In vivo 808 nm image-guided photodynamic therapy based on an upconversion theranostic nanoplatform

NASA Astrophysics Data System (ADS)

Liu, Xiaomin; Que, Ivo; Kong, Xianggui; Zhang, Youlin; Tu, Langping; Chang, Yulei; Wang, Tong Tong; Chan, Alan; Löwik, Clemens W. G. M.; Zhang, Hong

2015-09-01

A new strategy for efficient in vivo image-guided photodynamic therapy (PDT) has been demonstrated utilizing a ligand-exchange constructed upconversion-C60 nanophotosensitizer. This theranostic platform is superior to the currently reported nanophotosensitizers in (i) directly bonding photosensitizer C60 to the surface of upconversion nanoparticles (UCNPs) by a smart ligand-exchange strategy, which greatly shortened the energy transfer distance and enhanced the 1O2 production, resulting in the improvement of the therapeutic effect; (ii) realizing in vivo NIR 808 nm image-guided PDT with both excitation (980 nm) and emission (808 nm) light falling in the biological window of tissues, which minimized auto-fluorescence, reduced light scatting and improved the imaging contrast and depth, and thus guaranteed noninvasive diagnostic accuracy. In vivo and ex vivo tests demonstrated its favorable bio-distribution, tumor-selectivity and high therapeutic efficacy. Owing to the effective ligand exchange strategy and the excellent intrinsic photophysical properties of C60, 1O2 production yield was improved, suggesting that a low 980 nm irradiation dosage (351 J cm-2) and a short treatment time (15 min) were sufficient to perform NIR (980 nm) to NIR (808 nm) image-guided PDT. Our work enriches the understanding of UCNP-based PDT nanophotosensitizers and highlights their potential use in future NIR image-guided noninvasive deep cancer therapy.A new strategy for efficient in vivo image-guided photodynamic therapy (PDT) has been demonstrated utilizing a ligand-exchange constructed upconversion-C60 nanophotosensitizer. This theranostic platform is superior to the currently reported nanophotosensitizers in (i) directly bonding photosensitizer C60 to the surface of upconversion nanoparticles (UCNPs) by a smart ligand-exchange strategy, which greatly shortened the energy transfer distance and enhanced the 1O2 production, resulting in the improvement of the therapeutic effect; (ii) realizing in vivo NIR 808 nm image-guided PDT with both excitation (980 nm) and emission (808 nm) light falling in the biological window of tissues, which minimized auto-fluorescence, reduced light scatting and improved the imaging contrast and depth, and thus guaranteed noninvasive diagnostic accuracy. In vivo and ex vivo tests demonstrated its favorable bio-distribution, tumor-selectivity and high therapeutic efficacy. Owing to the effective ligand exchange strategy and the excellent intrinsic photophysical properties of C60, 1O2 production yield was improved, suggesting that a low 980 nm irradiation dosage (351 J cm-2) and a short treatment time (15 min) were sufficient to perform NIR (980 nm) to NIR (808 nm) image-guided PDT. Our work enriches the understanding of UCNP-based PDT nanophotosensitizers and highlights their potential use in future NIR image-guided noninvasive deep cancer therapy. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr03690a

Post-examination interpretation of objective test data: monitoring and improving the quality of high-stakes examinations--a commentary on two AMEE Guides.

PubMed

Tavakol, Mohsen; Dennick, Reg

2012-01-01

As great emphasis is rightly placed upon the importance of assessment to judge the quality of our future healthcare professionals, it is appropriate not only to choose the most appropriate assessment method, but to continually monitor the quality of the tests themselves, in a hope that we may continually improve the process. This article stresses the importance of quality control mechanisms in the exam cycle and briefly outlines some of the key psychometric concepts including reliability measures, factor analysis, generalisability theory and item response theory. The importance of such analyses for the standard setting procedures is emphasised. This article also accompanies two new AMEE Guides in Medical Education (Tavakol M, Dennick R. Post-examination Analysis of Objective Tests: AMEE Guide No. 54 and Tavakol M, Dennick R. 2012. Post examination analysis of objective test data: Monitoring and improving the quality of high stakes examinations: AMEE Guide No. 66) which provide the reader with practical examples of analysis and interpretation, in order to help develop valid and reliable tests.

