The need for PGY2-trained clinical pharmacy specialists.

PubMed

Ragucci, Kelly R; O'Bryant, Cindy L; Campbell, Kristin Bova; Buck, Marcia L; Dager, William E; Donovan, Jennifer L; Emerson, Kayleigh; Gubbins, Paul O; Haight, Robert J; Jackevicius, Cynthia; Murphy, John E; Prohaska, Emily

2014-06-01

The American College of Clinical Pharmacy and other stakeholder organizations seek to advance clinical pharmacist practitioners, educators, and researchers. Unfortunately, there remains an inadequate supply of residency-trained clinical specialists to meet the needs of our health care system, and nonspecialists often are called on to fill open specialist positions. The impact of clinical pharmacy specialists on pharmacotherapy outcomes in both acute care and primary care settings demonstrates the value of these specialists. This commentary articulates the need for postgraduate year two (PGY2)-trained clinical specialists within the health care system by discussing various clinical and policy rationales, interprofessional support, economic justifications, and their impact on quality of care and drug safety. The integrated practice model that has grown out of the American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) could threaten the growth and development of future clinical specialists. Therefore, the ways in which PGY2-trained clinical pharmacist specialists are deployed in the PPMI require further consideration. PGY2 residencies provide education and training opportunities that cannot be achieved in traditional professional degree programs or postgraduate year one residencies. These specialists are needed to provide direct patient care to complex patient populations and to educate and train pharmacy students and postgraduate residents. Limitations to training and hiring PGY2-trained clinical pharmacy specialists include site capacity limitations and lack of funding. A gap analysis is needed to define the extent of the mismatch between the demand for specialists by health care systems and educational institutions versus the capacity to train clinical pharmacists at the specialty level. © 2014 Pharmacotherapy Publications, Inc.

Profiles of children with Down syndrome who meet screening criteria for autism spectrum disorder (ASD): a comparison with children diagnosed with ASD attending specialist schools.

PubMed

Warner, G; Howlin, P; Salomone, E; Moss, J; Charman, T

2017-01-01

Recent research suggests that around 16% to 18% of children with Down syndrome (DS) also meet diagnostic criteria for autism spectrum disorder (ASD). However, there are indications that profiles of autism symptoms in this group may vary from those typically described in children with ASD. Rates of autism symptoms and emotional and behavioural problems among children with DS who screened positive for ASD on the Social Communication Questionnaire (SCQ) (n = 183) were compared with a group of children with clinical diagnoses of ASD (n = 189) attending specialist schools in the UK. Groups were matched for age and approximate language level (use of phrase speech). Profiles of autistic symptoms in the two groups were generally similar, but children with DS meeting ASD cut-off on the SCQ tended to show fewer problems in reciprocal social interaction than those in the ASD group. They also showed slightly lower rates of emotional and peer-related problems. The results mostly confirm findings from a previous study in which the original validation sample for the SCQ was used as a comparison group. Findings suggest that children with DS who meet screening criteria for ASD show similar profiles of communication and repetitive behaviours to those typically described in autism. However, they tend to have relatively milder social difficulties. It is important that clinicians are aware of this difference if children with DS and ASD are to be correctly diagnosed and eligible for specialist intervention and education services. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice.

PubMed

Jacobi, Judith; Ray, Shaunta'; Danelich, Ilya; Dodds Ashley, Elizabeth; Eckel, Stephen; Guharoy, Roy; Militello, Michael; O'Donnell, Paul; Sam, Teena; Crist, Stephanie M; Smidt, Danielle

2016-05-01

This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular. Moreover, although more consistent patient care can be achieved with an expanded team of pharmacist providers, the role of clinical pharmacy specialists must not be diminished, especially in the care of complex patients and populations. Specialist practitioners with advanced training and credentials must be available to model and train pharmacists in generalist positions, residents, and students. Indeed, specialist practitioners are often the innovators and practice leaders. Negotiation between hospitals and pharmacy schools is needed to ensure a continuing role for academic clinical pharmacists and their contributions as educators and researchers. Lessons can be applied from disciplines such as nursing and medicine, which have developed new models of care involving effective collaboration between generalists and specialists. Several different pharmacy practice models have been described to meet the PPMI goals, based on available personnel and local goals. Studies measuring the impact of these new practice models are needed. © 2016 Pharmacotherapy Publications, Inc.

Proceedings of the Joint IAEA/CSNI Specialists` Meeting on Fracture Mechanics Verification by Large-Scale Testing held at Pollard Auditorium, Oak Ridge, Tennessee

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

Pugh, C.E.; Bass, B.R.; Keeney, J.A.

This report contains 40 papers that were presented at the Joint IAEA/CSNI Specialists` Meeting Fracture Mechanics Verification by Large-Scale Testing held at the Pollard Auditorium, Oak Ridge, Tennessee, during the week of October 26--29, 1992. The papers are printed in the order of their presentation in each session and describe recent large-scale fracture (brittle and/or ductile) experiments, analyses of these experiments, and comparisons between predictions and experimental results. The goal of the meeting was to allow international experts to examine the fracture behavior of various materials and structures under conditions relevant to nuclear reactor components and operating environments. The emphasismore » was on the ability of various fracture models and analysis methods to predict the wide range of experimental data now available. The individual papers have been cataloged separately.« less

Foreword to the Special Issue on the 11th Specialist Meeting on Microwave Radiometry and Remote Sensing Applications (MicroRad 2010)

NASA Technical Reports Server (NTRS)

Le Vine, David M; Jackson, Thomas J.; Kim, Edward J.; Lang, Roger H.

2011-01-01

The Specialist Meeting on Microwave Radiometry and Remote Sensing of the Environment (MicroRad 2010) was held in Washington, DC from March 1 to 4, 2010. The objective of MicroRad 2010 was to provide an open forum to report and discuss recent advances in the field of microwave radiometry, particularly with application to remote sensing of the environment. The meeting was highly successful, with more than 200 registrations representing 48 countries. There were 80 oral presentations and more than 100 posters. MicroRad has become a venue for the microwave radiometry community to present new research results, instrument designs, and applications to an audience that is conversant in these issues. The meeting was divided into 16 sessions (listed in order of presentation): 1) SMOS Mission; 2) Future Passive Microwave Remote Sensing Missions; 3) Theory and Physical Principles of Electromagnetic Models; 4) Field Experiment Results; 5) Soil Moisture and Vegetation; 6) Snow and Cryosphere; 7) Passive/Active Microwave Remote Sensing Synergy; 8) Oceans; 9) Atmospheric Sounding and Assimilation; 10) Clouds and Precipitation; 11) Instruments and Advanced Techniques I; 12) Instruments and Advanced Techniques II; 13) Cross Calibration of Satellite Radiometers; 14) Calibration Theory and Methodology; 15) New Technologies for Microwave Radiometry; 16) Radio Frequency Interference.

The academic value of rehabilitation medicine meetings.

PubMed

Sivan, Manoj; Smith, Matthew; Bavikatte, Ganesh; Bradley, Lloyd

2010-01-01

Twice-yearly meetings of The British Society of Rehabilitation Medicine (BSRM) take place at which posters and free papers are generated, as abstracts, to present novel research findings, audits and case reports. The aim of this study was to evaluate the academic value of these meetings, by determining the subsequent rate of publication in peer-reviewed journals of abstracts presented. This was compared to the publication rate of other European medical specialist society meetings. The authors used MEDLINE, PubMed and Google Scholar search engines to look for publication of abstracts presented at BSRM meetings within peer-reviewed journals over a 7-year period (2000-2006). The abstracts were categorised into sub-groups (original study, audit, review, case report and service description) to determine which type was more likely to be published. The above databases were used also to extract studies on publication rate of other medical specialties in Europe. In 7 years, a total of 251 abstracts (of which 152 are original studies) have been presented as free papers or posters in a total of 13 meetings. The publication rate for the described study categories were: total 34%, original study 52%, review 50%, case report 5%, audit 0% and service description 0%. Publication rates from other specialist meetings in Europe range from 10% to 70%. The average publication rate for an abstract submitted to a BSRM meeting is 34% for any abstract and 52% for an original study suggesting that the meeting is generating abstracts of comparable academic interest to other specialist societies.

78 FR 42748 - Virginia Resource Advisory Committee Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-17

... each meeting, contact: Michael Williams, Public Affairs Specialist, Supervisor's Office, 540-265-5173... building in order to view comments. FOR FURTHER INFORMATION CONTACT: Michael Williams, Public Affairs... for time for oral comments must be sent to Michael Williams, Public Affairs Specialist, George...

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

EPA Pesticide Factsheets

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

Library Media Specialists: Premier Information Specialists for the Information Age

ERIC Educational Resources Information Center

Neuman, Delia

2011-01-01

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

Colorado Technology Competency Guidelines for Classroom Teachers and School Library Media Specialists.

ERIC Educational Resources Information Center

Colorado State Dept. of Education, Denver.

This document provides guidelines to school districts, BOCES, and teacher training institutions regarding technology-related skills that Colorado teachers, school library media specialists and other certified staff should have in order to meet the ever changing needs of Colorado's learners. The document is the result of deliberations by a working…

Meeting the Challenges of Literacy Difficulties: Developing a Qualification for Specialist Literacy Teachers.

ERIC Educational Resources Information Center

Limbrick, Libby; Parkhill, Faye; Smith, John

In 2001, the New Zealand Ministry of Education awarded a contract to a consortium of three colleges of education to provide a training program that would lead to a new national literacy qualification for a newly developed specialist literacy teaching position--Resource Teacher: Literacy. Resource Teachers of Literacy are skilled and experienced…

Examining the Promotion of Healthy Eating among Exercise Specialists: A Cross-sectional Study.

PubMed

Johnson, Steven T; Cornish, Stephen M; Lytvyak, Ellina; Taylor, Lorian M; Bell, Gordon; Vallance, Jeff; Fraser, Shawn; Murray, Terra

2015-06-01

The aim of this cross-sectional study was to survey exercise specialists about nutrition counselling practices, their own dietary practices, and to identify potential relationships. An electronic survey was used to examine characteristics and strategies used for assessing and promoting healthy eating to clients. Exercise specialists (n = 94) were recruited through a public registry and through targeted advertising on 2 professional websites in Alberta, Canada. Eighty-five percent of respondents promoted healthy eating to clients. Confidence in assessing and promoting healthy eating was moderate to low. Those with more than 6 years of professional experience reported higher confidence compared with those with less than 1 year of experience in assessing healthy eating (P < 0.05) and promoting healthy eating (P < 0.01). Confidence was higher among those with more professional experience but who did not meet Canada's Food Guide recommendations (P < 0.05). Professional experience, personal dietary practices, and confidence are important characteristics when considering the assessment and promotion of healthy eating by exercise specialists. Promoting collaborative relationships between registered dietitians and exercise specialists would likely benefit exercise specialists when they are assessing and promoting healthy eating among their clients.

Making Explicit the Implicit: Child Life Specialists Talk about Their Assessment Process

ERIC Educational Resources Information Center

Turner, Joan C.; Fralic, Jessica

2009-01-01

The purpose of this study was to explore the assessment process of child life specialists. During semi-structured interviews, twelve respondents talked about the experience of meeting a child and family for the first time, revealing aspects of the assessment process that developed in their ongoing interactions. The respondents spoke of building…

Christa McAuliffe meets other STS 51-L crewmembers

NASA Image and Video Library

1985-09-10

S85-39943 (9 Sept. 1985) --- Sharon Christa McAuliffe, STS-51L citizen observer/payload specialist representing the Teacher in Space Program, meets the other STS-51L crew members. The crew members pictured are (l.-r.) astronauts Michael J. Smith, pilot; Ronald E. McNair, mission specialist; and Francis R. (Dick) Scobee, mission commander. Photo credit: NASA

Revisioning a clinical nurse specialist curriculum in 3 specialty tracks.

PubMed

Arslanian-Engoren, Cynthia; Sullivan, Barbara-Jean; Struble, Laura

2011-01-01

The objective of the present study was to revise 3 clinical nurse specialist (CNS) educational tracks with current National Association of Clinical Nurse Specialist core competencies and educational expectations. National curricula recommendations include core competencies by the 3 spheres of influence. Advanced practice registered nurses consensus model educational requirements include a minimum of 500 faculty-supervised clinical hours; separate graduate courses in pharmacology, pathophysiology, and advanced physical assessment; and content in differential diagnosis disease management, decision making, and role preparation. This educational initiative was designed to (1) align with core competencies and advanced practice registered nurse consensus model recommendations, (2) create an innovative learning environment, (3) meet the needs of diverse student populations, (4) align with emerging doctor of nursing practice programs, (5) create a high-efficiency and high-quality environment to manage human and fiscal resources, and (6) reduce duplication of efforts. Courses were revised that did not meet current CNS educational preparation expectations. A total of 11 didactic and clinical sequences courses were developed for the 3 tracks to (1) ensure minimum numbers of clinical hours; (2) expand content on health promotion and risk reduction, advanced practice nurse role, and the healthcare delivery system; (3) consolidate clinical courses; and (4) resequence foundational content before beginning clinical courses. Revisioning a CNS curriculum in 3 specialty tracks is challenging but doable using innovative and creative approaches. The innovative process used to revise our CNS curriculum will assist nurse educators faced with similar program delivery challenges to meet future directions for educating CNS students in advanced nursing practice. Copyright © 2011 Lippincott Williams & Wilkins.

The psychiatric nurse specialist: a valuable asset in the general hospital.

PubMed

Fife, B; Lemler, S

1983-04-01

In summary, what are the ways in which the psychiatric/mental clinical specialist contributes to cost-effectiveness, the professional growth of nursing staff, and quality patient care in the general hospital setting? All services of the psychiatric/mental health clinical specialist are ultimately directed toward increasing the effectiveness with which staff can deliver care. This goal is accomplished by helping staff nurses maximize their knowledge, by providing needed educational opportunities, by promoting the use of a holistic model of care, and by helping staff cope with their own stress. In our experience, high quality care that meets the physiological, psychological, and sociological needs of patients decreases the length of the hospital stay, prevents repeated hospitalizations, and minimizes the development of psychosocial problems secondary to the illness. With the necessary support and cooperation from administration, this clinical specialist role reduces health care costs, promotes a higher level of functioning in patients and their families, and increases the level of job satisfaction for the staff who provide direct bedside care.

Specialist Bibliographic Databases

PubMed Central

2016-01-01

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

Specialist Bibliographic Databases.

PubMed

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

2016-05-01

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

Implementation of a gerontology nurse specialist role in primary health care: Health professional and older adult perspectives.

PubMed

King, Anna I I; Boyd, Michal L; Dagley, Lynelle; Raphael, Deborah L

2018-02-01

To explore an innovative primary healthcare gerontology nurse specialist role from the perspectives of older people and health professionals. Primary care is struggling to meet the needs and demands of complex older people. New models which incorporate holistic assessment and care coordination are necessary. A qualitative descriptive general inductive design was used. Older people at risk of health and functional decline were identified and received a comprehensive gerontology assessment and care coordination. Older adults (75 years+) enrolled within one of three primary healthcare practices in Auckland, New Zealand were eligible. Healthcare professionals directly involved with the primary healthcare gerontology nurse specialist model were invited for study participation. Face-to-face interviews were held with five older people and six health professionals were interviewed by telephone. A semistructured interview guide was used for all interviews. A general inductive approach was undertaken for analysis to systematically identify codes and themes. Data analysis revealed two central themes from the older people perspective: "holistic expertise" and "communication." Two main themes were identified from the health professional perspective: "competency" and "service delivery." Results showed the gerontology nurse specialist role was highly regarded by both older people and the health professionals. The in-home comprehensive geriatric assessment was identified as greatly beneficial. The competence and care coordination of the gerontology nurse specialist reduced fragmentation and were deemed immensely valuable. Care coordination should be recognised as a key component to meeting the complex needs of at-risk older people in the community. The expert knowledge of the gerontology nurse specialist and in-home comprehensive geriatric assessment were crucial aspects of the new model. Equally important was the assimilation of primary and secondary care infrastructure to

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Pain chronification: what should a non-pain medicine specialist know?

PubMed

Morlion, Bart; Coluzzi, Flaminia; Aldington, Dominic; Kocot-Kepska, Magdalena; Pergolizzi, Joseph; Mangas, Ana Cristina; Ahlbeck, Karsten; Kalso, Eija

2018-04-12

Pain is one of the most common reasons for an individual to consult their primary care physician, with most chronic pain being treated in the primary care setting. However, many primary care physicians/non-pain medicine specialists lack enough awareness, education and skills to manage pain patients appropriately, and there is currently no clear, common consensus/formal definition of "pain chronification". This article, based on an international Change Pain Chronic Advisory Board meeting which was held in Wiesbaden, Germany, in October 2016, provides primary care physicians/non-pain medicine specialists with a narrative overview of pain chronification, including underlying physiological and psychosocial processes, predictive factors for pain chronification, a brief summary of preventive strategies, and the role of primary care physicians and non-pain medicine specialists in the holistic management of pain chronification. Based on currently available evidence, we propose the following consensus-based definition of pain chronification which provides a common framework to raise awareness among non-pain medicine specialists: "Pain chronification describes the process of transient pain progressing into persistent pain; pain processing changes as a result of an imbalance between pain amplification and pain inhibition; genetic, environmental and biopsychosocial factors determine the risk, the degree, and time-course of chronification." Early intervention plays an important role in preventing pain chronification and, as key influencers in the management of patients with acute pain, it is critical that primary care physicians are equipped with the necessary awareness, education and skills to manage pain patients appropriately.

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

PubMed

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

2016-01-01

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

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

NASA Technical Reports Server (NTRS)

1978-01-01

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

Twelve Scientific Specialists of the Peenemuende Team

NASA Technical Reports Server (NTRS)

2004-01-01

Twelve scientific specialists of the Peenemuende team at the front of Building 4488, Redstone Arsenal, Huntsville, Alabama. They led the Army's space efforts at ABMA before transfer of the team to National Aeronautic and Space Administration (NASA), George C. Marshall Space Flight Center (MSFC). (Left to right) Dr. Ernst Stuhlinger, Director, Research Projects Office; Dr. Helmut Hoelzer, Director, Computation Laboratory: Karl L. Heimburg, Director, Test Laboratory; Dr. Ernst Geissler, Director, Aeroballistics Laboratory; Erich W. Neubert, Director, Systems Analysis Reliability Laboratory; Dr. Walter Haeussermarn, Director, Guidance and Control Laboratory; Dr. Wernher von Braun, Director Development Operations Division; William A. Mrazek, Director, Structures and Mechanics Laboratory; Hans Hueter, Director, System Support Equipment Laboratory;Eberhard Rees, Deputy Director, Development Operations Division; Dr. Kurt Debus, Director Missile Firing Laboratory; Hans H. Maus, Director, Fabrication and Assembly Engineering Laboratory

The use of Spielberger's State-Trait Personality Inventory (trait anxiety subscale) with naval subaquatic specialists.

PubMed

Van Wijk, Charles H

2014-12-01

Panic behavior poses a particular threat to the health and safety of subaquatic occupational specialists. Trait anxiety has previously been identified as a marker of panic behavior under water, and Spielberger's State-Trait Personality Inventory (trait anxiety subscale) has been previously used to measure trait anxiety among subaquatic specialists. Using archived data, the trait anxiety scores of subaquatic specialists were analyzed to meet 3 objectives: 1stly - to develop a trait anxiety profile of subaquatic specialists; 2ndly - to investigate the predictive value of trait anxiety measures upon entering an occupational field; and 3rdly - to establish the reliability of these scores over time. Archival trait-anxiety data from 322 subjects were analyzed statistically. Analysis of the available scores revealed a highly homogenous as well as a very low trait anxiety profile for the investigated occupational group. Additionally, low trait anxiety was somewhat associated with success during specialist training: fewer candidates with high trait anxiety scores completed their qualification. Moreover, measurement of trait anxiety was stable over time, which suggests that when scores for this occupational group are screened, deviations from previous scores could signify a potential need for referral to an intervention from health professionals. Using the trait anxiety subscale as part of occupational health surveillance of subaquatic specialists could support prevention of accidents by identifying high-risk candidates during their annual health assessments, and referral for timeous intervention.

Public or private care: where do specialists spend their time?

PubMed

Freed, Gary L; Turbitt, Erin; Allen, Amy

2017-10-01

Objectives The aim of the present study was to provide data to help clarify the public-private division of clinical care provision by doctors in Australia. Methods A secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields. The specialties were orthopaedic surgery, otolaryngology, ophthalmology, cardiology, neurology, nephrology, gastroenterology and rheumatology. Results For the specialities analysed in the present study, a large majority of the time spent in patient care was provided in the private sector. For the surgical specialties studied, on average less than 30% of clinical time was spent in the public sector. There was considerable variation among specialties in whether a greater proportion of time was spent in out-patient versus in-patient care and how that was divided between the public and private sectors. Conclusions Ensuring Australians have a medical workforce that meets the needs of the population will require assessments of the public and private medical markets, the needs of each market and the adequacy with which current physician clinical time allocation meets those requirements. By appreciating this nuance, Australia can develop policies and strategies for the current and future speciality workforce to meet the nation's needs. What is known about the topic? Australian medical specialists can split their clinical practice time between the public (e.g. public hospitals, public clinics) and private (e.g. private hospitals, private consulting rooms) sectors. For all medical specialists combined, working hours have been reported to be similar in the public and

Documentation and Analysis of IAEA (International Atomic Energy Agency) Safeguards Implementation at the Exxon Nuclear Fuel Fabrication Plant.

DTIC Science & Technology

1984-10-01

SAFEGUARDS AT SIMILAR FACILTTIES ASEA -ATOM LEU FUEL FABRICATION PLANT IN VASTERAS, SWEDEN..................B-1 APPENDIX C - EFFECTS OF NONMEASUREMENT ERRORS...second visit was to the ASEA -ATOM’s fuel fabrication plant in Vasteras, Sweden. The safeguards specialists for those plants were interviewed by R...Facilities, ASEA -ATOM LEU Fuel Fabrication Plant in Vasteras, Sweden, by V. Andersson of ASEA -ATOM, Vasteras, Sweden and R. Nilson of Exxon Nuclear

Conference Proceedings of Applications of Mesh Generation to Complex 3-D Configurations Held at the Specialists’ Meeting of the Fluid Dynamics Panel in Leon, Norway on 24th-25th May 1989

DTIC Science & Technology

1990-03-01

Computations, edited by I. Babu ka, 0. C . Zienkiewicz, J. Gago, and E. R. de A. Oliveira ( John Wiley and Sons, New York, 1986), p. 281. [4] B. Wedan and J...GENERATION TO COMPLEX 3-D CONFIGURATIONS ., " c 1- For Papers presented and discussion- held at the Specialists’ Meeting of the Fluid Dynamics Panel in...the Panels which are composed of experts appointed by the National Delegates. the Consultant and Fxch., ., c Progi amime and the Aerospace Applications

Extension Specialists: A Self-Analysis.

ERIC Educational Resources Information Center

Gerber, John M.

1985-01-01

To document perceived changes in the role of the extension horticulture specialist, a national survey of state horticulture specialists was conducted in 1983. Extension specialists in horticulture appear to be moving away from the traditional activities of farm visits and personal interaction with individual producers. (CT)

48 CFR 552.236-72 - Specialist.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Exploring Collaboration between Teachers and the School Library Information Specialist on the Instructional Design of Curriculum

ERIC Educational Resources Information Center

Allen, Lorraine

2013-01-01

The purpose of this research was to provide a qualitative study exploring the collaboration between three teachers and the School Library Information Specialist (SLIS) on the instructional design of curriculum. In this study, collaboration means working together to meet standards and guidelines. The SLIS, in the role of instructional consultant to…

Small Business Specialists.

DTIC Science & Technology

1997-12-01

located throughout the United States. Each service and agency has an Office of the Director of Small and Disadvantaged Business Utilization. They also...have small business specialists at each of their procurement and contract management offices to assist small businesses , small disadvantaged businesses ...and women-owned small businesses firms in marketing their products and services with the DoD. These specialists provide information and guidance on (1

[The fiscal position of medical specialists].

PubMed

Stevens, S; Moors, M

2013-01-01

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

Monitoring by Control Technique - Fabric Filters

EPA Pesticide Factsheets

Stationary source emissions monitoring is required to demonstrate that a source is meeting the requirements in Federal or state rules. This page is about fabric filter control techniques used to reduce pollutant emissions.

Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review.

PubMed

Cook, Olivia; McIntyre, Meredith; Recoche, Katrina; Lee, Susan

2017-08-01

The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from pre-diagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review. Studies that explored how women with gynecological cancer experience the care and interventions of specialist nurses were included. Qualitative studies including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for review. This review also considered the qualitative components of mixed method studies. Research conducted in any country was considered for inclusion in this review providing that the study was reported in English. Studies conducted in any setting including, but not limited to, acute hospitals, outpatient/ambulatory clinics, chemotherapy or radiotherapy units, support groups, palliative care units or the patient's home were included. A three-step search strategy

Conflict Management Strategies in the ICU Differ Between Palliative Care Specialists and Intensivists.

PubMed

Chiarchiaro, Jared; White, Douglas B; Ernecoff, Natalie C; Buddadhumaruk, Praewpannarai; Schuster, Rachel A; Arnold, Robert M

2016-05-01

Conflict is common between physicians and surrogate decision makers around end-of-life care in ICU. Involving experts in conflict management improve outcomes, but little is known about what differences in conflict management styles may explain the benefit. We used simulation to examine potential differences in how palliative care specialists manage conflict with surrogates about end-of-life treatment decisions in ICUs compared with intensivists. Subjects participated in a high-fidelity simulation of conflict with a surrogate in an ICU. In this simulation, a medical actor portrayed a surrogate decision maker during an ICU family meeting who refuses to follow an advance directive that clearly declines advanced life-sustaining therapies. We audiorecorded the simulation encounters and applied a coding framework to quantify conflict management behaviors, which was organized into two categories: task-focused communication and relationship building. We used negative binomial modeling to determine whether there were differences between palliative care specialists' and intensivists' use of task-focused communication and relationship building. Single academic medical center ICU. Palliative care specialists and intensivists. None. We enrolled 11 palliative care specialists and 25 intensivists. The palliative care specialists were all attending physicians. The intensivist group consisted of 11 attending physicians, 9 pulmonary and critical care fellows, and 5 internal medicine residents rotating in the ICU. We excluded five residents from the primary analysis in order to reduce confounding due to training level. Physicians' mean age was 37 years with a mean of 8 years in practice. Palliative care specialists used 55% fewer task-focused communication statements (incidence rate ratio, 0.55; 95% CI, 0.36-0.83; p = 0.005) and 48% more relationship-building statements (incidence rate ratio, 1.48; 95% CI, 0.89-2.46; p = 0.13) compared with intensivists. We found that palliative care

Designing Class Activities to Meet Specific Core Training Competencies: A Developmental Approach

ERIC Educational Resources Information Center

Guth, Lorraine J.; McDonnell, Kelly A.

2004-01-01

This article presents a developmental model for designing and utilizing class activities to meet specific Association for Specialists in Group Work (ASGW) core training competencies for group workers. A review of the relevant literature about teaching group work and meeting core training standards is provided. The authors suggest a process by…

Activities of Intellectual Disability Clinical Nurse Specialists in Ireland.

PubMed

Doody, Owen; Slevin, Eamonn; Taggart, Laurence

The aim of this study was to identify the contribution of Irish intellectual disability clinical nurse specialists (ID CNSs) to service delivery. A nonexperimental descriptive design was selected to survey ID CNSs presently working in Ireland. The questionnaire was developed based on focus group interviews, available literature, and expert panel views. Ethical approval and access were granted to all ID CNSs in Ireland. Thirty-two responded (33.68% response rate) from all work areas (voluntary organizations or health service executive) practicing within residential, community, or school services. Respondents were surveyed across a range of areas (demographic details and support to client, staff, family, organization, community, other agencies, and professional development). Findings identify that ID CNSs are active in all aspects of their roles as clinical specialist, educator, communicator, researcher, change agent, and leader, thus supporting person-centered care and improving service delivery. To meet changing healthcare demands, promote person-centered care, and improve service delivery, the CNS role in ID should be developed and supported. The findings merit a further study on ID CNS role activity, possible variables influencing role activity, and team members' views.

Best Evidence Medical Education (BEME): Report of Meeting--3-5 December 1999, London, UK.

ERIC Educational Resources Information Center

Medical Teacher, 2000

2000-01-01

Discusses a meeting about evidence-based medicine. Presents the format and aim of the meeting and explains what best evidence medical education (BEME) is. Believes medical education specialists are responsible for doing research and disseminating the information to users through workshops, journals, and funding. (YDS)

48 CFR 536.570-3 - Specialist.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Specialist. 536.570-3... CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 536.570-3 Specialist. Insert 552.236-72, Specialist, in solicitations and contracts for construction if the technical sections...

Telemedicine in the acute health setting: A disruptive innovation for specialists (an example from stroke).

PubMed

Bagot, Kathleen L; Cadilhac, Dominique A; Vu, Michelle; Moss, Karen; Bladin, Christopher F

2015-12-01

Telemedicine is a disruptive innovation within health care settings as consultations take place via audio-visual technology rather than traditional face-to-face. Specialist perceptions and experiences of providing audio-visual consultations in emergency situations, however, are not well understood. The aim of this exploratory study was to describe the experience of medical specialists providing acute stroke decision-making support via telemedicine. Data from the Victorian Stroke Telemedicine (VST) programme were used. The experiences of specialists providing an acute clinical telemedicine service to rural emergency departments were explored, drawing on disruptive innovation theory. Document analysis of programme consultation records, meeting minutes and in-depth individual interviews with three neurologists were analysed using triangulation. Since February 2014, 269 stroke telemedicine consultations with 12 neurologists have occurred. Retention on the roster has varied between 1 and >4 years. Overall, neurologists reported benefits of participation, as they were addressing health equity gaps for rural patients. Negative effects were the unpredictability of consultations impacting on their personal life, the mixed level of experience of colleagues initiating the consult and not knowing patient outcomes since follow-up communication was not routine. Insights into workforce experience and satisfaction were identified to inform strategies to support specialists to adapt to the disruptive innovation of telemedicine. © The Author(s) 2015.

Volunteers in Specialist Palliative Care: A Survey of Adult Services in the United Kingdom

PubMed Central

Burbeck, Rachel; Low, Joe; Sampson, Elizabeth L.; Bravery, Ruth; Hill, Matthew; Morris, Sara; Ockenden, Nick; Payne, Sheila

2014-01-01

Abstract Background: Worldwide, the demand for specialist palliative care is increasing but funding is limited. The role of volunteers is underresearched, although their contribution reduces costs significantly. Understanding what volunteers do is vital to ensure services develop appropriately to meet the challenges faced by providers of palliative care. Objective: The study's objective is to describe current involvement of volunteers with direct patient/family contact in U.K. specialist palliative care. Design: An online survey was sent to 290 U.K. adult hospices and specialist palliative care services involving volunteers covering service characteristics, involvement and numbers of volunteers, settings in which they are involved, extent of involvement in care services, specific activities undertaken in each setting, and use of professional skills. Results: The survey had a 67% response rate. Volunteers were most commonly involved in day care and bereavement services. They entirely ran some complementary therapy, beauty therapy/hairdressing, and pastoral/faith-based care services, and were involved in a wide range of activities, including sitting with dying patients. Conclusions: This comprehensive survey of volunteer activity in U.K. specialist palliative care provides an up-to-date picture of volunteer involvement in direct contact with patients and their families, such as providing emotional care, and the extent of their involvement in day and bereavement services. Further research could focus on exploring their involvement in bereavement care. PMID:24475743

Invisible Roles of Doctoral Program Specialists

ERIC Educational Resources Information Center

Bachman, Eva Burns; Grady, Marilyn L.

2016-01-01

The purpose of this study was to investigate the roles of doctoral program specialists in Big Ten universities. Face-to-face interviews with 20 doctoral program specialists employed in institutions in the Big Ten were conducted. Participants were asked to describe their roles within their work place. The doctoral program specialists reported their…

Andragogical Model in Language Training of Mining Specialists

NASA Astrophysics Data System (ADS)

Bondareva, Evgeniya; Chistyakova, Galina; Kleshevskyi, Yury; Sergeev, Sergey; Stepanov, Aleksey

2017-11-01

Nowadays foreign language competence is one of the main professional skills of mining engineers. Modern competitive conditions require the ability for meeting production challenges in a foreign language from specialists and managers of mining enterprises. This is the reason of high demand on foreign language training/retraining courses. Language training of adult learners fundamentally differs from children and adolescent education. The article describes the features of andragogical learning model. The authors conclude that distance learning is the most productive education form having a number of obvious advantages over traditional (in-class) one. Interactive learning method that involves active engagement of adult trainees appears to be of the greatest interest due to introduction of modern information and communication technologies for distance learning.

A survey of adult referrals to specialist attention-deficit/hyperactivity disorder clinics in Canada

PubMed Central

Klassen, Larry J; Blackwood, C Matthew; Reaume, Christopher J; Schaffer, Samuel; Burns, James G

2018-01-01

Background Canadian guidelines encourage family physicians to diagnose/manage adults with uncomplicated attention-deficit/hyperactivity disorder (ADHD); specialist referral is recommended only for complex cases. This retrospective case review investigated adults referred to Canadian ADHD clinics. Methods Adult ADHD specialists reviewed referral letters/charts of patients (aged ≥18 years and no family history/known/expressed childhood ADHD) from family physicians/psychiatrists over 2 years. Results Data on 515 referrals (mean age 33 years, 60% males) were collected (December 2014 to September 2015); 472/515 (92%) were made by family physicians. No psychiatric comorbid symptoms were noted in 344/515 (67%) referrals. ADHD was confirmed by a specialist in 483/515 (94%) cases, whether comorbid symptoms were noted at referral (155/171 [91%]) or not (328/344 [95%]). ADHD was reported to impact “work” (251/317 [79%]), “school” (121/166 [73%]), “social/friends” (260/483 [54%]), and “spouse/family” (231/483 [48%]). Overall, 335/483 (69%) patients had more than or equal to one comorbid symptom (diagnosed by referring physician or specialist). Stimulant monotherapy was recommended for 383/483 (79%) patients, non-stimulant monotherapy for 41/483 (8%) patients, and stimulant plus non-stimulant monotherapy for 39/483 (8%) patients. Almost half of patients were returned for referring physician’s follow-up, either before treatment initiation (102/483 [21%]) or after treatment stabilization (99/483 [20%]). Follow-up was by a specialist for 282/483 (58%) patients. Conclusion ADHD diagnosis was specialist confirmed in most cases. Although most referrals (67%) noted no psychiatric comorbid symptoms, 69% of patients had ≥1 such symptom (diagnosed by a referring physician or specialist), so comorbid symptoms although not always noted at referral, may have contributed to the decision to refer. ADHD has a wide-ranging impact on patients’ daily lives. It is possible

A comparison of risk and protective factors related to suicide ideation among residents and specialists in academic medicine

PubMed Central

2014-01-01

Background Physicians have an elevated risk of experiencing suicidal thoughts, which might be due to work-related factors. However, the hierarchical work positions as well as work-related health differ among resident and specialist physicians. As such, the correlates of suicide ideation may also vary between these two groups. Methods In the present study, work- and health-related factors and their association with suicidal thoughts among residents (n = 234) and specialists (n = 813) working at a university hospital were examined using cross-sectional data. Results Logistic regression analysis showed that having supportive meetings was associated with a lower level of suicide ideation among specialists (OR = 0.68, 95% CI: 0.50-0.94), while an empowering leadership was related to a lower level of suicide ideation among residents (OR = 0.55, 95% CI: 0.32-0.94). Having been harassed at work was associated with suicidal ideation among specialists (OR = 2.26, 95% CI: 1.31-3.91). In addition, sickness presenteeism and work disengagement were associated with suicide ideation in both groups of physicians. Conclusions These findings suggest that different workplace interventions are needed to prevent suicide ideation in residents and specialists. PMID:24655908

Drugs and having babies: an exploration of how a specialist clinic meets the needs of chemically dependent pregnant women.

PubMed

Morris, Michelle; Seibold, Carmel; Webber, Ruth

2012-04-01

to explore the extent to which a specialist clinic meets the needs of chemically dependent women. a critical ethnography informed by theorists such as Habermas and feminists' interpretation of Foucault. a specialist antenatal clinic for chemically dependent pregnant women at a major metropolitan women's hospital in Melbourne, Australia. a purposive sample of twenty (20) chemically dependent pregnant women who attended the clinic. Data collection and analysis included three taped interviews (two preceding the birth and one post birth), observation of the interactions between the women and the clinic staff over a 25-month period and chart audits. similar to other studies there were multiple factors influencing development and maintenance of chemical dependency in this group of women, including family instability, family history of drug and alcohol abuse, childhood sexual abuse, having a chemically dependent partner and having a dual diagnosis of both drug addiction and mental illness. Initially there was considerable variation between the women and the clinic staff's expectations with regard to attending for antenatal care and conforming to a set regime as the women struggled with the contradictions inherent in their lifestyle and that of the 'normal' expectant mother. Aspects of that struggle included their belief that their opinions and knowledge of their lives was largely ignored, leading to episodes of resistance. Several women alleged the clinics staff's relationship with them was influenced by a belief that the women were 'hopeless addicts in need of expert medical and midwifery care' and that the clinic staff exercised control in an authoritarian manner. However, as they explored possibilities for collaboration, they realised they could exercise power and work towards a more equal relationship with staff. The quality of relationships in most instances improved over time, and if not always strictly collaborative, was situated at various points along a continuum

Pediatric Specialists

MedlinePlus

... this site from a secured browser on the server. Please enable scripts and reload this page. Turn ... for Referral to Pediatric Surgical Specialists Sports Medicine Professionals What is a Child Abuse Pediatrician? What is ...

Spiritual care and kidney disease in NZ: a qualitative study with New Zealand renal specialists.

PubMed

Egan, Richard; Macleod, Rod; Tiatia, Ramona; Wood, Sarah; Mountier, Jane; Walker, Rob

2014-11-01

People with chronic kidney disease have a shortened life expectancy and carry a high symptom burden. Research suggests that attending to renal patients' spiritual needs may contribute to an improvement in their quality of life. The aim of this qualitative study was to investigate the provision of spiritual care in New Zealand renal units from the perspective of specialists. The study followed a generic qualitative approach and included semi-structured interviews with specialists recruited from New Zealand's ten renal centres. Five specialist doctors and nine specialist nurses were recruited for interviews. Understandings of spirituality were broad, with most participants having an inclusive understanding. Patients' spiritual needs were generally acknowledged and respected though formal spiritual assessments were not done. Consideration of death was discussed as an often-unexamined need. The dominant position was that the specialists did not provide explicit spiritual care of patients but there was some ad hoc provision offered through pre-dialysis educators, family meetings, Māori liaison staff members and the efforts of individuals. Chaplains were well used in some services. Participants had received no pre and little in-service training or education in spiritual care. Suggestions for improvements included in-service training, better utilization of chaplaincy services and training in advance care planning. Most participants indicated they would attempt to provide some form of spiritual care, either directly or by referring the patient to appropriate services. However, participants generally demonstrated a lack of confidence in addressing a patient's spiritual needs. © 2014 Asian Pacific Society of Nephrology.

Manpower planning in periodontology--how many specialists do we need?

PubMed

Griffiths, G S; Preshaw, P M

2014-10-01

Given that one of the major focus points within this issue of the journal is 'practical periodontal medicine' and the relationship between periodontal disease and systemic chronic diseases, it is surprising that we have no indication of the manpower required to secure better oral and general health in this field. Despite many of the heralded improvements in dental health reported in the Adult Dental Health Survey 2009, as monitored by the falling rates of edentulous subjects and decayed, missing and filled teeth (DMF), the overall increase between 1998 and 2009 in the number of subjects with deep pockets from 6% to 8% has largely gone unnoticed! This is a major concern given that most other indicators of oral health have improved over this time period. Furthermore, the tissue damage associated with periodontitis is largely irreversible, and has consequences not only for oral function and quality of life, but also may adversely impact on aspects of general health. This article aims to highlight why we need specialists in periodontics, which patients should be referred to them, how big a problem periodontal disease is and how many specialists in periodontics would be required to meet this treatment need. Estimates are made using the information gained from the Adult Dental Health Survey 2009 and the Office for National Statistics 2011 census, along with estimates of the average patient pool managed within specialist periodontal practices. However, the paper emphasises that these are estimates based on incomplete information which would be necessary to allow more complete models of manpower planning to be used.

Certification of School Media Specialists.

ERIC Educational Resources Information Center

Hawthorne, Dorothy, Ed.

Recommendations for certification requirements for the school media specialist in Texas were the concern of the conference reported here. Two papers presented were: "The Emerging Profession of Media Specialists," and "Certification for Tomorrow," chapter three of the proceedings gives a panel on "Certification" and…

78 FR 76175 - Notice of Public Meeting for the John Day-Snake Resource Advisory Council: Cancellation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

.... The meeting was cancelled. FOR FURTHER INFORMATION CONTACT: Lisa Clark, Public Affairs Specialist, BLM...] Notice of Public Meeting for the John Day--Snake Resource Advisory Council: Cancellation AGENCY: Bureau..., Oregon/Washington, published a document in the Federal Register on October 28, 2013, regarding a public...

Clinical nurse specialists as entrepreneurs: constrained or liberated.

PubMed

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

2006-12-01

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

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

14 CFR 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialist responsibilities. 1214.305 Section 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

A typology of specialists' clinical roles.

PubMed

Forrest, Christopher B

2009-06-08

High use of specialist physicians and specialized procedures coupled with low exposure to primary care are distinguishing traits of the US health care system. Although the tasks of the primary care medical home are well established, consensus on the normative clinical roles of specialist physicians has not been achieved, which makes it unlikely that the specialist workforce is being used most effectively and efficiently. This article describes a typology of specialists' clinical roles that is based on the conceptual basis for health care specialism and empirical evaluations of the specialty referral process. The report concludes with a discussion on the implications of the typology for improving the effectiveness and efficiency of the primary-specialty care interface.

STS-101 crew members meet family and friends

NASA Technical Reports Server (NTRS)

2000-01-01

The STS-101 crew gather during a meeting with family and friends at Launch Pad 39A. From left, Mission Specialist Susan J. Helms, Commander James D. Halsell Jr., Mission Specialist Mary Ellen Weber, Pilot Scott J. Horowitz and Mission Specialists Yuri Vladimirovich Usachev, Jeffery N. Williams and James S. Voss. In the background is the Space Shuttle Atlantis on the pad. Mission STS-101 will take the crew to the International Space Station to deliver logistics and supplies, plus prepare the Station for the arrival of the Zvezda Service Module, expected to be launched by Russia in July 2000. The crew will conduct one space walk to perform maintenance on the Space Station as well. This will be the third assembly flight for the Space Station. Launch is targeted for April 24 at about 4:15 p.m. EDT from Launch Pad 39A.

Nanocarbon materials fabricated using plasmas

NASA Astrophysics Data System (ADS)

Hatakeyama, Rikizo

2017-12-01

Since the discovery of fullerenes more than three decades ago, new kinds of nanoscale materials of carbon allotropes called "nanocarbons" have so far been discovered or synthesized at successive intervals as cases such as carbon nanotubes, carbon nanohorns, graphene, carbon nanowalls, and a carbon nanobelt, while nanodiamonds were actually discovered before then. Their attractively excellent mechanical, physical, and chemical properties have driven researchers to continuously create one of the hottest frontiers in materials science and technology. While plasma states have often been involved in their discovery, on the other hand, plasma-based approaches to this exciting field originally hold promising and enormous potentials for advancing and expanding industrial/biomedical applications of nanocarbons of great diversity. This article provides an extensive overview on plasma-fabricated nanocarbon materials, where the term "fabrication" is defined as synthesis, functionalization, and assembly of devices to cover a wide range of issues associated with the step-by-step plasma processes. Specific attention has been paid to the comparative examination between plasma-based and non-plasma methods for fabricating the nanocarobons with an emphasis on the advantages of plasma processing, such as low-temperature/large-scale fabrication and diversity-carrying structure controllability. The review ends with current challenges and prospects including a ripple effect of the nanocarbon studies on the development of related novel nanomaterials such as transition metal dichalcogenides. It contains not only the latest progress in the field for cutting-edge scientists and engineers, but also the introductory guidance to non-specialists such as lower-class graduate students.

The Surgical Nosology In Primary-care Settings (SNIPS): a simple bridging classification for the interface between primary and specialist care

PubMed Central

Gruen, Russell L; Knox, Stephanie; Britt, Helena; Bailie, Ross S

2004-01-01

Background The interface between primary care and specialist medical services is an important domain for health services research and policy. Of particular concern is optimising specialist services and the organisation of the specialist workforce to meet the needs and demands for specialist care, particularly those generated by referral from primary care. However, differences in the disease classification and reporting of the work of primary and specialist surgical sectors hamper such research. This paper describes the development of a bridging classification for use in the study of potential surgical problems in primary care settings, and for classifying referrals to surgical specialties. Methods A three stage process was undertaken, which involved: (1) defining the categories of surgical disorders from a specialist perspective that were relevant to the specialist-primary care interface; (2) classifying the 'terms' in the International Classification of Primary Care Version 2-Plus (ICPC-2 Plus) to the surgical categories; and (3) using referral data from 303,000 patient encounters in the BEACH study of general practice activity in Australia to define a core set of surgical conditions. Inclusion of terms was based on the probability of specialist referral of patients with such problems, and specialists' perception that they constitute part of normal surgical practice. Results A four-level hierarchy was developed, containing 8, 27 and 79 categories in the first, second and third levels, respectively. These categories classified 2050 ICPC-2 Plus terms that constituted the fourth level, and which covered the spectrum of problems that were managed in primary care and referred to surgical specialists. Conclusion Our method of classifying terms from a primary care classification system to categories delineated by specialists should be applicable to research addressing the interface between primary and specialist care. By describing the process and putting the bridging

Making Generalists Out of Specialists.

ERIC Educational Resources Information Center

Malinowski, Jon C.

2001-01-01

Most camps use specialists to run activities and cabin leaders to manage campers. However, a generalist model offers greater leadership development opportunities. To implement a more generalist paradigm, have camp leaders express their areas of skill and interest, pair up experienced and inexperienced staff, allow specialists to cover activities…

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

Elementary Reading Specialists' Perspectives towards Their Work

ERIC Educational Resources Information Center

Bunker, Wendy Woods

2017-01-01

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

Specialist clinics: a better way to care?

PubMed Central

Mutch, W J

1992-01-01

A questionnaire on the development of specialist clinics was distributed to the members of the Association of British Neurologists and completed by 104 members (85 consultants). Half of the respondents already ran a specialist clinic. The same proportion felt that a Parkinsonism clinic would be useful despite the fact that only 20% stated that they would run one. It is argued that specialist clinics facilitate the effective management of conditions such as Parkinson's disease, especially if supported by a specialist nurse or other appropriate staff. PMID:1564504

STS-107 crew meet with media in front of grandstand at KSC

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. - The STS-107 crew meet with the media in front of the grandstand. From left are Commander Rick Husband, Pilot William 'Willie' McCool, Payload Specialist Ilan Ramon, Mission Specialist David Brown, Payload Commander Michael Anderson, and Mission Specialists Laurel Clark and Kalpana Chawla. The crew just finished Terminal Countdown Demonstration Test activities, including a simulated launch countdown, in preparation for launch planned for Jan. 16, 2003, between 10 a.m. and 2 p.m. EST aboard Space Shuttle Columbia. STS-107 is a mission devoted to research and will include more than 80 experiments that will study Earth and space science, advanced technology development, and astronaut health and safety. .

[A new method of fabricating photoelastic model by rapid prototyping].

