engineering Standards and OSHA`s proposed rules. A joint union management team was formed, and this team began evaluating spaces which meet the confined space definition. In 1993, employees were trained, and all entriesmore » into spaces were done according to Alcoa`s and OSHA`s proposed rules. Rescue teams have been trained at each site. Some unique confined spaces and or unique entry conditions have been encountered which have required extensive evaluation.« less

Very-Long-Chain Acyl-CoA Dehydrogenase Deficiency--diagnostic difficulties and own experience in multidisciplinary management.

PubMed

Stępień, Karolina M; Roberts, Mark; Hendriksz, Christian J

2015-01-01

A 19-year old female patient presented with a two-year history of muscle pain and weakness before she was admitted to an acute medical ward with rhabdomyolysis (creatine kinase of 83,344 IU/L) and normal renal function tests. Following admission she was under the care of the rheumatology and neurology teams, which investigated her thoroughly. As part of the belt-and-braces approach, both teams contacted the specialist Adult Inherited Metabolic Disorders team for advice, instigating definitive diagnostic investigations. An accurate diagnosis was required, as an inherited metabolic disorders can present in adult patients as a milder form of the disease. Very-long-chain Acyl-CoA dehydrogenase (VLCAD) deficiency should always be considered as a differential diagnosis of myopathy-related symptoms. Hence, the liaison between neurologists, rheumatologists and metabolic physicians is essential in early diagnosis and the management of patients with conditions causing myopathy.

Understanding interprofessional collaboration in the context of chronic disease management for older adults living in communities: a concept analysis.

PubMed

Bookey-Bassett, Sue; Markle-Reid, Maureen; Mckey, Colleen A; Akhtar-Danesh, Noori

2017-01-01

To report a concept analysis of interprofessional collaboration in the context of chronic disease management, for older adults living in communities. Increasing prevalence of chronic disease among older adults is creating significant burden for patients, families and healthcare systems. Managing chronic disease for older adults living in the community requires interprofessional collaboration across different health and other care providers, organizations and sectors. However, there is a lack of consensus about the definition and use of interprofessional collaboration for community-based chronic disease management. Concept analysis. Electronic databases CINAHL, Medline, HealthStar, EMBASE, PsychINFO, Ageline and Cochrane Database were searched from 2000 - 2013. Rodgers' evolutionary method for concept analysis. The most common surrogate term was interdisciplinary collaboration. Related terms were interprofessional team, multidisciplinary team and teamwork. Attributes included: an evolving interpersonal process; shared goals, decision-making and care planning; interdependence; effective and frequent communication; evaluation of team processes; involving older adults and family members in the team; and diverse and flexible team membership. Antecedents comprised: role awareness; interprofessional education; trust between team members; belief that interprofessional collaboration improves care; and organizational support. Consequences included impacts on team composition and function, care planning processes and providers' knowledge, confidence and job satisfaction. Interprofessional collaboration is a complex evolving concept. Key components of interprofessional collaboration in chronic disease management for community-living older adults are identified. Implications for nursing practice, education and research are proposed. © 2016 John Wiley & Sons Ltd.

Design and Parametric Sizing of Deep Space Habitats Supporting NASA'S Human Space Flight Architecture Team

NASA Technical Reports Server (NTRS)

Toups, Larry; Simon, Matthew; Smitherman, David; Spexarth, Gary

2012-01-01

NASA's Human Space Flight Architecture Team (HAT) is a multi-disciplinary, cross-agency study team that conducts strategic analysis of integrated development approaches for human and robotic space exploration architectures. During each analysis cycle, HAT iterates and refines the definition of design reference missions (DRMs), which inform the definition of a set of integrated capabilities required to explore multiple destinations. An important capability identified in this capability-driven approach is habitation, which is necessary for crewmembers to live and work effectively during long duration transits to and operations at exploration destinations beyond Low Earth Orbit (LEO). This capability is captured by an element referred to as the Deep Space Habitat (DSH), which provides all equipment and resources for the functions required to support crew safety, health, and work including: life support, food preparation, waste management, sleep quarters, and housekeeping.The purpose of this paper is to describe the design of the DSH capable of supporting crew during exploration missions. First, the paper describes the functionality required in a DSH to support the HAT defined exploration missions, the parameters affecting its design, and the assumptions used in the sizing of the habitat. Then, the process used for arriving at parametric sizing estimates to support additional HAT analyses is detailed. Finally, results from the HAT Cycle C DSH sizing are presented followed by a brief description of the remaining design trades and technological advancements necessary to enable the exploration habitation capability.

Model building techniques for analysis.

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

Walther, Howard P.; McDaniel, Karen Lynn; Keener, Donald

2009-09-01

The practice of mechanical engineering for product development has evolved into a complex activity that requires a team of specialists for success. Sandia National Laboratories (SNL) has product engineers, mechanical designers, design engineers, manufacturing engineers, mechanical analysts and experimentalists, qualification engineers, and others that contribute through product realization teams to develop new mechanical hardware. The goal of SNL's Design Group is to change product development by enabling design teams to collaborate within a virtual model-based environment whereby analysis is used to guide design decisions. Computer-aided design (CAD) models using PTC's Pro/ENGINEER software tools are heavily relied upon in the productmore » definition stage of parts and assemblies at SNL. The three-dimensional CAD solid model acts as the design solid model that is filled with all of the detailed design definition needed to manufacture the parts. Analysis is an important part of the product development process. The CAD design solid model (DSM) is the foundation for the creation of the analysis solid model (ASM). Creating an ASM from the DSM currently is a time-consuming effort; the turnaround time for results of a design needs to be decreased to have an impact on the overall product development. This effort can be decreased immensely through simple Pro/ENGINEER modeling techniques that summarize to the method features are created in a part model. This document contains recommended modeling techniques that increase the efficiency of the creation of the ASM from the DSM.« less

The Cascading Impacts of Technology Selection: Incorporating Ruby on Rails into ECHO

NASA Astrophysics Data System (ADS)

Pilone, D.; Cechini, M.

2010-12-01

NASA’s Earth Observing System (EOS) ClearingHOuse (ECHO) is a SOA based Earth Science Data search and order system implemented in Java with one significant exception: the web client used by 98% of our users is written in Perl. After several decades of maintenance the Perl based application had reached the end of its serviceable life and ECHO was tasked with implementing a replacement. Despite a broad investment in Java, the ECHO team conducted a survey of modern development technologies including Flex, Python/Django, JSF2/Spring and Ruby on Rails. The team ultimately chose Ruby on Rails (RoR) with Cucumber for testing due to its perceived applicability to web application development and corresponding development efficiency gains. Both positive and negative impacts on the entire ECHO team, including our stakeholders, were immediate and sometimes subtle. The technology selection caused shifts in our architecture and design, development and deployment procedures, requirement definition approach, testing approach, and, somewhat surprisingly, our project team structure and software process. This presentation discusses our experiences, including technical, process, and psychological, using RoR on a production system. During this session we will discuss: - Real impacts of introducing a dynamic language to a Java team - Real and perceived efficiency advantages - Impediments to adoption and effectiveness - Impacts of transition from Test Driven Development to Behavior Driven Development - Leveraging Cucumber to provide fully executable requirement documents - Impacts on team structure and roles

The resident physician as leader within the healthcare team.

PubMed

Sonnenberg, Lyn Kathryn; Pritchard-Wiart, Lesley; Busari, Jamiu

2018-05-08

Purpose The purpose of this study was to explore inter-professional clinicians' perspectives on resident leadership in the context of inter-professional teams and to identify a definition for leadership in the clinical context. In 2015, CanMEDS changed the title of one of the core competencies from manager to leader. The shift in language was perceived by some as returning to traditional hierarchical and physician-dominant structures. The resulting uncertainty has resulted in a call to action to not only determine what physician leadership is but to also determine how to teach and assess it. Design/methodology/approach Focus groups and follow-up individual interviews were conducted with 23 inter-professional clinicians from three pediatric clinical service teams at a large, Canadian tertiary-level rehabilitation hospital. Qualitative thematic analysis was used to inductively analyze the data. Findings Data analysis resulted in one overarching theme: leadership is collaborative - and three related subthemes: leadership is shared; leadership is summative; and conceptualizations of leadership are shifting. Research limitations/implications Not all members of the three inter-professional teams were able to attend the focus group sessions because of scheduling conflicts. Participation of additional clinicians could have, therefore, affected the results of this study. The study was conducted locally at a single rehabilitation hospital, among Canadian pediatric clinicians, which highlights the need to explore conceptualization of leadership across different contexts. Practical implications There is an evident need to prepare physicians to be leaders in both their daily clinical and academic practices. Therefore, more concerted efforts are required to develop leadership skills among residents. The authors postulate that continued integration of various inter-professional disciplines during the early phases of training is essential to foster collaborative leadership and trust. Originality/value The results of this study suggest that inter-professional clinicians view clinical leadership as collaborative and fluid and determined by the fit between tasks and team member expertise. Mentorship is important for increasing the ability of resident physicians to develop collaborative leadership roles within teams. The authors propose a collaborative definition of clinical leadership based on the results of this study: a shared responsibility that involves facilitation of dialog; the integration of perspectives and expertise; and collaborative planning for the purpose of exceptional patient care.

What about Health Educators? Nutrition Education for Allied Health Professionals: A Review of the Literature

ERIC Educational Resources Information Center

Ettienne-Gittens, Reynolette; Lisako, E.; McKyer, J.; Goodson, Patricia; Guidry, Jeffrey; Outley, Corliss

2012-01-01

Background: Health educators are critical members of the health care team who may be called upon to provide nutrition education. However, are health educators prepared for this task? What have scholars concluded regarding this pertinent topic? Purpose: This study has three purposes: (1) to determine the definition of and criteria for nutrition…

US NDC Modernization Iteration E1 Prototyping Report: User Interface Framework

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

Lober, Randall R.

2014-12-01

During the first iteration of the US NDC Modernization Elaboration phase (E1), the SNL US NDC modernization project team completed an initial survey of applicable COTS solutions, and established exploratory prototyping related to the User Interface Framework (UIF) in support of system architecture definition. This report summarizes these activities and discusses planned follow-on work.

US NDC Modernization Iteration E1 Prototyping Report: Common Object Interface

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

Lewis, Jennifer E.; Hess, Michael M.

2014-12-01

During the first iteration of the US NDC Modernization Elaboration phase (E1), the SNL US NDC modernization project team completed an initial survey of applicable COTS solutions, and established exploratory prototyping related to the Common Object Interface (COI) in support of system architecture definition. This report summarizes these activities and discusses planned follow-on work.

Reading and Becoming Living Authors: Urban Girls Pursuing a Poetry of Self-Definition

ERIC Educational Resources Information Center

Wissman, Kelly

2009-01-01

When Don Imus made his infamous comments about the Rutgers University women's basketball team in 2007, he provoked widespread (yet short-lived) attention to the circulation of language practices demeaning to women of color. In an elective autobiographical writing course that the author designed with and for urban high school girls, the students…

US NDC Modernization Iteration E1 Prototyping Report: Processing Control Framework

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

Prescott, Ryan; Hamlet, Benjamin R.

2014-12-01

During the first iteration of the US NDC Modernization Elaboration phase (E1), the SNL US NDC modernization project team developed an initial survey of applicable COTS solutions, and established exploratory prototyping related to the processing control framework in support of system architecture definition. This report summarizes these activities and discusses planned follow-on work.

An Evaluation of the Informedia Digital Video Library System at the Open University.

ERIC Educational Resources Information Center

Kukulska-Hulme, Agnes; Van der Zwan, Robert; DiPaolo, Terry; Evers, Vanessa; Clarke, Sarah

1999-01-01

Reports on an Open University evaluation study of the Informedia Digital Video Library System developed at Carnegie Mellon University (CMU). Findings indicate that there is definite potential for using the system, provided that certain modifications can be made. Results also confirm findings of the Informedia team at CMU that the content of video…

The Role of Personality and Team-Based Product Dissection on Fixation Effects

ERIC Educational Resources Information Center

Toh, Christine; Miller, Scarlett; Kremer, Gül E. Okudan

2013-01-01

Design fixation has been found to be complex in its definition and expression, but it plays an important role in design idea generation. Identifying the factors that influence fixation is crucial in understanding how to enhance the design process and reduce the negative effects of fixation. One way to potentially mitigate fixation is through…

Squad as Community--A Group Communication Perspective on the Debate Workplace.

ERIC Educational Resources Information Center

Shelton, Michael W.

Virtually everyone involved with forensics has, at one time or another, seen or heard references to debate teams or squads as "groups." Many questions concerning the label "group," however, exist. A brief examination of definitions of the term group by scholars in the field of small group communication confirms that T. M.…

The Primary Care Behavioral Health (PCBH) Model: An Overview and Operational Definition.

PubMed

Reiter, Jeffrey T; Dobmeyer, Anne C; Hunter, Christopher L

2018-06-01

The Primary Care Behavioral Health (PCBH) model is a prominent approach to the integration of behavioral health services into primary care settings. Implementation of the PCBH model has grown over the past two decades, yet research and training efforts have been slowed by inconsistent terminology and lack of a concise, operationalized definition of the model and its key components. This article provides the first concise operationalized definition of the PCBH model, developed from examination of multiple published resources and consultation with nationally recognized PCBH model experts. The definition frames the model as a team-based approach to managing biopsychosocial issues that present in primary care, with the over-arching goal of improving primary care in general. The article provides a description of the key components and strategies used in the model, the rationale for those strategies, a brief comparison of this model to other integration approaches, a focused summary of PCBH model outcomes, and an overview of common challenges to implementing the model.

Social cognition in schizophrenia: an NIMH workshop on definitions, assessment, and research opportunities.

PubMed

Green, Michael F; Penn, David L; Bentall, Richard; Carpenter, William T; Gaebel, Wolfgang; Gur, Ruben C; Kring, Ann M; Park, Sohee; Silverstein, Steven M; Heinssen, Robert

2008-11-01

Social cognition has become a high priority area for the study of schizophrenia. However, despite developments in this area, progress remains limited by inconsistent terminology and differences in the way social cognition is measured. To address these obstacles, a consensus-building meeting on social cognition in schizophrenia was held at the National Institute of Mental Health in March 2006. Agreement was reached on several points, including definitions of terms, the significance of social cognition for schizophrenia research, and suggestions for future research directions. The importance of translational interdisciplinary research teams was emphasized. The current article presents a summary of these discussions.

Reporting Fatal Neglect in Child Death Review.

PubMed

Scott, Debbie

2018-01-01

Child death reviews are conducted with the aim of preventing child deaths however, definitions, inclusion criteria for the review of child deaths and reporting practices vary across Child Death Review Teams (CDRTs). This article aims to identify a common context and understanding of fatal neglect reporting by reviewing definitional issues of fatal neglect and comparing reporting practice across a number of CDRTs. Providing a consistent context for identifying and reporting neglect-related deaths may improve the understanding of the impact of fatal neglect and the risk factors associated with it and therefore, improve the potential of CDRT review to inform prevention programs, policies, and procedures.

Remediating Non-Positive Definite State Covariances for Collision Probability Estimation

NASA Technical Reports Server (NTRS)

Hall, Doyle T.; Hejduk, Matthew D.; Johnson, Lauren C.

2017-01-01

The NASA Conjunction Assessment Risk Analysis team estimates the probability of collision (Pc) for a set of Earth-orbiting satellites. The Pc estimation software processes satellite position+velocity states and their associated covariance matri-ces. On occasion, the software encounters non-positive definite (NPD) state co-variances, which can adversely affect or prevent the Pc estimation process. Inter-polation inaccuracies appear to account for the majority of such covariances, alt-hough other mechanisms contribute also. This paper investigates the origin of NPD state covariance matrices, three different methods for remediating these co-variances when and if necessary, and the associated effects on the Pc estimation process.

Social Cognition in Schizophrenia: An NIMH Workshop on Definitions, Assessment, and Research Opportunities

PubMed Central

Green, Michael F.; Penn, David L.; Bentall, Richard; Carpenter, William T.; Gaebel, Wolfgang; Gur, Ruben C.; Kring, Ann M.; Park, Sohee; Silverstein, Steven M.; Heinssen, Robert

2008-01-01

Social cognition has become a high priority area for the study of schizophrenia. However, despite developments in this area, progress remains limited by inconsistent terminology and differences in the way social cognition is measured. To address these obstacles, a consensus-building meeting on social cognition in schizophrenia was held at the National Institute of Mental Health in March 2006. Agreement was reached on several points, including definitions of terms, the significance of social cognition for schizophrenia research, and suggestions for future research directions. The importance of translational interdisciplinary research teams was emphasized. The current article presents a summary of these discussions. PMID:18184635

Delayed Rapid Response Team Activation Is Associated With Increased Hospital Mortality, Morbidity, and Length of Stay in a Tertiary Care Institution.

PubMed

Barwise, Amelia; Thongprayoon, Charat; Gajic, Ognjen; Jensen, Jeffrey; Herasevich, Vitaly; Pickering, Brian W

2016-01-01

To identify whether delays in rapid response team activation contributed to worse patient outcomes (mortality and morbidity). Retrospective observational cohort study including all rapid response team activations in 2012. Tertiary academic medical center. All those 18 years old or older who had a rapid response team call activated. Vital sign data were abstracted from individual patient electronic medical records for the 24 hours before the rapid response team activation took place. Patients were considered to have a delayed rapid response team activation if more than 1 hour passed between the first appearance in the record of an abnormal vital sign meeting rapid response team criteria and the activation of an rapid response team. None. A total of 1,725 patients were included in the analysis. Data were compared between those who had a delayed rapid response team activation and those who did not. Fifty seven percent patients met the definition of delayed rapid response team activation. Patients in high-frequency physiologic monitored environments were more likely to experience delay than their floor counterparts. In the no-delay group, the most common reasons for rapid response team activation were tachycardia/bradycardia at 29% (217/748), respiratory distress/low SpO2 at 28% (213/748), and altered level of consciousness at 23% (170/748) compared with respiratory distress/low SpO2 at 43% (423/977), tachycardia/bradycardia at 33% (327/977), and hypotension at 27% (261/977) in the delayed group. The group with no delay had a higher proportion of rapid response team calls between 8:00 and 16:00, whereas those with delay had a higher proportion of calls between midnight and 08:00. The delayed group had higher hospital mortality (15% vs 8%; adjusted odds ratio, 1.6; p = 0.005); 30-day mortality (20% vs 13%; adjusted odds ratio, 1.4; p = 0.02); and hospital length of stay (7 vs 6 d; relative prolongation, 1.10; p = 0.02) compared with the no-delay group. Delays in rapid response team activation occur frequently and are independently associated with worse patient mortality and morbidity outcomes.

Persistence of unsafe practice in everyday work: an exploration of organizational and psychological factors constraining safety in the operating room.

PubMed

Espin, S; Lingard, L; Baker, G R; Regehr, G

2006-06-01

This paper explores the factors that influence the persistence of unsafe practice in an interprofessional team setting in health care, towards the development of a descriptive theoretical model for analyzing problematic practice routines. Using data collected during a mixed method interview study of 28 members of an operating room team, participants' approaches to unsafe practice were analyzed using the following three theoretical models from organizational and cognitive psychology: Reason's theory of "vulnerable system syndrome", Tucker and Edmondson's concept of first and second order problem solving, and Amalberti's model of practice migration. These three theoretical approaches provide a critical insight into key trends in the interview data, including team members' definition of error as the breaching of standards of practice, nurses' sense of scope of practice as a constraint on their reporting behaviours, and participants' reports of the forces influencing tacit agreements to work around safety regulations. However, the relational factors underlying unsafe practice routines are poorly accounted for in these theoretical approaches. Incorporating an additional theoretical construct such as "relational coordination" to account for the emotional human features of team practice would provide a more comprehensive theoretical approach for use in exploring unsafe practice routines and the forces that sustain them in healthcare team settings.

Institutionalizing Lessons Learned

NASA Technical Reports Server (NTRS)

McBrayer, Robert O.; Thomas, Dale

2001-01-01

The NASA Integrated Action Team (NIAT) was formed by the NASA Administrator in March 2000. The purpose of this team was to identify the actions that NASA must take to address systemic findings reported in 4 different anomaly investigations. Team membership represented senior managers from all the field centers and NASA Headquarters. NIAT report addressed 165 findings and developed 17 action plans that are described in five themes: people and teams, technology, risk, formulation rigor, and communications. The NIAT actions present a systems solution for strengthening formulation and implementation of programs and improving the environment for their support. NIAT results included: enhancing success by avoiding failures that could have been prevented through good planning and sound practice; ensuring that prudent risks do not compromise safety; and ensuring that mission risks are objectively assessed, appropriately mitigated and consciously accepted by the program team and customers. Definitions of Faster, Better, Cheaper and Success Criteria were also developed and included as part of the NIAT report. As a result of the NIAT report, program and project management process changes were incorporated into NASA's quality system documentation, including NPG 7120.513, "NASA Program and Project Management Processes and Requirements. This paper describes the NIAT results and the resulting updates to NPG 7120.5 that keep this program and project management description a living process.

Effective Leadership in the 21st Century.

PubMed

Jones, Jacqueline

2015-01-01

Leaders know how to achieve goals and inspire people along the way. While the terms and definitions may change with the times, it is important to understand the skills and abilities needed to lead in the 21st century. Most effective leaders have one element in common, and that is they are able to keep their teams engaged. If team members are not engaged, they may very well leave the organization. With four generations in the workplace, leaders must adapt and modify their leadership style in order to maintain employee engagement. The ability to lead effectively is based on a number of skills, including communication, motivation, vision, modeling, demonstrating empathy, confidence, persistence, and integrity.

Key Personnel and “Long Distance” Settings: Determining Who Must Report Financial Conflict of Interest

PubMed Central

Lynch, John; Lindsell, Chris J.

2010-01-01

Conflicts of interest can impact the integrity of scientific research. While public imagination has focused on scientists, regulatory discourse recognizes a broader range of individuals who might have financial COIs. This essay asks, for personnel who enroll subjects at a physical and organizational remove from the primary research team, whether reporting COI to an institutional review board or COI committee protects research integrity. After examining definitions of COI, regulations on COI, and rubrics for evaluating COI policies, we argue that requiring recruitment personnel working at a distance from the primary research team to report potential COI protects neither research integrity nor human subjects. PMID:20597019

Standardization of the Definitions of Vertical Resolution and Uncertainty in the NDACC-archived Ozone and Temperature Lidar Measurements

NASA Technical Reports Server (NTRS)

Leblanc, T.; Godin-Beekmann, S.; Payen, Godin-Beekmann; Gabarrot, Franck; vanGijsel, Anne; Bandoro, J.; Sica, R.; Trickl, T.

2012-01-01

The international Network for the Detection of Atmospheric Composition Change (NDACC) is a global network of high-quality, remote-sensing research stations for observing and understanding the physical and chemical state of the Earth atmosphere. As part of NDACC, over 20 ground-based lidar instruments are dedicated to the long-term monitoring of atmospheric composition and to the validation of space-borne measurements of the atmosphere from environmental satellites such as Aura and ENVISAT. One caveat of large networks such as NDACC is the difficulty to archive measurement and analysis information consistently from one research group (or instrument) to another [1][2][3]. Yet the need for consistent definitions has strengthened as datasets of various origin (e.g., satellite and ground-based) are increasingly used for intercomparisons, validation, and ingested together in global assimilation systems.In the framework of the 2010 Call for Proposals by the International Space Science Institute (ISSI) located in Bern, Switzerland, a Team of lidar experts was created to address existing issues in three critical aspects of the NDACC lidar ozone and temperature data retrievals: signal filtering and the vertical filtering of the retrieved profiles, the quantification and propagation of the uncertainties, and the consistent definition and reporting of filtering and uncertainties in the NDACC- archived products. Additional experts from the satellite and global data standards communities complement the team to help address issues specific to the latter aspect.

Validation of Framework Code Approach to a Life Prediction System for Fiber Reinforced Composites

NASA Technical Reports Server (NTRS)

Gravett, Phillip

1997-01-01

The grant was conducted by the MMC Life Prediction Cooperative, an industry/government collaborative team, Ohio Aerospace Institute (OAI) acted as the prime contractor on behalf of the Cooperative for this grant effort. See Figure I for the organization and responsibilities of team members. The technical effort was conducted during the period August 7, 1995 to June 30, 1996 in cooperation with Erwin Zaretsky, the LERC Program Monitor. Phil Gravett of Pratt & Whitney was the principal technical investigator. Table I documents all meeting-related coordination memos during this period. The effort under this grant was closely coordinated with an existing USAF sponsored program focused on putting into practice a life prediction system for turbine engine components made of metal matrix composites (MMC). The overall architecture of the NMC life prediction system was defined in the USAF sponsored program (prior to this grant). The efforts of this grant were focussed on implementing and tailoring of the life prediction system, the framework code within it and the damage modules within it to meet the specific requirements of the Cooperative. T'he tailoring of the life prediction system provides the basis for pervasive and continued use of this capability by the industry/government cooperative. The outputs of this grant are: 1. Definition of the framework code to analysis modules interfaces, 2. Definition of the interface between the materials database and the finite element model, and 3. Definition of the integration of the framework code into an FEM design tool.

Increased injury rates after the restructure of Germany's national second league of team handball.

PubMed

Luig, Patrick; Krutsch, Werner; Nerlich, Michael; Henke, Thomas; Klein, Christian; Bloch, Hendrik; Platen, Petra; Achenbach, Leonard

2018-02-05

Scientific injury data in men's professional team handball injuries are rare and even less scientific information exists on injury prevention. In 2011, Germany's national second team handball league was restructured by merging the existing two regional leagues into one league. This study evaluates the injury patterns in professional team handball and compares the injury rates between the first and second league before and after the restructure. All players of Germany's national first and second men's team handball leagues have mandatory trauma insurance with the same insurance company. This retrospective cohort study analysed the injury data of three consecutive seasons 2010-2013 using standardized injury definitions. 1194 professional team handball players were included in this study. The majority of severe injuries affected the lower extremities, shoulders, and hands. The average injury incidence significantly differed between the first (4.9 injuries per 1000 h) and the second league (3.9 per 1000 h, p < 0.01). The injury incidence in the restructured second league had increased from 3.7 to 4.1 per 1000 h (p < 0.01) and prevalence from 67.1 to 79.3% (p < 0.001), thus almost to the same levels of the first league. The second league showed more time-loss injuries at all severity levels. This study yielded a high injury incidence after the restructure of the national second team handball league and presents details on prevalence, incidence, and patterns of injury in professional men's team handball. This study is an important basis for developing injury prevention strategies that should focus on the shoulders, hands, and lower extremities and on reducing the number of matches and travel burden. III.

A process-based framework to guide nurse practitioners integration into primary healthcare teams: results from a logic analysis.

PubMed

Contandriopoulos, Damien; Brousselle, Astrid; Dubois, Carl-Ardy; Perroux, Mélanie; Beaulieu, Marie-Dominique; Brault, Isabelle; Kilpatrick, Kelley; D'Amour, Danielle; Sansgter-Gormley, Esther

2015-02-27

Integrating Nurse Practitioners into primary care teams is a process that involves significant challenges. To be successful, nurse practitioner integration into primary care teams requires, among other things, a redefinition of professional boundaries, in particular those of medicine and nursing, a coherent model of inter- and intra- professional collaboration, and team-based work processes that make the best use of the subsidiarity principle. There have been numerous studies on nurse practitioner integration, and the literature provides a comprehensive list of barriers to, and facilitators of, integration. However, this literature is much less prolific in discussing the operational level implications of those barriers and facilitators and in offering practical recommendations. In the context of a large-scale research project on the introduction of nurse practitioners in Quebec (Canada) we relied on a logic-analysis approach based, on the one hand on a realist review of the literature and, on the other hand, on qualitative case-studies in 6 primary healthcare teams in rural and urban area of Quebec. Five core themes that need to be taken into account when integrating nurse practitioners into primary care teams were identified. Those themes are: planning, role definition, practice model, collaboration, and team support. The present paper has two objectives: to present the methods used to develop the themes, and to discuss an integrative model of nurse practitioner integration support centered around these themes. It concludes with a discussion of how this framework contributes to existing knowledge and some ideas for future avenues of study.

The Effect of Availability of Manpower on Trauma Resuscitation Times in a Tertiary Academic Hospital.

PubMed

Tan, Timothy Xin Zhong; Quek, Nathaniel Xin Ern; Koh, Zhi Xiong; Nadkarni, Nivedita; Singaram, Kanageswari; Ho, Andrew Fu Wah; Ong, Marcus Eng Hock; Wong, Ting Hway

2016-01-01

For trauma patients, delays to assessment, resuscitation, and definitive care affect outcomes. We studied the effects of resuscitation area occupancy and trauma team size on trauma team resuscitation speed in an observational study at a tertiary academic institution in Singapore. From January 2014 to January 2015, resuscitation videos of trauma team activated patients with an Injury Severity Score of 9 or more were extracted for review within 14 days by independent reviewers. Exclusion criteria were patients dead on arrival, inter-hospital transfers, and up-triaged patients. Data captured included manpower availability (trauma team size and resuscitation area occupancy), assessment (airway, breathing, circulation, logroll), interventions (vascular access, imaging), and process-of-care time intervals (time to assessment/intervention/adjuncts, time to imaging, and total time in the emergency department). Clinical data were obtained by chart review and from the trauma registry. Videos of 70 patients were reviewed over a 13-month period. The median time spent in the emergency department was 154.9 minutes (IQR 130.7-207.5) and the median resuscitation team size was 7, with larger team sizes correlating with faster process-of-care time intervals: time to airway assessment (p = 0.08) and time to disposition (p = 0.04). The mean resuscitation area occupancy rate (RAOR) was 1.89±2.49, and the RAOR was positively correlated with time spent in the emergency department (p = 0.009). Our results suggest that adequate staffing for trauma teams and resuscitation room occupancy are correlated with faster trauma resuscitation and reduced time spent in the emergency department.

Referee or Team Builder? The Director's Role in Managing Staff Conflict

ERIC Educational Resources Information Center

Jeffries, Yvonne

2004-01-01

There are as many different definitions of conflict as there are reasons for it to occur. Staff conflict is one of the realities of organizational life. Given the range of things that can cause or contribute to staff conflict, and the likelihood of workplace conflict, the author offers principles that can contribute to resolution of workplace or…

Leading from Every Seat: Empowering Principals to Cultivate Teacher Leadership for School Improvement. Version 1.0

ERIC Educational Resources Information Center

Broin, Alexandra

2015-01-01

Since 2000, "New Leaders" have prepared outstanding principals to transform America's underserved schools and communities. Yet the role has become vastly more complex and demanding--and principals, no matter how heroic, cannot do it all alone. Great leaders, by definition, bring out the best in their people to create exceptional teams.…

Definition and Outcome of a Curriculum to Prevent Disordered Eating and Body-Shaping Drug Use

ERIC Educational Resources Information Center

Elliot, Diane L.; Moe, Esther L.; Goldberg, Linn; DeFrancesco, Carol A.; Durham, Melissa B.; Hix-Small, Hollie

2006-01-01

Almost one half of male and female students participate in high school-sponsored athletics, and high school also is a time when classroom health promotion curricula are less effective. The Athletes Training and Learning to Avoid Steroids is a sport team-centered drug-use prevention program for male high school athletes, which has been shown to…

Ship to Shore Data Communication and Prioritization

DTIC Science & Technology

2011-12-01

First Out FTP File Transfer Protocol GCCS-M Global Command and Control System Maritime HAIPE High Assurance Internet Protocol Encryptor HTTP Hypertext...Transfer Protocol (world wide web protocol ) IBS Integrated Bar Code System IDEF0 Integration Definition IER Information Exchange Requirements...INTEL Intelligence IP Internet Protocol IPT Integrated Product Team ISEA In-Service Engineering Agent ISNS Integrated Shipboard Network System IT

Leadership training in health care action teams: a systematic review.

PubMed

Rosenman, Elizabeth D; Shandro, Jamie R; Ilgen, Jonathan S; Harper, Amy L; Fernandez, Rosemarie

2014-09-01

To identify and describe the design, implementation, and evidence of effectiveness of leadership training interventions for health care action (HCA) teams, defined as interdisciplinary teams whose members coordinate their actions in time-pressured, unstable situations. The authors conducted a systematic search of the PubMed/MEDLINE, CINAHL, ERIC, EMBASE, PsycINFO, and Web of Science databases, key journals, and review articles published through March 2012. They identified peer-reviewed English-language articles describing leadership training interventions targeting HCA teams, at all levels of training and across all health care professions. Reviewers, working in duplicate, abstracted training characteristics and outcome data. Methodological quality was evaluated using the Medical Education Research Study Quality Instrument (MERSQI). Of the 52 included studies, 5 (10%) focused primarily on leadership training, whereas the remainder included leadership training as part of a larger teamwork curriculum. Few studies reported using a team leadership model (2; 4%) or a theoretical framework (9; 17%) to support their curricular design. Only 15 studies (29%) specified the leadership behaviors targeted by training. Forty-five studies (87%) reported an assessment component; of those, 31 (69%) provided objective outcome measures including assessment of knowledge or skills (21; 47%), behavior change (8; 18%), and patient- or system-level metrics (8; 18%). The mean MERSQI score was 11.4 (SD 2.9). Leadership training targeting HCA teams has become more prevalent. Determining best practices in leadership training is confounded by variability in leadership definitions, absence of supporting frameworks, and a paucity of robust assessments.

Caregiver involvement in a large clinical systems project.

PubMed Central

Sales, S.; Mathews, P.; Gamblin, D.; Gee, S.

1994-01-01

The Kaiser Permanente Northern California Region (KPNCR) CareGiver Workstation (CGW) Project's mission is to develop and implement a clinical workstation system that will enhance each caregiver-member interaction and aid in the decision-making processes of direct patient care in the inpatient and outpatient settings. The requirements analysis approach for CareGiver Workstation (CGW) is based on the belief that extensive caregiver involvement will provide a better understanding of the diverse needs of Kaiser Permanente Northern California Region (KPNCR). In order to involve as many caregivers as reasonably possible, CGW included a 16 member caregiver core team and 6 different Medical Centers in the requirements definition process. The Medical Centers are referred to as "focus facilities". A "focus group" (caregiver team) at each selected focus facility consisted of a site coordinator and a 24-30 person multidisciplinary team involving physicians, nurses, therapists and other caregivers. The Medical Center selection process identified facilities that provided the best cross-sectional representation of KPNCR. The Lead Focus Facility participated in the initial round of requirements definition activities. These sessions assisted in the design of a simulation that was used at five additional Medical Centers to validate requirements. The five additional Focus Facilities participated in simulation review sessions. Feedback from these sessions was used to revise the simulation and update the requirements document. Caregivers from all six focus facilities and other identified groups participated in a requirements survey to assist CGW with identification of high priority features. Caregiver commitment and continuing involvement are essential for the success of CGW.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7949953

Acute care clinical pharmacy practice: unit- versus service-based models.

PubMed

Haas, Curtis E; Eckel, Stephen; Arif, Sally; Beringer, Paul M; Blake, Elizabeth W; Lardieri, Allison B; Lobo, Bob L; Mercer, Jessica M; Moye, Pamela; Orlando, Patricia L; Wargo, Kurt

2012-02-01

This commentary from the 2010 Task Force on Acute Care Practice Model of the American College of Clinical Pharmacy was developed to compare and contrast the "unit-based" and "service-based" orientation of the clinical pharmacist within an acute care pharmacy practice model and to offer an informed opinion concerning which should be preferred. The clinical pharmacy practice model must facilitate patient-centered care and therefore must position the pharmacist to be an active member of the interprofessional team focused on providing high-quality pharmaceutical care to the patient. Although both models may have advantages and disadvantages, the most important distinction pertains to the patient care role of the clinical pharmacist. The unit-based pharmacist is often in a position of reacting to an established order or decision and frequently is focused on task-oriented clinical services. By definition, the service-based clinical pharmacist functions as a member of the interprofessional team. As a team member, the pharmacist proactively contributes to the decision-making process and the development of patient-centered care plans. The service-based orientation of the pharmacist is consistent with both the practice vision embraced by ACCP and its definition of clinical pharmacy. The task force strongly recommends that institutions pursue a service-based pharmacy practice model to optimally deploy their clinical pharmacists. Those who elect to adopt this recommendation will face challenges in overcoming several resource, technologic, regulatory, and accreditation barriers. However, such challenges must be confronted if clinical pharmacists are to contribute fully to achieving optimal patient outcomes. © 2012 Pharmacotherapy Publications, Inc.

The incidence of injury in elite camogie, an in-season prospective study

PubMed Central

Blake, Catherine

2018-01-01

Background Camogie is a stickhandling, high-velocity, multidirectional field sport for females which is native to Ireland, but is also played internationally. Aim To establish the incidence, nature and severity of injuries in elite camogie players. Methods A prospective, observational cohort study was carried out during the Provincial Championships and extending into the All-Ireland Championship until a participating team was eliminated (11 weeks). A purposive sample of 62 players from 3 of the total 11 senior intercounty teams participated to generate geographical representation. Injury data were recorded and classified by team physiotherapists using a time loss definition, consistent with consensus statements. A concurrent measure of exposure to matches and training was recorded. Results Twenty-one incidents of injury were recorded with 14 players injured. Injury incidence rate was 26.4 (95% CI 13.44 to 47.16) per 1000 match hours and 4.2 (95% CI 2.12 to 7.46) per 1000 training hours. There were 11 contact and 10 non-contact injuries. The lower limb accounted for 71.4% (n=15), the upper limb 9.5% (n=2) and the trunk and head 19.1% (n=4) of injuries. The main tissues injured were both muscle and ligament, representing 57.2% (n=6 each). The mean duration time loss from sport per injury was 12.14 days. Conclusion These results provide data on the incidence, nature and severity of camogie injuries using definitions that reflect international consensus statements. Further study of injury incidence over a full season or multiple seasons is recommended. PMID:29719725

Concept Definition Study for In-Space Structural Characterization of a Lightweight Solar Array

NASA Technical Reports Server (NTRS)

Woods-Vedeler, Jessica A.; Pappa, Richard S.; Jones, Thomas W.; Spellman, Regina; Scott, Willis; Mockensturm, Eric M.; Liddle, Donn; Oshel, Ed; Snyder, Michael

2002-01-01

A Concept Definition Study (CDS) was conducted to develop a proposed "Lightweight High-Voltage Stretched-Lens Concentrator Solar Array Experiment" under NASA's New Millennium Program Space Technology-6 (NMP ST-6) activity. As part of a multi-organizational team, NASA Langley Research Center's role in this proposed experiment was to lead Structural Characterization of the solar array during the flight experiment. In support of this role, NASA LaRC participated in the CDS to de.ne an experiment for static, dynamic, and deployment characterization of the array. In this study, NASA LaRC traded state-of-the-art measurement approaches appropriate for an in-space, STS-based flight experiment, provided initial analysis and testing of the lightweight solar array and lens elements, performed a lighting and photogrammetric simulation in conjunction with JSC, and produced an experiment concept definition to meet structural characterization requirements.

A strategic value management approach for energy and maintenance management in a building

NASA Astrophysics Data System (ADS)

Nawi, Mohd Nasrun Mohd; Dahlan, Nofri Yenita; Nadarajan, Santhirasegaran

2015-05-01

Fragmentation process is always been highlighted by the stakeholders in the construction industry as one of the `critical' issue that diminishing the opportunity for stakeholders that involved during the operation and maintenance stage to influence design decisions. Failure of design professionals to consider how a maintenance contractor or facility manager will construct the design thus results in higher operating cost, wastage, defects during the maintenance and operation process. Moving towards team integration is considered a significant strategy for overcoming the issue. Value Management is a style of management dedicated to guiding people and promoting innovation with the aim to improve overall building performance through structured, team-oriented exercises which make explicit, and appraise subsequent decisions, by reference to the value requirements of the clients. Accordingly, this paper discusses the fragmentation issue in more detail including the definition, causes and effects to the maintenance and operation of building and at the same time will highlighted the potential of VM integrated team approach as a strategic management approach for overcoming that issue. It also explores that the team integration strategy alleviates scheduling problems, delays and disputes during the construction process, and, hence, prevent harming the overall building performance.

Patient-physician discussions about costs: definitions and impact on cost conversation incidence estimates.

PubMed

Hunter, Wynn G; Hesson, Ashley; Davis, J Kelly; Kirby, Christine; Williamson, Lillie D; Barnett, Jamison A; Ubel, Peter A

2016-03-31

Nearly one in three Americans are financially burdened by their medical expenses. To mitigate financial distress, experts recommend routine physician-patient cost conversations. However, the content and incidence of these conversations are unclear, and rigorous definitions are lacking. We sought to develop a novel set of cost conversation definitions, and determine the impact of definitional variation on cost conversation incidence in three clinical settings. Retrospective, mixed-methods analysis of transcribed dialogue from 1,755 outpatient encounters for routine clinical management of breast cancer, rheumatoid arthritis, and depression, occurring between 2010-2014. We developed cost conversation definitions using summative content analysis. Transcripts were evaluated independently by at least two members of our multi-disciplinary team to determine cost conversation incidence using each definition. Incidence estimates were compared using Pearson's Chi-Square Tests. Three cost conversation definitions emerged from our analysis: (a) Out-of-Pocket (OoP) Cost--discussion of the patient's OoP costs for a healthcare service; (b) Cost/Coverage--discussion of the patient's OoP costs or insurance coverage; (c) Cost of Illness- discussion of financial costs or insurance coverage related to health or healthcare. These definitions were hierarchical; OoP Cost was a subset of Cost/Coverage, which was a subset of Cost of Illness. In each clinical setting, we observed significant variation in the incidence of cost conversations when using different definitions; breast oncology: 16, 22, 24% of clinic visits contained cost conversation (OOP Cost, Cost/Coverage, Cost of Illness, respectively; P < 0.001); depression: 30, 38, 43%, (P < 0.001); and rheumatoid arthritis, 26, 33, 35%, (P < 0.001). The estimated incidence of physician-patient cost conversation varied significantly depending on the definition used. Our findings and proposed definitions may assist in retrospective interpretation and prospective design of investigations on this topic.

Optimizing Language for Stroke Motor Rehabilitation: Recommendations from the ACRM Stroke Movement Interventions Subcommittee

PubMed Central

Page, Stephen J.; Schmid, Arlene; Harris, Jocelyn

2012-01-01

As knowledge and interest in stroke motor rehabilitation continue to increase, consistent terminologies that are specific to this discipline must be established. Such language is critical to effective rehabilitative team communication, and is important to facilitating communication among the diverse groups interested in the science and practice of stroke motor rehabilitation. The purpose of this paper is to provide operational definitions for three concepts that are common - and commonly mislabeled - attributes of stroke motor rehabilitation interventions: intensity, duration, and frequency. In developing these guidelines, conceptual frameworks used in the pharmaceutical, exercise, and rehabilitative therapy realms were used. Implications of these definitions for research and clinical practice are also discussed. PMID:22446292

Pediatric surgeons and anesthesiologists expand the dialogue on the neurotoxicity question, rationale for early and delayed surgeries, and practice changes while awaiting definitive evidence.