Guia Para El Mejoramiento de la Produccion de Materiales Para la Educacion Formal y No Formal. Guias Metodologicas No. 6. (Guide for the Improvement of Production of Educational Materials for Formal and Non-formal Education. Methodology Guide No. 6). Revised Proceedings from the Regional Workshop on Improvement of the Production of Educational Materials on Teaching Population Education: Primary and Secondary Level (Santiago, Chile, May 27-June 5, 1987).

ERIC Educational Resources Information Center

Calvo, Gilbert

Various educators from Latin and Central America and the Caribbean met to design and produce materials for teaching family life, human sexuality, community life, and environmental studies. They concluded that the materials should meet community standards; help prepare for future change; develop working models for designing effective teaching…

Mobile technologies in medical education: AMEE Guide No. 105.

PubMed

Masters, Ken; Ellaway, Rachel H; Topps, David; Archibald, Douglas; Hogue, Rebecca J

2016-06-01

Mobile technologies (including handheld and wearable devices) have the potential to enhance learning activities from basic medical undergraduate education through residency and beyond. In order to use these technologies successfully, medical educators need to be aware of the underpinning socio-theoretical concepts that influence their usage, the pre-clinical and clinical educational environment in which the educational activities occur, and the practical possibilities and limitations of their usage. This Guide builds upon the previous AMEE Guide to e-Learning in medical education by providing medical teachers with conceptual frameworks and practical examples of using mobile technologies in medical education. The goal is to help medical teachers to use these concepts and technologies at all levels of medical education to improve the education of medical and healthcare personnel, and ultimately contribute to improved patient healthcare. This Guide begins by reviewing some of the technological changes that have occurred in recent years, and then examines the theoretical basis (both social and educational) for understanding mobile technology usage. From there, the Guide progresses through a hierarchy of institutional, teacher and learner needs, identifying issues, problems and solutions for the effective use of mobile technology in medical education. This Guide ends with a brief look to the future.

Use of the Job Model Concept to Guide Job Description Procedures for Army Officers.

ERIC Educational Resources Information Center

Whitmore, Paul G.

The objective of Work Unit SKYGUARD has been to facilitate the development of an improved Air Defense Officers Advanced Course (C-22) by the U.S. Army Air Defense School. Focus is on techniques for improving the completeness and relevance of the instructional objectives with respect to future job requirements. The job description procedures…

Preparing Students for the Future: Making Career Development a Priority.

ERIC Educational Resources Information Center

Hughey, Kenneth F.; Hughey, Judith K.

1999-01-01

Presents information relevant to school counseling about the implications of work changes. Outlines foundational guides for student success: improving decision making, learning about career paths, acquiring employability skills, and developing lifelong learning attitudes. Describes activities to facilitate career development. (SK)

Recent Science and Engineering Results with the Laser Guidestar Adaptive Optics System at Lick Observatory

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

Gavel, D T; Gates, E; Max, C

2002-10-17

The Lick Observatory laser guide star adaptive optics system has undergone continual improvement and testing as it is being integrated as a facility science instrument on the Shane 3 meter telescope. Both Natural Guide Star (NGS) and Laser Guide Star (LGS) modes are now used in science observing programs. We report on system performance results as derived from data taken on both science and engineering nights and also describe the newly developed on-line techniques for seeing and system performance characterization. We also describe the future enhancements to the Lick system that will enable additional science goals such as long-exposure spectroscopy.

NASA N+3 Subsonic Fixed Wing Silent Efficient Low-Emissions Commercial Transport (SELECT) Vehicle Study. Revision A

NASA Technical Reports Server (NTRS)

Bruner, Sam; Baber, Scott; Harris,Chris; Caldwell, Nicholas; Keding, Peter; Rahrig, Kyle; Pho, Luck; Wlezian, Richard

2010-01-01

A conceptual commercial passenger transport study was performed to define a single vehicle for entry into service in the 2030 to 2035 timeframe, meeting customer demands as well as NASA goals for improved fuel economy, NOx emissions, noise, and operability into smaller airports. A study of future market and operational scenarios was used to guide the design of an advanced tube-and-wing configuration that utilized advanced material and structural concepts, an advanced three-shaft high-bypass turbofan engine, natural laminar flow technology, and a suite of other advanced technologies. This configuration was found to meet the goals for NOx emissions, noise, and field length. A 64 percent improvement in fuel economy compared to a current state-of-the-art airliner was achieved, which fell slightly short of the desired 70 percent goal. Technology maturation plans for the technologies used in the design were developed to help guide future research and development activities.