PubMed

Fan, Li; Huang, Qing-feng; Zhang, Fu-qiang; Xia, Yin-pei

2011-10-01

To explore a novel method of fabricating the photoelastic model using rapid prototyping technique. A mandible model was made by rapid prototyping with computerized three-dimensional reconstruction, then the photoelastic model with teeth was fabricated by traditional impression duplicating and mould casting. The photoelastic model of mandible with teeth, which was fabricated indirectly by rapid prototyping, was very similar to the prototype in geometry and physical parameters. The model was of high optical sensibility and met the experimental requirements. Photoelastic model of mandible with teeth indirectly fabricated by rapid prototyping meets the photoelastic experimental requirements well.

Fabrication of Nanochannels

PubMed Central

Zhang, Yuqi; Kong, Xiang-Yu; Gao, Loujun; Tian, Ye; Wen, Liping; Jiang, Lei

2015-01-01

Nature has inspired the fabrication of intelligent devices to meet the needs of the advanced community and better understand the imitation of biology. As a biomimetic nanodevice, nanochannels/nanopores aroused increasing interest because of their potential applications in nanofluidic fields. In this review, we have summarized some recent results mainly focused on the design and fabrication of one-dimensional nanochannels, which can be made of many materials, including polymers, inorganics, biotic materials, and composite materials. These nanochannels have some properties similar to biological channels, such as selectivity, voltage-dependent current fluctuations, ionic rectification current and ionic gating, etc. Therefore, they show great potential for the fields of biosensing, filtration, and energy conversions. These advances can not only help people to understand the living processes in nature, but also inspire scientists to develop novel nanodevices with better performance for mankind. PMID:28793564

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

PubMed

Dhiliwal, Sunil R; Muckaden, Maryann

2015-01-01

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

What Is an Adolescent Health Specialist?

MedlinePlus

... Health Specialists — The Best Care For Teens And Young Adults Adolescents have unique and important health care ... know how to communicate effectively with teens and young adults. Adolescent health specialists are also specially trained ...

Meeting Abstracts - AMCP Managed Care & Specialty Pharmacy Annual Meeting 2018.

PubMed

2018-04-01

The AMCP Managed Care & Specialty Pharmacy Annual Meeting 2018 in Boston, Massachusetts, is expected to attract more than 3,800 managed care pharmacists and other health care professionals who manage and evaluate drug therapies, develop and manage networks, and work with medical managers and information specialists to improve the care of all individuals enrolled in managed care programs. The AMCP Abstracts program provides a forum through which authors can share their insights and outcomes of advanced managed care practice. Abstracts are presented as posters on Wednesday, April 25, from 12:30 pm to 2:30 pm. Posters will also be displayed on Tuesday, April 24, from 5:45 pm to 7:30 pm, and on Thursday, April 26, from 9:30 am to 11:00 am. Podium presentations for the Platinum award-winning abstracts are Thursday, April 26, from 8:00 am to 9:15 am. Professional abstracts that have been reviewed are published in the Journal of Managed Care & Specialty Pharmacy's Meeting Abstracts supplement.

E-learning for medical imaging specialists: introducing blended learning in a nuclear medicine specialist course.

PubMed

Haslerud, Torjan; Tulipan, Andreas Julius; Gray, Robert M; Biermann, Martin

2017-07-01

While e-learning has become an important tool in teaching medical students, the training of specialists in medical imaging is still dominated by lecture-based courses. To assess the potential of e-learning in specialist education in medical imaging. An existing lecture-based five-day course in Clinical Nuclear Medicine (NM) was enhanced by e-learning resources and activities, including practical exercises. An anonymized survey was conducted after participants had completed and passed the multiple choice electronic course examination. Twelve out of 15 course participants (80%) responded. Overall satisfaction with the new course format was high, but 25% of the respondents wanted more interactive elements such as discussions and practical exercises. The importance of lecture handouts and supplementary online material such as selected original articles and professional guidelines was affirmed by all the respondents (92% fully, 8% partially), while 75% fully and 25% partially agreed that the lectures had been interesting and relevant. E-learning represents a hitherto unrealized potential in the education of medical specialists. It may expedite training of medical specialists while at the same time containing costs.

Predicting resident confidence to lead family meetings.

PubMed

Butler, D J; Holloway, R L; Gottlieb, M

1998-05-01

Family physicians frequently encounter patients' family members in family meetings regarding health care. Although residents are expected to learn how to interview families, no quantitative studies have examined variables associated with building residents' confidence in their ability to lead family meetings. The current study sought to clarify the relationship between a number of training, participant, and situational components and resident confidence. All family practice residents (n = 90) in a five-residency program system were sent a survey that examined their experience in and perceived competence to conduct family meetings. Responses were analyzed with a hierarchical regression analysis and an ex post facto univariate analysis. Residents with higher perceived confidence in their ability to run a family meeting were male, had specific training for leading family meetings, had participated in and initiated more family meetings, perceived stronger family physician faculty support, and had more family systems training than lower-confidence residents. The results highlight the experiential, curricular, and environmental variables that are associated with building resident confidence to lead family meetings. Residents may benefit from early exposure to the skills needed for family meetings and from reinforcement of these skills through observations of skilled practitioners, the expectation that they will initiate meetings, and the opportunity to debrief meetings with supportive faculty. Family meeting curricula should include conflict management skills and incorporate input from other specialists and hospital personnel who meet with families.

Evaluation of the NMC community specialist practitioner award.

PubMed

Chambers, Claire; Goodman-Brown, Jane; Horn, Sue; Ryder, Elaine

2007-10-01

This paper discusses the evaluation of the NMC community specialist practitioner (CSP) programme over a period of four years. The purpose of the evaluation was to assess if the programme produced practitioners who were fit for purpose and fit for practice as well as assessing whether they were supported in their new roles. The evaluation took place eight months after qualification at a workshop where the practitioners discussed their experiences in focus groups. The evaluation is presented using Kirkpatrick's model and the results indicate the importance of collaboration between HEI's and their sponsors in meeting students' needs. Issues about support and work life balance are also highlighted as areas that were addressed as a result of the evaluation. Continued development of the programme through collaboration is desirable to produce effective practitioners who are able to function in the changing primary care arena.

Conflict Management Strategies in the ICU Differ Between Palliative Care Specialists and Intensivists

PubMed Central

Chiarchiaro, Jared; White, Douglas B.; Ernecoff, Natalie C.; Buddadhumaruk, Praewpannarai; Schuster, Rachel A.; Arnold, Robert M.

2016-01-01

OBJECTIVE Conflict is common between physicians and surrogate decision makers around end-of-life care in intensive care units (ICU). Involving experts in conflict management improve outcomes, but little is known about what differences in conflict management styles may explain the benefit. We used simulation to examine potential differences in how palliative care specialists manage conflict with surrogates about end-of-life treatment decisions in ICUs compared with intensivists. DESIGN Subjects participated in a high-fidelity simulation of conflict with a surrogate in an ICU. In this simulation, a medical actor portrayed a surrogate decision maker during an ICU family meeting who refuses to follow an advance directive that clearly declines advanced life-sustaining therapies. We audio-recorded the simulation encounters and applied a coding framework to quantify conflict management behaviors, which was organized into two categories: task-focused communication and relationship-building. We used negative binomial modeling to determine whether there were differences between palliative care specialists’ and intensivists’ use of task-focused communication and relationship building. SETTING Single academic medical center ICU PARTICIPANTS Palliative care specialists and intensivists INTERVENTIONS none MEASUREMENTS and MAIN RESULTS We enrolled 11 palliative care specialists and 25 intensivists. The palliative care specialists were all attending physicians. The intensivist group consisted of 11 attending physicians, 9 pulmonary and critical care fellows, and 5 internal medicine residents rotating in the intensive care unit. We excluded the 5 residents from the primary analysis in order to reduce confounding due to training level. Physicians’ mean age was 37 years with a mean of 8 years in practice. Palliative care specialists used 55% fewer task-focused communication statements (Incidence Rate Ratio 0.55, 95% CI 0.36–0.83, p= 0.005) and 48% more relationship building

Design and fabrication considerations for stainless steel liquid helium jackets surrounding SCRF cavities

NASA Astrophysics Data System (ADS)

Bonnema, E. C.; Cunningham, E. K.; Rumel, J. D.

2014-01-01

The Department of Energy requires its subcontractors to meet 10 CFR 851 Appendix A Part 4 for all new pressure vessels and pressure piping. The stainless steel pressure vessel boundaries surrounding SCRF cavities fall under this requirement. Methods for meeting this requirement include design and fabrication of the pressure vessels to meet the requirements of the ASME Boiler & Pressure Vessel Code Section VIII Division 1 or Division 2. Design considerations include determining whether the configuration of the SCRF cavity can be accommodated under the rules of Division 1 or must be analyzed under Division 2 Part 4 Design by Rule Requirements or Part 5 Design by Analysis Requirements. Regardless of the Division or Part choice, designers will find the rules of the ASME Code require thicker pressure boundary members, larger welds, and additional non-destructive testing and quality assurance requirements. These challenges must be met and overcome by the fabricator through the development of robust, detailed, and repeatable manufacturing processes. In this paper we discuss the considerations for stainless steel pressure vessels that must meet the ASME Code and illustrate the discussion with examples from direct experience fabricating such vessels.

76 FR 53416 - Gulf of Mexico Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... Ecosystem Scientific and Statistical Committee (SSC). DATES: The meeting will convene at 8 a.m. Eastern time... CONTACT: Dr. Karen Burns, Ecosystem Management Specialist; Gulf of Mexico Fishery Management Council; telephone: (813) 348-1630. SUPPLEMENTARY INFORMATION: The Ecosystem Scientific and Statistical Committee...

Attitudes regarding specialist referrals in periodontics.

PubMed

Sharpe, G; Durham, J A; Preshaw, P M

2007-02-24

To examine the attitudes of dental practitioners towards specialist periodontal referral in the North East of England. Semi-structured interviews were conducted with a purposive sample of 10 practitioners. Interviews continued until data saturation occurred. The data were organised using a framework and analysed by two researchers working independently. Perceptions of periodontal disease and treatment appear to be heavily influenced by the NHS remuneration system. Treatment in general practice was limited to simple scaling and there was an apparent reluctance to treat advanced periodontitis. Such cases were commonly referred to specialists, confirming the demand for a referral service in periodontics. The perceived potential for medico-legal consequences was a strong driver of referrals. Distance to the referral centre and the perceived costs of treatment were significant barriers to referral. Dentists valued the specialist's personal reputation and clinical skills more highly than academic status. Deficiencies in communication between primary and secondary care were highlighted. Increased resources are required to manage periodontal diseases within the NHS. There is a need for a periodontal referral service in the North East of England to improve accessibility to specialist care. This would appear to be most appropriately delivered by increased numbers of specialist practitioners.

Simulation-Based Assessment of ECMO Clinical Specialists.

PubMed

Fehr, James J; Shepard, Mark; McBride, Mary E; Mehegan, Mary; Reddy, Kavya; Murray, David J; Boulet, John R

2016-06-01

The aims of the study were (1) to create multiple scenarios that simulate a range of urgent and emergent extracorporeal membrane oxygenation (ECMO) events and (2) to determine whether these scenarios can provide reliable and valid measures of a specialist's advanced skill in managing ECMO emergencies. Multiscenario simulation-based performance assessment was performed. The study was conducted in the Saigh Pediatric Simulation Center at St. Louis Children's Hospital. ECMO clinical specialists participated in the study. Twenty-five ECMO specialists completed 8 scenarios presenting acute events in simulated ECMO patients. Participants were evaluated by 2 separate reviewers for completion of key actions and for global performance. The scores were highest for the hemodilution scenario, whereas the air entrainment scenario had the lowest scores. Psychometric analysis demonstrated that ECMO specialists with more than 1 year of experience outperformed the specialists with less than 1 year of experience. Participants endorsed these sessions as important and representative of events that might be encountered in practice. The scenarios could serve as a component of an ECMO education curriculum and be used to assess clinical specialists' readiness to manage ECMO emergencies.

Characteristics of holey fibers fabricated at different drawing speeds

NASA Astrophysics Data System (ADS)

Seraji, Faramarz E.; Rashidi, Mahnaz; Karimi, Maryam

2007-03-01

The effects of high drawing speeds on parameters of holey fibers are presented. A holey fiber preform structure was made by using tube-in-tube method and was drawn at high speeds with an aim of mass production to meet the demand of next generation communication systems. Transmission parameters such as numerical aperture and normalized frequency of the fabricated holey fibers have been measured and compared with theoretical values based on effective index method. Although the fabricated holey fibers were not of high quality, the analyses of the parameters have shown promising outlook for fabrication of such fibers.

STS-107 crew meet with media in front of grandstand at KSC

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- The STS-107 crew meet with the media in front of the grandstand. With the microphone is Payload Specialist Ilan Ramon, the first Israeli astronaut. Others, from left, are Commander Rick Husband, Pilot William 'Willie' McCool, Ramon, Mission Specialist David Brown, Payload Commander Michael Anderson, and Mission Specialists Laurel Clark and Kalpana Chawla. The crew just finished Terminal Countdown Demonstration Test activities, including a simulated launch countdown, in preparation for launch planned for Jan. 16, 2003, between 10 a.m. and 2 p.m. EST aboard Space Shuttle Columbia. STS-107 is a mission devoted to research and will include more than 80 experiments that will study Earth and space science, advanced technology development, and astronaut health and safety. .

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

14 CFR 1214.812 - Payload specialists.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Payload specialists. 1214.812 Section 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement for...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

Parts Specialist.

ERIC Educational Resources Information Center

Fuqua, Lou; Fuqua, Debbie

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

ATTITUDE OF CLEFT CARE SPECIALISTS IN AFRICA TOWARDS PRESURGICAL ORTHOPAEDICS.

PubMed

Adeyemi, A T; Bankole, O O

2012-12-01

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

E-learning for medical imaging specialists: introducing blended learning in a nuclear medicine specialist course

PubMed Central

Haslerud, Torjan; Tulipan, Andreas Julius; Gray, Robert M

2017-01-01

Background While e-learning has become an important tool in teaching medical students, the training of specialists in medical imaging is still dominated by lecture-based courses. Purpose To assess the potential of e-learning in specialist education in medical imaging. Material and Methods An existing lecture-based five-day course in Clinical Nuclear Medicine (NM) was enhanced by e-learning resources and activities, including practical exercises. An anonymized survey was conducted after participants had completed and passed the multiple choice electronic course examination. Results Twelve out of 15 course participants (80%) responded. Overall satisfaction with the new course format was high, but 25% of the respondents wanted more interactive elements such as discussions and practical exercises. The importance of lecture handouts and supplementary online material such as selected original articles and professional guidelines was affirmed by all the respondents (92% fully, 8% partially), while 75% fully and 25% partially agreed that the lectures had been interesting and relevant. Conclusion E-learning represents a hitherto unrealized potential in the education of medical specialists. It may expedite training of medical specialists while at the same time containing costs. PMID:28804642

Are peer specialists happy on the job?

PubMed

Jenkins, Sarah; Chenneville, Tiffany; Salnaitis, Christina

2018-03-01

This study was designed to examine the impact of role clarity and job training on job satisfaction among peer specialists. A 3-part survey assessing job training, job satisfaction, and role clarity was administered online to 195 peer specialists who are members of the International Association of Peer Specialists. Data was analyzed using descriptive statistics, correlational analyses to include multiple linear regressions and analysis of variance. Self-study and online training methods were negatively correlated with job satisfaction while job shadowing was positively correlated with job satisfaction. Role clarity was positively correlated with job satisfaction and job training satisfaction as well as job shadowing and one-on-one training. The use of self-study and online training for peer specialists is contraindicated by current findings, which suggest the need to utilize job shadowing or training methods that allow for personal interaction between peer specialists and their colleagues. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Specialist training in obstetrics and gynaecology: a survey on work-life balance and stress among trainees in UK.

PubMed

Thangaratinam, S; Yanamandra, S R; Deb, S; Coomarasamy, A

2006-05-01

The object of this study was to evaluate perceptions about work-life balance and levels of stress in obstetrics and gynaecology trainees in the UK. This was a questionnaire survey conducted at the National Obstetric and Gynaecology Specialist Registrar Meeting (SpROGs 2004, Birmingham, UK). A total of 190 trainees in obstetrics and gynaecology attended the meeting. Trainees at the meeting were given a questionnaire to fill in regarding their perception of work-life balance, stress at work and their attitude to training in obstetrics and gynaecology. The response rate was 128/190 (67%). Half of the trainees (64/128, 50%) felt that they had achieved satisfactory work-life balance. There was a trend towards more men achieving this balance compared with women (25/42 (60%) vs 38/83 (46%), p = 0.19). Unsatisfactory social life (82%) and scarce time with the family (74%) were cited as the most common reasons for not achieving a satisfactory work-life balance. More than two-thirds of the trainees (83/128, 65%) found their work moderately or very stressful. Senior trainees (years 4 or more of specialist training) found work more stressful than junior trainees (years 1 - 3 of specialist training) (29/35 (83%) vs 54/93 (58%), p = 0.01). However, 77/128 (60%) of trainees would still recommend a career in obstetrics and gynaecology to medical students. A majority (85/128, 66%) claimed that they would choose obstetrics and gynaecology again if given a second chance. A large number of trainees (110/128, 86%) were looking forward to their future in this field. In spite of the high levels of perceived work-life imbalance and stress at work, most trainees would choose the same specialty given another chance and would recommend the same to others, indicating a certain level of satisfaction with the specialty. However, our study shows that improvements in the working lives of obstetrics and gynaecology trainees are still needed, especially given the current context of difficulty with

Behavior medicine specialist.

PubMed

Tuso, Phillip

2014-01-01

Total Health is a vision for the future and a strategy to prevent preventable disease, save lives, and make health care more affordable. Total Health means health of mind (behavior health) and health of body (physical health). To achieve Total Health we need healthy people in healthy communities. A behavior medicine specialist is a psychologist who works in the medical home with the primary care physician instead of in the Mental Health Department with a psychiatrist. The key to achieving Total Health will be to transform our current health care system from a focus on treating disease to a focus on preventing disease. This transformation will require complex behavior change interventions and services not usually provided in the medical home. The behavior medicine specialist will bring the knowledge and experience used to treat mental illness into the medical home to help the primary care physician improve the care of all patients in the medical home. The behavior medicine specialist will help improve outcomes in synergy with the primary care physician by universal screening of high-risk diseases, stepped care protocols, and efficient use of all resources available to care for patients in the medical home (health education classes, wellness coaches, and online social networking lifestyle management programs). These interventions should increase patient satisfaction, increase access to specialty care (psychiatry), and help us achieve Total Health.

Telecommunications Specialist.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This publication contains 17 subjects appropriate for use in a competency list for the occupation of telecommunications specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 17 units are as…

Learning Opportunities for Library Media Specialists

ERIC Educational Resources Information Center

Newton, Jennifer W.

2008-01-01

To address the varying needs of media specialists, area Educational Technology Training Centers, Regional Educational Service Agencies (RESA), and larger school systems are forming professional development communities or consortia that cater specifically to the continuing education needs of library media specialists. In addition to academic and…

75 FR 72790 - Gulf of Mexico Fishery Management Council; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

... restoration plan, the Long Term Recovery Plan After the Deepwater Horizon Oil Spill, and the Essential Fish... Louisiana/Mississippi Habitat Protection Advisory Panel (AP). DATES: The meeting will convene at 9 a.m. on... FURTHER INFORMATION CONTACT: Jeff Rester, Habitat Support Specialist, Gulf States Marine Fisheries...

Brazilian infectious diseases specialists: who and where are they?

PubMed

Cassenote, Alex Jones Flores; Scheffer, Mario César; Segurado, Aluísio Augusto Cotrim

2016-01-01

The infectious diseases specialist is a medical doctor dedicated to the management of infectious diseases in their individual and collective dimensions. The aim of this paper was to evaluate the current profile and distribution of infectious diseases specialists in Brazil. This is a cross-sectional study using secondary data obtained from institutions that register medical specialists in Brazil. Variables of interest included gender, age, type of medical school (public or private) the specialist graduated from, time since finishing residency training in infectious diseases, and the interval between M.D. graduation and residency completion. Maps are used to study the geographical distribution of infectious diseases specialists. A total of 3229 infectious diseases specialist registries were counted, with 94.3% (3045) of individual counts (heads) represented by primary registries. The mean age was 43.3 years (SD 10.5), and a higher proportion of females was observed (57%; 95% CI 55.3-58.8). Most Brazilian infectious diseases specialists (58.5%) practice in the Southeastern region. However, when distribution rates were calculated, several states exhibited high concentration of infectious diseases specialists, when compared to the national rate (16.06). Interestingly, among specialists working in the Northeastern region, those trained locally had completed their residency programs more recently (8.7yrs; 95% CI 7.9-9.5) than physicians trained elsewhere in the country (13.6yrs: 95% CI 11.8-15.5). Our study shows that Brazilian infectious diseases specialists are predominantly young and female doctors. Most have concluded a medical residency training program. The absolute majority practice in the Southeastern region. However, some states from the Northern, Northeastern and Southeastern regions exhibit specialist rates above the national average. In these areas, nonetheless, there is a strong concentration of infectious diseases specialists in state capitals and in

14 CFR § 1214.305 - Payload specialist responsibilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Payload specialist responsibilities. § 1214.305 Section § 1214.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.305 Payload specialist...

Accounting Specialist.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This publication identifies 20 subjects appropriate for use in a competency list for the occupation of accounting specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 20 units are as follows:…

Primary care spirometry: test quality and the feasibility and usefulness of specialist reporting

PubMed Central

White, Patrick; Wong, Wun; Fleming, Tracey; Gray, Barry

2007-01-01

Background Provision of spirometry for chronic obstructive pulmonary disease (COPD) is a new requirement in primary care. Effective spirometry requires that tests and interpretations meet international criteria. Aim To assess the feasibility and usefulness of remote specialist reporting of primary care spirometry. Design of study Comparison of reporting by primary care clinicians and respiratory specialists of consecutive primary care spirometry tests. Setting South London primary care teams with patient lists ≥6000. Method Feasibility of remote reporting of spirometry was assessed by the frequency of electronic mailing of tests. Usefulness of remote reporting was defined by the frequency that specialist reports made a clinically significant addition. Usefulness was assessed by measuring agreement (κ) between primary care reports and those of specialists. Clinically significant disagreements were analysed with respect to test quality, diagnosis, and severity. Results Six practices emailed 312 tests over 3 months. Forty-nine tests sent without indices or curves (flow volume and time volume) were excluded. Mean age of patients tested was 65 years and 52% were female. Mean predicted forced expiratory volume in the first second (FEV1) was 69%. Clinically significant disagreements were identified in the interpretation of acceptability (quality) of 67/212 (32%) tests (κ = 0.07; 95% confidence interval [CI] = 0 to 0.24), of diagnosis in 49/168 (29%) tests (κ = 0.39; 95% CI = 0.25 to 0.55), and of severity in 62/191 (32%) tests (κ = 0.53; 95% CI = 0.43 to 0.63). Conclusion Remote reporting of primary care spirometry was feasible. Its usefulness was confirmed by the high rate of additional clinically significant information to the reports of primary care clinicians. The quality of primary care spirometry was so unsatisfactory that remote reporting of tests may be a means of establishing adequate spirometry. PMID:17761057

Guidelines for Certification of Media Specialists.

ERIC Educational Resources Information Center

Galey, Minaruth; Grady, William F.

This certification model, which is a refined version of the 1974 AECT Certification Model, is directed to the needs of educational media specialists, their employers and educators, and to certifying and accrediting agencies that approve programs preparing educational media specialists. Included in the document are reports on accreditation and…

Differences in the diagnosis and management of systemic lupus erythematosus by primary care and specialist providers in the American Indian/Alaska Native population.

PubMed

McDougall, J A; Helmick, C G; Lim, S S; Johnston, J M; Gaddy, J R; Gordon, C; Ferucci, E D

2018-06-01

Objectives The objective of this study is to investigate differences in the diagnosis and management of systemic lupus erythematosus (SLE) by primary care and specialist physicians in a population-based registry. Methods This study includes individuals from the 2009 Indian Health Service lupus registry population with a diagnosis of SLE documented by either a primary care provider or specialist. SLE classification criteria, laboratory testing, and medication use at any time during the course of disease were determined by medical record abstraction. Results Of the 320 individuals with a diagnosis of SLE, 249 had the diagnosis documented by a specialist, with 71 documented by primary care. Individuals with a specialist diagnosis of SLE were more likely to have medical record documentation of meeting criteria for SLE by all criteria sets (American College of Rheumatology, 79% vs 22%; Boston Weighted, 82% vs 32%; and Systemic Lupus International Collaborating Clinics, 83% vs 35%; p < 0.001 for all comparisons). In addition, specialist diagnosis was associated with documentation of ever having been tested for anti-double-stranded DNA antibody and complement 3 and complement 4 ( p < 0.001). Documentation of ever receiving hydroxychloroquine was also more common with specialist diagnosis (86% vs 64%, p < 0.001). Conclusions Within the population studied, specialist diagnosis of SLE was associated with a higher likelihood of having SLE classification criteria documented, being tested for biomarkers of disease, and ever receiving treatment with hydroxychloroquine. These data support efforts both to increase specialist access for patients with suspected SLE and to provide lupus education to primary care providers.

Extending specialist palliative care to all?

PubMed

Field, D; Addington-Hall, J

1999-05-01

How to extend palliative care services to all patients needing them is an issue currently exercising a range of bodies in contemporary Britain. This paper first considers the evidence regarding the needs of dying patients with long term conditions other than cancer and concludes that there is evidence to support their presumed need for palliative care. It then considers five potential barriers to extending specialist palliative care services to non-cancer patients in Britain. These are the skill base of current specialists in palliative care, difficulties in identifying candidates for specialist palliative care, the views of potential users of these services, resource implications and vested interests in present health service arrangements.

Development Of Methodologies Using PhabrOmeter For Fabric Drape Evaluation

NASA Astrophysics Data System (ADS)

Lin, Chengwei

Evaluation of fabric drape is important for textile industry as it reveals the aesthetic and functionality of the cloth and apparel. Although many fabric drape measuring methods have been developed for several decades, they are falling behind the need for fast product development by the industry. To meet the requirement of industries, it is necessary to develop an effective and reliable method to evaluate fabric drape. The purpose of the present study is to determine if PhabrOmeter can be applied to fabric drape evaluation. PhabrOmeter is a fabric sensory performance evaluating instrument which is developed to provide fast and reliable quality testing results. This study was sought to determine the relationship between fabric drape and other fabric attributes. In addition, a series of conventional methods including AATCC standards, ASTM standards and ISO standards were used to characterize the fabric samples. All the data were compared and analyzed with linear correlation method. The results indicate that PhabrOmeter is reliable and effective instrument for fabric drape evaluation. Besides, some effects including fabric structure, testing directions were considered to examine their impact on fabric drape.

42 CFR 410.76 - Clinical nurse specialists' services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Clinical nurse specialists' services. 410.76... § 410.76 Clinical nurse specialists' services. (a) Definition. As used in this section, the term...) Qualifications. For Medicare Part B coverage of his or her services, a clinical nurse specialist must— (1) Be a...

AG Bell Academy Certification Program for Listening and Spoken Language Specialists: Meeting a World-Wide Need for Qualified Professionals

ERIC Educational Resources Information Center

Goldberg, Donald M.; Dickson, Cheryl L.; Flexer, Carol

2010-01-01

This article discusses the AG Bell Academy for Listening and Spoken Language--an organization designed to build capacity of certified Listening and Spoken Language Specialists (LSLS) by defining and maintaining a set of professional standards for LSLS professionals and thereby addressing the global deficit of qualified LSLS. Definitions and…

Successful Public Relations Efforts: Using the Departmental Meeting as a Resource.

ERIC Educational Resources Information Center

Seewald, Jacqueline

1998-01-01

Explains how media specialists can use departmental meetings to develop and promote better public relations within the school community. Topics include changes in the media center; new programs or services being offered, including new software and Internet resources; teacher requests for materials to support their curriculum; and interlibrary-loan…

Organizing uninsured safety-net access to specialist physician services.

PubMed

Hall, Mark A

2013-05-01

Arranging referrals for specialist services is often the greatest difficulty that safety-net access programs face in attempting to provide fairly comprehensive services for the uninsured. When office-based community specialists are asked to care for uninsured patients, they cite the following barriers: difficulty determining which patients merit charity care, having to arrange for services patients need from other providers, and concerns about liability for providing inadequate care. Solutions to these barriers to specialist access can be found in the same institutional arrangements that support primary care and hospital services for the uninsured. These safety-net organization structures can be extended to include specialist physician care by funding community health centers to contract for specialist referrals, using free-standing referral programs to subsidize community specialists who accept uninsured patients at discounted rates, and encouraging hospitals through tax exemption or disproportionate share funding to require specialists on their medical staffs to accept an allocation of uninsured office-based referrals.

Preparing Elementary Mathematics-Science Teaching Specialists.

ERIC Educational Resources Information Center

Miller, L. Diane

1992-01-01

Describes a professional development program to train math/science specialists for the upper elementary school grades. Using results from an interest survey, 30 teachers were chosen to participate in a 3-year program to become math/science specialists. Presents the teaching model used and the advantages for teachers and students in having subject…

Performance and Fabrication Status of TREAT LEU Conversion Conceptual Design Concepts

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

IJ van Rooyen; SR Morrell; AE Wright

2014-10-01

Resumption of transient testing at the TREAT facility was approved in February 2014 to meet U.S. Department of Energy (DOE) objectives. The National Nuclear Security Administration’s Global Threat Reduction Initiative Convert Program is evaluating conversion of TREAT from its existing highly enriched uranium (HEU) core to a new core containing low enriched uranium (LEU). This paper describes briefly the initial pre-conceptual designs screening decisions with more detailed discussions on current feasibility, qualification and fabrication approaches. Feasible fabrication will be shown for a LEU fuel element assembly that can meet TREAT design, performance, and safety requirements. The statement of feasibility recognizesmore » that further development, analysis, and testing must be completed to refine the conceptual design. Engineering challenges such as cladding oxidation, high temperature material properties, and fuel block fabrication along with neutronics performance, will be highlighted. Preliminary engineering and supply chain evaluation provided confidence that the conceptual designs can be achieved.« less

STS-107 Mission Specialist Laurel Clark at SPACEHAB

NASA Technical Reports Server (NTRS)

2000-01-01

KENNEDY SPACE CENTER, FLA. -- At SPACEHAB, STS-107 Mission Specialist Laurel Clark gets hands-on experience with equipment that will be on the mission. Watching in the left foreground is Mission Specialist Kalpana Chawla; next to her at left is Mission Specialist Michael Anderson. Identified as a research mission, STS-107 is scheduled for launch July 19, 2001

[New business model for medical specialists].

PubMed

Houwen, L G H J Louis

2013-01-01

The reforms in the field of medical specialist care have important implications for the professional practice of medical specialists and their working relationship with the hospital. This leads to a considerable amount of pressure placed upon the way physicians have traditionally practiced their liberal professions, which is by forming partnerships and practicing from within the hospitals based on an admission agreement. As of 2015, the tax benefits for entrepreneurs will be abolished and the formation of regional partnerships will be discouraged. These developments not only pose threats but also offer opportunities for both the entrepreneurial medical specialist and the innovative hospital. In this article, the prospect of a future business model for specialist medical care will be outlined and explored by proposing three new organizational forms. The central vision of this model is that physicians who wish to retain their status of liberal professional practitioners in the twenty-first century should be more involved in the ownership structure of hospitals. The social importance of responsible patient care remains paramount.

Media Specialist's Corner.

ERIC Educational Resources Information Center

Parrini, Michelle; Kittlaus, Jennifer

2002-01-01

Presents an annotated bibliography of resources for students, teachers, and school library media specialists related to the topic, "Youth, Rights, and the Constitution," found in this issue of "Insights on Law and Society." Includes books and primary sources for students. (CMK)

An audit of management of differentiated thyroid cancer in specialist and non-specialist clinic settings.

PubMed

Kumar, H; Daykin, J; Holder, R; Watkinson, J C; Sheppard, M C; Franklyn, J A

2001-06-01

Thyroid cancer is the most common endocrine malignancy but is none the less rare. Some aspects of its management remain controversial. Previous audits of patient management in the United Kingdom have revealed deficiencies, especially in communication between specialists. We have audited patient management in a large university-associated teaching hospital, assessing points of good practice identified from published guidelines and reviews, and have compared findings in groups of patients managed jointly by specialists with an interest in thyroid cancer (including surgeon, endocrinologist and oncologist) with a group managed by other clinicians outside that setting. Retrospective case-note review of 205 patients with differentiated (papillary or follicular) cancer including group A (n = 134; managed in a specialist multi-disciplinary clinic setting) and group B (n = 71; managed in other clinic settings). Points of good practice investigated were adequacy of surgery, surgical complications, prescription and adequacy of T4 treatment, adequacy of monitoring by measurement of serum thyroglobulin and action taken and appropriate administration of ablative radioiodine. Deficiencies in management of the cohort as a whole were identified, including inadequate surgery and inadequate TSH suppression in approximately one-fifth of the cases. Monitoring with thyroglobulin measurements and action when serum thyroglobulin was high were also inadequate in some cases and ablative radioiodine was not given, despite being indicated in 11.7% of the cohort. Inadequate surgery and failure to administer radioiodine were less common in those managed in a specialist clinic setting than in those managed in other clinic settings. The findings highlight the need for locally agreed protocols in managing relatively rare endocrine disorders such as thyroid cancer and argue in favour of centralization of expertise and patient management in multi-disciplinary specialist clinic settings.

Academic learning for specialist nurses: a grounded theory study.

PubMed

Millberg, Lena German; Berg, Linda; Brämberg, Elisabeth Björk; Nordström, Gun; Ohlén, Joakim

2014-11-01

The aim was to explore the major concerns of specialist nurses pertaining to academic learning during their education and initial professional career. Specialist nursing education changed in tandem with the European educational reform in 2007. At the same time, greater demands were made on the healthcare services to provide evidence-based and safe patient-care. These changes have influenced specialist nursing programmes and consequently the profession. Grounded Theory guided the study. Data were collected by means of a questionnaire with open-ended questions distributed at the end of specialist nursing programmes in 2009 and 2010. Five universities were included. Further, individual, pair and group interviews were used to collect data from 12 specialist nurses, 5-14 months after graduation. A major concern for specialist nurses was that academic learning should be "meaningful" for their professional future. The specialist nurses' "meaningful academic learning process" was characterised by an ambivalence of partly believing in and partly being hesitant about the significance of academic learning and partly receiving but also lacking support. Specialist nurses were influenced by factors in two areas: curriculum and healthcare context. They felt that the outcome of contribution to professional confidence was critical in making academic learning meaningful. Copyright © 2014 Elsevier Ltd. All rights reserved.

Role Transition After Clinical Nurse Specialist Education.

PubMed

Ares, Terri L

This study explored the transition of clinical nurse specialists into new roles after completion of their graduate education. A quantitative longitudinal survey was used to measure certification, employment, career commitment, and the imposter phenomenon. An online survey was sent to 113 participants from a previous national study that agreed to follow-up. The Student Nurse Anesthetist Experience Questionnaire and Clance Imposter Phenomenon Scale instruments were used. Each case (N = 68) was matched with data from the primary study, and 2 comparison groups were formed based on employment status as a clinical nurse specialist. The advanced practice certification rate was 66.7%, and 48.5% were employed as a clinical nurse specialist. The employed group perceived more autonomy, a more positive view of the clinical nurse specialist lifestyle, and upset life plans if not able to practice in the role when compared with the not-employed group. Self-image was significantly different based on employment, but career commitment was not particularly strong regardless of employment status. The prevalence of imposter phenomenon experiences was 74.6% in this sample. Recent graduates are struggling with their transition into practice as clinical nurse specialists.

Clinical outcomes for patients with liver-limited metastatic colorectal cancer: Arguing the case for specialist hepatobiliary multidisciplinary assessment.

PubMed

Thillai, K; Repana, D; Korantzis, I; Kane, P; Prachalias, A; Ross, P

2016-09-01

In patients with liver-limited metastatic colorectal cancer, hepatic resection can offer a significant survival benefit over systemic therapy alone. Specialist hepatobiliary multidisciplinary meetings are currently believed to provide the best forum to discuss the management for these patients. A retrospective analysis was undertaken of patients diagnosed with liver-limited metastatic colorectal cancer over 6 months within a cancer network in the United Kingdom. In addition, patients who were diagnosed but not referred to the hepatobiliary meeting were discussed within a virtual multi-disciplinary setting. Contributors were blinded and proposed management recorded. 159 newly diagnosed patients with liver-limited metastatic colorectal cancer were identified. 68 (43%) were referred at initial diagnosis and 38 (24%) referred following systemic treatment. 35 (51%) who were discussed at baseline underwent a subsequent hepatectomy or radiofrequency ablation, as did 18 (47%) patients referred after chemotherapy. Of the remaining 53 (33%) patients not referred, imaging was available for 31 (58%). Decisions regarding potential liver-directed therapy were discussed within a multi-disciplinary setting. 13 (42%) were identified as resectable or potentially resectable and 11 (36%) may have been suitable for a clinical trial. In reality, none of these 31 patients (100%) underwent surgery or ablation. Whilst the majority of patients with liver-limited metastatic colorectal cancer were referred appropriately, this study demonstrates that a significant number with potentially resectable disease are not being discussed at specialist meetings. A review of all diagnosed cases would ensure that an increased number of patients are offered hepatic resection or ablation. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas

2010-01-01

The main objective of this study was to analyze pharmacy specialists' attitudes toward the quality of pharmaceutical services at Lithuanian community pharmacies. Between April and June 2009, a total of 471 Lithuanian community pharmacy specialists completed a questionnaire designed to evaluate their attitudes toward the quality of pharmaceutical services at community pharmacies. The main dimensions of pharmaceutical service quality were extracted by principal component analysis. Two main dimensions of pharmaceutical service quality were extracted: pharmacotherapeutic aspects (provision of information about drug therapy, possible side effects, health promotion, the amount of time spent with a patient, and the ascertainment that a patient understood the provided information) and socioeconomic aspects (considering patient's needs and financial capabilities, making a patient confident with the services provided). Pharmacy specialists evaluated the quality of both dimensions positively, but the quality of the first dimension was rated significantly worse than that of the second dimension. The attitudes of pharmacy specialists working at independent pharmacies were more positive toward pharmacotherapeutic aspects as compared to the specialists working at chain or state pharmacies. Pharmacotherapeutic aspects were rated better by pharmacy specialists, aged ≥ 55 years, than those younger than 45 years. Moreover, the attitudes of 45-54-year-old pharmacy specialists toward the socioeconomic aspects were more positive as compared with those of 35-44-year olds. Pharmacists rated the socioeconomic aspects of pharmaceutical service quality worse as compared with pharmacy technicians. The attitudes of pharmacy specialists working at pharmacies with 6-9 specialists were more negative toward pharmacotherapeutic aspects than those of the pharmacies with 1-2 specialists. Pharmacy specialists working at pharmacies with ≥ 10 specialists reported lower scores of socioeconomic

Enabling factors for specialist outreach in western KwaZulu-Natal

PubMed Central

2018-01-01

Background There exists a major disparity in access to specialist care between patients in urban and rural areas. Specialists are a scarce resource and are concentrated in urban areas. Specialist outreach attempts to fill the gap in service provision for patients situated remotely. While there is international evidence that multifaceted specialist outreach has achieved varying levels of success, factors that influence the effectiveness of outreach have not yet been fully elucidated in South Africa. Aim This study attempts to uncover some of the factors that enable good multifaceted specialist outreach. Setting The study was conducted in hospitals in western KwaZulu-Natal province. This health area is served by a tertiary hospital and 20 peripheral hospitals; three of these are regional level and the majority are district level hospitals. Specialist outreach emanates from the tertiary hospital. Methods Specialists providing outreach services from the tertiary hospital and medical officers at seven receiving hospitals were interviewed to explore perceptions regarding factors that might enable successful specialist outreach. Framework analysis on the transcribed interviews was carried out using NVivo version 11. Results A major positive finding concerns the relationships formed between outreach specialists and doctors at the recipient hospitals. The management of the programme with respect to structure, dependability, data management, transport provision, communication technology and public health systems was also seen as beneficial in specialist outreach. Conclusion Specialist outreach plays an essential role in providing equality in health care. To enable effectiveness, it is important to make full use of the multifaceted nature of this intervention. PMID:29781691

Design and fabrication of solar cell modules

NASA Technical Reports Server (NTRS)

Shaughnessy, T. P.

1978-01-01

A program conducted for design, fabrication and evaluation of twelve silicon solar cell modules is described. The purpose of the program was to develop a module design consistent with the requirements and objectives of JPL specification and to also incorporate elements of new technologies under development to meet LSSA Project goals. Module development emphasized preparation of a technically and economically competitive design based upon utilization of ion implanted solar cells and a glass encapsulation system. The modules fabricated, tested and delivered were of nominal 2 X 2 foot dimensions and 20 watt minimum rating. Basic design, design rationale, performance and results of environmental testing are described.

Administrative Assistant and Correspondence Specialist: Task List Competency Record.

ERIC Educational Resources Information Center

Minnesota Instructional Materials Center, White Bear Lake.

One of a series of 12 in the secretarial/clerical area, this booklet for the vocational instructor contains job descriptions for two word processing occupations, the non-typing administrative assistant and the correspondence specialist (also called word processing correspondence specialist, magnetic keyboard specialist, or word processing…

Specialist and generalist symbionts show counterintuitive levels of genetic diversity and discordant demographic histories along the Florida Reef Tract

NASA Astrophysics Data System (ADS)

Titus, Benjamin M.; Daly, Marymegan

2017-03-01

Specialist and generalist life histories are expected to result in contrasting levels of genetic diversity at the population level, and symbioses are expected to lead to patterns that reflect a shared biogeographic history and co-diversification. We test these assumptions using mtDNA sequencing and a comparative phylogeographic approach for six co-occurring crustacean species that are symbiotic with sea anemones on western Atlantic coral reefs, yet vary in their host specificities: four are host specialists and two are host generalists. We first conducted species discovery analyses to delimit cryptic lineages, followed by classic population genetic diversity analyses for each delimited taxon, and then reconstructed the demographic history for each taxon using traditional summary statistics, Bayesian skyline plots, and approximate Bayesian computation to test for signatures of recent and concerted population expansion. The genetic diversity values recovered here contravene the expectations of the specialist-generalist variation hypothesis and classic population genetics theory; all specialist lineages had greater genetic diversity than generalists. Demography suggests recent population expansions in all taxa, although Bayesian skyline plots and approximate Bayesian computation suggest the timing and magnitude of these events were idiosyncratic. These results do not meet the a priori expectation of concordance among symbiotic taxa and suggest that intrinsic aspects of species biology may contribute more to phylogeographic history than extrinsic forces that shape whole communities. The recovery of two cryptic specialist lineages adds an additional layer of biodiversity to this symbiosis and contributes to an emerging pattern of cryptic speciation in the specialist taxa. Our results underscore the differences in the evolutionary processes acting on marine systems from the terrestrial processes that often drive theory. Finally, we continue to highlight the Florida Reef

Heating Systems Specialist.

ERIC Educational Resources Information Center

Air Force Training Command, Sheppard AFB, TX.

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

14 CFR § 1214.812 - Payload specialists.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Payload specialists. § 1214.812 Section § 1214.812 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Reimbursement...-furnished mission specialists. Accommodations for, and mission-independent training of, any payload...

Caring for patients with cancer in non-specialist wards: the nurse experience.

PubMed

Mohan, S; Wilkes, L M; Ogunsiji, O; Walker, A

2005-07-01

This study aims to describe the experiences of nurses caring for cancer patients in non-specialist wards. The study was conducted in a large (420 beds) and small (32 beds) hospital in an area health service with urban and rural populations in the west of Sydney. A qualitative descriptive approach was utilized to collect data from the nurses. Data were collected using a survey and in-depth interviews of nurses working in non-specialist cancer wards. Transcribed data were managed with Nudist Vivo software and analysed for common themes using process of constant comparison and contrast. Twenty-five surveys were returned and five nurses volunteered to be interviewed. The six major themes that emerged from analysis of data were: emotional nature of care, lack of time, lack of knowledge of cancer treatment, family support, environment not conducive to proper care and dealing with patient's non-acceptance of cancer diagnosis. The nurses in this study wished to provide quality supportive care for cancer patients and their families but the inconducive environment and inadequate relevant training hindered the nurses' efforts. This then presents further need of relevant training for nurses in cancer care and time management, to meet up with these challenges.

Los Alamos National Laboratory Prototype Fabrication Division CNM Briefing

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

Hidalgo, Stephen P.; Keyser, Richard J.

2012-06-18

Prototype Fabrication Division designs, programs, manufactures, and inspects on-site high quality, diverse material parts and components that can be delivered at the pace the customer needs to meet their mission. Our goal is to bring vision to reality in the name of science.

Diet Therapy Specialist.

ERIC Educational Resources Information Center

Air Force Training Command, Sheppard AFB, TX.

This four-volume student text is intended for use in training Air Force diet therapy specialists. The first volume, a study guide and workbook for self-directed instruction, covers nutrition, food processing and preparation, therapeutic diets, security precautions in medical food service, procedures for ordering equipment and supplies, food…

Layered Metals Fabrication Technology Development for Support of Lunar Exploration at NASA/MSFC

NASA Technical Reports Server (NTRS)

Cooper, Kenneth G.; Good, James E.; Gilley, Scott D.

2007-01-01

NASA's human exploration initiative poses great opportunity and risk for missions to the Moon and beyond. In support of these missions, engineers and scientists at the Marshall Space Flight Center are developing technologies for ground-based and in-situ fabrication capabilities utilizing provisioned and locally-refined materials. Development efforts are pushing state-of-the art fabrication technologies to support habitat structure development, tools and mechanical part fabrication, as well as repair and replacement of ground support and space mission hardware such as life support items, launch vehicle components and crew exercise equipment. This paper addresses current fabrication technologies relative to meeting targeted capabilities, near term advancement goals, and process certification of fabrication methods.

17 CFR 240.11b-1 - Regulation of specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Regulation of specialists. 240... Securities Exchange Act of 1934 Adoption of Regulation on Conduct of Specialists § 240.11b-1 Regulation of specialists. (a)(1) The rules of a national securities exchange may permit a member of such exchange to...

Sports Medicine: What is a Sports Medicine Specialist?

MedlinePlus

What is a Sports Medicine Specialist? A physician with significant specialized training in both the treatment and prevention of illness and injury. The Sports Medicine Specialist helps patients maximize function and minimize ...

Portrait view of ESA Spacelab Specialists

NASA Technical Reports Server (NTRS)

1978-01-01

Portrait view of European Space Agency (ESA) Spacelab Specialist Byron K. Lichtenberg in civilian clothes standing in front of a display case. The photo was taken at the Marshall Space Flight Center (MSFC), Huntsville, Alabama (31779); portrait view of ESA Spacelab Specialist Michael L. Lampton, also in civilian clothes in front of display at MSFC (31780); portrait view of Wubbo Ockels, also in civilian clothes in front of display at MSFC (31781).

Fabrication of precise aperiodic multichannel fibre Bragg grating filters for spectral line suppression in hydrogenated standard telecommunications fibre.

PubMed

Gbadebo, Adenowo A; Turitsyna, Elena G; Williams, John A R

2018-01-22

We demonstrate the design and fabrication of multichannel fibre Bragg gratings (FBGs) with aperiodic channel spacings. These will be suitable for the suppression of specific spectral lines such as OH emission lines in the near infrared (NIR) which degrade ground based astronomical imaging. We discuss the design process used to meet a given specification and the fabrication challenges that can give rise to errors in the final manufactured device. We propose and demonstrate solutions to meet these challenges.

Does sugar content matter? Blood plasma glucose levels in an occasional and a specialist avian nectarivore.