PubMed

Byrne, Mary W; Casale, Pasquale; Garzon, Maria; Hyman, Joshua E; Lin, Albert Y; Lynch, Lisa R; Schleien, Charles L; Stylianos, Steven

2014-10-01

The Pediatric Anesthesia NeuroDevelopment Assessment team at Columbia University Medical Center Department of Anesthesiology convened its fourth biennial Symposium to address unresolved issues concerning potential neurotoxic effects of anesthetic agents and sedatives on young children and to assess study findings to date. Dialogue initiated at the third Symposium was continued between anesthesiologists, researchers, and a panel of expert pediatric surgeons representing general surgery and dermatology, orthopedic, and urology specialties. The panel explored the need to balance benefits of early surgery using improved technologies against potential anesthetic risks, practice changes while awaiting definitive answers, and importance of continued interprofessional dialogue.

The hospital library and the enterprise portal.

PubMed

Bandy, Margaret; Fosmire, Brenda

2004-01-01

At Exempla Healthcare, the medical librarians and the e-Business staff are creating an enterprise information portal where medical reference is targeted, easily accessible, and supported by the medical librarians. A team approach has been essential. The e-Business department has worked for nine months coordinating technical challenges required to support personalization, targeted communications, and a single access point for clinical patient data. Exempla medical librarians have been involved in the definition and design of information access needs from the very beginning. The Clinicians Portal was the first developed, with other customizations to follow. Many challenges remain, but by definition, a portal is designed to be flexible and adapt to the changing needs of the enterprise it supports.

Scientific management of Space Telescope

NASA Technical Reports Server (NTRS)

Odell, C. R.

1981-01-01

A historical summay is given on the science management of the Space Telescope, the inception of which began in 1962, when scientists and engineers first recommended the development of a nearly diffraction limited substantial-size optical telescope. Phase A, the feasibility requirements generation phase, began in 1971 and consisted largely of NASA scientists and a NASA design. Phase B, the preliminary design phase, established a tiered structure of scientists, led by the Large Space Telescope operations and Management Work Group. A Mission Operations Working Group headed six instrument definition teams to develop the essential instrument definitions. Many changes took place during Phase B, before design and development, which began in 1978 and still continues today.

Two Outs, Bottom of the Ninth

NASA Technical Reports Server (NTRS)

Snow, Frank

2002-01-01

It was eight months before launch when my second Flight Operations Team lead said he was leaving the project for another job. Six months earlier, the original lead had said he was leaving. I was stunned--but I remained confident that we would recover. I didn't expect to lose the second lead. After all, lightning is not supposed to strike twice in the same place. This time, with only eight months until launch, I was very much concerned. No, 'concerned' is probably too mild a word. Let's get it right: I was sweating. Losing a lead at any stage presents problems, but two losses within 6 months of each other can definitely shake the confidence of an inexperienced Flight Ops Team.

BOREAS AFM-5 Level-2 Upper Air Network Standard Pressure Level Data

NASA Technical Reports Server (NTRS)

Barr, Alan; Hrynkiw, Charmaine; Hall, Forrest G. (Editor); Newcomer, Jeffrey A. (Editor); Smith, David E. (Technical Monitor)

2000-01-01

The BOREAS AFM-5 team collected and processed data from the numerous radiosonde flights during the project. The goals of the AFM-05 team were to provide large-scale definition of the atmosphere by supplementing the existing AES aerological network, both temporally and spatially. This data set includes basic upper-air parameters interpolated at 0.5 kiloPascal increments of atmospheric pressure from data collected from the network of upper-air stations during the 1993, 1994, and 1996 field campaigns over the entire study region. The data are contained in tabular ASCII files. The data files are available on a CD-ROM (see document number 20010000884) or from the Oak Ridge National Laboratory (ORNL) Distributed Active Archive Center (DAAC).

Development of a large scale Chimera grid system for the Space Shuttle Launch Vehicle

NASA Technical Reports Server (NTRS)

Pearce, Daniel G.; Stanley, Scott A.; Martin, Fred W., Jr.; Gomez, Ray J.; Le Beau, Gerald J.; Buning, Pieter G.; Chan, William M.; Chiu, Ing-Tsau; Wulf, Armin; Akdag, Vedat

1993-01-01

The application of CFD techniques to large problems has dictated the need for large team efforts. This paper offers an opportunity to examine the motivations, goals, needs, problems, as well as the methods, tools, and constraints that defined NASA's development of a 111 grid/16 million point grid system model for the Space Shuttle Launch Vehicle. The Chimera approach used for domain decomposition encouraged separation of the complex geometry into several major components each of which was modeled by an autonomous team. ICEM-CFD, a CAD based grid generation package, simplified the geometry and grid topology definition by provoding mature CAD tools and patch independent meshing. The resulting grid system has, on average, a four inch resolution along the surface.

A Probability Based Approach for the Allocation of Player Draft Selections in Australian Rules Football

PubMed Central

Anthony, Bedford; Schembri, Adrian J.

2006-01-01

Australian Rules Football, governed by the Australian Football League (AFL) is the most popular winter sport played in Australia. Like North American team based leagues such as the NFL, NBA and NHL, the AFL uses a draft system for rookie players to join a team’s list. The existing method of allocating draft selections in the AFL is simply based on the reverse order of each team’s finishing position for that season, with teams winning less than or equal to 5 regular season matches obtaining an additional early round priority draft pick. Much criticism has been levelled at the existing system since it rewards losing teams and does not encourage poorly performing teams to win matches once their season is effectively over. We propose a probability-based system that allocates a score based on teams that win ‘unimportant’ matches (akin to Carl Morris’ definition of importance). We base the calculation of ‘unimportance’ on the likelihood of a team making the final eight following each round of the season. We then investigate a variety of approaches based on the ‘unimportance’ measure to derive a score for ‘unimportant’ and unlikely wins. We explore derivatives of this system, compare past draft picks with those obtained under our system, and discuss the attractiveness of teams knowing the draft reward for winning each match in a season. Key Points Draft choices are allocated using a probabilistic approach that rewards teams for winning unimportant matches. The method is based upon Carl Morris’ Importance and probabilistic calculations of making the finals. The importance of a match is calculated probabilistically to arrive at a DScore. Higher DScores are weighted towards teams winning unimportant matches which in turn lead to higher draft selections. Provides an alternative to current draft systems that are based on ‘losing to win’. PMID:24357945

A Matrix Approach to Software Process Definition

NASA Technical Reports Server (NTRS)

Schultz, David; Bachman, Judith; Landis, Linda; Stark, Mike; Godfrey, Sally; Morisio, Maurizio; Powers, Edward I. (Technical Monitor)

2000-01-01

The Software Engineering Laboratory (SEL) is currently engaged in a Methodology and Metrics program for the Information Systems Center (ISC) at Goddard Space Flight Center (GSFC). This paper addresses the Methodology portion of the program. The purpose of the Methodology effort is to assist a software team lead in selecting and tailoring a software development or maintenance process for a specific GSFC project. It is intended that this process will also be compliant with both ISO 9001 and the Software Engineering Institute's Capability Maturity Model (CMM). Under the Methodology program, we have defined four standard ISO-compliant software processes for the ISC, and three tailoring criteria that team leads can use to categorize their projects. The team lead would select a process and appropriate tailoring factors, from which a software process tailored to the specific project could be generated. Our objective in the Methodology program is to present software process information in a structured fashion, to make it easy for a team lead to characterize the type of software engineering to be performed, and to apply tailoring parameters to search for an appropriate software process description. This will enable the team lead to follow a proven, effective software process and also satisfy NASA's requirement for compliance with ISO 9001 and the anticipated requirement for CMM assessment. This work is also intended to support the deployment of sound software processes across the ISC.

East Europe Report

DTIC Science & Technology

1987-02-25

definite solution from among those admissible, specified in the from of a vector of criteria and weights. The set of criteria can be different depending on...was developed in stages, by aggregating an increasing number of submodels (i.e. partial models) prepared by different teams. Nor can its present...entities operating under different constraints and towards different objectives. These models and various combinations thereof can also be useful to

Computer-Based Automation of Discrete Product Manufacture: A preliminary Discussion of Feasibility and Impact

DTIC Science & Technology

1974-07-01

automated manufacturing processes and a rough technoeconomic evaluation of those concepts. Our evaluation is largely based on estimates; therefore, the...must be subjected to thorough analysis and experimental verification before they can be considered definitive. They are being published at this time...hardware and sensor technology, manufacturing engineering, automation, and economic analysis . Members of this team inspected over thirty manufacturing

Quality mind-set overcomes barriers to success.

PubMed

Anderson, C A; Daigh, R D

1991-02-01

To remove hindrances to fiscal strength, a healthcare facility needs a long-term, organization-wide strategy. Total quality management (TQM) can offer such a solution, but it requires a revised management philosophy. Under TQM, a hospital must adopt a workable definition of quality; develop a customer orientation; form organizational teams to study and revise work processes; involve all employees in quality efforts; and strive for continuous improvements.

Results of the Software Process Improvement Efforts of the Early Adopters in NAVAIR 4.0

DTIC Science & Technology

2007-12-01

and customer satisfaction. AIRSpeed utilizes a structured, problem solving methodology called DMAIC (Define, Measure, Analyze, Improve, Control...widely used in business. DMAIC leads project teams through the logical steps from problem definition to problem resolution. Each phase has a specific set...costs and improving productivity and customer satisfaction. AIRSpeed utilizes the DMAIC (Define, Measure, Analyze, Improve, Control) structured problem

Quantitative Procedure for Position Identity Definition.

DTIC Science & Technology

1979-12-01

integrated into an effi- cient and cohesive team, are necessary for the sucessful performance of the mission of the 2-17 Department of the Army. Military...Headquarters (Ft Monroe) ROTC Group (TRADOC-Ft Knox) Large Post Headquarters (Ft Bragg) Recruiting Support Center (Cameron Service School (Engineer) Station...College (Ft Belvoir) (Ft Belvoir) Defense Mapping School (Ft Belvoir) The apparent distinction in Army directives between combat, combat support, and

Developing the MD Explorer

NASA Astrophysics Data System (ADS)

Howie, Philip V.

1993-04-01

The MD Explorer is an eight-seat twin-turbine engine helicopter which is being developed using integrated product definition (IPD) team methodology. New techniques include NOTAR antitorque system for directional control, a composite fuselage, an all-composite bearingless main rotor, and digital cockpit displays. Three-dimensional CAD models are the basis of the entire Explorer design. Solid models provide vendor with design clarification, removing much of the normal drawing interpretation errors.

The Application of the NASA Advanced Concepts Office, Launch Vehicle Team Design Process and Tools for Modeling Small Responsive Launch Vehicles

NASA Technical Reports Server (NTRS)

Threet, Grady E.; Waters, Eric D.; Creech, Dennis M.

2012-01-01

The Advanced Concepts Office (ACO) Launch Vehicle Team at the NASA Marshall Space Flight Center (MSFC) is recognized throughout NASA for launch vehicle conceptual definition and pre-phase A concept design evaluation. The Launch Vehicle Team has been instrumental in defining the vehicle trade space for many of NASA s high level launch system studies from the Exploration Systems Architecture Study (ESAS) through the Augustine Report, Constellation, and now Space Launch System (SLS). The Launch Vehicle Team s approach to rapid turn-around and comparative analysis of multiple launch vehicle architectures has played a large role in narrowing the design options for future vehicle development. Recently the Launch Vehicle Team has been developing versions of their vetted tools used on large launch vehicles and repackaged the process and capability to apply to smaller more responsive launch vehicles. Along this development path the LV Team has evaluated trajectory tools and assumptions against sounding rocket trajectories and air launch systems, begun altering subsystem mass estimating relationships to handle smaller vehicle components, and as an additional development driver, have begun an in-house small launch vehicle study. With the recent interest in small responsive launch systems and the known capability and response time of the ACO LV Team, ACO s launch vehicle assessment capability can be utilized to rapidly evaluate the vast and opportune trade space that small launch vehicles currently encompass. This would provide a great benefit to the customer in order to reduce that large trade space to a select few alternatives that should best fit the customer s payload needs.

The Effect of Availability of Manpower on Trauma Resuscitation Times in a Tertiary Academic Hospital

PubMed Central

Quek, Nathaniel Xin Ern; Koh, Zhi Xiong; Nadkarni, Nivedita; Singaram, Kanageswari; Ho, Andrew Fu Wah; Ong, Marcus Eng Hock

2016-01-01

Background For trauma patients, delays to assessment, resuscitation, and definitive care affect outcomes. We studied the effects of resuscitation area occupancy and trauma team size on trauma team resuscitation speed in an observational study at a tertiary academic institution in Singapore. Methods From January 2014 to January 2015, resuscitation videos of trauma team activated patients with an Injury Severity Score of 9 or more were extracted for review within 14 days by independent reviewers. Exclusion criteria were patients dead on arrival, inter-hospital transfers, and up-triaged patients. Data captured included manpower availability (trauma team size and resuscitation area occupancy), assessment (airway, breathing, circulation, logroll), interventions (vascular access, imaging), and process-of-care time intervals (time to assessment/intervention/adjuncts, time to imaging, and total time in the emergency department). Clinical data were obtained by chart review and from the trauma registry. Results Videos of 70 patients were reviewed over a 13-month period. The median time spent in the emergency department was 154.9 minutes (IQR 130.7–207.5) and the median resuscitation team size was 7, with larger team sizes correlating with faster process-of-care time intervals: time to airway assessment (p = 0.08) and time to disposition (p = 0.04). The mean resuscitation area occupancy rate (RAOR) was 1.89±2.49, and the RAOR was positively correlated with time spent in the emergency department (p = 0.009). Conclusion Our results suggest that adequate staffing for trauma teams and resuscitation room occupancy are correlated with faster trauma resuscitation and reduced time spent in the emergency department. PMID:27136299

The (mis)use of subjective process measures in software engineering

NASA Technical Reports Server (NTRS)

Valett, Jon D.; Condon, Steven E.

1993-01-01

A variety of measures are used in software engineering research to develop an understanding of the software process and product. These measures fall into three broad categories: quantitative, characteristics, and subjective. Quantitative measures are those to which a numerical value can be assigned, for example effort or lines of code (LOC). Characteristics describe the software process or product; they might include programming language or the type of application. While such factors do not provide a quantitative measurement of a process or product, they do help characterize them. Subjective measures (as defined in this study) are those that are based on the opinion or opinions of individuals; they are somewhat unique and difficult to quantify. Capturing of subjective measure data typically involves development of some type of scale. For example, 'team experience' is one of the subjective measures that were collected and studied by the Software Engineering Laboratory (SEL). Certainly, team experience could have an impact on the software process or product; actually measuring a team's experience, however, is not a strictly mathematical exercise. Simply adding up each team member's years of experience appears inadequate. In fact, most researchers would agree that 'years' do not directly translate into 'experience.' Team experience must be defined subjectively and then a scale must be developed e.g., high experience versus low experience; or high, medium, low experience; or a different or more granular scale. Using this type of scale, a particular team's overall experience can be compared with that of other teams in the development environment. Defining, collecting, and scaling subjective measures is difficult. First, precise definitions of the measures must be established. Next, choices must be made about whose opinions will be solicited to constitute the data. Finally, care must be given to defining the right scale and level of granularity for measurement.

Design definition of the Laser Atmospheric Wind Sounder (LAWS), phase 2. Volume 2: Final report

NASA Technical Reports Server (NTRS)

Wilson, D. J.

1992-01-01

Lockheed personnel, along with team member subcontractors and consultants, have performed a preliminary design for the LAWS Instrument. Breadboarding and testing of a LAWS class laser have also been performed. These efforts have demonstrated that LAWS is a feasible Instrument and can be developed with existing state-of-the-art technology. Only a commitment to fund the instrument development and deployment is required to place LAWS in orbit and obtain the anticipated science and operational forecasting benefits. The LAWS Science Team was selected in 1988-89 as were the competing LAWS phase 1/2 contractor teams. The LAWS Science Team developed requirements for the LAWS Instrument, and the NASA/LAWS project office defined launch vehicle and platform design constraints. From these requirements and constraints, the lockheed team developed LAWS Instrument concepts and configurations. A system designed to meet these requirements and constraints is outlined. The LAWS primary subsystem and interfaces - laser, optical, and receiver/processor - required to assemble a lidar are identified. Also identified are the support subsystems required for the lidar to function from space: structures and mechanical, thermal, electrical, and command and data management. The Lockheed team has developed a preliminary design of a LAWS Instrument System consisting of these subsystems and interfaces which will meet the requirements and objectives of the Science Team. This final report provides a summary of the systems engineering analyses and trades of the LAWS. Summaries of the configuration, preliminary designs of the subsystems, testing recommendations, and performance analysis are presented. Environmental considerations associated with deployment of LAWS are discussed. Finally, the successful LAWS laser breadboard effort is discussed along with the requirements and test results.

Definition of supportive care: does the semantic matter?

PubMed

Hui, David

2014-07-01

'Supportive care' is a commonly used term in oncology; however, no consensus definition exists. This represents a barrier to communication in both the clinical and research settings. In this review, we propose a unifying conceptual framework for supportive care and discuss the proper use of this term in the clinical and research settings. A recent systematic review revealed several themes for supportive care: a focus on symptom management and improvement of quality of life, and care for patients on treatments and those with advanced stage disease. These findings are consistent with a broad definition for supportive care: 'the provision of the necessary services for those living with or affected by cancer to meet their informational, emotional, spiritual, social, or physical needs during their diagnostic, treatment, or follow-up phases encompassing issues of health promotion and prevention, survivorship, palliation, and bereavement.' Supportive care can be classified as primary, secondary, and tertiary based on the level of specialization. For example, palliative care teams provide secondary supportive care for patients with advanced cancer. Until a consensus definition is available for supportive care, this term should be clearly defined or cited whenever it is used.

A psychological injury prevention group intervention in Swedish floorball.

PubMed

Tranaeus, Ulrika; Johnson, Urban; Engström, Björn; Skillgate, Eva; Werner, Suzanne

2015-11-01

The main purpose of the study was to evaluate a psychological skills training intervention at group level aiming to prevent injuries, separated in traumatic and overuse, in male and female elite floorball players. Twenty-three teams in the premiere leagues for males and females were volunteered, and the teams were allocated to an intervention group (n = 11, males n = 94, females n = 99) and a control group (n = 12, males n = 109, females n = 99). The teams in the intervention group participated in a psychological skills training programme consisting of six meetings with each team. The control group received no substitute. All injuries were registered and documented according to the time-loss definition and classified into either traumatic or overuse. In total, 142 players (35 %) out of the 401 players sustained 197 injuries, 0.49 injury/player: in the intervention group 0.45 injury/player and in the control group 0.53 injury/player. The analyses revealed no significant differences in injuries between intervention groups and control groups. The effect size of the influence of the psychological skills training in overuse injuries was considered to be small, Cohen's d 0.2. This study comprised the whole team for a group intervention and did not screen for at-risk athletes, e.g. scoring high in anxiety or low in coping skills, which might have influenced the result. A psychological injury prevention intervention forward to a whole team might not influence the injury occurrence significantly. Thus, this psychological intervention decreased the injury incidence which is of clinical interest. Level II.

Defining post-sternotomy mediastinitis for clinical evidence-based studies.

PubMed

van Wingerden, Jan J; de Mol, Bas A J M; van der Horst, Chantal M A M

2016-05-01

Considerable advances have already been made in the treatment of deep thoracic wound infections following a median sternotomy for cardiac surgery. Further improvement in diagnosis, treatment, and outcome will require a targeted approach by multidisciplinary teams. Clear communication and synergy between the various clinical and supportive disciplines would assist in removing the last barriers to standardized evidence-based studies and the development of improved evidence-based guidelines. An extensive literature search without language restrictions was carried out on PubMed (Medline), EMBASE, and Web of Science, covering the period 1988 to week 16, 2014, and a manual search of the reference lists was performed regarding all possible definitions and classifications of post-sternotomy mediastinitis. Two hundred and eighteen papers describing post-sternotomy infections in a multitude of terms were identified, and the strengths and weaknesses of the most popular definitions and terms relating specifically to post-sternotomy infections were examined. This study revealed that clinicians use a multitude of terms to describe post-sternotomy infections without defining the condition under treatment. Occasionally, older epidemiological (surveillance) definitions were used. It also shows that supportive disciplines have their own definitions, or interpretations of existing definitions, to describe these infections. The outcome of this study is that clinicians have adopted no single definition, which is essential for further improvement for evidence-based studies. We suggest that it is possible to adopt a single term for thoracic infection after a sternotomy (and only sternotomy), and propose a clinical definition for this purpose. © The Author(s) 2016.

Defining Bladder Health in Women and Girls: Implications for Research, Clinical Practice, and Public Health Promotion.

PubMed

Lukacz, Emily S; Bavendam, Tamara G; Berry, Amanda; Fok, Cynthia S; Gahagan, Sheila; Goode, Patricia S; Hardacker, Cecilia T; Hebert-Beirne, Jeni; Lewis, Cora E; Lewis, Jessica; Low, Lisa Kane; Lowder, Jerry L; Palmer, Mary H; Smith, Ariana L; Brady, Sonya S

2018-05-24

Bladder health in women and girls is poorly understood, in part, due to absence of a definition for clinical or research purposes. This article describes the process used by a National Institutes of Health funded transdisciplinary research team (The Prevention of Lower Urinary Tract Symptoms [PLUS] Consortium) to develop a definition of bladder health. The PLUS Consortium identified currently accepted lower urinary tract symptoms (LUTS) and outlined elements of storage and emptying functions of the bladder. Consistent with the World Health Organization's definition of health, PLUS concluded that absence of LUTS was insufficient and emphasizes the bladder's ability to adapt to short-term physical, psychosocial, and environmental challenges for the final definition. Definitions for subjective experiences and objective measures of bladder dysfunction and health were drafted. An additional bioregulatory function to protect against infection, neoplasia, chemical, or biologic threats was proposed. PLUS proposes that bladder health be defined as: "A complete state of physical, mental, and social well-being related to bladder function and not merely the absence of LUTS. Healthy bladder function permits daily activities, adapts to short-term physical or environmental stressors, and allows optimal well-being (e.g., travel, exercise, social, occupational, or other activities)." Definitions for each element of bladder function are reported with suggested subjective and objective measures. PLUS used a comprehensive transdisciplinary process to develop a bladder health definition. This will inform instrument development for evaluation of bladder health promotion and prevention of LUTS in research, practice, and public health initiatives.

The Massive Black Hole in the Dwarf Galaxy NGC 4486B

NASA Astrophysics Data System (ADS)

Bender, A.; Green, R. F.; Gebhardt, K.; Bower, G. A.; Kormendy, J.; Lauer, T.; Richstone, D. O.; STIS IDT Galaxy Nuclei Team; Nuker Team

2003-12-01

We report results from the application of a three-integral galactic dynamical model to NGC 4486B. This dwarf E1 companion to M87 has long been known to be an outlier in the Fundamental Plane. Kormendy and Magorrian et al. found a substantial central black hole mass, making it an outlier in the MBH to Lbulge relationship as well. From the modeling we are able to determine the extent to which NGC 4486B follows the MBH - sigma relation more closely than the other bulge galaxy relationships. The other unique feature NGC 4486B exhibits is a double nucleus structure, the second of only two observed. We combine the high resolution of STIS spectra with ground based data to form a more complete description of the line-of-sight velocity distributions (LOSVDs) in the nuclear region of NGC 4486B. Through the increased resolution of the dynamics and the three-integral model, we place an improved constraint on the mass-to-light ratio and black hole mass. Bender's research was supported by the NOAO/KPNO Research Experiences for Undergraduates (REU) Program which is funded by the National Science Foundation through Scientific Program Order No. 3 (AST-0243875) of the Cooperative Agreement No. AST-0132798 between the Association of Universities for Research in Astronomy (AURA) and the NSF. RG and GB were supported by NASA for the STIS Instrument Definition Team. This work is a collaboration with the STIS Instrument Definition Team galaxy nuclei group, which also includes John Hutchings, Charles Joseph, Mary Elizabeth Kaiser, Charles Nelson, Donna Weistrop, and Bruce Woodgate. This work is a collaboration with the Nuker Team, which also includes Ralf Bender, Alan Dressler, Sandra Faber, Alex Filippenko, Carl Grillmair, Luis Ho, John Magorrian, Jason Pinkney, Christos Siopis, and Scott Tremaine.

Balloon aortic valvuloplasty as a bridge-to-decision in high risk patients with aortic stenosis: a new paradigm for the heart team decision making

PubMed Central

Saia, Francesco; Moretti, Carolina; Dall'Ara, Gianni; Ciuca, Cristina; Taglieri, Nevio; Berardini, Alessandra; Gallo, Pamela; Cannizzo, Marina; Chiarabelli, Matteo; Ramponi, Niccolò; Taffani, Linda; Bacchi-Reggiani, Maria Letizia; Marrozzini, Cinzia; Rapezzi, Claudio; Marzocchi, Antonio

2016-01-01

Background Whilst the majority of the patients with severe aortic stenosis can be directly addressed to surgical aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI), in some instances additional information may be needed to complete the diagnostic workout. We evaluated the role of balloon aortic valvuloplasty (BAV) as a bridge-to-decision (BTD) in selected high-risk patients. Methods Between 2007 and 2012, the heart team in our Institution required BTD BAV in 202 patients. Very low left ventricular ejection fraction, mitral regurgitation grade ≥ 3, frailty, hemodynamic instability, serious comorbidity, or a combination of these factors were the main drivers for this strategy. We evaluated how BAV influenced the final treatment strategy in the whole patient group and in each specific subgroup. Results Mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 23.5% ± 15.3%, age 81 ± 7 years. In-hospital mortality was 4.5%, cerebrovascular accident 1% and overall vascular complications 4% (0.5% major; 3.5% minor). Of the 193 patients with BTD BAV who survived and received a second heart team evaluation, 72.6% were finally deemed eligible for definitive treatment (25.4% for AVR; 47.2% for TAVI): 96.7% of patients with left ventricular ejection fraction recovery; 70.5% of patients with mitral regurgitation reduction; 75.7% of patients who underwent BAV in clinical hemodynamic instability; 69.2% of frail patients and 68% of patients who presented serious comorbidities. Conclusions Balloon aortic valvuloplasty can be considered as bridge-to-decision in high-risk patients with severe aortic stenosis who cannot be immediate candidates for definitive transcatheter or surgical treatment. PMID:27582761

Building information models for astronomy projects

NASA Astrophysics Data System (ADS)

Ariño, Javier; Murga, Gaizka; Campo, Ramón; Eletxigerra, Iñigo; Ampuero, Pedro

2012-09-01

A Building Information Model is a digital representation of physical and functional characteristics of a building. BIMs represent the geometrical characteristics of the Building, but also properties like bills of quantities, definition of COTS components, status of material in the different stages of the project, project economic data, etc. The BIM methodology, which is well established in the Architecture Engineering and Construction (AEC) domain for conventional buildings, has been brought one step forward in its application for Astronomical/Scientific facilities. In these facilities steel/concrete structures have high dynamic and seismic requirements, M&E installations are complex and there is a large amount of special equipment and mechanisms involved as a fundamental part of the facility. The detail design definition is typically implemented by different design teams in specialized design software packages. In order to allow the coordinated work of different engineering teams, the overall model, and its associated engineering database, is progressively integrated using a coordination and roaming software which can be used before starting construction phase for checking interferences, planning the construction sequence, studying maintenance operation, reporting to the project office, etc. This integrated design & construction approach will allow to efficiently plan construction sequence (4D). This is a powerful tool to study and analyze in detail alternative construction sequences and ideally coordinate the work of different construction teams. In addition engineering, construction and operational database can be linked to the virtual model (6D), what gives to the end users a invaluable tool for the lifecycle management, as all the facility information can be easily accessed, added or replaced. This paper presents the BIM methodology as implemented by IDOM with the E-ELT and ATST Enclosures as application examples.

The Oslo definitions for coeliac disease and related terms

PubMed Central

Ludvigsson, Jonas F; Leffler, Daniel A; Bai, Julio; Biagi, Federico; Fasano, Alessio; Green, Peter HR; Hadjivassiliou, Marios; Kaukinen, Katri; Kelly, Ciaran; Leonard, Jonathan N; Lundin, Knut E; Murray, Joseph A; Sanders, David S; Walker, Marjorie M; Zingone, Fabiana; Ciacci, Carolina

2012-01-01

Background The literature suggests a lack of consensus on the use of terms related to coeliac disease (CD) and gluten. Methods A multi-disciplinary task force of 16 physicians from 7 countries used the electronic database PubMed to review the literature with regards to CD-related terms up to January 2011. Teams of physicians then suggested a definition for each term, followed by feedback of these definitions through a web survey on definitions, discussions during a meeting in Oslo, and phone conferences. We evaluated the following terms (in alphabetical order): Coeliac disease and the following descriptors of CD: asymptomatic, atypical, classical, latent, non-classical, overt, paediatric classical, potential, refractory, silent, subclinical, symptomatic, typical, CD serology, CD autoimmunity, genetically at risk of CD, dermatitis herpetiformis, gluten, gluten ataxia, gluten intolerance, gluten sensitivity, and gliadin-specific antibodies. Results CD was defined as “a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals”. Classical CD was defined as “CD presenting with signs and symptoms of malabsorption. Diarrhoea, steatorrhoea, weight loss or growth failure is required.” We suggest that “gluten-related disorders” is the umbrella term for all diseases triggered by gluten and that the term gluten intolerance is not to be used. Other definitions are presented in the paper. Conclusion This paper presents the Oslo definitions for CD-related terms. PMID:22345659

Definitions of the Phenotypic Manifestations of Sickle Cell Disease

PubMed Central

Ballas, Samir K.; Lieff, Susan; Benjamin, Lennette J.; Dampier, Carlton D.; Heeney, Matthew M.; Hoppe, Carolyn; Johnson, Cage S.; Rogers, Zora R.; Smith-Whitley, Kim; Wang, Winfred C.; Telen, Marilyn J.

2016-01-01

Sickle cell disease (SCD) is a pleiotropic genetic disorder of hemoglobin that has profound multi-organ effects. The low prevalence of SCD (~100,000/US) has limited progress in clinical, basic, and translational research. Lack of a large, readily accessible population for clinical studies has contributed to the absence of standard definitions and diagnostic criteria for the numerous complications of SCD and inadequate understanding of SCD pathophysiology. In 2005, the Comprehensive Sickle Cell Centers initiated a project to establish consensus definitions of the most frequently occurring complications. A group of clinicians and scientists with extensive expertise in research and treatment of SCD gathered to identify and categorize the most common complications. From this group, a formal writing team was formed that further reviewed the literature, sought specialist input, and produced definitions in a standard format. This manuscript provides an overview of the process and describes twelve body system categories and the most prevalent or severe complications within these categories. A detailed Appendix provides standardized definitions for all complications identified within each system. This report proposes use of these definitions for studies of SCD complications, so future studies can be comparably robust and treatment efficacy measured. Use of these definitions will support greater accuracy in genotype-phenotype studies, thereby achieving a better understanding of SCD pathophysiology. This should nevertheless be viewed as a dynamic rather than final document; phenotype descriptions should be reevaluated and revised periodically to provide the most current standard definitions as etiologic factors are better understood and new diagnostic options are developed. PMID:19902523

Standard CMMI Appraisal Method for Process Improvement (SCAMPI) A, Version 1.3: Method Definition Document

DTIC Science & Technology

2011-03-01

performance of Federal Government Contract Number FA8721-05- C -0003 with Carnegie Mellon University for the operation of the Software Engineering... C Roles and Responsibilities 195 Appendix D Reporting Requirements and Options 201 Appendix E Managed Discovery 203 Appendix F Scoping and...Upgrade Team (SUT) • Mary Busby , Lockheed Martin • Palma Buttles-Valdez, Software Engineering Institute • Paul Byrnes, Integrated System Diagnostics

A Proposal to Study the Scientific Uses of Solar Electric Propulsion for Space Physics Missions

NASA Technical Reports Server (NTRS)

Kurth, William S.

1999-01-01

This effort was for the participation of Dr. William S. Kurth in the study of the application of spacecraft using solar electric propulsion (SEP) for a range of space physics missions. This effort included the participation of Dr. Kurth in the Tropix Science Definition Team but also included the generalization to various space physics and planetary missions, including specific Explorer mission studies.

What Are the Definitive Procedures and Instruments Used to Incorporate Chemotherapy Orientation and Preparation for Effective Team Membership, During Inservice and Preservice Training of Teachers and Administrators?

ERIC Educational Resources Information Center

Schwenn, John O.

An administrator discusses aspects of drug therapy with which special educators should be familiar. Briefly examined are administration form, factors affecting rate of absorption, dosage, interaction of one drug with another, drug tolerance, time factors, and side effects. The importance of a teacher's monitoring of the drugs is stressed, and…

The Environmental Assessment and Management (TEAM) Guide: North Carolina Supplement

DTIC Science & Technology

2010-03-01

for Federal Regulations incorporated by reference. Definitions • Abrasive - any material used in abrasive blasting operations (15A NCAC 2D.0541...Added March 2001]. • Abrasive Blasting - the operation of cleaning or preparing a surface by forcibly propelling a stream of abrasive material against...the surface. Sandblasting is one form of abrasive blasting (15A NCAC 2D.0541) [Added March 2001]. • Abrasive Blasting Equipment - any equipment

From the front line to the bottom line: building revenue integrity.

PubMed

Britt, John; Adams, Shawn; Snow, Trevor

2015-07-01

To improve trends in accounts receivable and a hospital's bottom line without fear of penalty or repayment, organizations should expand the definition of the revenue cycle team by: Engaging front-line clinical and business personnel. Training personnel to understand the roles they play in revenue integrity. Creating scorecards with measurable goals to promote accountability. Monitoring the outcomes and defining real-time, actionable responses to negative variances.

Nickel-hydrogen batteries from Intelsat 5 to space station

NASA Technical Reports Server (NTRS)

Vanommering, G.; Applewhite, A. Z.

1986-01-01

The heritage of the Ni-H2 technology that makes the space station application feasible is discussed. It also describes a design for a potential space station Ni-H2 battery system. Specific design values presented here were developed by Ford Aerospace as part of the Rocketdyne team effort on the Phase B Definition and Preliminary Design of the Space Station Power System in support of NASA Lewis Research Center.

Evaluating the Claims of Network Centric Warfare

DTIC Science & Technology

2005-12-01

judgments (see Bar- Tal , Raviv , & Spitzer, 1999). However, not everyone’s reactions to stressors are the same. A 12-month team performance study...45-58. Bar- Tal , Y. Raviv , A., & Spitzer, A. (1999). The need and ability to achieve cognitive structuring: Individual differences that moderate...definiteness, and regularity” (Bar- Tal , 1994, p. 45). Stress is one of the human responses to uncertainty. Stress can be initiated by a distinct event

The Far-Infrared Surveyor Mission Study: Paper I, the Genesis

NASA Technical Reports Server (NTRS)

Meixner, M.; Cooray, A.; Carter, R.; DiPirro, M.; Flores, A.; Leisawitz, D.; Armus, L.; Battersby, C.; Bergin, E.; Bradford, C. M.;

Afghanistan 2012 and Beyond: Clearing, Holding, and Building with Transition Teams

DTIC Science & Technology

2012-05-10

Afghan population, towards achieving those goals. However, given the time already spent in Afghanistan, the constant changes of command and rotation...messages from the White House and apathy of the Afghan government, the pressure is on commanders to expedite the COIN strategy. One problem that...prevents commanders from moving quicker towards transitioning to ANSF is that the definition of success in Afghanistan is difficult to define. In 2009

Building a collaborative culture in cardiothoracic operating rooms: pre and postintervention study protocol for evaluation of the implementation of teamSTEPPS training and the impact on perceived psychological safety

PubMed Central

Ben Abdallah, Arbi; Maniar, Hersh; Avidan, Michael Simon; Bollini, Mara L; Patterson, George Alexander; Steinberg, Aaron; Scaggs, Katie; Dribin, Brenda V; Ridley, Clare H

2017-01-01

Introduction The importance of effective communication, a key component of teamwork, is well recognised in the healthcare setting. Establishing a culture that encourages and empowers team members to speak openly in the cardiothoracic (CT) operating room (OR) is necessary to improve patient safety in this high-risk environment. Methods and analysis This study will take place at Barnes-Jewish Hospital, an academic hospital in affiliation with Washington University School of Medicine located in the USA. All team members participating in cardiac and thoracic OR cases during this 17-month study period will be identified by the primary surgical staff attending on the OR schedule. TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) training course will be taught to all CT OR staff. Before TeamSTEPPS training, staff will respond to a 39-item questionnaire that includes constructs from the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture, Edmondson’s ‘Measure of psychological safety’ questionnaire, and questionnaires on turnover intentions, job satisfaction and ‘burnout’. The questionnaires will be readministered at 6 and 12 months. The primary outcomes to be assessed include the perceived psychological safety of CT OR team members, the overall effect of TeamSTEPPS on burnout and job satisfaction, and observed turnover rate among the OR nurses. As secondary outcomes, we will be assessing self-reported rates of medical error and near misses in the ORs with a questionnaire at the end of each case. Ethics and dissemination Ethics approval is not indicated as this project does not meet the federal definitions of research requiring the oversight of the Institutional Review Board (IRB). Patient health information (PHI) will not be generated during the implementation of this project. Results of the trial will be made accessible to the public when published in a peer-reviewed journal following the completion of the study. PMID:28963302

Challenges of the science data processing, analysis and archiving approach in BepiColombo

NASA Astrophysics Data System (ADS)

Martinez, Santa

BepiColombo is a joint mission of the European Space Agency (ESA) and the Japan Aerospace Exploration Agency (JAXA) to the planet Mercury. It comprises two separate orbiters: the Mercury Planetary Orbiter (MPO) and the Mercury Magnetospheric Orbiter (MMO). After approximately 7.5 years of cruise, BepiColombo will arrive at Mercury in 2024 and will gather data during a 1-year nominal mission, with a possible 1-year extension. The approach selected for BepiColombo for the processing, analysis and archiving of the science data represents a significant change with respect to previous ESA planetary missions. Traditionally Instrument Teams are responsible for processing, analysing and preparing their science data for the long-term archive, however in BepiColombo, the Science Ground Segment (SGS), located in Madrid, Spain, will play a key role in these activities. Fundamental aspects of this approach include: the involvement of the SGS in the definition, development and operation of the instrument processing pipelines; the production of ready-to-archive science products compatible with NASA’s Planetary Data System (PDS) standards in all the processing steps; the joint development of a quick-look analysis system to monitor deviations between planned and executed observations to feed back the results into the different planning cycles when possible; and a mission archive providing access to the scientific products and to the operational data throughout the different phases of the mission (from the early development phase to the legacy phase). In order to achieve these goals, the SGS will need to overcome a number of challenges. The proposed approach requires a flexible infrastructure able to cope with a distributed data processing system, residing in different locations but designed as a single entity. For this, all aspects related to the integration of software developed by different Instrument Teams and the alignment of their development schedules will need to be considered. In addition, the SGS is taking full responsibility for the production of the first level of science data (un-calibrated), with the associated operational implications. An additional difficulty impacting the processing strategies relates to the various spacecraft data downlink mechanisms available for the MPO and their associated data latency. With regards to archiving, the main challenges include: the use of a new version of the PDS standards (so-called PDS4), being implemented for the first time in an ESA planetary mission; the use of external standards (CDF, FITS); and the implementation of interoperability protocols that aim to make all data (from both MPO and MMO) globally accessible through a distributed archive to the end-users. For the definition of the quick-look analysis system, it is very important to understand and harmonise the different views and expectations of the science team. Due to the long duration of the Cruise phase, and the fact that there are many years between the design of the system and the nominal mission, it might be difficult for some Instrument Teams to accurately define their needs so many years before operations. In particular, new scientific discoveries over the coming years by the MESSENGER spacecraft, currently orbiting Mercury, may influence how the Instrument Teams on BepiColombo define their operations and their reduction and analysis techniques. In addition, due to the long duration of the mission, it is not always possible or practical to document all accumulated knowledge on paper so if personnel leave some of their knowledge is lost as well. This is key, particularly for the Instrument Teams. By taking a pro-active role in the collection of requirements and expectations of the science team together with the definition of clear guidelines early in the mission and by developing close collaboration with the Instrument Teams, the SGS will be able to identify how to best exploit the expertise on both sides and to guarantee that the necessary support is provided when needed. This contribution will detail the main challenges and advantages associated with the data processing, analysis and archiving approach in BepiColombo, and will summarise the various efforts ongoing to guarantee that the scientific requirements of the mission and the expectations of the science team are fulfilled. Future ESA planetary missions (e.g. ExoMars, JUICE) will follow a similar approach, adapting the efforts to the profile of the mission.

Prospective study of symptom control in 133 cases of palliative care inpatients in Shatin Hospital.

PubMed

Lo, R S; Ding, A; Chung, T K; Woo, J

1999-07-01

We report a prospective study assessing the prevalence and severity of physical and nonphysical symptoms, and the benefits from treatment and intervention, in advanced cancer patients presenting to a local palliative care unit in Hong Kong. Patients were assessed by a modified version of the support team assessment schedule (STAS). The study highlighted some symptoms which needed better control, and also reinforced the team morale by demonstrating aspects where there was definite improvement. In general, the STAS was found to be practicable and acceptable by our patients and staff. The most important benefit gained from the study was the successful dissemination of the concept of audit and quality assurance throughout the unit, which is essential for continuous improvement in the future.

CADD medicine: design is the potion that can cure my disease

NASA Astrophysics Data System (ADS)

Manas, Eric S.; Green, Darren V. S.

2017-03-01

The acronym "CADD" is often used interchangeably to refer to "Computer Aided Drug Discovery" and "Computer Aided Drug Design". While the former definition implies the use of a computer to impact one or more aspects of discovering a drug, in this paper we contend that computational chemists are most effective when they enable teams to apply true design principles as they strive to create medicines to treat human disease. We argue that teams must bring to bear multiple sub-disciplines of computational chemistry in an integrated manner in order to utilize these principles to address the multi-objective nature of the drug discovery problem. Impact, resourcing principles, and future directions for the field are also discussed, including areas of future opportunity as well as a cautionary note about hype and hubris.

Administration of CroFab Antivenom by a Helicopter Emergency Medical Service Team.