Guide to resource conservation and cost savings opportunities in the soap, detergents and related products sector

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

NONE

1998-10-01

This guide was prepared to help those involved in the manufacturing of soap, detergent, and related products to identify potential process improvements that will reduce production costs and conserve resources. The guide offers a series of generic process descriptions and checklists of improvement opportunities specific to each of five major processes used in the industry: Soap production, surfactant production, solid cake product formulation, liquid product formulation, and granulated powdered product formulation. The checklists identify thermal, electrical, environmental, water use, and low- or no-cost measures that can be implemented, as well as retrofit technology options. A variety of new technologies thatmore » may exhibit future potential are also described. Appendices include a glossary, background information on the Ontario soap/detergent industry, and description of the four major categories of ingredients used in the industry.« less

Understanding and treating amotivation in people with psychosis: An experimental study of the role of guided imagery.

PubMed

Cox, Charlotte; Jolley, Suzanne; Johns, Louise

2016-12-30

Psychological models propose that the amotivational negative symptoms (ANS) of psychosis are influenced by expectations of future events; both anticipatory success (believing one can achieve something, AS) and anticipatory pleasure (mentally pre-creating potential future experiences of enjoyment, AP). Mental imagery manipulations have been shown to change expectations across a range of settings, and may therefore enhance psychological interventions for ANS in people with psychosis. We set out to investigate the impact of a guided imagery manipulation on AS and AP in this group. Forty-two participants with psychosis and ANS completed measures of ANS severity, before random allocation to either a positive or neutral imagery manipulation. AS and AP towards a dart-throwing task were measured before and after the manipulation. Greater ANS severity was associated with lower levels of AS, but not of AP, irrespective of task performance. AS, but not AP, improved during both positive and neutral imagery manipulations, with no effect of imagery type. Anticipatory success is a candidate psychological factor influencing the severity of ANS in psychosis that may be changed by guided imagery manipulation. Imagery interventions are feasible and acceptable for this group: further investigation is needed of their mechanism of action and potential to improve functioning. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Women Shaping the Future. The Future of Work Discussion Kit.

ERIC Educational Resources Information Center

Pine, Janet; Jackson, Sue; MacNeill, Kate

Designed to inform and empower women to participate in debates and decisions about the future of work in Australia, this kit provides everything needed to run a discussion session on the future of work with women in the community. It consists of a guide for users, workshop guide, topic sheets, and background reading. The guide for users introduces…

In vivo 808 nm image-guided photodynamic therapy based on an upconversion theranostic nanoplatform.

PubMed

Liu, Xiaomin; Que, Ivo; Kong, Xianggui; Zhang, Youlin; Tu, Langping; Chang, Yulei; Wang, Tong Tong; Chan, Alan; Löwik, Clemens W G M; Zhang, Hong

2015-09-28

A new strategy for efficient in vivo image-guided photodynamic therapy (PDT) has been demonstrated utilizing a ligand-exchange constructed upconversion-C60 nanophotosensitizer. This theranostic platform is superior to the currently reported nanophotosensitizers in (i) directly bonding photosensitizer C60 to the surface of upconversion nanoparticles (UCNPs) by a smart ligand-exchange strategy, which greatly shortened the energy transfer distance and enhanced the (1)O2 production, resulting in the improvement of the therapeutic effect; (ii) realizing in vivo NIR 808 nm image-guided PDT with both excitation (980 nm) and emission (808 nm) light falling in the biological window of tissues, which minimized auto-fluorescence, reduced light scatting and improved the imaging contrast and depth, and thus guaranteed noninvasive diagnostic accuracy. In vivo and ex vivo tests demonstrated its favorable bio-distribution, tumor-selectivity and high therapeutic efficacy. Owing to the effective ligand exchange strategy and the excellent intrinsic photophysical properties of C60, (1)O2 production yield was improved, suggesting that a low 980 nm irradiation dosage (351 J cm(-2)) and a short treatment time (15 min) were sufficient to perform NIR (980 nm) to NIR (808 nm) image-guided PDT. Our work enriches the understanding of UCNP-based PDT nanophotosensitizers and highlights their potential use in future NIR image-guided noninvasive deep cancer therapy.