PubMed

Witteveen, Minke; Brown, Mark; Downs, Colleen T

2014-01-01

Nectar composition within a plant pollinator group can be variable, and bird pollinated plants can be segregated into two groups based on their adaptations to either a specialist or an occasional bird pollination system. Specialist nectarivores rely primarily on nectar for their energy requirements, while occasional nectarivores meet their energy requirements from nectar as well as from seeds, fruit and insects. Avian blood plasma glucose concentration (PGlu) is generally high compared with mammals. It is also affected by a range of factors including species, gender, age, ambient temperature, feeding pattern, reproductive status, circadian rhythm and moult status, among others. We examined whether sugar content affected PGlu of two avian nectarivores, a specialist nectarivore the Amethyst Sunbird Chalcomitra amethystina, and an occasional nectarivore the Cape White-eye Zosterops virens, when fed sucrose-hexose sugar solution diets of varying concentrations (5%-35%). Both species regulated PGlu within a range which was affected by sampling time (fed or fasted) and not dietary sugar concentration. The range in mean PGlu was broader in Amethyst Sunbirds (11.52-16.51mmol/L) compared with Cape White-eyes (14.33-15.85mmol/L). This suggests that these birds are not constrained by dietary sugar concentration with regard to PGlu regulation, and consequently selective pressure on plants for their nectar characteristics is due to reasons other than glucose regulation. © 2013.

The Intensive care unit specialist: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine.

PubMed

Amin, Pravin; Fox-Robichaud, Alison; Divatia, J V; Pelosi, Paolo; Altintas, Defne; Eryüksel, Emel; Mehta, Yatin; Suh, Gee Young; Blanch, Lluís; Weiler, Norbert; Zimmerman, Janice; Vincent, Jean-Louis

2016-10-01

The role of the critical care specialist has been unequivocally established in the management of severely ill patients throughout the world. Data show that the presence of a critical care specialist in the intensive care unit (ICU) environment has reduced morbidity and mortality, improved patient safety, and reduced length of stay and costs. However, many ICUs across the world function as "open ICUs," in which patients may be admitted under a primary physician who has not been trained in critical care medicine. Although the concept of the ICU has gained widespread acceptance amongst medical professionals, hospital administrators and the general public; recognition and the need for doctors specializing in intensive care medicine has lagged behind. The curriculum to ensure appropriate training around the world is diverse but should ideally meet some minimum standards. The World Federation of Societies of Intensive and Critical Care Medicine has set up a task force to address issues concerning the training, functions, roles, and responsibilities of an ICU specialist. Copyright © 2016 Elsevier Inc. All rights reserved.

Calendar of Selected Aeronautical and Space Meetings (Calendrier des Manifestations Aeronautiques et Spatiales (Selection)).

DTIC Science & Technology

1983-01-01

Physique de l’Atmosphire et Environnement terrestre 71 09 - Information, Documentation et Informatique 74 10 - Thimes gin~raux (pluridisciplinaires) et...March Louisiana (US) Fiber Communication Optical Communications IEEE Fibre Optics Electro-Optics 02-08 7-9 March Baden-Baden VDE -IEEE Specialists...Conference on Very Large Electronic Systems VDE (GE) Scale Integrated Circuits Solid State Devices IEEE Integrated Circuits Engineering Design Fabrication

Information Support Specialist.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This publication contains 22 subjects appropriate for use in a competency list for the occupation of information support specialist, 1 of occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 22 units are as…

Microcomputer Applications Specialist.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This publication contains 16 subjects appropriate for use in a competency list for the occupation of microcomputer applications specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 16 units are…

STS-87 Mission Specialist Scott in white room

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Mission Specialist Winston Scott is assisted with his ascent and re-entry flight suit in the white room at Launch Pad 39B by Danny Wyatt, NASA quality assurance specialist. STS-87 is the fourth flight of the United States Microgravity Payload and Spartan-201. Scott is scheduled to perform an extravehicular activity spacewalk with Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan, during STS-87. Scott also performed a spacewalk on the STS-72 mission.

State Department Early Childhood Education Program Specialists' Review of the Content and Technical Quality of AEL's "Around the Bend" Pilot Tapes. Technical Report No. 30.

ERIC Educational Resources Information Center

Shively, Joe E.

In order to determine whether Appalachia Educational Laboratory (AEL) had the capacity to produce a TV series of technical quality and whose content meets criteria designed for the selection of children's television programs, two pilot tapes were produced by AEL and submitted for rating to seven early childhood education specialists from seven…

Management Information Specialist.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This publication contains 19 subjects appropriate for use in a competency list for the occupation of management information specialist, 1 of 12 occupations within the business/computer technologies cluster. Each unit consists of a number of competencies; a list of competency builders is provided for each competency. Titles of the 19 units are as…

Value, Challenges, and Satisfaction of Certification for Multiple Sclerosis Specialists

PubMed Central

Halper, June

2014-01-01

Background: Specialist certification among interdisciplinary multiple sclerosis (MS) team members provides formal recognition of a specialized body of knowledge felt to be necessary to provide optimal care to individuals and families living with MS. Multiple sclerosis specialist certification (MS Certified Specialist, or MSCS) first became available in 2004 for MS interdisciplinary team members, but prior to the present study had not been evaluated for its perceived value, challenges, and satisfaction. Methods: A sample consisting of 67 currently certified MS specialists and 20 lapsed-certification MS specialists completed the following instruments: Perceived Value of Certification Tool (PVCT), Perceived Challenges and Barriers to Certification Scale (PCBCS), Overall Satisfaction with Certification Scale, and a demographic data form. Results: Satisfactory reliability was shown for the total scale and four factored subscales of the PVCT and for two of the three factored PCBCS subscales. Currently certified MS specialists perceived significantly greater value and satisfaction than lapsed-certification MS specialists in terms of employer and peer recognition, validation of MS knowledge, and empowering MS patients. Lapsed-certification MS specialists reported increased confidence and caring for MS patients using evidence-based practice. Both currently certified and lapsed-certification groups reported dissatisfaction with MSCS recognition and pay/salary rewards. Conclusions: The results of this study can be used in efforts to encourage initial certification and recertification of interdisciplinary MS team members. PMID:25061432

[Databases for surgical specialists in Cancún, Quintana Roo].

PubMed

Contla-Hosking, Jorge Eduardo; Ceballos-Martínez, Zoila Inés; Peralta-Bahena, Mónica Esther

2004-01-01

Our aim was to identify the level of knowledge of surgical health-area specialists in Cancún, Quintana Roo, Mexico, from the personal productivity database. We carried out an investigation of 37 surgical specialists: 24 belonged to the Mexican Social Security Institute (IMSS), while 13 belonged to the Mexican Health Secretariat (SSA). In our research, we found that 61% of surgical health-area specialist physicians were familiar with some aspects of the institutional surgical registry, including the following: 54% knew of the existence of a personal registry of surgeries carried out, and 43% keep a record of their personal activities. From the latter percentage, 69% of surgical health-area specialist physicians mentioned keeping their records manually, while 44% used the computer. Results of the research suggest that these physicians would like to have some kind of record of the surgeries carried out by each. An important percentage of these specialists do not keep a personal record on a database; due to this lack of knowledge, we obtain incorrect information in institutional records of the reality of what is actually done. We consider it important to inform surgical specialists concerning the existence of personal institutional records in database form or even of record done manually, as well as correct terminology for the International Codification (CIE-9 & 10). We inform here of the need to encourage a culture in records and databases in the formative stage of surgeon specialists.

EDITORIAL: Nano Meets Spectroscopy Nano Meets Spectroscopy

NASA Astrophysics Data System (ADS)

Birch, David J. S.

2012-08-01

The multidisciplinary two-day Nano Meets Spectroscopy (NMS) event was held at the National Physical Laboratory (NPL), Teddington, UK, in September 2011. The event was planned from the outset to be at the interface of several areas—in particular, spectroscopy and nanoscience, and to bring together topics and people with different approaches to achieving common goals in biomolecular science. Hence the meeting cut across traditional boundaries and brought together researchers using diverse techniques, particularly fluorescence and Raman spectroscopy. Despite engaging common problems, these techniques are frequently seen as mutually exclusive with the two communities rarely interacting at conferences. The meeting was widely seen to have lived up to its billing in good measure. It attracted the maximum capacity of ~120 participants, including 22 distinguished speakers (9 from outside the UK), over 50 posters and a vibrant corporate exhibition comprising 10 leading instrument companies and IOP Publishing. The organizers were Professor David Birch (Chair), Dr Karen Faulds and Professor Duncan Graham of the University of Strathclyde, Professor Cait MacPhee of the University of Edinburgh and Dr Alex Knight of NPL. The event was sponsored by the European Science Foundation, the Institute of Physics, the Royal Society of Chemistry, NPL and the Scottish Universities Physics Alliance. The full programme and abstracts are available at http://sensor.phys.strath.ac.uk/nms/program.php. The programme was quite ambitious in terms of the breadth and depth of scope. The interdisciplinary and synergistic concept of 'X meets Y' played well, cross-fertilization between different fields often being a source of inspiration and progress. Fluorescence and Raman spectroscopy provided the core, but the meeting had little repetition and also attracted contributions on more specialist techniques such as CARS, super-resolution, single molecule and chiral methods. In terms of application the

The evolution of resource adaptation: how generalist and specialist consumers evolve.

PubMed

Ma, Junling; Levin, Simon A

2006-07-01

Why and how specialist and generalist strategies evolve are important questions in evolutionary ecology. In this paper, with the method of adaptive dynamics and evolutionary branching, we identify conditions that select for specialist and generalist strategies. Generally, generalist strategies evolve if there is a switching benefit; specialists evolve if there is a switching cost. If the switching cost is large, specialists always evolve. If the switching cost is small, even though the consumer will first evolve toward a generalist strategy, it will eventually branch into two specialists.

Does the specialist nurse enhance or deskill the general nurse?

PubMed

Marshall, Z; Luffingham, N

Much conflict and confusion surrounds the title and role of the specialist nurse, leading in some instances to disharmony between general and specialist nurses. It has been suggested that too many highly specialized nurses in a general area may lead to a deskilled workforce and fragmented care. Attempts to define the key concepts of specialist practice as described by the UKCC has resulted in elitism, conflict and abuse of the title. One suggestion to eliminate this conflict is for specialist nurses to achieve key competencies that encompass the role of the clinical expert. These key competencies should be devised by specialist nurses, in the absence of national guidelines, and be agreed by employers. They should incorporate the key roles of: change agent, expert clinician, educator, researcher and coordinator. It is contended that if all concerned have a clearer definition of the title, role and what is expected from the specialist nurse then this will result in reduced conflict and improved quality of care.

78 FR 2275 - National Advisory Council on Nurse Education and Practice; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-10

... Advisory Council on Nurse Education and Practice; Notice of Meeting In accordance with section 10(a)(2) of...: Name: National Advisory Council on Nurse Education and Practice (NACNEP). Dates and Times: January 31... Specialist, National Advisory Council on Nurse Education and Practice, Parklawn Building, Room 9-61, 5600...

Developing a speciality: regearing the specialist public health workforce.

PubMed

Chapman, J; Abbott, S; Carter, Y H

2005-03-01

To identify issues surrounding the future training needs of the specialist public health workforce following the most recent restructuring of the National Health Service (NHS) in England. All directors of public health (DsPH) based in strategic health authorities and nine senior staff working in public health at the regional level were invited to participate in a semi-structured telephone interview. Twenty-six people were interviewed. Many interviewees expressed concern that because consultants and specialists in public health will be working in much smaller teams than hitherto, they will have to generalize their skills to cover a much wider range of functions (including board-level duties). This may result in a loss of specialist expertise. Successful public health practice in the new structures will require new ways of interorganizational working that will add an administrative burden to specialists in public health. Also, the creation of a board-level post in each primary care trust (PCT) has resulted in more time spent on corporate responsibilities and less on public health for DsPH, who are often the only fully trained specialist in public health in their PCT. Furthermore, interviewees expressed their anxiety about the lack of diversity in the posts available to specialists in public health and particularly to those newly completing their specialist training. Generally, interviewees felt that traditional public health roles and responsibilities were being eclipsed by corporate and managerial ones. Professional development activities were being carried out, but in a rather ad-hoc fashion. Interviewees were hopeful that public health networks would lead professional development initiatives once they were more established. It is important that excellence in public health is maintained through a set of accreditable standards, whilst corporate skills, essential to successful public health practice in the new UK NHS, are developed among specialists in public health.

Does an in-house internist at a GP practice result in reduced referrals to hospital-based specialist care?

PubMed

Quanjel, Tessa C C; Winkens, Anne; Spreeuwenberg, Marieke D; Struijs, Jeroen N; Winkens, Ron A G; Baan, Caroline A; Ruwaard, Dirk

2018-03-01

Consistent evidence on the effects of specialist services in the primary care setting is lacking. Therefore, this study evaluated the effects of an in-house internist at a GP practice on the number of referrals to specialist care in the hospital setting. Additionally, the involved GPs and internist were asked to share their experiences with the intervention. A retrospective interrupted times series study. Two multidisciplinary general practitioner (GP) practices. An internist provided in-house patient consultations in two GP practices and participated in the multidisciplinary meetings. The referral data extracted from the electronic medical record system of the GP practices, including all referral letters from the GPs to specialist care in the hospital setting. The number of referrals to internal medicine in the hospital setting. This study used an autoregressive integrated moving average model to estimate the effect of the intervention taking account of a time trend and autocorrelation among the observations, comparing the pre-intervention period with the intervention period. It was found that the referrals to internal medicine did not statistically significant decrease during the intervention period. This small explorative study did not find any clues to support that an in-house internist at a primary care setting results in a decrease of referrals to internal medicine in the hospital setting. Key Points An in-house internist at a primary care setting did not result in a significant decrease of referrals to specialist care in the hospital setting. The GPs and internist experience a learning-effect, i.e. an increase of knowledge about internal medicine issues.

Job strain: a cross-sectional survey of dementia care specialists and other staff in Swedish home care services.

PubMed

Sandberg, Linda; Borell, Lena; Edvardsson, David; Rosenberg, Lena; Boström, Anne-Marie

2018-01-01

An increasing number of older persons worldwide live at home with various functional limitations such as dementia. So, home care staff meet older persons with extensive, complex needs. The staff's well-being is crucial because it can affect the quality of their work, although literature on job strain among home care staff is limited. To describe perceived job strain among home care staff and to examine correlations between job strain, personal factors, and organizational factors. The study applied a cross-sectional survey design. Participants were dementia care specialists who work in home care (n=34) and other home care staff who are not specialized in dementia care (n=35). The Strain in Dementia Care Scale (SDCS) and Creative Climate Questionnaire instruments and demographic variables were used. Descriptive and inferential statistics (including regression modeling) were applied. The regional ethical review board approved the study. Home care staff perceived job strain - particularly because they could not provide what they perceived to be necessary care. Dementia care specialists ranked job strain higher (m=5.71) than other staff members (m=4.71; p =0.04). Job strain (for total score and for all five SDCS factors) correlated with being a dementia care specialist. Correlations also occurred between job strain for SDCS factor 2 (difficulties understanding and interpreting) and not having Swedish as first language and SDCS factor 5 (lack of recognition) and stagnated organizational climate. The study indicates that home care staff and particularly dementia care specialists perceived high job strain. Future studies are needed to confirm or reject findings from this study.

Marketing and the medical specialist in the managed care environment.

PubMed

Treister, N W

1997-01-01

Marketing means more than just communicating or advertising to potential patients; marketing means identifying your customers and working to meet or exceed their expectations. There are five key areas of a marketing plan: (1) Establish the foundation, beginning with your mission statement; (2) Assess your marketing environment by internal and external research; (3) Target your efforts, looking at image and perception; (4) Develop your particular mix of product, price, place of distribution, and promotion; and (5) implement and evaluate your marketing process. This article discusses the importance of a marketing plan for the medical specialist and highlights the features unique to a practice working in a system of capitated reimbursement. Applying these principles will help to demonstrate added value, protect the fundamental role of the patient-physician relationship, ensure that our efforts are aligned with professional missions and goals, and ultimately increase profitability and professional success.

Supporting students undertaking the Specialist Practitioner Qualification in District Nursing.

PubMed

Ginger, Tracey; Ritchie, Georgina

2017-11-02

The ever-evolving role of the Specialist Practitioner Qualified District Nurse (SPQDN) presents an increasing number of challenges for Practice Teachers and mentors in preparing SPQDN students for the elevated level clinical and transformational leadership necessary to ensure high-quality patient care. The daily challenges of clinical practice within the community nursing setting in addition to undertaking educational interventions in the clinical arena demand that a structured approach to supervision and mentorship is crucial. Employing learning plans to assess individual students learning needs, prepare plans for educational developments and interventions and evaluate a student's progress can be a helpful tool in aiding the learning journey for both the SPQDN student and Practice Teacher or mentor. This article examines how and why a structured learning plan may be used in supporting learning and competency in achieving the necessary level of practice to meet the requirements of the SPQDN.

Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care

ERIC Educational Resources Information Center

McCann-Stone, Nancy; Robinson, Sherry B.; Rull, Gary; Rosher, Richard B.

2009-01-01

This paper describes an Elder Specialist Program developed by one school of medicine to sensitize medical students to geriatric psychosocial issues. Elder Specialists participate in panel discussions as part of each geriatric session. As an alternative to traditional senior mentoring programs, the Elder Specialist Program provides all students a…

Art Appreciation as a Learned Competence: A Museum-Based Qualitative Study of Adult Art Specialist and Art Non-Specialist Visitors

ERIC Educational Resources Information Center

Bracun Sova, Rajka

2015-01-01

Since Bourdieu, it has been argued that art appreciation requires "knowledge". The focus of this qualitative study was to examine art appreciation as a learned competence by exploring two different groups of museum visitors: art specialists and art non-specialists. The research was conducted at Moderna galerija in Ljubljana. Twenty-three…

The Search for Specialists and Managers. Staff Shortage in Germany.

ERIC Educational Resources Information Center

Stahl, Klaus, Ed.

1999-01-01

Despite its high unemployment level, Germany is experiencing a shortage of specialists and managers. Germany's need for highly qualified information technology (IT) workers and engineers is particularly great. Approximately 10,000 posts for computer scientists and IT specialists remained vacant in 1998. Because of the shortage of such specialists,…

STS-87 Mission Specialist Doi in white room

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan, is assisted with his ascent and re- entry flight suit by Dave Law, USA mechanical technician, in the white room at Launch Pad 39B as Dr. Doi prepares to enter the Space Shuttle orbiter Columbia on launch day. At right wearing glasses is Danny Wyatt, NASA quality assurance specialist. STS-87 is the fourth flight of the United States Microgravity Payload and Spartan-201. The 16-day mission will include a spacewalk by Dr. Doi and Mission Specialist Winston Scott.

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

NASA Technical Reports Server (NTRS)

1992-01-01

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

Factors associated with residents' satisfaction with their training as specialists.

PubMed

Ayala-Morillas, L E; Fuentes-Ferrer, M E; Sánchez-Díaz, J; Rumayor-Zarzuelo, M; Fernández-Pérez, C; Marco-Martínez, F

2014-05-01

We do not know what factors influence residents' perceived satisfaction during their training. The aim of this study was to analyze the satisfaction of specialists with their training and its associated factors. This was a cross-sectional study using self-completion surveys of residents in training at the Clinic Hospital San Carlos for the courses conducted in 2006, 2009, 2010 and 2012. The study's dependent variable was overall satisfaction with the training; the independent factors were demographic and occupational characteristics, variables related to healthcare, teaching and research activity. The total participation percentage was 83.7% (1,424/1,701), and the mean age was 28.4 years (SD, 3.2 years). The overall satisfaction percentage was 75.2%. The factors statistically associated with overall satisfaction in the multivariate analysis were the involvement of the teaching staff (tutors and assistants) in the training, greater satisfaction in medical versus surgical specialties, the year of residence, the facilities for completing the thesis, working less than 40 h a week, adequate time to perform daily tasks, appropriate number of department meetings and not having a previous specialty. the activities related to research and teaching are associated with the overall satisfaction of residents. The routine activity factors most closely associated with satisfaction were the time available and the work hours. More studies are necessary to understand the impact of resident satisfaction on care quality and in their activity as future specialists. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Understanding practice patterns of glaucoma sub-specialists in India

PubMed Central

Choudhari, Nikhil S.; Pathak-Ray, Vanita; Kaushik, Sushmita; Vyas, Prateep; George, Ronnie

2017-01-01

AIM To obtain information on the prevailing practice patterns of glaucoma specialists in India. METHODS Glaucoma specialists attending the Annual Conference of the Glaucoma Society of India (GSI) were surveyed. This survey, conducted in 2013, was based on an interactive audience response system. RESULTS The information was obtained from 146 glaucoma specialists. Approximately half (n=83; 57%) had ≥10y of experience in managing glaucoma and were in institutional practice (n=74, 51%). Goldmann applanation tonometry was preferred by 103 (72%) specialists whilst n=25 (17.4%) used non-contact tonometer. Indentation gonioscopy was favoured by two-thirds (n=90, 66%) whereas stereoscopic optic disc examination and visual fields using Humphrey perimeter was performed by a majority of the specialists surveyed (n=115, 86% and n=114; 83% respectively). Nearly three quarter specialists (n=96; 72%) preferred optical coherence tomography for imaging. The primary choice for treatment of angle closure disease and primary open angle glaucoma was laser (iridotomy, n=117; 93%) and medical management (prostaglandin analogue, n=104; 78%), respectively. Approximately only a third of the specialists surveyed (n=37; 28%) were performing both trabeculectomy and implantation of a glaucoma drainage device and about half (n=64; 47%) were not operating on congenital glaucoma at all. CONCLUSION This survey has found conformance with preferred practice patterns in several areas of diagnosis and management of glaucoma, but there was diversity in a few areas. The information is a significant step towards improvement of glaucoma care in India, including planning for future strategies. PMID:29062779

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

PubMed

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

2018-02-26

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

42 CFR 410.76 - Clinical nurse specialists' services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... master's degree in a defined clinical area of nursing from an accredited educational institution or a Doctor of Nursing Practice (DNP) doctoral degree; and (3) Be certified as a clinical nurse specialist by....26 are met. (e) Professional services. Clinical nurse specialists can be paid for professional...

Mission Specialist (MS) Ride on middeck

NASA Image and Video Library

1992-06-24

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

STS-86 Mission Specialist David Wolf in white room

NASA Technical Reports Server (NTRS)

1997-01-01

STS-86 Mission Specialist David A. Wolf, at center facing camera, prepares to enter the Space Shuttle Atlantis at Launch Pad 39A, with the assistance of Rick Welty, in foreground at center, United Space Alliance (USA) orbiter vehicle closeout chief; and closeout team members, in background from left, Jim Davis, NASA quality assurance specialist; and George Schramm, USA mechanical technician. STS-86 Mission Specialist Vladimir Georgievich Titov, in foreground at far left, is awaiting his turn.

Higher Education Institutions and Specialist Schools: Potential Partnerships

ERIC Educational Resources Information Center

Penney, Dawn; Houlihan, Barrie

2003-01-01

This paper argues that the development and growth in numbers of Specialist Schools in England raises a number of key questions about the relationships between higher education institutions (HEIs) involved in initial teacher training (ITT) and continuing professional development (CPD) work, and schools now designated as Specialist Schools. It…

Sports medicine and the accident and emergency medicine specialist.

PubMed

Abernethy, L; McNally, O; MacAuley, D; O'Neill, S

2002-05-01

Sport and exercise related injuries are responsible for about 5% of the workload in the accident and emergency (A&E) department, yet training in sports medicine is not a compulsory part of the curriculum for Higher Specialist Training. To determine how A&E medicine consultants and specialist trainees view their role and skill requirements in relation to sports medicine. A modified Delphi study, consisting of two rounds of a postal questionnaire. Participants were invited to rate the importance of statements relating to the role and training of the A&E specialist in relation to sports injuries (six statements) and the need for knowledge and understanding of defined skills of importance in sports medicine (16 statements). VALUE OF RESEARCH: This provides a consensus of opinion on issues in sport and exercise medicine that have educational implications for A&E specialists, and should be considered in the curriculum for Higher Specialist Training. There is also the potential for improving the health care provision of A&E departments, to the exercising and sporting population.

STS-95 Mission Specialist Duque suits up during TCDT

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Mission Specialist Pedro Duque of Spain, representing the European Space Agency, suits up in the Operations and Checkout Building prior to his trip to Launch Pad 39-B. Duque and the rest of the STS-95 crew are at KSC to participate in the Terminal Countdown Demonstration Test (TCDT) which includes mission familiarization activities, emergency egress training, and a simulated main engine cutoff. The other crew members are Payload Specialist Chiaki Mukai (M.D., Ph.D.), representing the National Space Development Agency of Japan (NASDA), Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Stephen K. Robinson, Payload Specialist John H. Glenn Jr., senator from Ohio, and Mission Commander Curtis L. Brown. The STS-95 mission, targeted for liftoff on Oct. 29, includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Following the TCDT, the crew will be returning to Houston for final flight preparations.

Early stages of development of a peer specialist fidelity measure

PubMed Central

Chinman, Matthew; McCarthy, Sharon; Mitchell-Miland, Chantele; Daniels, Karin; Youk, Ada; Edelen, Maria

2017-01-01

OBJECTIVE Research on peer specialists (individuals with serious mental illness supporting others with serious mental illness in clinical and other settings), has not yet included the measurement of fidelity. Without measuring fidelity, it’s unclear if the absence of impact in some studies is attributable to ineffective peer specialist services or because the services were not true to the intended role. This paper describes the initial development of a peer specialist fidelity measure for two content areas: services provided by peer specialists and factors that either support or hamper the performance of those services. METHODS A literature search identified 40 domains; an expert panel narrowed the number of domains and helped generate and then review survey items to operationalize those domains. Twelve peer specialists, individuals with whom they work, and their supervisors participated in a pilot test and cognitive interviews regarding item content. RESULTS Peer specialists tended to rate themselves as having engaged in various peer service activities more than supervisors and individuals with whom they work. A subset of items tapping peer specialist services “core” to the role regardless of setting had higher ratings. Participants stated the measure was clear, appropriate, and could be useful in performance improvement. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Although preliminary, findings were consistent with organizational research on performance ratings of supervisors and employees made in the workplace. Several changes in survey content and administration were identified. With continued work, the measure could crystalize the role of peer specialists and aid in research and clinical administration. PMID:27618462

Specialist training of Emergency Medicine in Finland.

PubMed

Naskali, Jarno; Lehtonen, Jarmo; Palomäki, Ari

Emergency Medicine with a six-year specialist training became a main specialty in Finland in the beginning of 2013. Specialist training has developed very quickly over just a few years. In the frontline clinics, the clinical results have already reached high international quality. When developing a new specialty, not only active research and high-quality training but also good co-operation with other specialties are of utmost importance.

Specialist participation in healthcare delivery transformation: influence of patient self-referral.

PubMed

Aliu, Oluseyi; Sun, Gordon; Burke, James; Chung, Kevin C; Davis, Matthew M

2014-01-01

Improving coordination of care and containing healthcare costs are prominent goals of healthcare reform. Specialist involvement in healthcare delivery transformation efforts like Accountable Care Organizations (ACOs) is necessary to achieve these goals. However, patients’ self-referrals to specialists may undermine care coordination and incur unnecessary costs if patients frequently receive care from specialists not engaged in such healthcare delivery transformation efforts. Additionally, frequent self-referrals may also diminish the incentive for specialist participation in reform endeavors like ACOs to get access to a referral base. To examine recent national trends in self-referred new visits to specialists. A descriptive cross-sectional study of new ambulatory visits to specialists from 2000 to 2009 using data from the National Ambulatory Medical Care Survey. We calculated nationally representative estimates of the proportion of new specialist visits through self-referrals among Medicare and private insurance beneficiaries. We also estimated the nationally representative absolute number of self-referred new specialist visits among both groups of beneficiaries. Among Medicare and private insurance beneficiaries, self-referred visits declined from 32.2% (95% confidence interval [CI], 24.0%-40.4%) to 19.6% (95% CI, 13.9%-23.3%) and from 32.4% (95% CI, 27.9%-36.8%) to 24.1% (95% CI,18.8%-29.4%), respectively. Hence, at least 1 in 5 and 1 in 4 new visits to specialists among Medicare and private insurance beneficiaries, respectively, are self-referred. The current considerable rate of self-referred new specialist visits among both Medicare and private insurance beneficiaries may have adverse implications for organizations attempting to transform healthcare delivery with improved care coordination.

42 CFR 410.76 - Clinical nurse specialists' services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the statutory exclusions; and (3) Performs them while working in collaboration with a physician. (i) Collaboration is a process in which a clinical nurse specialist works with one or more physicians to deliver... collaboration, collaboration is a process in which a clinical nurse specialist has a relationship with one or...

Optometry Specialist (AFSC 91255).

ERIC Educational Resources Information Center

Kille, Michael O.

This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for optometry specialists. Covered in the individual volumes are optometry clinic administration (optometry career and field training, ethical relationships and professionalism, eligibility for optometric care and appointment…

U.S. ocean acidification researchers: First national meeting

NASA Astrophysics Data System (ADS)

Cooley, Sarah R.; Kleypas, Joan; Benway, Heather

2011-09-01

Ocean Carbon and Biogeochemistry Program Ocean Acidification Principal Investigators' Meeting; Woods Hole, Massachusetts, 22-24 March 2011 ; Ocean acidification (OA) is the progressive decrease in seawater pH and change in inorganic carbon chemistry caused by uptake of anthropogenic carbon dioxide (CO2). Marine species respond to OA in multiple ways that could profoundly alter ocean ecosystems and the goods and services they provide to human communities. With major support from the National Oceanic and Atmospheric Administration (NOAA) and the U.S. National Science Foundation (NSF) and additional support from the U.S. Environmental Protection Agency (EPA), the Naval Postgraduate School, and the U.S. Geological Survey (USGS), the Ocean Carbon and Biogeochemistry (OCB) Project Office and Ocean Acidification Subcommittee (http://www.us-ocb.org/about/subcommittees.html) held the first multidisciplinary workshop for U.S. OA researchers at the Woods Hole Oceanographic Institution. The 112 attendees included ecologists, paleoceanographers, instrumentation specialists, chemists, biologists, economists, ocean and ecosystem modelers, and communications specialists.

A qualitative evaluation of the Scottish Staff and Associate Specialist Development Programme.

PubMed

Cleland, Jennifer; Burr, Jacqueline; Johnston, Peter

2016-05-01

The continued professional development of staff and associate specialist doctors in the UK was ill served prior to the introduction of the new staff and associate specialist doctor's contract in 2008. The aim of this study was to independently evaluate NHS Education for Scotland's approach to improving professional development for staff and associate specialist doctors, the staff and associate specialist Professional Development Fund. Semi-structured telephone interviews with key stakeholders, framed by a realistic approach to evaluate what works, for whom and in how and under what circumstances. An inductive and data-driven thematic analysis was carried out and then the realist framework was applied to the data. We interviewed 22 key stakeholders: staff and associate specialist doctors, staff and associate specialist educational advisors, programme architects and clinical directors, between end February and May 2014. The resultant data indicated five broad themes: organisational barriers to continued professional development for staff and associate specialist doctors, the purpose of funding, gains from funding, the need for better communication about the staff and associate specialist Programme Development Fund, and the interplay between individual and systems factors. The staff and associate specialist Programme Development Fund has changed the opportunities available to staff and associate specialist doctors in Scotland and, in that sense, has changed the context for this group - or at least those who have realised the opportunities. © The Author(s) 2016.

Job sharing: a viable option for the clinical nurse specialist.

PubMed

Haibeck, S V; Howard, J L

1991-01-01

NUMEROUS WORK TIME options have been developed to attract, retain and meet the various needs of nurses. Job sharing, a work option little known to nurses, can be a successful alternative for balancing professional and personal lifestyle. The business literature supports job sharing and other innovative work options as successful mechanisms in retaining quality employees in their respective professions. After exploring the literature in this area, a proposal for job sharing the oncology clinical nurse specialist (CNS) position was presented to the Personnel Director and Vice President of Nursing at our institution. The proposal addressed the advantages and disadvantages of the concept. These included: (1) scheduling flexibility, (2) reduced absenteeism and turnover, (3) increased productivity, (4) handling fringe benefits, and (5) job satisfaction. The proposal was accepted, and the job sharing position has been successfully implemented for more than 2 years now. This paper describes issues relevant to designing and implementing job sharing in a CNS position.

48 CFR 1519.201-72 - Small and disadvantaged business utilization specialists.

Code of Federal Regulations, 2011 CFR

2011-10-01

... prescribed from time to time in furtherance of overall small and small disadvantaged business utilization... business utilization specialists. 1519.201-72 Section 1519.201-72 Federal Acquisition Regulations System... disadvantaged business utilization specialists. (a) Small Business Specialists (SBS) shall be appointed in...

Management Matters: The Library Media Specialist's Management Toolbox

ERIC Educational Resources Information Center

Pappas, Marjorie L.

2004-01-01

Library media specialists need tools to help them manage the school library media program. The Internet includes a vast array of tools that a library media specialist might find useful. The websites and electronic resources included in this article are only a representative sample and future columns may explore additional tools. All the tools are…

Weather Specialist (AFSC 25120).

ERIC Educational Resources Information Center

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

This correspondence course is designed for self-study to help military personnel to attain the rating of weather specialist. The course is organized in three volumes. The first volume, containing seven chapters, covers background knowledge, meteorology, and climatology. In the second volume, which also contains seven chapters, surface…

Job strain: a cross-sectional survey of dementia care specialists and other staff in Swedish home care services

PubMed Central

Sandberg, Linda; Borell, Lena; Edvardsson, David; Rosenberg, Lena; Boström, Anne-Marie

2018-01-01

Introduction An increasing number of older persons worldwide live at home with various functional limitations such as dementia. So, home care staff meet older persons with extensive, complex needs. The staff’s well-being is crucial because it can affect the quality of their work, although literature on job strain among home care staff is limited. Aim To describe perceived job strain among home care staff and to examine correlations between job strain, personal factors, and organizational factors. Methods The study applied a cross-sectional survey design. Participants were dementia care specialists who work in home care (n=34) and other home care staff who are not specialized in dementia care (n=35). The Strain in Dementia Care Scale (SDCS) and Creative Climate Questionnaire instruments and demographic variables were used. Descriptive and inferential statistics (including regression modeling) were applied. The regional ethical review board approved the study. Results Home care staff perceived job strain – particularly because they could not provide what they perceived to be necessary care. Dementia care specialists ranked job strain higher (m=5.71) than other staff members (m=4.71; p=0.04). Job strain (for total score and for all five SDCS factors) correlated with being a dementia care specialist. Correlations also occurred between job strain for SDCS factor 2 (difficulties understanding and interpreting) and not having Swedish as first language and SDCS factor 5 (lack of recognition) and stagnated organizational climate. Conclusion The study indicates that home care staff and particularly dementia care specialists perceived high job strain. Future studies are needed to confirm or reject findings from this study. PMID:29861636

Does an in-house internist at a GP practice result in reduced referrals to hospital-based specialist care?

PubMed Central

Quanjel, Tessa C. C.; Winkens, Anne; Spreeuwenberg, Marieke D.; Struijs, Jeroen N.; Winkens, Ron A. G.; Baan, Caroline A.; Ruwaard, Dirk

2018-01-01

Objective Consistent evidence on the effects of specialist services in the primary care setting is lacking. Therefore, this study evaluated the effects of an in-house internist at a GP practice on the number of referrals to specialist care in the hospital setting. Additionally, the involved GPs and internist were asked to share their experiences with the intervention. Design A retrospective interrupted times series study. Setting Two multidisciplinary general practitioner (GP) practices. Intervention An internist provided in-house patient consultations in two GP practices and participated in the multidisciplinary meetings. Subjects The referral data extracted from the electronic medical record system of the GP practices, including all referral letters from the GPs to specialist care in the hospital setting. Main outcome measures The number of referrals to internal medicine in the hospital setting. This study used an autoregressive integrated moving average model to estimate the effect of the intervention taking account of a time trend and autocorrelation among the observations, comparing the pre-intervention period with the intervention period. Results It was found that the referrals to internal medicine did not statistically significant decrease during the intervention period. Conclusions This small explorative study did not find any clues to support that an in-house internist at a primary care setting results in a decrease of referrals to internal medicine in the hospital setting. Key Points An in-house internist at a primary care setting did not result in a significant decrease of referrals to specialist care in the hospital setting. The GPs and internist experience a learning-effect, i.e. an increase of knowledge about internal medicine issues. PMID:29376458

The clinical nurse specialist: leadership in quality improvement.

PubMed

Finkelman, Anita

2013-01-01

Healthcare delivery is in a crisis, requiring improvement. How to improve and who should assume more leadership are not clear. At the same time, the nursing profession struggles with a weak education system, graduating students who require major support for an extended time. There is also confusion related to nursing roles, particularly with nurses who have a graduate degree. The Institute of Medicine has published a series of reports about the healthcare system and need for improvement and describes a structure for improvement. The clinical nurse specialist is particularly suited to assume a major role in nursing leadership to guide staff and the healthcare system to better ensure improved care. There is great need to communicate that the clinical nurse specialist can and should assume this role. This will require a review and development of more quality improvement content and experiences in clinical nurse specialist educational programs, but much of the content is already in programs. The clinical nurse specialist works in systems, impacts systems, works with staff, and can thus reach more patients with improvement approaches.

STS-97 crew meets with the media at Launch Pad 39B

NASA Technical Reports Server (NTRS)

2000-01-01

STS-97 Mission Specialist Marc Garneau (right) answers a question from the media. At left is Mission Specialist Joe Tanner. They and the other crew members are meeting with the media before beginning emergency egress training at Launch Pad 39B. The training is part of Terminal Countdown Demonstration Test activities that include a simulated launch countdown. Mission STS-97 is the sixth construction flight to the International Space Station. Its payload includes the P6 Integrated Truss Structure and a photovoltaic (PV) module, with giant solar arrays that will provide power to the Station. The mission includes two spacewalks to complete the solar array connections. STS-97 is scheduled to launch Nov. 30 at 10:05 p.m. EST.

Contemporary challenges for specialist nursing in interstitial lung disease.

PubMed

Russell, Anne Marie; Olive, Sandra; Lines, Sarah; Murphy, Anna; Hocking, Julie; Newell, Karen; Morris, Helen; Harris, Emma; Dixon, Catherine; Agnew, Sarah; Burge, Geraldine

2018-03-01

The role of clinical nurse specialists (CNSs) in interstitial lung disease (ILD) is evolving in response to clinical guidelines and the growth of clinical research. The role is well established in the UK, although more ILD posts are needed to ensure supply meets clinical demand. This phenomenon is also happening across Europe. An appreciation of the similarities and differences between CNS and advanced nurse practitioners is important given the challenges in defining, developing and supporting this nursing specialisation. Globally, different models exist. In some countries charitable organisations take a leading role in supporting patients. Many European centres look to the National Institute for Health and Care Excellence guidelines and quality standards as a template to develop and evaluate the role of the ILD CNS. We present a UK perspective in the context of a government subsidised healthcare system to promote professional discussion and debate regarding the future of nursing practice in the ILD specialty. ILDs are often complex and associated with significant mortality, morbidity and co-morbid conditions that require a technical healthcare skill setThere is worldwide shortage of nurses, low retention rates and retirement of many skilled nursesCollaboration across the ILD interdisciplinary community is needed to safeguard the future of our professions and high-quality patient careThe ILD interdisciplinary and nurse network has identified key priorities to help secure the future of the ILD clinical and academic nurse specialism. To explain the similarities and differences between clinical nurse specialists (CNSs) and advanced nurse practitioners (ANPs) in the context of ILD specialismTo review contemporary nursing specialism in the UK's government subsidised healthcare systemTo stimulate discussion and debate across the European/international respiratory community regarding the clinical and academic development of the ILD CNSTo identify key priorities that will

STS-95 Mission Specialist Robinson suits up during TCDT

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Mission Specialist Stephen K. Robinson, with the help of Carlos Gillis, of Lockheed Martin, suits up in the Operations and Checkout Building prior to his trip to Launch Pad 39-B. Robinson and the rest of the STS-95 crew are at KSC to participate in the Terminal Countdown Demonstration Test (TCDT) which includes mission familiarization activities, emergency egress training, and a simulated main engine cutoff. The other crew members are Payload Specialist Chiaki Mukai (M.D., Ph.D.), representing the National Space Development Agency of Japan (NASDA), Pilot Steven W. Lindsey, Mission Specialist Scott E. Parazynski, Mission Specialist Pedro Duque of Spain, representing the European Space Agency (ESA), Payload Specialist John H. Glenn Jr., senator from Ohio, and Mission Commander Curtis L. Brown. The STS-95 mission, targeted for liftoff on Oct. 29, includes research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process. Following the TCDT, the crew will be returning to Houston for final flight preparations.

[Survey of Specialist Pulmonary Medicine Health Care Structures for Patients with Interstitial Lung Disease in Nordrhein-Westfalen, Germany - A Pilot Project of the Western German Respiratory Society (WdGP)].

PubMed

Hagmeyer, L; Haidl, P; Westhoff, M; Schulte, W; Randerath, W; Lorenz, J

2018-05-22

 Survey of specialist pulmonary medicine health care structures for patients with interstitial lung disease (ILD) in Nordrhein-Westfalen, Germany.  The Western German Respiratory Society initiated a voluntary registration of ILD expert centers. Structural quality and processes were evaluated by questionnaire.  49 centers were registered, 46 allowed analysis of their center data (15 pulmonology specialist practices, 34 hospital pulmonology departments). Specialist practices saw a median of 360 ILD patients per year (26 % first diagnosis), hospital departments a median of 105 ILD patients per year (63 % first diagnosis). 10 centers diagnose more than 100 new ILD cases per year. Specialist practices report median 50 bronchoscopies per year, hospital departments median 1396. 78 % of the centers participate in a multidisciplinary ILD case conference.  Several ILD expert centers were identified in Nordrhein-Westfalen. Outpatient care mainly involves the monitoring of ILD patients, inpatient services focus on complex initial diagnostics or cases with unusual disease behaviour. ILD centers meeting regional health care needs should be supported in their development. © Georg Thieme Verlag KG Stuttgart · New York.

Professional Sense-Makers: Instructional Specialists in Contemporary Schooling

ERIC Educational Resources Information Center

Domina, Thurston; Lewis, Ryan; Agarwal, Priyanka; Hanselman, Paul

2015-01-01

This brief documents the expansion of instructional specialist staffing in U.S. public school districts. We use data from the National Center of Education Statistics' annual Common Core of Data to chart staffing trends in public school districts between 1997-98 and 2012-13. The number of instructional specialists per 1,000 U.S students doubled…

Professional Sense-Makers: Instructional Specialists in Contemporary Schooling

ERIC Educational Resources Information Center

Domina, Thurston; Lewis, Ryan; Agarwal, Priyanka; Hanselman, Paul

2015-01-01

This brief documents the expansion of instructional specialist staffing in U.S. public school districts. We use data from the National Center of Education Statistics' annual Common Core of Data to chart staffing trends in public school districts between 1997-1998 and 2012-2013. The number of instructional specialists per 1,000 U.S students doubled…

Fabrication of elliptical SRF cavities

NASA Astrophysics Data System (ADS)

Singer, W.

2017-03-01

The technological and metallurgical requirements of material for high-gradient superconducting cavities are described. High-purity niobium, as the preferred metal for the fabrication of superconducting accelerating cavities, should meet exact specifications. The content of interstitial impurities such as oxygen, nitrogen, and carbon must be below 10 μg g-1. The hydrogen content should be kept below 2 μg g-1 to prevent degradation of the quality factor (Q-value) under certain cool-down conditions. The material should be free of flaws (foreign material inclusions or cracks and laminations) that can initiate a thermal breakdown. Traditional and alternative cavity mechanical fabrication methods are reviewed. Conventionally, niobium cavities are fabricated from sheet niobium by the formation of half-cells by deep drawing, followed by trim machining and electron beam welding. The welding of half-cells is a delicate procedure, requiring intermediate cleaning steps and a careful choice of weld parameters to achieve full penetration of the joints. A challenge for a welded construction is the tight mechanical and electrical tolerances. These can be maintained by a combination of mechanical and radio-frequency measurements on half-cells and by careful tracking of weld shrinkage. The main aspects of quality assurance and quality management are mentioned. The experiences of 800 cavities produced for the European XFEL are presented. Another cavity fabrication approach is slicing discs from the ingot and producing cavities by deep drawing and electron beam welding. Accelerating gradients at the level of 35-45 MV m-1 can be achieved by applying electrochemical polishing treatment. The single-crystal option (grain boundary free) is discussed. It seems that in this case, high performance can be achieved by a simplified treatment procedure. Fabrication of the elliptical resonators from a seamless pipe as an alternative is briefly described. This technology has yielded good

Of Specialists and Generalists.

ERIC Educational Resources Information Center

DeVore, Paul W.

The issues involving the role and impact of specialists and generalists in society are critically examined in this paper. Currently held views on specialization are analyzed and challenged. Perspectives on this dilemma are developed in the following areas: (1) limitations of experts (casts doubt on the assumption that ordinary citizens are…

Careers in the U.S. Department of Education: Education Program Specialist.

ERIC Educational Resources Information Center

Horace Mann Learning Center (ED), Washington, DC.

Education program specialists in the United States Department of Education establish and lead the education program, policies, and activities for which the Department of Education is responsible under law. This brochure provides information about the job of education program specialist, describing how the specialists fit into the department's…

75 FR 8990 - Notice of Public Meeting, Northwest Colorado Resource Advisory Council Subgroup for McInnis...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-26

... Land Management Grand Junction Field Office at 2815 H Road, Grand Junction, CO 81506. The meeting will... Conservation Area Manager, 2815 H Road, Grand Junction, CO; telephone 970-244-3049; or Erin Curtis, Public Affairs Specialist, 2815 H Road, Grand Junction, CO, telephone 970-244-3097. SUPPLEMENTARY INFORMATION...

Host specialist clownfishes are environmental niche generalists.

PubMed

Litsios, Glenn; Kostikova, Anna; Salamin, Nicolas

2014-11-22

Why generalist and specialist species coexist in nature is a question that has interested evolutionary biologists for a long time. While the coexistence of specialists and generalists exploiting resources on a single ecological dimension has been theoretically and empirically explored, biological systems with multiple resource dimensions (e.g. trophic, ecological) are less well understood. Yet, such systems may provide an alternative to the classical theory of stable evolutionary coexistence of generalist and specialist species on a single resource dimension. We explore such systems and the potential trade-offs between different resource dimensions in clownfishes. All species of this iconic clade are obligate mutualists with sea anemones yet show interspecific variation in anemone host specificity. Moreover, clownfishes developed variable environmental specialization across their distribution. In this study, we test for the existence of a relationship between host-specificity (number of anemones associated with a clownfish species) and environmental-specificity (expressed as the size of the ecological niche breadth across climatic gradients). We find a negative correlation between host range and environmental specificities in temperature, salinity and pH, probably indicating a trade-off between both types of specialization forcing species to specialize only in a single direction. Trade-offs in a multi-dimensional resource space could be a novel way of explaining the coexistence of generalist and specialists. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Host specialist clownfishes are environmental niche generalists

PubMed Central

Litsios, Glenn; Kostikova, Anna; Salamin, Nicolas

2014-01-01

Why generalist and specialist species coexist in nature is a question that has interested evolutionary biologists for a long time. While the coexistence of specialists and generalists exploiting resources on a single ecological dimension has been theoretically and empirically explored, biological systems with multiple resource dimensions (e.g. trophic, ecological) are less well understood. Yet, such systems may provide an alternative to the classical theory of stable evolutionary coexistence of generalist and specialist species on a single resource dimension. We explore such systems and the potential trade-offs between different resource dimensions in clownfishes. All species of this iconic clade are obligate mutualists with sea anemones yet show interspecific variation in anemone host specificity. Moreover, clownfishes developed variable environmental specialization across their distribution. In this study, we test for the existence of a relationship between host-specificity (number of anemones associated with a clownfish species) and environmental-specificity (expressed as the size of the ecological niche breadth across climatic gradients). We find a negative correlation between host range and environmental specificities in temperature, salinity and pH, probably indicating a trade-off between both types of specialization forcing species to specialize only in a single direction. Trade-offs in a multi-dimensional resource space could be a novel way of explaining the coexistence of generalist and specialists. PMID:25274370

Specialist outreach clinics in primary care and rural hospital settings.