PubMed

Steuerwald, Michael T; Gabbard, Season R K; Beauchamp, Gillian A; Riddle, Matthew K; Otten, Edward J

The case presented here highlights an unconventional use of a helicopter emergency medical service (HEMS) to provide a specialized medication to a critically ill patient when definitive transport was delayed. A 39-year-old man presented to a rural hospital 1 hour after sustaining a copperhead envenomation. He developed severe symptoms and was intubated. Arrangements were made for transfer to a tertiary referral center by HEMS, but because of incoming weather conditions, the team would not be able to make the return flight safely. The decision was made for the HEMS team to fly antivenom to the patient, administer the medication, and then transport the patient by ground to the tertiary medical center. This plan was executed, and the patient was safely transported to the accepting facility. Antivenom is most effective when administered early because this will halt the progression of edema and may reverse the systemic effects of envenomation. In this case, HEMS transport of antivenom to the patient with severe toxicity prevented a delay to administration and likely improved the patient's outcome. Although the traditional role of HEMS is to provide rapid transport to critically ill patients, HEMS teams can also function to deliver specialized medications to remote settings. Copyright © 2016 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

STS-27R OV-104 Orbiter TPS damage review team, volume 1

NASA Technical Reports Server (NTRS)

Thomas, John W. (Compiler)

1989-01-01

Following the return to earth on December 2, 1988, of Orbiter OV-104, Atlantis, it was observed that there was substantial Thermal Protection System (TPS) tile damage present on the lower right fuselage and wing. Damage sites were more numerous than on previous flights and conversely, there was almost no damage present on Atlantis' left side. A review team investigated the cause beginning with a detailed inspection of the Atlantis TPS damage, and a review of related inspection reports to establish an indepth anomaly definition. An exhaustive data review followed. A fault tree and several failure scenarios were developed. Finally, the failure scenarios were categorized as either not possible, possible but not probable, or probable. This and other information gained during the review formed the basis for the team's findings and recommendations. The team concluded that the most probable cause of the severe STS-27R Orbiter tile damage is that the ablative insulating material covering the RH SRB Nose Cap dislodged and struck the Orbiter tile near 85 seconds into flight and possibly that debris from other sources, including repaired insulation and missing joint cork, caused minor tile damage. Findings are presented, and recommendations that are believed pertinent to minimizing the potential for inflight debris are described.

Hardware Development Process for Human Research Facility Applications

NASA Technical Reports Server (NTRS)

Bauer, Liz

2000-01-01

The simple goal of the Human Research Facility (HRF) is to conduct human research experiments on the International Space Station (ISS) astronauts during long-duration missions. This is accomplished by providing integration and operation of the necessary hardware and software capabilities. A typical hardware development flow consists of five stages: functional inputs and requirements definition, market research, design life cycle through hardware delivery, crew training, and mission support. The purpose of this presentation is to guide the audience through the early hardware development process: requirement definition through selecting a development path. Specific HRF equipment is used to illustrate the hardware development paths. The source of hardware requirements is the science community and HRF program. The HRF Science Working Group, consisting of SCientists from various medical disciplines, defined a basic set of equipment with functional requirements. This established the performance requirements of the hardware. HRF program requirements focus on making the hardware safe and operational in a space environment. This includes structural, thermal, human factors, and material requirements. Science and HRF program requirements are defined in a hardware requirements document which includes verification methods. Once the hardware is fabricated, requirements are verified by inspection, test, analysis, or demonstration. All data is compiled and reviewed to certify the hardware for flight. Obviously, the basis for all hardware development activities is requirement definition. Full and complete requirement definition is ideal prior to initiating the hardware development. However, this is generally not the case, but the hardware team typically has functional inputs as a guide. The first step is for engineers to conduct market research based on the functional inputs provided by scientists. CommerCially available products are evaluated against the science requirements as well as modifications needed to meet program requirements. Options are consolidated and the hardware development team reaches a hardware development decision point. Within budget and schedule constraints, the team must decide whether or not to complete the hardware as an in-house, subcontract with vendor, or commercial-off-the-shelf (COTS) development. An in-house development indicates NASA personnel or a contractor builds the hardware at a NASA site. A subcontract development is completed off-site by a commercial company. A COTS item is a vendor product available by ordering a specific part number. The team evaluates the pros and cons of each development path. For example, in-bouse developments utilize existing corporate knowledge regarding bow to build equipment for use in space. However, technical expertise would be required to fully understand the medical equipment capabilities, such as for an ultrasound system. It may require additional time and funding to gain the expertise that commercially exists. The major benefit of subcontracting a hardware development is the product is delivered as an end-item and commercial expertise is utilized. On the other hand, NASA has limited control over schedule delays. The final option of COTS or modified COTS equipment is a compromise between in-house and subcontracts. A vendor product may exist that meets all functional requirements but req uires in-house modifications for successful operation in a space environment. The HRF utilizes equipment developed using all of the paths described: inhouse, subcontract, and modified COTS.

The healthcare team's perception of the role of the perioperative nurse: A qualitative study.

PubMed

Espinoza, Pilar; Galaz Letelier, Luz Maria; Cunill Leppe, María Dolores; Yercic Bravo, Margarita; Ferdinand, Constanza; Ferrer Lagunas, Lilian

2016-09-01

The surgical process requires the coordination of a number of professionals who understand their own roles and responsibilities, as well as those of the team. In the perioperative setting, expectations are established around behaviors and competencies of every team member. These expectations are influenced by knowledge, training and experience, and may ultimately influence results and the ability to adapt and respond to work demands. In Chile, there exists an ambiguity and lack of definition in the role of the nurse. The objective of this study was to examine the healthcare team's perception of the current role of the perioperative nurse, as well as the expected and desired characteristics of the role from the team's perspective. A qualitative, descriptive case study was carried out, using semi-structured interviews conducted with a purposive sample of surgeons, anaesthesiologists, professional nurses and technical nurses from three hospitals in Santiago, Chile. The accounts were analysed using an inductive, thematic format. It was found that the current perioperative nursing role, with a predominance of administrative charting, recordkeeping and guidelines for the management of safety, quality control and human and material resources, restricts direct patient care. Expected characteristics of the role included comprehensive theoretical and practical training and the development of relational skills for teamwork, direct patient care and advocacy in the surgical context. These results provided initial steps towards redefining the role of the perioperative nurse, strengthening collaborative efforts and optimising patient care during a time of high vulnerability. Copyright the Association for Perioperative Practice.

Space Transportation System Liftoff Debris Mitigation Process Overview

NASA Technical Reports Server (NTRS)

Mitchell, Michael; Riley, Christopher

2011-01-01

Liftoff debris is a top risk to the Space Shuttle Vehicle. To manage the Liftoff debris risk, the Space Shuttle Program created a team with in the Propulsion Systems Engineering & Integration Office. The Shutt le Liftoff Debris Team harnesses the Systems Engineering process to i dentify, assess, mitigate, and communicate the Liftoff debris risk. T he Liftoff Debris Team leverages off the technical knowledge and expe rtise of engineering groups across multiple NASA centers to integrate total system solutions. These solutions connect the hardware and ana lyses to identify and characterize debris sources and zones contribut ing to the Liftoff debris risk. The solutions incorporate analyses sp anning: the definition and modeling of natural and induced environmen ts; material characterizations; statistical trending analyses, imager y based trajectory analyses; debris transport analyses, and risk asse ssments. The verification and validation of these analyses are bound by conservative assumptions and anchored by testing and flight data. The Liftoff debris risk mitigation is managed through vigilant collab orative work between the Liftoff Debris Team and Launch Pad Operation s personnel and through the management of requirements, interfaces, r isk documentation, configurations, and technical data. Furthermore, o n day of launch, decision analysis is used to apply the wealth of ana lyses to case specific identified risks. This presentation describes how the Liftoff Debris Team applies Systems Engineering in their proce sses to mitigate risk and improve the safety of the Space Shuttle Veh icle.

Managed Development Environment Successes for MSFC's VIPA Team

NASA Technical Reports Server (NTRS)

Finckenor, Jeff; Corder, Gary; Owens, James; Meehan, Jim; Tidwell, Paul H.

2005-01-01

This paper outlines the best practices of the Vehicle Design Team for VIPA. The functions of the VIPA Vehicle Design (VVD) discipline team are to maintain the controlled reference geometry and provide linked, simplified geometry for each of the other discipline analyses. The core of the VVD work, and the approach for VVD s first task of controlling the reference geometry, involves systems engineering, top-down, layout-based CAD modeling within a Product Data Manager (PDM) development environment. The top- down approach allows for simple control of very large, integrated assemblies and greatly enhances the ability to generate trade configurations and reuse data. The second VVD task, model simplification for analysis, is handled within the managed environment through application of the master model concept. In this approach, there is a single controlling, or master, product definition dataset. Connected to this master model are reference datasets with live geometric and expression links. The referenced models can be for drawings, manufacturing, visualization, embedded analysis, or analysis simplification. A discussion of web based interaction, including visualization, between the design and other disciplines is included. Demonstrated examples are cited, including the Space Launch Initiative development cycle, the Saturn V systems integration and verification cycle, an Orbital Space Plane study, and NASA Exploration Office studies of Shuttle derived and clean sheet launch vehicles. The VIPA Team has brought an immense amount of detailed data to bear on program issues. A central piece of that success has been the Managed Development Environment and the VVD Team approach to modeling.

NASA Advanced Concepts Office, Earth-To-Orbit Team Design Process and Tools

NASA Technical Reports Server (NTRS)

Waters, Eric D.; Garcia, Jessica; Beers, Benjamin; Philips, Alan; Holt, James B.; Threet, Grady E., Jr.

2013-01-01

The Earth to Orbit (ETO) Team of the Advanced Concepts Office (ACO) at NASA Marshal Space Flight Center (MSFC) is considered the preeminent group to go to for prephase A and phase A concept definition. The ACO team has been at the forefront of a multitude of launch vehicle studies determining the future direction of the Agency as a whole due, in part, to their rapid turnaround time in analyzing concepts and their ability to cover broad trade spaces of vehicles in that limited timeframe. Each completed vehicle concept includes a full mass breakdown of each vehicle to tertiary subsystem components, along with a vehicle trajectory analysis to determine optimized payload delivery to specified orbital parameters, flight environments, and delta v capability. Additionally, a structural analysis of the vehicle based on material properties and geometries is performed as well as an analysis to determine the flight loads based on the trajectory outputs. As mentioned, the ACO Earth to Orbit Team prides themselves on their rapid turnaround time and often need to fulfill customer requests within limited schedule or little advanced notice. Due to working in this fast paced environment, the ETO team has developed some finely honed skills and methods to maximize the delivery capability to meet their customer needs. This paper will describe the interfaces between the 3 primary disciplines used in the design process; weights and sizing, trajectory, and structural analysis, as well as the approach each discipline employs to streamline their particular piece of the design process.

Injury surveillance in multi-sport events: the International Olympic Committee approach.

PubMed

Junge, A; Engebretsen, L; Alonso, J M; Renström, P; Mountjoy, M; Aubry, M; Dvorak, J

2008-06-01

The protection of athletes' health by preventing injuries is an important task for international sports federations. Standardised injury surveillance provides not only important epidemiological information, but also directions for injury prevention, and the opportunity for monitoring long-term changes in the frequency and circumstances of injury. Numerous studies have evaluated sports injuries during the season, but few have focused on injuries during major sport events such as World Championships, World Cups or the Olympic Games. To provide an injury surveillance system for multi-sports tournaments, using the 2008 Olympic Games in Beijing as an example. A group of experienced researchers reviewed existing injury report systems and developed a scientific sound and concise injury surveillance system for large multi-sport events. The injury report system for multi-sport events is based on an established system for team sports tournaments and has proved feasible for individual sports during the International Association of Athletics Federations World Championships in Athletics 2007. The most important principles and advantages of the system are comprehensive definition of injury, injury report by the physician responsible for the athlete, a single-page report of all injuries, and daily report irrespective of whether or not an injury occurred. Implementation of the injury surveillance system, all definitions, the report form, and the analysis of data are described in detail to enable other researchers to implement the injury surveillance system in any sports tournament. The injury surveillance system has been accepted by experienced team physicians and shown to be feasible for single-sport and multi-sport events. It can be modified depending on the specific objectives of a certain sport or research question; however, a standardised use of injury definition, report forms and methodology will ensure the comparability of results.

A Strategy to Overcome the Radiology Lottery in the Staging of Head and Neck Cancer: An Aid to Attaining the 30-Day Rule

PubMed Central

Elloy, Marianne; Jarvis, Sara; Davis, Anne

2009-01-01

INTRODUCTION Rapid access to radiological services is essential, if the British Association of Otolaryngologists – Head and Neck Surgeons Minimum Temporal Standards are to be met in the management of head and neck cancer patients. This study assesses a new initiative whereby the multidisciplinary team prioritises allocated imaging appointments rather than using the traditional radiological triage system. PATIENTS AND METHODS This study was a prospective audit of all patients referred over a 3-month period with suspected head and neck cancer. The main outcome measures were: (i) median interval in days from general practitioner (GP) referral to staging scan; and (ii) median interval in days from first clinic appointment to staging scan. RESULTS The new multidisciplinary team booking system led to a statistically significant reduction in the ‘request-to-scan time’ (from 12 days to 5 days). The time from ‘GP to scan’ also improved. CONCLUSIONS This new multidisciplinary team-led booking system, could, in the future, speed up access to radiology services lead and neck cancer patients, allowing earlier definitive treatment. PMID:19126338

[Interdisciplinary teamwork in the OR: Identification and measurement of teamwork in the operating room].

PubMed

Passauer-Baierl, Stefanie; Baschnegger, Heiko; Bruns, Christiane; Weigl, Matthias

2014-01-01

Effective teamwork is one of the essentials in conducting successful and safe surgical procedures in the operating theatre (OT). The present paper aims to provide a selective review of various approaches describing effective interdisciplinary teamwork in the OT. Furthermore, it covers observational methods to assess OT teamwork with particular focus on Germany. Our definition of successful surgical teamwork is based on an already established classification system considering five criteria for effective and safe OT teams: coordination, communication, cooperation, leadership, and team monitoring. Well-defined and reliable measures are necessary to examine the quality of OT teamwork. Those methods should entail the special characteristics of the OT team. They should include all phases of the surgical procedure and incorporate all the professions involved (surgeons, surgical nurses, and anaesthetic staff). We conclude that research into methods for the assessment of OTs in Germany needs to be undertaken as a prerequisite to investigating the relationship between OT teamwork and its effects on patient safety and surgical quality. Copyright © 2013. Published by Elsevier GmbH.

Zero to Integration in Eight Months, the Dawn Ground Data System Engineering Challenge

NASA Technical Reports Server (NTRS)

Dubon, Lydia P.

2006-01-01

The Dawn Project has presented the Ground Data System (GDS) with technical challenges driven by cost and schedule constraints commonly associated with National Aeronautics and Space Administration (NASA) Discovery Projects. The Dawn mission consists of a new and exciting Deep Space partnership among: the Jet Propulsion Laboratory (JPL), manages the project and is responsible for flight operation; Orbital Sciences Corporation (OSC), is the spacecraft builder and is responsible for flight system test and integration; and the University of California, at Los Angeles (UCLA), is responsible for science planning and operations. As a cost-capped mission, one of Dawn's implementation strategies is to leverage from both flight and ground heritage. OSC's ground data system is used for flight system test and integration as part of the flight heritage strategy. Mission operations, however, are to be conducted with JPL's ground system. The system engineering challenge of dealing with two heterogeneous ground systems emerged immediately. During the first technical interchange meeting between the JPL's GDS Team and OSC's Flight Software Team, August 2003, the need to integrate the ground system with the flight software was brought to the table. This need was driven by the project's commitment to enable instrument engineering model integration in a spacecraft simulator environment, for both demonstration and risk mitigation purposes, by April 2004. This paper will describe the system engineering approach that was undertaken by JPL's GDS Team in order to meet the technical challenge within a non-negotiable eight-month schedule. Key to the success was adherence to fundamental systems engineering practices: decomposition of the project request into manageable requirements; integration of multiple ground disciplines and experts into a focused team effort; definition of a structured yet flexible development process; definition of an in-process risk reduction plan; and aggregation of the intermediate products to an integrated final product. In addition, this paper will highlight the role of lessons learned from the integration experience. The lessons learned from an early GDS deployment have served as the foundation for the design and implementation of the Dawn Ground Data System.

Standard CMMI (Registered Trademark) Appraisal Method for Process Improvement (SCAMPI (Service Mark)) A, Version 1.3: Method Definition Document

DTIC Science & Technology

2011-03-01

performance of Federal Government Contract Number FA8721-05- C -0003 with Carnegie Mellon University for the operation of the Software Engineering... C Roles and Responsibilities 195 Appendix D Reporting Requirements and Options 201 Appendix E Managed Discovery 203 Appendix F Scoping and...Upgrade Team (SUT) • Mary Busby , Lockheed Martin • Palma Buttles-Valdez, Software Engineering Institute • Paul Byrnes, Integrated System Diagnostics

A Systemic Approach to the Development of a Sexual Abuse Protocol in a Rural Community: An Examination of Social Work Leadership Theory and Practice. Issues in Clinical Practice.

ERIC Educational Resources Information Center

Catalano, Stephen

The paper presents the multi-factorial problem of sexual abuse of children within their families, provides definitions of relevant terms (incest, sexual abuse, sexual misuse, molestation, sexual assault, rape), reviews the epidemiology of sexual abuse and its effects, and traces development of a Sexual Abuse Resource Team in a rural/resort New…

Sensitivity Analysis of the Seakeeping Behavior of Trimaran Ships

DTIC Science & Technology

2003-12-01

Architects and Marine Engineers; 1967. 827 p. [18] Lloyd ARJM. Seakeeping: Ship Behavior in Rough Weather. West Yorkshire ; Ellis Horwood Ltd ; 1989...INCAT Australia Pty Ltd . This design features side hulls with a very low freeboard at their bows and a definite, above-water center bow. Additional...composite ship, uses an Air Cushion Catamaran (ACC) design, which is an advanced variant of SES technology. Most recently, a co -operative design team that

Improving Statistical Machine Translation Through N-best List Re-ranking and Optimization

DTIC Science & Technology

2014-03-27

of Master of Science in Cyber Operations Jordan S. Keefer, B.S.C.S. Second Lieutenant, USAF March 2014 DISTRIBUTION STATEMENT A: APPROVED FOR PUBLIC...Atlantic Trade Organization NIST National Institute of Standards and Technology NL natural language NSF National Science Foundation ix Acronym Definition...the machine translation problem. In 1964 the Director of the National Science Foundation (NSF), 4 Dr. Leland Haworth, commissioned a research team to

Understanding Treatment of Mild Traumatic Brain Injury in the Military Health System

DTIC Science & Technology

2016-04-18

OEF Veterans: Polytrauma Clinical Triad,” Journal of Rehabilitation Research and Development, Vol. 46, No. 6, July 2009, pp. 697–702. Lew, Henry L...pubs/permissions.html. The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities...case definition for mTBI based on codes in the International Classification of Dis- eases, Ninth Revision (ICD-9), Clinical Modification. The team then

Decision making, procedural compliance, and outcomes definition in U.S. forest service planning processes

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

Stern, Marc J., E-mail: mjstern@vt.ed; Predmore, S. Andrew, E-mail: sapredmo@vt.ed

2011-04-15

The National Environmental Policy Act (NEPA) dictates a process of analyzing and disclosing the likely impacts of proposed agency actions on the human environment. This study addresses two key questions related to NEPA implementation in the U.S. Forest Service: 1) how do Interdisciplinary (ID) team leaders and decision makers conceptualize the outcomes of NEPA processes? And 2), how does NEPA relate to agency decision making? We address these questions through two separate online surveys that posed questions about recently completed NEPA processes - the first with the ID team leaders tasked with carrying out the processes, and the second withmore » the line officers responsible for making the processes' final decisions. Outcomes of NEPA processes include impacts on public relations, on employee morale and team functioning, on the achievement of agency goals, and on the achievement of NEPA's procedural requirements (disclosure) and substantive intent (minimizing negative environmental impacts). Although both tended to view public relations outcomes as important, decision makers' perceptions of favorable outcomes were more closely linked to the achievement of agency goals and process efficiency than was the case for ID team leaders. While ID team leaders' responses suggest that they see decision making closely integrated with the NEPA process, decision makers more commonly decoupled decision making from the NEPA process. These findings suggest a philosophical difference between ID team leaders and decision makers that may pose challenges for both the implementation and the evaluation of agency NEPA. We discuss the pros and cons of integrating NEPA with decision making or separating the two. We conclude that detaching NEPA from decision making poses greater risks than integrating them.« less

Integrating technical and non-technical skills coaching in an acute trauma surgery team training: Is it too much?

PubMed

Alken, Alexander; Luursema, Jan-Maarten; Weenk, Mariska; Yauw, Simon; Fluit, Cornelia; van Goor, Harry

2017-08-25

Research on effective integration of technical and non-technical skills in surgery team training is sparse. In a previous study we found that surgical teachers predominantly coached on technical and hardly on non-technical skills during the Definitive Surgical and Anesthetic Trauma Care (DSATC) integrated acute trauma surgery team training. This study aims to investigate whether the priming of teachers could increase the amount of non-technical skills coaching during such a training. Coaching activities of 12 surgical teachers were recorded on audio and video. Six teachers were primed on non-technical skills coaching prior to the training. Six others received no priming and served as controls. Blind observers reviewed the recordings of 2 training scenario's and scored whether the observed behaviors were directed on technical or non-technical skills. We compared the frequency of the non-technical skills coaching between the primed and the non-primed teachers and analyzed for differences according to the trainees' level of experience. Surgical teachers coached trainees during the highly realistic DSATC integrated acute trauma surgery team training. Trainees performed damage control surgery in operating teams on anesthetized porcine models during 6 training scenario's. Twelve experienced surgical teachers participated in this study. Coaching on non-technical skills was limited to about 5%. The primed teachers did not coach more often on non-technical skills than the non-primed teachers. We found no differences in the frequency of non-technical skills coaching based on the trainees' level of experience. Priming experienced surgical teachers does not increase the coaching on non-technical skills. The current DSATC acute trauma surgery team training seems too complex for integrating training on technical and non-technical skills. Patient care, Practice based learning and improvement. Copyright © 2017 Elsevier Inc. All rights reserved.

NTP comparison process

NASA Technical Reports Server (NTRS)

Corban, Robert

1993-01-01

The systems engineering process for the concept definition phase of the program involves requirements definition, system definition, and consistent concept definition. The requirements definition process involves obtaining a complete understanding of the system requirements based on customer needs, mission scenarios, and nuclear thermal propulsion (NTP) operating characteristics. A system functional analysis is performed to provide a comprehensive traceability and verification of top-level requirements down to detailed system specifications and provides significant insight into the measures of system effectiveness to be utilized in system evaluation. The second key element in the process is the definition of system concepts to meet the requirements. This part of the process involves engine system and reactor contractor teams to develop alternative NTP system concepts that can be evaluated against specific attributes, as well as a reference configuration against which to compare system benefits and merits. Quality function deployment (QFD), as an excellent tool within Total Quality Management (TQM) techniques, can provide the required structure and provide a link to the voice of the customer in establishing critical system qualities and their relationships. The third element of the process is the consistent performance comparison. The comparison process involves validating developed concept data and quantifying system merits through analysis, computer modeling, simulation, and rapid prototyping of the proposed high risk NTP subsystems. The maximum amount possible of quantitative data will be developed and/or validated to be utilized in the QFD evaluation matrix. If upon evaluation of a new concept or its associated subsystems determine to have substantial merit, those features will be incorporated into the reference configuration for subsequent system definition and comparison efforts.

The practicality of including the systemic inflammatory response syndrome in the definition of polytrauma: experience of a level one trauma centre.

PubMed

Butcher, Nerida E; Balogh, Zsolt J

2013-01-01

The systemic inflammatory response syndrome (SIRS) has been advocated as a significant predictor of outcome in trauma. Recent trauma literature has proposed SIRS as a surrogate for physiological derangements characteristic of polytrauma with some authors recommending its inclusion into the definition of polytrauma. The practicality of daily SIRS collection outside of specifically designed prospective trials is unknown. The purpose of this study was to assess the availability of SIRS variables and its appropriateness for inclusion into a definition of polytrauma. We hypothesised SIRS variables would be readily available and easy to collect, thus represent an appropriate inclusion into the definition of polytrauma. A prospective observational study of all trauma team activation patients over 7-months (August 2009 to February 2010) at a University affiliated level-1 urban trauma centre. SIRS data (temperature>38°C or <36°C; Pulse >90 bpm; RR>20/min or a PaCO(2)<32 mmHg; WCC>12.0×10(9)L(-1), or <4.0×10(9)L(-1), or the presence of >10 immature bands) collected from presentation, at 24 h intervals until 72 h post injury. Inclusion criteria were all patients generating a trauma team activation response age >16. 336 patients met inclusion criteria. In 46% (155/336) serial SIRS scores could not be calculated due to missing data. Lowest rates of missing data observed on admission [3% (11/336)]. Stratified by ISS>15 (132/336), in 7% (9/132) serial SIRS scores could not be calculated due to missing data. In 123 patients ISS>15 with complete data, 81% (100/123) developed SIRS. For Abbreviated Injury Scale (AIS)>2 in at least 2 body regions (64/336) in 5% (3/64) serial SIRS scores could not be calculated, with 92% (56/61) of patients with complete data developing SIRS. For Direct ICU admissions [25% (85/336)] 5% (4/85) of patients could not have serial SIRS calculated [mean ISS 15(±11)] and 90% (73/81) developed SIRS at least once over 72 h. Based on the experience of our level-1 trauma centre, the practicability of including SIRS into the definition of polytrauma as a surrogate for physiological derangement appears questionable even in prospective fashion. Copyright © 2012 Elsevier Ltd. All rights reserved.

BOREAS AFM-5 Level-1 Upper Air Network Data

NASA Technical Reports Server (NTRS)

Barr, Alan; Hrynkiw, Charmaine; Newcomer, Jeffrey A. (Editor); Hall, Forrest G. (Editor); Smith, David E. (Technical Monitor)

2000-01-01

The Boreal Ecosystem-Atmosphere Study (BOREAS) Airborne Fluxes and Meteorology (AFM)-5 team collected and processed data from the numerous radiosonde flights during the project. The goals of the AFM-05 team were to provide large-scale definition of the atmosphere by supplementing the existing Atmospheric Environment Service (AES) aerological network, both temporally and spatially. This data set includes basic upper-air parameters collected from the network of upper-air stations during the 1993, 1994, and 1996 field campaigns over the entire study region. The data are contained in tabular ASCII files. The level-1 upper-air network data are available from the Earth Observing System Data and Information System (EOSDIS) Oak Ridge National Laboratory (ORNL) Distributed Active Archive Center (DAAC). The data files also are available on a CD-ROM (see document number 20010000884).

Aortic valve replacement in a Jehovah’s Witness: a case of multi-disciplinary clinical management for bloodless surgery

PubMed Central

Park, John Jungpa; Lang, Christopher C; Manson, Lynn; Brackenbury, Edward T

2012-01-01

An 81-year-old female Jehovah’s Witness (JW) patient with severe aortic stenosis required aortic valve replacement (AVR). However, the patient’s religious beliefs precluded the use of primary blood components. Since the definitive treatment of AVR required bloodless open heart surgery, careful peri-operative plans were set forth by a multi-disciplinary team involving the cardiothoracic surgeon, haematologist and anaesthetist. The patient went on to successfully recover postoperatively. This case highlights: 1) The importance of carefully navigating through the most recent clinical and ethical protocol involved in the surgical management of JW’s. 2) The importance of preparing individually tailored pre, intra and postoperative plans that are delivered through a multi-disciplinary clinical team to ensure the best and safest possible outcomes. PMID:22665474

Personalizing behavioral interventions: the case of late-life depression

PubMed Central

Arean, Patricia A

2013-01-01

SUMMARY This article reviews the potential utility of behavioral interventions in personalized depression treatment. The paper begins with a definition of personalized treatment, moves to current thinking regarding the various causes of depression, and proposes how those causes can be used to inform the selection of behavioral interventions. Two examples from the late-life depression field will illustrate how a team of researchers at Cornell University (NY, USA) and University of California, San Francisco (CA, USA) created a research partnership to select and study behavioral interventions for older adults with risk factors associated with poor response to selective serotonin reuptake inhibitor medications. The paper ends with a discussion of how the process used by the Cornell University–University of California, San Francisco team can be applied to the selection and development of behavioral interventions for other psychiatric disorders. PMID:23646065

[Integration of a psychologist into Nephrology-Dialysis-Hypertension Operative Unit: from needs evaluation to the definition of an intervention model].

PubMed

Monica, Ratti Maria; Delli Zotti, Giulia Bruna; Spotti, Donatella; Sarno, Lucio

2014-01-01

Chronic Kidney Disease (CKD) and the dialytic treatment cause a significant psychological impact on patients, their families and on the medical-nursing staff too. The psychological aspects linked to the chronic condition of Kidney Disease generate the need to integrated a psychologist into the healthcare team of the Nephrology, Dialysis and Hypertension Operative Unit, in order to offer a specific and professional support to the patient during the different stages of the disease, to their caregivers and to the medical team. The aim of this collaboration project between Nephrology and Psychology is to create a global and integrated healthcare model. It does not give attention simply to the physical dimension of patients affected by CKD, but also to the emotional-affective, cognitive and social dimensions and to the health environment.

HDEV Flight Assembly

NASA Image and Video Library

2014-05-07

View of the High Definition Earth Viewing (HDEV) flight assembly installed on the exterior of the Columbus European Laboratory module. Image was released by astronaut on Twitter. The High Definition Earth Viewing (HDEV) experiment places four commercially available HD cameras on the exterior of the space station and uses them to stream live video of Earth for viewing online. The cameras are enclosed in a temperature specific housing and are exposed to the harsh radiation of space. Analysis of the effect of space on the video quality, over the time HDEV is operational, may help engineers decide which cameras are the best types to use on future missions. High school students helped design some of the cameras' components, through the High Schools United with NASA to Create Hardware (HUNCH) program, and student teams operate the experiment.

Injury risk is different in team and individual youth sport.

PubMed

Theisen, Daniel; Frisch, Anne; Malisoux, Laurent; Urhausen, Axel; Croisier, Jean-Louis; Seil, Romain

2013-05-01

This study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries. Prospective cohort follow-up. Pupils from a public sports school (12-19 years) were recruited over two separate school years (2008-2009: 42 weeks, n=199 athletes; 2009-2010: 40 weeks, n=89 athletes). Training and competition volume and intensity were recorded via a personal sports diary. Sports injuries (time-loss definition) were registered by medical staff members using a standardized questionnaire. Injury incidence was significantly higher in team compared with individual sports (6.16 versus 2.88 injuries/1000h, respectively), as a result of a higher incidence of both traumatic (RR=2.17; CI95%=1.75-2.70; p<0.001), and overuse injuries (RR=2.06; CI95%=1.46-2.91; p<0.001). A Cox proportional hazards regression revealed that team sports participation had a hazard ratio of 2.00 (CI95%=1.49-2.68; p<0.001) compared to individual sports, with additionally previous injury being a risk and age a protective factor. The number of competitions per 100 days was significantly higher in team sports, whereas the number of intense training sessions per 100 days was significantly lower. In team sports, the number of competitions per 100 days was positively associated with injuries (HR=1.072; CI95% [1.033; 1.113]; p<0.001), while in individual sports the number of competitions per 100 days had a protective effect (HR=0.940; CI95% [0.893; 0.989]; p=0.017). Team sports participation entailed a higher injury risk, whatever the injury category. Further research should elucidate the role of characteristics related to sport participation in injury causation. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

When Is a Sprint a Sprint? A Review of the Analysis of Team-Sport Athlete Activity Profile

PubMed Central

Sweeting, Alice J.; Cormack, Stuart J.; Morgan, Stuart; Aughey, Robert J.

2017-01-01

The external load of a team-sport athlete can be measured by tracking technologies, including global positioning systems (GPS), local positioning systems (LPS), and vision-based systems. These technologies allow for the calculation of displacement, velocity and acceleration during a match or training session. The accurate quantification of these variables is critical so that meaningful changes in team-sport athlete external load can be detected. High-velocity running, including sprinting, may be important for specific team-sport match activities, including evading an opponent or creating a shot on goal. Maximal accelerations are energetically demanding and frequently occur from a low velocity during team-sport matches. Despite extensive research, conjecture exists regarding the thresholds by which to classify the high velocity and acceleration activity of a team-sport athlete. There is currently no consensus on the definition of a sprint or acceleration effort, even within a single sport. The aim of this narrative review was to examine the varying velocity and acceleration thresholds reported in athlete activity profiling. The purposes of this review were therefore to (1) identify the various thresholds used to classify high-velocity or -intensity running plus accelerations; (2) examine the impact of individualized thresholds on reported team-sport activity profile; (3) evaluate the use of thresholds for court-based team-sports and; (4) discuss potential areas for future research. The presentation of velocity thresholds as a single value, with equivocal qualitative descriptors, is confusing when data lies between two thresholds. In Australian football, sprint efforts have been defined as activity >4.00 or >4.17 m·s−1. Acceleration thresholds differ across the literature, with >1.11, 2.78, 3.00, and 4.00 m·s−2 utilized across a number of sports. It is difficult to compare literature on field-based sports due to inconsistencies in velocity and acceleration thresholds, even within a single sport. Velocity and acceleration thresholds have been determined from physical capacity tests. Limited research exists on the classification of velocity and acceleration data by female team-sport athletes. Alternatively, data mining techniques may be used to report team-sport athlete external load, without the requirement of arbitrary or physiologically defined thresholds. PMID:28676767

2005 Earth-Mars Round Trip

NASA Technical Reports Server (NTRS)

2000-01-01

This paper presents, in viewgraph form, the 2005 Earth-Mars Round Trip. The contents include: 1) Lander; 2) Mars Sample Return Project; 3) Rover; 4) Rover Size Comparison; 5) Mars Ascent Vehicle; 6) Return Orbiter; 7) A New Mars Surveyor Program Architecture; 8) Definition Study Summary Result; 9) Mars Surveyor Proposed Architecture 2003, 2005 Opportunities; 10) Mars Micromissions Using Ariane 5; 11) Potential International Partnerships; 12) Proposed Integrated Architecture; and 13) Mars Exploration Program Report of the Architecture Team.

Variation in the Interpretation of Scientific Integrity in Community-based Participatory Health Research

PubMed Central

Kraemer Diaz, Anne E.; Spears Johnson, Chaya R.; Arcury, Thomas A.

2013-01-01

Community-based participatory research (CBPR) has become essential in health disparities and environmental justice research; however, the scientific integrity of CBPR projects has become a concern. Some concerns, such as appropriate research training, lack of access to resources and finances, have been discussed as possibly limiting the scientific integrity of a project. Prior to understanding what threatens scientific integrity in CBPR, it is vital to understand what scientific integrity means for the professional and community investigators who are involved in CBPR. This analysis explores the interpretation of scientific integrity in CBPR among 74 professional and community research team members from of 25 CBPR projects in nine states in the southeastern United States in 2012. It describes the basic definition for scientific integrity and then explores variations in the interpretation of scientific integrity in CBPR. Variations in the interpretations were associated with team member identity as professional or community investigators. Professional investigators understood scientific integrity in CBPR as either conceptually or logistically flexible, as challenging to balance with community needs, or no different than traditional scientific integrity. Community investigators interpret other factors as important in scientific integrity, such as trust, accountability, and overall benefit to the community. This research demonstrates that the variations in the interpretation of scientific integrity in CBPR call for a new definition of scientific integrity in CBPR that takes into account the understanding and needs of all investigators. PMID:24161098

[Role expectations of various professional groups in the operating theatre].

PubMed

Gfrörer, R; Bernard, U; Schaper, C; Bauer, M; Schüpfer, G K

2007-11-01

Clearly defined professional roles have the advantage that team members know what they are expected to do and what their expectations of other professional groups are. For the definition of roles a distinct number of interactions between persons are a prerequisite. In a typical operations room (OR) team members are not constantly involved and are often exchanged. Interactions between personnel are not strong enough to fulfil the designing process of role shaping. In this study the possible substitution of defined roles by a distinct professional culture in an OR was studied. Using a shortened form of the SYMLOG questionnaire, 179 persons working in the ORs of 2 Swiss hospitals were interviewed. The three main professional groups in the OR setting were represented in this cohort: anaesthesia personnel (physicians and nurses), surgeons and operating room technicians and nurses. The SYMLOG questionnaire allows the rating of sympathy, influence and goal orientation of the professional groups. Surgeons and anaesthetists had the strongest influence and higher ratings for goal orientation. In comparison, the influence of members of the nursing profession was less valued. All three professional groups rated themselves higher than in the perception of the other professional groups. It is concluded that in this analysis the role definition was not clear. Optimization is therefore possible which could reduce conflict potential and contribute to a higher productivity.

Dimensions and intensity of inter-professional teamwork in primary care: evidence from five international jurisdictions.

PubMed

Levesque, Jean-Frederic; Harris, Mark F; Scott, Cathie; Crabtree, Benjamin; Miller, William; Halma, Lisa M; Hogg, William E; Weenink, Jan-Willem; Advocat, Jenny R; Gunn, Jane; Russell, Grant

2017-10-23

Inter-professional teamwork in primary care settings offers potential benefits for responding to the increasing complexity of patients' needs. While it is a central element in many reforms to primary care delivery, implementing inter-professional teamwork has proven to be more challenging than anticipated. The objective of this study was to better understand the dimensions and intensity of teamwork and the developmental process involved in creating fully integrated teams. Secondary analyses of qualitative and quantitative data from completed studies conducted in Australia, Canada and USA. Case studies and matrices were used, along with face-to-face group retreats, using a Collaborative Reflexive Deliberative Approach. Four dimensions of teamwork were identified. The structural dimension relates to human resources and mechanisms implemented to create the foundations for teamwork. The operational dimension relates to the activities and programs conducted as part of the team's production of services. The relational dimension relates to the relationships and interactions occurring in the team. Finally, the functional dimension relates to definitions of roles and responsibilities aimed at coordinating the team's activities as well as to the shared vision, objectives and developmental activities aimed at ensuring the long-term cohesion of the team. There was a high degree of variation in the way the dimensions were addressed by reforms across the national contexts. The framework enables a clearer understanding of the incremental and iterative aspects that relate to higher achievement of teamwork. Future reforms of primary care need to address higher-level dimensions of teamwork to achieve its expected outcomes. © The Author 2017. Published by Oxford University Press.

Fit for the fight? Illnesses in the Norwegian team in the Vancouver Olympic Games.

PubMed

Hanstad, Dag Vidar; Rønsen, Ola; Andersen, Svein S; Steffen, Kathrin; Engebretsen, Lars

2011-06-01

The development of strategies to prevent illnesses before and during Olympic Games provides a basis for improved health and Olympic results. (1) To document the efficacy of a prevention programme on illness in a national Olympic team before and during the 2010 Vancouver Olympic Winter Games (OWG), (2) to compare the illness incidence in the Norwegian team with Norwegian incidence data during the Turin 2006 OWG and (3) to compare the illness incidence in the Norwegian team with illness rates of other nations in the Vancouver OWG. Information on prevention measures of illnesses in the Norwegian Olympic team was based on interviews with the Chief Medical Officer (CMO) and the Chief Nutrition and Sport Psychology Officers, and on a review of CMO reports before and after the 2010 OWG. The prevalence data on illness were obtained from the daily reports on injuries and illness to the International Olympic Committee. The illness rate was 5.1% (five of 99 athletes) compared with 17.3% (13 out of 75 athletes) in Turin (p=0.008). A total of four athletes missed one competition during the Vancouver Games owing to illness, compared with eight in Turin. The average illness rate for all nations in the Vancouver OWG was 7.2%. Conclusions Although no definite cause-and-effect link between the implementation of preventive measures and the prevalence of illness in the 2010 OWG could be established, the reduced illness rate compared with the 2006 OWG, and the low prevalence of illnesses compared with other nations in the Vancouver OWG suggest that the preparations were effective.

Conflicts and communication gaps in the intensive care unit.

PubMed

Fassier, Thomas; Azoulay, Elie

2010-12-01

Conflicts occur frequently in the ICU. Research on ICU conflicts is an emerging field, with only few recent studies being available on intrateam and team-family conflicts. Research on communication in the ICU is developing at a faster pace. Recent findings come from one multinational epidemiological survey on intrateam conflicts and one qualitative study on the causes and consequences of conflicts. Advances in research on communication with families in the ICU have improved our understanding of team-family and intrateam conflicts, thus suggesting targets for improvement. Data about ICU conflicts depend on conflict definition, study designs (qualitative versus quantitative), patient case-mix, and detection bias. Conflicts perceived by caregivers are frequent and consist mainly in intrateam conflicts. The two main sources of conflicts in the ICU are end-of-life decisions and communication issues. Conflicts negatively impact patient safety, patient/family-centered care, and team welfare and cohesion. They generate staff burnout and increase healthcare costs. Further qualitative studies rooted in social-science theories about workplace conflicts are needed to better understand the typology of ICU conflicts (sources and consequences) and to address complex ICU conflicts that involve systems as opposed to people. Conflict prevention and resolution are complex issues requiring multimodal interventions. Clinical research in this field is insufficiently developed, and no guidelines are available so far. Prevention strategies need to be developed along two axes: improved understanding of family experience, preferences, and values, as well as evidence-based communication may reduce team-family conflicts and organizational measures including restoring leadership, multidisciplinary teamwork, and improved communication within the team may prevent intrateam conflicts in the ICU.

[Self-perception of health care team leaders in Andalusia. A quantitative and qualitative study].

PubMed

García-Romera, I; Danet, A; March-Cerdà, J C

To determine the perception and self-assessment on leadership among health care team leaders in Andalusia. Design: Exploratory descriptive study using quantitative and qualitative methodology, developed between 2013 and 2015, using a questionnaire and semi-structured interviews. Andalusia. All health managers from the Primary Care Management Units and Health Management Areas of the Departments of Paediatrics, Emergency and Internal Medicine, for the quantitative study. A purposive sample of 24 health managers was used for the qualitative study. Descriptive statistical study and bivariate analysis of comparison of means. Content analysis of the semi-structured interviews: Codification, category tree, and triangulation of results. The best self-assessment dimension relates to support, and the worst to considering oneself as a 'good leader'. The definition of a 'good leader' includes: Honesty, trust, and attitudes of good communication, closeness, appreciation, and reinforcement of the health team members. Different leadership styles were perceived. Main difficulties for leadership are related to the economic crisis and the management of personal conflicts. Health managers describe an adaptive leadership style, based on personal and professional support, and using communication as the main cohesive element for the team project. More studies on leaders' perspectives are important, in order to better understand their experiences, needs and expectations. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Safety of definitive in-theater repair of facial fractures.