Evaluation of Long-Term Pavement Performance (LTTP) Climatic Data for Use in Mechanistic-Empirical Pavement Design Guide (MEPDG) Calibration and Other Pavement Analysis

DOT National Transportation Integrated Search

2015-05-01

Improvements in the Long-Term Pavement Performance (LTPP) Programs climate data are needed to support current and future research into climate effects on pavement materials, design, and performance. The calibration and enhancement of the Mechanist...

Quality Indicators for California Community College Job Placement Programs.

ERIC Educational Resources Information Center

Mount San Antonio Community Coll. District, Walnut, CA.

Designed to help California community colleges in assessing their job placement services, identifying strengths and needs for improvement, and establishing priorities for the future, this color-coded guide lists specific tasks and responsibilities within the four essential functional areas of job placement programs and includes quality indicators…

Level System Use in Special Education: Classroom Intervention with Prima Facie Appeal.

ERIC Educational Resources Information Center

Smith, Stephen W.; Farrell, Daniel T.

1993-01-01

This article chronicles the development of level systems designed for students with significant behavior problems, to foster student improvement through self-management and positive reinforcement. The article examines assumptions underlying level systems' concepts and components and offers recommendations to guide future research into the design…

Strategic Leadership in Schools

ERIC Educational Resources Information Center

Williams, Henry S.; Johnson, Teryl L.

2013-01-01

Strategic leadership is built upon traits and actions that encompass the successful execution of all leadership styles. In a world that is rapidly changing, strategic leadership in schools guides school leader through assuring constant improvement process by anticipating future trends and planning for them and noting that plans must be flexible to…

Defense Acquisition Workforce: Actions Needed to Guide Planning Efforts and Improve Workforce Capability

DTIC Science & Technology

2015-12-01

positions. However, 6 of the 13 acquisition career fields, including 3 priority career fields—contracting, business and engineering—did not meet growth...the competency assessment process and challenges. The leaders we interviewed were from the business ; program management; contracting; engineering...Complete Assessments to Improve Future Civilian Strategic Workforce Plans, GAO-12- 1014 (Washington, D.C.: September 27, 2012). 5GAO, High-Risk Series: An

Synthetic Biology Guides Biofuel Production

PubMed Central

Connor, Michael R.; Atsumi, Shota

2010-01-01

The advancement of microbial processes for the production of renewable liquid fuels has increased with concerns about the current fuel economy. The development of advanced biofuels in particular has risen to address some of the shortcomings of ethanol. These advanced fuels have chemical properties similar to petroleum-based liquid fuels, thus removing the need for engine modification or infrastructure redesign. While the productivity and titers of each of these processes remains to be improved, progress in synthetic biology has provided tools to guide the engineering of these processes through present and future challenges. PMID:20827393

Improving a web-based employability intervention for work-disabled employees: results of a pilot economic evaluation.

PubMed

Noben, Cindy; Evers, Silvia; Genabeek, Joost van; Nijhuis, Frans; de Rijk, Angelique

2017-04-01

Purpose The purpose of this study is to improve web-based employability interventions for employees with work-related health problems for both intervention content and study design by means of a pilot economic evaluation. Methods Uptake rate analysis for the intervention elements, cost effectiveness, cost utility and subgroup analyses were conducted to identify potential content-related intervention improvements. Differences in work ability and quality-adjusted life years and overall contribution of resource items to the total costs were assessed. These were used to guide study design improvements. Results Sixty-three participants were a-select allocated to either the intervention (n = 29) or the control (n = 34) group. Uptake regarding the intervention elements ranged between 3% and 70%. Cost-effectiveness and cost-utility analyses resulted in negative effects although higher total costs. Incremental effects were marginal (work ability -0.51; QALY -0.01). Conclusions The web-based tool to enhance employability among work disabled employees requires improvements regarding targeting and intensity; outcome measures selected and collection of cost data. With respect to the studies of disability and rehabilitation, the findings and methods presented in this pilot economic evaluation could guide the assessment of future assistive "e-health" technologies. IMPLICATIONS FOR REHABILITATION The methods presented in this pilot economic evaluation have large potentials to guide the assessment of future assistive e-health technologies addressing work-disabilities. The findings show that the web-based tool requires content related improvements with respect to targeting and intensity to enhance employability among work disabled employees. The findings show that the web-based tool would benefit from improvements related to the study design by more adequately selecting and collecting both outcome measures and cost data. The burden attributable to large-scale studies and implementation issues were prevented as the outcomes of the pilot economic evaluation did not support the implementation of the web-based tool.