PubMed

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

2004-01-01

Specialist medical practitioners have conducted clinics in primary care and rural hospital settings for a variety of reasons in many different countries. Such clinics have been regarded as an important policy option for increasing the accessibility and effectiveness of specialist services and their integration with primary care services. To undertake a descriptive overview of studies of specialist outreach clinics and to assess the effectiveness of specialist outreach clinics on access, quality, health outcomes, patient satisfaction, use of services, and costs. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) specialised register (March 2002), the Cochrane Controlled Trials Register (CCTR) (Cochrane Library Issue 1, 2002), MEDLINE (including HealthStar) (1966 to May 2002), EMBASE (1988 to March 2002), CINAHL (1982 to March 2002), the Primary-Secondary Care Database previously maintained by the Centre for Primary Care Research in the Department of General Practice at the University of Manchester, a collection of studies from the UK collated in "Specialist Outreach Clinics in General Practice" (Roland 1998), and the reference lists of all retrieved articles. Randomised trials, controlled before and after studies and interrupted time series analyses of visiting specialist outreach clinics in primary care or rural hospital settings, either providing simple consultations or as part of complex multifaceted interventions. The participants were patients, specialists, and primary care providers. The outcomes included objective measures of access, quality, health outcomes, satisfaction, service use, and cost. Four reviewers working in pairs independently extracted data and assessed study quality. 73 outreach interventions were identified covering many specialties, countries and settings. Nine studies met the inclusion criteria. Most comparative studies came from urban non-disadvantaged populations in developed countries. Simple 'shifted outpatients

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

PubMed

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

2006-01-01

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

Redefining "Community" through Collaboration and Co-Teaching: A Case Study of an ESOL Specialist, a Literacy Specialist, and a Fifth-Grade Teacher

ERIC Educational Resources Information Center

Ahmed Hersi, Afra; Horan, Deborah A.; Lewis, Mark A.

2016-01-01

This article explores the development of a professional learning community through a case study of three teachers--an ESOL specialist, a literacy specialist, and a fifth-grade teacher--who engaged in co-teaching and collaboration. The emerging community of practice offered these teachers a space to learn and problem-solve by utilizing their…

The School Librarian as Information Specialist: A Vibrant Species

ERIC Educational Resources Information Center

Harris, Frances Jacobson

2011-01-01

In this article, the author talks about the school librarian as information specialist. She stresses that the school librarian's information specialist role is more important than ever. She offers her personal toolkit that consists of four strategies in helping and teaching students to use content responsibly.

Payload specialist Merbold performing experiment in Spacelab

NASA Image and Video Library

1983-11-28

STS009-13-699 (28 Nov - 8 Dec 1983) --? Ulf Merbold, Spacelab 1 payload specialist, carries out one of the experiments using the gradient heating facility on the materials science double rack facility in the busy science module aboard the Earth-orbiting Space Shuttle Columbia. Representing the European Space Agency, Dr. Merbold comes from Max-Planck Institute in Stuttgart, the Federal Republic of Germany. He is a specialist in crystal lattice defects and low temperature physics. The photograph was made with a 35mm camera.

Study on the Filament Yarns Spreading Techniques and Assessment Methods of the Electronic Fiberglass Fabric

NASA Astrophysics Data System (ADS)

Wang, Xi; Chen, Shouhui; Zheng, Tianyong; Ning, Xiangchun; Dai, Yifei

2018-03-01

The filament yarns spreading techniques of electronic fiberglass fabric were developed in the past few years in order to meet the requirements of the development of electronic industry. Copper clad laminate (CCL) requires that the warp and weft yarns of the fabric could be spread out of apart and formed flat. The penetration performance of resin could be improved due to the filament yarns spreading techniques of electronic fiberglass fabric, the same as peeling strength of CCL and drilling performance of printed circuit board (PCB). This paper shows the filament yarns spreading techniques of electronic fiberglass fabric from several aspects, such as methods and functions, also with the assessment methods of their effects.

Specialist payment schemes and patient selection in private and public hospitals.

PubMed

Wright, Donald J

2007-09-01

It has been observed that specialist physicians who work in private hospitals are usually paid by fee-for-service while specialist physicians who work in public hospitals are usually paid by salary. This paper provides an explanation for this observation. Essentially, fee-for-service aligns the interests of income preferring specialists with profit maximizing private hospitals and results in private hospitals treating a high proportion of short stay patients. On the other hand, salary aligns the interests of fairness preferring specialists with benevolent public hospitals that commit to admit all patients irrespective of their expected length of stay.

STS-47 Japanese Payload Specialist Mohri and backups during Homestead training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Japanese Payload Specialist Mamoru Mohri (far left), backup Payload Specialist Takao Doi (center), and backup Payload Specialist Chiaki Mukai (right) participate in water survival training at Homestead Air Force Base, Florida. Dockside, Mohri and Mukai wash the salt water from their personalized helmets after a water exercise. The three-day course was attended by the STS-47 prime and alternate payload specialists shortly after they were announced for the scheduled summer of 1992 Spacelab Japan (SLJ) mission. Mohri, Doi, and Mukai all represent the National Space Development Agency of Japan (NASDA).

Route to one-step microstructure mold fabrication for PDMS microfluidic chip

NASA Astrophysics Data System (ADS)

Lv, Xiaoqing; Geng, Zhaoxin; Fan, Zhiyuan; Wang, Shicai; Su, Yue; Fang, Weihao; Pei, Weihua; Chen, Hongda

2018-04-01

The microstructure mold fabrication for PDMS microfluidic chip remains complex and time-consuming process requiring special equipment and protocols: photolithography and etching. Thus, a rapid and cost-effective method is highly needed. Comparing with the traditional microfluidic chip fabricating process based on the micro-electromechanical system (MEMS), this method is simple and easy to implement, and the whole fabrication process only requires 1-2 h. Different size of microstructure from 100 to 1000 μm was fabricated, and used to culture four kinds of breast cancer cell lines. Cell viability and morphology was assessed when they were cultured in the micro straight channels, micro square holes and the bonding PDMS-glass microfluidic chip. The experimental results indicate that the microfluidic chip is good and meet the experimental requirements. This method can greatly reduce the process time and cost of the microfluidic chip, and provide a simple and effective way for the structure design and in the field of biological microfabrications and microfluidic chips.

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

Becoming a Specialist Nurse in Psychiatric Mental Health Care

ERIC Educational Resources Information Center

Södergren, Ulrika; Benjaminson, Carin; Mattsson, Janet

2017-01-01

Background: Specialist nurse students are upon graduation certified to have increased their professional competence to an advanced level. But how do specialist nurse students themselves experience and understand their professional competence and its development upon graduation? This is what this study aims at describing. Method: This study has a…

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

22 CFR 61.6 - Consultation with subject matter specialists.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Consultation with subject matter specialists. 61.6 Section 61.6 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.6 Consultation with subject matter specialists. (a) The...

The Experiences of Specialist Nurses Working Within the Uro-oncology Multidisciplinary Team in the United Kingdom

PubMed Central

Punshon, Geoffrey; Endacott, Ruth; Aslett, Phillippa; Brocksom, Jane; Fleure, Louisa; Howdle, Felicity; Masterton, Morven; O’Connor, Anita; Swift, Adrian; Trevatt, Paul; Leary, Alison

2017-01-01

Purpose: United Kingdom prostate cancer nursing care is provided by a variety of urology and uro-oncology nurses. The experience of working in multidisciplinary teams (MDT) was investigated in a national study. Design: The study consisted of a national survey with descriptive statistics and thematic analysis. Methods: A secondary analysis of a data subset from a UK whole population survey was undertaken (n = 285) of the specialist nursing workforce and the services they provide. Data were collected on the experience of working in the MDT. Results: Forty-five percent of the respondents felt that they worked in a functional MDT, 12% felt that they worked in a dysfunctional MDT, and 3.5% found the MDT meeting intimidating. Furthermore, 34% of the nurses felt that they could constructively challenge all members of the MDT in meetings. Themes emerging from open-ended questions were lack of interest in nonmedical concerns by other team members, ability to constructively challenge decisions or views within the meeting, and little opportunity for patients’ wishes to be expressed. Conclusions: Despite expertise and experience, nurses had a variable, often negative, experience of the MDT. It is necessary to ensure that all participants can contribute and are heard and valued. More emphasis should be given to patients’ nonmedical needs. PMID:28594672

The Experiences of Specialist Nurses Working Within the Uro-oncology Multidisciplinary Team in the United Kingdom.

PubMed

Punshon, Geoffrey; Endacott, Ruth; Aslett, Phillippa; Brocksom, Jane; Fleure, Louisa; Howdle, Felicity; Masterton, Morven; O'Connor, Anita; Swift, Adrian; Trevatt, Paul; Leary, Alison

United Kingdom prostate cancer nursing care is provided by a variety of urology and uro-oncology nurses. The experience of working in multidisciplinary teams (MDT) was investigated in a national study. The study consisted of a national survey with descriptive statistics and thematic analysis. A secondary analysis of a data subset from a UK whole population survey was undertaken (n = 285) of the specialist nursing workforce and the services they provide. Data were collected on the experience of working in the MDT. Forty-five percent of the respondents felt that they worked in a functional MDT, 12% felt that they worked in a dysfunctional MDT, and 3.5% found the MDT meeting intimidating. Furthermore, 34% of the nurses felt that they could constructively challenge all members of the MDT in meetings. Themes emerging from open-ended questions were lack of interest in nonmedical concerns by other team members, ability to constructively challenge decisions or views within the meeting, and little opportunity for patients' wishes to be expressed. Despite expertise and experience, nurses had a variable, often negative, experience of the MDT. It is necessary to ensure that all participants can contribute and are heard and valued. More emphasis should be given to patients' nonmedical needs.

An empirical investigation of differences between mathematics specialists and non-specialists at the high school level in Cyprus: A Logistic regression Approach

NASA Astrophysics Data System (ADS)

Papanastasiou, Elena C.; Zembylas, Michalinos

2006-12-01

AN EMPIRICAL INVESTIGATION OF DIFFERENCES BETWEEN MATHEMATICS SPECIALISTS AND NON-SPECIALISTS AT THE HIGH-SCHOOL LEVEL in Cyprus - The data obtained from high-school seniors for the Third International Mathematics and Science Study (TIMSS) for the country of Cyprus appear to be contradictory. Although Cypriot students did not perform well in mathematics in elementary school, middle school, and in the non-advanced sectors of high school, students in advanced mathematics courses in high school managed to perform exceptionally well. In seeking to account for this apparent disparity, the present study examines the differences between mathematics specialists and non-specialists at the high-school level and discusses the implications that these have for teaching practice. It shows how students educated in an environment that might not be optimal for producing high-achieving students in mathematics and science in elementary and middle school (according to the TIMSS) might nonetheless manage to excel in these fields at the end of their schooling. In conclusion, the authors address the implications of their study for similar educational systems in other developing countries.

Polish Code of Ethics of a Medical Laboratory Specialist.

PubMed

Elżbieta, Puacz; Waldemar, Glusiec; Barbara, Madej-Czerwonka

2014-09-01

Along with the development of medicine, increasingly significant role has been played by the laboratory diagnostics. For over ten years the profession of the medical laboratory specialist has been regarded in Poland as the autonomous medical profession and has enjoyed a status of one of public trust. The process of education of medical laboratory specialists consists of a five-year degree in laboratory medicine, offered at Medical Universities, and of a five-year Vocational Specialization in one of the fields of laboratory medicine such as clinical biochemistry, medical microbiology, medical laboratory toxicology, medical laboratory cytomorphology and medical laboratory transfusiology. An important component of medical laboratory specialists' identity is awareness of inherited ethos obtained from bygone generations of workers in this particular profession and the need to continue its further development. An expression of this awareness is among others Polish Code of Ethics of a Medical Laboratory Specialist (CEMLS) containing a set of values and a moral standpoint characteristic of this type of professional environment. Presenting the ethos of the medical laboratory specialist is a purpose of this article. Authors focus on the role CEMLS plays in areas of professional ethics and law. Next, they reconstruct the Polish model of ethos of medical diagnostic laboratory personnel. An overall picture consists of a presentation of the general moral principles concerning execution of this profession and rules of conduct in relations with the patient, own professional environment and the rest of the society. Polish model of ethical conduct, which is rooted in Hippocratic medical tradition, harmonizes with the ethos of medical laboratory specialists of other European countries and the world.

A Spiral Step-by-Step Educational Method for Cultivating Competent Embedded System Engineers to Meet Industry Demands

ERIC Educational Resources Information Center

Jing,Lei; Cheng, Zixue; Wang, Junbo; Zhou, Yinghui

2011-01-01

Embedded system technologies are undergoing dramatic change. Competent embedded system engineers are becoming a scarce resource in the industry. Given this, universities should revise their specialist education to meet industry demands. In this paper, a spirally tight-coupled step-by-step educational method, based on an analysis of industry…

Design, fracture control, fabrication, and testing of pressurized space-vehicle structures

NASA Technical Reports Server (NTRS)

Babel, H. W.; Christensen, R. H.; Dixon, H. H.

1974-01-01

The relationship between analysis, design, fabrication, and testing of thin shells is illustrated by Saturn S-IVB, Thor, Delta, and other single-use and reusable large-size cryogenic aluminum tankage. The analyses and design to meet the design requirements are reviewed and include consideration of fracture control, general instability, and other failure modes. The effect of research and development testing on the structure is indicated. It is shown how fabrication and nondestructive and acceptance testing constrain the design. Finally, qualification testing is reviewed to illustrate the extent of testing used to develop the Saturn S-IVB.

An analysis of specialist and non-specialist user requirements for geographic climate change information.

PubMed

Maguire, Martin C

2013-11-01

The EU EuroClim project developed a system to monitor and record climate change indicator data based on satellite observations of snow cover, sea ice and glaciers in Northern Europe and the Arctic. It also contained projection data for temperature, rainfall and average wind speed for Europe. These were all stored as data sets in a GIS database for users to download. The process of gathering requirements for a user population including scientists, researchers, policy makers, educationalists and the general public is described. Using an iterative design methodology, a user survey was administered to obtain initial feedback on the system concept followed by panel sessions where users were presented with the system concept and a demonstrator to interact with it. The requirements of both specialist and non-specialist users is summarised together with strategies for the effective communication of geographic climate change information. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

On the emotional connection of medical specialists dealing with death and dying: a qualitative study of oncologists, surgeons, intensive care specialists and palliative medicine specialists.

PubMed

Zambrano, Sofia Carolina; Chur-Hansen, Anna; Crawford, Gregory B

2012-09-01

This paper reports on qualitative data exploring the experiences and coping mechanisms of medical specialists from the specialties of intensive care, surgery, oncology and palliative care, when dealing with death and dying and their emotional connection with dying patients in the context of a life-threatening illness. Thirty-three semi-structured individual interviews were analysed using thematic analysis. One of the key themes of medical specialists' experiences with death and dying was their ambivalence about developing emotional connections with patients and families. Advantages of not engaging emotionally with patients were related to preserving objectivity in the decision making process, while a perceived disadvantage was the loss of the opportunity to engage in meaningful relationships that could positively influence patients, families and the medical specialist. Finding a balance in the face of ambivalence was a preferred approach and participants employed a variety of coping strategies. Participants took different positions about the emotional connection that should develop with their dying patients and their families. Although there was agreement about finding a balance between objectivity and connection, their strategies for achieving this seem to be subjective and prescribed by individual notions. By sharing perspectives and learning how other colleagues deal with similar issues, there is an opportunity for medical practitioners to develop a well-rounded approach to dealing with death and dying, which may enhance personal and professional relationships and may ultimately influence future generations of medical practitioners.

Specialist Schools and Academies Trust Annual Report, 2008-2009

ERIC Educational Resources Information Center

Specialist Schools and Academies Trust, 2010

2010-01-01

This paper presents the annual activities of the Specialist Schools and Academies Trust (SSAT) during 2008-2009. SSAT's activities this year have reflected its commitment to the priorities of the Government's Children's Plan. Its active and expert support of specialist schools, academies and trust schools continued to develop and enrich the…

Developing Fabrication Technologies to Provide On Demand Manufacturing for Exploration of the Moon and Mars

NASA Technical Reports Server (NTRS)

Hammond, Monica S.; Good, James E.; Gilley, Scott D.; Howard, Richard W.

2006-01-01

NASA's human exploration initiative poses great opportunity and risk for manned and robotic missions to the Moon, Mars, and beyond. Engineers and scientists at the Marshall Space Flight Center (MSFC) are developing technologies for in situ fabrication capabilities during lunar and Martian surface operations utilizing provisioned and locally refined materials. Current fabrication technologies must be advanced to support the special demands and applications of the space exploration initiative such as power, weight and volume constraints. In Situ Fabrication and Repair (ISFR) will advance state-of-the-art technologies in support of habitat structure development, tools, and mechanical part fabrication. The repair and replacement of space mission components, such as life support items or crew exercise equipment, fall within the ISFR scope. This paper will address current fabrication technologies relative to meeting ISFR targeted capabilities, near-term advancement goals, and systematic evaluation of various fabrication methods.

22 CFR 62.26 - Specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., international educational exchange, museum exhibitions, labor law, public administration, and library science... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Specialists. 62.26 Section 62.26 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Specific Program...

Certification of School Media Specialists.

ERIC Educational Resources Information Center

Penland, Patrick R.

1982-01-01

Professional organizations, such as the American Association of School Librarians and the Association for Educational Communications and Technology, have established guidelines and standards for certification of school media specialists and have identified necessary professional competencies. Issues and problems concerning state certification and…

[Integral financing stifles innovation: consequences of the new form of financing for specialists].

PubMed

Berden, H J J M Bart; Keuzenkamp, Hugo A

2015-01-01

Of the 22,800 Dutch medical specialists, 43% are self-employed, which involves various tax benefits. In 2015 an important change took place. In the past, specialists declared their services independently from the hospital, which impeded process adjustments. Although this gives the impression of improvement, it is not, mainly because specialists are organized separately from the hospital organization. In addition, specialists are not entrepreneurs, which means that they avoid risks and uncertainty. The complex situation that has arisen is further complicated by fuzzy implementation that lacks an overall plan. For the individual specialist, the situation is unclear. The specialists consider necessary renewals and innovations to be irresponsible risks. This creates a cautious attitude and inertia. To achieve improvement, government and policy-makers should set clear rules and health insurers should value good governance. This protection would allow specialists and hospital boards to balance medical content and finance.

Fabrication and installation of the Solar Two central receiver

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

Litwin, R.Z.; Rogers, R.D.

The heart of the Solar Two power plant is the molten salt central receiver that has been designed, fabricated, and installed over an 18 month schedule. During this time, the receiver system from Solar One was also completely disassembled and removed. The receiver tower structure, for the most part, was left intact because Solar Two was designed to fit this structure such that construction time and costs could be minimized. In order to meet this aggressive schedule, receiver panel fabrication required the parallel production of many components. The sequence for assembly of the four major receiver panel components (i.e., tubes,more » header assembly, strongback, and header oven covers) and key fabrication activities such as welding are described. Once the receiver panels were complete, their installation at the site was begun, and the order in which receiver system components were installed in the tower is described. The completion of the Solar Two receiver proved the fabricability of this important system. However, successful operation of the system at Solar Two is needed to demonstrate the technical feasibility of the molten salt central receiver concept.« less

STS-47 Payload Specialist Mohri adjusts life vest during Homestead training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Payload Specialist Mamoru Mohri adjusts his life jacket with a training instructor's assistance as backup (alternate) payload specialist Takao Doi looks on. The STS-47 prime and alternate payload specialists are participating in a special water survival training course hosted by Homestead Air Force Base in Florida. Mohri and Doi represent the National Space Development Agency of Japan (NASDA).

Payload specialist Reinhard Furrer show evidence of previous blood sampling

NASA Technical Reports Server (NTRS)

1985-01-01

Payload specialist Reinhard Furrer shows evidence of previous blood sampling while Wubbo J. Ockels, Dutch payload specialist (only partially visible), extends his right arm after a sample has been taken. Both men show bruises on their arms.

Motivational Profiles and Motivation for Lifelong Learning of Medical Specialists.

PubMed

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

2018-05-22

Medical specialists face the challenge of maintaining their knowledge and skills and continuing professional development, that is, lifelong learning. Motivation may play an integral role in many of the challenges facing the physician workforce today including maintenance of a high performance. The aim of this study was to determine whether medical specialists show different motivational profiles and if these profiles predict differences in motivation for lifelong learning. An online questionnaire was sent to every medical specialist working in five hospitals in the Netherlands. The questionnaire included the validated Multidimensional Work Motivation Scale and the Jefferson Scale of Physician Lifelong Learning together with background questions like age, gender, and type of hospital. Respondents were grouped into different motivational profiles by using a two-step clustering approach. Four motivational profiles were identified: (1) HAMC profile (for High Autonomous and Moderate Controlled motivation), (2) MAMC profile (for Moderate Autonomous and Moderate Controlled motivation), (3) MALC profile (for Moderate Autonomous and Low Controlled motivation), and (4) HALC profile (for High Autonomous and Low Controlled motivation). Most of the female specialists that work in an academic hospital and specialists with a surgical specialty were represented in the HALC profile. Four motivational profiles were found among medical specialists, differing in gender, experience and type of specialization. The profiles are based on the combination of autonomous motivation (AM) and controlled motivation (CM) in the specialists. The profiles that have a high score on autonomous motivation have a positive association with lifelong learning.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work

Using non-specialist observers in 4AFC human observer studies

NASA Astrophysics Data System (ADS)

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

2017-03-01

Virtual clinical trials (VCTs) are an emergent approach for rapid evaluation and comparison of various breast imaging technologies and techniques using computer-based modeling tools. Increasingly 4AFC (Four alternative forced choice) virtual clinical trials are used to compare detection performances of different breast imaging modalities. Most prior studies have used physicists and/or radiologists and physicists interchangeably. However, large scale use of statistically significant 4AFC observer studies is challenged by the individual time commitment and cost of such observers, often drawn from a limited local pool of specialists. This work aims to investigate whether non-specialist observers can be used to supplement such studies. A team of five specialist observers (medical physicists) and five non-specialists participated in a 4AFC study containing simulated 2D-mammography and DBT (digital breast tomosynthesis) images, produced using the OPTIMAM toolbox for VCTs. The images contained 4mm irregular solid masses and 4mm spherical targets at a range of contrast levels embedded in a realistic breast phantom background. There was no statistically significant difference between the detection performance of medical physicists and non-specialists (p>0.05). However, non-specialists took longer to complete the study than their physicist counterparts, which was statistically significant (p<0.05). Overall, the results from both observer groups indicate that DBT has a lower detectable threshold contrast than 2D-mammography for both masses and spheres, and both groups found spheres easier to detect than irregular solid masses.

Addressing cultural diversity: the hepatitis B clinical specialist perspective.

PubMed

Wallace, Jack; Smith, Elizabeth; Hajarizadeh, Behzad; Richmond, Jacqueline; Lucke, Jayne

2017-08-31

Hepatitis B is a viral infection primarily affecting people from culturally diverse communities in Australia. While vaccination prevents infection, there is increasing mortality resulting from liver damage associated with chronic infection. Deficits in the national policy and clinical response to hepatitis B result in a low diagnosis rate, inadequate testing and diagnosis processes, and poor access to hepatitis B treatment services. While research identifies inadequate hepatitis B knowledge among people with the virus and primary health care workers, this project sought to identify how specialist clinicians in Australia negotiate cultural diversity, and provide often complex clinical information to people with hepatitis B. A vignette was developed and presented to thirteen viral hepatitis specialist clinicians prior to an electronically recorded interview. Recruitment continued until saturation of themes was reached. Data were thematically coded into themes outlined in the interview schedule. Ethical approval for the research was provided by the La Trobe University Human Research Ethics Committee. Key messages provided to patients with hepatitis B by clinical specialists were identified. These messages were not consistently provided to all patients with hepatitis B, but were determined on perceptions of patient knowledge, age and highest educational level. While the vignette stated that English was not an issue for the patient, most specialists identified the need for an interpreter. Combating stigma related to hepatitis B was seen as important by the specialists and this was done through normalising the virus. Having an awareness of different cultural understandings about hepatitis B specifically, and health and well-being generally, was noted as a communication strategy. Key core competencies need to be developed to deliver educational messages to people with hepatitis B within clinical encounters. The provision of adequate resources to specialist clinics will

Comparing Clinical Nurse Specialist Students' Socialization Based on Magnet Employment.

PubMed

Ares, Terri L

The purpose of this study is to ascertain if clinical nurse specialist students differed on measures of professional socialization based on employment in a Magnet-oriented hospital. A secondary analysis of data from a previous national study of the socialization of clinical nurse specialist students was used. Anticipatory socialization variables (nursing leadership, workplace exposure to the role, and preconceived impression of the role), mentorship by a clinical nurse specialist, and socialization outcomes (self-concept, perceived preparedness for practice, and nursing specialty certification) were explored. Data were divided into 2 groups: Magnet (n = 106) and non-Magnet (n = 119). Comparisons between the groups on researcher-designed items and the Professionalism and Work Ethic subscales of the Nurses Self-Description Form were analyzed. The Magnet group was more likely to be exposed to the clinical nurse specialist role in the workplace. Overall, there were no group differences in socialization outcome measures; but in the subset of students with workplace exposure to the role, those with Magnet experience had higher professionalism self-concept scores. Magnet employment was not a significant socializing factor for nurses pursuing clinical nurse specialist education. The graduate program is likely the primary socializing agent for these students.

Perceptions of Information Technology Specialists Regarding Securing Re-Employment after Offshoring Displacement

ERIC Educational Resources Information Center

Gallaway, Ricky A.

2015-01-01

The purpose of this qualitative exploratory case study was to explore why some IT specialists, after experiencing unemployment because of corporate offshoring, acquired gainful re-employment, whereas other similarly unemployed IT specialists had not. To effectively address this case study, two cases were studied: (a) displaced IT specialists who…

Payload specialists Millie Hughes-Fulford in Body Mass Measurement Device

NASA Image and Video Library

1985-02-01

S85-26553 (Feb 1985) --- STS-40/SLS-1 payload specialist Millie Hughes-Fulford sits strapped in the special device scientists have developed for determining mass on orbit. As the chair swings back and forth, a timer records how much the crewmember's mass retards the chair's movement. Dr. Hughes-Fulford will be joined by three mission specialists, the mission commander, the pilot and a second payload specialist for the scheduled 10-day Spacelab Life Sciences-1 (SLS-1) mission. The flight is totally dedicated to biological and medical experimentation.

Balanced scorecards for specialists: a tool for quality improvement.

PubMed

Marr, Thomas J; Mullen, Deborah M

2004-04-01

This article describes a program that HealthPartners uses to assess and compare the performance of specialists that serve its members. HealthPartners' Balanced Scorecards program focuses on cardiologist and orthopedist practices in the Minneapolis/St. Paul metro area and St. Cloud, Minnesota. The scorecards assess the clinical and business processes of specialist practices, their use of resources, the degree to which patients and referring physicians are satisfied with their performance, and their patient outcomes. Unblinded comparative data is made available to referring physicians, employers, and consumers only after each individual specialist group has had the opportunity to review its own data against blinded results, discuss the methodology, and comment on the results.

The problems of professional training of practice-oriented specialists for small enterprises of footwear and leather production industries in Uzbekistan

NASA Astrophysics Data System (ADS)

Ilkhamova, M. U.; Gafurov, J. K.; Maksudova, U. M.; Vassiliadis, S.

2017-10-01

At the present, the State authorities of the Republic of Uzbekistan pay special attention to the development of small and medium businesses and, in particular, to the enterprises oriented on manufacturing products with high added value. The leather and footwear industry of Uzbekistan is one of the dynamically developing sectors of economy. However, the study of the situation demonstrates that the increase in number of small and medium footwear and leather enterprises that have taken place in recent years, is not accompanied by a formation of corresponding professional training system for the enterprises, especially for associate specialists. The analysis of the legal base disclosed that the professional training level in footwear industry enterprises does not meet the up-to-date manufacturing requirements. The study is devoted to the issues of professional training of practice-oriented staff - the specialists for small enterprises of footwear and leather industry. The main task is the development of new vocational courses and programs for the training and professional development of personnel at all levels. The basic stages of complete staff training cycle for footwear sector have been determined based on the practical experience of staff training for small footwear enterprises in Greece. The 3-6 months duration short-term courses recommended for associate and medium level specialists have been developed and evaluated.

Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-01-07

The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations. A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest. Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%). Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist's main practice is likely to support participation and improve service distribution.

22 CFR 41.54 - Intracompany transferees (executives, managers, and specialists).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Intracompany transferees (executives, managers, and specialists). 41.54 Section 41.54 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION....54 Intracompany transferees (executives, managers, and specialists). (a) Requirements for L...

STS-9 payload specialists and backup in training session

NASA Technical Reports Server (NTRS)

1983-01-01

Two Spacelab 1 payload specialists and a backup for that flight prepare for a training session in the JSC mockup and integration laboratory. Fully decked out in the Shuttle constant wear garments (foreground) are Ulf Merbold, left, and Byron K. Licktenberg, prime crewmembers on the STS-9 team. In civilian clothes is payload specialist backup Michael L. Lampton.

AGU Cinema: Festival of short science films at Fall Meeting

NASA Astrophysics Data System (ADS)

Harned, Douglas A.

2012-11-01

New technologies have revolutionized the use of video as a means of science communication and have made it easier to create, distribute, and view. With video having become omnipresent in our culture, it sometime supplements or even replaces writing in many science and education applications. An inaugural science film festival sponsored by AGU at the 2012 Fall Meeting in San Francisco, Calif., in December will showcase short videos—30 minutes or less in length—developed to disseminate scientific results to various audiences and to enhance learning in the classroom. AGU Cinema will feature professionally produced, big budget films alongside low-budget videos aimed at niche audiences and made by amateurs. The latter category includes videos made by governmental agency scientists, educators, communications specialists within scientific organizations, and Fall Meeting oral and poster presenters.

How much does the specialist know about cardiogastroenterology?

PubMed

Aguilar-Nájera, O; Valdovinos-García, L R; Tepox-Padrón, A; Valdovinos-Díaz, M A

Cardiovascular disease is a growing public health problem. Forty percent of the general population will suffer from the disease by 2030, consequently requiring antithrombotic therapy. Cardiogastroenterology is a new area of knowledge that evaluates the gastrointestinal effects and complications of antithrombotic therapy. Our aim was to evaluate, through a validated questionnaire, the knowledge held by a group of specialists and residents in the areas of gastroenterology and internal medicine, about pharmacology and drug prescription, as well as gastrointestinal risks and complications, in relation to antithrombotic therapy. A validated questionnaire composed of 30 items was applied to a group of specialists and residents in the areas of gastroenterology and internal medicine. The questions were on indications, pharmacology, evaluation of risks for gastrointestinal bleeding and thromboembolic events, and use of antithrombotic therapy during endoscopic procedures. Sufficient knowledge was defined as 18 or more (≥ 60%) correct answers. The questionnaire was answered by 194 physicians: 82 (42%) internal medicine residents and gastroenterology residents and 112 (58%) specialists. Only 40 (20.6%) of the participants had sufficient knowledge of cardiogastroenterology. Residents had a higher number of correct answers than specialists (53 vs. 36%, P<.0001). The gastroenterology residents had more correct answers than the internal medicine residents, gastroenterologists, and internists (70 vs. 53, 40, and 46%, respectively, P<.001). Only residents had sufficient knowledge regarding pharmacology and the use of antithrombotic therapy in endoscopy (P<.0001). All groups had insufficient knowledge in evaluating the risk for gastrointestinal bleeding and thrombosis. Knowledge of cardiogastroenterology was insufficient in the group of residents and specialists surveyed. There is a need for medical education programs on the appropriate use of antithrombotic therapy. Copyright �

Inequalities in Specialist Hand Surgeon Distribution across the United States.

PubMed

Rios-Diaz, Arturo J; Metcalfe, David; Singh, Mansher; Zogg, Cheryl K; Olufajo, Olubode A; Ramos, Margarita S; Caterson, Edward J; Talbot, Simon G

2016-05-01

Unequal access to hospital specialists for emergency care is an issue in the United States. The authors sought to describe the geographic distribution of specialist hand surgeons and associated factors in the United States. Geographic distributions of surgeons holding a Subspecialty Certificate in Surgery of the Hand and hand surgery fellowship positions were identified from the American Board of Medical Specialties Database and the literature (2013), respectively. State-level population and per capita income were ascertained using U.S. Census data. Variations in hand trauma admissions were determined using Healthcare Cost and Utilization Project national/state inpatient databases. Risk-adjusted generalized linear models were used to assess independent association between hand surgeon density and hand trauma admission density, fellowship position density, and per capita income. Among 2019 specialist hand surgeons identified, 72.1 percent were orthopedic surgeons, 18.3 percent were plastic surgeons, and 9.6 percent were general surgeons. There were 157 hand surgery fellowship positions nationwide. There were 149,295 annual hand trauma admissions. The national density of specialist hand surgeons and density of trauma admission were 0.6 and 47.6, respectively. The density of specialist hand surgeons varied significantly between states. State-level variations in density of surgeons were independent and significantly associated with median per capita income (p < 0.001) and with density of fellowships (p = 0.014). Specialist hand surgeons are distributed unevenly across the United States. State-level analyses suggest that states with lower per capita incomes may be particularly underserved, which may contribute to regional disparities in access to emergency hand trauma care.

Pest Management Specialist (AFSC 56650).

ERIC Educational Resources Information Center

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

This eight-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for pest management specialists. Covered in the individual volumes are civil engineering; pest management (entomology, pest management planning and coordination, and safety and protective equipment); pest management chemicals and…

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

14 CFR 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payload specialist relationship with sponsoring institutions. 1214.306 Section 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

20 CFR 702.408 - Evaluation of medical questions; impartial specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Evaluation of medical questions; impartial specialists. 702.408 Section 702.408 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF... PROCEDURE Medical Care and Supervision § 702.408 Evaluation of medical questions; impartial specialists. In...

Structural considerations for fabrication and mounting of the AXAF HRMA optics

NASA Technical Reports Server (NTRS)

Cohen, Lester M.; Cernoch, Larry; Mathews, Gary; Stallcup, Michael

1990-01-01

A methodology is described which minimizes optics distortion in the fabrication, metrology, and launch configuration phases. The significance of finite element modeling and breadboard testing is described with respect to performance analyses of support structures and material effects in NASA's AXAF X-ray optics. The paper outlines the requirements for AXAF performance, optical fabrication, metrology, and glass support fixtures, as well as the specifications for mirror sensitivity and the high-resolution mirror assembly. Analytical modeling of the tools is shown to coincide with grinding and polishing experiments, and is useful for designing large-area polishing and grinding tools. Metrological subcomponents that have undergone initial testing show evidence of meeting force requirements.

Burns education for non-burn specialist clinicians in Western Australia.

PubMed

McWilliams, Tania; Hendricks, Joyce; Twigg, Di; Wood, Fiona

2015-03-01

Burn patients often receive their initial care by non-burn specialist clinicians, with increasingly collaborative burn models of care. The provision of relevant and accessible education for these clinicians is therefore vital for optimal patient care. A two phase design was used. A state-wide survey of multidisciplinary non-burn specialist clinicians throughout Western Australia identified learning needs related to paediatric burn care. A targeted education programme was developed and delivered live via videoconference. Pre-post-test analysis evaluated changes in knowledge as a result of attendance at each education session. Non-burn specialist clinicians identified numerous areas of burn care relevant to their practice. Statistically significant differences between perceived relevance of care and confidence in care provision were reported for aspects of acute burn care. Following attendance at the education sessions, statistically significant increases in knowledge were noted for most areas of acute burn care. Identification of learning needs facilitated the development of a targeted education programme for non-burn specialist clinicians. Increased non-burn specialist clinician knowledge following attendance at most education sessions supports the use of videoconferencing as an acceptable and effective method of delivering burns education in Western Australia. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

STS-75 Payload Specialist Umberto Guidoni suits up

NASA Technical Reports Server (NTRS)

1996-01-01

STS-75 Payload Specialist Umberto Guidoni (right) chats with fellow crew member Mission Specialist Claude Nicollier during suitup activities in the Operations and Checkout Building. Guidoni represents the Italian Space Agency and is one of three international crew members assigned to STS-75. He and six fellow crew members will depart shortly for Launch Pad 39B, where the Space Shuttle Columbia awaits liftoff during a two-and-a-half- hour launch window opening at 3:18 p.m. EST.

Payload specialist Robert Cenker after adjusting DSO equipment

NASA Image and Video Library

1986-01-12

61C-05-035 (12-17 Jan 1986) --- Robert J. Cenker, 61-C payload specialist representing RCA, returns a tiny tool to its stowage position after adjusting the inner workings of a device used in one of a number of detailed supplementary objective (DSO) studies for NASA's Space Biomedical Research Institute. The device is a pair of ocular counter-rolling goggles used by U.S. Rep. Bill Nelson (D., Florida), 61-C's other payload specialist aboard the Columbia for this five-day flight.

STS-87 Mission Specialist Takao Doi suits up

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan, gives a thumbs up in his launch and entry suit in the Operations and Checkout Building. He and the five other crew members will depart shortly for Launch Pad 39B, where the Space Shuttle Columbia awaits liftoff on a 16-day mission to perform microgravity and solar research. Dr. Doi is scheduled to perform an extravehicular activity spacewalk with Mission Specialist Winston Scott during STS-87.

Portrait view of ESA Spacelab Specialists

NASA Technical Reports Server (NTRS)

1978-01-01

Portrait view of European Space Agency (ESA) Spacelab Specialist Ulf Merbold in civilian clothes standing in front of a display case. The photo was taken at the Marshall Space Flight Center (MSFC), Huntsville, Alabama.

[Smoking among patients of selected specialist clinics of Miedzylesie Specialist Hospital in Warsaw].

PubMed

Pytka, Dorota; Doboszyńska, Anna

2011-01-01

The purpose of the study is to examine the issue of smoking among patients of selected clinics of the Miedzylesie Specialist Hospital in Warsaw, assessment of nicotine addiction of smokers and motivation to give up smoking. The survey was carried out in June and July 2009 after obtaining the consent of the Director of Miedzylesie Specialist Hospital in Warsaw. The survey was participated in by 100 patients of selected specialist clinics. The survey was carried out on the basis of a questionnaire consisting of 7 questions. Furthermore, the "Test of motivation to give up smoking" (Schneider's test) and the "Assessment of nicotine addiction level" (Fagerström's test), published in the "Consensus regarding recognition and treatment of nicotine addiction", were used. When processing data, the descriptive statistics were applied. Those surveyed included 53 former cigarette smokers 47 active smokers and. In the group of former smokers, 19 people still were exposed to passive smoking. In the past, the problem regarded 41 people. Thirty former smokers smoked cigarettes among non-smokers, including young children (18 people) and when pregnant and breastfeeding (2 people). Also 30 respondents smoked despite medical contraindications and bad conscience. For 27 people, expenditures on cigarettes constituted a considerable burden of their respective household budgets, and 20 said that it was a significant item in their expenditures. Smokers have been smoking cigarettes for 30 years, on average 20 cigarettes a day. Those patients began to smoke at the age of 20. Thirty one active smokers exposed other people to passive smoking and 38 respondents smoked cigarettes despite medical contraindications and with bad conscience. For 22 people, expenditures related to smoking are a considerable burden of the household budget and for 21 people, it is a significant expenditure. Almost one half of the patients smoke cigarettes although they should brake off smoking for medical reasons. Most

Contemporary challenges for specialist nursing in interstitial lung disease

PubMed Central

Russell, Anne Marie; Olive, Sandra; Lines, Sarah; Murphy, Anna; Hocking, Julie; Newell, Karen; Morris, Helen; Harris, Emma; Dixon, Catherine; Agnew, Sarah; Burge, Geraldine

2018-01-01

The role of clinical nurse specialists (CNSs) in interstitial lung disease (ILD) is evolving in response to clinical guidelines and the growth of clinical research. The role is well established in the UK, although more ILD posts are needed to ensure supply meets clinical demand. This phenomenon is also happening across Europe. An appreciation of the similarities and differences between CNS and advanced nurse practitioners is important given the challenges in defining, developing and supporting this nursing specialisation. Globally, different models exist. In some countries charitable organisations take a leading role in supporting patients. Many European centres look to the National Institute for Health and Care Excellence guidelines and quality standards as a template to develop and evaluate the role of the ILD CNS. We present a UK perspective in the context of a government subsidised healthcare system to promote professional discussion and debate regarding the future of nursing practice in the ILD specialty. Key points ILDs are often complex and associated with significant mortality, morbidity and co-morbid conditions that require a technical healthcare skill set There is worldwide shortage of nurses, low retention rates and retirement of many skilled nurses Collaboration across the ILD interdisciplinary community is needed to safeguard the future of our professions and high-quality patient care The ILD interdisciplinary and nurse network has identified key priorities to help secure the future of the ILD clinical and academic nurse specialism Educational aims To explain the similarities and differences between clinical nurse specialists (CNSs) and advanced nurse practitioners (ANPs) in the context of ILD specialism To review contemporary nursing specialism in the UK’s government subsidised healthcare system To stimulate discussion and debate across the European/international respiratory community regarding the clinical and academic development of the ILD CNS To

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

PubMed

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

2017-09-01

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

Are Specialist Certification Examinations a Reliable Measure of Physician Competence?

ERIC Educational Resources Information Center

Burch, V. C.; Norman, G. R.; Schmidt, H. G.; van der Vleuten, C. P. M.

2008-01-01

High stakes postgraduate specialist certification examinations have considerable implications for the future careers of examinees. Medical colleges and professional boards have a social and professional responsibility to ensure their fitness for purpose. To date there is a paucity of published data about the reliability of specialist certification…

The Role of the Technical Specialist in Disaster Response and Recovery

NASA Astrophysics Data System (ADS)

Curtis, J. C.

2017-12-01

Technical Specialists provide scientific expertise for making operational decisions during natural hazards emergencies. Technical Specialists are important members of any Incident Management Team (IMT) as is described in in the National Incident Management System (NIMS) that has been designed to respond to emergencies. Safety for the responders and the threatened population is the foremost consideration in command decisions and objectives, and the Technical Specialist is on scene and in the command post to support and promote safety while aiding decisions for incident objectives. The Technical Specialist's expertise can also support plans, logistics, and even finance as well as operations. This presentation will provide actual examples of the value of on-scene Technical Specialists, using National Weather Service "Decision Support Meteorologists" and "Incident Meteorologists". These examples will demonstrate the critical role of scientists that are trained in advising and presenting life-critical analysis and forecasts during emergencies. A case will be made for local, state, and/or a national registry of trained and deployment-ready scientists that can support emergency response.

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

PubMed

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

2016-08-01

Medical specialists seem to increasingly work in- and be affiliated to- multiple organizations. We define this phenomenon as specialist sharing. This form of inter-organizational cooperation has received scant scholarly attention. We investigate the extent of- and motives behind- specialist sharing, in the price-competitive hospital market of the Netherlands. A mixed-method was adopted. Social network analysis was used to quantitatively examine the extent of the phenomenon. The affiliations of more than 15,000 medical specialists to any Dutch hospital were transformed into 27 inter-hospital networks, one for each medical specialty, in 2013 and in 2015. Between February 2014 and February 2016, 24 semi-structured interviews with 20 specialists from 13 medical specialties and four hospital executives were conducted to provide in-depth qualitative insights regarding the personal and organizational motives behind the phenomenon. Roughly, 20% of all medical specialists are affiliated to multiple hospitals. The phenomenon occurs in all medical specialties and all Dutch hospitals share medical specialists. Rates of specialist sharing have increased significantly between 2013 and 2015 in 14 of the 27 specialties. Personal motives predominantly include learning, efficiency, and financial benefits. Increased workload and discontinuity of care are perceived as potential drawbacks. Hospitals possess the final authority to decide whether and which specialists are shared. Adhering to volume norms and strategic considerations are seen as their main drivers to share specialists. We conclude that specialist sharing should be interpreted as a form of inter-organizational cooperation between healthcare organizations, facilitating knowledge flow between them. Although quality improvement is an important perceived factor underpinning specialist sharing, evidence of enhanced quality of care is anecdotal. Additionally, the widespread occurrence of the phenomenon and the underlying

Neurofibromatosis and the role of the specialist adviser.

PubMed

Redman, Carolyn

2017-09-11

Neurofibromatosis (NF) is a genetic condition that mainly involves the nervous system. There are two types: NF1 affects about one in 2,500 of the population worldwide and NF2 affects one in 35,000. Both types result in complex health problems for patients and can pose significant challenges for all those involved in their management. Established in 1981, The Neuro Foundation is a patient-focused charity that funds a network of specialist advisers who work in partnership with the NHS to offer support and advice for families affected by NF and the professionals who care for them. With a significant level of autonomy, the specialist adviser role is flexible in matching the needs of those affected while working cooperatively alongside the national specialist services for NF1 and NF2. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

One Point of View: Elementary School Mathematics Specialists: Where Are They?

ERIC Educational Resources Information Center

Dossey, John A.

1984-01-01

A plea is made for the mathematics education community to support the need for elementary school mathematics specialists. Roles of such specialists in primary as well as intermediate grades are listed. (MNS)

Internet for Library Media Specialists.

ERIC Educational Resources Information Center

Simpson, Carol Mann

This guide introduces the library media specialist to the Internet, its history and features, and provides information on specific uses of the Internet in school libraries and specific areas. Section 1, "What is the Internet?" introduces the reader to the Internet; electronic mail; telnet; file transfer protocol (FTP); wide area…

Dental Assistant Specialist. (AFSC 98150).

ERIC Educational Resources Information Center

Eling, David R.

This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for dental assistant specialists. Covered in the individual volumes are an introduction to dental services (the mission and organization of medical/dental service, career ladder progressions, medical readiness/wartime training, and…

Environmental Medicine Specialist (AFSC 90850).

ERIC Educational Resources Information Center

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

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

General practice and specialist palliative care teams: an exploration of their working relationship from the perspective of clinical staff working in New Zealand.

PubMed

Keane, Barry; Bellamy, Gary; Gott, Merryn

2017-01-01

With the future focus on palliative and end-of-life care provision in the community, the role of the general practice team and their relationship with specialist palliative care providers is key to responding effectively to the projected increase in palliative care need. Studies have highlighted the potential to improve co-ordination and minimise fragmentation of care for people living with palliative care need through a partnership between generalist services and specialist palliative care. However, to date, the exact nature of this partnership approach has not been well defined and debate exists about how to make such partnerships work successfully. The aim of this study was to explore how general practice and specialist palliative care team (SPCT) members view their relationship in terms of partnership working. Five focus group discussions with general practices and SPCT members (n = 35) were conducted in 2012 in two different regions of New Zealand and analysed using a general inductive approach. The findings indicate that participants' understanding of partnership working was informed by their identity as a generalist or specialist, their existing rules of engagement and the approach they took towards sustaining the partnership. Considerable commitment to partnership working was shown by all participating teams. However, their working relationship was based primarily on trust and personal liaison, with limited formal systems in place to enable partnership working. Tensions between the cultures of 'generalism' and 'specialism' also provided challenges for those endeavouring to meet palliative care need collaboratively in the community. Further research is required to better understand the factors associated with successful partnership working between general practices and specialist palliative care in order to develop robust strategies to support a more sustainable model of community palliative care. © 2015 John Wiley & Sons Ltd.

Assessing the economic burden of Alzheimer's disease patients first diagnosed by specialists.