PubMed

Lopez, Manuel A; Arnholt, Jonathan L

2007-01-01

To determine the safety of definitive in-theater facial fracture repair on American military personnel wounded during Operation Iraqi Freedom. A retrospective review of all patients with head and neck trauma treated at the 322nd Expeditionary Medical Group/Air Force Theater Hospital, Balad Air Base, Iraq, from May 7, 2005, through September 18, 2005, was performed. This study focused on the outcomes of wounded American military personnel whose facial fractures were definitively repaired in theater. The criteria used to determine candidacy for definitive in-theater facial fracture repair on American military personnel were (1) the fracture site was exposed through either a soft tissue wound or because of an adjacent surgical approach, (2) treatment would not delay evacuation from theater, and (3) treatment would allow the military member to remain in theater. From May 2005 to September 2005, 207 patients were taken to the operating room and required 388 procedures. A total of 175 patients (85%) were operated on for traumatic injuries, and 52 of these patients required open reduction and internal fixation (ORIF) of a facial fracture. Of the 52 patients who underwent an ORIF, 17 were American military personnel. Of the 17 American patients who were definitively treated for their facial fractures in theater, 16 were contacted and/or followed up on the global military medical database. None of these patients developed an Acinetobacter baumannii infection or had a complication caused by the definitive in-theater ORIF. The range of follow-up was 2 months to 11 months, with a mean of 8.3 months. Definitive repair of facial fractures with ORIF on American military personnel in theater is advised when the aforementioned criteria are observed. An otolaryngologist is a crucial member of the head and neck trauma team.

Advanced Space Transportation Program (ASTP)

NASA Image and Video Library

2002-10-01

NASA's Marshall Space Flight Center in Huntsville, Alabama, manages the Space Launch Initiative (SLI), NASA's priority developmental program focused on empowering America's leadership in space. SLI includes commercial, higher education, and defense partnerships and contracts to offer widespread participation in both the risk and success of developing our nation's next-generation reusable launch vehicle. This photo depicts an artist's concept of a future second-generation launch vehicle. For the SLI, architecture definition includes all components of the next-generation reusable launch system: Earth-to-orbit vehicles (the Space Shuttle is the first generation earth-to-orbit vehicle), crew transfer vehicles, transfer stages, ground processing systems, flight operations systems, and development of business case strategies. Three contractor teams have each been funded to develop potential second- generation reusable launch system architectures: The Boeing Company of Seal Beach, California; Lockheed Martin Corporation of Denver, Colorado along with a team including Northrop Grumman of El Segundo, California; and Orbital Sciences Corporation of Dulles, Virginia.

Advanced Space Transportation Program (ASTP)

NASA Image and Video Library

2002-10-01

NASA's Marshall Space Flight Center in Huntsville, Alabama, manages the Space Launch Initiative (SLI), NASA's priority developmental program focused on empowering America's leadership in space. SLI includes commercial, higher education and defense partnerships and contracts to offer widespread participation in both the risk and success of developing our nation's next-generation reusable launch vehicle. This photo depicts an artist's concept of a future second-generation launch vehicle during separation of stages. For SLI, architecture definition includes all components of the next-generation reusable launch system: Earth-to-orbit vehicles (the Space Shuttle is the first-generation earth-to-orbit vehicle), crew transfer vehicles, transfer stages, ground processing systems, flight operations systems, and development of business case strategies. Three contractor teams have each been funded to develop potential second generation reusable launch system architectures: The Boeing Company of Seal Beach, California; Lockheed Martin Corporation of Denver, Colorado; a team including Northrop Grumman of El Segundo, California; and Orbital Sciences Corporation of Dulles, Virginia.

SLI Artist's Concept

NASA Technical Reports Server (NTRS)

2002-01-01

NASA's Marshall Space Flight Center in Huntsville, Alabama, manages the Space Launch Initiative (SLI), NASA's priority developmental program focused on empowering America's leadership in space. SLI includes commercial, higher education, and defense partnerships and contracts to offer widespread participation in both the risk and success of developing our nation's next-generation reusable launch vehicle. This photo depicts an artist's concept of a future second-generation launch vehicle. For the SLI, architecture definition includes all components of the next-generation reusable launch system: Earth-to-orbit vehicles (the Space Shuttle is the first generation earth-to-orbit vehicle), crew transfer vehicles, transfer stages, ground processing systems, flight operations systems, and development of business case strategies. Three contractor teams have each been funded to develop potential second- generation reusable launch system architectures: The Boeing Company of Seal Beach, California; Lockheed Martin Corporation of Denver, Colorado along with a team including Northrop Grumman of El Segundo, California; and Orbital Sciences Corporation of Dulles, Virginia.

SLI Artist `s Launch Concept

NASA Technical Reports Server (NTRS)

2002-01-01

NASA's Marshall Space Flight Center in Huntsville, Alabama, manages the Space Launch Initiative (SLI), NASA's priority developmental program focused on empowering America's leadership in space. SLI includes commercial, higher education and defense partnerships and contracts to offer widespread participation in both the risk and success of developing our nation's next-generation reusable launch vehicle. This photo depicts an artist's concept of a future second-generation launch vehicle during launch. For SLI, architecture definition includes all components of the next-generation reusable launch system: Earth-to-orbit vehicles (the Space Shuttle is the first generation earth-to-orbit vehicle), crew transfer vehicles, transfer stages, ground processing systems, flight operations systems, and development of business case strategies. Three contractor teams have each been funded to develop potential second generation reusable launch system architectures: The Boeing Company of Seal Beach, California; Lockheed Martin Corporation of Denver, Colorado along with a team including Northrop Grumman of El Segundo, California; and Orbital Sciences Corporation of Dulles, Virginia.

SLI Artist's Concept-Stage Separation

NASA Technical Reports Server (NTRS)

2002-01-01

NASA's Marshall Space Flight Center in Huntsville, Alabama, manages the Space Launch Initiative (SLI), NASA's priority developmental program focused on empowering America's leadership in space. SLI includes commercial, higher education and defense partnerships and contracts to offer widespread participation in both the risk and success of developing our nation's next-generation reusable launch vehicle. This photo depicts an artist's concept of a future second-generation launch vehicle during separation of stages. For SLI, architecture definition includes all components of the next-generation reusable launch system: Earth-to-orbit vehicles (the Space Shuttle is the first-generation earth-to-orbit vehicle), crew transfer vehicles, transfer stages, ground processing systems, flight operations systems, and development of business case strategies. Three contractor teams have each been funded to develop potential second generation reusable launch system architectures: The Boeing Company of Seal Beach, California; Lockheed Martin Corporation of Denver, Colorado; a team including Northrop Grumman of El Segundo, California; and Orbital Sciences Corporation of Dulles, Virginia.

Toward a definition of teamwork in emergency medicine.

PubMed

Fernandez, Rosemarie; Kozlowski, Steve W J; Shapiro, Marc J; Salas, Eduardo

2008-11-01

The patient safety literature from the past decade emphasizes the importance of teamwork skills and human factors in preventing medical errors. Simulation has been used within aviation, the military, and now health care domains to effectively teach and assess teamwork skills. However, attempts to expand and generalize research and training principles have been limited due to a lack of a well-defined, well-researched taxonomy. As part of the 2008 Academic Emergency Medicine Consensus Conference on "The Science of Simulation in Healthcare," a subset of the group expertise and group assessment breakout sections identified evidence-based recommendations for an emergency medicine (EM) team taxonomy and performance model. This material was disseminated within the morning session and was discussed both during breakout sessions and via online messaging. Below we present a well-defined, well-described taxonomy that will help guide design, implementation, and assessment of simulation-based team training programs.

An industrial approach to design compelling VR and AR experience

NASA Astrophysics Data System (ADS)

Richir, Simon; Fuchs, Philippe; Lourdeaux, Domitile; Buche, Cédric; Querrec, Ronan

2013-03-01

The convergence of technologies currently observed in the field of VR, AR, robotics and consumer electronic reinforces the trend of new applications appearing every day. But when transferring knowledge acquired from research to businesses, research laboratories are often at a loss because of a lack of knowledge of the design and integration processes in creating an industrial scale product. In fact, the innovation approaches that take a good idea from the laboratory to a successful industrial product are often little known to researchers. The objective of this paper is to present the results of the work of several research teams that have finalized a working method for researchers and manufacturers that allow them to design virtual or augmented reality systems and enable their users to enjoy "a compelling VR experience". That approach, called "the I2I method", present 11 phases from "Establishing technological and competitive intelligence and industrial property" to "Improvements" through the "Definition of the Behavioral Interface, Virtual Environment and Behavioral Software Assistance". As a result of the experience gained by various research teams, this design approach benefits from contributions from current VR and AR research. Our objective is to validate and continuously move such multidisciplinary design team methods forward.

The simulation of emergent dispatch of cars for intelligent driving autos

NASA Astrophysics Data System (ADS)

Zheng, Ziao

2018-03-01

It is widely acknowledged that it is important for the development of intelligent cars to be widely accepted by the majority of car users. While most of the intelligent cars have the system of monitoring itself whether it is on the good situation to drive, it is also clear that studies should be performed on the way of cars for the emergent rescue of the intelligent vehicles. In this study, writer focus mainly on how to derive a separate system for the car caring teams to arrive as soon as they get the signal sent out by the intelligent driving autos. This simulation measure the time for the rescuing team to arrive, the cost it spent on arriving on the site of car problem happens, also how long the queue is when the rescuing auto is waiting to cross a road. This can be definitely in great use when there are a team of intelligent cars with one car immediately having problems causing it's not moving and can be helpful in other situations. Through this way, the interconnection of cars can be a safety net for the drivers encountering difficulties in any time.

The comparing analysis of simulation of emergent dispatch of cars for intelligent driving autos in crossroads

NASA Astrophysics Data System (ADS)

Zheng, Ziao

2018-03-01

It is widely acknowledged that it is important for the development of intelligent cars to be widely accepted by the majority of car users. While most of the intelligent cars have the system of monitoring itself whether it is on the good situation to drive, it is also clear that studies should be performed on the way of cars for the emergent rescue of the intelligent vehicles. In this study, writer focus mainly on how to derive a separate system for the car caring teams to arrive as soon as they get the signal sent out by the intelligent driving autos. This simulation measure the time for the rescuing team to arrive, the cost it spent on arriving on the site of car problem happens, also how long the queue is when the rescuing auto is waiting to cross a road. This can be definitely in great use when there are a team of intelligent cars with one car immediately having problems causing its not moving and can be helpful in other situations. Through this way, the interconnection of cars can be a safety net for the drivers encountering difficulties in any time.

Determining the composition and benefit of the pre-hospital medical response team in the conflict setting.

PubMed

Davis, P R; Rickards, A C; Ollerton, J E

2007-12-01

To determine the optimal composition o f the pre-hospital medical response team (MERT) and the value of pre-hospital critical care interventions in a military setting, and specifically to determine both the benefit of including a doctor in the pre-hospital response team and the relevance of the time and distance to definitive care. A comprehensive review of the literature incorporating a range of electronic search engines and hand searches of key journals. There was no level 1 evidence on which to base conclusions. The 15 most relevant articles were analysed in detail. There was one randomized controlled trial (level 2 evidence) that supports the inclusion of a doctor on MERT. Several cohort studies were identified that analysed the benefits of specific critical care interventions in the pre-hospital setting. A doctor with critical care skills deployed on the MERT is associated with improved survival in victims of major trauma. Specific critical care interventions including emergency endotracheal intubation and ventilation, and intercostal drainage are associated with improved survival and functional recovery in certain patients. These benefits appear to be more easily demonstrated for the rural and remote setting than for the urban setting.

Mars Hybrid Propulsion System Trajectory Analysis. Part I; Crew Missions

NASA Technical Reports Server (NTRS)

Chai, Patrick R.; Merrill, Raymond G.; Qu, Min

2015-01-01

NASAs Human spaceflight Architecture team is developing a reusable hybrid transportation architecture in which both chemical and electric propulsion systems are used to send crew and cargo to Mars destinations such as Phobos, Deimos, the surface of Mars, and other orbits around Mars. By combining chemical and electrical propulsion into a single space- ship and applying each where it is more effective, the hybrid architecture enables a series of Mars trajectories that are more fuel-efficient than an all chemical architecture without significant increases in flight times. This paper provides the analysis of the interplanetary segments of the three Evolvable Mars Campaign crew missions to Mars using the hybrid transportation architecture. The trajectory analysis provides departure and arrival dates and propellant needs for the three crew missions that are used by the campaign analysis team for campaign build-up and logistics aggregation analysis. Sensitivity analyses were performed to investigate the impact of mass growth, departure window, and propulsion system performance on the hybrid transportation architecture. The results and system analysis from this paper contribute to analyses of the other human spaceflight architecture team tasks and feed into the definition of the Evolvable Mars Campaign.

Research-oriented teaching in optical design course and its function in education

NASA Astrophysics Data System (ADS)

Cen, Zhaofeng; Li, Xiaotong; Liu, Xiangdong; Deng, Shitao

2008-03-01

The principles and operation plans of research-oriented teaching in the course of computer aided optical design are presented, especially the mode of research in practice course. This program includes contract definition phase, project organization and execution, post project evaluation and discussion. Modes of academic organization are used in the practice course of computer aided optical design. In this course the students complete their design projects in research teams by autonomous group approach and cooperative exploration. In this research process they experience the interpersonal relationship in modern society, the importance of cooperation in team, the functions of each individual, the relationships between team members, the competition and cooperation in one academic group and with other groups, and know themselves objectively. In the design practice the knowledge of many academic fields is applied including applied optics, computer programming, engineering software and etc. The characteristic of interdisciplinary is very useful for academic research and makes the students be ready for innovation by integrating the knowledge of interdisciplinary field. As shown by the practice that this teaching mode has taken very important part in bringing up the abilities of engineering, cooperation, digesting the knowledge at a high level and problem analyzing and solving.

Strategies for interprofessional education: the Interprofessional Team Objective Structured Clinical Examination for midwifery and medical students.

PubMed

Cullen, Lindsay; Fraser, Diane; Symonds, Ian

2003-08-01

This paper provides an overview of the processes involved in implementing an interprofessional education (IPE) strategy in a recently established School of Human Development at the University of Nottingham. The merger of the academic divisions of child health, midwifery, obstetrics and gynaecology was a deliberate initiative to create an organisational infrastructure intended to enhance opportunities for interprofessional collaborations in research and education. As a first step, a small group of academic midwives and obstetricians formed a project group to find the best way of facilitating IPE for medical and midwifery students at undergraduate level. A discussion is provided of the work the project group undertook to: determine an agreed definition of IPE; decide an action research approach was needed; determine the ways in which teaching and learning strategies were to be implemented, evaluated and compared; and identify the factors inhibiting and enhancing developments. Evaluations have demonstrated that the Interprofessional Team Objective Structured Clinical Examination (ITOSCE) focusing on intrapartum scenarios is effective in promoting interprofessional learning. Both medical and midwifery students and facilitators agree that team working and understanding each other's roles has been enhanced and that although resource intensive, IPE is worth the time and effort involved.

Redo pullthrough for Hirschsprung disease.

PubMed

Ralls, Matthew W; Coran, Arnold G; Teitelbaum, Daniel H

2017-04-01

Pullthrough procedures for Hirschsprung diseases typically have favorable results. However, some children experience long-term postoperative complications comprising stooling disorders, such as intermittent enterocolitis, severe stool retention, intestinal obstruction, as well as incontinence. Reoperative Hirschsprung Disease surgery is complex. This begins with the workup after the initial presentation following primary pullthrough, continues with the definitive surgical correction with redo pullthrough, and ends with long-term follow-up of individuals. The decision tree can be varied with each patient. The operating pediatric surgeon must be able to utilize different operations and treatment options available. While lesser procedures may provide relief in a select population, those with residual aganglionosis or transition zone pathology or mechanical problems will likely require a redo pullthrough. Thus, the diagnostic workup, treatment plan, and definitive surgical care should be coordinated, and executed by an experienced, specialized team at a pediatric referral center.

Engineering Technical Review Planning Briefing

NASA Technical Reports Server (NTRS)

Gardner, Terrie

2012-01-01

The general topics covered in the engineering technical planning briefing are 1) overviews of NASA, Marshall Space Flight Center (MSFC), and Engineering, 2) the NASA Systems Engineering(SE) Engine and its implementation , 3) the NASA Project Life Cycle, 4) MSFC Technical Management Branch Services in relation to the SE Engine and the Project Life Cycle , 5) Technical Reviews, 6) NASA Human Factor Design Guidance , and 7) the MSFC Human Factors Team. The engineering technical review portion of the presentation is the primary focus of the overall presentation and will address the definition of a design review, execution guidance, the essential stages of a technical review, and the overall review planning life cycle. Examples of a technical review plan content, review approaches, review schedules, and the review process will be provided and discussed. The human factors portion of the presentation will focus on the NASA guidance for human factors. Human factors definition, categories, design guidance, and human factor specialist roles will be addressed. In addition, the NASA Systems Engineering Engine description, definition, and application will be reviewed as background leading into the NASA Project Life Cycle Overview and technical review planning discussion.

Update 2016: Considerations for Using Agile in DoD Acquisition

DTIC Science & Technology

2016-12-01

What Is Agile? 4 2.1 Agile Manifesto and Principles—A Brief History 4 2.2 A Practical Definition 6 2.3 Example Agile Method 6 2.4 Example Agile...5.8 Team Composition 45 5.9 Culture 46 6 Conclusion 48 Appendix A: Examples of Agile Methods 50 Appendix B: Common Objections to Agile 53...thank all those who have contributed to our knowledge of apply- ing “other than traditional” methods for software system acquisition and management over

Selection of a Development Methodology for the Acquisition of Command, Control and Communication Systems

DTIC Science & Technology

1991-09-01

ref lect the of ficial policy or position of the Department of Defense or the U.S. Government. Accesion For NTIS CrA&,i By D, st ibtt:or~f 11--- ... Si...capability 3. A flexible, well-planned overall architecture 4. A plan for incremental achievement of full capability 5. Early definition, funding...2. a system architecture and design that will satisfy the requirements. 3. a development team that communicates effectively and have previous

User systems guidelines for software projects

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

Abrahamson, L.

1986-04-01

This manual presents guidelines for software standards which were developed so that software project-development teams and management involved in approving the software could have a generalized view of all phases in the software production procedure and the steps involved in completing each phase. Guidelines are presented for six phases of software development: project definition, building a user interface, designing software, writing code, testing code, and preparing software documentation. The discussions for each phase include examples illustrating the recommended guidelines. 45 refs. (DWL)

Gender Perspectives and Military Effectiveness: Implementing UNSCR 1325 and the National Action Plan on Women, Peace, and Security

DTIC Science & Technology

2016-03-01

20 It is indeed important to stress that there is a difference between sex and gender, and that women are not by definition gender aware, or...effectively as mixed engagement teams can? Does the sex of the interpreter matter when attempting to engage local men and women? All-female engagement...18 Egnell, Hojem, and Berts, Gender, Military Effectiveness, and Organizational Change. 19 Kronsell, Gender, Sex , and the Postnational Defense, 135

Management Approaches for Enterocutaneous Fistulas.

PubMed

Heimroth, Jamie; Chen, Eric; Sutton, Erica

2018-03-01

There are very few clinical studies that highlight a definitive and comprehensive guideline for the management of enterocutaneous fistulas. Most accepted guidelines are found in textbooks and are taken from expert advice and case reports. The goal of this review is to highlight advancements relevant to the management of enterocutaneous fistulas from the recent two to three years. Although strong evidence-based guidelines are lacking, the consensus is that a multidisciplinary team working with a clear treatment plan targeting multiple aspects of management can maximize patient outcomes.

Computer-Aided Design (CAD) Tools to Support the Human Factors Design Teams

NASA Technical Reports Server (NTRS)

Null, Cynthia H.; Jackson, Mariea D.; Perry, Trey; Quick, Jason C.; Stokes, Jack W.

2014-01-01

The scope of this assessment was to develop a library of basic 1-Gravity (G) human posture and motion elements used to construct complex virtual simulations of ground processing and maintenance tasks for spaceflight vehicles, including launch vehicles, crewed spacecraft, robotic spacecraft, satellites, and other payloads. The report herein describes the task, its purpose, performance, findings, NASA Engineering and Safety Center (NESC) recommendations, and conclusions in the definition and assemblage of the postures and motions database (PMD).

Definition of Roles and Responsibilities of Health Care Team Members in a Population-Based Model of Primary Health Care Delivery

DTIC Science & Technology

1997-06-01

practice guidelines. David Sackett defines 10 evidence - based medicine as "the conscientious, explicit and judicious use of current best evidence in...not medical tradition or marketing campaigns. With evidence - based medicine , the best available evidence with which to answer a medical question is...1996. Sackett, D. L., et al. " Evidence Based Medicine : What It Is and What It Isn’t." British MedicalJournal 312, no. 7023 (January 1996). 41

Globus Online: Climate Data Management for Small Teams

NASA Astrophysics Data System (ADS)

Ananthakrishnan, R.; Foster, I.

2013-12-01

Large and highly distributed climate data demands new approaches to data organization and lifecycle management. We need, in particular, catalogs that can allow researchers to track the location and properties of large numbers of data files, and management tools that can allow researchers to update data properties and organization during their research, move data among different locations, and invoke analysis computations on data--all as easily as if they were working with small numbers of files on their desktop computer. Both catalogs and management tools often need to be able to scale to extremely large quantities of data. When developing solutions to these problems, it is important to distinguish between the needs of (a) large communities, for whom the ability to organize published data is crucial (e.g., by implementing formal data publication processes, assigning DOIs, recording definitive metadata, providing for versioning), and (b) individual researchers and small teams, who are more frequently concerned with tracking the diverse data and computations involved in what highly dynamic and iterative research processes. Key requirements in the latter case include automated data registration and metadata extraction, ease of update, close-to-zero management overheads (e.g., no local software install); and flexible, user-managed sharing support, allowing read and write privileges within small groups. We describe here how new capabilities provided by the Globus Online system address the needs of the latter group of climate scientists, providing for the rapid creation and establishment of lightweight individual- or team-specific catalogs; the definition of logical groupings of data elements, called datasets; the evolution of catalogs, dataset definitions, and associated metadata over time, to track changes in data properties and organization as a result of research processes; and the manipulation of data referenced by catalog entries (e.g., replication of a dataset to a remote location for analysis, sharing of a dataset). Its software-as-a-service ('SaaS') architecture means that these capabilities are provided to users over the network, without a need for local software installation. In addition, Globus Online provides well defined APIs, thus providing a platform that can be leveraged to integrate the capabilities with other portals and applications. We describe early applications of these new Globus Online to climate science. We focus in particular on applications that demonstrate how Globus Online capabilities complement those of the Earth System Grid Federation (ESGF), the premier system for publication and discovery of large community datasets. ESGF already uses Globus Online mechanisms for data download. We demonstrate methods by which the two systems can be further integrated and harmonized, so that for example data collections produced within a small team can be easily published from Globus Online to ESGF for archival storage and broader access--and a Globus Online catalog can be used to organize an individual view of a subset of data held in ESGF.

Provider Agreement in the Assessment of Glaucoma Progression within a Team Model.

PubMed

Shah, Saumya; Choo, Clara; Odden, Jamie; Zhao, Bingying; Fang, Chengbo; Schornack, Muriel; Stalboerger, Gina; Bennett, Jeffrey R; Khanna, Cheryl L

2018-06-04

Glaucoma specialists and optometrists who work in a team model at a single institution utilize a common definition of glaucoma progression and treatment algorithm. The purpose of this study was to assess the consistency of agreement in identifying glaucoma progression among glaucoma specialists and optometrists of one team. 399 eyes of 200 patients age 18 or older with glaucoma were enrolled over two years. Clinical data, disc photographs, OCT, and visual fields were independently reviewed by two masked optometrists and two masked fellowship-trained glaucoma specialists. Each eye was judged as progression or no-progression of glaucomatous disease. The following were assessed: (1) agreement among optometrists; (2) agreement among glaucoma specialists; and (3) agreement among optometrists and glaucoma specialists. The frequency of use of testing modality to determine progression was also studied. Kappa statistics were used to evaluate agreements. Optometrists agreed with each other for 74.2% of the eyes assessed (κ=0.42), whereas glaucoma specialists agreed with each other for 78.7% of eyes (κ=0.39). All four providers agreed with each other for 54.4% of the eyes evaluated (κ=0.37). Providers had the highest agreement when the progression decision was based on disc hemorrhage (92%) and the lowest agreement when based on OCT progression analysis (36%). Compared to optometrists, glaucoma specialists used OCT (P= <0.01) more frequently to determine disease progression. Fair to moderate agreement levels were found among providers in their assessment of glaucoma progression, suggesting that a team approach to glaucoma management may be effective. Further work is needed to investigate ways to optimize consistency within the glaucoma team.

Definition and outcome of a curriculum to prevent disordered eating and body-shaping drug use.

PubMed

Elliot, Diane L; Moe, Esther L; Goldberg, Linn; DeFrancesco, Carol A; Durham, Melissa B; Hix-Small, Hollie

2006-02-01

Almost one half of male and female students participate in high school-sponsored athletics, and high school also is a time when classroom health promotion curricula are less effective. The Athletes Training and Learning to Avoid Steroids is a sport team-centered drug-use prevention program for male high school athletes, which has been shown to reduce alcohol and illicit drug use. Just as anabolic steroid use is associated with male athletes, female sport participants may be at a greater risk for disordered eating and body-shaping drug use. Extending sport team-centered programs to young women athletes required defining and ranking factors related to developing those harmful behaviors. Survey results from a cross-sectional cohort of female middle and high school student athletes were used to identify and prioritize potential curriculum components, including mood and self-esteem, norms of behavior, perceptions of healthy body weight, effects of media depictions of women, and societal pressures to be thin. The derived sport team-centered program was prospectively assessed among a second group of female student athletes from 18 high schools, randomized to receive the intervention or the usual care control condition. The Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) intervention is a scripted, coach-facilitated, peer-led 8-session program, which was incorporated into a team's usual training activities. The ATHENA program significantly altered the targeted risk factors and reduced ongoing and new use of diet pills and body-shaping substances (amphetamines, anabolic steroids, and sport supplements). These findings illustrate the utility of a structured process to define curriculum content, and the program's positive results also confirm the sport team's potential as a vehicle to effectively deter health-harming behaviors.

Assessing the accuracy of the International Classification of Diseases codes to identify abusive head trauma: a feasibility study.

PubMed

Berger, Rachel P; Parks, Sharyn; Fromkin, Janet; Rubin, Pamela; Pecora, Peter J

2015-04-01

To assess the accuracy of an International Classification of Diseases (ICD) code-based operational case definition for abusive head trauma (AHT). Subjects were children <5 years of age evaluated for AHT by a hospital-based Child Protection Team (CPT) at a tertiary care paediatric hospital with a completely electronic medical record (EMR) system. Subjects were designated as non-AHT traumatic brain injury (TBI) or AHT based on whether the CPT determined that the injuries were due to AHT. The sensitivity and specificity of the ICD-based definition were calculated. There were 223 children evaluated for AHT: 117 AHT and 106 non-AHT TBI. The sensitivity and specificity of the ICD-based operational case definition were 92% (95% CI 85.8 to 96.2) and 96% (95% CI 92.3 to 99.7), respectively. All errors in sensitivity and three of the four specificity errors were due to coder error; one specificity error was a physician error. In a paediatric tertiary care hospital with an EMR system, the accuracy of an ICD-based case definition for AHT was high. Additional studies are needed to assess the accuracy of this definition in all types of hospitals in which children with AHT are cared for. 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.

The Team to Address Bariatric Care in Canadian Children (Team ABC3): Team Grant Research Proposal.

PubMed

2017-10-05

Severe obesity (SO) in Canadian children remains poorly understood. However, based on international data, the prevalence of SO appears to be increasing and is associated with a number of psychosocial, bio-mechanical, and cardiometabolic health risks. The purpose of our national Team to Address Bariatric Care in Canadian Children (Team ABC3) is to develop and lead a series of inter-related studies to enhance the understanding and management of SO in Canadian children and adolescents (0-18 years). From 2015 to 2019, Team ABC3 will conduct a series of projects at the regional, provincial, and national levels using multiple methods and study designs to respond to key knowledge gaps by (i) generating evidence on the prevalence of SO and its impact on health services utilization in children using existing Canadian data sources from primary care settings, (ii) exploring contemporary definitions of SO that link with health outcomes, (iii) comparing and contrasting health risks across the continuum of SO, (iv) understanding potential barriers to and facilitators of treatment success in children with SO, and (v) examining innovative lifestyle and behavioral interventions designed to successfully manage SO in children and their families. Furthermore, to examine the impact of innovative interventions on the management SO, we will (vi) evaluate whether adding a health coach, who provides support via text, email, and/or phone, improves children's ability to adhere to a web-based weight management program and (vii) test the feasibility and impact of a community-based weight management program for pre-school children with SO and their parents that combines group-based parenting sessions with in-home visits. Our research aligns with national priorities in obesity research, brings together leading scientists, clinicians, and stakeholders from across Canada, and will inform health services delivery throughout the country to provide the best care possible for children with SO and their families.

Team play in surgical education: a simulation-based study.

PubMed

Marr, Mollie; Hemmert, Keith; Nguyen, Andrew H; Combs, Ronnie; Annamalai, Alagappan; Miller, George; Pachter, H Leon; Turner, James; Rifkind, Kenneth; Cohen, Steven M

2012-01-01

Simulation-based training provides a low-stress learning environment where real-life emergencies can be practiced. Simulation can improve surgical education and patient care in crisis situations through a team approach emphasizing interpersonal and communication skills. This study assessed the effects of simulation-based training in the context of trauma resuscitation in teams of trainees. In a New York State-certified level I trauma center, trauma alerts were assessed by a standardized video review process. Simulation training was provided in various trauma situations followed by a debriefing period. The outcomes measured included the number of healthcare workers involved in the resuscitation, the percentage of healthcare workers in role position, time to intubation, time to intubation from paralysis, time to obtain first imaging study, time to leave trauma bay for computed tomography scan or the operating room, presence of team leader, and presence of spinal stabilization. Thirty cases were video analyzed presimulation and postsimulation training. The two data sets were compared via a 1-sided t test for significance (p < 0.05). Nominal data were analyzed using the Fischer exact test. The data were compared presimulation and postsimulation. The number of healthcare workers involved in the resuscitation decreased from 8.5 to 5.7 postsimulation (p < 0.001). The percentage of people in role positions increased from 57.8% to 83.6% (p = 0.46). The time to intubation from paralysis decreased from 3.9 to 2.8 minutes (p < 0.05). The presence of a definitive team leader increased from 64% to 90% (p < 0.05). The rate of spine stabilization increased from 82% to 100% (p < 0.08). After simulation, training adherence to the advanced trauma life support algorithm improved from 56% to 83%. High-stress situations simulated in a low-stress environment can improve team interaction and educational competencies. Providing simulation training as a tool for surgical education may enhance patient care. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Use of integrated technology in team sports: a review of opportunities, challenges, and future directions for athletes.

PubMed

Dellaserra, Carla L; Gao, Yong; Ransdell, Lynda

2014-02-01

Integrated technology (IT), which includes accelerometers, global positioning systems (GPSs), and heart rate monitors, has been used frequently in public health. More recently, IT data have been used in sports settings to assess training and performance demands. However, the impact of IT in sports settings is yet to be evaluated, particularly in field-based team sports. This narrative-qualitative review provides an overview of the emerging impact of IT in sports settings. Twenty electronic databases (e.g., Medline, SPORTdiscus, and ScienceDirect), print publications (e.g., Signal Processing Magazine and Catapult Innovations news releases), and internet resources were searched using different combinations of keywords as follows: accelerometers, heart rate monitors, GPS, sport training, and field-based sports for relevant articles published from 1990 to the present. A total of 114 publications were identified, and 39 that examined a field-based team sport using a form of IT were analyzed. The articles chosen for analysis examined a field-based team sport using a form of IT. The uses of IT can be divided into 4 categories: (a) quantifying movement patterns (n = 22), (b) assessing the differences between demands of training and competition (n = 12), (c) measuring physiological and metabolic responses (n = 16), and (d) determining a valid definition for velocity and a sprint effort (n = 8). Most studies used elite adult male athletes as participants and analyzed the sports of Australian Rules football, field hockey, cricket, and soccer, with sample sizes between 5 and 20 participants. The limitations of IT in a sports setting include scalability issues, cost, and the inability to receive signals within indoor environments. Integrated technology can contribute to significant improvements in the preparation, training, and recovery aspects of field-based team sports. Future research should focus on using IT with female athlete populations and developing resources to use IT indoors to further enhance individual and team performances.

2011 John M. Eisenberg Patient Safety and Quality Awards. Mentored implementation: building leaders and achieving results through a collaborative improvement model. Innovation in patient safety and quality at the national level.

PubMed

Maynard, Gregory A; Budnitz, Tina L; Nickel, Wendy K; Greenwald, Jeffrey L; Kerr, Kathleen M; Miller, Joseph A; Resnic, JoAnne N; Rogers, Kendall M; Schnipper, Jeffrey L; Stein, Jason M; Whitcomb, Winthrop F; Williams, Mark V

2012-07-01

The Society of Hospital Medicine (SHM) created "Mentored Implementation" (MI) programs with the dual aims of educating and mentoring hospitalists and their quality improvement (QI) teams and accelerating improvement in the inpatient setting in three signature programs: Venous Thromboembolism (VTE) Prevention, Glycemic Control, and Project BOOST (Better Outcomes for Older adults through Safe Transitions). More than 300 hospital improvement teams were enrolled in SHM MI programs in a series of cohorts. Hospitalist mentors worked with individual hospitals/health systems to guide local teams through the life cycle of a QI project. Implementation Guides and comprehensive Web-based "Resource Rooms," as well as the mentor's own experience, provided best-practice definitions, practical implementation tips, measurement strategies, and other tools. E-mail interactions and mentoring were augmented by regularly scheduled teleconferences; group webinars; and, in some instances, a site visit. Performance was tracked in a centralized data tracking center. Preliminary data on all three MI programs show significant improvement in patient outcomes, as well as enhancements of communication and leadership skills of the hospitalists and their QI teams. Although objective data on outcomes and process measures for the MI program's efficacy remain preliminary at this time, the maturing data tracking system, multiple awards, and early results indicate that the MI programs are successful in providing QI training and accelerating improvement efforts.

Developing systems interventions in a school setting: an application of community-based participatory research for mental health.

PubMed

Mulvaney-Day, Norah E; Rappaport, Nancy; Alegría, Margarita; Codianne, Leslie M

2006-01-01

The goal of this study was to develop systems interventions in a public school district using community-based participatory research (CBPR) methods to improve the social and academic functioning of children from racial and ethnic minority populations. The study used qualitative methods in the process of problem definition and intervention planning, including in-depth qualitative interviews and stakeholder dialogue groups. The study was conducted at three levels--the school system as a whole, two individual schools, and a multiple-stakeholder participatory group. The study took place in a public school system in an urban city with a population of 101,355 and in two public schools located in this city. The CBPR team included two researchers, a researcher/consulting psychiatrist in the schools, the director of the special education office, her management team, four teachers, and two school-based administrators. The CBPR group engaged in a process of problem definition and intervention planning at all three levels of the system. In addition, both schools initiated systems interventions to target the needs of their school environments. The project led to system interventions at both schools, clarity about the policy constraints to effective collaboration, and increased awareness regarding the behavioral and academic needs of minority children in the schools. The process produced a series of questions to use as a framework in CBPR partnership development. The CBPR approach can expand the scope of mental-health services research, particularly related to services for racial and ethnic minorities.

Initial Technology Assessment for the Large-Aperture UV-Optical-Infrared (LUVOIR) Mission Concept Study

NASA Technical Reports Server (NTRS)

Bolcar, Matthew R.; Feinberg, Lee; France, Kevin; Rauscher, Bernard J.; Redding, David; Schiminovich, David

2016-01-01

The NASA Astrophysics Division's 30-Year Roadmap prioritized a future large-aperture space telescope operating in the ultra-violet/optical/infrared wavelength regime. The Association of Universities for Research in Astronomy envisioned a similar observatory, the High Definition Space Telescope. And a multi-institution group also studied the Advanced Technology Large Aperture Space Telescope. In all three cases, a broad science case is outlined, combining general astrophysics with the search for biosignatures via direct-imaging and spectroscopic characterization of habitable exoplanets. We present an initial technology assessment that enables such an observatory that is currently being studied for the 2020 Decadal Survey by the Large UV/Optical/Infrared (LUVOIR) surveyor Science and Technology Definition Team. We present here the technology prioritization for the 2016 technology cycle and define the required technology capabilities and current state-of-the-art performance. Current, planned, and recommended technology development efforts are also reported.

Using a commodity high-definition television for collaborative structural biology

PubMed Central

Yennamalli, Ragothaman; Arangarasan, Raj; Bryden, Aaron; Gleicher, Michael; Phillips, George N.

2014-01-01

Visualization of protein structures using stereoscopic systems is frequently needed by structural biologists working to understand a protein’s structure–function relationships. Often several scientists are working as a team and need simultaneous interaction with each other and the graphics representations. Most existing molecular visualization tools support single-user tasks, which are not suitable for a collaborative group. Expensive caves, domes or geowalls have been developed, but the availability and low cost of high-definition televisions (HDTVs) and game controllers in the commodity entertainment market provide an economically attractive option to achieve a collaborative environment. This paper describes a low-cost environment, using standard consumer game controllers and commercially available stereoscopic HDTV monitors with appropriate signal converters for structural biology collaborations employing existing binary distributions of commonly used software packages like Coot, PyMOL, Chimera, VMD, O, Olex2 and others. PMID:24904249

Subjective evaluation of next-generation video compression algorithms: a case study

NASA Astrophysics Data System (ADS)

De Simone, Francesca; Goldmann, Lutz; Lee, Jong-Seok; Ebrahimi, Touradj; Baroncini, Vittorio

2010-08-01

This paper describes the details and the results of the subjective quality evaluation performed at EPFL, as a contribution to the effort of the Joint Collaborative Team on Video Coding (JCT-VC) for the definition of the next-generation video coding standard. The performance of 27 coding technologies have been evaluated with respect to two H.264/MPEG-4 AVC anchors, considering high definition (HD) test material. The test campaign involved a total of 494 naive observers and took place over a period of four weeks. While similar tests have been conducted as part of the standardization process of previous video coding technologies, the test campaign described in this paper is by far the most extensive in the history of video coding standardization. The obtained subjective quality scores show high consistency and support an accurate comparison of the performance of the different coding solutions.

Initial Technology Assessment for the Large UV-Optical-Infrared (LUVOIR) Mission Concept Study

NASA Technical Reports Server (NTRS)

Bolcar, Matthew R.; Feinberg, Lee D.; France, Kevin; Rauscher, Bernard J.; Redding, David; Schiminovich, David

2016-01-01

The NASA Astrophysics Divisions 30-Year Roadmap prioritized a future large-aperture space telescope operating in the ultra-violet-optical-infrared wavelength regime. The Association of Universities for Research in Astronomy envisioned a similar observatory, the High Definition Space Telescope. And a multi-institution group also studied the Advanced Technology Large Aperture Space Telescope. In all three cases, a broad science case is outlined, combining general astrophysics with the search for bio-signatures via direct-imaging and spectroscopic characterization of habitable exo-planets. We present an initial technology assessment that enables such an observatory that is currently being studied for the 2020 Decadal Survey by the Large UV-Optical Infrared (LUVOIR) surveyor Science and Technology Definition Team. We present here the technology prioritization for the 2016 technology cycle and define the required technology capabilities and current state-of-the-art performance. Current, planned, and recommended technology development efforts are also reported.

Magnetospheric Multiscale (MMS) Mission Attitude Ground System Design

NASA Technical Reports Server (NTRS)

Sedlak, Joseph E.; Superfin, Emil; Raymond, Juan C.

2011-01-01

This paper presents an overview of the attitude ground system (AGS) currently under development for the Magnetospheric Multiscale (MMS) mission. The primary responsibilities for the MMS AGS are definitive attitude determination, validation of the onboard attitude filter, and computation of certain parameters needed to improve maneuver performance. For these purposes, the ground support utilities include attitude and rate estimation for validation of the onboard estimates, sensor calibration, inertia tensor calibration, accelerometer bias estimation, center of mass estimation, and production of a definitive attitude history for use by the science teams. Much of the AGS functionality already exists in utilities used at NASA's Goddard Space Flight Center with support heritage from many other missions, but new utilities are being created specifically for the MMS mission, such as for the inertia tensor, accelerometer bias, and center of mass estimation. Algorithms and test results for all the major AGS subsystems are presented here.

Understanding Teamwork in the Provision of Cancer Care: Highlighting the Role of Trust

PubMed Central

Keebler, Joseph R.; Day, Soosi; DiazGranados, Deborah; Pan, Minggui; King, Michael A.; Tu, Shin-Ping

2016-01-01

Team science research has indicated that trust is a critical variable of teamwork, contributing greatly to a team’s performance. Trust has long been examined in health care with research focusing on the development of trust by patients with their health care practitioners. Studies have indicated that trust is linked to patient satisfaction, adherence to treatment, continuity of care, and improved outcomes. We explore the construct of trust using a case example of a patient who received a surgical procedure for a precancerous polyp. We apply the principle of trust to the case as well as present the literature on trust and key definitions for understanding trust. Additionally, we apply the definitions presented to the specific case example by highlighting moments where trust is developed or violated. Lastly, we offer insights to health care practitioners on the development of trust in their own patient interactions to improve care. PMID:27601505

The development of a program analysis environment for Ada

NASA Technical Reports Server (NTRS)

Brown, David B.; Carlisle, Homer W.; Chang, Kai-Hsiung; Cross, James H.; Deason, William H.; Haga, Kevin D.; Huggins, John R.; Keleher, William R. A.; Starke, Benjamin B.; Weyrich, Orville R.

1989-01-01

A unit level, Ada software module testing system, called Query Utility Environment for Software Testing of Ada (QUEST/Ada), is described. The project calls for the design and development of a prototype system. QUEST/Ada design began with a definition of the overall system structure and a description of component dependencies. The project team was divided into three groups to resolve the preliminary designs of the parser/scanner: the test data generator, and the test coverage analyzer. The Phase 1 report is a working document from which the system documentation will evolve. It provides history, a guide to report sections, a literature review, the definition of the system structure and high level interfaces, descriptions of the prototype scope, the three major components, and the plan for the remainder of the project. The appendices include specifications, statistics, two papers derived from the current research, a preliminary users' manual, and the proposal and work plan for Phase 2.

Why and how Mastering an Incremental and Iterative Software Development Process

NASA Astrophysics Data System (ADS)

Dubuc, François; Guichoux, Bernard; Cormery, Patrick; Mescam, Jean Christophe

2004-06-01

One of the key issues regularly mentioned in the current software crisis of the space domain is related to the software development process that must be performed while the system definition is not yet frozen. This is especially true for complex systems like launchers or space vehicles.Several more or less mature solutions are under study by EADS SPACE Transportation and are going to be presented in this paper. The basic principle is to develop the software through an iterative and incremental process instead of the classical waterfall approach, with the following advantages:- It permits systematic management and incorporation of requirements changes over the development cycle with a minimal cost. As far as possible the most dimensioning requirements are analyzed and developed in priority for validating very early the architecture concept without the details.- A software prototype is very quickly available. It improves the communication between system and software teams, as it enables to check very early and efficiently the common understanding of the system requirements.- It allows the software team to complete a whole development cycle very early, and thus to become quickly familiar with the software development environment (methodology, technology, tools...). This is particularly important when the team is new, or when the environment has changed since the previous development. Anyhow, it improves a lot the learning curve of the software team.These advantages seem very attractive, but mastering efficiently an iterative development process is not so easy and induces a lot of difficulties such as:- How to freeze one configuration of the system definition as a development baseline, while most of thesystem requirements are completely and naturally unstable?- How to distinguish stable/unstable and dimensioning/standard requirements?- How to plan the development of each increment?- How to link classical waterfall development milestones with an iterative approach: when should theclassical reviews be performed: Software Specification Review? Preliminary Design Review? CriticalDesign Review? Code Review? Etc...Several solutions envisaged or already deployed by EADS SPACE Transportation will be presented, both from a methodological and technological point of view:- How the MELANIE EADS ST internal methodology improves the concurrent engineering activitiesbetween GNC, software and simulation teams in a very iterative and reactive way.- How the CMM approach can help by better formalizing Requirements Management and Planningprocesses.- How the Automatic Code Generation with "certified" tools (SCADE) can still dramatically shorten thedevelopment cycle.Then the presentation will conclude by showing an evaluation of the cost and planning reduction based on a pilot application by comparing figures on two similar projects: one with the classical waterfall process, the other one with an iterative and incremental approach.

Measuring team factors thought to influence the success of quality improvement in primary care: a systematic review of instruments

PubMed Central

2013-01-01

Background Measuring team factors in evaluations of Continuous Quality Improvement (CQI) may provide important information for enhancing CQI processes and outcomes; however, the large number of potentially relevant factors and associated measurement instruments makes inclusion of such measures challenging. This review aims to provide guidance on the selection of instruments for measuring team-level factors by systematically collating, categorizing, and reviewing quantitative self-report instruments. Methods Data sources: We searched MEDLINE, PsycINFO, and Health and Psychosocial Instruments; reference lists of systematic reviews; and citations and references of the main report of instruments. Study selection: To determine the scope of the review, we developed and used a conceptual framework designed to capture factors relevant to evaluating CQI in primary care (the InQuIRe framework). We included papers reporting development or use of an instrument measuring factors relevant to teamwork. Data extracted included instrument purpose; theoretical basis, constructs measured and definitions; development methods and assessment of measurement properties. Analysis and synthesis: We used qualitative analysis of instrument content and our initial framework to develop a taxonomy for summarizing and comparing instruments. Instrument content was categorized using the taxonomy, illustrating coverage of the InQuIRe framework. Methods of development and evidence of measurement properties were reviewed for instruments with potential for use in primary care. Results We identified 192 potentially relevant instruments, 170 of which were analyzed to develop the taxonomy. Eighty-one instruments measured constructs relevant to CQI teams in primary care, with content covering teamwork context (45 instruments measured enabling conditions or attitudes to teamwork), team process (57 instruments measured teamwork behaviors), and team outcomes (59 instruments measured perceptions of the team or its effectiveness). Forty instruments were included for full review, many with a strong theoretical basis. Evidence supporting measurement properties was limited. Conclusions Existing instruments cover many of the factors hypothesized to contribute to QI success. With further testing, use of these instruments measuring team factors in evaluations could aid our understanding of the influence of teamwork on CQI outcomes. Greater consistency in the factors measured and choice of measurement instruments is required to enable synthesis of findings for informing policy and practice. PMID:23410500

Temporary and definitive external fixation of war injuries: use of a French dedicated fixator.

PubMed

Mathieu, Laurent; Ouattara, Naklan; Poichotte, Antoine; Saint-Macari, Erwan; Barbier, Olivier; Rongiéras, Fréderic; Rigal, Sylvain

2014-08-01

External fixation is the recommended stabilization method for both open and closed fractures of long bones in forward surgical hospitals. Specific combat surgical tactics are best performed using dedicated external fixators. The Percy Fx (Biomet) fixator was developed for this reason by the French Army Medical Service, and has been used in various theatres of operations for more than ten years. The tactics of Percy Fx (Biomet) fixator use were analysed in two different situations: for the treatment of French soldiers wounded on several battlefields and then evacuated to France and for the management of local nationals in forward medical treatment facilities in Afghanistan and Chad. Overall 48 externals fixators were implanted on 37 French casualties; 28 frames were temporary and converted to definitive rigid frames or internal fixation after medical evacuation. The 77 Afghan patients totalled 85 external fixators, including 13 temporary frames applied in Forward Surgical Teams (FSTs) prior to their arrival at the Kabul combat support hospital. All of the 47 Chadian patients were treated in a FST with primary definitive frames because of delayed surgical management and absence of higher level of care in Chad. Temporary frames were mostly used for French soldiers to facilitate strategic air medical evacuation following trauma damage control orthopaedic principles. Definitive rigid frames permitted achieving treatment of all types of war extremity injuries, even in poor conditions.

The Carnegie Mellon University Insert Project

DTIC Science & Technology

1997-02-01

Real - Time Systems (INSERT) project under the DARPA Evolutionary Design for Complex Software (EDCS) Program. The INSERT team has completed an initial API definition and ported the existing real-time publication subscription group communication software to LynxOS 2.4, a POSIX.1b compliant OS. The distributed real-time publisher/subscriber communication model is now supported by a processor membership protocol which allows a node in the system to fail, or to rejoin the system later. When a node fails, all the publishers and subscribers on that node have to be

WFIRST Project Science Activities

NASA Technical Reports Server (NTRS)

Gehrels, Neil

2012-01-01

The WFIRST Project is a joint effort between GSFC and JPL. The project scientists and engineers are working with the community Science Definition Team to define the requirements and initial design of the mission. The objective is to design an observatory that meets the WFIRST science goals of the Astr02010 Decadal Survey for minimum cost. This talk will be a report of recent project activities including requirements flowdown, detector array development, science simulations, mission costing and science outreach. Details of the interim mission design relevant to scientific capabilities will be presented.

Measuring and improving quality of care in an academic medical center.

PubMed

Blayney, Douglas W

2013-05-01

The Donabedian definition of quality—structure, process, and outcome—provides a useful framework. A relentless focus on measuring process adherence and outcome is critical. Systemic improvements usually require teams to plan and to implement them. The lean or Toyota production system for process improvement is one useful method of organizing work, although different approaches are often necessary at the physician, practice unit, and statewide level. Challenges include scalability of the change (ie, rolling them out across the institution or system), tailoring the information technology tools, and building systems for sustainability.

Collaborative teaching models for health professionals.

PubMed

Falk-Kessler, Janet; Macrae, Nancy; Dyer, Jean

2005-01-01

Multidisciplinary faculty collaboration within the health professions educational system is explored. The definitions for the concepts of intradisciplinary, multidisciplinary, interdisciplinary and transdisciplinary faculty teams are provided along with the strengths and weaknesses of collaborative teaching and course development across various health profession programs. Examples of these teaching models are described using case studies to illustrate collaborative course development by faculty from Occupational Therapy, Nursing, Physician Assistant, Social Work and Dental Hygiene, Nurse Anesthesia, and Health Services Management programs offered at the University of New England in Portland, Maine, United States of America.

The Pivot to Asia: Can It Serve as the Foundation for American Grand Strategy in the 21st Century

DTIC Science & Technology

in which the Obama Administration cannot make a definitive choice in favor of one of these schools of thought, it has opted for a policy of hedging...also discusses the problems that the Obama Administration has been forced to confront in other placese.g., Ukraine, Libya, Syria, etc.that have...complicated its efforts to keep its focus on the pivot strategy in the IAP region. He concludes with some lessons for strategists, derived from the Obama teams experience with the pivot.

A risk-based approach to robotic mission requirements

NASA Technical Reports Server (NTRS)

Dias, William C.; Bourke, Roger D.

1992-01-01

A NASA Risk Team has developed a method for the application of risk management to the definition of robotic mission requirements for the Space Exploration Initiative. These requirements encompass environmental information, infrastructural emplacement in advance, and either technology testing or system/subsystems demonstration. Attention is presently given to a method for step-by-step consideration and analysis of the risk component inherent in mission architecture, followed by a calculation of the subjective risk level. Mitigation strategies are then applied with the same rules, and a comparison is made.

Phase 1 of the near team hybrid passenger vehicle development program. Appendix C: Preliminary design data package, volume 1

NASA Technical Reports Server (NTRS)

Piccolo, R.

1979-01-01

The methodology used for vehicle layout and component definition is described as well as techniques for system optimization and energy evaluation. The preliminary design is examined with particular attention given to body and structure; propulsion system; crash analysis and handling; internal combustion engine; DC motor separately excited; Ni-Zn battery; transmission; control system; vehicle auxiliarries; weight breakdown, and life cycle costs. Formulas are given for the quantification of energy consumption and results are compared with the reference vehicle.

Ethics in family violence research: cross-cultural issues.

PubMed

Fontes, L A

1998-01-01

This article examines ethical issues in cross-cultural research on family violence. It suggests ways for researchers to increase understanding and avoid abuses of power. Special attention to informed consent, definition of the sample, composition of the research team, research methods, and potential harm and benefit are considered key to designing ethical cross-cultural research. The discussion is illustrated with examples from the literature and from the author's experiences conducting research on sexual abuse in a shanty town in Chile and with Puerto Ricans in the U.S.

[The liaison psychiatry approach of the psychiatric crisis, urgencies and emergencies].

PubMed

Tenconi, Juan Cristóbal

2003-01-01

The purpose of this paper is to differentiate crisis, emergencies and urgencies within the frame of Liaison psychiatry. It begins with the definition of each one of the terms, later the emphasis is put in the clinical characteristics of each one of these situations. These characteristics are determined by the patient and the therapeutic team. At last therapeutic guidelines are stated, which allow more precision in the intervention, in function of the direct involvement of these situations in the development and evolution of the patients.

Concussion Incidence and Recurrence in Professional Australian Football Match-Play: A 14-Year Analysis

PubMed Central

2017-01-01

Background Concussion incidence rates in professional Australian football may be underreported due to the injury classification definition. A myriad of factors contribute to concussion risk; however, there is limited long-term surveillance in Australian football. This study analysed concussion in one Australian football team over an extended period. Method Match-play concussion injuries in one team (n = 116 participants) were diagnosed and treated by the team physician over 14 years. Analysis of factors related to concussion including matches played, time of day and season, and return to play provided an insight into occurrence and recurrence rates. Results 140 concussions were recorded (17.6 per 1000 player match hours). A strong relationship was evident between matches played and concussion incidence (r = 0.70) and match conditions did not negatively affect the concussion rate. Whether an athlete returned to play in the same match or suffered a loss-of-consciousness concussion (p = 0.84), their ensuing rate of concussion was not affected. Conclusion Concussion in professional Australian football was related to the number of matches played. Further, neither previous incidence nor loss of consciousness affected future concussion risk. This study provides ecologically valid evidence of the concussion incidence rate in professional Australian football and has implications for the management of athletes sustaining concussion injuries. PMID:28804753

Cross-cultural adaptation and validation of the teamwork climate scale

PubMed Central

Silva, Mariana Charantola; Peduzzi, Marina; Sangaleti, Carine Teles; da Silva, Dirceu; Agreli, Heloise Fernandes; West, Michael A; Anderson, Neil R

2016-01-01

ABSTRACT OBJECTIVE To adapt and validate the Team Climate Inventory scale, of teamwork climate measurement, for the Portuguese language, in the context of primary health care in Brazil. METHODS Methodological study with quantitative approach of cross-cultural adaptation (translation, back-translation, synthesis, expert committee, and pretest) and validation with 497 employees from 72 teams of the Family Health Strategy in the city of Campinas, SP, Southeastern Brazil. We verified reliability by the Cronbach’s alpha, construct validity by the confirmatory factor analysis with SmartPLS software, and correlation by the job satisfaction scale. RESULTS We problematized the overlap of items 9, 11, and 12 of the “participation in the team” factor and the “team goals” factor regarding its definition. The validation showed no overlapping of items and the reliability ranged from 0.92 to 0.93. The confirmatory factor analysis indicated suitability of the proposed model with distribution of the 38 items in the four factors. The correlation between teamwork climate and job satisfaction was significant. CONCLUSIONS The version of the scale in Brazilian Portuguese was validated and can be used in the context of primary health care in the Country, constituting an adequate tool for the assessment and diagnosis of teamwork. PMID:27556966

Errors in veterinary practice: preliminary lessons for building better veterinary teams.

PubMed

Kinnison, T; Guile, D; May, S A

2015-11-14

Case studies in two typical UK veterinary practices were undertaken to explore teamwork, including interprofessional working. Each study involved one week of whole team observation based on practice locations (reception, operating theatre), one week of shadowing six focus individuals (veterinary surgeons, veterinary nurses and administrators) and a final week consisting of semistructured interviews regarding teamwork. Errors emerged as a finding of the study. The definition of errors was inclusive, pertaining to inputs or omitted actions with potential adverse outcomes for patients, clients or the practice. The 40 identified instances could be grouped into clinical errors (dosing/drugs, surgical preparation, lack of follow-up), lost item errors, and most frequently, communication errors (records, procedures, missing face-to-face communication, mistakes within face-to-face communication). The qualitative nature of the study allowed the underlying cause of the errors to be explored. In addition to some individual mistakes, system faults were identified as a major cause of errors. Observed examples and interviews demonstrated several challenges to interprofessional teamworking which may cause errors, including: lack of time, part-time staff leading to frequent handovers, branch differences and individual veterinary surgeon work preferences. Lessons are drawn for building better veterinary teams and implications for Disciplinary Proceedings considered. British Veterinary Association.

The source of display rules and their effects on primary health care professionals' well-being.

PubMed

Martínez-Iñigo, David; Totterdell, Peter; Alcover, Carlos Maria; Holman, David

2009-11-01

Employees' perceptions of the emotional requirements of their work role are considered a necessary antecedent of emotion work. The impact of these requirements on the emotions employees display, their well-being, and their clients' satisfaction has been explored in previous research. Emotional requirements have been characterized as organizationally-based expectations (e.g., Brotheridge & Lee, 2003), formal and informal organizational rules (e.g., Cropanzano, Weiss & Elias, 2004), occupational norms (e.g., Rafaeli & Sutton, 1987; Smith & Kleinman, 1989) and job-based demands (Brotheridge & Lee, 2002). Although all these definitions assume some kind of shared source for perceptions of emotional requirements, it remains unclear to what extent these different sources contribute and to what extent the requirements are shared by different units, teams and individuals in the organization. The present study analyses the perception of emotional requirements from a survey of ninety-seven Primary Health Care teams composed of general practitioners, nurses and administrative staff (N = 1057). The relative contribution of different sources of variance (team, organizational, and occupational) to perceived emotional requirements and the effects on employees' job satisfaction and well being are examined. Results confirm the relevance of the source and show the contribution of emotional demands to prediction of emotional exhaustion and job satisfaction levels.

Considerations in identifying pediatric dental neglect and the legal obligation to report.

PubMed

Katner, David; Brown, Christopher; Fournier, Suzanne

2016-10-01

Dental health care professionals play an important role as mandated advocates when health care neglect is suspected in children; however, there is some confusion around what constitutes child neglect. The authors reviewed the dental literature for descriptors and definitions of neglect. They studied the individual state statutes to learn the protection afforded for both victims of neglect and for health care providers acting on behalf of such children. They also reviewed methods of action to address suspected neglect. The authors found confusion around what is or is not child neglect. Yet, dental professionals are tasked by the law, and by a moral code, to protect children from neglect. The authors offer a definition of neglect and suggested practice guidelines to assist the practitioner acting as a child's advocate. Clinicians can use strategies to address the problem of child neglect. A digital data treatment registry may provide additional views of a child's health status. With a better understanding of the definition of neglect, strategies can be implemented for use by the dental team to address this problem of neglect and reduce its incidence. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Neptune Aerocapture Systems Analysis

NASA Technical Reports Server (NTRS)

Lockwood, Mary Kae

2004-01-01

A Neptune Aerocapture Systems Analysis is completed to determine the feasibility, benefit and risk of an aeroshell aerocapture system for Neptune and to identify technology gaps and technology performance goals. The high fidelity systems analysis is completed by a five center NASA team and includes the following disciplines and analyses: science; mission design; aeroshell configuration screening and definition; interplanetary navigation analyses; atmosphere modeling; computational fluid dynamics for aerodynamic performance and database definition; initial stability analyses; guidance development; atmospheric flight simulation; computational fluid dynamics and radiation analyses for aeroheating environment definition; thermal protection system design, concepts and sizing; mass properties; structures; spacecraft design and packaging; and mass sensitivities. Results show that aerocapture can deliver 1.4 times more mass to Neptune orbit than an all-propulsive system for the same launch vehicle. In addition aerocapture results in a 3-4 year reduction in trip time compared to all-propulsive systems. Aerocapture is feasible and performance is adequate for the Neptune aerocapture mission. Monte Carlo simulation results show 100% successful capture for all cases including conservative assumptions on atmosphere and navigation. Enabling technologies for this mission include TPS manufacturing; and aerothermodynamic methods and validation for determining coupled 3-D convection, radiation and ablation aeroheating rates and loads, and the effects on surface recession.

A Candidate Wake Vortex Strength Definition for Application to the NASA Aircraft Vortex Spacing System (AVOSS)

NASA Technical Reports Server (NTRS)

Hinton, David A.; Tatnall, Chris R.

1997-01-01

A significant effort is underway at NASA Langley to develop a system to provide dynamical aircraft wake vortex spacing criteria to Air Traffic Control (ATC). The system under development, the Aircraft Vortex Spacing System (AVOSS), combines the inputs of multiple subsystems to provide separation matrices with sufficient stability for use by ATC and sufficient monitoring to ensure safety. The subsystems include a meteorological subsystem, a wake behavior prediction subsystem, a wake sensor subsystem, and system integration and ATC interfaces. The proposed AVOSS is capable of using two factors, singly or in combination, for reducing in-trail spacing. These factors are wake vortex motion out of a predefined approach corridor and wake decay below a strength that is acceptable for encounter. Although basic research into the wake phenomena has historically used wake total circulation as a strength parameter, there is a requirement for a more specific strength definition that may be applied across multiple disciplines and teams to produce a real-time, automated system. This paper presents some of the limitations of previous applications of circulation to aircraft wake observations and describes the results of a preliminary effort to bound a spacing system strength definition.

Advanced Space Transportation Program (ASTP)

NASA Image and Video Library

2002-10-01

NASA's Marshall Space Flight Center in Huntsville, Alabama, manages the Space Launch Initiative (SLI), NASA's priority developmental program focused on empowering America's leadership in space. SLI includes commercial, higher education, and Defense partnerships and contracts to offer widespread participation in both the risk and success of developing our nation's next-generation reusable launch vehicle. This photo depicts an artist's concept of a future second-generation launch vehicle enroute to the International Space Station. For the SLI, architecture definition includes all components of the next-generation reusable launch system: Earth-to-orbit vehicles (the Space Shuttle is the first generation earth-to-orbit vehicle), crew transfer vehicles, transfer stages, ground processing systems, flight operations systems, and development of business case strategies. Three contractor teams have each been funded to develop potential second-generation reusable launch system architectures: The Boeing Company of Seal Beach, California; Lockheed Martin Corporation of Denver, Colorado along with a team including Northrop Grumman of El Segundo, California; and Orbital Sciences Corporation of Dulles, Virginia.

Implementation of consumer providers into mental health intensive case management teams.

PubMed

Hamilton, Alison B; Chinman, Matthew; Cohen, Amy N; Oberman, Rebecca Shoai; Young, Alexander S

2015-01-01

In mental health care, consumer providers (CPs) are individuals with serious mental illness (SMI) who draw upon their lived experiences while providing services to others with SMI. Implementation of CPs has proven to be challenging in a variety of settings. The PEER project (Peers Enhancing Recovery) involved rolling out CPs using an implementation science model and evaluating implementation and impact in mental health treatment settings (three intervention, three control). In qualitative interviews, facilitators and challenges to implementation were described by the CPs, their team members, clients, and study researchers. Site preparation, external facilitation, and positive, reinforcing experiences with CPs facilitated implementation. Role definitions and deficiencies in CPs' technical knowledge posed challenges to implementation. Sustainability was not realized due to insufficient resources. However, implementation was positive overall, characterized by diffusion of innovation concepts of high relative advantage, strong trialability, compatibility with prevailing norms, compelling observability, and relatively low complexity. By preparing and working systematically with intervention sites to incorporate new services, implementation was strengthened and challenges were minimized.

[Methodological aspects of integrated care pathways].

PubMed

Gomis, R; Mata Cases, M; Mauricio Puente, D; Artola Menéndez, S; Ena Muñoz, J; Mediavilla Bravo, J J; Miranda Fernández-Santos, C; Orozco Beltrán, D; Rodríguez Mañas, L; Sánchez Villalba, C; Martínez, J A

An Integrated Healthcare Pathway (PAI) is a tool which has as its aim to increase the effectiveness of clinical performance through greater coordination and to ensure continuity of care. PAI places the patient as the central focus of the organisation of health services. It is defined as the set of activities carried out by the health care providers in order to increase the level of health and satisfaction of the population receiving services. The development of a PAI requires the analysis of the flow of activities, the inter-relationships between professionals and care teams, and patient expectations. The methodology for the development of a PAI is presented and discussed in this article, as well as the success factors for its definition and its effective implementation. It also explains, as an example, the recent PAI for Hypoglycaemia in patients with Type 2 Diabetes Mellitus developed by a multidisciplinary team and supported by several scientific societies. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

[Health situation assessment by primary care workers based on geographic information systems].

PubMed

Ritter, Fernando; Rosa, Roger dos Santos; Flores, Rui

2013-12-01

Primary healthcare has made little use of information systems to assess the population's health situation due to the difficulty in understanding the reports. Generic definitions of actions are common, based on empirical observations. The current study aimed to evaluate whether the introduction of georeferenced indicators can serve to better identify individuals' health situation, which would help planning actions by health teams. Healthcare workers from eight teams answered a questionnaire at three different moments: the first, before reading the information system's reports; the second after reading; and the third after using georeferencing. The results showed a significant difference in the classification of the health situation using georeferencing when compared to the previous moments (p < 0.05). Georeferencing facilitated analysis of the health situation, fostering better monitoring of work processes. Finally, use of the data points to rationalization of actions and possible upgrading of healthcare. The study suggests the use of georeferencing in the work agenda to become an effective tool for orienting actions.

The Next Giant Leap: NASA's Ares Launch Vehicles Overview

NASA Technical Reports Server (NTRS)

Cook, Stephen A.; Vanhooser, Teresa

2007-01-01

The National Aeronautics and Space Administration (NASA)'s Constellation Program is developing new launch vehicles (Ares) and spacecraft (Orion) to send astronauts to the Moon, Mars, and beyond. This paper presents plans, projections, and progress toward fielding the Ares I and Ares V vehicles, and the Ares I-X test flight in 2009. NASA is building on both new research and aeronautical capabilities, as well as lessons learned from almost 50 years of aerospace experience. The Ares Projects Office (APO) completed the Ares I System Requirements Review (SRR) in 2006 and the System Definition Review in autumn 2007; and will focus on the Preliminary Design Review in 2008. Ares I is currently being refined to meet safety, operability, reliability, and affordability goals. The Ares team is simultaneously testing Ares I elements and building hardware for Ares I-X, while the Ares V is in the early design stage, with the team validating requirements and ensuring commonality with Ares I. Ares I and V are key to opening the space frontier for peaceful endeavors.

Physical Therapists' Perceptions of School-Based Practices.

PubMed

Holt, Sheryl L; Kuperstein, Janice; Effgen, Susan K

2015-01-01

Surveys have reported that most school-based physical therapists perceive ideal practices are not commonly implemented in their settings. Our aim was to obtain a more in-depth understanding of these perceptions through open-ended inquiry. Qualitative data were derived from voluntary open-ended responses provided upon completion of a survey regarding school-based physical therapy practice. Of the survey's 561 participants, 250 provided open-ended commentaries that were analyzed using interpretive phenomenology. Six qualitative themes emerged from the open-ended responses, including: In quest: Meeting students' school-based needs via physical therapy; Seeking relatedness: Finding working teams in the school system; Building understanding: Developing a voice/identity in the school context; Stretched beyond limits: Managing workloads; Networking: Coordinating services outside school to meet student needs; Defying definition: What does working in an educational model mean? School-based physical therapists seek to meet educationally relevant physical therapy needs of students, ages 3 to 21 years. Successes appear woven of a multitude of factors such as therapist expertise, team dynamics, and district supports.

Framework for the Parametric System Modeling of Space Exploration Architectures

NASA Technical Reports Server (NTRS)

Komar, David R.; Hoffman, Jim; Olds, Aaron D.; Seal, Mike D., II

2008-01-01

This paper presents a methodology for performing architecture definition and assessment prior to, or during, program formulation that utilizes a centralized, integrated architecture modeling framework operated by a small, core team of general space architects. This framework, known as the Exploration Architecture Model for IN-space and Earth-to-orbit (EXAMINE), enables: 1) a significantly larger fraction of an architecture trade space to be assessed in a given study timeframe; and 2) the complex element-to-element and element-to-system relationships to be quantitatively explored earlier in the design process. Discussion of the methodology advantages and disadvantages with respect to the distributed study team approach typically used within NASA to perform architecture studies is presented along with an overview of EXAMINE s functional components and tools. An example Mars transportation system architecture model is used to demonstrate EXAMINE s capabilities in this paper. However, the framework is generally applicable for exploration architecture modeling with destinations to any celestial body in the solar system.

Revisiting the 1988 Pluto Occultation

NASA Astrophysics Data System (ADS)

Bosh, Amanda S.; Dunham, Edward W.; Young, Leslie A.; Slivan, Steve; Barba née Cordella, Linda L.; Millis, Robert L.; Wasserman, Lawrence H.; Nye, Ralph

2015-11-01

In 1988, Pluto's atmosphere was surmised to exist because of the surface ices that had been detected through spectroscopy, but it had not yet been directly detected in a definitive manner. The key to making such a detection was the stellar occultation method, used so successfully for the discovery of the Uranian rings in 1977 (Elliot et al. 1989; Millis et al. 1993) and before that for studies of the atmospheres of other planets.On 9 June 1988, Pluto occulted a star, with its shadow falling over the South Pacific Ocean region. One team of observers recorded this event from the Kuiper Airborne Observatory, while other teams captured the event from various locations in Australia and New Zealand. Preceding this event, extensive astrometric observations of Pluto and the star were collected in order to refine the prediction.We will recount the investigations that led up to this important Pluto occultation, discuss the unexpected atmospheric results, and compare the 1988 event to the recent 2015 event whose shadow followed a similar track through New Zealand and Australia.

A platform for discovery: The University of Pennsylvania Integrated Neurodegenerative Disease Biobank

PubMed Central

Toledo, Jon B.; Van Deerlin, Vivianna M.; Lee, Edward B.; Suh, EunRan; Baek, Young; Robinson, John L.; Xie, Sharon X.; McBride, Jennifer; Wood, Elisabeth M.; Schuck, Theresa; Irwin, David J.; Gross, Rachel G.; Hurtig, Howard; McCluskey, Leo; Elman, Lauren; Karlawish, Jason; Schellenberg, Gerard; Chen-Plotkin, Alice; Wolk, David; Grossman, Murray; Arnold, Steven E.; Shaw, Leslie M.; Lee, Virginia M.-Y.; Trojanowski, John Q.

2014-01-01

Neurodegenerative diseases (NDs) are defined by the accumulation of abnormal protein deposits in the central nervous system (CNS), and only neuropathological examination enables a definitive diagnosis. Brain banks and their associated scientific programs have shaped the actual knowledge of NDs, identifying and characterizing the CNS deposits that define new diseases, formulating staging schemes, and establishing correlations between neuropathological changes and clinical features. However, brain banks have evolved to accommodate the banking of biofluids as well as DNA and RNA samples. Moreover, the value of biobanks is greatly enhanced if they link all the multidimensional clinical and laboratory information of each case, which is accomplished, optimally, using systematic and standardized operating procedures, and in the framework of multidisciplinary teams with the support of a flexible and user-friendly database system that facilitates the sharing of information of all the teams in the network. We describe a biobanking system that is a platform for discovery research at the Center for Neurodegenerative Disease Research at the University of Pennsylvania. PMID:23978324

NASA Human Spaceflight Architecture Team Cis-Lunar Analysis

NASA Technical Reports Server (NTRS)

Lupisella, M.; Bobskill, M. R.

2012-01-01

The Cis-Lunar Destination Team of NASA's Human Spaceflight Architecture Teait1 (HAT) has been perfom1ing analyses of a number of cis-lunar locations to infom1 architecture development, transportation and destination elements definition, and operations. The cis-lunar domain is defined as that area of deep space under the gravitation influence of the earth-moon system, including a set of orbital locations (low earth orbit (LEO]. geosynchronous earth orbit [GEO]. highly elliptical orbits [HEO]); earth-moon libration or "Lagrange·· points (EMLl through EMLS, and in particular, EMLI and EML2), and low lunar orbit (LLO). We developed a set of cis-lunar mission concepts defined by mission duration, pre-deployment, type of mission, and location, to develop mission concepts and the associated activities, capabilities, and architecture implications. To date, we have produced two destination operations J concepts based on present human space exploration architectural considerations. We have recently begun defining mission activities that could be conducted within an EM LI or EM L2 facility.

SLI Artist's Concept-Vehicle Enroute to Space Station

NASA Technical Reports Server (NTRS)

2002-01-01

NASA's Marshall Space Flight Center in Huntsville, Alabama, manages the Space Launch Initiative (SLI), NASA's priority developmental program focused on empowering America's leadership in space. SLI includes commercial, higher education, and Defense partnerships and contracts to offer widespread participation in both the risk and success of developing our nation's next-generation reusable launch vehicle. This photo depicts an artist's concept of a future second-generation launch vehicle enroute to the International Space Station. For the SLI, architecture definition includes all components of the next-generation reusable launch system: Earth-to-orbit vehicles (the Space Shuttle is the first generation earth-to-orbit vehicle), crew transfer vehicles, transfer stages, ground processing systems, flight operations systems, and development of business case strategies. Three contractor teams have each been funded to develop potential second-generation reusable launch system architectures: The Boeing Company of Seal Beach, California; Lockheed Martin Corporation of Denver, Colorado along with a team including Northrop Grumman of El Segundo, California; and Orbital Sciences Corporation of Dulles, Virginia.

Report on monitoring and support instruments for solar physics research from Spacelab

NASA Technical Reports Server (NTRS)

1978-01-01

The Quick Reaction and Special Purpose Facility Definition Team for Solar Physics Spacelab Payloads examined a variety of instruments to fulfill the following functions: (1) solar physics research appropriate to Spacelab, (2) correlative data for research in such fields as aeronomy, magnetospheric physics, ionospheric physics, meteorology and climatology, (3) target selection for activity alert monitoring and (4) pointing accuracy monitoring of Spacelab platforms. In this examination the team accepted a number of restrictions and qualifications: (1) the cost of such instruments must be low, so as not to adversely impact the development of new, research class instrumentation in the early Spacelab era; (2) the instruments should be of such a size that they each would occupy a small fraction of a pointing system, and (3) the weight and power consumption of the instruments should also be small. With these restrictions, the instruments chosen are: the visible light telescope and magnetograph, the extreme-ultraviolet telescope, and the solar irradiance monitor.

Asteroid Exploration with Autonomic Systems

NASA Technical Reports Server (NTRS)

Truszkowski, Walt; Rash, James; Rouff, Christopher; Hinchey, Mike

2004-01-01

NASA is studying advanced technologies for a future robotic exploration mission to the asteroid belt. The prospective ANTS (Autonomous Nano Technology Swarm) mission comprises autonomous agents including worker agents (small spacecra3) designed to cooperate in asteroid exploration under the overall authoriq of at least one ruler agent (a larger spacecraft) whose goal is to cause science data to be returned to Earth. The ANTS team (ruler plus workers and messenger agents), but not necessarily any individual on the team, will exhibit behaviors that qualify it as an autonomic system, where an autonomic system is defined as a system that self-reconfigures, self-optimizes, self-heals, and self-protects. Autonomic system concepts lead naturally to realistic, scalable architectures rich in capabilities and behaviors. In-depth consideration of a major mission like ANTS in terms of autonomic systems brings new insights into alternative definitions of autonomic behavior. This paper gives an overview of the ANTS mission and discusses the autonomic properties of the mission.

A metropolitan airport disaster plan--coordination of a multihospital response to provide on-site resuscitation and stabilization before evacuation.

PubMed

Dove, D B; Del Guercio, L R; Stahl, W M; Star, L D; Abelson, L C

1982-07-01

At the John F. Kennedy International Airport in New York City, disaster planning has been an integral part of the airport operations for the past 20 years. The medical component of this disaster planning has focused around the Medical Office at JFK. Through this office, on-site emergency medical teams have been established and trained from all ranks of airport personnel. Following the crash of a Boeing 727 aircraft in 1975, a new concept was added to disaster planning for JFK, which involves bringing the hospital, its facilities, and its personnel to the scene. A new piece of equipment, known as Emergency Mobile Hospital, was developed with the cooperation of the airlines, the operating authority of the airport, and other interested parties. Two such vehicles are now in constant readiness at the airport, and together provide two operating rooms, 12 monitored ICU beds, a 16-bed burn unit, and 72 other beds to be used for on-site stabilization of critically ill patients, before transfer to a definitive care facility. Under the auspices of a single area medical school (New York Medical College) and its affiliated departments of surgery, trauma teams are made available to be airlifted to the scene within 30 minutes of notification. Additional medical teams from other medical school hospitals serve as backup support. The principle of bringing the hospital to the emergency, and of assembling trauma teams for the initial phase, remains the same for Kennedy Airport as for that of any other metropolitan airport.

Clinical indicators for routine use in the evaluation of early psychosis intervention: development, training support and inter-rater reliability.

PubMed

Catts, Stanley V; Frost, Aaron D J; O'Toole, Brian I; Carr, Vaughan J; Lewin, Terry; Neil, Amanda L; Harris, Meredith G; Evans, Russell W; Crissman, Belinda R; Eadie, Kathy

2011-01-01

Clinical practice improvement carried out in a quality assurance framework relies on routinely collected data using clinical indicators. Herein we describe the development, minimum training requirements, and inter-rater agreement of indicators that were used in an Australian multi-site evaluation of the effectiveness of early psychosis (EP) teams. Surveys of clinician opinion and face-to-face consensus-building meetings were used to select and conceptually define indicators. Operationalization of definitions was achieved by iterative refinement until clinicians could be quickly trained to code indicators reliably. Calculation of percentage agreement with expert consensus coding was based on ratings of paper-based clinical vignettes embedded in a 2-h clinician training package. Consensually agreed upon conceptual definitions for seven clinical indicators judged most relevant to evaluating EP teams were operationalized for ease-of-training. Brief training enabled typical clinicians to code indicators with acceptable percentage agreement (60% to 86%). For indicators of suicide risk, psychosocial function, and family functioning this level of agreement was only possible with less precise 'broad range' expert consensus scores. Estimated kappa values indicated fair to good inter-rater reliability (kappa > 0.65). Inspection of contingency tables (coding category by health service) and modal scores across services suggested consistent, unbiased coding across services. Clinicians are able to agree upon what information is essential to routinely evaluate clinical practice. Simple indicators of this information can be designed and coding rules can be reliably applied to written vignettes after brief training. The real world feasibility of the indicators remains to be tested in field trials.

NASA Program Office Technology Investments to Enable Future Missions

NASA Astrophysics Data System (ADS)

Thronson, Harley; Pham, Thai; Ganel, Opher

2018-01-01

The Cosmic Origins (COR) and Physics of the Cosmos (PCOS) Program Offices (POs) reside at NASA GSFC and implement priorities for the NASA HQ Astrophysics Division (APD). One major aspect of the POs’ activities is managing our Strategic Astrophysics Technology (SAT) program to mature technologies for future strategic missions. The Programs follow APD guidance on which missions are strategic, currently informed by the NRC’s 2010 Decadal Survey report, as well as APD’s Implementation Plan and the Astrophysics Roadmap.In preparation for the upcoming 2020 Decadal Survey, the APD has established Science and Technology Definition Teams (STDTs) to study four large-mission concepts: the Origins Space Telescope (née, Far-IR Surveyor), Habitable Exoplanet Imaging Mission, Large UV/Optical/IR Surveyor, and Lynx (née, X-ray Surveyor). The STDTs will develop the science case and design reference mission, assess technology development needs, and estimate the cost of their concept. A fifth team, the L3 Study Team (L3ST), was charged to study potential US contributions to ESA’s planned Laser Interferometer Space Antenna (LISA) gravitational-wave observatory.The POs use a rigorous and transparent process to solicit technology gaps from the scientific and technical communities, and prioritize those entries based on strategic alignment, expected impact, cross-cutting applicability, and urgency. For the past two years, the technology-gap assessments of the four STDTs and the L3ST are included in our process. Until a study team submits its final report, community-proposed changes to gaps submitted or adopted by a study team are forwarded to that study team for consideration.We discuss our technology development process, with strategic prioritization informing calls for SAT proposals and informing investment decisions. We also present results of the 2017 technology gap prioritization and showcase our current portfolio of technology development projects. To date, 96 COR and 86 PCOS SAT proposals have been received, of which 22 COR and 28 PCOS projects were awarded. For more information, see the Program Annual Technology Reports available through the PO Technology web page at https://apd440.gsfc.nasa.gov/technology.html .

NASA Astrophysics Prioritizes Technology Development Funding for Strategic Missions

NASA Astrophysics Data System (ADS)

Thronson, Harley A.; Pham, Bruce; Ganel, Opher

2017-01-01

The Cosmic Origins (COR) and Physics of the Cosmos (PCOS) Program Offices (POs) reside at NASA GSFC and implement priorities for the NASA HQ Astrophysics Division (APD). One major aspect of the POs’ activities is managing our Strategic Astrophysics Technology (SAT) program to mature technologies for future strategic missions. The Programs follow APD guidance on which missions are strategic, currently informed by the NRC’s 2010 Decadal Survey report, as well as APD’s Implementation Plan and the Astrophysics Roadmap.In preparation for the upcoming 2020 Decadal Survey, the APD has established Science and Technology Definition Teams (STDTs) to study four large-mission concepts: the Origins Space Telescope, Habitable Exoplanet Imaging Mission, Large UV/Optical/IR Surveyor, and X-ray Surveyor. The STDTs will develop the science case and design reference mission, assess technology development needs, and estimate the cost of their concept. A fifth team, the L3 Study Team (L3ST), was charged to study potential US contributions to ESA’s planned L3 gravitational-wave observatory.The POs use a rigorous and transparent process to solicit technology gaps from the scientific and technical communities, and prioritize those entries based on strategic alignment, expected impact, cross-cutting applicability, and urgency. Starting in 2016, the technology-gap assessments of the four STDTs and the L3ST are included in our process. Until a study team submits its final report, community-proposed changes to gaps submitted or adopted by a study team are forwarded to that study team for consideration.We discuss our technology development process, with strategic prioritization informing calls for SAT proposals and informing investment decisions. We also present results of this year’s technology gap prioritization and showcase our current portfolio of technology development projects. To date, 77 COR and 80 PCOS SAT proposals have been received, of which 18 COR and 22 PCOS projects were funded (PCOS awards starting in 2017 have yet to be announced). For more information, see the respective Program Annual Technology Reports under the technology tabs of the COR website at cor.gsfc.nasa.gov and the PCOS website at pcos.gsfc.nasa.gov.

A novel cognitive behaviour therapy for bipolar disorders (Think Effectively About Mood Swings or TEAMS): study protocol for a randomized controlled trial.

PubMed

Mansell, Warren; Tai, Sara; Clark, Alexandra; Akgonul, Savas; Dunn, Graham; Davies, Linda; Law, Heather; Morriss, Richard; Tinning, Neil; Morrison, Anthony P

2014-10-24

Existing psychological therapies for bipolar disorders have been found to have mixed results, with a consensus that they provide a significant, but modest, effect on clinical outcomes. Typically, these approaches have focused on promoting strategies to prevent future relapse. An alternative treatment approach, termed 'Think Effectively About Mood Swings' (TEAMS) addresses current symptoms, including subclinical hypomania, depression and anxiety, and promotes long-term recovery. Following the publication of a theoretical model, a range of research studies testing the model and a case series have demonstrated positive results. The current study reports the protocol of a feasibility randomized controlled trial to inform a future multi-centre trial. A target number of 84 patients with a diagnosis of bipolar I or II disorder, or bipolar disorder not-otherwise-specified are screened, allocated to a baseline assessment and randomized to either 16 sessions of TEAMS therapy plus treatment-as-usual (TAU) or TAU. Patients complete self-report inventories of depression, anxiety, recovery status and bipolar cognitions targeted by TEAMS. Assessments of diagnosis, bipolar symptoms, medication, access to services and quality of life are conducted by assessors blind to treatment condition at 3, 6, 12 and 18 months post-randomization. The main aim is to evaluate recruitment and retention of participants into both arms of the study, as well as adherence to therapy, to determine feasibility and acceptability. It is predicted that TEAMS plus TAU will reduce self-reported depression in comparison to TAU alone at six months post-randomization. The secondary hypotheses are that TEAMS will reduce the severity of hypomanic symptoms and anxiety, reduce bipolar cognitions, improve social functioning and promote recovery compared to TAU alone at post-treatment and follow-up. The study also incorporates semi-structured interviews about the experiences of previous treatment and the experience of TEAMS therapy that will be subject to qualitative analyses to inform future developments of the approach. The design will provide preliminary evidence of efficacy, feasibility, acceptability, uptake, attrition and barriers to treatment to design a definitive trial of this novel intervention compared to treatment as usual. This trial was registered with Current Controlled Trials (ISRCTN83928726) on registered 25 July 2014.