PubMed

Kirson, Noam Y; Desai, Urvi; Ristovska, Ljubica; Cummings, Alice Kate G; Birnbaum, Howard G; Ye, Wenyu; Andrews, J Scott; Ball, Daniel; Kahle-Wrobleski, Kristin

2016-07-11

It is not known if there is a differential impact on Alzheimer's disease (AD) diagnosis and outcomes if/when patients are diagnosed with cognitive decline by specialists versus non-specialists. This study examined the cost trajectories of Medicare beneficiaries initially diagnosed by specialists compared to similar patients who received their diagnosis in primary care settings. Patients with ≥2 claims for AD were selected from de-identified administrative claims data for US Medicare beneficiaries (5 % random sample). The earliest observed diagnosis of cognitive decline served as the index date. Patients were required to have continuous Medicare coverage for ≥12 months pre-index (baseline) and ≥12 months following the first AD diagnosis, allowing for up to 3 years from index to AD diagnosis. Time from index date to AD diagnosis was compared between those diagnosed by specialists (i.e., neurologist, psychiatrist, or geriatrician) versus non-specialists using Kaplan-Meier analyses with log-rank tests. Patient demographics, Charlson Comorbidity Index (CCI) during baseline, and annual all-cause medical costs (reimbursed by Medicare) in baseline and follow-up periods were compared across propensity-score matched cohorts. Patients first diagnosed with cognitive decline by specialists (n = 2593) were younger (78.8 versus 80.8 years old), more likely to be male (40 % versus 34 %), and had higher CCI scores and higher medical costs at baseline than those diagnosed by non-specialists (n = 13,961). However, patients diagnosed by specialists had a significantly shorter time to AD diagnosis, both before and after matching (mean [after matching]: 3.5 versus 4.6 months, p < 0.0001). In addition, patients diagnosed by specialists had significantly lower average total all-cause medical costs in the first 12 months after their index date, a finding that persisted after matching ($19,824 versus $25,863, p < 0.0001). Total per-patient annual medical costs

Peculiarities of Future Social Sphere Specialists' Professional Training in Poland

ERIC Educational Resources Information Center

Zieba, Beata

2016-01-01

The article reviews certain aspects of organising the process of professional training of future specialists in social sphere. It identifies, considers and analyzes the main definitions of scientific research, the object of which is to make specialists in social sphere ready for professional activity. The article highlights peculiarities of…

[Multidisciplinary meeting about the use of direct oral anticoagulants in nonvalvular atrial fibrillation].

PubMed

Rodríguez-Reyes, Humberto; Arauz-Góngora, Antonio; Asensio-Lafuente, Enrique; Celaya-Cota, Manuel de Jesús; Cordero-Cabra, Alejandro; Guevara-Valdivia, Milton; Izaguirre-Avila, Raúl; Lara-Vaca, Susano; Mariona-Moreno, Vitelio; Martínez-Flores, Enrique; Nava-Townsend, Santiago; Pozas-Garza, Gerardo; Rodríguez-Diez, Gerardo

Knowing the real impact of atrial fibrillation in the stroke, the Sociedad Mexicana of Electrofisiología y Estimulación Cardiaca (SOMEEC) had the initiative to develop a multidisciplinary meeting of experts the with the purpose to update the available scientific evidence from clinical practice guidelines, meta-analyses, controlled clinical trials, and complementing with the experience and views of a group of experts. To meet this goal, SOMEEC gathered a group of specialists in the area of cardiology, electrophysiology, neurology and hematology that given their experience in certain areas, they share the scientific evidence with the panel of experts to leave open a discussion about the information presented in this article. This document brings together the best scientific evidence available and aims to be a useful tool in the decision to use of new oral anticoagulants in nonvalvular atrial fibrillation and ischemic heart disease, or relating to the management of patients with stroke or renal failure, and even those that will be submitted to elective surgery and invasive procedures. In the same, they handled comparative schemes of follow-up and treatment which simplifies the decision making by the specialists participants. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

Design of Tailored Non-Crimp Fabrics Based on Stitching Geometry

NASA Astrophysics Data System (ADS)

Krieger, Helga; Gries, Thomas; Stapleton, Scott E.

2018-02-01

Automation of the preforming process brings up two opposing requirements for the used engineering fabric. On the one hand, the fabric requires a sufficient drapeability, or low shear stiffness, for forming into double-curved geometries; but on the other hand, the fabric requires a high form stability, or high shear stiffness, for automated handling. To meet both requirements tailored non-crimp fabrics (TNCFs) are proposed. While the stitching has little structural influence on the final part, it virtually dictates the TNCFs local capability to shear and drape over a mold during preforming. The shear stiffness of TNCFs is designed by defining the local stitching geometry. NCFs with chain stitch have a comparatively high shear stiffness and NCFs with a stitch angle close to the symmetry stitch angle have a very low shear stiffness. A method to design the component specific local stitching parameters of TNCFs is discussed. For validation of the method, NCFs with designed tailored stitching parameters were manufactured and compared to benchmark NCFs with uniform stitching parameters. The designed TNCFs showed both, generally a high form stability and in locally required zones a good drapeability, in drape experiments over an elongated hemisphere.

The process of disclosing a diagnosis of dementia and mild cognitive impairment: A national survey of specialist physicians in Denmark.

PubMed

Nielsen, T Rune; Svensson, Birthe Hjorth; Rohr, Gitte; Gottrup, Hanne; Vestergaard, Karsten; Høgh, Peter; Waldemar, Gunhild

2018-01-01

Background Although general recommendations for diagnostic disclosure of dementia are available, little is known about how these recommendations are implemented. The aim of the current study was to investigate the process and content of dementia diagnostic disclosure meetings, and to compare key aspects of disclosing a diagnosis of dementia and mild cognitive impairment. Method A total of 54 specialist physicians in Danish dementia diagnostic departments completed an online survey on their practices regarding diagnostic disclosure of dementia and mild cognitive impairment. The influence of respondent characteristics was assessed, and differences on key aspects of disclosing a diagnosis of dementia and mild cognitive impairment were analyzed. Results The results suggest that among Danish specialist physicians, there is a general consensus regarding the organization of diagnostic disclosure meetings. However, differences in employed terminology and information provided when disclosing a dementia diagnosis were evident. Significant differences were present on key aspects of the diagnostic disclosure of dementia and mild cognitive impairment. For instance, 91% would use the term dementia during diagnostic disclosures compared to just 72% for mild cognitive impairment. Conclusion The range of practices reflected in the present study confirms the complexity of diagnostic disclosure and highlights the importance of preparation and follow-up strategies to tailor the disclosure process to the needs of individual patients with dementia and their caregivers. Due to earlier diagnosis of neurodegenerative disorders, more research is urgently needed on this aspect of the diagnostic process, especially to develop evidence-based models for the disclosure of mild cognitive impairment.

Payload Specialist Gregory T. Linteris

NASA Technical Reports Server (NTRS)

1997-01-01

KENNEDY SPACE CENTER, FLA. -- STS-83 Payload Specialist Gregory T. Linteris chats with white room closeout crew members as he prepares to enter the Space Shuttle Columbia at Launch Pad 39A. Closeout crew workers Max Kandler (second from right) and Bob Saulnier wait to assist Linteris with his ascent/reentry suit.

The Changing Role of the Reading Specialist: A Case Study

ERIC Educational Resources Information Center

Ginsburg, Victoria Elaine

2012-01-01

This descriptive qualitative case study explored the changing role of the reading specialist through various perceptions of professionals in the Neon Shadow School District. The purpose of the study was to explore what, how, and why the duties and responsibilities of the reading specialist have changed since first employed as an…

The Visiting Specialist Model of Rural Health Care Delivery: A Survey in Massachusetts

ERIC Educational Resources Information Center

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

2006-01-01

Context: Hospitals in rural communities may seek to increase specialty care access by establishing clinics staffed by visiting specialists. Purpose: To examine the visiting specialist care delivery model in Massachusetts, including reasons specialists develop secondary rural practices and distances they travel, as well as their degree of…

[Demand and supply of otolaryngology specialists based on evidence: What is the required number of specialists who should be trained?].

PubMed

Sánchez Gómez, Serafín; Suárez Nieto, Carlos; Cobeta Marco, Ignacio

2009-01-01

Several concurrent circumstances have created an impression through the media of a presumed lack of specialists in Spain, which has one of the highest densities of doctors per population in the world: simultaneous creation of jobs in many newly built hospitals; accepting garbage contracts (for months, half/thirds of days, shifts) in relevant hospitals rather than moving to unattractive positions; full dedication to the field of public or private healthcare rather than matching them; bad public healthcare working conditions (low wages, excessive healthcare pressure, lack of respect from the public and from healthcare managers, shifts, scarce professional promotion, difficult family reunification); decreased mobility due to insulation of the markets as a result of decentralization of healthcare by regions. There is no shortage of specialists in otolaryngology, but instead there are sporadic inequalities in their geographical distribution. The current number of positions as training doctors offered annually is higher at the moment than the demand of the Spanish society, for specialists who have adapted smoothly to the requirements of the new medical practice: clinical management, care quality, technology-based efficiency, evidence-based medicine. The modification of working conditions through higher flexibility in the working models and an increase of salaries based on activity and quality will show that the otolaryngology workforce which is generated with the current offer can assume the present and future demand. A high quality of specialized otolaryngology training is the substrate to be improved, so that future otolaryngology specialists will be able to face health challenges without unduly increasing their number.

Investigation on mechanical properties of basalt composite fabrics (experiment study)

NASA Astrophysics Data System (ADS)

Talebi Mazraehshahi, H.; Zamani, H.

2010-06-01

To fully appreciate the role and application of composite materials to structures, correct understanding of mechanical behaviors required for selection of optimum material. Fabric reinforced composites are composed of a matrix that is reinforced with pliable fabric, glass fabric is most popular reinforcement for different application specially in aircraft structure, although other fabric material are also used. At this study new fabric material called basalt with epoxy resin introduced and mechanical behaviors of this material investigated from view point of testing. For this study two type of fabric with different thickness used. Comparison between this composite reinforcement with popular reinforcement as carbon, glass, kevlar performed. To determine mechanical properties of epoxy based basalt fabric following test procedure performed : 1). Tensile testing according to ASTM D3039 in 0° and 90° direction to find ultimate strength in tension and shear, modulus of elasticity, elangation and ultimate strain. 2). Compression testing according to EN 2850 ultimate compression strength and maximum deformation under compression loading. 3). Shear testing according to ASTM D3518-94 to find in plane shear response of polymer matrix composites materials. 4). Predict flexural properties of sandwich construction which manufactured from basalt facing with PVC foam core according to ASTM C393-94. Material strength properties must be based on enough tests of material to meet the test procedure specifications [1]. For this reason six specimens were manufactured for testing and the tests were performed on them using an INSTRON machine model 5582. In the study, the effect of percent of resin in basalt reinforced composite was investigated. Also the weights of the ballast based composites with different percent of resin were measured with conventional composites. As the weight is an important parameter in aerospace industry when the designer wants to replace one material with

The requirements of a specialist Breast Centre.

PubMed

Wilson, A R M; Marotti, L; Bianchi, S; Biganzoli, L; Claassen, S; Decker, T; Frigerio, A; Goldhirsch, A; Gustafsson, E G; Mansel, R E; Orecchia, R; Ponti, A; Poortmans, P; Regitnig, P; Rosselli Del Turco, M; Rutgers, E J Th; van Asperen, C; Wells, C A; Wengström, Y; Cataliotti, L

2013-11-01

In recognition of the advances and evidence based changes in clinical practice that have occurred in recent years and taking into account the knowledge and experience accumulated through the voluntary breast unit certification programme, Eusoma has produced this up-dated and revised guidelines on the requirements of a Specialist Breast Centre (BC). The content of these guidelines is based on evidence from the recent relevant peer reviewed literature and the consensus of a multidisciplinary team of European experts. The guidelines define the requirements for each breast service and for the specialists who work in specialist Breast Centres. The guidelines identify the minimum requirements needed to set up a BC, these being an integrated Breast Centre, dealing with a sufficient number of cases to allow effective working and continuing expertise, dedicated specialists working with a multidisciplinary approach, providing all services throughout the patients pathway and data collection and audit. It is essential that the BC also guarantees the continuity of care for patients with advanced (metastatic) disease offering treatments according to multidisciplinary competencies and a high quality palliative care service. The BC must ensure that comprehensive support and expertise may be needed, not only through the core BC team, but also ensure that all other medical and paramedical expertise that may be necessary depending on the individual case are freely available, referring the patient to the specific care provider depending on the problem. Applying minimum requirements and quality indicators is essential to improve organisation, performance and outcome in breast care. Efficacy and compliance have to be constantly monitored to evaluate the quality of patient care and to allow appropriate corrective actions leading to improvements in patient care. Copyright © 2013 Elsevier Ltd. All rights reserved.

Barriers and facilitators of return to work for individuals with strokes: perspectives of the stroke survivor, vocational specialist, and employer.

PubMed

Culler, Kathleen H; Wang, Ying-Chih; Byers, Katherine; Trierweiler, Robert

2011-01-01

The purpose of this study was to identify factors that facilitated or acted as a barrier to return to work (RTW) for stroke survivors. We applied 3 approaches to identify the factors. First, we conducted qualitative interviews with 10 stroke survivors about their RTW experience post stroke. Second, we surveyed 21 vocational specialists about barriers and facilitators of RTW based on their clinical practice. Last, we interviewed 7 employers who had experience in interviewing individuals with disabilities or had the authority to make hiring decisions. Descriptions of barriers and facilitators to RTW from these 3 perspectives were illustrated. Identified components were mapped based on the ICF framework. From stroke survivors' perspectives, factors affecting employment after stroke include neurological (motor, cognition, communication), social, personal, and environmental factors. Vocational specialists described similar barriers and facilitators of RTW as the stroke survivors but emphasized personal factors such as flexibility and being realistic in vocational goals. The employers explained that the candidate's disability plays no role in the hiring process and indicated that all applicants must meet the essential job requirements. Some employers described the benefits of having the support of vocational rehabilitation staff and being able to interact with the vocational rehabilitation specialists during the hiring process. The interaction allows the employer to gather initial information (consented to by the job applicant) about the applicants from the vocational rehabilitation service and to be educated about any specific needs related to the applicant's medical issues.

Polish Code of Ethics of a Medical Laboratory Specialist

PubMed Central

2014-01-01

Along with the development of medicine, increasingly significant role has been played by the laboratory diagnostics. For over ten years the profession of the medical laboratory specialist has been regarded in Poland as the autonomous medical profession and has enjoyed a status of one of public trust. The process of education of medical laboratory specialists consists of a five-year degree in laboratory medicine, offered at Medical Universities, and of a five-year Vocational Specialization in one of the fields of laboratory medicine such as clinical biochemistry, medical microbiology, medical laboratory toxicology, medical laboratory cytomorphology and medical laboratory transfusiology. An important component of medical laboratory specialists’ identity is awareness of inherited ethos obtained from bygone generations of workers in this particular profession and the need to continue its further development. An expression of this awareness is among others Polish Code of Ethics of a Medical Laboratory Specialist (CEMLS) containing a set of values and a moral standpoint characteristic of this type of professional environment. Presenting the ethos of the medical laboratory specialist is a purpose of this article. Authors focus on the role CEMLS plays in areas of professional ethics and law. Next, they reconstruct the Polish model of ethos of medical diagnostic laboratory personnel. An overall picture consists of a presentation of the general moral principles concerning execution of this profession and rules of conduct in relations with the patient, own professional environment and the rest of the society. Polish model of ethical conduct, which is rooted in Hippocratic medical tradition, harmonizes with the ethos of medical laboratory specialists of other European countries and the world. PMID:27683468

Patient-centered family meetings in palliative care: a quality improvement project to explore a new model of family meetings with patients and families at the end of life.

PubMed

Sanderson, Christine R; Cahill, Philippa J; Phillips, Jane L; Johnson, Anne; Lobb, Elizabeth A

2017-12-01

Family meetings in palliative care can enhance communication with family members and identify unmet needs. However, the patient's voice may not be heard. This pre and post-test quality improvement project was conducted from 2013-2014 and investigated a patient-centered family meeting, which is a different approach to palliative care family meetings, to determine its feasibility and acceptability for patients, family and the palliative care team. Newly admitted patients to an Australian in-patient specialist palliative care unit were invited to ask anyone they wished to join them in a meeting with the palliative care team and to identify issues they wished to discuss. Consenting inpatients were interviewed shortly after admission; participated in a family meeting and re-interviewed 2-3 days after the meeting. Family members provided feedback at the end of the meeting. A focus group was held with staff for feedback on this new approach for family meetings. Meetings were observed, documented and thematically analyzed. Thirty-one newly admitted patients were approached to participate in a family meeting. Eighty-four percent had family meetings and the majority (96%) was attended by the patient. Thematic analysis revealed 69% of patient-centered meetings raised end-of-life concerns and 54% were "family-focused". Patient-centered family meetings in palliative care were shown to be feasible and acceptable for staff, patients and family members. Many patients and families spontaneously shared end-of-life concerns. A patient-centered approach to family meetings that includes active patient involvement may provide additional and valued opportunities for patients and families to: express mutual concerns, deliver messages of comfort and appreciation, and prepare for death. Further investigation of this approach, including families' bereavement outcomes, is warranted.

Impact of a Clinical Pharmacy Specialist in an Emergency Department for Seniors.

PubMed

Shaw, Paul B; Delate, Thomas; Lyman, Alfred; Adams, Jody; Kreutz, Heather; Sanchez, Julia K; Dowd, Mary Beth; Gozansky, Wendolyn

2016-02-01

This study assesses outcomes associated with the implementation of an emergency department (ED) for seniors in which a clinical pharmacy specialist, with specialized geriatric training that included medication management training, is a key member of the ED care team. This was a retrospective cohort analysis of patients aged 65 years or older who presented at an ED between November 1, 2012, and May 31, 2013. Three groups of seniors were assessed: treated by the clinical pharmacy specialist in the ED for seniors, treated in the ED for seniors but not by the clinical pharmacy specialist, and not treated in the ED for seniors. Outcomes included rates of an ED return visit, mortality and hospital admissions, and follow-up total health care costs. Multivariable regression modeling was used to adjust for any potential confounders in the associations between groups and outcomes. A total of 4,103 patients were included, with 872 (21%) treated in the ED for seniors and 342 (39%) of these treated by the clinical pharmacy specialist. Groups were well matched overall in patient characteristics. Patients who received medication review and management by the clinical pharmacy specialist did not experience a reduction in ED return visits, mortality, cost of follow-up care, or hospital admissions compared with the other groups. Of the patients treated by the clinical pharmacy specialist, 154 (45.0%) were identified as having at least 1 medication-related problem. Although at least 1 medication-related problem was identified in almost half of patients treated by the clinical pharmacy specialist in the ED for seniors, incorporation of a clinical pharmacy specialist into the ED staff did not improve clinical outcomes. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Understanding the internet-based distance learning preferences of European respiratory specialists.

PubMed

Roberts, C M; Milon, S; Kurosinski, P

2006-08-01

We studied the learning preferences of 160 respiratory specialists from four European countries who participated in ten internet-based learning modules and answered linked survey questions. Specialists were enthusiastic for internet learning amongst all national groups and particularly wanted to access material for teaching others. The value of social interactive learning was acknowledged but British and German subjects appeared more reluctant to participate. Internet delivered distance learning is well perceived amongst respiratory specialists. There is potential for both individual and group learning that could be realized by developing Europe-wide continuing professional development communities.

Contracting in specialists for emergency obstetric care- does it work in rural India?

PubMed

Randive, Bharat; Chaturvedi, Sarika; Mistry, Nerges

2012-12-31

Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Density and geographic distribution of private specialists are important influencing factors in determining feasibility and use of

Contracting in specialists for emergency obstetric care- does it work in rural India?

PubMed Central

2012-01-01

Background Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Methods Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Results Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Conclusions Density and geographic distribution of private specialists are important influencing factors in

Integrating HCI Specialists into Open Source Software Development Projects

NASA Astrophysics Data System (ADS)

Hedberg, Henrik; Iivari, Netta

Typical open source software (OSS) development projects are organized around technically talented developers, whose communication is based on technical aspects and source code. Decision-making power is gained through proven competence and activity in the project, and non-technical end-user opinions are too many times neglected. In addition, also human-computer interaction (HCI) specialists have encountered difficulties in trying to participate in OSS projects, because there seems to be no clear authority and responsibility for them. In this paper, based on HCI and OSS literature, we introduce an extended OSS development project organization model that adds a new level of communication and roles for attending human aspects of software. The proposed model makes the existence of HCI specialists visible in the projects, and promotes interaction between developers and the HCI specialists in the course of a project.

ISD Designed Medical Specialist Training.

ERIC Educational Resources Information Center

Rock, Samuel K., Jr.; Chagalis, George P.

The Basic Medical Specialist course has one of the largest enrollments of the U.S. Army's Academy of Health Sciences; 11,000 soldiers were trained in this course in 1977 and 1978. Training encompasses both emergency first aid (for field medics) and basic nursing skills. A task force working to improve Army training developed this course, in…

The changing role of specialist care in NHS dentistry.

PubMed

Seward, M

1998-07-11

Specialisation and Specialist Training in Dentistry in the UK have been central issues for debate in the last few years. The profession has emerged stronger in understanding the respective roles of the generalist who should remain free to practise across the whole spectrum of dentistry and the specialist who can work in primary and secondary care. The overriding principle is that the patient remains the true beneficiary of a specialised service within the NHS.

Inequalities in utilisation of general practitioner and specialist services in 9 European countries.

PubMed

Stirbu, Irina; Kunst, Anton E; Mielck, Andreas; Mackenbach, Johan P

2011-10-31

The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. People with lower education used GP services equally often in most countries (except Belgium and Germany) compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases. © 2011 Stirbu et al; licensee BioMed Central Ltd.

Specialist public health capacity in England: working in the new primary care organizations.

PubMed

Chapman, J; Shaw, S; Congdon, P; Carter, Y H; Abbott, S; Petchey, R

2005-01-01

To determine the capacity and development needs, in relation to key areas of competency and skills, of the specialist public health workforce based in primary care organizations following the 2001 restructuring of the UK National Health Service. Questionnaire survey to all consultants and specialists in public health (including directors of public health) based in primary care trusts (PCTs) and strategic health authorities (SHAs) in England. Participants reported a high degree of competency. However, skill gaps were evident in some areas of public health practice, most notably "developing quality and risk management" and in relation to media communication, computing, management and leadership. In general, medically qualified individuals were weaker on community development than non-medically qualified specialists, and non-medically qualified specialists were less able to perform tasks that require epidemiological or clinical expertise than medically qualified specialists. Less than 50% of specialists felt that their links to external organizations, including public health networks, were strong. Twenty-nine percent of respondents felt professionally isolated and 22% reported inadequate team working within their PCT or SHA. Approximately 21% of respondents expressed concerns that they did not have access to enough expertise to fulfil their tasks and that their skills were not being adequately utilized. Some important skill gaps are evident among the specialist public health workforce although, in general, a high degree of competency was reported. This suggests that the capacity deficit is a problem of numbers of specialists rather than an overall lack of appropriate skills. Professional isolation must be addressed by encouraging greater partnership working across teams.

Environmental Compliance Specialists, Inc. (ECSI) Information Sheet

EPA Pesticide Factsheets

Environmental Compliance Specialists, Inc. (ECSI) (the Company) is located in Kingston, New Hampshire. The Complaint involves renovation activities conducted at property constructed prior to 1978, located in Manchester, New Hampshire.

[Management of allocation of positions for specialist medical training].

PubMed

Alonso, M I

2003-01-01

Currently there is a large imbalance between supply and demand for medical specialists in the Spanish Health System. The aim of this study was to demonstrate the possible effects of current policies of allocating vacancies for interns and residents as well as to describe several measures and alternative policies. Using the methodology of System Dynamics, we designed a simulation model of the allocation process. Based on the validated model, possible changes in the system through time in response to diverse allocation policies were simulated. Specifically, changes in the accumulated number of graduates who over the years have remained without specialty, the number of unemployed specialists, and the imbalance between supply and demand in the period under consideration were observed. The results obtained from the simulation indicate that allocation policies such as the current one tends to reduce the accumulated number of graduates without specialty, due to the philosophy characterizing this policy, but that it considerably increases the number of unemployed specialists and aggravates the supply-demand imbalance. In the simulation, this tendency remained over time even though more restrictive measures in numerus clausus and retirement age were adopted. Equally, a policy based on social needs and aware of delays in training would substantially contribute to eliminating unemployment among specialists and supply-demand imbalance over time. If such a policy were combined with the above-mentioned measures the results would be even better, more rapidly eliminating graduates without specialty, unemployed specialists, and supply-demand imbalances. If the Health Administration continues with the current system of allocation of places, the present imbalance in supply and demand will become even worse. Therefore, new and far-sighted measures and policies are required, as well as greater coordination between undergraduate and postgraduate training.

STS-107 Mission Specialist David Brown arrives at KSC for TCDT

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- STS-107 Mission Specialist David Brown arrives at KSC to take part in Terminal Countdown Demonstration Test activities, which include a simulated launch countdown. Other crew members are Commander Rick Husband, Pilot William 'Willie' McCool, Payload Commander Michael Anderson, Mission Specialists Kalpana Chawla and Laurel Clark and Payload Specialist Ilan Ramon (the first Israeli astronaut). STS-107 is a mission devoted to research and will include more than 80 experiments that will study Earth and space science, advanced technology development, and astronaut health and safety. Launch is scheduled for Jan. 16, 2003.

STS-107 Mission Specialist Laurel Clark arrives at KSC for TCDT

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. -- STS-107 Mission Specialist Laurel Clark arrives at KSC to take part in Terminal Countdown Demonstration Test activities, which include a simulated launch countdown. Other crew members are Commander Rick Husband, Pilot William 'Willie' McCool, Payload Commander Michael Anderson, Mission Specialists Kalpana Chawla and David Brown, and Payload Specialist Ilan Ramon, the first Israeli astronaut. STS-107 is a mission devoted to research and will include more than 80 experiments that will study Earth and space science, advanced technology development, and astronaut health and safety. Launch is scheduled for Jan. 16, 2003.

STS-107 Mission Specialist Kalpana Chawla arrives at KSC for TCDT

NASA Technical Reports Server (NTRS)

2002-01-01

KENNEDY SPACE CENTER, FLA. - STS-107 Mission Specialist Kalpana Chawla arrives at KSC to take part in Terminal Countdown Demonstration Test activities, which include a simulated launch countdown. Other crew members are Commander Rick Husband, Pilot William 'Willie' McCool, Payload Commander Michael Anderson, Mission Specialists David Brown and Laurel Clark and Payload Specialist Ilan Ramon (the first Israeli astronaut). STS-107 is a mission devoted to research and will include more than 80 experiments that will study Earth and space science, advanced technology development, and astronaut health and safety. Launch is scheduled for Jan. 16, 2003.

STS-87 Mission Specialist Doi addresses the media at the SLF

NASA Technical Reports Server (NTRS)

1997-01-01

As STS-87 Commander Kevin Kregel looks on, Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan addresses members of the press and media at Kennedy Space Center's Shuttle Landing Facility after arriving for the final prelaunch activities leading up to the scheduled Nov. 19 liftoff. Other STS-87 crew members not pictured are Pilot Steven Lindsey; Mission Specialists Kalpana Chawla, Ph.D., and Winston Scott; and Payload Specialist Leonid Kadenyuk of the National Space Agency of Ukraine. STS-87 will be the fourth flight of the United States Microgravity Payload and the Spartan-201 deployable satellite.

Internal medicine specialists' attitudes towards working part-time: a comparison between 1996 and 2004

PubMed Central

Lugtenberg, Marjolein; Heiligers, Phil JM; de Jong, Judith D; Hingstman, Lammert

2006-01-01

Background Although medical specialists traditionally hold negative views towards working part-time, the practice of medicine has evolved. Given the trend towards more part-time work and that there is no evidence that it compromises the quality of care, attitudes towards part-time work may have changed as well in recent years. The aim of this paper was to examine the possible changes in attitudes towards part-time work among specialists in internal medicine between 1996 and 2004. Moreover, we wanted to determine whether these attitudes were associated with individual characteristics (age, gender, investments in work) and whether attitudes of specialists within a partnership showed more resemblance than specialists' attitudes from different partnerships. Methods Two samples were used in this study: data of a survey conducted in 1996 and in 2004. After selecting internal medicine specialists working in general hospitals in The Netherlands, the sample consisted of 219 specialists in 1996 and 363 specialists in 2004. They were sent a questionnaire, including topics on the attitudes towards part-time work. Results Internal medicine specialists' attitudes towards working part-time became slightly more positive between 1996 and 2004. Full-time working specialists in 2004 still expressed concerns regarding the investments of part-timers in overhead tasks, the flexibility of task division, efficiency, communication and continuity of care. In 1996 gender was the only predictor of the attitude, in 2004 being a full- or a part-timer, age and the time invested in work were associated with this attitude. Furthermore, specialists' attitudes were not found to cluster much within partnerships. Conclusion In spite of the increasing number of specialists working or preferring to work part-time, part-time practice among internal medicine specialists seems not to be fully accepted. The results indicate that the attitudes are no longer gender based, but are associated with age and work

Personal life and working conditions of trainees and young specialists in clinical microbiology and infectious diseases in Europe: a questionnaire survey.

PubMed

Maraolo, A E; Ong, D S Y; Cortez, J; Dedić, K; Dušek, D; Martin-Quiros, A; Maver, P J; Skevaki, C; Yusuf, E; Poljak, M; Sanguinetti, M; Tacconelli, E

2017-07-01

The purpose of this investigation was to assess the balance between the personal and professional lives of trainees and young European specialists in clinical microbiology (CM) and infectious diseases (ID), and determine differences according to gender, country of training, workplace and specialty. The Steering Committee of the Trainee Association of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) devised a questionnaire survey consisting, beyond the demographic questions, of nine yes/no questions, 11 Likert scale self-evaluations and one open-response item on parenthood, working conditions, quality of life, alcohol consumption and burnout. This anonymous survey in English was held between April and July 2015 among European CM/ID trainees and young specialists (<3 years after training completion). Responses from 416 participants with a mean age of 32 years [standard deviation (SD) 5 years] were analysed. Females and physicians from Northern/Western Europe (NWE) benefit more from paternity/maternity leaves even during training than their counterparts. Among all respondents, only half of breastfeeding mothers enjoyed the benefit of working hours flexibility. Only two-thirds of respondents found their working environment stimulating. In comparison to colleagues from other parts of Europe, trainees and young specialists from Southern/Eastern Europe (SEE) had less frequent regular meetings with mentors/supervisors and head of departments where trainees' issues are discussed. Also, physicians from SEE were more frequently victims of workplace mobbing/bullying in comparison to those from other regions. Finally, multivariate analysis showed that female gender, SEE region and ID specialty were associated with burnout feelings. Female gender and country of work from SEE largely determine satisfactory working conditions, the possibility of parenthood leaves, amount of leisure time, mobbing experiences and burnout feelings among European CM

Apprentice Still Photographic Specialist (AFSC 23132).

ERIC Educational Resources Information Center

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

This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for apprentice still photographic specialists. Covered in the individual volumes are general subjects (career ladder progression, security, photographic safety, and photographic laboratory administration); still photographic…

Impact of specialist palliative care on coping with Parkinson's disease: patients and carers.

PubMed

Badger, Nathan J; Frizelle, Dorothy; Adams, Debi; Johnson, Miriam J

2018-06-01

UK guidelines recommend palliative care access for people with Parkinson's disease; however, this remains sporadic, and it is unknown whether specialist palliative care helps patients and carers cope with this distressing condition. This study aimed to explore whether, and how, access to specialist palliative care services affected patients' and carers' coping with Parkinson's disease. Semistructured interviews were conducted, audio-recorded and verbatim transcribed. Data were analysed using interpretative phenomenological analysis. Participants were patients with advanced idiopathic Parkinson's disease (n=3), and carers of people with Parkinson's disease (n=5, however, one diagnosis was reviewed) receiving care from an integrated specialist palliative care and Parkinson's disease service in North East England. Access to specialist palliative care helped participants cope with some aspects of advanced Parkinson's disease. Three superordinate themes were developed:' managing uncertainty', 'impacts on the self' and 'specialist palliative care maintaining a positive outlook'. Specialist palliative care helped patients and carers cope with advanced Parkinson's disease. Specialist palliative care is a complex intervention that acknowledges the complex and holistic nature of Parkinson's disease, enabling health in some domains despite continued presence of pathology. These exploratory findings support the utility of this approach for people living with Parkinson's disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The specialist physician's approach to rheumatoid arthritis in South Africa.

PubMed

Bester, Frederik C J; Bosch, Fredricka J; van Rensburg, Barend J Jansen

2016-03-01

Rheumatoid arthritis (RA) is expected to increase in Africa and South Africa. Due to the low numbers of rheumatologists in South Africa, specialist physicians also have to care for patients with RA. Furthermore several new developments have taken place in recent years which improved the management and outcome of RA. Classification criteria were updated, assessment follow-up tools were refined and above all, several new biological disease-modifying anti-rheumatic drugs were developed. Therefore it is imperative for specialist physicians to update themselves with the newest developments in the management of RA. This article provides an overview of the newest developments in the management of RA in the South African context. This approach may well apply to countries with similar specialist to patient ratios and disease profiles.

Vision-based in-line fabric defect detection using yarn-specific shape features

NASA Astrophysics Data System (ADS)

Schneider, Dorian; Aach, Til

2012-01-01

We develop a methodology for automatic in-line flaw detection in industrial woven fabrics. Where state of the art detection algorithms apply texture analysis methods to operate on low-resolved ({200 ppi) image data, we describe here a process flow to segment single yarns in high-resolved ({1000 ppi) textile images. Four yarn shape features are extracted, allowing a precise detection and measurement of defects. The degree of precision reached allows a classification of detected defects according to their nature, providing an innovation in the field of automatic fabric flaw detection. The design has been carried out to meet real time requirements and face adverse conditions caused by loom vibrations and dirt. The entire process flow is discussed followed by an evaluation using a database with real-life industrial fabric images. This work pertains to the construction of an on-loom defect detection system to be used in manufacturing practice.

[What is parents' and medical health care specialists knowledge about vaccinations?].

PubMed

Tarczoń, Izabela; Domaradzka, Ewa; Czajka, Hanna

2009-01-01

The aim of the study was to become familiar with parents' and Medical Health Care specialists knowledge and attitude towards vaccinations. The influence of information, provided to patients from various sources, on general opinion about immunization and its coverage within the last year were evaluated. Analysis of questionnaires about vaccinations performed among 151 parents and 180 Medical Health Care specialists. Medical Health Care specialists knowledge was considerably higher in comparison to questioned parents. Surprisingly enough, only approximately 90% of Medical Health Care workers knew about prophylaxis of Hib infections. A doctor is the main and the most reliable source of information for parents. Significant impact on parents' attitude to vaccinations is made not only by campaigns promoting vaccinations, but also by widespread opinions about their harmfulness. The doctor is the major source of reliable information about vaccinations for parents. Therefore, there is the need of continuous improvement of Medical Health Care specialists knowledge, but also the ability of successfully communicating it to parents.

The role of rehabilitation specialists in Canadian NICUs: a national survey.

PubMed

Limperopoulos, Catherine; Majnemer, Annette

2002-01-01

Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). A national survey was conducted to elucidate the current roles of rehabilitation specialists. Occupational therapy (OT), physical therapy (PT), and speech and language pathology (SLP) departments in all Canadian health care institutions with tertiary level NICUs (n = 38) were surveyed by telephone. Results indicate that 16% have no rehabilitation coverage, while 11% receive very limited external services (< 1/month). Over half of the OT and PT departments provide weekly services whereas only 5/38 provide SLP coverage. Service delivery includes assessment and a number of therapeutic interventions. Splinting and feeding are predominantly performed by OT, whereas chest physiotherapy and ROM are carried out primarily by PT. Rehabilitation specialists are actively involved in education and case management. The extent of involvement of rehabilitation specialists was discrepant, and highly associated with the type of facility. Rehabilitation services, when provided, are comprehensive and include evaluation, treatment, teaching, decision-making, and family support.

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

NASA Technical Reports Server (NTRS)

1998-01-01

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

A Survey of Headache Medicine Specialists on Career Satisfaction and Burnout.

PubMed

Evans, Randolph W; Ghosh, Kamalika

2015-01-01

Physicians report increasing rates of career dissatisfaction and professional burnout, which may be related to the practice environment and subspecialty. There has never been a survey of professional burnout among headache medicine specialists. The aim of the present survey was to learn more about how headache medicine physicians are affected by these issues. An email survey was sent to 749 physician members of the American Headache Society with questions or statements about demographics, professional quality of life and satisfaction, future practice plans, and professional burnout using the Maslach Burnout Inventory. In a sample of 127 headache medicine specialists, 66 (57.4%) physicians reported symptoms of professional burnout reflected by high Emotional Exhaustion and/or high Depersonalization. There is widespread dissatisfaction with work schedules, government regulations, implementation of the Affordable Care Act, insurance company policies, malpractice concerns, patient telephone calls, and compensation. Sixty-two percent of respondents concur that headache medicine is becoming more complicated without patient benefit, 14% concur that headache medicine specialists are fairly compensated, and 59% would go into headache medicine again if they were fourth year medical students. In the next 1 to 3 years, 21.3% plan to cut back on hours, 14.2% plan to cut back on patients seen, and 12.6% plan to switch to a cash practice. Medicine and healthcare are changing in such a way that 33.9% concur that they will accelerate their retirement plans. Headache medicine specialists have one of the highest rates of burnout compared to other physician specialists, which is twice the rate of working adults. Physicians' age and practice environment and experience are related with their career satisfaction and professional burnout. Some attributes of career satisfaction can decrease burnout by reducing emotional exhaustion and depersonalization and by enhancing personal

Payload specialist Ronald Parise using SAREX

NASA Technical Reports Server (NTRS)

1995-01-01

ASTRO-2 payload specialist Ronald A. Parise reminisces on his inspace amateur radio experience of five years ago in the ASTRO-1 mission. Using the Shuttle Amateur Radio Experiment (SAREX), Parise talks to students on Earth from the flight deck of the Earth orbiting Space Shuttle Endeavour.

School Library Media Specialists: Essentially Administrators.

ERIC Educational Resources Information Center

Alewine, Martha

2003-01-01

Considers how school library media specialist administrative responsibilities can carry over to a job as state consultant for school library media services. Discusses characteristics of effective administrators; collaboration; the appreciative inquiry process for systemic change; and duties and projects of the state program that strengthen media…

Administrative Perceptions on the Role of the School Library Media Specialist

ERIC Educational Resources Information Center

Page, Kayla

2013-01-01

Despite the efforts of local school library media specialists to promote their programming, many administrators do not understand the roles and responsibilities of the school library media specialist. Using a constructivist theoretical framework, this study was designed to examine the local school administrators' perceptions of the role of the…

Health Education Specialist Practice Analysis 2015 (HESPA 2015): Process and Outcomes

ERIC Educational Resources Information Center

McKenzie, James F.; Dennis, Dixie; Auld, M. Elaine; Lysoby, Linda; Doyle, Eva; Muenzen, Patricia M.; Caro, Carla M.; Kusorgbor-Narh, Cynthia S.

2016-01-01

The Health Education Specialist Practice Analysis 2015 (HESPA 2015) was conducted to update and validate the Areas of Responsibilities, Competencies, and Sub-competencies for Entry- and Advanced-Level Health Education Specialists. Two data collection instruments were developed--one was focused on Sub-competencies and the other on knowledge items…

The European Federation of Clinical Chemistry and Laboratory Medicine syllabus for postgraduate education and training for Specialists in Laboratory Medicine: version 5 - 2018.

PubMed

Jassam, Nuthar; Lake, Jennifer; Dabrowska, Milena; Queralto, Jose; Rizos, Demetrios; Lichtinghagen, Ralf; Baum, Hannsjörg; Ceriotti, Ferruccio; O'Mullane, John; Homšak, Evgenija; Charilaou, Charis; Ohlson, Mats; Rako, Ivana; Vitkus, Dalius; Kovac, Gustav; Verschuure, Pauline; Racek, Jaroslav; Chifiriuc, Mariana Carmen; Wieringa, Gilbert

2018-06-05

Although laboratory medicine practise varies across the European Union's (EU) member states, the extent of overlap in scope is such that a common syllabus describing the education and training associated with high-quality, specialist practise can be identified. In turn, such a syllabus can help define the common set of skills, knowledge and competence in a Common Training Framework (CTF) for non-medical Specialists in Laboratory Medicine under EU Directive 2013/55/EU (The recognition of Professional Qualifications). In meeting the requirements of the directive's CTF patient safety is particularly enhanced when specialists seek to capitalise on opportunities for free professional migration across EU borders. In updating the fourth syllabus, the fifth expands on individual discipline requirements, new analytical techniques and use of statistics. An outline structure for a training programme is proposed together with expected responsibilities of trainees and trainers; reference is provided to a trainee's log book. In updating the syllabus, it continues to support national programmes and the aims of EU Directive 2013/55/EU in providing safeguards to professional mobility across European borders at a time when the demand for highly qualified professionals is increasing in the face of a disparity in their distribution across Europe. In support of achieving a CTF, the syllabus represents EFLM's position statement for the education and training that underpins the framework.

STS-95 Payload Specialist Mukai poses with NASDA president

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Payload Specialist Chiaki Mukai, M.D. (center), with the National Space Development Agency of Japan (NASDA), poses for a photograph with NASDA President Isao Uchida (left). Behind her at the right is a representative of the European Space Agency (ESA). Mukai was one of a crew of seven aboard orbiter Discovery, which landed at KSC at 12:04 p.m. EST, after a successful mission spanning nine days and 3.6 million miles. The other crew members are Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialists Stephen K. Robinson; Scott E. Parazynski and Pedro Duque of Spain, with the European Space Agency; and Payload Specialist John H. Glenn Jr., senator from Ohio. The mission included research payloads such as the Spartan solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as the SPACEHAB single module with experiments on space flight and the aging process.

Payload specialists Rodolfo Neri prepares to begin experiments for Mexico

NASA Image and Video Library

1985-11-26

61B-05-021 (26 Nov-3 Dec 1985) --- Payload Specialist Rodolfo Neri, representing Mexico on the STS-61B space mission aboard the Atlantis, prepares to begin one of the experiments for Mexico. Neri used a nearby 35mm camera to record plants and bacteria for various prescribed testing. Here the payload specialist has opened a stowage drawer to retrieve components of one of the tests.

76 FR 65544 - Standard Format and Content of License Applications for Mixed Oxide Fuel Fabrication Facilities

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-21

...The U.S. Nuclear Regulatory Commission (NRC or Commission) is issuing a revision to regulatory guide (RG) 3.39, ``Standard Format and Content of License Applications for Mixed Oxide Fuel Fabrication Facilities.'' This guide endorses the standard format and content for license applications and integrated safety analysis (ISA) summaries described in the current version of NUREG-1718, ``Standard Review Plan for the Review of an Application for a Mixed Oxide (MOX) Fuel Fabrication Facility,'' as a method that the NRC staff finds acceptable for meeting the regulatory requirements of Title 10 of the Code of Federal Regulations (10 CFR) part 70, ``Domestic Licensing of Special Nuclear Material'' for mixed oxide fuel fabrication facilities.

Seed dispersal by specialist versus generalist foragers: the plant's perspective

USGS Publications Warehouse

Larson, D.L.

1996-01-01

I examined the seed dispersal ecology of the stem parasitic plant, desert mistletoe (Phoradendron californicum, Viscaceae), with the objectives of (1) determining the relative effectiveness of specialist and generalist foragers for seed dispersal, (2) determining the extent to which desert mistletoe fruiting characteristics correspond to those predicted for plants attracting specialist versus generalist foragers, and (3) examining the potential consequences of the observed dispersal strategy for mistletoe reproduction. Three species of birds, phainopepla, Gila woodpecker, and northern mockingbird, fed on desert mistletoe at my study site. The specialist, phainopepla, was the most abundant and the most likely to perch in host species, where defecated seeds had a greater probability of lodging in a site suitable for establishment. Gila woodpeckers, although abundant, spent little time in host plants, thus dooming most of the seeds they consumed. Mockingbirds may disperse a small number of seeds, but were abundant enough to consume only a small portion of the available fruits. As expected for plants attracting specialist frugivores, mistletoes produced fruits throughout the 6-month season in which phainopeplas reside in the Sonoran desert. Contrary to expectation, numbers of fruits produced far exceeded the amount that could be consumed by the frugivores at my study site. Fruit crop size was positively related to absolute fruit removal, but not to proportional removal at the scale of the entire study site. However, crop size was positively related to proportional removal within the neighborhood of mistletoes occupying an individual host tree. Frugivores were attracted to infected hosts, host attractiveness increased, although proportional removal of fruit declined, with number of female mistletoes. The observed dispersal ecology of desert mistletoe suggests the likelihood of increasingly clumped distributions of mistletoe plants, as more and more seeds are deposited

High volume fabrication of laser targets using MEMS techniques

NASA Astrophysics Data System (ADS)

Spindloe, C.; Arthur, G.; Hall, F.; Tomlinson, S.; Potter, R.; Kar, S.; Green, J.; Higginbotham, A.; Booth, N.; Tolley, M. K.

2016-04-01

The latest techniques for the fabrication of high power laser targets, using processes developed for the manufacture of Micro-Electro-Mechanical System (MEMS) devices are discussed. These laser targets are designed to meet the needs of the increased shot numbers that are available in the latest design of laser facilities. Traditionally laser targets have been fabricated using conventional machining or coarse etching processes and have been produced in quantities of 10s to low 100s. Such targets can be used for high complexity experiments such as Inertial Fusion Energy (IFE) studies and can have many complex components that need assembling and characterisation with high precision. Using the techniques that are common to MEMS devices and integrating these with an existing target fabrication capability we are able to manufacture and deliver targets to these systems. It also enables us to manufacture novel targets that have not been possible using other techniques. In addition, developments in the positioning systems that are required to deliver these targets to the laser focus are also required and a system to deliver the target to a focus of an F2 beam at 0.1Hz is discussed.

What Is a Pediatric Infectious Diseases Specialist?

MedlinePlus

... mode Turn off more accessible mode Skip Ribbon Commands Skip to main content Turn off Animations Turn ... through the teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases ...

What Is a Pediatric Critical Care Specialist?

MedlinePlus

... mode Turn off more accessible mode Skip Ribbon Commands Skip to main content Turn off Animations Turn ... offered in the PICU. What Kind of Training Do Pediatric Critical Care Specialists Have? Pediatric critical care ...

14 CFR § 1214.306 - Payload specialist relationship with sponsoring institutions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Payload specialist relationship with sponsoring institutions. § 1214.306 Section § 1214.306 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION SPACE FLIGHT Payload Specialists for Space Transportation System (STS) Missions § 1214.306 Payload...

Special Education Technology Specialist. Careers in Special Education and Related Services.

ERIC Educational Resources Information Center

National Clearinghouse for Professions in Special Education, Reston, VA.

Designed for high school students interested in careers in special education and related services, this guide outlines the role of the special education technology specialist. It addresses the nature of the work, the education required, personal qualities that technology specialists should have, job outlook and advancement, and how to prepare for…

STS-40 Payload Specialist Hughes-Fulford "flies" through SLS-1 module

NASA Image and Video Library

1991-06-14

STS040-212-006 (5-14 June 1991) --- Payload specialist Millie Hughes-Fulford floats through the Spacelab Life Sciences (SLS-1) module aboard the Earth-orbiting Columbia. Astronaut James P. Bagian, mission specialist, is at the blood draw station in the background. The scene was photographed with a 35mm camera.

The Curriculum Roles and Responsibilities of Library Media Specialists. ERIC Digest.

ERIC Educational Resources Information Center

Berkowitz, Robert E.; Eisenberg, Michael B.

This digest brings together the various views on curriculum-related roles for library media specialists. The first section considers reasons why a disparity between theory and practice exists in regard to the involvement of library media specialists as curriculum consultants. Several sources addressing this issue are reviewed in the second…

Few older people in New Zealand who commit suicide receive specialist psychogeriatric services.

PubMed

Cheung, Gary; Casey, Jane

2014-08-01

Suicide in older people is a growing public health concern in many parts of the world. The literature on this issue is lacking in New Zealand. The aim of this study is to ascertain whether this group is accessing specialist psychogeriatric services. A retrospective case series study of completed suicides in older people (≥65 years) during a three-year period from January 2010 to December 2012 was performed. An online survey detailing demographic and clinical information was completed by psychiatrists in 15 of the 20 District Health Boards in New Zealand. Only about 15% of older people who committed suicide were accessing specialist psychogeriatric services and the group with the highest suicide rate (men≥85 years) did not feature in specialist services. Depression (61%) was the most common diagnosis and nearly half (35%) had had contact with specialist services within three days prior to the suicide. Over half (52%) had a history of past suicide attempt(s). Older people who complete suicide are infrequently accessing specialist services. In those that do, there are questions to be answered regarding suicide prediction and prevention for this high-risk group of vulnerable individuals. More research is required targeting those not accessing specialist services, in particular the high risk group of older men. The role of general practitioner, community care, the assessment and management of depression and whether there is any access issue to specialist psychogeriatric services require elucidation. © The Royal Australian and New Zealand College of Psychiatrists 2014.

STS-120 Mission Specialist Doug Wheelock During EVA

NASA Technical Reports Server (NTRS)

2007-01-01

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

Research competency and specialist registration: Quo vadis ?

PubMed

Szabo, C P; Ramlall, S

2016-12-01

The requirement of 'research completion' as necessary for specialist registration with the Health Professions Council of South Africa (HPCSA) has recently been subject to legal action, with a court order potentially shifting requirements beyond those envisaged by the HPCSA. The research requirement is congruent with National Department of Health strategy in this regard, i.e. the strengthening of research as a stated priority. While the expectation of research competency is not in itself contentious, the capacity of institutions and the ability of registrars to facilitate and complete, respectively, have brought the issue into focus. Specifically, the apparent discrepancy between a court order and a regulation needs to be resolved to ensure that specialist registration is not unduly hampered, while ensuring that a potentially important contributor to a national priority is not prejudiced.

Part-time and full-time medical specialists, are there differences in allocation of time?

PubMed

de Jong, Judith D; Heiligers, Phil; Groenewegen, Peter P; Hingstman, Lammert

2006-03-03

An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and continuity of care. People tend to think that physicians working part-time are less devoted to their work, implying that full-time physicians complete a greater number of tasks. The central question in this article is whether part-time medical specialists allocate their time differently to their tasks than full-time medical specialists. A questionnaire was sent by mail to all internists (N = 817), surgeons (N = 693) and radiologists (N = 621) working in general hospitals in the Netherlands. Questions were asked about the actual situation, such as hours worked and night and weekend shifts. The response was 53% (n = 411) for internists, 52% (n = 359) for surgeons, and 36% (n = 213) for radiologists. Due to non-response on specific questions there were 367 internists, 316 surgeons, and 71 radiologists included in the analyses. Multilevel analyses were used to analyze the data. Part-time medical specialists do not spend proportionally more time on direct patient care. With respect to night and weekend shifts, part-time medical specialists account for proportionally more or an equal share of these shifts. The number of hours worked per FTE is higher for part-time than for full-time medical specialists, although this difference is only significant for surgeons. In general, part-time medical specialists do their share of the job. However, we focussed on input only. Besides input, output like the numbers of services provided deserves attention as well. The trend in medicine towards more part-time work has an important consequence: more medical specialists are needed to get the work done. Therefore, a greater number of medical specialists have to be trained. Part-time work is not only a female

Part-time and full-time medical specialists, are there differences in allocation of time?

PubMed Central

de Jong, Judith D; Heiligers, Phil; Groenewegen, Peter P; Hingstman, Lammert

2006-01-01

Background An increasing number of medical specialists prefer to work part-time. This development can be found worldwide. Problems to be faced in the realization of part-time work in medicine include the division of night and weekend shifts, as well as communication between physicians and continuity of care. People tend to think that physicians working part-time are less devoted to their work, implying that full-time physicians complete a greater number of tasks. The central question in this article is whether part-time medical specialists allocate their time differently to their tasks than full-time medical specialists. Methods A questionnaire was sent by mail to all internists (N = 817), surgeons (N = 693) and radiologists (N = 621) working in general hospitals in the Netherlands. Questions were asked about the actual situation, such as hours worked and night and weekend shifts. The response was 53% (n = 411) for internists, 52% (n = 359) for surgeons, and 36% (n = 213) for radiologists. Due to non-response on specific questions there were 367 internists, 316 surgeons, and 71 radiologists included in the analyses. Multilevel analyses were used to analyze the data. Results Part-time medical specialists do not spend proportionally more time on direct patient care. With respect to night and weekend shifts, part-time medical specialists account for proportionally more or an equal share of these shifts. The number of hours worked per FTE is higher for part-time than for full-time medical specialists, although this difference is only significant for surgeons. Conclusion In general, part-time medical specialists do their share of the job. However, we focussed on input only. Besides input, output like the numbers of services provided deserves attention as well. The trend in medicine towards more part-time work has an important consequence: more medical specialists are needed to get the work done. Therefore, a greater number of medical specialists have to be trained. Part

STS-47 Payload Specialist Mohri and Japanese backups pose in SLJ module at KSC

NASA Technical Reports Server (NTRS)

1992-01-01

STS-47 payload specialists representing Japan's National Space Development Agency (NASDA) examine the interior of the Spacelab Japan (SLJ) laboratory module recently installed in Endeavour's, Orbiter Vehicle (OV) 105's, payload bay (PLB). Left to right are Payload Specialist Mamoru Mohri, backup Payload Specialist Chiaki Naito-Mukai, and backup Payload Specialist Takao Doi. The crewmembers visited OV-105, currently undergoing preflight processing in a high bay area of Kennedy Space Center's (KSC's) Orbiter Processing Facility (OPF). View provided by KSC with alternate KSC number KSC-92PC-1649.

What influences the job satisfaction of staff and associate specialist hospital doctors?

PubMed

French, Fiona; Ikenwilo, Divine; Scott, Anthony

2007-08-01

Despite their rising numbers in the National Health Service (NHS), the recruitment, retention, morale and educational needs of staff and associate specialist hospital doctors have traditionally not been the focus of attention. A postal survey of all staff grades and associate specialists in NHS Scotland was conducted to investigate the determinants of their job satisfaction. Doctors in both grades were least satisfied with their pay. They were more satisfied if they were treated as equal members of the clinical team, but less satisfied if their workload adversely affected the quality of patient care. With the exception of female associate specialists, respondents who wished to become a consultant were less satisfied with all aspects of their jobs. Associate specialists who worked more sessions also had lower job satisfaction. Non-white staff grades were less satisfied with their job compared with their white counterparts. It is important that associate specialists and staff grades are promoted to consultant posts, where this is desired. It is also important that job satisfaction is enhanced for doctors who do not desire promotion, thereby improving retention. This could be achieved through improved pay, additional clinical training, more flexible working hours and improved status.

Foreign Area Studies in the USSR. Training and Employment of Specialists.

ERIC Educational Resources Information Center

Gottemoeller, Rose E.; Langer, Paul F.

A study was undertaken to arrive at a broad overview of the Soviet training utilization of foreign area specialists. To gather data for the study, researchers examined European, United States, and Soviet publications and interviewed Soviet emigres and U.S. specialists on the Soviet Union. According to these data sources, specialized training for…

A guide to breast implants for the non-breast specialist.

PubMed

Harvey, Kate L; Clark, Sarah E

2016-11-01

Breast augmentation is an increasingly popular cosmetic surgery procedure, and breast implants can also be used in reconstructive surgery following mastectomy. Problematic breast implants can present to any discipline of medicine, most frequently to primary care or acute service such as emergency medicine. This guide aims to inform the non-breast specialist in how to assess and treat common problems and when referral to specialist services is necessary.

A guide to breast implants for the non-breast specialist

PubMed Central

Harvey, Kate L.; Clark, Sarah E.

2016-01-01

Breast augmentation is an increasingly popular cosmetic surgery procedure, and breast implants can also be used in reconstructive surgery following mastectomy. Problematic breast implants can present to any discipline of medicine, most frequently to primary care or acute service such as emergency medicine. This guide aims to inform the non-breast specialist in how to assess and treat common problems and when referral to specialist services is necessary. PMID:29334026

Avionics Instrument Systems Specialist (AFSC 32551).

ERIC Educational Resources Information Center

Miller, Lawrence B.; Crowcroft, Robert A.

This six-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for avionics instrument systems specialists. Covered in the individual volumes are career field familiarization (career field progression and training, security, occupational safety and health, and career field reference material);…

Metrication: What Can HRD Specialists Do?

ERIC Educational Resources Information Center

Short, Larry G.

1978-01-01

First discusses some features of the Metric Conversion Act which established federal support of metric system usage in the United States. Then covers the following: what HRD (Human Resources Development) specialists can do to assist their company managers during the conversion process; metric training strategies; and how to prepare for metric…

Community-Based Prevention Specialist. Trainer Manual.

ERIC Educational Resources Information Center

University Research Corp., Bethesda, MD.

This trainer manual is designed to assist facilitators in the design of entry-level courses and programs for substance abuse prevention specialists. The manual initially concentrates on a basic, generic approach to community work, and introduces the knowledge and skills needed to implement substance abuse prevention programs by using the community…

Specialist Teams Needed to Support Youth.

ERIC Educational Resources Information Center

Mellin, Laurel M.

1991-01-01

Presents seven reasons why it is important for health specialist teams to take action supporting the prevention and treatment of childhood obesity. The article offers guidelines to help parents assist their children in maintaining positive eating, exercise, and self-esteem patterns, noting sensitive intervention is preferable to imposed diets. (SM)

Air traffic control specialist performance measurement database.

DOT National Transportation Integrated Search

1999-06-01

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

STS-101 crew members meet family and friends

NASA Technical Reports Server (NTRS)

2000-01-01

STS-101 Mission Specialist Mary Ellen Weber and her husband Jerome Elkind during a meeting of the STS-101 crew with family and friends at Launch Pad 39A. Mission STS-101 will take the crew to the International Space Station to deliver logistics and supplies, plus prepare the Station for the arrival of the Zvezda Service Module, expected to be launched by Russia in July 2000. The crew will conduct one space walk to perform maintenance on the Space Station as well. This will be the third assembly flight for the Space Station. Launch is targeted for April 24 at about 4:15 p.m. EDT from Launch Pad 39A.

STS-101 crew members meet family and friends

NASA Technical Reports Server (NTRS)

2000-01-01

STS-101 Mission Specialist Yuri Vladimirovich Usachev, a Russian cosmonaut, and his wife Vera Sergeevna Usacheva during a meeting of the STS-101 crew with family and friends at Launch Pad 39A. Mission STS-101 will take the crew to the International Space Station to deliver logistics and supplies, plus prepare the Station for the arrival of the Zvezda Service Module, expected to be launched by Russia in July 2000. The crew will conduct one space walk to perform maintenance on the Space Station as well. This will be the third assembly flight for the Space Station. Launch is targeted for April 24 at about 4:15 p.m. EDT from Launch Pad 39A.

Clinical Nurse Specialists Guide Staff Nurses to Promote Practice Accountability Through Peer Review.

PubMed

Semper, Julie; Halvorson, Betty; Hersh, Mary; Torres, Clare; Lillington, Linda

2016-01-01

The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles. Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet-designated community hospital were charged with developing a staff nurse peer review education program. Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability. Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability. The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice. Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice. The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.

The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

PubMed

Schoonover, Heather

The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.

[Beginners' operations and medical specialist standards : Avoidance of criminal liability and civil liability].

PubMed

Schneider, H

2018-05-16

In all phases, patients are entitled to receive medical treatment according to medical specialist standards. This does not mean that patients necessarily have to be treated by a medical specialist. Operations performed by "beginners", e. g. assistant physicians, are permitted. However, there are increased liability risks, both for the specialist and the assistant physician. Furthermore, there are risks of criminal responsibility for causing bodily harm by negligence or negligent manslaughter. This article portrays the requirements of civil liability and criminal responsibility concerning beginners' operations on the basis of cases and judgments of the Federal Court and the Higher Regional Courts in Germany. Additionally, the reception of the jurisprudence by the relevant legal literature will be discussed. Jurisprudence and legal literature categorize breaches of duty of care. Assistant physicians can be subject to contributory negligence liabilities, while specialists can bear liabilities for negligent selection, organization or supervision. Responsible specialist and assistant physicians can protect themselves (and the patient) and avoid legal risks by only performing operations adequate to their educational level or by delegating operations to beginners and ensuring intervention by a specialist by supervision of the operation which is suitable to the assistant physician's level of education.

STS-67 Payload Specialists Durrance and Parise suit up

NASA Technical Reports Server (NTRS)

1995-01-01

In the Operations and Checkout Building, STS-67 Payload Specialists Samuel T. Durrance (left) and Ronald A. Parise have finished donning their launch/entry suits and chat with astronaut Joe Tanner while waiting for the rest of the crew. The two payload specialists -- who are both making their second trip into space -- and five fellow crew members will soon depart for Launch Pad 39A, where the Space Shuttle Endeavour is being readied for liftoff during a launch window opening at 1:37 a.m. EST, March 2.

View of Mission Specialist Judith Resnik on the middeck

NASA Image and Video Library

1984-09-08

41D-13-025 (30 Aug 1984) --- Astronaut Judith A. Resnik, one of three mission specialists, positions herself on the floor of the Space Shuttle Discovery's mid-deck to note some items on a clipboard pad. Nearby, Charles D. Walker, payload specialist (partially out of frame at left), anchors himself with a foot restraint while working at a stowage locker. Between the two is a sign fashioned by Dr. Resnik and held up to a nearby TV camera during early STS-41D downlinked television. This is a 35mm frame.

Design and fabrication of engineering model fiber-optics detector

NASA Technical Reports Server (NTRS)

Mcsweeney, A.

1972-01-01

The design and fabrication of an annular ring detector consisting of optical fibers terminated with photodetectors is described. The maximum width of each concentric ring has to be small enough to permit the resolution of a Ronchi ruling transform with a dot spacing of 150 microns. A minimum of 100 concentric rings covering a circular area of 2.54 cm diameter also is necessary. A fiber-optic array consisting of approximately 89,000 fibers of 76 microns diameter was fabricated to meet the above requirements. The fibers within a circular area of 2.5 cm diameter were sorted into 168 adjacent rings concentric with the center fiber. The response characteristics of several photodetectors were measured, and the data used to compare their linearity of response and dynamic range. Also, coupling loss measurements were made for three different methods of terminating the optical fibers with a photodetector.

Current Practices in Ocular Toxoplasmosis: A Survey of Brazilian Uveitis Specialists.

PubMed

Morais, Fábio Barreto; Arantes, Tiago Eugênio Faria E; Muccioli, Cristina

2018-01-01

To describe treatment practices for ocular toxoplasmosis among members of the Brazilian Uveitis Society. An online questionnaire sent to specialists, between October 2014 and March 2015. Most respondents (67.9%) treat all active cases. Most specialists consider visual acuity <20/200 (88.2%), severe vitreous inflammation (94.1%), and ocular disease during acquired infection (88.2%) as absolute indications for treatment. Systemic steroids are associated with anti-toxoplasmic therapy in most cases by 50.9% of the respondents. For immunocompetent individuals, 57.4% of the respondents chose trimethoprim/sulfamethoxazole. Classical therapy (sulfadiazine/pyrimethamine) is preferred most for patients with central lesions (70.4%), immunosuppression (68.4%), acquired infection (70.4%), and atypical forms (74.1%). For patients with frequent relapses, 84.9% of the respondents preferred antibiotic prophylaxis. Treatment patterns of ocular toxoplasmosis are not uniform among Brazilian specialists. Most specialists treat all cases of active retinochoroiditis. Typical cases are more frequently treated with trimethoprim/sulfamethoxazole. However, classical therapy is the regimen of choice when lesions are considered more severe.

Role expectations in dementia care among family physicians and specialists.

PubMed

Hum, Susan; Cohen, Carole; Persaud, Malini; Lee, Joyce; Drummond, Neil; Dalziel, William; Pimlott, Nicholas

2014-09-01

The assessment and ongoing management of dementia falls largely on family physicians. This pilot study explored perceived roles and attitudes towards the provision of dementia care from the perspectives of family physicians and specialists. Semi-structured, one-to-one interviews were conducted with six family physicians and six specialists (three geriatric psychiatrists, two geriatricians, and one neurologist) from University of Toronto-affiliated hospitals. Transcripts were subjected to thematic content analysis. Physicians' clinical experience averaged 16 years. Both physician groups acknowledged that family physicians are more confident in diagnosing/treating uncomplicated dementia than a decade ago. They agreed on care management issues that warranted specialist involvement. Driving competency was contentious, and specialists willingly played the "bad cop" to resolve disputes and preserve long-standing therapeutic relationships. While patient/caregiver education and support were deemed essential, most physicians commented that community resources were fragmented and difficult to access. Improving collaboration and communication between physician groups, and clarifying the roles of other multi-disciplinary team members in dementia care were also discussed. Future research could further explore physicians' and other multi-disciplinary members' perceived roles and responsibilities in dementia care, given that different health-care system-wide dementia care strategies and initiatives are being developed and implemented across Ontario.

Role Expectations in Dementia Care Among Family Physicians and Specialists

PubMed Central

Hum, Susan; Cohen, Carole; Persaud, Malini; Lee, Joyce; Drummond, Neil; Dalziel, William; Pimlott, Nicholas

2014-01-01

Background The assessment and ongoing management of dementia falls largely on family physicians. This pilot study explored perceived roles and attitudes towards the provision of dementia care from the perspectives of family physicians and specialists. Methods Semi-structured, one-to-one interviews were conducted with six family physicians and six specialists (three geriatric psychiatrists, two geriatricians, and one neurologist) from University of Toronto-affiliated hospitals. Transcripts were subjected to thematic content analysis. Results Physicians’ clinical experience averaged 16 years. Both physician groups acknowledged that family physicians are more confident in diagnosing/treating uncomplicated dementia than a decade ago. They agreed on care management issues that warranted specialist involvement. Driving competency was contentious, and specialists willingly played the “bad cop” to resolve disputes and preserve long-standing therapeutic relationships. While patient/caregiver education and support were deemed essential, most physicians commented that community resources were fragmented and difficult to access. Improving collaboration and communication between physician groups, and clarifying the roles of other multi-disciplinary team members in dementia care were also discussed. Conclusions Future research could further explore physicians’ and other multi-disciplinary members’ perceived roles and responsibilities in dementia care, given that different health-care system-wide dementia care strategies and initiatives are being developed and implemented across Ontario. PMID:25232368

Fabric strain sensor integrated with CNPECs for repeated large deformation

NASA Astrophysics Data System (ADS)

Yi, Weijing

Flexible and soft strain sensors that can be used in smart textiles for wearable applications are much desired. They should meet the requirements of low modulus, large working range and good fatigue resistance as well as good sensing performances. However, there were no commercial products available and the objective of the thesis is to investigate fabric strain sensors based on carbon nanoparticle (CNP) filled elastomer composites (CNPECs) for potential wearing applications. Conductive CNPECs were fabricated and investigated. The introduction of silicone oil (SO) significantly decreased modulus of the composites to less than 1 MPa without affecting their deformability and they showed good stability after heat treatment. With increase of CNP concentration, a percolation appeared in electrical resistivity and the composites can be divided into three ranges. I-V curves and impedance spectra together with electro-mechanical studies demonstrated a balance between sensitivity and working range for the composites with CNP concentrations in post percolation range, and were preferred for sensing applications only if the fatigue life was improved. Due to the good elasticity and failure resist property of knitted fabric under repeated extension, it was adopted as substrate to increase the fatigue life of the conductive composites. After optimization of processing parameters, the conductive fabric with CNP concentration of 9.0CNP showed linear I-V curves when voltage is in the range of -1 V/mm and 1 V/mm and negligible capacitive behavior when frequency below 103 Hz even with strain of 60%. It showed higher sensitivity due to the combination of nonlinear resistance-strain behavior of the CNPECs and non-even strain distribution of knitted fabric under extension. The fatigue life of the conductive fabric was greatly improved. Extended on the studies of CNPECs and the coated conductive fabrics, a fabric strain sensor was designed, fabricated and packaged. The Young's modulus of

Effects of a Malpractice Crisis on Specialist Supply and Patient Access to Care

PubMed Central

Mello, Michelle M.; Studdert, David M.; DesRoches, Catherine M.; Peugh, Jordon; Zapert, Kinga; Brennan, Troyen A.; Sage, William M.

2005-01-01

Objective: To investigate specialist physicians' practice decisions in response to liability concerns and their perceptions of the impact of the malpractice environment on patient access to care. Summary Background Data: A perennial concern during “malpractice crises” is that liability costs will drive physicians in high-risk specialties out of practice, creating specialist shortages and access-to-care problems. Methods: Mail survey of 824 Pennsylvania physicians in general surgery, neurosurgery, orthopedic surgery, obstetrics/gynecology, emergency medicine, and radiology eliciting information on practice decisions made in response to rising liability costs. Results: Strong majorities of specialists reported increases over the last 3 years in patients' driving distances (58%) and waiting times (83%) for specialist care or surgery, waiting times for emergency department care (82%), and the number of patients forced to switch physicians (89%). Professional liability costs and managed care were both considered important contributing factors. Small proportions of specialists reported that they would definitely retire (7%) or relocate their practice out of state (4%) within the next 2 years; another third (32% and 29%, respectively) said they would likely do so. Forty-two percent of specialists have reduced or eliminated high-risk aspects of their practice, and 50% are likely to do so over the next 2 years. Conclusions: Our data suggest that claims of a “physician exodus” from Pennsylvania due to rising liability costs are overstated, but the malpractice situation is having demonstrable effects on the supply of specialist physicians in affected areas and their scope of practice, which likely impinges upon patients' access to care. PMID:16244532

Composite nuclear fuel fabrication methodology for gas fast reactors

NASA Astrophysics Data System (ADS)

Vasudevamurthy, Gokul

characterized to understand the required fabrication techniques and at the same time meet the necessary GFR fuel characteristics.

Sources of satisfaction and dissatisfaction among specialists within the public and private health sectors.

PubMed

Ashton, Toni; Brown, Paul; Sopina, Elizaveta; Cameron, Linda; Tenbensel, Timothy; Windsor, John

2013-09-27

As in many countries, medical and surgical specialists in New Zealand have the opportunity of working in the public sector, the private sector or both. This study aimed to explore the level and sources of satisfaction and dissatisfaction of specialists in New Zealand with working in the two sectors. Such information can assist workforce planning, management and policy and may inform the wider debate about the relationship between the two sectors. A postal survey was conducted of 1983 registered specialists throughout New Zealand. Respondents were asked to assess 14 sources of satisfaction and 9 sources of dissatisfaction according to a 5-point Likert scale. Means and standard deviations were calculated for the total sample, and for procedural and non-procedural specialties. Differences between the means of each source of satisfaction and dissatisfaction were also calculated. Completed surveys were received from 943 specialists (47% response rate). Overall mean levels of satisfaction were higher in the private sector than the public sector while levels of dissatisfaction were lower. While the public system is valued for its opportunities for further education and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Sources of job satisfaction and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system.

Commissioning of specialist palliative care services in England.

PubMed

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

2018-03-01

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

Apprentice Food Service Specialist (AFSC 62230).

ERIC Educational Resources Information Center

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

This two-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for apprentice food service specialists. Covered in the first volume are fundamentals of food preparation and service (careers in food service, food service sanitation, principles of food preparation and service, and baking…

Safe use of chemicals by professional users and health care specialists

PubMed Central

Apatsidou, Margarita; Konstantopoulou, Ioanna; Foufa, Eleni; Tsarouhas, Konstantinos; Papalexis, Petros; Rezaee, Ramin; Spandidos, Demetrios A.; Kouretas, Demetrios; Tsitsimpikou, Christina

2018-01-01

The awareness of Greek professional users and health care specialists regarding the safe use of chemicals was investigated, to be the best of our knowledge, for the first time after the introduction of Regulations (EC) 1907/2006 (REACH) and 1272/2008 (CLP) on chemicals. A total of 200 professional users and 150 health care specialists from various regions of Greece contributed to the use of a closed-ended, anonymous and validated questionnaire. The findings showed that over 85% of the responders were not aware of classification, labelling and packaging (CLP) and 67.8% of the responders were unaware of any changes made in the labeling of the products they were using. The majority (>75%) of individuals were cognizant that they were using hazardous products; however, the perception of hazard varied significantly between the two groups (P=0.012) and statistically were dependent on the educational (P=0.022) and the profession (P=0.014) level. One third of the professional users read the label as the main source of information for the product, while for health care specialists the number increased to 65% and a strong correlation was detected with the educational level (P=0.017). In both groups, 7% of professional users and health care specialists declared that hazard communication through product labeling is not well understood. The use of personal protective equipment (PPE) is almost universal for health care specialists with women being more sensitive (P=0.041), while 25% of the professional users do not use any PPE. Almost 60% of the health care specialists are required to provide instructions regarding the safe use of chemicals or the action to be undertaken in case of accident. In the latter situation, the National Poisoning Centre is the reference point for information. Limited use of the safety data sheets has been observed both for professional users (18%) and health care specialists (23%). In conclusion, rising awareness campaigns are needed, in collaboration

Bioinstrumentation for evaluation of workload in payload specialists - Results of ASSESS II

NASA Technical Reports Server (NTRS)

Wegmann, H. M.; Herrmann, R.; Winget, C. M.

1979-01-01

Results of the medical experiment on payload specialist workloads conducted as part of the ASSESS II airborne simulation of Spacelab conditions are reported. Subjects were fitted with temperature probes and ECG, EEG and EOG electrodes, and hormone and electrolyte excretion was monitored in order to evaluate the changes in circadian rhythms, sleep patterns and stress responses brought about by mission schedules over the ten days of the experiment. Internal dissociations of circadian rhythms, sleep disturbances and increased stress levels were observed, especially during the first three days of the experiment, indicating a considerable workload to be imposed upon the payload specialists. An intensive premission simulation is suggested as a means of estimating overall workloads and allowing payload specialist adaptation to mission conditions. The bioinstrumentation which was developed and applied to the airborne laboratory is concluded to be a practical and reliable tool in the assessment of payload specialist workloads.

Analysis of pharmacologic and nonpharmacologic prescription patterns of general practitioners and specialists in the AMICA study.

PubMed

Scarpa, Raffaele; Sarzi-Puttini, Piercarlo; Cimmino, Marco A; Caporali, Roberto; Parazzini, Fabio; Zaninelli, Augusto; Canesi, Bianca

2005-08-01

To evaluate the prescription modalities of general practitioners (GPs) and specialists in symptomatic osteoarthritis (OA) patients enrolled in the AMICA study. This study started in 2001 as a cohort investigation of OA patients seen by 2764 GPs and 316 specialists. Enrolled were 28,981 patients with symptomatic OA of the hand, hip, or knee. GPs and physical medicine specialists treated OA less frequently with pharmacological therapy than rheumatologists (OR 0.35; CI 0.26 to 0.47) or orthopedic surgeons (OR 0.65; CI 0.54 to 0.77). Pharmacological therapies (alone or in association with nonpharmacological modalities) were selected by 97% of the GPs, 96% of the rheumatologists, 94% of the orthopedic surgeons, and 85% of the physical medicine specialists. In comparison with GPs, all of the specialists more frequently used disease-modifying OA drugs (DMOADs) (rheumatologists: OR 6.86, CI 6.03 to 7.80; orthopedic surgeons: OR 2.20, CI 1.94 to 2.49; physical medicine specialists: OR 2.11, CI 1.69 to 2.63). Nonpharmacological therapies were selected by 44% of the GPs, 54% of the rheumatologists, 71% of the orthopedic surgeons, and 90% of the physical medicine specialists. They were used alone uncommonly (by 3% of the GPs, 3% of the rheumatologists, 6% of the orthopedic surgeons, and 15% of the physical medicine specialists). GPs use nonpharmacological treatment less than specialists: OR 0.53; CI 0.47 to 0.60 versus rheumatologists; OR 0.20; CI 0.18 to 0.21 versus orthopedic surgeons; and OR 0.07; CI 0.05 to 0.09 versus physical medicine specialists. Ultrasound (US) (11%) and transcutaneous electrical nerve stimulation (TENS) (7%) were the nonpharmacological therapies most frequently prescribed by GPs. Among the specialists, physical medicine specialists most frequently prescribed US (35%) and TENS (21%); US was also preferred by rheumatologists, whereas the orthopedic surgeon's choice was magnetotherapy (21%). Exercises and other passive or active rehabilitation strategies

Polymorphous computing fabric

DOEpatents

Wolinski, Christophe Czeslaw [Los Alamos, NM; Gokhale, Maya B [Los Alamos, NM; McCabe, Kevin Peter [Los Alamos, NM

2011-01-18

Fabric-based computing systems and methods are disclosed. A fabric-based computing system can include a polymorphous computing fabric that can be customized on a per application basis and a host processor in communication with said polymorphous computing fabric. The polymorphous computing fabric includes a cellular architecture that can be highly parameterized to enable a customized synthesis of fabric instances for a variety of enhanced application performances thereof. A global memory concept can also be included that provides the host processor random access to all variables and instructions associated with the polymorphous computing fabric.

STS-87 Payload Specialist Kadenyuk in white room

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Payload Specialist Leonid Kadenyuk of the National Space Agency of Ukraine is assisted with final preparations before launch in the white room at Launch Pad 39B by Danny Wyatt, NASA quality assurance specialist, at left; Dave Law, USA mechanical technician, facing Kadenyuk; and Travis Thompson, USA orbiter vehicle closeout chief, at right. STS-87 is the fourth flight of the United States Microgravity Payload and Spartan-201. The 16- day mission will include the Collaborative Ukrainian Experiment (CUE), a collection of 10 plant space biology experiments that will fly in Columbias middeck and will feature an educational component that involves evaluating the effects of microgravity on Brassica rapa seedlings.

Personalizing protocol-driven care: the case of specialist heart failure nurses.

PubMed

Sanders, Tom; Harrison, Stephen; Checkland, Katherine

2010-09-01

This paper is a report of a study conducted to explore how specialist heart failure nurses negotiate treatment advice with patients, in the context of an increasing expectation that clinical staff in the National Health Services will follow guidelines in their daily work. The development of specialist nurse roles has given rise to questions about their compatibility with patient-centred care. However, research has revealed little about how specialist nurses balance clinical guidelines with traditional caring tasks. Semi-structured interviews (n = 10) were conducted with specialist heart failure nurses in northern England recruited from a heart failure specialist nursing contact list. In addition, non-participant observations were carried out on nurse-patient consultations (n = 16) in one regional nurse-led heart failure clinic. Data were collected between 2003 and 2005, and analysed using a variation of grounded theory. Heart failure nurses sought to combine traditional caring work with the wider goal of improving patient outcomes by 'personalizing' their advice to patients and presenting their heart failure as 'typical'. They accommodated protocol-driven care into their daily routines, and perceived no disjuncture between evidence-based practice and patient-centredness. However, their approach allowed little space for the exploration of each patient's own priorities about their illness. There is a need both to re-examine the appropriateness of traditional caring concepts, and to reflect on the need to incorporate patients' own values into the consultation process.

Fabrication of artificial gemstones from glasses: From waste to jewelry

NASA Astrophysics Data System (ADS)

Srisittipokakun, N.; Ruangtaweep, Y.; Horprathum, M.; Kaewkhao, J.

2014-09-01

In this review, several aspects of artificial gemstones from glasses have been addressed from the advantages, the fabrication process, the coloration, their properties and finally the use of RHA as the glass former for the simulant gemstones. The silica sources for preparation of glasses were locally obtained from sand and biomass ashes in Thailand. The refractive index, density and hardness values of the glass gemstones reported in these researches had been meet the standard of EU-regulation for crystal. The glass gemstones were fabricated in a variety of colors with some special features such as color changing when exposed under different light sources. Barium was used instead of lead to increase the density and refractive index of the glasses. The developments of high refractive index lead-free glasses are also leave non-toxically impact to our environment.

The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services

PubMed Central

Riordan, Fiona; McHugh, Sheena M; Murphy, Katie; Barrett, Julie; Kearney, Patricia M

2017-01-01

Objectives International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. Design A cross-sectional survey of hospital and community-based DNS in Ireland. Methods Between September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave. Results The response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration. Conclusions Delivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed. PMID:28801394

One Team: Classroom Teachers and Specialists

ERIC Educational Resources Information Center

Gale, Sheila Levine

2016-01-01

This View from the Chalkboard article reflects my view of how today's classroom teacher and specialist have joined together to create "One Team" that benefits the student. This was not always the case but the trend, in my view, is clear and the benefits compelling. I highlight the "reading workshop model" as an approach with…

Business Systems Specialist. Technical Committee Report.

ERIC Educational Resources Information Center

Idaho State Dept. of Education, Boise. Div. of Vocational Education.

This Technical Committee Report prepared by industry representatives in Idaho lists the skills currently necessary for an employee in that state to obtain a job as a business systems specialist, retain a job once hired, and advance in that occupational field. (Task lists are grouped according to duty areas generally used in industry settings, and…

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

PubMed

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

2001-01-01

Multiple sclerosis (MS) is a disease of the central nervous system. The cause is unknown. There are about 80-160 people with MS per 100,000 population, with twice as many women affected as men. The management of individuals with MS includes treatment of acute relapses and chronic symptoms. The care of MS patients is provided by various healthcare professionals, such as general practitioners (GPs), neurologists, physiotherapists, occupational therapists and nurses. Some MS patients have access to an MS specialist nurse, although this provision varies geographically. The aim of this report is to assess the effectiveness and relative cost-effectiveness of MS specialist nurses in improving care and outcomes for patients with MS. A systematic review of the literature, involving a range of databases, was performed. Full details are described in the main report. Only one study was identified that tried to evaluate the benefit of MS specialist nurses. The study concluded that MS patients and their carers found the MS specialist nurse to be helpful, particularly in improving their knowledge of MS, ability to cope, mood and confidence about the future. GPs also reported finding the nurse to be helpful with their MS patients, and 40% of the GPs stated they would purchase the services of an MS specialist nurse if their practices became fundholding. However, there were considerable methodological weaknesses inherent in the study design, and it was unclear whether the results of the study could be extrapolated to other settings or to other MS patient groups. RESULTS - ONGOING RESEARCH: There are two ongoing research studies regarding MS specialist nurses. One of these studies involves the provision of MS nurses to several areas, but also has two control populations to allow evaluation of the health benefits of the nurses to MS patients and their carers. This study will help to fill the evidence gap. RESULTS - COSTS: The costs of providing MS specialist nurses consist of their

Are specialists at risk under environmental change? Neoecological, paleoecological and phylogenetic approaches

PubMed Central

Colles, Audrey; Liow, Lee Hsiang; Prinzing, Andreas

2009-01-01

The question ‘what renders a species extinction prone’ is crucial to biologists. Ecological specialization has been suggested as a major constraint impeding the response of species to environmental changes. Most neoecological studies indicate that specialists suffer declines under recent environmental changes. This was confirmed by many paleoecological studies investigating longer-term survival. However, phylogeneticists, studying the entire histories of lineages, showed that specialists are not trapped in evolutionary dead ends and could even give rise to generalists. Conclusions from these approaches diverge possibly because (i) of approach-specific biases, such as lack of standardization for sampling efforts (neoecology), lack of direct observations of specialization (paleoecology), or binary coding and prevalence of specialists (phylogenetics); (ii) neoecologists focus on habitat specialization; (iii) neoecologists focus on extinction of populations, phylogeneticists on persistence of entire clades through periods of varying extinction and speciation rates; (iv) many phylogeneticists study species in which specialization may result from a lack of constraints. We recommend integrating the three approaches by studying common datasets, and accounting for range-size variation among species, and we suggest novel hypotheses on why certain specialists may not be particularly at risk and consequently why certain generalists deserve no less attention from conservationists than specialists. PMID:19580588

Bleeding Hearts, Profiteers, or Both: Specialist Physician Fees in an Unregulated Market.

PubMed

Johar, Meliyanni; Mu, Chunzhou; Van Gool, Kees; Wong, Chun Yee

2017-04-01

This study shows that, in an unregulated fee-setting environment, specialist physicians practise price discrimination on the basis of their patients' income status. Our results are consistent with profit maximisation behaviour by specialists. These findings are based on a large population survey that is linked to administrative medical claims records. We find that, for an initial consultation, specialist physicians charge their high-income patients AU$26 more than their low-income patients. While this gap equates to a 19% lower fees for the poorest patients (bottom 25% of the household income distribution), it is unlikely to remove the substantial financial barriers they face in accessing specialist care. There are large variations across specialties, with neurologists exhibiting the largest fee gap between the high-income and low-income patients. Several possible channels for deducing the patient's income are examined. We find that patient characteristics such as age, health concession card status and private health insurance status are all used by specialists as proxies for income status. These characteristics are particularly important to further practise price discrimination among the low-income patients but are less relevant for the high-income patients. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Payload specialists Patrick Baudry conducts equilibrium experiments

NASA Technical Reports Server (NTRS)

1985-01-01

Payload specialists Patrick Baudry participates in an experiment involving equilibrium and vertigo. He is anchored to the orbiter floor by foot restraints and is wearing a device over his eyes to measure angular head movement and up and down eye movement.

Stars For Citizens With Urban Star Parks and Lighting Specialists

NASA Astrophysics Data System (ADS)

Grigore, Valentin

2015-08-01

General contextOne hundred years ago, almost nobody imagine a life without stars every night even in the urban areas. Now, to see a starry sky is a special event for urban citizens.It is possible to see the stars even inside cities? Yes, but for that we need star parks and lighting specialists as partners.Educational aspectThe citizens must be able to identify the planets, constellations and other celestial objects in their urban residence. This is part of a basic education. The number of the people living in the urban area who never see the main constellations or important stars increase every year. We must do something for our urban community.What is an urban star park?An urban public park where we can see the main constellations can be considered an urban star park. There can be organized a lot of activities as practical lessons of astronomy, star parties, etc.Classification of the urban star parksA proposal for classification of the urban star parks taking in consideration the quality of the sky and the number of the city inhabitants:Two categories:- city star parks for cities with < 100.000 inhabitants- metropolis star parks for cities with > 100.000 inhabitantsFive levels of quality:- 1* level = can see stars of at least 1 magnitude with the naked eyes- 2* level = at least 2 mag- 3* level = at least 3 mag- 4* level= at least 4 mag- 5* level = at least 5 magThe urban star urban park structure and lighting systemA possible structure of a urban star park and sky-friend lighting including non-electric illumination are descripted.The International Commission on IlluminationA description of this structure which has as members national commissions from all over the world.Dark-sky activists - lighting specialistsNational Commissions on Illumination organize courses of lighting specialist. Dark-sky activists can become lighting specialists. The author shows his experience in this aspect as a recent lighting specialist and his cooperation with the Romanian National

Relative costs of specialist services in a family practice population

PubMed Central

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

1985-01-01

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

STS-108 Mission Specialist Linda A. Godwin arrives at KSC

NASA Technical Reports Server (NTRS)

2001-01-01

STS-108 Mission Specialist Linda A. Godwin arrives at KSC KSC-01PD-1710 KENNEDY SPACE CENTER, Fla. -- STS-108 Mission Specialist Linda A. Godwin pauses after her arrival at KSC. She and the rest of the crew will be preparing for launch Nov. 29 on Space Shuttle Endeavour. Liftoff is scheduled for 7:41 p.m. EST. Top priorities for the STS-108 (UF-1) mission of Endeavour are rotation of the International Space Station Expedition Three and Expedition Four crews, bringing water, equipment and supplies to the station in the Multi-Purpose Logistics Module Raffaello, and completion of spacewalk and robotics tasks. Mission Specialists Daniel M. Tani and Godwin will take part in the spacewalk to install thermal blankets over two pieces of equipment at the bases of the Space Station's solar wings. Other crew members are Commander Dominic L. Gorie and Pilot Mark E. Kelly.

STS-108 Mission Specialist Daniel M. Tani arrives at KSC

NASA Technical Reports Server (NTRS)

2001-01-01

STS-108 Mission Specialist Daniel M. Tani arrives at KSC KSC-01PD-1707 KENNEDY SPACE CENTER, Fla. -- STS-108 Mission Specialist Daniel M. Tani arrives at KSC in a T-38 jet trainer. He and the rest of the crew will be preparing for launch Nov. 29 on Space Shuttle Endeavour. Liftoff is scheduled for 7:41 p.m. EST. Top priorities for the STS-108 (UF-1) mission of Endeavour are rotation of the International Space Station Expedition Three and Expedition Four crews, bringing water, equipment and supplies to the station in the Multi-Purpose Logistics Module Raffaello, and completion of spacewalk and robotics tasks. Mission Specialists Linda A. Godwin and Tani will take part in the spacewalk to install thermal blankets over two pieces of equipment at the bases of the Space Station's solar wings. Other crew members are Commander Dominic L. Gorie and Pilot Mark E. Kelly.

The impact of specialist trauma service on major trauma mortality.

PubMed

Wong, Ting Hway; Lumsdaine, William; Hardy, Benjamin M; Lee, Keegan; Balogh, Zsolt J

2013-03-01

Trauma services throughout the world have had positive effects on trauma-related mortality. Australian trauma services are generally more consultative in nature rather than the North American model of full trauma admission service. We hypothesized that the introduction of a consultative specialist trauma service in a Level I Australian trauma center would reduce mortality of the severely injured. A 10-year retrospective study (January 1, 2002-December 31, 2011) was performed on all trauma patients admitted with an Injury Severity Score (ISS) > 15. Patients were identified from the trauma registry, and data for age, sex, mechanism of injury, ISS, survival to discharge, and length of stay were collected. Mortality was examined for patients with severe injury (ISS > 15) and patients with critical injury (ISS > 24) and compared for the three periods: 2002-2004 (without trauma specialist), 2005-2007 (with trauma specialist), and 2008-2011 (with specialist trauma service). A total of 3,869 severely injured (ISS > 15) trauma patients were identified during the 10-year period. Of these, 2,826 (73%) were male, 1,513 (39%) were critically injured (ISS > 24), and more than 97% (3,754) were the victim of blunt trauma. Overall mortality decreased from 12.4% to 9.3% (relative risk, 0.75) from period one to period three and from 25.4% to 20.3% (relative risk, 0.80) for patients with critical injury. A 0.46% per year decrease (p = 0.018) in mortality was detected (odds ratio, 0.63; p < 0.001). For critically injured (ISS > 24), the trend was (0.61% per year; odds ratio, 0.68; p = 0.039). The introduction of a specialist trauma service decreased the mortality of patients with severe injury, the model of care should be considered to implement state- and nationwide in Australia. Epidemiologic study, level III.

The Association for Educational Communications and Technology: Division of School Media Specialists.

ERIC Educational Resources Information Center

Miller, Mary Mock

1993-01-01

Reports on the Division of School Media Specialists of the Association for Educational Communications and Technology (AECT). Highlights include the mission statement; publications; board members and committee chairs; activities at the AECT conferences; and future concerns, including public relations and marketing plans for media specialists and…

Entomology Specialist 1-1. Military Curriculum Materials for Vocational and Technical Education.

ERIC Educational Resources Information Center

Jones, Jimmie L.

This individualized, self-paced course for training an entomology specialist was adapted from military curriculum materials for use in vocational and technical education. Completion of the course should provide students with basic information needed to accomplish the following duties of an entomology specialist: perform entomological work, apply…

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

PubMed

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

2017-06-01

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

Charismatic authority in modern healthcare: the case of the 'diabetes specialist podiatrist'.

PubMed

Bacon, Dawn; Borthwick, Alan M

2013-09-01

Professional specialisation is broadly considered to result from increased complexity in professional knowledge and to be linked to specialist education, formalised credentials and registration. However, the degree of formal organisation may vary across professions. In healthcare, although medical specialisation is linked to rigorous selection criteria, formal training programmes and specialist registration, some forms of specialisation in the allied health professions are much less formal. Drawing on Weber's concept of charismatic authority, the establishment of a specialist role in podiatry, the 'diabetes specialist podiatrist', in the absence of codified or credentialed authority, is explored. 'Charismatic' leaders in podiatry, having attracted a following of practitioners, were able to constitute a speciality area of practice in the absence of established career pathways and acquire a degree of legitimacy in the medical field of diabetology. © 2012 The Authors. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/JohnWiley & Sons Ltd. Published by John Wiley & Sons Ltd.

The content of the work of clinical nurse specialists described by use of daily activity diaries.

PubMed

Oddsdóttir, Elín Jakobína; Sveinsdóttir, Herdís

2011-05-01

Evaluate the usefulness of the role of clinical nurse specialists and the content of their work by mapping their activities. The clinical work of advanced practice nursing differs in different countries, and a clear picture is lacking on what exactly advanced practice nurses do. Prospective exploratory study. The setting of the study was the largest hospital in Iceland where over half of the country's active nursing workforce are employed, including the only clinical nurse specialists. Of 19 clinical nurse specialists working at the hospital, 15 participated. Data were collected over seven days with a structured activity diary that lists 65 activities, classified into six roles and three domains. In 17 instances, the 'role activities' and 'domain activities' overlap and form 17 categories of practice. The clinical nurse specialists coded their activities at 15-minutes interval and could code up to four activities simultaneously. Daily, the clinical nurse specialists evaluated their clinical nurse specialist background. The roles that occupied the greatest proportion of the clinical nurse specialists' time were education, expert practice and 'other' activities, while the smallest proportions were in counselling, research and practice development. The domain they worked in most was the institutional domain, followed by the client/family domain and the clinical outcome management domain. All of the clinical nurse specialists reported working on two activities simultaneously, 11 of them on three activities and six on four activities. They self-assessed their background as clinical nurse specialists as being very useful. The activity diary is a useful tool for assessing the content of practice. Clinical nurse specialists spend too much time on activities related to the institution. Nurse managers are advised to provide clinical nurse specialists with ample time to develop the direct practice role in the client/family domain. The development of advanced nursing practice

STS-55 German payload specialists and backups pose in front of SL-D2 at KSC

NASA Technical Reports Server (NTRS)

1992-01-01

STS-55 Columbia, Orbiter Vehicle (OV) 102, German payload specialists and backup (alternate) payload specialists pose in front of the Spacelab Deutsche 2 (SL-D2) science module at a Kennedy Space Center (KSC) processing facility. These four Germans have been assigned to support the STS-55/SL-D2 mission. Left to right are Payload Specialist 2 Hans Schlegel, backup Payload Specialist Dr. P. Gerhard Thiele (kneeling), Payload Specialist 1 Ulrich Walter, and backup Payload Specialist Renate Brummer. Walter and Schlegel are scheduled to fly aboard OV-102 for the mission while Brummer and Thiele will serve as alternates and fill supportive roles on the ground. Clearly visible on the SL-D2 module are the European Space Agency (ESA) insignia, the feedthrough plate, and the D2 insignia.

Impact of specialist care on clinical outcomes for medical emergencies.