NASA Advanced Concepts Office, Earth-To-Orbit Team Design Process and Tools

NASA Technical Reports Server (NTRS)

Waters, Eric D.; Creech, Dennis M.; Garcia, Jessica; Threet, Grady E., Jr.; Phillips, Alan

2012-01-01

The Earth-to-Orbit Team (ETO) of the Advanced Concepts Office (ACO) at NASA Marshall Space Flight Center (MSFC) is considered the pre-eminent go-to group for pre-phase A and phase A concept definition. Over the past several years the ETO team has evaluated thousands of launch vehicle concept variations for a significant number of studies including agency-wide efforts such as the Exploration Systems Architecture Study (ESAS), Constellation, Heavy Lift Launch Vehicle (HLLV), Augustine Report, Heavy Lift Propulsion Technology (HLPT), Human Exploration Framework Team (HEFT), and Space Launch System (SLS). The ACO ETO Team is called upon to address many needs in NASA s design community; some of these are defining extremely large trade-spaces, evaluating advanced technology concepts which have not been addressed by a large majority of the aerospace community, and the rapid turn-around of highly time critical actions. It is the time critical actions, those often limited by schedule or little advanced warning, that have forced the five member ETO team to develop a design process robust enough to handle their current output level in order to meet their customer s needs. Based on the number of vehicle concepts evaluated over the past year this output level averages to four completed vehicle concepts per day. Each of these completed vehicle concepts includes a full mass breakdown of the vehicle to a tertiary level of subsystem components and a vehicle trajectory analysis to determine optimized payload delivery to specified orbital parameters, flight environments, and delta v capability. A structural analysis of the vehicle to determine flight loads based on the trajectory output, material properties, and geometry of the concept is also performed. Due to working in this fast-paced and sometimes rapidly changing environment, the ETO Team has developed a finely tuned process to maximize their delivery capabilities. The objective of this paper is to describe the interfaces between the three disciplines used in the design process: weights and sizing, trajectory, and structural analysis. The tools used to perform such analysis are INtegrated Rocket Sizing (INTROS), Program to Optimize Simulated Trajectories (POST), and Launch Vehicle Analysis (LVA) respectively. The methods each discipline uses to streamline their particular part of the design process will also be discussed.

NASA Advanced Concepts Office, Earth-To-Orbit Team Design Process and Tools

NASA Technical Reports Server (NTRS)

Waters, Eric D.; Garcia, Jessica; Threet, Grady E., Jr.; Phillips, Alan

2013-01-01

The Earth-to-Orbit Team (ETO) of the Advanced Concepts Office (ACO) at NASA Marshall Space Flight Center (MSFC) is considered the pre-eminent "go-to" group for pre-phase A and phase A concept definition. Over the past several years the ETO team has evaluated thousands of launch vehicle concept variations for a significant number of studies including agency-wide efforts such as the Exploration Systems Architecture Study (ESAS), Constellation, Heavy Lift Launch Vehicle (HLLV), Augustine Report, Heavy Lift Propulsion Technology (HLPT), Human Exploration Framework Team (HEFT), and Space Launch System (SLS). The ACO ETO Team is called upon to address many needs in NASA's design community; some of these are defining extremely large trade-spaces, evaluating advanced technology concepts which have not been addressed by a large majority of the aerospace community, and the rapid turn-around of highly time critical actions. It is the time critical actions, those often limited by schedule or little advanced warning, that have forced the five member ETO team to develop a design process robust enough to handle their current output level in order to meet their customer's needs. Based on the number of vehicle concepts evaluated over the past year this output level averages to four completed vehicle concepts per day. Each of these completed vehicle concepts includes a full mass breakdown of the vehicle to a tertiary level of subsystem components and a vehicle trajectory analysis to determine optimized payload delivery to specified orbital parameters, flight environments, and delta v capability. A structural analysis of the vehicle to determine flight loads based on the trajectory output, material properties, and geometry of the concept is also performed. Due to working in this fast-paced and sometimes rapidly changing environment, the ETO Team has developed a finely tuned process to maximize their delivery capabilities. The objective of this paper is to describe the interfaces between the three disciplines used in the design process: weights and sizing, trajectory, and structural analysis. The tools used to perform such analysis are INtegrated Rocket Sizing (INTROS), Program to Optimize Simulated Trajectories (POST), and Launch Vehicle Analysis (LVA) respectively. The methods each discipline uses to streamline their particular part of the design process will also be discussed.

Clarifying the role of the mental health peer specialist in Massachusetts, USA: insights from peer specialists, supervisors and clients.

PubMed

Cabral, Linda; Strother, Heather; Muhr, Kathy; Sefton, Laura; Savageau, Judith

2014-01-01

Mental health peer specialists develop peer-to-peer relationships of trust with clients to improve their health and well-being, functioning in ways similar to community health workers. Although the number of peer specialists in use has been increasing, their role in care teams is less defined than that of the community health worker. This qualitative study explored how the peer specialist role is defined across different stakeholder groups, the expectations for this role and how the peer specialist is utilised and integrated across different types of mental health services. Data were collected through interviews and focus groups conducted in Massachusetts with peer specialists (N = 44), their supervisors (N = 14) and clients (N = 10) between September 2009 and January 2011. A consensus coding approach was used and all data outputs were reviewed by the entire team to identify themes. Peer specialists reported that their most important role is to develop relationships with clients and that having lived mental health experience is a key element in creating that bond. They also indicated that educating staff about the recovery model and peer role is another important function. However, they often felt a lack of clarity about their role within their organisation and care team. Supervisors valued the unique experience that peer specialists bring to an organisation. However, without a defined set of expectations for this role, they struggled with training, guiding and evaluating their peer specialist staff. Clients reported that the shared lived experience is important for the relationship and that working with a peer specialist has improved their mental health. With increasing support for person-centred integrated healthcare delivery models, the demand for mental health peer specialist services will probably increase. Therefore, clearer role definition, as well as workforce development focused on team orientation, is necessary for peer specialists to be fully integrated and supported in care teams. © 2013 John Wiley & Sons Ltd.

Processes and procedures for a worldwide biological samples distribution; product assurance and logistic activities to support the mice drawer system tissue sharing event

NASA Astrophysics Data System (ADS)

Benassai, Mario; Cotronei, Vittorio

The Mice Drawer System (MDS) is a scientific payload developed by the Italian Space Agency (ASI), it hosted 6 mice on the International Space Station (ISS) and re-entered on ground on November 28, 2009 with the STS 129 at KSC. Linked to the MDS experiment, a Tissue Sharing Program (TSP), was developed in order to make available to 16 Payload Investigators (PI) (located in USA, Canada, EU -Italy, Belgium and Germany -and Japan) the biological samples coming from the mice. ALTEC SpA (a PPP owned by ASI, TAS-I and local institutions) was responsible to support the logistics aspects of the MDS samples for the first MDS mission, in the frame of Italian Space Agency (ASI) OSMA program (OSteoporosis and Muscle Atrophy). The TSP resulted in a complex scenario, as ASI, progressively, extended the original OSMA Team also to researchers from other ASI programs and from other Agencies (ESA, NASA, JAXA). The science coordination was performed by the University of Genova (UNIGE). ALTEC has managed all the logistic process with the support of a specialized freight forwarder agent during the whole shipping operation phases. ALTEC formalized all the steps from the handover of samples by the dissection Team to the packaging and shipping process in a dedicated procedure. ALTEC approached all the work in a structured way, performing: A study of the aspects connected to international shipments of biological samples. A coopera-tive work with UNIGE/ASI /PIs to identify all the needs of the various researchers and their compatibility. A complete revision and integration of shipment requirements (addresses, tem-peratures, samples, materials and so on). A complete definition of the final shipment scenario in terms of boxes, content, refrigerant and requirements. A formal approach to identification and selection of the most suited and specialized Freight Forwarder. A clear identification of all the processes from sample dissection by PI Team, sample processing, freezing, tube preparation, labeling, packaging, shipment and inspection at receiving sites, by introducing and using Forms and Procedures. A clear identification of Roles, by introducing a Board composed of NASA, ASI, PIs and ALTEC to drive and certify the critical points. Support to Team also for acces-sory aspects like badging or other kind of shipments. Support to meetings and teleconferences to cooperate in definition of mission scenario, that resulted also in the need of splitting the teams for KSC and Dryden. Support to dry run tests and meetings to tune the procedures and activities to the most refined detail. Support at both landing sites, with final shipment from KSC to all the final destination. Support data collection about status of the various incoming inspections at receiving sites. All the above mentioned activities will be detailed in the paper.

Lightweight application for generating clinical research information systems: MAGIC.

PubMed

Leskošek, Brane; Pajntar, Marjan

2015-12-01

Our purpose was to build and test a lightweight solution for generating clinical research information systems (CRIS) that would allow non-IT professionals with basic knowledge of computer usage to quickly define and build a ready-to-use, safe and secure web-based clinical research system for data management. We use the acronym MAGIC (Medical Application Generator InteraCtive) for the system. The generated CRIS should be very easy to build and use, so a common LAMP (Linux Apache MySQL Perl) platform was used, which also enables short development cycles. The application was built and tested using eXtreme Programming (XP) principles by a small development team consisting of one informatics specialist, one physician and one graphical designer/programmer. The parameter and graphical user interface (GUI) definitions for the CRIS can be made by non-IT professionals using an intuitive English-language-like formalism called application definition language (ADL). From these definitions, the MAGIC builds an end-user CRIS that can be used on a wide variety of platforms (from standard workstations to hand-held devices). A working example of a national health-care-quality assessment program is presented to illustrate this process. The lightweight application for generating CRIS (MAGIC) has proven to be useful for both clinical and analytical users in real working environment. To achieve better performance and interoperability, we are planning to recompile the application using XML schemas (XSD) in HL7 CDA or openEHR archetypes formats used for parameters definition and for data interchange between different information systems.

Magnetosphere imager science definition team: Executive summary

NASA Technical Reports Server (NTRS)

Armstrong, T. P.; Gallagher, D. L.; Johnson, C. L.

1995-01-01

For three decades, magnetospheric field and plasma measurements have been made by diverse instruments flown on spacecraft in many different orbits, widely separated in space and time, and under various solar and magnetospheric conditions. Scientists have used this information to piece together an intricate, yet incomplete view of the magnetosphere. A simultaneous global view, using various light wavelengths and energetic neutral atoms, could reveal exciting new data and help explain complex magnetospheric processes, thus providing a clear picture of this region of space. This report summarizes the scientific rationale for such a magnetospheric imaging mission and outlines a mission concept for its implementation.

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

Kenda, W.; Shrivastava, V.K.

A Definitional Mission team evaluated the prospects of the US Trade and Development Program (TDP) funding a feasibility study that would assist the Government of Kenya in developing power cogeneration plants in three Kenyan sugar factories and possibly two more that are now in the planning stage or construction. The major Kenyan sugar producing region around Kisumu, on Lake Victoria has climatic conditions that permit cane growing operations ideally suitable for cogeneration of power in sugar factories. The total potentially available capacity from the proposed rehabilitation of the three mills will be approximately 25.15 MW, or 5.7 percent of totalmore » electricity production.« less

A Whale of a Tale: Creating Spacecraft Telemetry Data Analysis Products for the Deep Impact Mission

NASA Technical Reports Server (NTRS)

Sturdevant, Kathryn

2006-01-01

A description of the Whale product generation utility and its means of analyzing project data for Deep Impact Missions is presented. The topics include: 1) Whale Definition; 2) Whale Overview; 3) Whale Challenges; 4) Network Configuration; 5) Network Diagram; 6) Whale Data Flow: Design Decisions; 7) Whale Data Flow Diagram; 8) Whale Data Flow; 9) Whale Team and Users; 10) Creeping Requirements; 11) Whale Competition; 12) Statistics: Processing Time; 13) CPU and Disk Usage; 14) The Ripple Effect of More Data; and 15) Data Validation and the Automation Challenge.

Expedition 48/49 crew visit to MSFC

NASA Image and Video Library

2017-04-06

NASA astronaut Kate Rubins presents highlights from Expedition 48/49, her mission to the International Space Station, to team members and Space Camp students from the U.S. Space & Rocket Center in Huntsville, April 6 at NASA's Marshall Space Flight Center. During her mission, Rubins became the first person to sequence DNA in space, researching technology development for deep-space exploration by humans, Earth and space science. She also conducted two spacewalks, in which she and NASA astronaut Jeff Williams installed an International Docking Adapter and performed maintenance of the station's external thermal control system and installed high-definition cameras.

Surgery and Research: A Practical Approach to Managing the Research Process

PubMed Central

Swiatek, Peter R.; Chung, Kevin C.; Mahmoudi, Elham

2016-01-01

Following a practical project management method is essential in completing a research project on time and within budget. Although this concept is well developed in the business world, it has yet to be explored in academic surgical research. Defining and adhering to a suitable workflow would increase portability, reusability, and therefore, efficiency of the research process. In this article, we briefly review project management techniques. We specifically underline four main steps of project management: (1) definition and organization, (2) planning, (3) execution, and (4) evaluation, using practical examples from our own multidisciplinary plastic surgery research team. PMID:26710037

Overview, prevention and management of chemotherapy extravasation.

PubMed

Kreidieh, Firas Y; Moukadem, Hiba A; El Saghir, Nagi S

2016-02-10

Chemotherapy extravasation remains an accidental complication of chemotherapy administration and may result in serious damage to patients. We review in this article the clinical aspects of chemotherapy extravasation and latest advances in definitions, classification, prevention, management and guidelines. We review the grading of extravasation and tissue damage according to various chemotherapeutic drugs and present an update on treatment and new antidotes including dexrazoxane for anthracyclines extravasation. We highlight the importance of education and training of the oncology team for prevention and prompt pharmacological and non-pharmacological management and stress the availability of new antidotes like dexrazoxane wherever anthracyclines are being infused.

Overview, prevention and management of chemotherapy extravasation

PubMed Central

Kreidieh, Firas Y; Moukadem, Hiba A; El Saghir, Nagi S

2016-01-01

Chemotherapy extravasation remains an accidental complication of chemotherapy administration and may result in serious damage to patients. We review in this article the clinical aspects of chemotherapy extravasation and latest advances in definitions, classification, prevention, management and guidelines. We review the grading of extravasation and tissue damage according to various chemotherapeutic drugs and present an update on treatment and new antidotes including dexrazoxane for anthracyclines extravasation. We highlight the importance of education and training of the oncology team for prevention and prompt pharmacological and non-pharmacological management and stress the availability of new antidotes like dexrazoxane wherever anthracyclines are being infused. PMID:26862492

Crystal Growth Furnace (CGF)

NASA Technical Reports Server (NTRS)

Billingsley, Charles E.; Frederick, Larry

1993-01-01

The contract baseline, contract requirements review, contract modifications, contract problem areas and conclusions are addressed. Contract baseline was established 11 June 1987 and updated 1 December 1989. Significant changes were introduced into the 1989 baseline as compared to the original baseline. Contract modifications were made to add requirements as the program matured and as definition of requirements were completed. Problems were solved in real time through the contractor/customer team involvement and relationship to assure a timely and successful mission. The conclusion is that the CGF performed as designed and the experiments performed during the USML-1 Mission supports the conclusion.

Magnetosphere imager science definition team interim report

NASA Technical Reports Server (NTRS)

Armstrong, T. P.; Johnson, C. L.

1995-01-01

For three decades, magnetospheric field and plasma measurements have been made by diverse instruments flown on spacecraft in may different orbits, widely separated in space and time, and under various solar and magnetospheric conditions. Scientists have used this information to piece together an intricate, yet incomplete view of the magnetosphere. A simultaneous global view, using various light wavelengths and energetic neutral atoms, could reveal exciting new data nd help explain complex magnetospheric processes, thus providing a clear picture of this region of space. This report documents the scientific rational for such a magnetospheric imaging mission and provides a mission concept for its implementation.

Approach to an Affordable and Sustainable Space Transportation System

NASA Technical Reports Server (NTRS)

McCleskey, Caey M.; Rhodes, R. E.; Robinson, J. W.; Henderson, E. M.

2012-01-01

This paper describes an approach and a general procedure for creating space transportation architectural concepts that are at once affordable and sustainable. Previous papers by the authors and other members of the Space Propulsion Synergy Team (SPST) focused on a functional system breakdown structure for an architecture and definition of high-payoff design techniques with a technology integration strategy. This paper follows up by using a structured process that derives architectural solutions focused on achieving life cycle affordability and sustainability. Further, the paper includes an example concept that integrates key design techniques discussed in previous papers. !

Shortening and Angulation for Soft-Tissue Reconstruction of Extremity Wounds in a Combat Support Hospital

DTIC Science & Technology

2009-08-01

l\\I ILIT\\R\\’ ’\\ I EDICt E. 174. K:83X. 2009 Shortening and Angulation for Soft-Tissue Reconstruction of Extremity Wounds in a Combat Support...team in theater. Thereafter. they can be rapidly evacuated to treatment facilities in their respective countries for definitive reconstruct ion of...cripl "’"’ rccCI\\ ec.J ft•r re’ 1ew 1n ovcmb.:r 2008. The revbe<.l manu,cnpl "a’ accepted tor publicauon 1n May 2()()9. 838 vide a reconstructive

Study for identification of Beneficial Uses of Space (BUS). Volume 2: Technical report. Book 5: Study methods and trade studies

NASA Technical Reports Server (NTRS)

1975-01-01

A glossary of terms, a work breakdown structure, and work element descriptions, resource needs, and costs are introduced. The generic work breakdown structure was utilized to organize specific structures for each product under study; each structure containing both space and ground elements arrived at via mutual interaction. Concept definition and assessment, provided the study team and the participants visibility of the limits, and the organization of the efforts provided by both groups spelling out where such efforts fit into the generation of processing concepts.

The LUVOIR Ultraviolet Multi-Object Spectrograph (LUMOS): instrument definition and design

NASA Astrophysics Data System (ADS)

France, Kevin; Fleming, Brian; West, Garrett; McCandliss, Stephan R.; Bolcar, Matthew R.; Harris, Walter; Moustakas, Leonidas; O'Meara, John M.; Pascucci, Ilaria; Rigby, Jane; Schiminovich, David; Tumlinson, Jason

2017-08-01

The Large Ultraviolet/Optical/Infrared Surveyor (LUVOIR) is one of four large mission concepts currently undergoing community study for consideration by the 2020 Astronomy and Astrophysics Decadal Survey. LUVOIR is being designed to pursue an ambitious program of exoplanetary discovery and characterization, cosmic origins astrophysics, and planetary science. The LUVOIR study team is investigating two large telescope apertures (9- and 15-meter primary mirror diameters) and a host of science instruments to carry out the primary mission goals. Many of the exoplanet, cosmic origins, and planetary science goals of LUVOIR require high-throughput, imaging spectroscopy at ultraviolet (100 - 400 nm) wavelengths. The LUVOIR Ultraviolet Multi-Object Spectrograph, LUMOS, is being designed to support all of the UV science requirements of LUVOIR, from exoplanet host star characterization to tomography of circumgalactic halos to water plumes on outer solar system satellites. LUMOS offers point source and multi-object spectroscopy across the UV bandpass, with multiple resolution modes to support different science goals. The instrument will provide low (R = 8,000 - 18,000) and medium (R = 30,000 - 65,000) resolution modes across the far-ultraviolet (FUV: 100 - 200 nm) and nearultraviolet (NUV: 200 - 400 nm) windows, and a very low resolution mode (R = 500) for spectroscopic investigations of extremely faint objects in the FUV. Imaging spectroscopy will be accomplished over a 3 × 1.6 arcminute field-of-view by employing holographically-ruled diffraction gratings to control optical aberrations, microshutter arrays (MSA) built on the heritage of the Near Infrared Spectrograph (NIRSpec) on the James Webb Space Telescope (JWST), advanced optical coatings for high-throughput in the FUV, and next generation large-format photon-counting detectors. The spectroscopic capabilities of LUMOS are augmented by an FUV imaging channel (100 - 200nm, 13 milliarcsecond angular resolution, 2 × 2 arcminute field-of-view) that will employ a complement of narrow- and medium-band filters. The instrument definition, design, and development are being carried out by an instrument study team led by the University of Colorado, Goddard Space Flight Center, and the LUVOIR Science and Technology Definition Team. LUMOS has recently completed a preliminary design in Goddard's Instrument Design Laboratory and is being incorporated into the working LUVOIR mission concept. In this proceeding, we describe the instrument requirements for LUMOS, the instrument design, and technology development recommendations to support the hardware required for LUMOS. We present an overview of LUMOS' observing modes and estimated performance curves for effective area, spectral resolution, and imaging performance. Example "LUMOS 100-hour Highlights" observing programs are presented to demonstrate the potential power of LUVOIR's ultraviolet spectroscopic capabilities.

The risk of acute liver injury associated with the use of antibiotics--evaluating robustness of results in the pharmacoepidemiological research on outcomes of therapeutics by a European consortium (PROTECT) project.

PubMed

Udo, Renate; Tcherny-Lessenot, Stéphanie; Brauer, Ruth; Dolin, Paul; Irvine, David; Wang, Yunxun; Auclert, Laurent; Juhaeri, Juhaeri; Kurz, Xavier; Abenhaim, Lucien; Grimaldi, Lamiae; De Bruin, Marie L

2016-03-01

To examine the robustness of findings of case-control studies on the association between acute liver injury (ALI) and antibiotic use in the following different situations: (i) Replication of a protocol in different databases, with different data types, as well as replication in the same database, but performed by a different research team. (ii) Varying algorithms to identify cases, with and without manual case validation. (iii) Different exposure windows for time at risk. Five case-control studies in four different databases were performed with a common study protocol as starting point to harmonize study outcome definitions, exposure definitions and statistical analyses. All five studies showed an increased risk of ALI associated with antibiotic use ranging from OR 2.6 (95% CI 1.3-5.4) to 7.7 (95% CI 2.0-29.3). Comparable trends could be observed in the five studies: (i) without manual validation the use of the narrowest definition for ALI showed higher risk estimates, (ii) narrow and broad algorithm definitions followed by manual validation of cases resulted in similar risk estimates, and (iii) the use of a larger window (30 days vs 14 days) to define time at risk led to a decrease in risk estimates. Reproduction of a study using a predefined protocol in different database settings is feasible, although assumptions had to be made and amendments in the protocol were inevitable. Despite differences, the strength of association was comparable between the studies. In addition, the impact of varying outcome definitions and time windows showed similar trends within the data sources. Copyright © 2015 John Wiley & Sons, Ltd.

CAD/CAM-generated high-density polymer restorations for the pretreatment of complex cases: a case report.

PubMed

Edelhoff, Daniel; Beuer, Florian; Schweiger, Josef; Brix, Oliver; Stimmelmayr, Michael; Guth, Jan-Frederik

2012-06-01

Complex rehabilitations represent a particular challenge for the restorative team, especially if the vertical dimension of occlusion (VDO) needs to be reconstructed or redefined. The use of provisional acrylic or composite materials allows clinicians to evaluate the treatment objective over a certain period of time and therefore generates a high predictability of the definitive rehabilitation in terms of esthetics and function. CAD/CAM technology enables the use of prefabricated polymer materials, which are fabricated under industrial conditions to form a highly homogeneous structure compared with those of direct fabrication. This increases long-term stability, biocompatibility, and resistance to wear. Furthermore, they offer more suitable CAD/CAM processing characteristics and can be used in thinner thicknesses than ceramic restorative materials. Also, based on the improved long-term stability, the transfer into the definitive restoration can be divided into multiple treatment steps. This article presents different clinical cases with minimally invasive indications for CAD/CAM-fabricated temporary restorations for the pretreatment of complex cases.

Sensory processing issues in young children presenting to an outpatient feeding clinic.

PubMed

Davis, Ann M; Bruce, Amanda S; Khasawneh, Rima; Schulz, Trina; Fox, Catherine; Dunn, Winifred

2013-02-01

The aim of the study was to describe the relation between sensory issues and medical complexity in a series of patients presenting to an outpatient multidisciplinary feeding team for evaluation, by a standardized measure of sensory-processing abilities. A retrospective chart review of all of the patients seen from 2004 to 2009 on 2 key variables: medical diagnostic category and short sensory profile (SSP) score. On the SSP, 67.6% of children scored in the clinical ("definite difference") range. The most common diagnostic categories were developmental (n = 23), gastrointestinal (n = 16), and neurological (n = 13). Behavioral and cardiorespiratory medical diagnostic categories were significantly related to SSP total score and SSP definite difference score. Children who present for feeding evaluation do indeed tend to have clinically elevated scores regarding sensory processing, and these elevated scores are significantly related to certain medical diagnostic categories. Future research is needed to determine why these significant relations exist as well as their implications for treatment of feeding-related issues.

A theory of requirements definition in engineering design

NASA Astrophysics Data System (ADS)

Eodice, Michael Thomas

2000-10-01

Traditional requirements-definition activities begin with the engineer or design team performing a needs-analysis to identify user requirements. Needs-analysis is generally subjective, and varies according to the composition and experience of the design team. Systematic procedures for defining and ranking requirements are necessary to consolidate the foundation on which the design process is predicated, and to enhance its outcome by providing the designer with a consistent, reliable approach to product development. As a first step towards developing such procedures, research was conducted at Stanford University using empirical data from a NASA spaceflight experiment that flew aboard Space Shuttle mission STS-90 (April 1998). This research was accomplished using ex post facto data analysis. This researcher served in the central role of Experiment Manager for the spaceflight experiment, and acted as a participant-observer while conducting formal research. To better understand requirement structure and evolution, individual requirements were decomposed using AND/OR graphs. The AND/OR graph data structure illustrates requirements evolution, and reveals that the original requirement is often met by fulfilling a series of sub-requirements that are easier to implement. Early in the product life cycle, many hundreds of potential needs were identified; however, it was a smaller subset of these initial needs that were realized in the final product. Based on analysis of a large group of requirements, it was observed that two critical components for any individual requirement were: (1) a stated need, and (2) an advocate to implement the need. Identification of need, or needs-analysis, although a necessary condition, is insufficient to ensure that a stated need evolves into a formal requirement. Equally important to the concept of requirements-definition is the notion of advocacy. Early in the product development cycle of the of the NASA experiment, many potential needs were identified; however, it was only through need-advocate pairing that a stated need became a requirement. Empirical data revealed that when needs were accompanied by strong advocates, they became clear requirements. Conversely, needs without advocates did not become requirements. Hence, need-advocate pairing is useful for predicting needs which will become requirements, and more importantly, needs at risk of not becoming requirements.

Effects of a lighter, smaller football on acute match injuries in adolescent female football: a pilot cluster-randomized controlled trial.

PubMed

Zebis, Mette K; Thorborg, Kristian; Andersen, Lars L; Møller, Merete; Christensen, Karl B; Clausen, Mikkel B; Hölmich, Per; Wedderkopp, Niels; Andersen, Thomas B; Krustrup, Peter

2018-05-01

The high injury incidence during match-play in female adolescent football is a major concern. In football, males and females play matches with the same football size. No studies have investigated the effect of football size on injury incidence in female adolescent football. Thus, the aim of the present study was to investigate the effects of introducing a lighter, smaller football on the injury pattern in female adolescent football. We conducted a pilot cluster randomized controlled trial including 26 football teams representing 346 adolescent female football players (age 15-18 years). The teams were randomized to a new lighter, smaller football (INT, N.=12 teams) or a traditional FIFA size 5 football (CON, N.=14 teams) during a full match-season. Acute time-loss injuries and football-exposure during match-play were reported weekly by text-message questions and verified subsequently by telephone interview. In total, 46 acute time-loss injuries were registered (5 severe injuries), yielding an incidence rate of 15.2 injuries per 1000 hours of match-play (95% CI: 8.5-27.2) in INT and 18.6 injuries per 1000 hours of match-play (95% CI: 14.0-24.8) in CON. The estimated 22% greater injury incidence rate risk (IRR: 1.22 [95% CI: 0.64-2.35]) in the CON group was not significant. With an IRR of 1.22, a future RCT main study would need to observe 793 acute time-loss injuries during match-play, in order to have a power of 80%. A large-scaled RCT is required to definitively test for beneficial or harmful effects of a lighter, smaller football in adolescent female football.

The Outer Planetary Mission Design Project

NASA Astrophysics Data System (ADS)

Benfield, Michael; Turner, M. W.

2010-10-01

With the recent focus from the planetary science community on the outer planets of the solar system, The University of Alabama in Huntsville Integrated Product Team program is embarking on a new challenge to develop an outer planetary mission for the academic year 2010-2011. Currently four bodies are of interest for this mission: Titan, Europa, Triton, and Enceledus, with one body being chosen by the instructors by the beginning of the fall semester. This project will use the 2010 Discovery Announcement of Opportunity as its Request for Proposal (RFP). All of the teams competing in this project will use the AO to respond with a proposal to the instructors for their proposed mission and spacecraft concept. The project employs the two-semester design sequence of the IPT program to provide a framework for the development of this mission. This sequence is divided into four phases. Phase 1 - Requirements Development - focuses on the development of both the scientific and engineering requirements of the mission. During this phase the teams work very closely with the PI organization, represented by the College of Charleston. Phase 2 - Team Formation and Architecture Development - concentrates on the assessment of the overall mission architecture from the launch vehicle to the ground operations of the proposed spacecraft. Phase 3 - System Definition - provides for spacecraft subsystem trade studies and further refinement of the specific spacecraft to meet the scientific requirements and objectives developed in Phase 1. Phase 4 - Design - is the phase where the engineers provide the spacecraft design that is required for the mission of interest. At the conclusion of Phases 2 and 4, an external review board evaluates the proposed designs and chooses one winner of the competition.

[The Balanced Scorecard as a management tool in a public health organization].

PubMed

Villalbí, Joan R; Villalbí, Joan; Guix, Joan; Casas, Conrad; Borrell, Carme; Duran, Júlia; Artazcoz, Lucía; Camprubí, Esteve; Cusí, Meritxell; Rodríguez-Montuquín, Pau; Armengol, Josep M; Jiménez, Guy

2007-01-01

The Balanced Scorecard is a tool for strategic planning in business. We present our experience after introducing this instrument in a public health agency to align daily management practice with strategic objectives. Our management team required deep discussions with external support to clarify the concepts behind the Balanced Scorecard, adapt them to a public organization in the health field distinct from the business sector in which the Balanced Scorecard was designed, and adopt this instrument as a management tool. This process led to definition of the Balanced Scorecard by our Management Committee in 2002, the subsequent evaluation of the degree to which its objectives had been reached, and its periodic redefinition. In addition, second-level Balanced Scorecards were defined for different divisions and services within the agency. The adoption of the Balanced Scorecard by the management team required prior effort to clarify who are the stockholders and who are the clients of a public health organization. The agency's activity and production were also analyzed and a key processes model was defined. Although it is hard to attribute specific changes to a single cause, we believe several improvements in management can be ascribed, at least in part, to the use of the Balanced Scorecard. The systematic use of the Balanced Scorecard produced greater cohesion in the management team and the entire organization and brought the strategic objectives closer to daily management operations. The organization is more attentive to its clients, has taken steps to improve its most complex cross-sectional processes, and has developed further actions for the development and growth of its officers and its entire personnel. At the same time, its management team is more in tune with the needs of the agency's administrative bodies that compose its governing board.

Quality Metrics in Neonatal and Pediatric Critical Care Transport: A National Delphi Project.

PubMed

Schwartz, Hamilton P; Bigham, Michael T; Schoettker, Pamela J; Meyer, Keith; Trautman, Michael S; Insoft, Robert M

2015-10-01

The transport of neonatal and pediatric patients to tertiary care facilities for specialized care demands monitoring the quality of care delivered during transport and its impact on patient outcomes. In 2011, pediatric transport teams in Ohio met to identify quality indicators permitting comparisons among programs. However, no set of national consensus quality metrics exists for benchmarking transport teams. The aim of this project was to achieve national consensus on appropriate neonatal and pediatric transport quality metrics. Modified Delphi technique. The first round of consensus determination was via electronic mail survey, followed by rounds of consensus determination in-person at the American Academy of Pediatrics Section on Transport Medicine's 2012 Quality Metrics Summit. All attendees of the American Academy of Pediatrics Section on Transport Medicine Quality Metrics Summit, conducted on October 21-23, 2012, in New Orleans, LA, were eligible to participate. Candidate quality metrics were identified through literature review and those metrics currently tracked by participating programs. Participants were asked in a series of rounds to identify "very important" quality metrics for transport. It was determined a priori that consensus on a metric's importance was achieved when at least 70% of respondents were in agreement. This is consistent with other Delphi studies. Eighty-two candidate metrics were considered initially. Ultimately, 12 metrics achieved consensus as "very important" to transport. These include metrics related to airway management, team mobilization time, patient and crew injuries, and adverse patient care events. Definitions were assigned to the 12 metrics to facilitate uniform data tracking among programs. The authors succeeded in achieving consensus among a diverse group of national transport experts on 12 core neonatal and pediatric transport quality metrics. We propose that transport teams across the country use these metrics to benchmark and guide their quality improvement activities.

ExoMars Trace Gas Orbiter Instrument Modelling Approach to Streamline Science Operations

NASA Astrophysics Data System (ADS)

Munoz Fernandez, Michela; Frew, David; Ashman, Michael; Cardesin Moinelo, Alejandro; Garcia Beteta, Juan Jose; Geiger, Bernhard; Metcalfe, Leo; Nespoli, Federico; Muniz Solaz, Carlos

2018-05-01

ExoMars Trace Gas Orbiter (TGO) science operations activities are centralised at ESAC's Science Operations Centre (SOC). The SOC receives the inputs from the principal investigators (PIs) in order to implement and deliver the spacecraft pointing requests and instrument timelines to the Mission Operations Centre (MOC). The high number of orbits per planning cycle has made it necessary to abstract the planning interactions between the SOC and the PI teams at the observation level. This paper describes the modelling approach we have conducted for TGOís instruments to streamline science operations. We have created dynamic observation types that scale to adapt to the conditions specified by the PI teams including observation timing, and pointing block parameters calculated from observation geometry. This approach is considered and improvement with respect to previous missions where the generation of the observation pointing and commanding requests was performed manually by the instrument teams. Automation software assists us to effectively handle the high density of planned orbits with increasing volume of scientific data and to successfully meet opportunistic scientific goals and objectives. Our planning tool combines the instrument observation definition files provided by the PIs together with the flight dynamics products to generate the Pointing Requests and the instrument timeline (ITL). The ITL contains all the validated commands at the TC sequence level and computes the resource envelopes (data rate, power, data volume) within the constraints. At the SOC, our main goal is to maximise the science output while minimising the number of iterations among the teams, ensuring that the timeline does not violate the state transitions allowed in the Mission Operations Rules and Constraints Document.

Development of the Assessment of Burden of COPD tool: an integrated tool to measure the burden of COPD.

PubMed

Slok, Annerika H M; in 't Veen, Johannes C C M; Chavannes, Niels H; van der Molen, Thys; Rutten-van Mölken, Maureen P M H; Kerstjens, Huib A M; Salomé, Philippe L; Holverda, Sebastiaan; Dekhuijzen, P N Richard; Schuiten, Denise; Asijee, Guus M; van Schayck, Onno C P

2014-07-10

In deciding on the treatment plan for patients with chronic obstructive pulmonary disease (COPD), the burden of COPD as experienced by patients should be the core focus. It is therefore important for daily practice to develop a tool that can both assess the burden of COPD and facilitate communication with patients in clinical practice. This paper describes the development of an integrated tool to assess the burden of COPD in daily practice. A definition of the burden of COPD was formulated by a Dutch expert team. Interviews showed that patients and health-care providers agreed on this definition. We found no existing instruments that fully measured burden of disease according to this definition. However, the Clinical COPD Questionnaire meets most requirements, and was therefore used and adapted. The adapted questionnaire is called the Assessment of Burden of COPD (ABC) scale. In addition, the ABC tool was developed, of which the ABC scale is the core part. The ABC tool is a computer program with an algorithm that visualises outcomes and provides treatment advice. The next step in the development of the tool is to test the validity and effectiveness of both the ABC scale and tool in daily practice.

Development of the Assessment of Burden of COPD tool: an integrated tool to measure the burden of COPD

PubMed Central

Slok, Annerika H M; in ’t Veen, Johannes C C M; Chavannes, Niels H; van der Molen, Thys; Rutten-van Mölken, Maureen P M H; Kerstjens, Huib A M; Salomé, Philippe L; Holverda, Sebastiaan; Dekhuijzen, PN Richard; Schuiten, Denise; Asijee, Guus M; van Schayck, Onno C P

2014-01-01

In deciding on the treatment plan for patients with chronic obstructive pulmonary disease (COPD), the burden of COPD as experienced by patients should be the core focus. It is therefore important for daily practice to develop a tool that can both assess the burden of COPD and facilitate communication with patients in clinical practice. This paper describes the development of an integrated tool to assess the burden of COPD in daily practice. A definition of the burden of COPD was formulated by a Dutch expert team. Interviews showed that patients and health-care providers agreed on this definition. We found no existing instruments that fully measured burden of disease according to this definition. However, the Clinical COPD Questionnaire meets most requirements, and was therefore used and adapted. The adapted questionnaire is called the Assessment of Burden of COPD (ABC) scale. In addition, the ABC tool was developed, of which the ABC scale is the core part. The ABC tool is a computer program with an algorithm that visualises outcomes and provides treatment advice. The next step in the development of the tool is to test the validity and effectiveness of both the ABC scale and tool in daily practice. PMID:25010353

Public health literacy defined.

PubMed

Freedman, Darcy A; Bess, Kimberly D; Tucker, Holly A; Boyd, David L; Tuchman, Arleen M; Wallston, Kenneth A

2009-05-01

Public health literacy is an emerging concept necessary to understand and address the broad array of factors, such as climate change, globalization, and poverty, that influence the public's health. Whereas health literacy has traditionally been operationalized as an individual-level construct, public health literacy takes into account the complex social, ecologic, and systemic forces affecting health and well-being. However, public health literacy has not yet been fully articulated. This paper addresses this gap by outlining a broad, new definition of public health literacy. This definition was developed through an inductive analytic process conducted in 2007 by a multidisciplinary research team, and two expert-panel sessions were convened to assess the consensual validity of the emergent definition. Based on this process, public health literacy is defined as the degree to which individuals and groups can obtain, process, understand, evaluate, and act on information needed to make public health decisions that benefit the community. Three dimensions of public health literacy--conceptual foundations, critical skills, and civic orientation--and related competencies are also proposed. Public health literacy is distinct from individual-level health literacy, and together, the two types of literacy form a more comprehensive model of health literacy. A five-part agenda is offered for future research and action aimed at increasing levels of public health literacy.

Understanding frailty in the geriatric population.

PubMed

Wick, Jeannette Y

2011-09-01

Clinicians who work with the frail elderly know what frailty looks like, but until recently, they have had no science-based definition of this condition. Frailty is classified as a medical syndrome, and Fried et al. were among the first to standardize the definition of frailty as a distinct syndrome with biologic underpinnings. Their definition describes a clinical phenotype of decreased reserve and resistance to stressors, with clinical manifestations of a mutually exacerbating cycle of negative energy balance, sarcopenia, diminished strength, and exertion intolerance. Age is no longer considered a defining characteristic, although frailty is still considered primarily a geriatric problem. Approximately two-thirds of affected individuals enter frailty in a slow, progressive way, while one-third become frail cataclysmically. Weakness is a common early sign, and exhaustion and weight loss are often late manifestations. Observing early behavioral changes before frailty develops could provide insight into its development and suggest early interventions. Since frailty is clearly associated with adverse outcomes, a healthy, active lifestyle is the cornerstone of prevention, and many researchers suggest that resistance training can reverse some muscle loss and improve functioning. When the health care team proposes any change in care, including a new medication, it should be prepared to describe how the intervention may affect cognition, memory, energy, or function.

SE Requirements Development Tool User Guide

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

Benson, Faith Ann

2016-05-13

The LANL Systems Engineering Requirements Development Tool (SERDT) is a data collection tool created in InfoPath for use with the Los Alamos National Laboratory’s (LANL) SharePoint sites. Projects can fail if a clear definition of the final product requirements is not performed. For projects to be successful requirements must be defined early in the project and those requirements must be tracked during execution of the project to ensure the goals of the project are met. Therefore, the focus of this tool is requirements definition. The content of this form is based on International Council on Systems Engineering (INCOSE) and Departmentmore » of Defense (DoD) process standards and allows for single or collaborative input. The “Scoping” section is where project information is entered by the project team prior to requirements development, and includes definitions and examples to assist the user in completing the forms. The data entered will be used to define the requirements and once the form is filled out, a “Requirements List” is automatically generated and a Word document is created and saved to a SharePoint document library. SharePoint also includes the ability to download the requirements data defined in the InfoPath from into an Excel spreadsheet. This User Guide will assist you in navigating through the data entry process.« less

Results from the Science Instrument Definition Team for the Gondola for High Altitude Planetary Science Project

NASA Astrophysics Data System (ADS)

Chanover, Nancy J.; Aslam, Shahid; DiSanti, Michael A.; Hibbitts, Charles A.; Honniball, Casey I.; Paganini, Lucas; Parker, Alex; Skrutskie, Michael F.; Young, Eliot F.

2016-10-01

The Gondola for High Altitude Planetary Science (GHAPS) is an observing asset under development by NASA's Planetary Science Division that will be hosted on stratospheric balloon missions intended for use by the broad planetary science community. GHAPS is being designed in a modular fashion to interface to a suite of instruments as called for by science needs. It will operate at an altitude of 30+ km and will include an optical telescope assembly with a 1-meter aperture and a pointing stability of approximately 1 arcsecond with a flight duration of ~100 days. The spectral grasp of the system is envisaged to include wavelengths spanning the near-ultraviolet to near/mid-infrared (~0.3-5 µm) and possibly to longer wavelengths.The GHAPS Science Instrument Definition Team (SIDT) was convened in May 2016 to define the scope of science investigations, derive the science requirements and instrument concepts for GHAPS, prioritize the instruments according to science priorities that address Planetary Science Decadal Survey questions, and generate a report that is broadly disseminated to the planetary science community. The SIDT examined a wide range of solar system targets and science questions, focusing on unique measurements that could be made from a balloon-borne platform to address high-priority planetary science questions for a fraction of the cost of space missions. The resulting instrument concepts reflect unique capabilities offered by a balloon-borne platform (e.g., observations at spectral regions inaccessible from the ground due to telluric absorption, diffraction-limited imaging, and long duration uninterrupted observations of a target). We discuss example science cases that can be addressed with GHAPS and describe a notional instrument suite that can be used by guest observers to pursue decadal-level science questions.

Multiple Authorship in Scientific Manuscripts: Ethical Challenges, Ghost and Guest/Gift Authorship, and the Cultural/Disciplinary Perspective.

PubMed

Teixeira da Silva, Jaime A; Dobránszki, Judit

2016-10-01

Multiple authorship is the universal solution to multi-tasking in the sciences. Without a team, each with their own set of expertise, and each involved mostly in complementary ways, a research project will likely not advance quickly, or effectively. Consequently, there is a risk that research goals will not be met within a desired timeframe. Research teams that strictly scrutinize their modus operandi select and include a set of authors that have participated substantially in the physical undertaking of the research, in its planning, or who have contributed intellectually to the ideas or the development of the manuscript. Authorship is not an issue that is taken lightly, and save for dishonest authors, it is an issue that is decided collectively by the authors, usually in sync with codes of conduct established by their research institutes or national ministries of education. Science, technology and medicine (STM) publishers have, through independent, or sometimes coordinated efforts, also established their own sets of guidelines regarding what constitutes valid authorship. However, these are, for the greater part, merely guidelines. A previous and recent analysis of authorship definitions indicates that the definitions in place regarding authorship and its validity by many leading STM publishers is neither uniform, nor standard, despite several of them claiming to follow the guidelines as set forward by the International Committee of Medical Journal Editors or ICMJE. This disparity extends itself to ghost and guest authorship, two key authorship-related issues that are examined in this paper to assess the extent of discrepancies among the same set of STM publishers and what possible influence they might have on publishing ethics.

Drawing Boundaries: The Difficulty in Defining Clinical Reasoning.

PubMed

Young, Meredith; Thomas, Aliki; Lubarsky, Stuart; Ballard, Tiffany; Gordon, David; Gruppen, Larry D; Holmboe, Eric; Ratcliffe, Temple; Rencic, Joe; Schuwirth, Lambert; Durning, Steven J

2018-01-23

Clinical reasoning is an essential component of a health professional's practice. Yet clinical reasoning research has produced a notably fragmented body of literature. In this article, the authors describe the pause-and-reflect exercise they undertook during the execution of a synthesis of the literature on clinical reasoning in the health professions. Confronted with the challenge of establishing a shared understanding of the nature and relevant components of clinical reasoning, members of the review team paused to independently generate their own personal definitions and conceptualizations of the construct. Here, the authors describe the variability of definitions and conceptualizations of clinical reasoning present within their own team. Drawing on an analogy from mathematics, they hypothesize that the presence of differing "boundary conditions" could help explain individuals' differing conceptualizations of clinical reasoning and the fragmentation at play in the wider sphere of research on clinical reasoning. Specifically, boundary conditions refer to the practice of describing the conditions under which a given theory is expected to hold, or expected to have explanatory power. Given multiple theoretical frameworks, research methodologies, and assessment approaches contained within the clinical reasoning literature, different boundary conditions are likely at play. Open acknowledgment of different boundary conditions and explicit description of the conceptualization of clinical reasoning being adopted within a given study would improve research communication, support comprehensive approaches to teaching and assessing clinical reasoning, and perhaps encourage new collaborative partnerships among researchers who adopt different boundary conditions.Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a "work of the United States Government" for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.

Occupant Protection during Orion Crew Exploration Vehicle Landings

NASA Technical Reports Server (NTRS)

Gernhardt, Michael L.; Jones, J. A.; Granderson, B. K.; Somers, J. T.

2009-01-01

The constellation program is evaluating current vehicle design capabilities for nominal water landings and contingency land landings of the Orion Crew Exploration vehicle. The Orion Landing Strategy tiger team was formed to lead the technical effort for which associated activities include the current vehicle design, susceptibility to roll control and tip over, reviewing methods for assessing occupant injury during ascent / aborts /landings, developing an alternate seat/attenuation design solution which improves occupant protection and operability, and testing the seat/attenuation system designs to ensure valid results. The EVA physiology, systems and Performance (EPSP) project is leading the effort under the authority of the Tiger Team Steering committee to develop, verify, validate and accredit biodynamics models using a variety of crash and injury databases including NASCAR, Indy Car and military aircraft. The validated biodynamics models will be used by the Constellation program to evaluate a variety of vehicle, seat and restraint designs in the context of multiple nominal and off-nominal landing scenarios. The models will be used in conjunction with Acceptable Injury Risk definitions to provide new occupant protection requirements for the Constellation Program.

Model-Based Systems Engineering in Concurrent Engineering Centers

NASA Technical Reports Server (NTRS)

Iwata, Curtis; Infeld, Samantha; Bracken, Jennifer Medlin; McGuire; McQuirk, Christina; Kisdi, Aron; Murphy, Jonathan; Cole, Bjorn; Zarifian, Pezhman

2015-01-01

Concurrent Engineering Centers (CECs) are specialized facilities with a goal of generating and maturing engineering designs by enabling rapid design iterations. This is accomplished by co-locating a team of experts (either physically or virtually) in a room with a focused design goal and a limited timeline of a week or less. The systems engineer uses a model of the system to capture the relevant interfaces and manage the overall architecture. A single model that integrates other design information and modeling allows the entire team to visualize the concurrent activity and identify conflicts more efficiently, potentially resulting in a systems model that will continue to be used throughout the project lifecycle. Performing systems engineering using such a system model is the definition of model-based systems engineering (MBSE); therefore, CECs evolving their approach to incorporate advances in MBSE are more successful in reducing time and cost needed to meet study goals. This paper surveys space mission CECs that are in the middle of this evolution, and the authors share their experiences in order to promote discussion within the community.

The QATSDD critical appraisal tool: comments and critiques.

PubMed

Fenton, Lara; Lauckner, Heidi; Gilbert, Robert

2015-12-01

The aim of this research note is to reflect on the effectiveness of the QATSDD tool for its intended use in critical appraisals of synthesis work such as integrative reviews. A seven-member research team undertook a critical appraisal of qualitative and quantitative studies using the QATSDD. We believe that the tool can spur useful dialogue among researchers and increase in-depth understanding of reviewed papers, including the strengths and limitations of the literature. To increase the clarity of the process, we suggest further definition of the language in each indicator and inclusion of explicit examples for each criterion. We would also like to see the authors outline clear parameters around the use of the tool, essentially stating that the tool should be used in synthesis work for studies of mixed methods or work that includes qualitative and quantitative research informed by a positivist paradigm. In the context of an appropriate team composition, the tool can be a useful mechanism for guiding people who are coming together to discuss the merits of studies across multiple methodologies and disciplines. © 2015 John Wiley & Sons, Ltd.

[Monitoring a home care cohort].

PubMed

Gené Badia, Joan; Hidalgo García, Antonio; Contel Segura, Joan Carles; Borràs Santos, Alicia; Ortiz Molina, Jacinto; Martín Royo, Jaume; García Planas, Noemí; Heras Tebar, Antonio; Noguera Rodríguez, Ramon; Borrell Muñoz, Manuel; Farràs Salles, Cristina; Porta Borges, Montserrat; Oliver Olius, Anna; Rivas Zuazo, Sonia; Aranzana Martínez, Antonio; Cegri Lombardo, Francisco; Limón Ramírez, Esther; Adell Aguiló, Núria; Camprubí Casellas, Maria Dolors

2006-06-15

To evaluate home care by primary care teams for people over 65 years old with chronic conditions, in order to identify improvement opportunities. To identify patient and care variables associated with cognitive and functional impairment, nursing home admission, attendance at casualty units, hospital admission and death. Analytic study of the follow-up of a cohort for 3 years. Primary health care teams in Catalonia, Spain. One thousand three hundred patients over 65 with chronic pathologies and cared for by home care programmes in Catalonia. The following will be recorded annually: health status (Charlson, Barthel, Pfeiffer, Braden, and Gijón), data on the carer (Zarit), care received (social and health), self-perception of health (SF-12), Casualty attendance, short-term admissions and the final results, i.e. death or definitive admission to a nursing home or hospital. The statistical analyses will be based on logistic regression and a survival analysis. The study should reveal patient characteristics with prognostic value, as well as identify the social and health factors related to better survival and lower consumption of health and social resources.

Model-Based Systems Engineering in Concurrent Engineering Centers

NASA Technical Reports Server (NTRS)

Iwata, Curtis; Infeld, Samatha; Bracken, Jennifer Medlin; McGuire, Melissa; McQuirk, Christina; Kisdi, Aron; Murphy, Jonathan; Cole, Bjorn; Zarifian, Pezhman

2015-01-01

Concurrent Engineering Centers (CECs) are specialized facilities with a goal of generating and maturing engineering designs by enabling rapid design iterations. This is accomplished by co-locating a team of experts (either physically or virtually) in a room with a narrow design goal and a limited timeline of a week or less. The systems engineer uses a model of the system to capture the relevant interfaces and manage the overall architecture. A single model that integrates other design information and modeling allows the entire team to visualize the concurrent activity and identify conflicts more efficiently, potentially resulting in a systems model that will continue to be used throughout the project lifecycle. Performing systems engineering using such a system model is the definition of model-based systems engineering (MBSE); therefore, CECs evolving their approach to incorporate advances in MBSE are more successful in reducing time and cost needed to meet study goals. This paper surveys space mission CECs that are in the middle of this evolution, and the authors share their experiences in order to promote discussion within the community.

Outsourcing strategy and tendering methodology for the operation and maintenance of CERN’s cryogenic facilities

NASA Astrophysics Data System (ADS)

Serio, L.; Bremer, J.; Claudet, S.; Delikaris, D.; Ferlin, G.; Ferrand, F.; Pezzetti, M.; Pirotte, O.

2017-12-01

CERN operates and maintains the world largest cryogenic infrastructure ranging from ageing but well maintained installations feeding detectors, test facilities and general services, to the state-of-the-art cryogenic system serving the flagship LHC machine complex. A study was conducted and a methodology proposed to outsource to industry the operation and maintenance of the whole cryogenic infrastructure. The cryogenic installations coupled to non LHC-detectors, test facilities and general services infrastructure have been fully outsourced for operation and maintenance on the basis of performance obligations. The contractor is responsible for the operational performance of the installations based on a yearly operation schedule provided by CERN. The maintenance of the cryogenic system serving the LHC machine and its detectors has been outsourced on the basis of tasks oriented obligations, monitored by key performance indicators. CERN operation team, with the support of the contractor operation team, remains responsible for the operational strategy and performances. We report the analysis, strategy, definition of the requirements and technical specifications as well as the achieved technical and economic performances after one year of operation.

Report of the Joint Scientific Mission Definition Team for an infrared astronomical satellite

NASA Technical Reports Server (NTRS)

1976-01-01

The joint effort is reported of scientists and engineers from the Netherlands, the United Kingdom, and the United States working as a team for the purpose of exploring the possibility of a cooperative venture. The proposed mission builds upon experience gained from the successful Astronomical Netherlands Satellite (ANS). This satellite will be in a polar orbit at an altitude of 900 km. It will carry an 0.6 m diameter telescope cooled with helium to a temperature near 10K. An array of approximately 100 detectors will be used to measure the infrared flux in four wavelength bands centered at 10, 20, 50, and 100 microns. Sources will be located on the sky with positional accuracy of 1/2 arcminute. The instrument should be able to investigate the structure of extended sources with angular scales up to 1.0 deg. The entire sky will be surveyed and the full lifetime of the mission of about one year will be necessary to complete the survey. Special observational programs will also be incorporated into the mission.

An International Approach to Enhancing a National Guideline on Driving and Dementia.

PubMed

Rapoport, Mark J; Chee, Justin N; Carr, David B; Molnar, Frank; Naglie, Gary; Dow, Jamie; Marottoli, Richard; Mitchell, Sara; Tant, Mark; Herrmann, Nathan; Lanctôt, Krista L; Taylor, John-Paul; Donaghy, Paul C; Classen, Sherrilene; O'Neill, Desmond

2018-03-12

The purpose of this study was to update a national guideline on assessing drivers with dementia, addressing limitations of previous versions which included a lack of developmental rigor and stakeholder involvement. An international multidisciplinary team reviewed 104 different recommendations from 12 previous guidelines on assessing drivers with dementia in light of a recent review of the literature. Revised guideline recommendations were drafted by consensus. A preliminary draft was sent to specialist physician and occupational therapy groups for feedback, using an a priori definition of 90% agreement as consensus. The research team drafted 23 guideline recommendations, and responses were received from 145 stakeholders. No recommendation was endorsed by less than 80% of respondents, and 14 (61%) of the recommendations were endorsed by more than 90%.The recommendations are presented in the manuscript. The revised guideline incorporates the perspectives of consensus of an expert group as well as front-line clinicians who regularly assess drivers with dementia. The majority of the recommendations were based on evidence at the level of expert opinion, revealing gaps in the evidence and future directions for research.

What is the Final Verification of Engineering Requirements?

NASA Technical Reports Server (NTRS)

Poole, Eric

2010-01-01

This slide presentation reviews the process of development through the final verification of engineering requirements. The definition of the requirements is driven by basic needs, and should be reviewed by both the supplier and the customer. All involved need to agree upon a formal requirements including changes to the original requirements document. After the requirements have ben developed, the engineering team begins to design the system. The final design is reviewed by other organizations. The final operational system must satisfy the original requirements, though many verifications should be performed during the process. The verification methods that are used are test, inspection, analysis and demonstration. The plan for verification should be created once the system requirements are documented. The plan should include assurances that every requirement is formally verified, that the methods and the responsible organizations are specified, and that the plan is reviewed by all parties. The options of having the engineering team involved in all phases of the development as opposed to having some other organization continue the process once the design has been complete is discussed.

Salvaging catastrophe in transcatheter aortic valve implantation: rehearsal, preassigned roles, and emergency preparedness.

PubMed

Tam, Derrick Y; Jones, Philip M; Kiaii, Bob; Diamantouros, Pantelis; Teefy, Patrick; Bainbridge, Daniel; Cleland, Andrew; Fernandes, Philip; Chu, Michael W A

2015-08-01

Emergency rescue plans for acute complications during transcatheter aortic valve implantation (TAVI) commonly include cardiopulmonary resuscitation, femoro-femoral cardiopulmonary bypass (CPB), and hemodynamic stabilization before definitive intervention is achieved. Nevertheless, most cases of emergency resuscitation remain chaotic and disorganized and often take longer than necessary, even in experienced centres. We sought to determine which factors and procedures may be associated with improved patient outcomes when emergencies arise during TAVI. MEDLINE(®) and EMBASE™ were searched with the following key words: "TAVI" or "TAVR" or "transcatheter valve implantation" or "transcatheter valve replacement" and "emergency cardiac surgery" or "conversion". Two hundred seventeen articles met the criteria and were reviewed. Utilization of a formal emergency checklist by a multidisciplinary TAVI team may reduce procedural errors, smooth the transition to CPB, and ultimately speed the delivery of corrective measures including emergency cardiac surgery. A well-organized regularly-rehearsed emergency rescue plan that preassigns resuscitative roles may shorten the duration of patient instability and resuscitation and improve patient outcomes when catastrophe occurs in TAVI. The anesthesia team plays a central role in preventing, detecting, and treating intraprocedural complications during TAVI.

[An assessment of the Family Health Program in municipalities of Northeast Brazil: old and new challenges].

PubMed

Rocha, Paulo de Medeiros; Uchoa, Alice da Costa; Rocha, Nadja de Sá Pinto Dantas; Souza, Elizabethe Cristina Fagundes de; Rocha, Marconi de Lima; Pinheiro, Themis Xavier de Albuquerque

2008-01-01

This article presents part of the results from the Baseline Studies, an evaluative research conducted in 21 municipalities with more than 100,000 inhabitants each, in three States of Northeast Brazil. The overall objective was to assess experiences in the implementation of the Family Health Program (FHP), with a focus on inductions in the PROESF. An implementation analysis was performed, using the case study method. The analysis focused on these dimensions: political-institutional, health organization, and comprehensive care. Outstanding advances included: prioritize the FHP in high-risk areas; institutional learning, with qualification of managers and teams; definition of institutional levels for regulating the FHP; and health team-user bonds and positive perceptions concerning the program. Challenges included: strengthening of local policy and decision-making capacity; allocation of primary care resources; greater employment security for human resources; effective implementation of the health care network; strengthening of social participation; upgrading of monitoring and evaluation for decision-making; receptivity; waiting lines for tests, appointments, and hospital admissions; implementation of teamwork; health promotion and inter-sector activities.

CisLunar Habitat Internal Architecture Design Criteria

NASA Technical Reports Server (NTRS)

Jones, R.; Kennedy, K.; Howard, R.; Whitmore, M.; Martin, C.; Garate, J.

2017-01-01

BACKGROUND: In preparation for human exploration to Mars, there is a need to define the development and test program that will validate deep space operations and systems. In that context, a Proving Grounds CisLunar habitat spacecraft is being defined as the next step towards this goal. This spacecraft will operate differently from the ISS or other spacecraft in human history. The performance envelope of this spacecraft (mass, volume, power, specifications, etc.) is being defined by the Future Capabilities Study Team. This team has recognized the need for a human-centered approach for the internal architecture of this spacecraft and has commissioned a CisLunar Phase-1 Habitat Internal Architecture Study Team to develop a NASA reference configuration, providing the Agency with a "smart buyer" approach for future acquisition. THE CISLUNAR HABITAT INTERNAL ARCHITECTURE STUDY: Overall, the CisLunar Habitat Internal Architecture study will address the most significant questions and risks in the current CisLunar architecture, habitation, and operations concept development. This effort is achieved through definition of design criteria, evaluation criteria and process, design of the CisLunar Habitat Phase-1 internal architecture, and the development and fabrication of internal architecture concepts combined with rigorous and methodical Human-in-the-Loop (HITL) evaluations and testing of the conceptual innovations in a controlled test environment. The vision of the CisLunar Habitat Internal Architecture Study is to design, build, and test a CisLunar Phase-1 Habitat Internal Architecture that will be used for habitation (e.g. habitability and human factors) evaluations. The evaluations will mature CisLunar habitat evaluation tools, guidelines, and standards, and will interface with other projects such as the Advanced Exploration Systems (AES) Program integrated Power, Avionics, Software (iPAS), and Logistics for integrated human-in-the-loop testing. The mission of the CisLunar Habitat Internal Architecture Study is to become a forcing function to establish a common understanding of CisLunar Phase-1 Habitation Internal Architecture design criteria, processes, and tools. The scope of the CisLunar Habitat Internal Architecture study is to design, develop, demonstrate, and evaluate a Phase-1 CisLunar Habitat common module internal architecture based on design criteria agreed to by NASA, the International Partners, and Commercial Exploration teams. This task is to define the CisLunar Phase-1 Internal Architecture Government Reference Design, assist NASA in becoming a "smart buyer" for Phase-1 Habitat Concepts, and ultimately to derive standards and requirements from the Internal Architecture Design Process. The first step was to define a Habitat Internal Architecture Design Criteria and create a structured philosophy to be used by design teams as a filter by which critical aspects of consideration would be identified for the purpose of organizing and utilizing interior spaces. With design criteria in place, the team will develop a series of iterative internal architecture concept designs which will be assessed by means of an evaluation criteria and process. These assessments will successively drive and refine the design, leading to the combination and down-selection of design concepts. A single refined reference design configuration will be developed into in a medium-to-high fidelity mockup. A multi-day human-in-the-loop mission test will fully evaluate the reference design and validate its configuration. Lessons learned from the design and evaluation will enable the team to identify appropriate standards for Phase-1 CisLunar Habitat Internal Architecture and will enable NASA to develop derived requirements in support of maturing CisLunar Habitation capabilities. This paper will describe the criteria definition process, workshop event, and resulting CisLunar Phase-1 Habitat Internal Architecture Design Criteria.

Specialized stroke rehabilitation services in seven countries: Preliminary results from nine rehabilitation centers.

PubMed

Langhammer, Birgitta; Becker, Frank; Sunnerhagen, Katharina S; Zhang, Tong; Du, Xiaoxia; Bushnik, Tamara; Panchenko, Maria; Keren, Ofer; Banura, Samir; Elessi, Khamis; Luzon, Fuad; Lundgren-Nilsson, Åsa; Li, Xie; Sällström, Susanne; Stanghelle, Johan Kvalvik

2015-12-01

There is a lack of defined levels of rehabilitation, indicating possibly random content and access to specialized services. The aim of the study was to perform a multinational descriptive study of specialized rehabilitation in persons with stroke, to elucidate what the different centers define as prerequisites for specialized rehabilitation, and to analyze whether these descriptions map to currently applied standards or constructs of specialized rehabilitation. A secondary aim was to look for similarities and differences between therapies and services for persons with stroke in the sub-acute stage in the different institutions. Descriptive data of the collaborating centers regarding structure and processes of services were recorded and compared with the British Society of Rehabilitation Medicine and Specialized Services National Definitions sets. Comparisons of the definitions showed that all centers admitted severely disabled persons with stroke, in need of complex rehabilitation, and provided high levels of physical services, with specialized equipment and facilities. However, funding, size, university affiliation, quality accreditation, staffing levels, specialist training, cognitive and vocational services, coordination of the professional teams, admission procedures, time and type of therapies, estimated length of stay, and follow-up procedures differed between the centers. This multinational study of specialized stroke rehabilitation centers shows that a universal definition of specialized rehabilitation is possible, even in quite different countries and settings, in terms of general principles. There were however differences in structures and procedures, which may influence patients' outcomes, indicating a need for refinement of the definitions to be globally applicable. © 2015 World Stroke Organization.

Resolving the Milky Way and Nearby Galaxies with WFIRST

NASA Astrophysics Data System (ADS)

Kalirai, Jasonjot

High-resolution studies of nearby stellar populations have served as a foundation for our quest to understand the nature of galaxies. Today, studies of resolved stellar populations constrain fundamental relations -- such as the initial mass function of stars, the time scales of stellar evolution, the timing of mass loss and amount of energetic feedback, the color-magnitude relation and its dependency on age and metallicity, the stellar-dark matter connection in galaxy halos, and the build up of stellar populations over cosmic time -- that represent key ingredients in our prescription to interpret light from the Universe and to measure the physical state of galaxies. More than in any other area of astrophysics, WFIRST will yield a transformative impact in measuring and characterizing resolved stellar populations in the Milky Way and nearby galaxies. The proximity and level of detail that such populations need to be studied at directly map to all three pillars of WFIRST capabilities - sensitivity from a 2.4 meter space based telescope, resolution from 0.1" pixels, and large 0.3 degree field of view from multiple detectors. Our WFIRST GO Science Investigation Team (F) will develop three WFIRST (notional) GO programs related to resolved stellar populations to fully stress WFIRST's Wide Field Instrument. The programs will include a Survey of the Milky Way, a Survey of Nearby Galaxy Halos, and a Survey of Star-Forming Galaxies. Specific science goals for each program will be validated through a wide range of observational data sets, simulations, and new algorithms. As an output of this study, our team will deliver optimized strategies and tools to maximize stellar population science with WFIRST. This will include: new grids of IR-optimized stellar evolution and synthetic spectroscopic models; pipelines and algorithms for optimal data reduction at the WFIRST sensitivity and pixel scale; wide field simulations of MW environments and galaxy halos; cosmological simulations of nearby galaxy halos matched to WFIRST observations; strategies and automated algorithms to find substructure and dwarf galaxies in WFIRST IR data sets; and documentation. Our team will work closely with the WFIRST Science Center to translate our notional programs into inputs that can help achieve readiness for WFIRST science operations. This includes building full observing programs with target definitions, observing sequences, scheduling constraints, data processing needs, and calibration requirements. Our team has been chosen carefully. Team members are leading scientists in stellar population work that will be a core science theme for WFIRST and are also involved in all large future astronomy projects that will operate in the WFIRST era. The team is intentionally small, and each member will "own" significant science projects. The team will aggressively advocate for WFIRST through innovative initiatives. The team is also diverse in geographical location, observers and theorists, and gender.

Ethical issues in family violence research in healthcare settings.

PubMed

Paavilainen, Eija; Lepistö, Sari; Flinck, Aune

2014-02-01

Research ethics is always important. However, it is especially crucial with sensitive research topics such as family violence. The aim of this article is to describe and discuss some crucial issues regarding intimate partner violence and child maltreatment, based on the authors' own research experiences. We focus on and discuss examples concerning the definition of family violence, research design, ethical approval, participant recruitment and safety and data collection and processing. During the research process, the significance of teamwork is emphasized. Support provided by the participants to each other and support given by experienced researchers within the team is very important for high ethical standards.

Research Issues in Image Registration for Remote Sensing

NASA Technical Reports Server (NTRS)

Eastman, Roger D.; LeMoigne, Jacqueline; Netanyahu, Nathan S.

2007-01-01

Image registration is an important element in data processing for remote sensing with many applications and a wide range of solutions. Despite considerable investigation the field has not settled on a definitive solution for most applications and a number of questions remain open. This article looks at selected research issues by surveying the experience of operational satellite teams, application-specific requirements for Earth science, and our experiments in the evaluation of image registration algorithms with emphasis on the comparison of algorithms for subpixel accuracy. We conclude that remote sensing applications put particular demands on image registration algorithms to take into account domain-specific knowledge of geometric transformations and image content.

Management of a CFD organization in support of space hardware development

NASA Technical Reports Server (NTRS)

Schutzenhofer, L. A.; Mcconnaughey, P. K.; Mcconnaughey, H. V.; Wang, T. S.

1991-01-01

The management strategy of NASA-Marshall's CFD branch in support of space hardware development and code validation implements various elements of total quality management. The strategy encompasses (1) a teaming strategy which focuses on the most pertinent problem, (2) quick-turnaround analysis, (3) the evaluation of retrofittable design options through sensitivity analysis, and (4) coordination between the chief engineer and the hardware contractors. Advanced-technology concepts are being addressed via the definition of technology-development projects whose products are transferable to hardware programs and the integration of research activities with industry, government agencies, and universities, on the basis of the 'consortium' concept.

Launch system development in the Pacific Rim

NASA Technical Reports Server (NTRS)

Stone, Barbara A.; Page, John R.

1993-01-01

Several Western Pacific Rim nations are beginning to challenge the domination of the United States, Europe, and the former Soviet Union in the international market for commercial launch sevices. This paper examines the current development of launch systems in China, Japan, and Australia. China began commercial launch services with their Long March-3 in April 1990, and is making enhancements to vehicles in this family. Japan is developing the H-2 rocket which will be marketed on a commercial basis. In Australia, British Aerospace Ltd. is leading a team conducting a project definition study for an Australian Launch Vehicle, aimed at launching the new generation of satellites into low Earth orbit.

PLAYERS' PERCEPTIONS OF HOME ADVANTAGE IN THE AUSTRALIAN RUGBY LEAGUE COMPETITION.

PubMed

Mcguckin, Teneale A; Sinclair, Wade H; Sealey, Rebecca M; Bowman, Paul W

2015-12-01

This study was designed to pilot a survey to explore players' perception of home advantage in a rugby league. Twenty-seven players from one team with an identified home advantage believed a home advantage existed as a result of their home crowd (52%), family and friends' support (41%), normal travel (45%) and sleeping arrangements (37%), home weather conditions (48%), and familiarity with playing amenities (37%). However, the players were less definite about influences while playing away from home. The current sample of players identified differing influences, highlighting individual variations in perceived determinants. Individual interviews or focus groups will be required for further exploration.

A view of software management issues

NASA Technical Reports Server (NTRS)

Manley, J. H.

1985-01-01

The Software Development Environment (SDE) Panel addressed key programmatic, scope, and structural issues raised by its members and the general audience regarding the proposed software development environment for the Space Station program. The general team approach taken by this group led to a consensus on 18 recommendations to NASA mangament regarding the acquisition and definition of the SDE. This approach was keyed by the initial issues presentation given to the general audience. Additional issues (for a total of 23) were developed by the panelists in their first closed session from which key areas were selected and discussed in open session. These discussions led to key recommendations which are summarized and described.

Brief Communication: On the rapid and efficient monitoring results dissemination in landslide emergency scenarios: the Mont de La Saxe case study

NASA Astrophysics Data System (ADS)

Giordan, D.; Manconi, A.; Allasia, P.; Bertolo, D.

2015-09-01

Straightforward communication of monitoring results is of major importance in emergency scenarios relevant to large slope instabilities. Here we describe the communication strategy developed for the Mont de La Saxe rockslide threatening La Palud and Entrèves hamlets in the Courmayeur municipality (Aosta Valley, Italy). Starting from the definition of actions and needs of the landslide management team, including scientists, technicians, civil protection operators, decision makers, and politicians, we show that sharing and disseminating ad hoc information simplifies the understanding of the landslide evolution, as well as the correct communication of the level of criticality.

Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team

NASA Technical Reports Server (NTRS)

Landon, Lauren Blackwell; Vessey, William B.; Barrett, Jamie D.

2015-01-01

A team is defined as: "two or more individuals who interact socially and adaptively, have shared or common goals, and hold meaningful task interdependences; it is hierarchically structured and has a limited life span; in it expertise and roles are distributed; and it is embedded within an organization/environmental context that influences and is influenced by ongoing processes and performance outcomes" (Salas, Stagl, Burke, & Goodwin, 2007, p. 189). From the NASA perspective, a team is commonly understood to be a collection of individuals that is assigned to support and achieve a particular mission. Thus, depending on context, this definition can encompass both the spaceflight crew and the individuals and teams in the larger multi-team system who are assigned to support that crew during a mission. The Team Risk outcomes of interest are predominantly performance related, with a secondary emphasis on long-term health; this is somewhat unique in the NASA HRP in that most Risk areas are medically related and primarily focused on long-term health consequences. In many operational environments (e.g., aviation), performance is assessed as the avoidance of errors. However, the research on performance errors is ambiguous. It implies that actions may be dichotomized into "correct" or "incorrect" responses, where incorrect responses or errors are always undesirable. Researchers have argued that this dichotomy is a harmful oversimplification, and it would be more productive to focus on the variability of human performance and how organizations can manage that variability (Hollnagel, Woods, & Leveson, 2006) (Category III1). Two problems occur when focusing on performance errors: 1) the errors are infrequent and, therefore, difficult to observe and record; and 2) the errors do not directly correspond to failure. Research reveals that humans are fairly adept at correcting or compensating for performance errors before such errors result in recognizable or recordable failures. Astronauts are notably adept high performers. Most failures are recorded only when multiple, small errors occur and humans are unable to recognize and correct or compensate for these errors in time to prevent a failure (Dismukes, Berman, Loukopoulos, 2007) (Category III). More commonly, observers record variability in levels of performance. Some teams commit no observable errors but fail to achieve performance objectives or perform only adequately, while other teams commit some errors but perform spectacularly. Successful performance, therefore, cannot be viewed as simply the absence of errors or the avoidance of failure Johnson Space Center (JSC) Joint Leadership Team, 2008). While failure is commonly attributed to making a major error, focusing solely on the elimination of error(s) does not significantly reduce the risk of failure. Failure may also occur when performance is simply insufficient or an effort is incapable of adjusting sufficiently to a contextual change (e.g., changing levels of autonomy).

Evolution of Mobil`s methods to evaluate exploration and producing opportunities

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

Gaynor, C.B.; Cook, D.M. Jr.

1996-08-01

Over the past decade, Mobil has changed significantly in size, structure and focus to improve profitability. Concurrently, work processes and methodologies have been modified to improve resource utilization and opportunity selection. The key imperative has been recognition of the full range of hydrocarbon volume uncertainty, its risk and value. Exploration has focussed on increasing success through improved geotechnical estimates and demonstrating value addition. For Producing, the important tasks: (1) A centralized Exploration and Producing team was formed to help ensure an integrated, consistent worldwide approach to prospect and field assessments. Monte Carlo simulation was instituted to recognize probability-weighted ranges ofmore » possible outcomes for prospects and fields, and hydrocarbon volume category definitions were standardized. (2) Exploration instituted a global Prospect Inventory, tracking wildcat predictions vs. results. Performance analyses led to initiatives to improve the quality and consistency of assessments. Process improvement efforts included the use of multidisciplinary teams and peer reviews. Continued overestimates of hydrocarbon volumes prompted methodology changes such as the use of {open_quotes}reality checks{close_quotes} and log-normal distributions. The communication of value predictions and additions became paramount. (3) Producing now recognizes the need for Exploration`s commercial discoveries and new Producing ventures, notwithstanding the associated risk. Multi-disciplinary teams of engineers and geoscientists work on post-discovery assessments to optimize field development and maximize the value of opportunities. Mobil now integrates volume and risk assessment with correlative future capital investment programs to make proactive strategic choices to maximize shareholder value.« less

Team clinician variability in return-to-play decisions.

PubMed

Shultz, Rebecca; Bido, Jennifer; Shrier, Ian; Meeuwisse, Willem H; Garza, Daniel; Matheson, Gordon O

2013-11-01

To describe the variability in the return-to-play (RTP) decisions of experienced team clinicians and to assess their clinical opinion as to the relevance of 19 factors described in a RTP decision-making model. Survey questionnaire. Advanced Team Physician Course. Sixty-seven of 101 sports medicine clinicians completed the questionnaire. Results were analyzed using descriptive statistics. For categorical variables, we report percentage and frequency. For continuous variables, we report mean (SD) if data were approximately normally distributed and frequencies for clinically relevant categories for skewed data. The average number of years of clinical sports medicine experience was 13.6 (9.8). Of the 62 clinicians who responded fully, 35% (n = 22) would "clear" (vs "not clear") an athlete to participate in sport even if the risk of an acute reinjury or long-term sequelae is increased. When respondents were given 6 different RTP options rather than binary choices, there were increased discrepancies across some injury risk scenarios. For example, 8.1% to 16.1% of respondents who chose to clear an athlete when presented with binary choices, later chose to "not clear" an athlete when given 6 graded RTP options. The respondents often considered factors of potential importance to athletes as nonimportant to the RTP decision process if risk of reinjury was unaffected (range, n = 4 [10%] to n = 19 [45%]). There is a high degree of variability in how different clinicians weight the different factors related to RTP decision making. More precise definitions decrease but do not eliminate this variability.

Radioisotope Power Systems Reference Book for Mission Designers and Planners

NASA Technical Reports Server (NTRS)

Lee, Young; Bairstow, Brian

2015-01-01

The RPS Program's Program Planning and Assessment (PPA) Office commissioned the Mission Analysis team to develop the Radioisotope Power Systems (RPS) Reference Book for Mission Planners and Designers to define a baseline of RPS technology capabilities with specific emphasis on performance parameters and technology readiness. The main objective of this book is to provide RPS technology information that could be utilized by future mission concept studies and concurrent engineering practices. A progress summary from the major branches of RPS technology research provides mission analysis teams with a vital tool for assessing the RPS trade space, and provides concurrent engineering centers with a consistent set of guidelines for RPS performance characteristics. This book will be iterated when substantial new information becomes available to ensure continued relevance, serving as one of the cornerstone products of the RPS PPA Office. This book updates the original 2011 internal document, using data from the relevant publicly released RPS technology references and consultations with RPS technologists. Each performance parameter and RPS product subsection has been reviewed and cleared by at least one subject matter representative. A virtual workshop was held to reach consensus on the scope and contents of the book, and the definitions and assumptions that should be used. The subject matter experts then reviewed and updated the appropriate sections of the book. The RPS Mission Analysis Team then performed further updates and crosschecked the book for consistency. Finally, a second virtual workshop was held to ensure all subject matter experts and stakeholders concurred on the contents.

Scientific Investigation of the Jovian System: the Jupiter System Observer Mission Concept

NASA Astrophysics Data System (ADS)

Spilker, Thomas R.; Senske, D. A.; Prockter, L.; Kwok, J. H.; Tan-Wang, G. H.; SDT, JSO

2007-10-01

NASA's Science Mission Directorate (SMD), in efforts to start an outer solar system flagship mission in the near future, commissioned studies of mission concepts for four high-priority outer solar system destinations: Europa, the Jovian system, Titan, and Enceladus. Our team has identified and evaluated science and mission architectures to investigate major elements of the Jovian system: Jupiter, the Galilean moons, rings, and magnetosphere, and their interactions. SMD dubbed the mission concept the "Jupiter System Observer (JSO)." At abstract submission this JPL-led study is nearly complete, with final report submission in August 2007. SMD intends to select a subset of these four concepts for additional detailed study, leading to a potential flagship mission new start. A rich set of science objectives that JSO can address quite well have been identified. The highly capable science payload (including 50-cm optic), an extensive tour with multiple close flybys of Io, Europa, Ganymede and Callisto, and a significant time in orbit at Ganymede, addresses a large set of Solar System Exploration Decadal Survey (2003) and NASA Solar System Exploration Roadmap (2006) high-priority objectives. With the engineering team, the Science Definition Team evaluated a suite of mission architectures and the science they enable to arrive at two architectures that provide the best science for their estimated mission costs. This paper discusses the science objectives and operational capabilities and considerations for these mission concepts. This work was performed at JPL, APL, and other institutions under contract to NASA.

Model-driven approach to data collection and reporting for quality improvement

PubMed Central

Curcin, Vasa; Woodcock, Thomas; Poots, Alan J.; Majeed, Azeem; Bell, Derek

2014-01-01

Continuous data collection and analysis have been shown essential to achieving improvement in healthcare. However, the data required for local improvement initiatives are often not readily available from hospital Electronic Health Record (EHR) systems or not routinely collected. Furthermore, improvement teams are often restricted in time and funding thus requiring inexpensive and rapid tools to support their work. Hence, the informatics challenge in healthcare local improvement initiatives consists of providing a mechanism for rapid modelling of the local domain by non-informatics experts, including performance metric definitions, and grounded in established improvement techniques. We investigate the feasibility of a model-driven software approach to address this challenge, whereby an improvement model designed by a team is used to automatically generate required electronic data collection instruments and reporting tools. To that goal, we have designed a generic Improvement Data Model (IDM) to capture the data items and quality measures relevant to the project, and constructed Web Improvement Support in Healthcare (WISH), a prototype tool that takes user-generated IDM models and creates a data schema, data collection web interfaces, and a set of live reports, based on Statistical Process Control (SPC) for use by improvement teams. The software has been successfully used in over 50 improvement projects, with more than 700 users. We present in detail the experiences of one of those initiatives, Chronic Obstructive Pulmonary Disease project in Northwest London hospitals. The specific challenges of improvement in healthcare are analysed and the benefits and limitations of the approach are discussed. PMID:24874182

Quality of working life indicators in Canadian health care organizations: a tool for healthy, health care workplaces?

PubMed

Cole, Donald C; Robson, Lynda S; Lemieux-Charles, Louise; McGuire, Wendy; Sicotte, Claude; Champagne, Francois

2005-01-01

Quality-of-work-life (QWL) includes broad aspects of the work environment that affect employee learning and health. Canadian health care organizations (HCOs) are being encouraged to monitor QWL, expanding existing occupational health surveillance capacities. To investigate the understanding, collection, diffusion and use of QWL indicators in Canadian HCOs. We obtained cooperation from six diverse public HCOs managing 41 sites. We reviewed documentation relevant to QWL and conducted 58 focus groups/team interviews with strategic, support and programme teams. Group interviews were taped, reviewed and analysed for themes using qualitative data techniques. Indicators were classified by purpose and HCO level. QWL indicators, as such, were relatively new to most HCOs yet the data managed by human resource and occupational health and safety support teams were highly relevant to monitoring of employee well-being (119 of 209 mentioned indicators), e.g. sickness absence. Monitoring of working conditions (62/209) was also important, e.g. indicators of employee workload. Uncommon were indicators of biomechanical and psychosocial hazards at work, despite their being important causes of morbidity among HCO employees. Although imprecision in the definition of QWL indicators, limited links with other HCO performance measures and inadequate HCO resources for implementation were common, most HCOs cited ways in which QWL indicators had influenced planning and evaluation of prevention efforts. Increase in targeted HCO resources, inclusion of other QWL indicators and greater integration with HCO management systems could all improve HCO decision-makers' access to information relevant to employee health.

Surface Habitat Systems

NASA Technical Reports Server (NTRS)

Kennedy, Kriss J.

2009-01-01

The Surface Habitat Systems (SHS) Focused Investment Group (FIG) is part of the National Aeronautics and Space Administration (NASA) Johnson Space Center (JSC) effort to provide a focused direction and funding to the various projects that are working on human surface habitat designs and technologies for the planetary exploration missions. The overall SHS-FIG effort focuses on directing and guiding those projects that: 1) develop and demonstrate new surface habitat system concepts, innovations, and technologies to support human exploration missions, 2) improve environmental systems that interact with human habitats, 3) handle and emplace human surface habitats, and 4) focus on supporting humans living and working in habitats on planetary surfaces. The activity areas of the SHS FIG described herein are focused on the surface habitat project near-term objectives as described in this document. The SHS-FIG effort focuses on mitigating surface habitat risks (as identified by the Lunar Surface Systems Project Office (LSSPO) Surface Habitat Element Team; and concentrates on developing surface habitat technologies as identified in the FY08 gap analysis. The surface habitat gap assessment will be updated annually as the surface architecture and surface habitat definition continues to mature. These technologies are mapped to the SHS-FIG Strategic Development Roadmap. The Roadmap will bring to light the areas where additional innovative efforts are needed to support the development of habitat concepts and designs and the development of new technologies to support of the LSSPO Habitation Element development plan. Three specific areas of development that address Lunar Architecture Team (LAT)-2 and Constellation Architecture Team (CxAT) Lunar habitat design issues or risks will be focused on by the SHS-FIG. The SHS-FIG will establish four areas of development that will help the projects prepare in their planning for surface habitat systems development. Those development areas are the 1) surface habitat concept definition, 2) inflatable surface habitat development, and 3) autonomous habitat operations, and 4) cross-cutting / systems engineering. In subsequent years, the SHS-FIG will solicit a call for innovations and technologies that will support the development of these four development areas. The other development areas will be assessed yearly and identified on the SHS-FIG s Strategic Development Roadmap. Initial investment projects that are funded by the Constellation Program Office (CxPO), LSSPO, or the Exploration Technology Development Projects (ETDP) will also be included on the Roadmap. For example, in one or two years from now, the autonomous habitat operations and testbed would collaborations with the Integrated Systems Health Management (ISHM) and Automation for Operations ETDP projects, which will give the surface habitat projects an integrated habitat autonomy testbed to test software and systems. The SHS-FIG scope is to provide focused direction for multiple innovations, technologies and subsystems that are needed to support humans at a remote planetary surface habitat during the concept development, design definition, and integration phases of that project. Subsystems include: habitability, lightweight structures, power management, communications, autonomy, deployment, outfitting, life support, wireless connectivity, lighting, thermal and more.

Dealing with the archetypes development process for a regional EHR system.