PubMed

Moore, Stuart; Gemmell, Islay; Almond, Solomon; Buchan, Iain; Osman, Isameldin; Glover, Andrew; Williams, Peter; Carroll, Nadine; Rhodes, Jonathan

2006-01-01

General hospitals have commonly involved a wide range of medical specialists in the care of unselected medical emergency admissions. In 1999, the Royal Liverpool University Hospital, a 915-bed hospital with a busy emergency service, changed its system of care for medical emergencies to allow early placement of admitted patients under the care of the most appropriate specialist team, with interim care provided by specialist acute physicians on an acute medicine unit - a system we have termed 'specialty triage'. Here we describe a retrospective study in which all 133,509 emergency medical admissions from February 1995 to January 2003 were analysed by time-series analysis with correction for the underlying downward trend from 1995 to 2003. This showed that the implementation of specialty triage in May 1999 was associated with a subsequent additional reduction in the mortality of the under-65 age group by 0.64% (95% CI 0.11 to 1.17%; P=0.021) from the 2.4% mortality rate prior to specialty triage, equivalent to approximately 51 fewer deaths per year. No significant effect was seen for those over 65 or all age groups together when corrected for the underlying trend. Length of stay and readmission rates showed a consistent downward trend that was not significantly affected by specialty triage. The data suggest that appropriate specialist management improves outcomes for medical emergencies, particularly amongst younger patients.

Exploring the situational motivation of medical specialists: a qualitative study

PubMed Central

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

2018-01-01

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

Evaluation of specialist referrals at a rural health care clinic.

PubMed

Biggerstaff, Mary Ellen; Short, Nancy

2017-07-01

Transition to a value-based care system involves reducing costs improving population health and enhancing the patient experience. Many rural hospitals must rely on specialist referrals because of a lack of an internal system of specialists on staff. This evaluation of the existing specialist referrals from primary care was conducted to better understand and improve the referral process and address costs, population health, and the patient experience. A 6-month retrospective chart review was conducted to evaluate quality and outcomes of specialty referrals submitted by 10 primary care providers. During a 6-month period in 2015, there was a total of 13,601 primary care patient visits and 3814 referrals, a referral rate of approximately 27%. The most striking result of this review was that nearly 50% of referred patients were not making the prescribed specialist appointment. Rather than finding a large number of unnecessary referrals, we found overall referral rates higher than expected, and a large percentage of our patients were not completing their referrals. The data and patterns emerging from this investigation would guide the development of referral protocols for a newly formed accountable care organization and lead to further quality improvement projects: a LEAN effort, dissemination of results to clinical and executive staff, protocols for orthopedic and neurosurgical referrals, and recommendations for future process improvements. ©2017 American Association of Nurse Practitioners.

Trying To Reduce Your Technostress?: Helpful Activities for Teachers and Library Media Specialists.

ERIC Educational Resources Information Center

McKenzie, Barbara K.; And Others

1997-01-01

As pressure increases to integrate technology into instruction, many teachers and library media specialists are having difficulty coping with "technostress." Presents suggestions and activities for teachers and library media specialists designed to reduce "technostress." (PEN)

The Generalist versus the Specialist: The New Oxford Dictionary Reveals a Gap.

ERIC Educational Resources Information Center

Levine, Martin Lyon

1981-01-01

There is a gap, it is suggested, separating the generally cultured person, not just from the scientist, but from specialists in many fields. Dictionary definitions are seen as one means of seeing the extent to which specialists and those in the general culture speak the same language. (MLW)

Novel fabrication method for zirconia restorations: bonding strength of machinable ceramic to zirconia with resin cements.

PubMed

Kuriyama, Soichi; Terui, Yuichi; Higuchi, Daisuke; Goto, Daisuke; Hotta, Yasuhiro; Manabe, Atsufumi; Miyazaki, Takashi

2011-01-01

A novel method was developed to fabricate all-ceramic restorations which comprised CAD/CAM-fabricated machinable ceramic bonded to CAD/CAM-fabricated zirconia framework using resin cement. The feasibility of this fabrication method was assessed in this study by investigating the bonding strength of a machinable ceramic to zirconia. A machinable ceramic was bonded to a zirconia plate using three kinds of resin cements: ResiCem (RE), Panavia (PA), and Multilink (ML). Conventional porcelain-fused-to-zirconia specimens were also prepared to serve as control. Shear bond strength test (SBT) and Schwickerath crack initiation test (SCT) were carried out. SBT revealed that PA (40.42 MPa) yielded a significantly higher bonding strength than RE (28.01 MPa) and ML (18.89 MPa). SCT revealed that the bonding strengths of test groups using resin cement were significantly higher than those of Control. Notably, the bonding strengths of RE and ML were above 25 MPa even after 10,000 times of thermal cycling -adequately meeting the ISO 9693 standard for metal-ceramic restorations. These results affirmed the feasibility of the novel fabrication method, in that a CAD/CAM-fabricated machinable ceramic is bonded to a CAD/CAM-fabricated zirconia framework using a resin cement.

Embracing technology: patients', family members' and nurse specialists' experience of communicating using e-mail.

PubMed

Cornwall, Amanda; Moore, Sally; Plant, Hilary

2008-07-01

This paper reports on a study exploring the usefulness of e-mail as a means of communication between nurse specialists and patients with lung cancer and their families. The study involved two lung cancer nurse specialists and 16 patients and family members who used e-mail with them during the 6-month study period. Data were collected from three sources: (1) e-mail contact between the nurse specialists and patients/family members, (2) patient/family member questionnaire and (3) a focus group/reflective session with the nurse specialists. Quantitative data collected from the e-mails and the questionnaires were analysed descriptively and are presented as summary statistics. Text data from the questionnaires and e-mails were analysed using content analysis. Findings suggest that e-mail can be an effective and convenient means of communication between nurse specialists, and patients and family members. Patients and family members reported high levels of satisfaction with this method of communication. It was found to be quick and easy, and patients and family members were satisfied with both the response and the speed of response from the nurse specialists. Nurse specialists were also positive about e-mail use and found that the benefits of using e-mail with patients/family members outweighed any disadvantages. Further investigation is recommended involving other health care professionals and different patient groups to ensure the safe and appropriate use of e-mail within health care.

Facilitating the quality of care in a specialist Pacific ophthalmic nursing workforce.

PubMed

du Toit, R; Hughes, F; Mason, I; Tousignant, B

2011-03-01

Sufficient, appropriately trained health personnel need to be retained in the workforce, and their performance maintained, to achieve quality care. Mid-level ophthalmic personnel in Western Pacific Island Countries and Territories (WPICT) are no exception. The study aims to assess influences on the quality of care provided by specialist mid-level ophthalmic personnel in WPICT and devise strategies to train, retain and maintain performance of these personnel. A situational assessment employed a checklist and semi-structured interviews with specialist mid-level ophthalmic personnel, nursing bodies and Ministry of Health representatives from seven WPICT. A selective literature review guided strategies to address the issues identified. Appropriate training allows nurses to fulfill a mid-level role in WPICT as specialist ophthalmic nurses. Resources generally do not restrict practice. Nursing structures have generally failed to support professionalism: scope and conditions of service, clinical supervision, career structures, professional recognition and opportunities for continuing professional development are rudimentary. Ophthalmic nurses were dissatisfied with the lack of specialty recognition, career progression and salary increase. Regional and local strategies tailored to each country have been devised to establish sustainable processes for support. Salary was a major cause of dissatisfaction. It should be addressed along with professional recognition and related processes. Without professional support, specialist and advanced cadres within nursing may cease to exist, nurses' performance may be affected or they may leave. Specialist ophthalmic nursing, recognized, situated within and properly supported by nursing structures can provide a model for specialist clinical care for other specialties and in other countries. © 2010 The Authors. International Nursing Review © 2010 International Council of Nurses.

Comorbidities and medications of patients with chronic hepatitis C under specialist care in the UK

PubMed Central

Hudson, Benjamin; Walker, Alex J.

2017-01-01

Designing services with the capacity and expertise to meet the needs of the chronic hepatitis C (CHC) population in the era of direct acting antivirals (DAAs), and widening access to such treatments, requires detailed understanding of the characteristics and healthcare needs of the existing patient population. In this retrospective analysis of data from the National HCV Research UK Biobank between March 2012 and October 2014, the characteristics of the CHC population currently under specialist care in the UK were evaluated—with specific focus upon use of medications, adverse lifestyle choices, and comorbidities. Demographic data, risk factors for CHC acquisition, HCV genotype, liver disease status, lifestyle factors, comorbidities, and medication classes were collected. Data were analyzed by history of injecting drug use (IDU), age, and severity of liver disease. A total of 6278 patients (70.5% white; median age, 52 years) from 59 UK specialist centres were included; 59.1% of patients had acquired HCV through IDU. The prevalence of adverse lifestyle factors was significantly lower in non‐IDU compared with previous IDU or recent IDU patients. Depression was common in the previous (50.8%) and recent IDU (68.1%) groups, compared with 27.6% in non‐IDU patients. Cirrhosis was common (23.6%), and prevalence increased with age. We describe a heterogeneous, polymorbid, and aging population of CHC patients in secondary care, and demonstrate underrepresentation of injecting drug users within the current system. The implications of this present significant challenges to physicians and healthcare commissioners in designing services which are fit for purpose inthe DAA era. PMID:28480974

Monitoring stream temperatures—A guide for non-specialists

USGS Publications Warehouse

Heck, Michael P.; Schultz, Luke D.; Hockman-Wert, David; Dinger, Eric C.; Dunham, Jason B.

2018-04-19

Executive SummaryWater temperature influences most physical and biological processes in streams, and along with streamflows is a major driver of ecosystem processes. Collecting data to measure water temperature is therefore imperative, and relatively straightforward. Several protocols exist for collecting stream temperature data, but these are frequently directed towards specialists. This document was developed to address the need for a protocol intended for non-specialists (non-aquatic) staff. It provides specific step-by-step procedures on (1) how to launch data loggers, (2) check the factory calibration of data loggers prior to field use, (3) how to install data loggers in streams for year-round monitoring, (4) how to download and retrieve data loggers from the field, and (5) how to input project data into organizational databases.

View of Zero-G training for astronauts and payload specialists

NASA Image and Video Library

1984-08-27

S84-40538 (24 Aug 1984) --- Two 41-G payload specialists and a backup for one of them appear to be at home in zero gravity in this scene photographed aboard a KC-135 "Zero gravity" aircraft flying one of its weightlessness opportunity parabolas. Paul D. Scully-Power, a civilian oceanographer with the U.S. Navey, is flanked by Marc Garneau (left) and Robert Thirsk, both representing the National Research Council of Canada. Thirsk is back up payload specialist for Garneau.

STS-47 Japanese Payload Specialist Mohri during Homestead water training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Japanese Payload Specialist Mamoru Mohri, wearing inflated life jacket, participates in water survival training at Homestead Air Force Base, Florida. Dockside, Mohri washes the salt water from his personalized helmet (#3) after a water exercise. The three-day course was attended by the STS-47 prime and alternate payload specialists shortly after they were announced for the scheduled summer of 1992 Spacelab Japan (SLJ) mission. Mohri represents the National Space Development Agency of Japan (NASDA).

NEON non-specialist use case; science data reuse in a classroom

NASA Astrophysics Data System (ADS)

Fox, P. A.; Wee, B.; West, P.; Wilson, J.; Wang, H.; Zednik, S.

2012-12-01

We present our experience in bringing science data into the undergraduate classroom. In particular we have worked with scientists associated with the NSF-funded NEON (neoninc.org) project. We have developed a non-specialist use case aimed at undergraduate education. This exercise was developed to give the teacher/professor/facilitator the means to create a lesson plan that will allow students the opportunity to work with large, spatially diverse data sets on water quality and other ecological parameters of streams in the United States. The stream parameters investigated here are total nitrogen, total phosphorus and a macro invertebrate index for the 10 EPA regions in the contiguous US. Instructors would use this lesson as an opportunity to discuss the concept of "ecosystem health," a controversial topic in science but with intuitive resonance among the general public. However, current research data is highly specialized, lacking understandable, or all together lacking, metadata. This metadata is highly specialized, understandable by only the science specialist, or domain expert. Also, the data and metadata is difficult to locate by a non-specialist. The scientist knows where to find the data, how to collect the data, and can understand the structure of the data and what the data means. The meaning, the knowledge, the understanding is in the minds of the scientist. Thus, specific accommodation of the semantics for non-specialists is required. We include a current description of the activity and its outcomes and discuss the effectiveness of our semantic web development methodology in developing this non-specialist use case.

STS-55 MS3 Harris & Payload Specialist Schlegel conduct Anthrorack experiment

NASA Image and Video Library

1993-05-06

STS055-45-017 (26 April-6 May 1993) --- Hans Schlegel (foreground) participates in the ongoing investigation of human physiology under microgravity conditions as he works out on the ergometer at the Anthrorack. Monitoring the "run" is astronaut Bernard A. Harris, Jr., STS-55 mission specialist. Schlegel is one of two payload specialists representing the German Aerospace Research Establishment (DLR) on the Spacelab D-2 mission.

Ensemble modeling to predict habitat suitability for a large-scale disturbance specialist

Treesearch

Quresh S. Latif; Victoria A. Saab; Jonathan G. Dudley; Jeff P. Hollenbeck

2013-01-01

To conserve habitat for disturbance specialist species, ecologists must identify where individuals will likely settle in newly disturbed areas. Habitat suitability models can predict which sites at new disturbances will most likely attract specialists. Without validation data from newly disturbed areas, however, the best approach for maximizing predictive accuracy can...

Professional Insiders/Outsiders? Teacher Professionalism and the Primary School Physical Education Specialist

ERIC Educational Resources Information Center

Brooks, Caroline; DinanThompson, Maree

2013-01-01

This paper provides a context for exploring the positioning of Physical Education specialist teachers (PE specialist teachers) in primary schools in Queensland in the discourses of teacher professionalism. A critical analysis of literature on the history and status of the subject and its practitioners aims to contextualize discourses in and about…

Variation of fee-for-service specialist direct care work effort with patient overall illness burden.

PubMed

Goodman, Robert

2011-08-01

To explore whether a common industry measure of overall patient illness burden, used to assess the total costs of members in a health plan, would be suitable to describe variation in a summary metric of utilization that assesses specialist physician direct patient care services not grouped into clinical episodes, but with exclusion criteria applied to reduce any bias in the data. Data sources/study setting Calendar year 2006 administrative data on 153,557 commercial members enrolled in a non-profit single-state statewide Health Maintenance Organization (HMO) and treated by 4356 specialists in 11 specialties. The health plan's global referral process and specialist fee-for-service reimbursement likely makes these results applicable to the non-managed care setting, as once a global referral was authorized there was no required intervention by the HMO or referring primary care provider for the majority of any subsequent specialist direct clinical care. Study design Specialty-specific correlations and ordinary least-squares regression models to assess variations in specialist direct patient care work effort with patient overall illness burden, after the application of exclusion criteria to reduce potential bias in the data. Principle findings Statistically significant positive correlations exist between specialist direct patient care work effort and patient overall illness burden for all studied specialties. Regression models revealed a generally monotonic increasing relationship between illness burden categories and aggregate specialist direct patient care work effort. Almost all regression model differences from the reference category across specialties are statistically significant (P ≤ 0.012). Assessment of additional results demonstrates the relationship has more substantive significance in some specialties and less in others. The most substantive relationships in this study were found in the specialties of orthopaedic surgery, general surgery and interventional

Subsidies to target specialist outreach services into more remote locations: a national cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

2017-07-01

Objective Targeting rural outreach services to areas of highest relative need is challenging because of the higher costs it imposes on health workers to travel longer distances. This paper studied whether subsidies have the potential to support the provision of specialist outreach services into more remote locations. Methods National data about subsidies for medical specialist outreach providers as part of the Wave 7 Medicine in Australia: Balancing Employment and Life (MABEL) Survey in 2014. Results Nearly half received subsidies: 19% (n=110) from a formal policy, namely the Australian Government Rural Health Outreach Fund (RHOF), and 27% (n=154) from other sources. Subsidised specialists travelled for longer and visited more remote locations relative to the non-subsidised group. In addition, compared with non-subsidised specialists, RHOF-subsidised specialists worked in priority areas and provided equally regular services they intended to continue, despite visiting more remote locations. Conclusion This suggests the RHOF, although limited to one in five specialist outreach providers, is important to increase targeted and stable outreach services in areas of highest relative need. Other subsidies also play a role in facilitating remote service distribution, but may need to be more structured to promote regular, sustained outreach practice. What is known about this topic? There are no studies describing subsidies for specialist doctors to undertake rural outreach work and whether subsidies, including formal and structured subsidies via the Australian Government RHOF, support targeted outreach services compared with no financial support. What does this paper add? Using national data from Australia, we describe subsidisation among specialist outreach providers and show that specialists subsidised via the RHOF or another source are more likely to provide remote outreach services. What are the implications for practitioners? Subsidised specialist outreach providers are

Introducing the National Library for Health Skin Conditions Specialist Library.

PubMed

Grindlay, Douglas; Boulos, Maged N Kamel; Williams, Hywel C

2005-04-26

This paper introduces the new National Library for Health Skin Conditions Specialist Library http://www.library.nhs.uk/skin. The aims, scope and audience of the new NLH Skin Conditions Specialist Library, and the composition and functions of its core Project Team, Editorial Team and Stakeholders Group are described. The Library's collection building strategy, resource and information types, editorial policies, quality checklist, taxonomy for content indexing, organisation and navigation, and user interface are all presented in detail. The paper also explores the expected impact and utility of the new Library, as well as some possible future directions for further development. The Skin Conditions Specialist Library is not just another new Web site that dermatologists might want to add to their Internet favourites then forget about it. It is intended to be a practical, "one-stop shop" dermatology information service for everyday practical use, offering high quality, up-to-date resources, and adopting robust evidence-based and knowledge management approaches.

Introducing the National Library for Health Skin Conditions Specialist Library

PubMed Central

Grindlay, Douglas; Boulos, Maged N Kamel; Williams, Hywel C

2005-01-01

Background This paper introduces the new National Library for Health Skin Conditions Specialist Library . Description The aims, scope and audience of the new NLH Skin Conditions Specialist Library, and the composition and functions of its core Project Team, Editorial Team and Stakeholders Group are described. The Library's collection building strategy, resource and information types, editorial policies, quality checklist, taxonomy for content indexing, organisation and navigation, and user interface are all presented in detail. The paper also explores the expected impact and utility of the new Library, as well as some possible future directions for further development. Conclusion The Skin Conditions Specialist Library is not just another new Web site that dermatologists might want to add to their Internet favourites then forget about it. It is intended to be a practical, "one-stop shop" dermatology information service for everyday practical use, offering high quality, up-to-date resources, and adopting robust evidence-based and knowledge management approaches. PMID:15854224

Orienting and Onboarding Clinical Nurse Specialists: A Process Improvement Project.

PubMed

Garcia, Mayra G; Watt, Jennifer L; Falder-Saeed, Karie; Lewis, Brennan; Patton, Lindsey

Clinical nurse specialists (CNSs) have a unique advanced practice role. This article describes a process useful in establishing a comprehensive orientation and onboarding program for a newly hired CNS. The project team used the National Association of Clinical Nurse Specialists core competencies as a guide to construct a process for effectively onboarding and orienting newly hired CNSs. Standardized documents were created for the orientation process including a competency checklist, needs assessment template, and professional evaluation goals. In addition, other documents were revised to streamline the orientation process. Standardizing the onboarding and orientation process has demonstrated favorable results. As of 2016, 3 CNSs have successfully been oriented and onboarded using the new process. Unique healthcare roles require special focus when onboarding and orienting into a healthcare system. The use of the National Association of Clinical Nurse Specialists core competencies guided the project in establishing a successful orientation and onboarding process for newly hired CNSs.

Use of buprenorphine for addiction treatment: perspectives of addiction specialists and general psychiatrists.

PubMed

Thomas, Cindy Parks; Reif, Sharon; Haq, Sayeda; Wallack, Stanley S; Hoyt, Alexander; Ritter, Grant A

2008-08-01

In 2002 buprenorphine (Suboxone or Subutex) was approved by the U.S. Food and Drug Administration for office-based treatment of opioid addiction. The goal of office-based pharmacotherapy is to bring more opiate-dependent people into treatment and to have more physicians address this problem. This study examined prescribing practices for buprenorphine, including facilitators and barriers, and the organizational settings that facilitate its being incorporated into treatment. Addiction specialists and other psychiatrists in four market areas were surveyed by mail and Internet in fall 2005 to examine prescribing practices for buprenorphine. Respondents included 271 addiction specialists (72% response rate) and 224 psychiatrists who were not listed as addiction specialists but who had patients with addictions in their practice (57% response rate). Three years after approval of buprenorphine for office-based addiction treatment, nearly 90% of addiction specialists had been approved to prescribe it and two-thirds treated patients with buprenorphine. However, fewer than 10% of non-addiction specialist psychiatrists prescribed it. Regression-adjusted factors predicting prescribing of buprenorphine included support of training and use of buprenorphine by the physician's main affiliated organization, less time in general psychiatry compared with addictions treatment, more time in group practice rather than solo, ten or more opiate-dependent patients, belief that drugs play a large role in addiction treatment, and patient demand. Office-based pharmacotherapy offers a promising path to improved access to addictions treatment, but prescribing has expanded little beyond the addiction specialist community.

The specialist physician’s approach to rheumatoid arthritis in South Africa

PubMed Central

Bester, Frederik C. J.; Bosch, Fredricka J.; van Rensburg, Barend J. Jansen

2016-01-01

Rheumatoid arthritis (RA) is expected to increase in Africa and South Africa. Due to the low numbers of rheumatologists in South Africa, specialist physicians also have to care for patients with RA. Furthermore several new developments have taken place in recent years which improved the management and outcome of RA. Classification criteria were updated, assessment follow-up tools were refined and above all, several new biological disease-modifying anti-rheumatic drugs were developed. Therefore it is imperative for specialist physicians to update themselves with the newest developments in the management of RA. This article provides an overview of the newest developments in the management of RA in the South African context. This approach may well apply to countries with similar specialist to patient ratios and disease profiles. PMID:26932399

Self-assembled nanostructured resistive switching memory devices fabricated by templated bottom-up growth

PubMed Central

Song, Ji-Min; Lee, Jang-Sik

2016-01-01

Metal-oxide-based resistive switching memory device has been studied intensively due to its potential to satisfy the requirements of next-generation memory devices. Active research has been done on the materials and device structures of resistive switching memory devices that meet the requirements of high density, fast switching speed, and reliable data storage. In this study, resistive switching memory devices were fabricated with nano-template-assisted bottom up growth. The electrochemical deposition was adopted to achieve the bottom-up growth of nickel nanodot electrodes. Nickel oxide layer was formed by oxygen plasma treatment of nickel nanodots at low temperature. The structures of fabricated nanoscale memory devices were analyzed with scanning electron microscope and atomic force microscope (AFM). The electrical characteristics of the devices were directly measured using conductive AFM. This work demonstrates the fabrication of resistive switching memory devices using self-assembled nanoscale masks and nanomateirals growth from bottom-up electrochemical deposition. PMID:26739122

How medical specialists appraise three controversial health innovations: scientific, clinical and social arguments.

PubMed

Lehoux, Pascale; Denis, Jean-Louis; Rock, Melanie; Hivon, Myriam; Tailliez, Stephanie

2010-01-01

Medical specialists play a pivotal role in health innovation evaluation and policy making. Their influence derives not only from their expertise, but also from their social status and the power of their professional organisations. Little is known, however, about how medical specialists determine what makes a health innovation desirable and why. Our qualitative study investigated the views of 28 medical specialists and experts from Quebec and Ontario (Canada) on three controversial innovations: electroconvulsive therapy, prostate-specific antigen screening and prenatal screening for Down's syndrome. Our findings indicate that the scientific, clinical and social arguments of medical specialists combine to create a relatively consistent narrative for each innovation. Our comparative analysis suggests that these narratives bring about a 'soft' resolution to controversies, which relies on a more or less tacit understanding of the social desirability of innovations and which sets the stage for their routinisation. Such an unpacking of medical specialists' arguments both for and against new technologies is needed because such arguments may easily be considered authoritative and because there are few forums for debating the social desirability of innovations not generally deemed to be highly controversial.

Tests and measures used by specialist physical therapists when examining patients with stroke.

PubMed

Andrews, A Williams; Folger, Stephen E; Norbet, Shannon E; Swift, Lindsay C

2008-09-01

Examination procedures preferred by physical therapists have not been documented either specifically or comprehensively. The purpose of this study was to determine which tests and measures are used most frequently by specialists in the examination of adults with stroke. Physical therapy specialists were identified as having geriatric or neurologic certification through the American Board of Physical Therapy Specialties. A request to participate in a Web-based survey was sent to 471 individuals in the American Physical Therapy Association's Directory of Certified Specialists. A comprehensive list of tests and measures was first derived from the Interactive Guide to Physical Therapist Practice. The list was finalized based on several exclusion criteria and the results of a pilot study. Subjects rated the frequency of use of 294 tests and measures with patients post-stroke on a Likert scale. The survey response rate was 31.7% (n = 128). The 50 most frequently used tests and measures were identified. The results of this study do not identify the tests and measures that clinicians should use, only those that the specialists use. Nevertheless, clinicians may want to consider tests and measurements frequently used by specialists when examining adults with stroke.

Protecting an endangered species: the contribution and constraints of nurses working in a specialist role.

PubMed

McCorkell, Gillian; Brown, Geraldine; Michaelides, Bernie; Coates, Vivien

2015-03-01

The project aims to assess current specialist practice in relation to the new and ever-changing healthcare climate and explore some of the issues that specialist nurses encounter. The current financial recession is driving a range of economic policy changes and consequently service provision, in particular the work and impact of nurses working in a specialist role, being examined. This has resulted in many specialist nurses feeling very vulnerable. A cross sectional survey was completed by nurses working in specialist roles (n = 96) in a large health and social care setting in the United Kingdom. A response rate of 62% was achieved: 44% provide nurse led clinics and 42% are nurse prescribers. The mean length of time qualified as a registered nurse was 27 years. Less than a third felt that the current computer system for activity recording reflected their current workload and 65% needed administrative support. This study demonstrates the insufficient resources available to specialist nurses resulting in inappropriate but necessary, use of time and restricted opportunities for learning and development. © 2013 John Wiley & Sons Ltd.

STS-101 crew members meet family and friends

NASA Technical Reports Server (NTRS)

2000-01-01

A light-hearted moment during a meeting of the STS-101 crew with family and friends at Launch Pad 39A. From left, Commander James D. Halsell Jr., Mission Specialist Mary Ellen Weber and Pilot Scott J. Horowitz. Mission STS-101 will take the crew to the International Space Station to deliver logistics and supplies, plus prepare the Station for the arrival of the Zvezda Service Module, expected to be launched by Russia in July 2000. The crew will conduct one space walk to perform maintenance on the Space Station as well. This will be the third assembly flight for the Space Station. Launch is targeted for April 24 at about 4:15 p.m. EDT from Launch Pad 39A.

E-learning as a technological tool to meet the requirements of occupational standards in training of it specialists

NASA Astrophysics Data System (ADS)

Tokareva, N. A.; Tyatyushkina, O. Y.; Cheremisina, E. N.

2016-09-01

We discuss issues of updating educational programs to meet requirements of the labor market and occupational standards of IT industry. We suggest the technology of e-learning that utilizes an open educational resource to provide the employers' participation in the development of educational content and the intensification of practical training.

Dancing in a Minefield: An Analysis of Turnaround Specialists in Arizona Schools

ERIC Educational Resources Information Center

McMillie, Kyann L.

2010-01-01

In 2008, educational leaders from the Arizona Department of Education (ADE) assigned a group of turnaround specialists to work in four failing public schools in a large, urban school district in Phoenix, Arizona in hopes of improving those schools. The utilization of turnaround specialists in failing schools was Arizona's method of enacting…

STS-26 Mission Specialist (MS) Hilmers prepares meal on OV-103's middeck

NASA Image and Video Library

1988-10-03

STS026-06-033 (5 Oct 1988) --- Astronaut David C. Hilmers, STS-26 mission specialist, reads teleprinted message which has been clipped to stowage locker doors on the middeck. Food, a galley and various experiments surround the mission specialist.

Silicon photonics and challenges for fabrication

NASA Astrophysics Data System (ADS)

Feilchenfeld, N. B.; Nummy, K.; Barwicz, T.; Gill, D.; Kiewra, E.; Leidy, R.; Orcutt, J. S.; Rosenberg, J.; Stricker, A. D.; Whiting, C.; Ayala, J.; Cucci, B.; Dang, D.; Doan, T.; Ghosal, M.; Khater, M.; McLean, K.; Porth, B.; Sowinski, Z.; Willets, C.; Xiong, C.; Yu, C.; Yum, S.; Giewont, K.; Green, W. M. J.

2017-03-01

Silicon photonics is rapidly becoming the key enabler for meeting the future data speed and volume required by the Internet of Things. A stable manufacturing process is needed to deliver cost and yield expectations to the technology marketplace. We present the key challenges and technical results from both 200mm and 300mm facilities for a silicon photonics fabrication process which includes monolithic integration with CMOS. This includes waveguide patterning, optical proximity correction for photonic devices, silicon thickness uniformity and thick material patterning for passive fiber to waveguide alignment. The device and process metrics show that the transfer of the silicon photonics process from 200mm to 300mm will provide a stable high volume manufacturing platform for silicon photonics designs.

Clinical nurse specialist education: actualizing the systems leadership competency.

PubMed

Thompson, Cathy J; Nelson-Marten, Paula

2011-01-01

The purpose of this article was to show how sequenced educational strategies aid in the acquisition of systems leadership and change agent skills, as well as other essential skills for professional clinical nurse specialist (CNS) practice. Clinical nurse specialist education offers the graduate student both didactic and clinical experiences to help the student transition into the CNS role. Clinical nurse specialist faculty have a responsibility to prepare students for the realities of advanced practice. Systems leadership is an integral competency of CNS practice. The contemporary CNS is to be a leader in the translation of evidence into practice. To assist students to acquire this competency, all CNS students are expected to use research and other sources of evidence to identify, design, implement, and evaluate a specific practice change. Anecdotal comments from students completing the projects are offered. Student projects have been focused in acute and critical care, palliative care, and adult/gerontologic health clinical settings; community outreach has been the focus of a few change projects. Examples of student projects related to the systems leadership competency and correlated to the spheres of influence impacted are presented.

Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study.

PubMed

O'Sullivan, Belinda G; McGrail, Matthew R; Joyce, Catherine M; Stoelwinder, Johannes

2016-06-01

Objective This paper describes the service distribution and models of rural outreach by specialist doctors living in metropolitan or rural locations. Methods The present study was a national cross-sectional study of 902 specialist doctors providing 1401 rural outreach services in the Medicine in Australia: Balancing Employment and Life study, 2008. Five mutually exclusive models of rural outreach were studied. Results Nearly half of the outreach services (585/1401; 42%) were provided to outer regional or remote locations, most (58%) by metropolitan specialists. The most common model of outreach was drive-in, drive-out (379/902; 42%). In comparison, metropolitan-based specialists were less likely to provide hub-and-spoke models of service (odd ratio (OR) 0.31; 95% confidence interval (CI) 0.21-0.46) and more likely to provide fly-in, fly-out models of service (OR 4.15; 95% CI 2.32-7.42). The distance travelled by metropolitan specialists was not affected by working in the public or private sector. However, rural-based specialists were more likely to provide services to nearby towns if they worked privately. Conclusions Service distribution and models of outreach vary according to where specialists live as well as the practice sector of rural specialists. Multilevel policy and planning is needed to manage the risks and benefits of different service patterns by metropolitan and rural specialists so as to promote integrated and accessible services. What is known about this topic? There are numerous case studies describing outreach by specialist doctors. However, there is no systematic evidence describing the distribution of rural outreach services and models of outreach by specialists living in different locations and the broad-level factors that affect this. What does this paper add? The present study provides the first description of outreach service distribution and models of rural outreach by specialist doctors living in rural versus metropolitan areas. It shows

Entrustable professional activity (EPA) reshapes the practice of specialist training.

PubMed

Niemi-Murola, Leila

In addition to medical expertise, competence-based medical training comprises communication and collaboration skills, professionalism, and leadership skills. Continuous feedback is essential for learning and development, and feedback only from the medical specialist examination taken in the end of training does not ensure thorough specialist training. Entrustable professional activity (EPA) is a unit of professional practice, defined as tasks or responsibilities typical of the specialty. EPA translates competence-based training into manageable and meaningful entities and provides tools for the evaluation of medical competence.

STS-47 Payload Specialist Mohri during Homestead water survival training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Spacelab Japan (SLJ) Payload Specialist Mamoru Mohri participates in water survival training exercises at Homestead Air Force Base, Florida. Mohri ignites a flare used to find assistance during an emergency as training personnel look on. The flare familiarization was part of an overall course on water survival, attended by STS-47 prime and alternate payload specialists shortly after they were announced for the scheduled summer of 1992 SLJ mission. Mohri represents the National Space Development Agency of Japan (NASDA).

Source Dependence and Story Production: A Comparison of Religion News Coverage by Specialists and Non-specialists at Three Newspapers.

ERIC Educational Resources Information Center

Buddenbaum, Judith M.

A study was conducted to compare the news reporting of religion specialists and nonspecialists at three major metropolitan newspapers. Representing different news policies and structural constraints, 1,164 religion news items from the "New York Times," Minneapolis "Star," and the Richmond (Virginia) "Times-Dispatch"…

Loss to specialist follow-up in congenital heart disease; out of sight, out of mind

PubMed Central

Wray, Jo; Frigiola, Alessandra; Bull, Catherine

2013-01-01

Objective To evaluate the scale and clinical importance of loss to follow-up of past patients with serious congenital heart disease, using a common malformation as an example. To better understand the antecedents of loss to specialist follow-up and patients’ attitudes to returning. Design Cohort study using NHS number functionality. Content and thematic analysis of telephone interviews of subset contacted after loss to follow-up. Patients, intervention and setting Longitudinal follow-up of complete consecutive list of all 1085 UK patients with repair of tetralogy of Fallot from single institution 1964–2009. Main outcome measures Survival, freedom from late pulmonary valve replacement, loss to specialist follow-up, shortfall in late surgical revisions related to loss to follow-up. Patients’ narrative about loss to follow-up. Results 216 (24%) of patients known to be currently alive appear not to be registered with specialist clinics; some are seen in general cardiology clinics. Their median age is 32 years and median duration of loss to follow-up is 22 years; most had been lost before Adult Congenital services had been consolidated in their present form. 48% of the late deaths to date have occurred in patients not under specialist follow-up. None of those lost to specialist follow-up has had secondary pulmonary valve replacement while 188 patients under specialist care have. Patients lost to specialist follow-up who were contacted by telephone had no knowledge of its availability. Conclusions Loss to specialist follow-up, typically originating many years ago, impacts patient management. PMID:23257171

An Analysis of the Alteration Specialist Occupation.

ERIC Educational Resources Information Center

Buerkel, Elaine; Rehling, Joseph H.

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the textile service occupation. The industry needs properly trained alteration specialists, bushelmen and dressmakers, in the repairing, remodeling, altering or renovating of garments. Their personal…

Readying the Health Education Specialist for Emergencies

ERIC Educational Resources Information Center

Geiger, Brian F.; Firsing, Stephen L., III; Beric, Bojana; Rodgers, Joel B.

2013-01-01

This article provides a resourceful guide for the health education specialist to improve emergency management knowledge and skills specific to their setting, including training and preparing for emergencies and providing adequate support to students, clients, and colleagues. Five steps guide competent health education practice before, during, and…

Fabrication and radio frequency test of large-area MgB 2 films on niobium substrates

DOE PAGES

Ni, Zhimao; Guo, Xin; Welander, Paul B.; ...

2017-01-19

Magnesium diboride (MgB 2) is a promising candidate material for superconducting radio frequency (RF) cavities because of its higher transition temperature and critical field compared with niobium. To meet the demand of RF test devices, the fabrication of large-area MgB 2 films on metal substrates is needed. Here, in this work, high quality MgB 2 films with 50 mm diameter were fabricated on niobium by using an improved HPCVD system at Peking University, and RF tests were carried out at SLAC National Accelerator Laboratory. The transition temperature is approximately 39.6 K and the RF surface resistance is about 120 μΩmore » at 4 K and 11.4 GHz. Finally, the fabrication processes, surface morphology, DC superconducting properties and RF tests of these large-area MgB 2 films are presented.« less

Fabrication and radio frequency test of large-area MgB 2 films on niobium substrates

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

Ni, Zhimao; Guo, Xin; Welander, Paul B.

Magnesium diboride (MgB 2) is a promising candidate material for superconducting radio frequency (RF) cavities because of its higher transition temperature and critical field compared with niobium. To meet the demand of RF test devices, the fabrication of large-area MgB 2 films on metal substrates is needed. Here, in this work, high quality MgB 2 films with 50 mm diameter were fabricated on niobium by using an improved HPCVD system at Peking University, and RF tests were carried out at SLAC National Accelerator Laboratory. The transition temperature is approximately 39.6 K and the RF surface resistance is about 120 μΩmore » at 4 K and 11.4 GHz. Finally, the fabrication processes, surface morphology, DC superconducting properties and RF tests of these large-area MgB 2 films are presented.« less

38 CFR 17.142 - Authority to approve sharing agreements, contracts for scarce medical specialist services and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... sharing agreements, contracts for scarce medical specialist services and contracts for other medical... medical specialist services and contracts for other medical services. The Under Secretary for Health is... specialist services at Department of Veterans Affairs health care facilities (including, but not limited to...

Fabrication and testing of 4.2m off-axis aspheric primary mirror of Daniel K. Inouye Solar Telescope

NASA Astrophysics Data System (ADS)

Oh, Chang Jin; Lowman, Andrew E.; Smith, Greg A.; Su, Peng; Huang, Run; Su, Tianquan; Kim, Daewook; Zhao, Chunyu; Zhou, Ping; Burge, James H.

2016-07-01

Daniel K. Inouye Solar Telescope (formerly known as Advanced Technology Solar Telescope) will be the largest optical solar telescope ever built to provide greatly improved image, spatial and spectral resolution and to collect sufficient light flux of Sun. To meet the requirements of the telescope the design adopted a 4m aperture off-axis parabolic primary mirror with challenging specifications of the surface quality including the surface figure, irregularity and BRDF. The mirror has been completed at the College of Optical Sciences in the University of Arizona and it meets every aspect of requirement with margin. In fact this mirror may be the smoothest large mirror ever made. This paper presents the detail fabrication process and metrology applied to the mirror from the grinding to finish, that include extremely stable hydraulic support, IR and Visible deflectometry, Interferometry and Computer Controlled fabrication process developed at the University of Arizona.

Fostering a "Feeling of Worth" Among Vulnerable HIV Populations: The Role of Linkage to Care Specialists.

PubMed

Broaddus, Michelle R; Owczarzak, Jill; Schumann, Casey; Koester, Kimberly A

2017-10-01

To address barriers to adequate engagement in medical care among people living with HIV, Wisconsin's AIDS/HIV Program created a new position, the Linkage to Care (LTC) Specialist. Specialists provide intensive, short-term case management and patient navigation services for small caseloads of individuals at high risk of disengaging with medical care. Clients are eligible if they are newly diagnosed with HIV or new to medical care, recently released from incarceration, recently out of care, nonadherent to scheduled medical care visits, or have detectable viral load while in care. Interviews with 30 clients of Specialists were conducted to understand experiences with the program and medical care. Common themes included the ability of Specialists to navigate complex systems of care and support services, the unique role Specialists played in their clients' lives, and the challenges of transitioning out of the program. Although the primary goal of Specialists is to address barriers to medical care, they often adopted a holistic approach that also included housing, financial assistance, and other social determinants of health. Descriptions of the Specialist's role in implementation manuals focus on their functional roles and the services provided. However, clients often discussed the emotional support they received, especially for clients without strong social support networks. Many clients also desired an ongoing relationship with their Specialists even after discharge, but had been able to establish independence and self-efficacy. The LTC Specialists are resource-intensive considering their small caseloads, but fill an important gap in existing, often overtaxed case management systems.

Welded-woven fabrics for use as synthetic, minimally invasive orthopaedic implants

NASA Astrophysics Data System (ADS)

Rodts, Timothy W.

The treatment of osteoarthritis in healthcare today focuses on minimizing pain and retaining mobility. Osteoarthritis of the knee is a common disease and known to be associated with traumatic injuries, among other factors. An identified trend is that patients are younger and have expectations of life with the preservation of an active lifestyle. As a result, great strain is placed on the available offerings of healthcare professionals and device manufacturers alike. This results in numerous design challenges for managing pain and disease over an extended period of time. The available treatments are being extended into younger populations, which increasingly suffer traumatic knee injuries. However, these patients are not good candidates for total joint replacement. A common problem for young patients is localized cartilage damage. This can heal, but often results in a painful condition that requires intervention. A welded-woven three-dimensional polymer fabric was developed to mimic the properties of articular cartilage. A process for the laser welding reinforcement of the surface layers of three-dimensional fabrics was investigated. Confined compression creep and pin-on-disc wear studies were conducted to characterize the contribution of the surface welding reinforcement. All materials used in the studies have previously been used in orthopaedic devices or meet the requirements for United States Pharmacopeial Convention (USP) Class VI biocompatibility approval. The compressive behavior of three-dimensional fabrics was tailored by the inclusion of surface welds. The compressive properties of the welded-woven fabrics were shown to better approximate articular cartilage compressive properties than conventional woven materials. The wear performance was benchmarked against identical fabrics without welding reinforcement. The wear rates were significantly reduced and the lifespan of the fabrics was markedly improved due to surface welding. Welding reinforcement offers a

Fabrication of superhydrophobic cotton fabrics using crosslinking polymerization method

NASA Astrophysics Data System (ADS)

Jiang, Bin; Chen, Zhenxing; Sun, Yongli; Yang, Huawei; Zhang, Hongjie; Dou, Haozhen; Zhang, Luhong

2018-05-01

With the aim of removing and recycling oil and organic solvent from water, a facile and low-cost crosslinking polymerization method was first applied on surface modification of cotton fabrics for water/oil separation. Micro-nano hierarchical rough structure was constructed by triethylenetetramine (TETA) and trimesoyl chloride (TMC) that formed a polymeric layer on the surface of the fabric and anchored Al2O3 nanoparticles firmly between the fabric surface and the polymer layer. Superhydrophobic property was further obtained through self-assembly grafting of hydrophobic groups on the rough surface. The as-prepared cotton fabric exhibited superoleophilicity in atmosphere and superhydrophobicity both in atmosphere and under oil with the water contact angle of 153° and 152° respectively. Water/oil separation test showed that the as-prepared cotton fabric can handle with various oil-water mixtures with a high separation efficiency over 99%. More importantly, the separation efficiency remained above 98% over 20 cycles of reusing without losing its superhydrophobicity which demonstrated excellent reusability in oil/water separation process. Moreover, the as-prepared cotton fabric possessed good contamination resistance ability and self-cleaning property. Simulation washing process test showed the superhydrophobic cotton fabric maintained high value of water contact angle above 150° after 100 times washing, indicating great stability and durability. In summary, this work provides a brand-new way to surface modification of cotton fabric and makes it a promising candidate material for oil/water separation.

Post-Baccalaureate Laboratory Specialist Certifications and Master’s Degrees in Laboratory Medicine

PubMed Central

Johnson, Susan T.

2013-01-01

Opportunities to advance one’s knowledge and position are available within the clinical laboratory arena. By obtaining a specialist credential in chemistry, hematology or microbiology, a laboratorian has demonstrated advance knowledge and ability in their respective discipline. These specialist certifications open doors within and outside the laboratory profession and may lead to promotion. The specialist in blood banking credential is unique in that accredited training programs are available, some of which are affiliated with universities and graduate credit is granted for program completion. Other avenues available include pathologist assistants programs, diplomats in laboratory management and Master of Science degrees in clinical laboratory science. There are a number of choices available to achieve your professional goal. PMID:27683434

Fabrication of Pop-up Detector Arrays on Si Wafers

NASA Technical Reports Server (NTRS)

Li, Mary J.; Allen, Christine A.; Gordon, Scott A.; Kuhn, Jonathan L.; Mott, David B.; Stahle, Caroline K.; Wang, Liqin L.

1999-01-01

High sensitivity is a basic requirement for a new generation of thermal detectors. To meet the requirement, close-packed, two-dimensional silicon detector arrays have been developed in NASA Goddard Space Flight Center. The goal of the task is to fabricate detector arrays configured with thermal detectors such as infrared bolometers and x-ray calorimeters to use in space fliGht missions. This paper focuses on the fabrication and the mechanical testing of detector arrays in a 0.2 mm pixel size, the smallest pop-up detectors being developed so far. These array structures, nicknamed "PUDS" for "Pop-Up Detectors", are fabricated on I pm thick, single-crystal, silicon membranes. Their designs have been refined so we can utilize the flexibility of thin silicon films by actually folding the silicon membranes to 90 degrees in order to obtain close-packed two-dimensional arrays. The PUD elements consist of a detector platform and two legs for mechanical support while also serving as electrical and thermal paths. Torsion bars and cantilevers connecting the detector platform to the legs provide additional flexures for strain relief. Using micro-electromechanical structure (MEMS) fabrication techniques, including photolithography, anisotropic chemical etching, reactive-ion etching, and laser dicing, we have fabricated PLTD detector arrays of fourteen designs with a variation of four parameters including cantilever length, torsion bar length and width, and leg length. Folding tests were conducted to test mechanical stress distribution for the array structures. We obtained folding yields and selected optimum design parameters to reach minimal stress levels. Computer simulation was also employed to verify mechanical behaviors of PUDs in the folding process. In addition, scanning electron microscopy was utilized to examine the flatness of detectors and the alignment of detector pixels in arrays. The fabrication of thermistors and heaters on the pop-up detectors is under way

Modelling invasion for a habitat generalist and a specialist plant species

USGS Publications Warehouse

Evangelista, P.H.; Kumar, S.; Stohlgren, T.J.; Jarnevich, C.S.; Crall, A.W.; Norman, J. B.; Barnett, D.T.

2008-01-01

Predicting suitable habitat and the potential distribution of invasive species is a high priority for resource managers and systems ecologists. Most models are designed to identify habitat characteristics that define the ecological niche of a species with little consideration to individual species' traits. We tested five commonly used modelling methods on two invasive plant species, the habitat generalist Bromus tectorum and habitat specialist Tamarix chinensis, to compare model performances, evaluate predictability, and relate results to distribution traits associated with each species. Most of the tested models performed similarly for each species; however, the generalist species proved to be more difficult to predict than the specialist species. The highest area under the receiver-operating characteristic curve values with independent validation data sets of B. tectorum and T. chinensis was 0.503 and 0.885, respectively. Similarly, a confusion matrix for B. tectorum had the highest overall accuracy of 55%, while the overall accuracy for T. chinensis was 85%. Models for the generalist species had varying performances, poor evaluations, and inconsistent results. This may be a result of a generalist's capability to persist in a wide range of environmental conditions that are not easily defined by the data, independent variables or model design. Models for the specialist species had consistently strong performances, high evaluations, and similar results among different model applications. This is likely a consequence of the specialist's requirement for explicit environmental resources and ecological barriers that are easily defined by predictive models. Although defining new invaders as generalist or specialist species can be challenging, model performances and evaluations may provide valuable information on a species' potential invasiveness.

Didactical determinants use of information and communication technology in process of training of future specialists.

PubMed

Palamar, Borys I; Vaskivska, Halyna O; Palamar, Svitlana P

In the article the author touches upon the subject of significance of computer equipment for organization of cooperation of professor and future specialists. Such subject-subject interaction may be directed to forming of professional skills of future specialists. By using information and communication technologies in education system range of didactic tasks can be solved. Improving of process of teaching of subjects in high school, self-learning future specialists, motivating to learning and self-learning, the development of reflection in the learning process. The authors considers computer equipment as instrument for development of intellectual skills, potential and willingness of future specialists to solve communicative and communication tasks and problems on the creative basis. Based on results of researches the author comes to certain conclusions about the effectiveness of usage of computer technologies in process of teaching future specialists and their self-learning. Improper supplying of high schools with computer equipment, lack of appropriate educational programs, professors' teachers' poor knowledge and usage of computers have negative impact on organization of process of teaching disciplines in high schools. Computer equipment and ICT in general are the instruments of development of intellectual skills, potential and willingness of future specialists to solve communicative and communication tasks and problems. So, the formation of psychosocial environment of development of future specialist is multifaceted, complex and didactically important issue.