PubMed

Santos, M R; Bax, M P; Kalra, D

2012-01-01

This paper aims to present the archetype modelling process used for the Health Department of Minas Gerais State, Brazil (SES/MG), to support building its regional EHR system, and the lessons learned during this process. This study was undertaken within the Minas Gerais project. The EHR system architecture was built assuming the reference model from the ISO 13606 norm. The whole archetype development process took about ten months, coordinated by a clinical team co-ordinated by three health professionals and one systems analyst from the SES/MG. They were supported by around 30 health professionals from the internal SES/MG areas, and 5 systems analysts from the PRODEMGE. Based on a bottom-up approach, the project team used technical interviews and brainstorming sessions to conduct the modelling process. The main steps of the archetype modelling process were identified and described, and 20 archetypes were created. -The set of principles established during the selection of PCS elements helped the clinical team to keep the focus in their objectives;-The initial focus on the archetype structural organization aspects was important;-The data elements identified were subjected to a rigorous analysis aimed at determining the most suitable clinical domain;-Levelling the concepts to accommodate them within the hierarchical levels in the reference model was definitely no easy task, and the use of a mind mapping tool facilitated the modelling process;-Part of the difficulty experienced by the clinical team was related to a view focused on the original forms previously used;-The use of worksheets facilitated the modelling process by health professionals;-It was important to have a health professional that knew about the domain tables and health classifications from the Brazilian Federal Government as member in the clinical team. The archetypes (referencing terminology, domain tables and term lists) provided a favorable condition for the use of a controlled vocabulary between the central repository and the EMR systems and, probably, will increase the chances of preserving the semantics from the knowledge domain. Finally, the reference model from the ISO 13606 norm, along with the archetypes, proved sufficient to meet the specificities for the creation of an EHR system for basic healthcare in a Brazilian state.

Exploration Blueprint: Data Book

NASA Technical Reports Server (NTRS)

Drake, Bret G. (Editor)

2007-01-01

The material contained in this report was compiled to capture the work performed by the National Aeronautics and Space Administration's (NASA's) Exploration study team in the late 2002 timeframe. The "Exploration Blueprint Data Book" documents the analyses and findings of the 90-day Agency-wide study conducted from September - November 2002. During the summer of 2002, the NASA Deputy Administrator requested that a study be performed with the following objectives: (1) Develop the rationale for exploration beyond low-Earth orbit (2) Develop roadmaps for how to accomplish the first steps through humans to Mars (3) Develop design reference missions as a basis for the roadmaps 4) Make recommendations on what can be done now to effect this future This planning team, termed the Exploration Blueprint, performed architecture analyses to develop roadmaps for how to accomplish the first steps beyond LEO through the human exploration of Mars. The previous NASA Exploration Team activities laid the foundation and framework for development of NASA's Integrated Space Plan. The reference missions resulting from the analysis performed by the Exploration Blueprint team formed the basis for requirement definition, systems development, technology roadmapping, and risk assessments for future human exploration beyond low-Earth orbit. Emphasis was placed on developing recommendations on what could be done now to effect future exploration activities. The Exploration Blueprint team embraced the "Stepping Stone" approach to exploration where human and robotic activities are conducted through progressive expansion outward beyond low-Earth orbit. Results from this study produced a long-term strategy for exploration with near-term implementation plans, program recommendations, and technology investments. Specific results included the development of a common exploration crew vehicle concept, a unified space nuclear strategy, focused bioastronautics research objectives, and an integrated human and robotic exploration strategy. Recommendations from the Exploration Blueprint included the endorsement of the Nuclear Systems Initiative, augmentation of the bioastronautics research, a focused space transportation program including heavy-lift launch and a common exploration vehicle design for ISS and exploration missions, as well as an integrated human and robotic exploration strategy for Mars.

Exploration Blueprint: Data Book

NASA Astrophysics Data System (ADS)

Drake, Bret G.

2007-02-01

The material contained in this report was compiled to capture the work performed by the National Aeronautics and Space Administration's (NASA's) Exploration study team in the late 2002 timeframe. The "Exploration Blueprint Data Book" documents the analyses and findings of the 90-day Agency-wide study conducted from September - November 2002. During the summer of 2002, the NASA Deputy Administrator requested that a study be performed with the following objectives: (1) Develop the rationale for exploration beyond low-Earth orbit (2) Develop roadmaps for how to accomplish the first steps through humans to Mars (3) Develop design reference missions as a basis for the roadmaps 4) Make recommendations on what can be done now to effect this future This planning team, termed the Exploration Blueprint, performed architecture analyses to develop roadmaps for how to accomplish the first steps beyond LEO through the human exploration of Mars. The previous NASA Exploration Team activities laid the foundation and framework for development of NASA's Integrated Space Plan. The reference missions resulting from the analysis performed by the Exploration Blueprint team formed the basis for requirement definition, systems development, technology roadmapping, and risk assessments for future human exploration beyond low-Earth orbit. Emphasis was placed on developing recommendations on what could be done now to effect future exploration activities. The Exploration Blueprint team embraced the "Stepping Stone" approach to exploration where human and robotic activities are conducted through progressive expansion outward beyond low-Earth orbit. Results from this study produced a long-term strategy for exploration with near-term implementation plans, program recommendations, and technology investments. Specific results included the development of a common exploration crew vehicle concept, a unified space nuclear strategy, focused bioastronautics research objectives, and an integrated human and robotic exploration strategy. Recommendations from the Exploration Blueprint included the endorsement of the Nuclear Systems Initiative, augmentation of the bioastronautics research, a focused space transportation program including heavy-lift launch and a common exploration vehicle design for ISS and exploration missions, as well as an integrated human and robotic exploration strategy for Mars.

Engineering within the assembly, verification, and integration (AIV) process in ALMA

NASA Astrophysics Data System (ADS)

Lopez, Bernhard; McMullin, Joseph P.; Whyborn, Nicholas D.; Duvall, Eugene

2010-07-01

The Atacama Large Millimeter/submillimeter Array (ALMA) is a joint project between astronomical organizations in Europe, North America, and East Asia, in collaboration with the Republic of Chile. ALMA will consist of at least 54 twelve-meter antennas and 12 seven-meter antennas operating as an interferometer in the millimeter and sub-millimeter wavelength range. It will be located at an altitude above 5000m in the Chilean Atacama desert. As part of the ALMA construction phase the Assembly, Verification and Integration (AIV) team receives antennas and instrumentation from Integrated Product Teams (IPTs), verifies that the sub-systems perform as expected, performs the assembly and integration of the scientific instrumentation and verifies that functional and performance requirements are met. This paper aims to describe those aspects related to the AIV Engineering team, its role within the 4-station AIV process, the different phases the group underwent, lessons learned and potential space for improvement. AIV Engineering initially focused on the preparation of the necessary site infrastructure for AIV activities, on the purchase of tools and equipment and on the first ALMA system installations. With the first antennas arriving on site the team started to gather experience with AIV Station 1 beacon holography measurements for the assessment of the overall antenna surface quality, and with optical pointing to confirm the antenna pointing and tracking capabilities. With the arrival of the first receiver AIV Station 2 was developed which focuses on the installation of electrical and cryogenic systems and incrementally establishes the full connectivity of the antenna as an observing platform. Further antenna deliveries then allowed to refine the related procedures, develop staff expertise and to transition towards a more routine production process. Stations 3 and 4 deal with verification of the antenna with integrated electronics by the AIV Science Team and is not covered directly in this paper. It is believed that both continuous improvement and the clear definition of the AIV 4-station model were key factors in achieving the goal of bringing the antennas into a state that is well enough characterized in order to smoothly start commissioning activities.

An evolutionary concept analysis of futility in health care.

PubMed

Morata, Lauren

2018-06-01

To report a concept analysis of futility in health care. Each member of the healthcare team: the physician, the nurse, the patient, the family and all others involved perceive futility differently. The current evidence and knowledge in regard to futility in health care manifest a plethora of definitions, meanings and interpretations without consensus. Concept analysis. Databases searched included Medline, Cumulative Index of Nursing and Allied Health Literature, Academic Search Premier, Cochrane Database of Systematic Reviews and PsycINFO. Search terms included "futil*," "concept analysis," "concept," "inefficacious," "non-beneficial," "ineffective" and "fruitless" from 1935-2016 to ensure a historical perspective of the concept. A total of 106 articles were retained to develop the concept. Rogers' evolutionary concept analysis was used to evaluate the concept of futility from ancient medicine to the present. Seven antecedents (the patient/family autonomy, surrogate decision-making movement, the patient-family/physician relationship, physician authority, legislation and court rulings, catastrophic events and advancing medical technology) lead to four major attributes (quantitative, physiologic, qualitative, and disease-specific). Ultimately, futile care could lead to consequences such as litigation, advancing technology, increasing healthcare costs, rationing, moral distress and ethical dilemmas. Futility in health care demonstrates components of a cyclical process and a consensus definition is proposed. A framework is developed to clarify the concept and articulate relationships among attributes, antecedents and consequences. Further testing of the proposed definition and framework are needed. © 2018 John Wiley & Sons Ltd.

Ethics of Liver Transplantation: The Role of the Anesthesiologist.

PubMed

West, James M

2018-06-01

Anesthesiologists have clearly established their place in the history of medical ethics. Our involvement goes back to 1966 when Henri Beecher published his landmark paper on research and informed consent. Participation in the ethics of transplantation is no less important than our previous work. Organ transplant has been life saving for many but also has given rise to many misunderstandings not just from the public but also among our own colleagues. These include methods of allocation and donation, the role that affluence may play in receiving an organ, the definition of death and donation after circulatory death. As perioperative physicians and important members of the transplant team, anesthesiologists are expected to participate in all aspects of care including ethical judgments. This article discusses some of the issues that seem to cause the most confusion and angst for those of us involved in both liver transplantation and in the procurement of organs. It will discuss the definition of death, donation after circulatory death, the anesthesiologists' role on the selection committee, living donor liver transplantation, and transplantation of patients with alcohol-related liver disease.

Refeeding syndrome: problems with definition and management.

PubMed

Crook, Martin A

2014-01-01

Refeeding syndrome (RFS) broadly encompasses a severe electrolyte disturbance (principally low serum concentrations of intracellular ions such as phosphate, magnesium, and potassium) and metabolic abnormalities in undernourished patients undergoing refeeding whether orally, enterally, or parenterally. RFS reflects the change from catabolic to anabolic metabolism. RFS sometimes is undiagnosed and unfortunately some clinicians remain oblivious to its presence. This is particularly concerning as RFS is a life-threatening condition, although it need not be so and early recognition reduces morbidity and mortality. Careful patient monitoring and multidiscipline nutrition team management may help to achieve this goal. The diagnosis of RFS is not facilitated by the fact that there is no universal agreement as to its definition. The presence of hypophosphatemia alone does not necessarily mean that RFS is present as there are many other causes for this, as discussed later in this article. RFS is increasingly being recognized in neonates and children. An optimal refeeding regimen for RFS is not universally agreed on due to the paucity of randomized controlled trials in the field. Copyright © 2014 Elsevier Inc. All rights reserved.

Improving The Near-Earth Meteoroid And Orbital Debris Environment Definition With LAD-C

NASA Technical Reports Server (NTRS)

Liou, J.-C.; Giovane, F. J.; Corsaro, R. C.; Burchell, M. J.; Drolshagen, G.; Kawai, H.; Tabata, M.; Stansbery, E. G.; Westphal, A. J.; Yano, H.

2006-01-01

To improve the near-Earth meteoroid and orbital debris environment definition, a large area particle sensor/collector is being developed to be placed on the International Space Station (ISS). This instrument, the Large Area Debris Collector (LAD-C), will attempt to record meteoroid and orbital debris impact flux, and capture the same particles with aerogel. After at least one year of deployment, the whole system will be brought back for additional laboratory analysis of the captured meteoroids and orbital debris. This project is led by the U.S. Naval Research Laboratory (NRL) while the U.S. Department of Defense (DoD) Space Test Program (STP) is responsible for the integration, deployment, and retrieval of the system. Additional contributing team members of the consortium include the NASA Orbital Debris Program Office, JAXA Institute of Space and Astronautical Science (ISAS), Chiba University (Japan), ESA Space Debris Office, University of Kent (UK), and University of California at Berkeley. The deployment of LAD-C on the ISS is planned for 2008, with the system retrieval in late 2009.

The concept and definition of therapeutic inertia in hypertension in primary care: a qualitative systematic review.

PubMed

Lebeau, Jean-Pierre; Cadwallader, Jean-Sébastien; Aubin-Auger, Isabelle; Mercier, Alain; Pasquet, Thomas; Rusch, Emmanuel; Hendrickx, Kristin; Vermeire, Etienne

2014-07-02

Therapeutic inertia has been defined as the failure of health-care provider to initiate or intensify therapy when therapeutic goals are not reached. It is regarded as a major cause of uncontrolled hypertension. The exploration of its causes and the interventions to reduce it are plagued by unclear conceptualizations and hypothesized mechanisms. We therefore systematically searched the literature for definitions and discussions on the concept of therapeutic inertia in hypertension in primary care, to try and form an operational definition. A systematic review of all types of publications related to clinical inertia in hypertension was performed. Medline, EMbase, PsycInfo, the Cochrane library and databases, BDSP, CRD and NGC were searched from the start of their databases to June 2013. Articles were selected independently by two authors on the basis of their conceptual content, without other eligibility criteria or formal quality appraisal. Qualitative data were extracted independently by two teams of authors. Data were analyzed using a constant comparative qualitative method. The final selection included 89 articles. 112 codes were grouped in 4 categories: terms and definitions (semantics), "who" (physician, patient or system), "how and why" (mechanisms and reasons), and "appropriateness". Regarding each of these categories, a number of contradictory assertions were found, most of them relying on little or no empirical data. Overall, the limits of what should be considered as inertia were not clear. A number of authors insisted that what was considered deleterious inertia might in fact be appropriate care, depending on the situation. Our data analysis revealed a major lack of conceptualization of therapeutic inertia in hypertension and important discrepancies regarding its possible causes, mechanisms and outcomes. The concept should be split in two parts: appropriate inaction and inappropriate inertia. The development of consensual and operational definitions relying on empirical data and the exploration of the intimate mechanisms that underlie these behaviors are now needed.

The concept and definition of therapeutic inertia in hypertension in primary care: a qualitative systematic review

PubMed Central

2014-01-01

Background Therapeutic inertia has been defined as the failure of health-care provider to initiate or intensify therapy when therapeutic goals are not reached. It is regarded as a major cause of uncontrolled hypertension. The exploration of its causes and the interventions to reduce it are plagued by unclear conceptualizations and hypothesized mechanisms. We therefore systematically searched the literature for definitions and discussions on the concept of therapeutic inertia in hypertension in primary care, to try and form an operational definition. Methods A systematic review of all types of publications related to clinical inertia in hypertension was performed. Medline, EMbase, PsycInfo, the Cochrane library and databases, BDSP, CRD and NGC were searched from the start of their databases to June 2013. Articles were selected independently by two authors on the basis of their conceptual content, without other eligibility criteria or formal quality appraisal. Qualitative data were extracted independently by two teams of authors. Data were analyzed using a constant comparative qualitative method. Results The final selection included 89 articles. 112 codes were grouped in 4 categories: terms and definitions (semantics), “who” (physician, patient or system), “how and why” (mechanisms and reasons), and “appropriateness”. Regarding each of these categories, a number of contradictory assertions were found, most of them relying on little or no empirical data. Overall, the limits of what should be considered as inertia were not clear. A number of authors insisted that what was considered deleterious inertia might in fact be appropriate care, depending on the situation. Conclusions Our data analysis revealed a major lack of conceptualization of therapeutic inertia in hypertension and important discrepancies regarding its possible causes, mechanisms and outcomes. The concept should be split in two parts: appropriate inaction and inappropriate inertia. The development of consensual and operational definitions relying on empirical data and the exploration of the intimate mechanisms that underlie these behaviors are now needed. PMID:24989986

The importance of the command-physician in trauma resuscitation.

PubMed

Hoff, W S; Reilly, P M; Rotondo, M F; DiGiacomo, J C; Schwab, C W

1997-11-01

Definitive trauma team leadership, although difficult to measure, has been shown to improve trauma resuscitation performance. The purpose of this study was to evaluate the effect of an identified command-physician on resuscitation performance. In addition, the leadership capability of four physician combinations functioning as command-physician was studied. Retrospective review. Videotapes of trauma resuscitations performed at a Level I trauma center over a 25-month period were reviewed. The presence of an identified command-physician was determined by multidisciplinary consensus. Resuscitation performance was measured by compliance with three objective criteria: primary survey, secondary survey, and definitive plan; and two subjective criteria: orderliness, and adherence to Advanced Trauma Life Support protocol. Performance was then analyzed (1) as a function of the presence or absence of a command-physician, and (2) between four identified physician combinations: AF (attending surgeon + trauma fellow); F (trauma fellow); ASR (attending surgeon + senior surgical resident); SR (senior surgical resident). Chi square and the Mann-Whitney U tests were applied. A total of 425 trauma resuscitations were reviewed. A command-physician was identified (CP[Pos]) in 365 resuscitations (85.7%); no command-physician was identified (CP[NEG]) in 60 (14.3%). Compliance with completion of secondary survey (81.4%) and formulation of a definitive plan (89.6%) was significantly higher in the CP(POS) group. Subjective scores for orderliness and adherence to Advanced Trauma Life Support protocol were significantly higher in the CP(POS) group. In the CP(POS) resuscitations, formulation of a definitive plan was lower in SR when compared with the other three physician combinations. An identified command-physician enhances trauma resuscitation performance. Completion of the primary and secondary survey is not affected by the physician combination. Prompt formulation of a definitive plan is facilitated by the active involvement of an attending traumatologist or a properly mentored trauma fellow.

Global Interoperability of High Definition Video Streams Via ACTS and Intelsat

NASA Technical Reports Server (NTRS)

Hsu, Eddie; Wang, Charles; Bergman, Larry; Pearman, James; Bhasin, Kul; Clark, Gilbert; Shopbell, Patrick; Gill, Mike; Tatsumi, Haruyuki; Kadowaki, Naoto

2000-01-01

In 1993, a proposal at the Japan.-U.S. Cooperation in Space Program Workshop lead to a subsequent series of satellite communications experiments and demonstrations, under the title of Trans-Pacific High Data Rate Satellite Communications Experiments. The first of which is a joint collaboration between government and industry teams in the United States and Japan that successfully demonstrated distributed high definition video (HDV) post-production on a global scale using a combination of high data rate satellites and terrestrial fiber optic asynchronous transfer mode (ATM) networks. The HDV experiment is the first GIBN experiment to establish a dual-hop broadband satellite link for the transmission of digital HDV over ATM. This paper describes the team's effort in using the NASA Advanced Communications Technology Satellite (ACTS) at rates up to OC-3 (155 Mbps) between Los Angeles and Honolulu, and using Intelsat at rates up to DS-3 (45 Mbps) between Kapolei and Tokyo, with which HDV source material was transmitted between Sony Pictures High Definition Center (SPHDC) in Los Angeles and Sony Visual Communication Center (VCC) in Shinagawa, Tokyo. The global-scale connection also used terrestrial networks in Japan, the States of Hawaii and California. The 1.2 Gbps digital HDV stream was compressed down to 22.5 Mbps using a proprietary Mitsubishi MPEG-2 codec that was ATM AAL-5 compatible. The codec: employed four-way parallel processing. Improved versions of the codec are now commercially available. The successful post-production activity performed in Tokyo with a HDV clip transmitted from Los Angeles was predicated on the seamless interoperation of all the equipment between the sites, and was an exciting example in deploying a global-scale information infrastructure involving a combination of broadband satellites and terrestrial fiber optic networks. Correlation of atmospheric effects with cell loss, codec drop-out, and picture quality were made. Current efforts in the Trans-Pacific series plan to examine the use of Internet Protocol (IP)-related technologies over such an infrastructure. The use of IP allows the general public to be an integral part of the exciting activities, helps to examine issues in constructing the solar-system internet, and affords an opportunity to tap the research results from the (reliable) multicast and distributed systems communities. The current Trans- Pacific projects, including remote astronomy and digital library (visible human) are briefly described.

Developing a Consensus-based Definition of "Kokoro-no Care" or Mental Health Services and Psychosocial Support: Drawing from Experiences of Mental Health Professionals Who Responded to the Great East Japan Earthquake.

PubMed

Suzuki, Yuriko; Fukasawa, Maiko; Nakajima, Satomi; Narisawa, Tomomi; Keiko, Asano; Kim, Yoshiharu

2015-01-29

In this survey, we aimed to build consensus and gather opinions on 'Kokoro-no care' or mental health services and psychosocial support (MHSPSS) after a disaster, among mental health professionals who engaged in care after the Great East Japan Earthquake. We recruited mental health professionals who engaged in support activities after the Great East Japan Earthquake, which included local health professionals in the affected areas and members of mental health care teams dispatched from outside (n = 131). Adopting the Delphi process, we proposed a definition of 'Kokoro-no care', and asked the participants to rate the appropriateness on a 5-point Likert scale. We also solicited free comments based on the participants' experiences during the disaster. After Round 1, we presented the summary statistics and comments, and asked the participants to re-rate the definition that had been modified based on their comments. This process was repeated twice, until the consensus criterion of ≥ 80% of the participants scoring ≥ 4 on the statement was fulfilled. In Round 1, 68.7% of the respondents rated the proposed definition ≥ 4 for its appropriateness, and 88.4% did so in Round 2. The comments were grouped into categories (and subcategories) based on those related to the definition in general (Appropriate, Continuum of MHSPSS, Cautions in operation, Alternative categorisation of care components, Whether the care component should be categorised according to the professional involved, Ambiguous use of psychology, and Others), to mental health services (Appropriate, More specification within mental health services, More explicit remarks on mental health services, and Others), and to psychosocial support (Whether the care component should be categorised according to the professional involved, Raising concerns about the terms, and Others), and others. We achieved a consensus on the definition of 'Kokoro-no care', and systematically obtained suggestions on the concept, and practical advice on operation, based on the participants' experiences from the Great East Japan Earthquake. This collective knowledge will serve as reference to prepare and respond to future disasters.

The prevalence of Achilles and patellar tendon injuries in Australian football players beyond a time-loss definition.

PubMed

Docking, S I; Rio, E; Cook, J; Orchard, J W; Fortington, L V

2018-03-23

Little is known about the prevalence and associated of morbidity of tendon problems. With only severe cases of tendon problems missing games, players that have their training and performance impacted are not captured by traditional injury surveillance. The aim of this study was to report the prevalence of Achilles and patellar tendon problems in elite male Australian football players using the Oslo Sports Trauma Research Centre (OSTRC) overuse questionnaire, compared to a time-loss definition. Male athletes from 12 professional Australian football teams were invited to complete a monthly questionnaire over a 9-month period in the 2016 pre- and competitive season. The OSTRC overuse injury questionnaire was used to measure the prevalence and severity of Achilles and patellar tendon symptoms and was compared to traditional match-loss statistics. A total of 441 participants were included. Of all participants, 21.5% (95% CI: 17.9-25.6) and 25.2% (95% CI 21.3-29.4) reported Achilles or patellar tendon problems during the season, respectively. Based on the traditional match-loss definition, a combined 4.1% of participants missed games due to either Achilles or patellar tendon injury. A greater average monthly prevalence was observed during the pre-season compared to the competitive season. Achilles and patellar tendon problems are prevalent in elite male Australian football players. These injuries are not adequately captured using a traditional match-loss definition. Prevention of these injuries may be best targeted during the off- and pre-season due to higher prevalence of symptoms during the pre-season compared to during the competitive season. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Using implementation tools to design and conduct quality improvement projects for faster and more effective improvement.

PubMed

Ovretveit, John; Mittman, Brian; Rubenstein, Lisa; Ganz, David A

2017-10-09

Purpose The purpose of this paper is to enable improvers to use recent knowledge from implementation science to carry out improvement changes more effectively. It also highlights the importance of converting research findings into practical tools and guidance for improvers so as to make research easier to apply in practice. Design/methodology/approach This study provides an illustration of how a quality improvement (QI) team project can make use of recent findings from implementation research so as to make their improvement changes more effective and sustainable. The guidance is based on a review and synthesis of improvement and implementation methods. Findings The paper illustrates how research can help a quality project team in the phases of problem definition and preparation, in design and planning, in implementation, and in sustaining and spreading a QI. Examples of the use of different ideas and methods are cited where they exist. Research limitations/implications The example is illustrative and there is little limited experimental evidence of whether using all the steps and tools in the one approach proposed do enable a quality team to be more effective. Evidence supporting individual guidance proposals is cited where it exists. Practical implications If the steps proposed and illustrated in the paper were followed, it is possible that quality projects could avoid waste by ensuring the conditions they need for success are in place, and sustain and spread improvement changes more effectively. Social implications More patients could benefit more quickly from more effective implementation of proven interventions. Originality/value The paper is the first to describe how improvement and implementation science can be combined in a tangible way that practical improvers can use in their projects. It shows how QI project teams can take advantage of recent advances in improvement and implementation science to make their work more effective and sustainable.

Early humans' egalitarian politics: runaway synergistic competition under an adapted veil of ignorance.

PubMed

Harvey, Marc

2014-09-01

This paper proposes a model of human uniqueness based on an unusual distinction between two contrasted kinds of political competition and political status: (1) antagonistic competition, in quest of dominance (antagonistic status), a zero-sum, self-limiting game whose stake--who takes what, when, how--summarizes a classical definition of politics (Lasswell 1936), and (2) synergistic competition, in quest of merit (synergistic status), a positive-sum, self-reinforcing game whose stake becomes "who brings what to a team's common good." In this view, Rawls's (1971) famous virtual "veil of ignorance" mainly conceals politics' antagonistic stakes so as to devise the principles of a just, egalitarian society, yet without providing any means to enforce these ideals (Sen 2009). Instead, this paper proposes that human uniqueness flourished under a real "adapted veil of ignorance" concealing the steady inflation of synergistic politics which resulted from early humans' sturdy egalitarianism. This proposition divides into four parts: (1) early humans first stumbled on a purely cultural means to enforce a unique kind of within-team antagonistic equality--dyadic balanced deterrence thanks to handheld weapons (Chapais 2008); (2) this cultural innovation is thus closely tied to humans' darkest side, but it also launched the cumulative evolution of humans' brightest qualities--egalitarian team synergy and solidarity, together with the associated synergistic intelligence, culture, and communications; (3) runaway synergistic competition for differential merit among antagonistically equal obligate teammates is the single politically selective mechanism behind the cumulative evolution of all these brighter qualities, but numerous factors to be clarified here conceal this mighty evolutionary driver; (4) this veil of ignorance persists today, which explains why humans' unique prosocial capacities are still not clearly understood by science. The purpose of this paper is to start lifting this now-ill-adapted veil of ignorance, thus uncovering the tight functional relations between egalitarian team solidarity and the evolution of human uniqueness.

PS3-11: Beyond General Equivalency Mappings (GEMs): Understanding the Implications of ICD 10 in Research

PubMed Central

Riordan, Rick

2013-01-01

Background/Aims With the implementation of ICD 10 CM and ICD 10 PCS less than two years away, there are still unanswered questions as to how research teams will effectively translate or use ICD 10 codes in research. Approximately 84% of the ICD 10 codes have only approximate matches with 10% having multiple matches and only 5% have exact one-to-one matches between ICD 9 and ICD 10. With the number of codes increasing five-fold, this offers additional opportunities and risks when pulling data. Methods Besides looking at the General Equivalency Mappings and other tools that are used to translate ICD 9 codes to ICD 10 codes, we will examine some common research areas where only approximate matches between ICD 9 and ICD 10 exist. We will also discuss how the finer level of detail that ICD 10 gives allows research teams to pinpoint exactly what type of asthma, Crohn’s disease, and diabetic retinopathy they wish to study without including some of the other cases that do not meet their research criteria. Results There are significant ambiguities and irregularity in several common areas such as diabetes, mental health, asthma, and gastroenterology due to approximate, multiple, or combination matches. Even in the case of exact matches such as an old myocardial infarction where there is an exact match, the definition of when a myocardial infarction becomes “old” is different. Conclusions ICD 10 offers a finer level of detail and a higher level of specificity, thereby allowing research teams to be more targeted when pulling data. On the other hand, research teams need to exercise caution when using GEMs and other tools to translate ICD 9 codes into ICD 10 codes and vice versa, especially if they are looking at data that overlaps the implementation date of October 1, 2014.

Structural Definition and Mass Estimation of Lunar Surface Habitats for the Lunar Architecture Team Phase 2 (LAT-2) Study

NASA Technical Reports Server (NTRS)

Dorsey, John T.; Wu, K, Chauncey; Smith, Russell W.

2008-01-01

The Lunar Architecture Team Phase 2 study defined and assessed architecture options for a Lunar Outpost at the Moon's South Pole. The Habitation Focus Element Team was responsible for developing concepts for all of the Habitats and pressurized logistics modules particular to each of the architectures, and defined the shapes, volumes and internal layouts considering human factors, surface operations and safety requirements, as well as Lander mass and volume constraints. The Structures Subsystem Team developed structural concepts, sizing estimates and mass estimates for the primary Habitat structure. In these studies, the primary structure was decomposed into a more detailed list of components to be sized to gain greater insight into concept mass contributors. Structural mass estimates were developed that captured the effect of major design parameters such as internal pressure load. Analytical and empirical equations were developed for each structural component identified. Over 20 different hard-shell, hybrid expandable and inflatable soft-shell Habitat and pressurized logistics module concepts were sized and compared to assess structural performance and efficiency during the study. Habitats were developed in three categories; Mini Habs that are removed from the Lander and placed on the Lunar surface, Monolithic habitats that remain on the Lander, and Habitats that are part of the Mobile Lander system. Each category of Habitat resulted in structural concepts with advantages and disadvantages. The same modular shell components could be used for the Mini Hab concept, maximizing commonality and minimizing development costs. Larger Habitats had higher volumetric mass efficiency and floor area than smaller Habitats (whose mass was dominated by fixed items such as domes and frames). Hybrid and pure expandable Habitat structures were very mass-efficient, but the structures technology is less mature, and the ability to efficiently package and deploy internal subsystems remains an open issue.

Interprofessional collaboration in the ICU: how to define?

PubMed

Rose, Louise

2011-01-01

The intensive care unit (ICU) is a dynamic, complex and, at times, highly stressful work environment that involves ongoing exposure to the complexities of interprofessional team functioning. Failures of communication, considered examples of poor collaboration among health care professionals, are the leading cause of inadvertent harm across all health care settings. Evidence suggests effective interprofessional collaboration results in improved outcomes for critically ill patients. One recent study demonstrated a link between low standardized mortality ratios and self-identified levels of collaboration. The aim of this paper is to discuss determinants and complexities of interprofessional collaboration, the evidence supporting its impact on outcomes in the ICU, and interventions designed to foster better interprofessional team functioning. Elements of effective interprofessional collaboration include shared goals and partnerships including explicit, complementary and interdependent roles; mutual respect; and power sharing. In the ICU setting, teams continually alter due to large staff numbers, shift work and staff rotations through the institution. Therefore, the ideal 'unified' team working together to provide better care and improve patient outcomes may be difficult to sustain. Power sharing is one of the most complex aspects of interprofessional collaboration. Ownership of specialized knowledge, technical skills, clinical territory, or even the patient, may produce interprofessional conflict when ownership is not acknowledged. Collaboration by definition implies interdependency as opposed to autonomy. Yet, much nursing literature focuses on achievement of autonomy in clinical decision-making, cited to improve job satisfaction, retention and patient outcomes. Autonomy of health care professionals may be an inappropriate goal when striving to foster interprofessional collaboration. Tools such as checklists, guidelines and protocols are advocated, by some, as ways for nurses to gain influence and autonomy in clinical decision-making. Protocols to guide ICU practices such as sedation and weaning reduce the duration of mechanical ventilation in some studies, while others have failed to demonstrate this advantage. Existing organizational strategies that facilitate effective collaboration between health care professionals may contribute to this lack of effect.

The Impact of System Factors on Quality and Safety in Arterial Surgery: A Systematic Review.

PubMed

Lear, R; Godfrey, A D; Riga, C; Norton, C; Vincent, C; Bicknell, C D

2017-07-01

A systems approach to patient safety proposes that a wide range of factors contribute to surgical outcome, yet the impact of team, work environment, and organisational factors, is not fully understood in arterial surgery. The aim of this systematic review is to summarize and discuss what is already known about the impact of system factors on quality and safety in arterial surgery. A systematic review of original research papers in English using MEDLINE, Embase, PsycINFO, and Cochrane databases, was performed according to PRISMA guidelines. Independent reviewers selected papers according to strict inclusion and exclusion criteria, and using predefined data fields, extracted relevant data on team, work environment, and organisational factors, and measures of quality and/or safety, in arterial procedures. Twelve papers met the selection criteria. Study endpoints were not consistent between papers, and most failed to report their clinical significance. A variety of tools were used to measure team skills in five papers; only one paper measured the relationship between team factors and patient outcomes. Two papers reported that equipment failures were common and had a significant impact on operating room efficiency. The influence of hospital characteristics on failure-to-rescue rates was tested in one large study, although their conclusions were limited to the American Medicare population. Five papers implemented changes in the patient pathway, but most studies failed to account for potential confounding variables. A small number of heterogenous studies have evaluated the relationship between system factors and quality or safety in arterial surgery. There is some evidence of an association between system factors and patient outcomes, but there is more work to be done to fully understand this relationship. Future research would benefit from consistency in definitions, the use of validated assessment tools, measurement of clinically relevant endpoints, and adherence to national reporting guidelines. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

A Remote Lab for Experiments with a Team of Mobile Robots

PubMed Central

Casini, Marco; Garulli, Andrea; Giannitrapani, Antonio; Vicino, Antonio

2014-01-01

In this paper, a remote lab for experimenting with a team of mobile robots is presented. Robots are built with the LEGO Mindstorms technology and user-defined control laws can be directly coded in the Matlab programming language and validated on the real system. The lab is versatile enough to be used for both teaching and research purposes. Students can easily go through a number of predefined mobile robotics experiences without having to worry about robot hardware or low-level programming languages. More advanced experiments can also be carried out by uploading custom controllers. The capability to have full control of the vehicles, together with the possibility to define arbitrarily complex environments through the definition of virtual obstacles, makes the proposed facility well suited to quickly test and compare different control laws in a real-world scenario. Moreover, the user can simulate the presence of different types of exteroceptive sensors on board of the robots or a specific communication architecture among the agents, so that decentralized control strategies and motion coordination algorithms can be easily implemented and tested. A number of possible applications and real experiments are presented in order to illustrate the main features of the proposed mobile robotics remote lab. PMID:25192316

A remote lab for experiments with a team of mobile robots.

PubMed

Casini, Marco; Garulli, Andrea; Giannitrapani, Antonio; Vicino, Antonio

2014-09-04

In this paper, a remote lab for experimenting with a team of mobile robots is presented. Robots are built with the LEGO Mindstorms technology and user-defined control laws can be directly coded in the Matlab programming language and validated on the real system. The lab is versatile enough to be used for both teaching and research purposes. Students can easily go through a number of predefined mobile robotics experiences without having to worry about robot hardware or low-level programming languages. More advanced experiments can also be carried out by uploading custom controllers. The capability to have full control of the vehicles, together with the possibility to define arbitrarily complex environments through the definition of virtual obstacles, makes the proposed facility well suited to quickly test and compare different control laws in a real-world scenario. Moreover, the user can simulate the presence of different types of exteroceptive sensors on board of the robots or a specific communication architecture among the agents, so that decentralized control strategies and motion coordination algorithms can be easily implemented and tested. A number of possible applications and real experiments are presented in order to illustrate the main features of the proposed mobile robotics remote lab.

Gaining the Competitive Edge: Design for Manufacturing

NASA Technical Reports Server (NTRS)

Batill, Stephen M.; Pinkelman, Jim; Sellar, Richard

1993-01-01

The successful design of a commercial aircraft which is intended to be in direct competition with existing aircraft requires a market analysis to establish design requirements, the development of a concept to achieve those goals. and the ability to economically manufacture the aircraft. It is often the case that an engineer designs system components with only the perspective of a particular discipline. The relationship of that component to the entire system is often a minor consideration. In an effort to highlight the interaction that is necessary during the design process, the students were organized into design/build teams and required to integrate aspects of market analysis, engineering design, production and economics into their concepts. In order to facilitate this process a hypothetical "Aeroworld" was established. Having been furnished relevant demographic and economic data for "Aeroworld". students were given the task of designing and building an aircraft for a specific market while achieving an economically competitive design. Involvement of the team in the evolution of the design from market definition to technical development to manufacturing allowed the students to identify critical issues in the design process and to encounter many of the conflicting requirements which arise in an aerospace systems design.

Integrating International Engineering Organizations For Successful ISS Operations

NASA Technical Reports Server (NTRS)

Blome, Elizabeth; Duggan, Matt; Patten, L.; Pieterek, Hhtrud

2006-01-01

The International Space Station (ISS) is a multinational orbiting space laboratory that is built in cooperation with 16 nations. The design and sustaining engineering expertise is spread worldwide. As the number of Partners with orbiting elements on the ISS grows, the challenge NASA is facing as the ISS integrator is to ensure that engineering expertise and data are accessible in a timely fashion to ensure ongoing operations and mission success. Integrating international engineering teams requires definition and agreement on common processes and responsibilities, joint training and the emergence of a unique engineering team culture. ISS engineers face daunting logistical and political challenges regarding data sharing requirements. To assure systematic information sharing and anomaly resolution of integrated anomalies, the ISS Partners are developing multi-lateral engineering interface procedures. Data sharing and individual responsibility are key aspects of this plan. This paper describes several examples of successful multilateral anomaly resolution. These successes were used to form the framework of the Partner to Partner engineering interface procedures, and this paper describes those currently documented multilateral engineering processes. Furthermore, it addresses the challenges experienced to date, and the forward work expected in establishing a successful working relationship with Partners as their hardware is launched.

Trends in blood culture contamination: a College of American Pathologists Q-Tracks study of 356 institutions.

PubMed

Bekeris, Leonas G; Tworek, Joseph A; Walsh, Molly K; Valenstein, Paul N

2005-10-01

Blood culture contamination extends hospital stays and increases the cost of care. To measure blood culture contamination rates in a large number of institutions over time and to elucidate practice patterns and demographic factors associated with sustained reduction in contamination rates. Longitudinal cohort study of 356 clinical laboratories that provided quarterly data about blood culture results, using a uniform definition of contamination. Mixed linear model analysis of the 1999 through 2003 data set. Blood culture contamination was significantly higher in institutions that used nonlaboratory personnel to collect blood (P = .03) and significantly lower in facilities that used a dedicated phlebotomy team (P < .001). Higher volume of blood collection was significantly associated with lower contamination rates (P < .001). Continued participation in the Q-Tracks monitoring program was associated with significant and progressive reduction in contamination rates. By the fifth year of participation, the median institution had reduced its blood culture contamination rate by 0.67% (P < .001). Institutions that use decentralized patient-centered personnel rather than dedicated phlebotomy teams to collect blood cultures experience significantly higher contamination rates. Long-term monitoring of contamination is associated with sustained improvement in performance.

Staff nurse clinical leadership: a concept analysis.

PubMed

Chávez, Eduardo C; Yoder, Linda H

2015-01-01

The purpose of this article is to provide a concept analysis of staff nurse clinical leadership (SNCL). A clear delineation of SNCL will promote understanding and encourage communication of the phenomenon. Clarification of the concept will establish a common understanding of the concept, and advance the practice, education, and research of this phenomenon. A review of the literature was conducted using several databases. The databases were searched using the following keywords: clinical leadership, nursing, bedside, staff nurse, front-line, front line, and leadership. The search yielded several sources; however, only those that focused on clinical leadership demonstrated by staff nurses in acute care hospital settings were selected for review. SNCL is defined as staff nurses who exert significant influence over other individuals in the healthcare team, and although no formal authority has been vested in them facilitates individual and collective efforts to accomplish shared clinical objectives. The theoretical definition for SNCL within the team context will provide a common understanding of this concept and differentiate it from other types of leadership in the nursing profession. This clarification and conceptualization of the concept will assist further research of the concept and advance its practical application in acute care hospital settings. © 2014 Wiley Periodicals, Inc.

Multidisciplinary full-mouth rehabilitation with soft tissue regeneration in the esthetic zone.

PubMed

Liebermann, Anja; Frei, Stefan; Pinheiro Dias Engler, Madalena Lucia; Zuhr, Otto; Prandtner, Otto; Edelhoff, Daniel; Saeidi Pour, Reza

2018-01-01

Oral rehabilitation often requires a multidisciplinary approach including restorative dentistry, prosthodontics, and periodontology to fulfill high esthetic and functional demands, frequently combined with changes in the vertical dimension. The presence of gingival recessions can be associated with numerous factors, such as brushing or preparation trauma and persistent inflammation of the gingiva due to inadequate marginal fit of restorations. Because gingival recessions can cause major esthetic and functional problems, obtaining stability of the gingival tissue around prosthetic restorations is of essential concern. Modifications of the occlusal vertical dimension require sufficient experience of the whole dental team. Especially in patients with functional problems and craniomandibular dysfunction, a newly defined occlusal position should be adequately tested and possibly adjusted. This case report presents a complete prosthetic rehabilitation combined with a periodontal surgical approach for a patient with gingival recessions and functional/esthetic related problems. The vertical dimension was carefully defined through long-term polymethyl methacrylate provisionals as a communication tool between all parts involved. All-ceramic crowns were inserted after periodontal healing as definitive rehabilitation. Complex rehabilitation in patients with high esthetic demands including soft tissue corrections requires a multidisciplinary team approach that consists of periodontal surgeon, dentist and dental technician. © 2017 Wiley Periodicals, Inc.

Public Health Surveillance of Fatal Child Maltreatment: Analysis of 3 State Programs

PubMed Central

Schnitzer, Patricia G.; Covington, Theresa M.; Wirtz, Stephen J.; Verhoek-Oftedahl, Wendy; Palusci, Vincent J.

2008-01-01

Objectives. We sought to describe approaches to surveillance of fatal child maltreatment and to identify options for improving case ascertainment. Methods. Three states—California, Michigan, and Rhode Island—used multiple data sources for surveillance. Potential cases were identified, operational definitions were applied, and the number of maltreatment deaths was determined. Results. These programs identified 258 maltreatment deaths in California, 192 in Michigan, and 60 in Rhode Island. Corresponding maltreatment fatality rates ranged from 2.5 per 100000 population in Michigan to 8.8 in Rhode Island. Most deaths were identified by child death review teams in Rhode Island (98%), Uniform Crime Reports in California (56%), and child welfare agency data in Michigan (44%). Compared with the total number of cases identified, child welfare agency (the official source for maltreatment reports) and death certificate data underascertain child maltreatment deaths by 55% to 76% and 80% to 90%, respectively. In all 3 states, more than 90% of cases ascertained could be identified by combining 2 data sources. Conclusions. No single data source was adequate for thorough surveillance of fatal child maltreatment, but combining just 2 sources substantially increased case ascertainment. The child death review team process may be the most promising surveillance approach. PMID:17538060