Challenging the 'view from nowhere': citizen reflections on specialist expertise in a deliberative process.

PubMed

Davies, Gail; Burgess, Jacquelin

2004-12-01

This paper presents analysis of citizen encounters with specialists in a deliberative process, called Deliberative Mapping, which explored options for addressing the shortage of organs for transplantation in the UK. There is a rich theoretical literature about the extent to which citizens are competent to question the knowledge claims of specialists in complex decision-making processes, suggesting the trustworthiness of scientific expertise will depend on the qualities of social interaction in face-to-face dialogue, but little empirical analysis of specific encounters. This paper presents evidence of how citizens located specialist expertise in making judgements about the legitimacy and credibility of specialist knowledge claims, in ways that reflect differences in epistemic procedures valued by the panels of men and women in this process.

Insideness and Outsideness: An Autoethnography of a Primary Physical Education Specialist Teacher

ERIC Educational Resources Information Center

Brooks, Caroline; Thompson, Maree Dinan

2015-01-01

The purpose of this study is to provide an authentic and legitimate voice to the physical education (PE) specialist teacher in the primary school and to give an insight into professional knowledge. An autoethnographic approach has been used to invite readers to enter my world of the primary PE specialist teacher and observe and respond to its…

Learning Mathematics for Teaching Mathematics: Non-Specialist Teachers' Mathematics Teacher Identity

ERIC Educational Resources Information Center

Crisan, Cosette; Rodd, Melissa

2017-01-01

A non-specialist teacher of mathematics is a school teacher who qualified to teach in a subject other than mathematics yet teaches mathematics to students in secondary school. There is an emerging interest internationally in this population, a brief report of which is given in the paper. Because of concerns about the quality of non-specialists'…

The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services.

PubMed

Riordan, Fiona; McHugh, Sheena M; Murphy, Katie; Barrett, Julie; Kearney, Patricia M

2017-08-11

International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. A cross-sectional survey of hospital and community-based DNS in Ireland. Between September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave. The response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration. Delivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

Adoption, implementation and prioritization of specialist outreach policy in Australia: a national perspective.

PubMed

O'Sullivan, Belinda G; Joyce, Catherine M; McGrail, Matthew R

2014-07-01

The World Health Organization has endorsed the use of outreach to promote: efficient redeployment of the health-care workforce; continuity of care at the local level; and professional support for local, rural, health-care workers. Australia is the only country that has had, since 2000, a sustained national policy on outreach for subsidizing medical specialist outreach to rural areas. This paper describes the adoption, implementation and prioritization of a national specialist outreach policy in Australia. Adoption of the national policy followed a long history of successful outreach, largely driven by the professional interest and personal commitment of the workforce. Initially the policy supported only new outreach services but concerns about the sustainability of existing services resulted in eligibility for funding being extended to all specialist services. The costs of travel, travel time, accommodation, professional support, staff relief at specialists' primary practices and equipment hire were subsidized. Over time, a national political commitment to the equitable treatment of indigenous people resulted in more targeted support for outreach in remote areas. Current priorities are: (i) establishing team-based outreach services; (ii) improving local staff's skills; (iii) achieving local coordination; and (iv) conducting a nationally consistent needs assessment. The absence of subsidies for specialists' clinical work can discourage private specialists from providing services in remote areas where clinical throughput is low. To be successful, outreach policy must harmonize with the interests of the workforce and support professional autonomy. Internationally, the development of outreach policy must take account of the local pay and practice conditions of health workers.

Specialist Physicians' Attitudes and Practice Patterns Regarding Disclosure of Pre-referral Medical Errors.

PubMed

Dossett, Lesly A; Kauffmann, Rondi M; Lee, Jay S; Singh, Harkamal; Lee, M Catherine; Morris, Arden M; Jagsi, Reshma; Quinn, Gwendolyn P; Dimick, Justin B

2018-06-01

Our objective was to determine specialist physicians' attitudes and practices regarding disclosure of pre-referral errors. Physicians are encouraged to disclose their own errors to patients. However, no clear professional norms exist regarding disclosure when physicians discover errors in diagnosis or treatment that occurred at other institutions before referral. We conducted semistructured interviews of cancer specialists from 2 National Cancer Institute-designated Cancer Centers. We purposively sampled specialists by discipline, sex, and experience-level who self-described a >50% reliance on external referrals (n = 30). Thematic analysis of verbatim interview transcripts was performed to determine physician attitudes regarding disclosure of pre-referral medical errors; whether and how physicians disclose these errors; and barriers to providing full disclosure. Participants described their experiences identifying different types of pre-referral errors including errors of diagnosis, staging and treatment resulting in adverse events ranging from decreased quality of life to premature death. The majority of specialists expressed the belief that disclosure provided no benefit to patients, and might unnecessarily add to their anxiety about their diagnoses or prognoses. Specialists had varying practices of disclosure including none, non-verbal, partial, event-dependent, and full disclosure. They identified a number of barriers to disclosure, including medicolegal implications and damage to referral relationships, the profession's reputation, and to patient-physician relationships. Specialist physicians identify pre-referral errors but struggle with whether and how to provide disclosure, even when clinical circumstances force disclosure. Education- or communication-based interventions that overcome barriers to disclosing pre-referral errors warrant development.

STS-95 Payload Specialist Glenn participates in a media briefing before returning to JSC

NASA Technical Reports Server (NTRS)

1998-01-01

STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, participates in a media briefing at the Kennedy Space Center Press Site Auditorium before returning to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. Also participating in the briefing were the other STS-95 crew members: Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist and Payload Commander Stephen K. Robinson; Mission Specialist Scott E. Parazynski; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process.

Fabrication of Low-Noise TES Arrays for the SAFARI Instrument on SPICA

NASA Astrophysics Data System (ADS)

Ridder, M. L.; Khosropanah, P.; Hijmering, R. A.; Suzuki, T.; Bruijn, M. P.; Hoevers, H. F. C.; Gao, J. R.; Zuiddam, M. R.

2016-07-01

Ultra-low-noise transition edge sensors (TES) with noise equivalent power lower than 2 × 10^{-19} W/Hz^{1/2 } have been fabricated by SRON, which meet the sensitivity requirements for the far-infrared SAFARI instrument on space infrared telescope for cosmology and astrophysics. Our TES detector is based on a titanium/gold (Ti/Au) thermistor on a silicon nitride (SiN) island. The island is thermally linked with SiN legs to a silicon support structure at the bath temperature. The SiN legs are very thin (250 nm), narrow (500 nm), and long (above 300 {\\upmu } m); these dimensions are needed in leg-isolated bolometers to achieve the required level of sensitivity. In this paper, we describe the latest fabrication process for our TES bolometers with improved sensitivity.

Specialist practitioner' in surgical dentistry: preliminary report on a pilot scheme at East Surrey Hospital, Redhill, UK.

PubMed

Parker, J K

1999-12-01

This continuing pilot scheme was designed to assess whether minor oral operations could be done by a 'specialist practitioner' in surgical dentistry in hospital. The preliminary results indicate that patients benefit from the improved facilities and expertise that are available in the hospital, that the provision of treatment within the hospital is at a sufficiently 'local' level to meet their requirements, and that this increased quality of service can be provided at no greater cost to the NHS than treating them in a dental surgery. A large amount of the dentoalveolar surgery done (such as removal of third molars) is regarded as routine, but 'routine' is often mistakenly thought to mean 'simple' or 'easy'. Dentoalveolar surgery not only demands the highest quality of care and expertise but it also requires the necessary immediate support if medical or surgical complications arise.

Effect of heat-setting on UV protection and antibacterial properties of cotton/spandex fabric

NASA Astrophysics Data System (ADS)

Pervez, M. N.; Talukder, M. E.; Shafiq, F.; Hasan, K. M. F.; Taher, M. A.; Meraz, M. M.; Cai, Y.; Lin, Lina

2018-01-01

An unexampled approach for simultaneous heat setting process with optimized condition at C3 (140°C, 45 s) and functional finishing, i.e. UV protection and antibacterial properties of cotton/spandex fabric were studied in this research. Experimental results disclosed that, ameliorative antibacterial efficacy and perdurable UV protection of heat-treated cotton/spandex fabrics with best sample A3 among all samples was achieved and mechanical properties also improved as the temperature rose from 120 to 140°C. In addition, Ultraviolet (UV) radiation protection and antibacterial properties are becoming increasingly necessary for human health, and textiles play an important role and this report will be appurtenant to meet regular demand.

22 CFR 501.8 - Reappointment of Foreign Service Officers and Career Overseas Specialists.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Career Overseas Specialists. 501.8 Section 501.8 Foreign Relations BROADCASTING BOARD OF GOVERNORS APPOINTMENT OF FOREIGN SERVICE OFFICERS § 501.8 Reappointment of Foreign Service Officers and Career Overseas... Governors) may reappoint to the Service a former career Overseas Specialist. (a) Requirements for...

STS-87 Mission Specialist Doi and his wife pose at LC 39B

NASA Technical Reports Server (NTRS)

1997-01-01

STS-87 Mission Specialist Takao Doi, Ph.D., of the National Space Development Agency of Japan poses with his wife, Hitomi Doi, in front of Kennedy Space Center's Launch Pad 39B during final prelaunch activities leading up to the scheduled Nov. 19 liftoff. The other STS-87 crew members are Commander Kevin Kregel; Pilot Steven Lindsey; Mission Specialists Kalpana Chawla, Ph.D., and Winston Scott; and Payload Specialist Leonid Kadenyuk of the National Space Agency of Ukraine. STS-87 will be the fourth flight of the United States Microgravity Payload and the Spartan- 201 deployable satellite.

Can plant resistance to specialist herbivores be explained by plant chemistry or resource use strategy?

PubMed

Kirk, Heather; Vrieling, Klaas; Pelser, Pieter B; Schaffner, Urs

2012-04-01

At both a macro- and micro-evolutionary level, selection of and performance on host plants by specialist herbivores are thought to be governed partially by host plant chemistry. Thus far, there is little evidence to suggest that specialists can detect small structural differences in secondary metabolites of their hosts, or that such differences affect host choice or performance of specialists. We tested whether phytochemical differences between closely related plant species are correlated with specialist host choice. We conducted no-choice feeding trials using 17 plant species of three genera of tribe Senecioneae (Jacobaea, Packera, and Senecio; Asteraceae) and a more distantly related species (Cynoglossum officinale; Boraginaceae) containing pyrrolizidine alkaloids (PAs), and four PA-sequestering specialist herbivores of the genus Longitarsus (Chrysomelidae). We also assessed whether variation in feeding by specialist herbivores is attributable to different resource use strategies of the tested plant species. Plant resource use strategy was quantified by measuring leaf dry matter content, which is related to both plant nutritive value and to plant investment in quantitative defences. We found no evidence that intra-generic differences in PA profiles affect feeding by specialist herbivores. Instead, our results indicate that decisions to begin feeding are related to plant resource use strategy, while decisions to continue feeding are not based on any plant characteristics measured in this study. These findings imply that PA composition does not significantly affect host choice by these specialist herbivores. Leaf dry matter content is somewhat phylogenetically conserved, indicating that plants may have difficulty altering resource use strategy in response to selection pressure by herbivores and other environmental factors on an evolutionary time scale.

Fabrication Technologies of the High Gradient Accelerator Structures at 100MV/M Range

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

Wang, Juwen; /SLAC; Lewandowski, James

A CERN-SLAC-KEK collaboration on high gradient X-band structure research has been established in order to demonstrate the feasibility of the CLIC baseline design for the main linac stably operating at more than 100 MV/m loaded accelerating gradient. Several prototype CLIC structures were successfully fabricated and high power tested. They operated at 105 MV/m with a breakdown rate that meets the CLIC linear collider specifications of < 5 x 10{sup -7}/pulse/m. This paper summarizes the fabrication technologies including the mechanical design, precision machining, chemical cleaning, diffusion bonding as well as vacuum baking and all related assembly technologies. Also, the tolerances control,more » tuning and RF characterization will be discussed.« less

Provision and practice of specialist preterm labour clinics: a UK survey of practice.

PubMed

Sharp, A N; Alfirevic, Z

2014-03-01

To identify the current status of specialist preterm labour (PTL) clinic provision and management within the UK. Postal survey of clinical practice. All consultant-led obstetric units within the UK. A questionnaire was sent by post to all 210 NHS consultant-led obstetric units within the UK. Units that had a specialist PTL clinic were asked to complete a further 20 questions defining their protocol for risk stratification and management. Current practice in specialist preterm labour clinics. We have identified 23 specialist clinics; the most common indications for attendance were previous PTL (100%), preterm prelabour rupture of membranes (95%), two large loop excisions of the transformation zone (95%) or cone biopsy (95%). There was significant heterogeneity in the indications for and method of primary treatment for short cervix, with cervical cerclage used in 45% of units, progesterone in 18% of units and Arabin cervical pessary in 5%. A further 23% used multiple treatment modalities in combination. A significant heterogeneity in all topics surveyed suggests an urgent need for networking, more evidence-based guidelines and prospective comparative audits to ascertain the real impact of specialist PTL clinics on the reduction in preterm birth and its sequelae. © 2013 Royal College of Obstetricians and Gynaecologists.

Fabrication of the HIAD Large-Scale Demonstration Assembly

NASA Technical Reports Server (NTRS)

Swanson, G. T.; Johnson, R. K.; Hughes, S. J.; DiNonno, J. M.; Cheatwood, F. M.

2017-01-01

Over a decade of work has been conducted in the development of NASA's Hypersonic Inflatable Aerodynamic Decelerator (HIAD) technology. This effort has included multiple ground test campaigns and flight tests culminating in the HIAD projects second generation (Gen-2) deployable aeroshell system and associated analytical tools. NASAs HIAD project team has developed, fabricated, and tested inflatable structures (IS) integrated with flexible thermal protection system (F-TPS), ranging in diameters from 3-6m, with cone angles of 60 and 70 deg.In 2015, United Launch Alliance (ULA) announced that they will use a HIAD (10-12m) as part of their Sensible, Modular, Autonomous Return Technology (SMART) for their upcoming Vulcan rocket. ULA expects SMART reusability, coupled with other advancements for Vulcan, will substantially reduce the cost of access to space. The first booster engine recovery via HIAD is scheduled for 2024. To meet this near-term need, as well as future NASA applications, the HIAD team is investigating taking the technology to the 10-15m diameter scale. In the last year, many significant development and fabrication efforts have been accomplished, culminating in the construction of a large-scale inflatable structure demonstration assembly. This assembly incorporated the first three tori for a 12m Mars Human-Scale Pathfinder HIAD conceptual design that was constructed with the current state of the art material set. Numerous design trades and torus fabrication demonstrations preceded this effort. In 2016, three large-scale tori (0.61m cross-section) and six subscale tori (0.25m cross-section) were manufactured to demonstrate fabrication techniques using the newest candidate material sets. These tori were tested to evaluate durability and load capacity. This work led to the selection of the inflatable structures third generation (Gen-3) structural liner. In late 2016, the three tori required for the large-scale demonstration assembly were fabricated, and then

The Multi-Faceted Role of Ohio's Elementary Reading Specialists: Instruction, Assessment, Leadership and beyond

ERIC Educational Resources Information Center

Lipp, Jamie R.

2017-01-01

Over the past 65 years, the roles of the reading specialist have continually evolved. Historically, reading specialists have been hired by schools to work predominantly with struggling readers (Bean, Cassidy, Grumet, Shelton & Wallis, 2002; Bean, Swan & Knaub, 2003). Reading specialists today serve in a variety of roles within their…

Clinical nurse specialist prescriber characteristics and challenges in Oregon.

PubMed

Klein, Tracy

2015-01-01

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

Blur and the School Library Media Specialist.

ERIC Educational Resources Information Center

Barron, Daniel D.

1999-01-01

Discusses the concept of "Blur" (described in "Blur: The Speed of Change in the Connected Economy") and what the technology-based, expanded connectivity means for K-12 educators and information specialists. Reviews online and print resources that deal with the rapid development of technology and its effects on society. (AEF)

Environmental Support Specialist. J3ABR56631

ERIC Educational Resources Information Center

Air Force Training Command, Sheppard AFB, TX.

This document package contains an Air Force course used to train environmental support specialists. The course is organized in four blocks of instruction covering 320 hours (or eight weeks), and is designed for group instruction. The four blocks cover the following topics: environmental fundamentals and support equipment, water and wastewater…

US Influence on the Education System in Turkey: An Analysis of Reports by American Education Specialists

ERIC Educational Resources Information Center

Keskin, Yusuf

2014-01-01

This study aimed to analyse reports prepared by American education specialists visiting Turkey from the Proclamation of the Republic till the end of the 1950's to inspect Turkey's education system. In accordance with this purpose, first, the foreign specialists' reports are briefly introduced chronologically and then American specialist reports…

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

PubMed

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

2016-06-08

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

Initiation of a voluntary certification program for health education specialists.

PubMed Central

Wolle, J M; Cleary, H P; Stone, E J

1989-01-01

As health education has become a major strategy for addressing current health problems, the need for expertise in health education has increased. Today health education specialists work not only in health agencies and educational institutions but also in hospitals and other health and medical facilities, in businesses and industries, and in consulting firms. To promote quality assurance in the delivery of health education services to the public, the profession has launched a voluntary credentialing system for health education specialists. Seven areas of responsibilities and the competencies that they require have been delineated as generic to the practice of entry level health education specialists, regardless of the setting (for example, school, health agency, work site) where they work. The purposes and rationale for new National Commission for Health Education Credentialing, Inc., are described as well as the benefits of certification for the profession. The events and accomplishments of the past decade that have provided the foundation for the newly established credentialing program for the health education profession are chronicled. PMID:2502814

Are cost differences between specialist and general hospitals compensated by the prospective payment system?

PubMed

Longo, Francesco; Siciliani, Luigi; Street, Andrew

2017-10-23

Prospective payment systems fund hospitals based on a fixed-price regime that does not directly distinguish between specialist and general hospitals. We investigate whether current prospective payments in England compensate for differences in costs between specialist orthopaedic hospitals and trauma and orthopaedics departments in general hospitals. We employ reference cost data for a sample of hospitals providing services in the trauma and orthopaedics specialty. Our regression results suggest that specialist orthopaedic hospitals have on average 13% lower profit margins. Under the assumption of break-even for the average trauma and orthopaedics department, two of the three specialist orthopaedic hospitals appear to make a loss on their activity. The same holds true for 33% of departments in our sample. Patient age and severity are the main drivers of such differences.

HMO growth and the geographical redistribution of generalist and specialist physicians, 1987-1997.

PubMed Central

Escarce, J J; Polsky, D; Wozniak, G D; Kletke, P R

2000-01-01

OBJECTIVE: To assess the impact of the growth in HMO penetration in different metropolitan areas on the change in the number of generalists, specialists, and total physicians, and on the change in the proportion of physicians who are generalists. DATA SOURCES/STUDY SETTING: The American Medical Association Physician Masterfile, to obtain the number of patient care generalists and specialists in 1987 and in 1997 who were practicing in each of 316 metropolitan areas in the United States. Additional data for each metropolitan area were obtained from a variety of sources, and included HMO penetration in 1986 and 1996. STUDY DESIGN: We estimated multivariate regression models in which the change in the number of physicians between 1987 and 1997 was a function of HMO penetration in 1986, the change in HMO penetration between 1986 and 1996, population characteristics and physician fees in 1986, and the change in population characteristics and fees between 1986 and 1996. Each model was estimated using ordinary least squares (OLS) and two-stage least squares (TSLS). PRINCIPAL FINDINGS: HMO penetration did not affect the number of generalist physicians or hospital-based specialists, but faster HMO growth led to smaller increases in the numbers of medical/surgical specialists and total physicians. Faster HMO growth also led to larger increases in the proportion of physicians who were generalists. Our best estimate is that an increase in HMO penetration of .10 between 1986 and 1996 reduced the rate of increase in medical/surgical specialists by 10.3 percent and reduced the rate of increase in total physicians by 7.2 percent. CONCLUSIONS: The findings of this study support the notion that HMOs reduce the demand for physician services, particularly for specialists' services. The findings also imply that, during the past decade, there has been a redistribution of physicians-especially medical/surgical specialists-from metropolitan areas with high HMO penetration to low

Factors supporting good partnership working between generalist and specialist palliative care services: a systematic review.

PubMed

Gardiner, Clare; Gott, Merryn; Ingleton, Christine

2012-05-01

The care that most people receive at the end of their lives is provided not by specialist palliative care professionals but by generalists such as GPs, district nurses and others who have not undertaken specialist training in palliative care. A key focus of recent UK policy is improving partnership working across the spectrum of palliative care provision. However there is little evidence to suggest factors which support collaborative working between specialist and generalist palliative care providers. To explore factors that support partnership working between specialist and generalist palliative care providers. Systematic review. A systematic review of studies relating to partnership working between specialist and generalist palliative care providers was undertaken. Six electronic databases were searched for papers published up until January 2011. Of the 159 articles initially identified, 22 papers met the criteria for inclusion. Factors supporting good partnership working included: good communication between providers; clear definition of roles and responsibilities; opportunities for shared learning and education; appropriate and timely access to specialist palliative care services; and coordinated care. Multiple examples exist of good partnership working between specialist and generalist providers; however, there is little consistency regarding how models of collaborative working are developed, and which models are most effective. Little is known about the direct impact of collaborative working on patient outcomes. Further research is required to gain the direct perspectives of health professionals and patients regarding collaborative working in palliative care, and to develop appropriate and cost-effective models for partnership working.

Improving specialist drug prescribing in primary care using task and error analysis: an observational study.

PubMed

Chana, Narinder; Porat, Talya; Whittlesea, Cate; Delaney, Brendan

2017-03-01

Electronic prescribing has benefited from computerised clinical decision support systems (CDSSs); however, no published studies have evaluated the potential for a CDSS to support GPs in prescribing specialist drugs. To identify potential weaknesses and errors in the existing process of prescribing specialist drugs that could be addressed in the development of a CDSS. Semi-structured interviews with key informants followed by an observational study involving GPs in the UK. Twelve key informants were interviewed to investigate the use of CDSSs in the UK. Nine GPs were observed while performing case scenarios depicting requests from hospitals or patients to prescribe a specialist drug. Activity diagrams, hierarchical task analysis, and systematic human error reduction and prediction approach analyses were performed. The current process of prescribing specialist drugs by GPs is prone to error. Errors of omission due to lack of information were the most common errors, which could potentially result in a GP prescribing a specialist drug that should only be prescribed in hospitals, or prescribing a specialist drug without reference to a shared care protocol. Half of all possible errors in the prescribing process had a high probability of occurrence. A CDSS supporting GPs during the process of prescribing specialist drugs is needed. This could, first, support the decision making of whether or not to undertake prescribing, and, second, provide drug-specific parameters linked to shared care protocols, which could reduce the errors identified and increase patient safety. © British Journal of General Practice 2017.

78 FR 14359 - Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-05

... Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA; Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Tampa, Florida; Amended Certification Regarding... Business Networks Services, Inc., Order Management Division, Philadelphia, Pennsylvania and Verizon...

Equity in specialist waiting times by socioeconomic groups: evidence from Spain.

PubMed

Abásolo, Ignacio; Negrín-Hernández, Miguel A; Pinilla, Jaime

2014-04-01

In countries with publicly financed health care systems, waiting time--rather than price--is the rationing mechanism for access to health care services. The normative statement underlying such a rationing device is that patients should wait according to need and irrespective of socioeconomic status or other non-need characteristics. The aim of this paper is to test empirically that waiting times for publicly funded specialist care do not depend on patients' socioeconomic status. Waiting times for specialist care can vary according to the type of medical specialty, type of consultation (review or diagnosis) and the region where patients' reside. In order to take into account such variability, we use Bayesian random parameter models to explain waiting times for specialist care in terms of need and non-need variables. We find that individuals with lower education and income levels wait significantly more time than their counterparts.

Developing a Vision: Strategic Planning and the Library Media Specialist. Greenwood Professional Guides in School Librarianship.

ERIC Educational Resources Information Center

Crowley, John D.

Although the role of the school library media specialist is frequently undervalued, the media specialist can become a leader in restructuring a school through strategic planning methods. The book shows library media specialists how to help direct the planning team that is developing the vision of the school's future. The overall strategic planning…

Scholarly Productivity of School Psychology Faculty Members in Specialist-Level Programs: 2002-2011

ERIC Educational Resources Information Center

Laurent, Jeff; Runia, Elizabeth

2016-01-01

The scholarly productivity of school psychology faculty members in specialist-level only programs was examined. Information was gathered from the School Psychology Program Information portion of the website for the National Association of School Psychologists. A total of 137 specialist-level only school psychology programs were identified.…

STS-95 Payload Specialist Glenn and his wife pose before their return flight to JSC

NASA Technical Reports Server (NTRS)

1998-01-01

At the Skid Strip at Cape Canaveral Air Station, STS-95 Payload Specialist John H. Glenn Jr., a senator from Ohio and one of the original seven Project Mercury astronauts, poses with his wife Annie before their return flight to the Johnson Space Center in Houston, Texas. The STS-95 mission ended with landing at Kennedy Space Center's Shuttle Landing Facility at 12:04 p.m. EST on Nov. 7. The STS-95 crew also includes Mission Commander Curtis L. Brown Jr.; Pilot Steven W. Lindsey; Mission Specialist Scott E. Parazynski; Mission Specialist Stephen K. Robinson; Mission Specialist Pedro Duque, with the European Space Agency (ESA); and Payload Specialist Chiaki Mukai, with the National Space Development Agency of Japan (NASDA). The mission included research payloads such as the Spartan-201 solar-observing deployable spacecraft, the Hubble Space Telescope Orbital Systems Test Platform, the International Extreme Ultraviolet Hitchhiker, as well as a SPACEHAB single module with experiments on space flight and the aging process.

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

PubMed

Arab, Alberto; Trigo, José Roberto

2011-05-01

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

Comparison of the capture efficiency, prey processing, and nutrient extraction in a generalist and a specialist spider predator.

PubMed

García, Luis Fernando; Viera, Carmen; Pekár, Stano

2018-04-02

Predators are traditionally classified as generalists and specialists based on the presence of adaptations that increase efficiency of prey capture and consumption and selection of particular prey types. Nevertheless, empirical evidence comparing foraging efficiency between generalist and specialist carnivores is scarce. We compared the prey-capture and feeding efficiency in a generalist and a specialist (araneophagous) spider predator. By using two related species, the generalist Harpactea rubicunda (Dysderidae) and the specialist Nops cf. variabilis (Caponiidae), we evaluated their fundamental trophic niche by studying the acceptance of different prey. Then, we compared their predatory behavior, efficiency in capturing prey of varying sizes, feeding efficiency, and nutrient extraction. Nops accepted only spiders as prey, while Harpactea accepted all offered prey, confirming that Nops is stenophagous, while Harpactea is euryphagous. Further, Nops displayed more specialized (stereotyped) capture behavior than Harpactea, suggesting that Nops is a specialist, while Harpactea is a generalist. The specialist immobilized prey faster, overcame much larger prey, and gained more mass (due to feeding on larger prey) than the generalist. Both the specialist and the generalist spider extracted more proteins than lipids, but the extraction of macronutrients in the specialist was achieved mainly by consuming the prosoma of the focal prey. We show that the specialist has more efficient foraging strategy than the generalist.

Design, fabrication, testing, and delivery of a solar energy collector system for residential heating and cooling

NASA Technical Reports Server (NTRS)

Holland, T. H.; Borzoni, J. T.

1976-01-01

A low cost flat plate solar energy collector was designed for the heating and cooling of residential buildings. The system meets specified performance requirements, at the desired system operating levels, for a useful life of 15 to 20 years, at minimum cost and uses state-of-the-art materials and technology. The rationale for the design method was based on identifying possible material candidates for various collector components and then selecting the components which best meet the solar collector design requirements. The criteria used to eliminate certain materials were: performance and durability test results, cost analysis, and prior solar collector fabrication experience.

Clinical Nurse Specialist Roles in Conducting Research: Changes Over 3 Years.

PubMed

Albert, Nancy M; Rice, Karen L; Waldo, Mary J; Bena, James F; Mayo, Ann M; Morrison, Shannon L; Westlake, Cheryl; Ellstrom, Kathleen; Powers, Jan; Foster, Jan

2016-01-01

The aim of this study is to describe clinical nurse specialists' characteristics, interest, confidence, motivators, and barriers in conducting research. This study was a descriptive, multicohort design. Clinical nurse specialists were recruited electronically through national and local organizations to complete anonymous surveys 3 times, over 3 years. Comparative analyses included χ and Kruskal-Wallis tests. Of 2052 responders (initial, n = 629; 18 months, n = 465; and 3 years, n = 958), mean (SD) participant age was 50.3 (9.3) years. Overall, 41.7% of participants were involved as principal or coinvestigators in research. Interest in conducting nursing research (on a 0-100 scale) was 61.1 (38.4) and was lowest among the 18-month time point participant group (score, 39.1 [32.2]) and highest at the 3-year time point (68.3, [30.7]; P < .001). Confidence in conducting research, discussion of statistics, and perceptions of motivators and barriers to conducting research did not differ across time period groups. Access to literature and mentors and research knowledge were the most prevalent barriers to conducting research. Less than 42% of clinical nurse specialists conducted research and the rate did not change between different time groups. Access and knowledge barriers to conducting research were prominent. Workplace leaders need to consider resources and support of academic educational opportunities to increase research conduct by clinical nurse specialists.

Facilities for investigating occupational asthma in UK non-specialist respiratory departments.

PubMed

Barber, Christopher M; Naylor, Steven; Bradshaw, Lisa; Francis, Mandy; Harris-Roberts, Joanne; Rawbone, Roger; Curran, Andrew; Fishwick, David

2008-01-01

The facilities which should be available to physicians offering specialist occupational asthma services have recently been agreed upon by a UK panel of experts. This study aimed to investigate whether these facilities are available in UK non-specialist secondary care respiratory departments and to document tertiary care referral patterns. A random sample of 100 UK respiratory units was selected, and the lead consultant invited to participate. Face-to-face interviews were conducted to document information on departmental facilities available for investigating cases of occupational asthma and utilization of tertiary referral centres. In total, 66% of consultants interviewed had seen a case of occupational asthma in the previous month, and 76% reported having ever referred a patient with suspected occupational asthma to a specialist centre for further investigation (referral distance range 1-111 miles). All the departments were able to perform the investigations previously deemed an absolute necessity in all patients. The availability of in-house facilities that were deemed as must be available varied between 3-100%. The results of this study demonstrate that while the majority of basic facilities are widely available, many respiratory departments do not have direct access to investigations routinely required to investigate occupational asthma. Access to specialist occupational respiratory centres varies within the UK, and in some parts of the country involves long travelling distances for patients.

Paediatric conscious sedation: views and experience of specialists in paediatric dentistry.

PubMed

Woolley, S M; Hingston, E J; Shah, J; Chadwick, B L

2009-09-26

The objectives were three-fold: to investigate the level of conscious sedation training received prior to and during specialist training in paediatric dentistry; to establish the use of conscious sedation during and following specialisation; and to determine the attitudes of specialists in paediatric dentistry to conscious sedation. A self-administered postal questionnaire was sent to all specialists in paediatric dentistry registered with the General Dental Council in January 2008. Non-responders were contacted again after a four-week period. A response rate of 60% was achieved. Of the 122 respondents, 67 (55%) had received sedation training as an undergraduate; 89 (75%) had been trained during specialisation. All respondents performed dental treatment under sedation as a trainee and the majority used nitrous oxide inhalation sedation (NOIS). Over 90% of respondents felt that NOIS should be available to all children, both in appropriate primary care settings and in hospitals. One hundred and twenty-one (99%) respondents thought that all trainees in paediatric dentistry should have sedation training. The most popular form of sedation amongst specialists in paediatric dentistry was NOIS. However, some of the respondents felt that children should have access to other forms of sedation in both the primary care and hospital settings. Additional research on other forms of sedation is required to evaluate their effectiveness and safety.

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

PubMed

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

2017-07-01

Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic

Present status of yellow fever: memorandum from a PAHO meeting.

PubMed

1986-01-01

An international seminar on the treatment and laboratory diagnosis of yellow fever, sponsored by the Pan American Health Organization (PAHO) and held in 1984, differed from previous meetings on yellow fever because of its emphasis on the care and management of patients and because the participants included specialists from several branches of medicine, such as hepatology, haematology, cardiology, infectious diseases, pathology and nephrology. The meeting reviewed the current status of yellow fever and problems associated with case-finding and notification; features of yellow fever in individual countries of Latin America; health services and facilities for medical care as they relate to diagnosis and management of cases; prevention strategies for and current status of immunization programmes; clinical and pathological aspects of yellow fever in humans; pathogenesis and pathophysiology of yellow fever in experimental animal models; clinical and specific laboratory diagnosis; treatment of the disease and of complications in the functioning of individual organ systems; prognosis and prognostic indicators; and directions for future clinical and experimental research on pathophysiology and treatment.

Elementary School Math Instruction: Can Reading Specialists Assist?

ERIC Educational Resources Information Center

Heinrichs, Audrey S.

1987-01-01

Discusses the contradictions found in recommendations for direction instruction or informal math language development, and some suggestions for practical resolution of disagreements, to enable school reading specialists to provide both background and practical help to classroom instructors teaching math. (HTH)

Commentary: Sense and sensibility: the role of specialists in health care reform.

PubMed

Schwann, Nanette M; Nester, Brian A; McLoughlin, Thomas M

2012-03-01

How to redesign the incentives structure in the United States to reward effective coordinated care rather than production volume is a staggering public health policy challenge. In the mind of the public, there is a fine distinction between health care rationing and rational health care. Specialists have a vital but underappreciated role in reining in health care costs, but specific incentives to elicit behavior change with positive social outcomes remain ambiguous. It is imperative, therefore, that redesigning the incentives structure is thoughtfully considered, modeled, and tested prior to implementation, lest an inferior-quality model is inadvertently adopted and costs are only marginally contained. Quality metrics need to be universal and reflect real patient outcomes instead of the degree of investment by the institution in the reporting tools. Still, specialists should take immediate action to implement safe and efficient procedures and to assess their long-term impact on patients' quality of life. Scientific evaluations should guide both the assessment of the appropriateness and the safe delivery of care. Investment in high-quality data architecture and the science of health delivery implementation is an imperative if health care reform is to achieve its goals. Coordination and collaboration between specialists and primary care physicians is essential to this enterprise. Specialists can champion these efforts as they pertain to their areas of expertise by considering their care episodes in the context of the patient as a whole, working closely with generalists, and returning to the mindset of the specialist as a family doctor.

The Top Ten Reasons a Library Media Specialist Is a Teacher's Best Friend

ERIC Educational Resources Information Center

Hylen, Jan

2004-01-01

Many teachers think too little about the role of the library media specialist in their professional lives, and because of this oversight they underutilize this great resource. This article explains the top ten reasons why teachers should work with their library media specialists: (1) Improving test scores and enhancing student academic…

A decade in diabetes specialist services, 2000 to 2011, in England: the views of consultant diabetologists and diabetes specialist nurses amidst persistent healthcare delivery change.

PubMed

Gosden, C A; Barnard, K; Williams, D R R; Tinati, T; Turner, B; Holt, R I G

2015-12-01

To assess the impact of continual major National Health Service reorganization on commissioning, organizational and delivery arrangements for secondary care diabetes services. To explore how consultant diabetologists and diabetes specialist nurses perceive the issues facing diabetes specialist services in 2011 and how these have changed in the preceding decade. We used a longitudinal case study approach that combined quantitative and qualitative methods. Five locations in England were purposively selected to represent the wider diabetes specialist community, and seven semi-structured interviews were conducted. Interviews were recorded, transcribed verbatim and analysed using Framework analysis. Findings were compared with and contrasted to results from national quantitative surveys of diabetes specialist services undertaken in 2000 and 2006. Clinicians viewed positively the expertise and commitment of multidisciplinary teams and their ability to adapt to new situations. Negative perceptions persisted throughout the decade, relating to the continual change that threatens to dismantle relationships and services which had taken many years to establish. Lack of resources, inadequate manpower planning and poor access to psychological support for people with diabetes remained constant themes from 2000 to 2011. A willingness to innovate and work differently to improve services was identified; however, clinicians must be supported through organizational changes to ensure people with diabetes receive high-quality care. The disruptive nature of organizational change was a recurrent theme throughout the decade. Periods of stability must exist within commissioning to allow relationships, which are key to integration, to be maintained and permit service improvements to develop. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

Preparation, Endorsement, and Employment of Mathematics Specialists

ERIC Educational Resources Information Center

Cicmanec, Karen B. Mauck

2008-01-01

For over 30 years, educators have recommended that mathematics specialists be placed in schools to provide teachers with the resources they need to assist their students. To assess whether these recommendations have been realized, a survey was used to gather data from large school districts, the 50 states, and District of Columbia. The outcome of…

STS-47 Payload Specialist Mohri parasails during Homestead AFB water training

NASA Technical Reports Server (NTRS)

1990-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Payload Specialist Mamoru Mohri parasails during a special survival training course hosted by Homestead Air Force Base (AFB) in Florida. Mohri simulates a paraglide into water. The exercise was part of an overall course on water survival, attended by the STS-47 prime and alternate (backup) payload specialists shortly after they were announced for the scheduled summer of 1992 Spacelab Japan (SLJ) mission. Mohri represents the National Space Development Agency of Japan (NASDA).

Weekend specialist intensity and admission mortality in acute hospital trusts in England: a cross-sectional study.

PubMed

Aldridge, Cassie; Bion, Julian; Boyal, Amunpreet; Chen, Yen-Fu; Clancy, Mike; Evans, Tim; Girling, Alan; Lord, Joanne; Mannion, Russell; Rees, Peter; Roseveare, Chris; Rudge, Gavin; Sun, Jianxia; Tarrant, Carolyn; Temple, Mark; Watson, Sam; Lilford, Richard

2016-07-09

Increased mortality rates associated with weekend hospital admission (the so-called weekend effect) have been attributed to suboptimum staffing levels of specialist consultants. However, evidence for a causal association is elusive, and the magnitude of the weekend specialist deficit remains unquantified. This uncertainty could hamper efforts by national health systems to introduce 7 day health services. We aimed to examine preliminary associations between specialist intensity and weekend admission mortality across the English National Health Service. Eligible hospital trusts were those in England receiving unselected emergency admissions. On Sunday June 15 and Wednesday June 18, 2014, we undertook a point prevalence survey of hospital specialists (consultants) to obtain data relating to the care of patients admitted as emergencies. We defined specialist intensity at each trust as the self-reported estimated number of specialist hours per ten emergency admissions between 0800 h and 2000 h on Sunday and Wednesday. With use of data for all adult emergency admissions for financial year 2013-14, we compared weekend to weekday admission risk of mortality with the Sunday to Wednesday specialist intensity ratio within each trust. We stratified trusts by size quintile. 127 of 141 eligible acute hospital trusts agreed to participate; 115 (91%) trusts contributed data to the point prevalence survey. Of 34,350 clinicians surveyed, 15,537 (45%) responded. Substantially fewer specialists were present providing care to emergency admissions on Sunday (1667 [11%]) than on Wednesday (6105 [42%]). Specialists present on Sunday spent 40% more time caring for emergency patients than did those present on Wednesday (mean 5·74 h [SD 3·39] vs 3·97 h [3·31]); however, the median specialist intensity on Sunday was only 48% (IQR 40-58) of that on Wednesday. The Sunday to Wednesday intensity ratio was less than 0·7 in 104 (90%) of the contributing trusts. Mortality risk among patients

Use of a screening tool and primary health care gerontology nurse specialist for high-needs older people.

PubMed

King, Anna; Boyd, Michal; Dagley, Lynelle

2017-02-01

To describe implementation of an innovative gerontology nurse specialist role within one primary health organisation in Auckland, New Zealand. Quantitative outcomes of the screening tool as well as the nurse specialist assessment will be presented. The intervention involved use of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify high-needs older people with subsequent comprehensive geriatric assessment (CGA) performed by the gerontology nurse specialist. A total 384 of the 416 BRIGHTs were completed (92% response rate) and 15% of these were identified as high risk (n = 57). The BRIGHTs for high-risk older people revealed the highest scoring question was 'needing help with housework' (26%). The most frequent intervention by the gerontology nurse specialist was education (30%). The primary health care gerontology nurse specialist model delivers a proactive case finding and specialist gerontology intervention for older people at high risk of functional or health decline.

A Crime Scene Fabricated as Suicide.

PubMed

Amararatne, Rrg Sriyantha; Vidanapathirana, Muditha

2017-02-01

When ascertaining the manner of death, the forensic pathologist should be careful, because in some instances, attempts are made by the criminals to conceal homicides as suicides. The case under discussion highlights the contribution of the forensic pathologist in the ascertainment of the manner in firearm deaths. The deceased was a poacher and his dead body was found in a cashew land with his shotgun lying over him. The shirt had a roughly circular defect with muzzle mark, and burnt and blackened margin. Beneath that, on front of the left upper chest a 2cm diameter circular, perforated laceration, with muzzle imprint and, burnt and blackened margin was found. Shelving was found at the upper margin. Chest X-ray showed the downward pellet distribution. Cause of death was chest injuries due to pellets discharged from a smooth bore weapon. Length of the upper arm reach was 65cm (25 inches) and the length from the muzzle to the trigger was 79cm (31 inches). In conclusion, it was found to be a fabricated suicide scene and the manner of death was ascertained as homicide. This reiterates that the postmortem investigation of firearm deaths should be performed or conducted under direct supervision of forensic specialist to deliver justice.

A Crime Scene Fabricated as Suicide

PubMed Central

Amararatne, RRG Sriyantha

2017-01-01

When ascertaining the manner of death, the forensic pathologist should be careful, because in some instances, attempts are made by the criminals to conceal homicides as suicides. The case under discussion highlights the contribution of the forensic pathologist in the ascertainment of the manner in firearm deaths. The deceased was a poacher and his dead body was found in a cashew land with his shotgun lying over him. The shirt had a roughly circular defect with muzzle mark, and burnt and blackened margin. Beneath that, on front of the left upper chest a 2cm diameter circular, perforated laceration, with muzzle imprint and, burnt and blackened margin was found. Shelving was found at the upper margin. Chest X-ray showed the downward pellet distribution. Cause of death was chest injuries due to pellets discharged from a smooth bore weapon. Length of the upper arm reach was 65cm (25 inches) and the length from the muzzle to the trigger was 79cm (31 inches). In conclusion, it was found to be a fabricated suicide scene and the manner of death was ascertained as homicide. This reiterates that the postmortem investigation of firearm deaths should be performed or conducted under direct supervision of forensic specialist to deliver justice. PMID:28384886

Fabric circuits and method of manufacturing fabric circuits

NASA Technical Reports Server (NTRS)

Chu, Andrew W. (Inventor); Dobbins, Justin A. (Inventor); Scully, Robert C. (Inventor); Trevino, Robert C. (Inventor); Lin, Greg Y. (Inventor); Fink, Patrick W. (Inventor)

2011-01-01

A flexible, fabric-based circuit comprises a non-conductive flexible layer of fabric and a conductive flexible layer of fabric adjacent thereto. A non-conductive thread, an adhesive, and/or other means may be used for attaching the conductive layer to the non-conductive layer. In some embodiments, the layers are attached by a computer-driven embroidery machine at pre-determined portions or locations in accordance with a pre-determined attachment layout before automated cutting. In some other embodiments, an automated milling machine or a computer-driven laser using a pre-designed circuit trace as a template cuts the conductive layer so as to separate an undesired portion of the conductive layer from a desired portion of the conductive layer. Additional layers of conductive fabric may be attached in some embodiments to form a multi-layer construct.

Supported employment specialist strategies to assist clients with severe mental illness and criminal justice issues.

PubMed

Whitley, Rob; Kostick, Kristin M; Bush, Philip W

2009-12-01

The aim of this study was to document and analyze common strategies used by supported employment specialists to overcome criminal justice issues among clients with severe mental illness. Semistructured qualitative interviews were conducted with a group of 22 supported employment specialists and their supervisors. Interviews were open ended and supplemented by ethnographic observation. Data were examined thematically by content analysis. Assisting clients with past and present criminal histories to find employment was confirmed as one of the hardest self-identified challenges for employment specialists. Three specific strategies commonly used by specialists for this subpopulation are documented and analyzed. These include taking an incremental approach with clients vis-à-vis obtaining work and career advancement, using a strengths-based model that emphasizes the client's strong points, and focusing the job search on "mom and pop" businesses that typically do not conduct background checks or do not have rigid recruitment policies. Enacting these strategies led to some deviation from the individualized placement and support model of supported employment. Participants noted that they felt most challenged when attempting to serve and assist clients with sex offenses. The findings imply that specialists are challenged when dealing with clients with criminal justice issues and use several approaches to overcome these challenges. Current specialist training may be deficient in preparing staff to effectively serve people with criminal justice issues. Further research should assess the efficacy of the approaches outlined in this article to give more guidance to specialists working with clients with criminal justice issues.

Freedom of choice of specialist physicians is important to Swiss resident: a cross-sectional study.

PubMed

Peytremann-Bridevaux, Isabelle; Ruffieux, Christiane; Burnand, Bernard

2011-12-19

To assess how important the possibility to choose specialist physicians is for Swiss residents and to determine which variables are associated with this opinion. This cross-sectional study used data from the 2007 Swiss population-based health survey and included 13,642 non-institutionalised adults who responded to the telephone and paper questionnaires. The dependent variable included answers to the question "How important is it for you to be able to choose the specialist you would like to visit?" Independent variables included socio-demographics, health and past year healthcare use measures. Crude and adjusted logistic regressions for the importance of being able to choose specialist physicians were performed, accounting for the survey design. 45% of participants found it very important to be able to choose the specialist physician they wanted to visit. The answers "rather important", "rather not important" and "not important" were reported by 28%, 20% and 7% of respondents. Women, individuals in middle/high executive position, those with an ordinary insurance scheme, those reporting ≥2 chronic conditions or poorer subjective health, or those who had had ≥2 outpatient visits in the preceding year were more likely to find this choice very important. In 2007, almost half of all Swiss residents found it very important to be able to choose his/her specialist physician. The further development of physician networks or other chronic disease management initiatives in Switzerland, towards integrated care, need to pay attention to the freedom of choice of specialist physicians that Swiss residents value. Future surveys should provide information on access and consultations with specialist physicians.

Altitudinal gradients of generalist and specialist herbivory on three montane Asteraceae

NASA Astrophysics Data System (ADS)

Scheidel, U.; Röhl, S.; Bruelheide, H.

Different functional types of herbivory on three montane Asteraceae were investigated in natural populations in central Germany to test the hypothesis that herbivory is decreasing with altitude. Generalist herbivory was assessed as leaf area loss, mainly caused by slugs, and, in Petasites albus, as rhizome mining by oligophagous insect larvae. Capitules were found to be parasitized by oligophagous insects in Centaurea pseudophrygia and by the specialist fly Tephritis arnicae in Arnica montana. Only the damage to leaves of P. albus showed the hypothesized decrease with increasing altitude. No altitudinal gradient could be found in the leaf and capitule damage to C. pseudophrygia. In A. montana, capitule damage increased with increasing elevation. The data suggest that abundance and activity of generalist herbivores are more affected by climatic conditions along altitudinal gradients than specialist herbivores. In all probability, specialist herbivores depend less on abiotic conditions than on their host's population characteristics, such as host population size.

French payload specialist Patrick Baudry prepares a meal

NASA Image and Video Library

1985-06-17

51G-08-021 (17-24 June 1985) --- Patrick Baudry, payload specialist representing the Centre National d'Etudes Spatiales of France, prepares to open a can of lobster. The bag attached to a nearby locker door appears to contain several other French snacks.

Why are some medical specialists working part-time, while others work full-time?

PubMed