Image-guided robotic surgery.

PubMed

Marescaux, Jacques; Solerc, Luc

2004-06-01

Medical image processing leads to an improvement in patient care by guiding the surgical gesture. Three-dimensional models of patients that are generated from computed tomographic scans or magnetic resonance imaging allow improved surgical planning and surgical simulation that offers the opportunity for a surgeon to train the surgical gesture before performing it for real. These two preoperative steps can be used intra-operatively because of the development of augmented reality, which consists of superimposing the preoperative three-dimensional model of the patient onto the real intraoperative view. Augmented reality provides the surgeon with a view of the patient in transparency and can also guide the surgeon, thanks to the real-time tracking of surgical tools during the procedure. When adapted to robotic surgery, this tool tracking enables visual serving with the ability to automatically position and control surgical robotic arms in three dimensions. It is also now possible to filter physiologic movements such as breathing or the heart beat. In the future, by combining augmented reality and robotics, these image-guided robotic systems will enable automation of the surgical procedure, which will be the next revolution in surgery.

The quality encounter between purchasers and providers: what to ask and how to answer.

PubMed

Pine, M

1993-01-01

It is not easy to lay prejudices aside, to find and face the facts, and to let the chips fall where they may. There is no need to wait for improvements in technology before beginning to use outcomes monitoring to guide the business exchange between purchasers and providers. Although future technological improvements will greatly improve the capacity to use objective data to differentiate among providers and to identify strengths and weaknesses within a health care organization, reasonable methods are available today to undertake these important tasks. All that is needed is the courage and willingness to embrace them. The future belongs to purchaser and provider organizations that are willing to seek enlightenment rather than blame.

Using procalcitonin-guided algorithms to improve antimicrobial therapy in ICU patients with respiratory infections and sepsis.

PubMed

Schuetz, Philipp; Raad, Issam; Amin, Devendra N

2013-10-01

In patients with systemic bacterial infections hospitalized in ICUs, the inflammatory biomarker procalcitonin (PCT) has been shown to aid diagnosis, antibiotic stewardship, and risk stratification. Our aim is to summarize recent evidence about the utility of PCT in the critical care setting and discuss the potential benefits and limitations of PCT when used for clinical decision-making. A growing body of evidence supports PCT use to differentiate bacterial from viral respiratory infections (including influenza), to help risk stratify patients, and to guide decisions about optimal duration of antibiotic therapy. Different PCT protocols were evaluated for these and similar purposes in randomized controlled trials in patients with varying severities of predominantly respiratory tract infection and sepsis. These trials demonstrated effectiveness of monitoring PCT to de-escalate antibiotic treatment earlier without increasing rates of relapsing infections or other adverse outcomes. Although serial PCT measurement has shown value in risk stratification of ICU patients, PCT-guided antibiotic escalation protocols have not yet shown benefit for patients. Inclusion of PCT data in clinical algorithms improves individualized decision-making regarding antibiotic treatment in patients in critical care for respiratory infections or sepsis. Future research should focus on use of repeated PCT measurements to risk-stratify patients and guide treatment to improve their outcomes.

Low Impact Development Master Plan

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

Loftin, Samuel R.

This project creates a Low Impact Development (LID) Master Plan to guide and prioritize future development of LID projects at Los Alamos National Laboratory (LANL or the Laboratory). The LID Master Plan applies to developed areas across the Laboratory and focuses on identifying opportunities for storm water quality and hydrological improvements in the heavily urbanized areas of Technical Areas 03, 35 and 53. The LID Master Plan is organized to allow the addition of LID projects for other technical areas as time and funds allow in the future.

Remote sensing and disease control in China: past, present and future

PubMed Central

2013-01-01

Satellite measurements have distinct advantages over conventional ground measurements because they can collect the information repeatedly and automatically. Since 1970 globally and 1985 in China, the availability of remote sensing (RS) techniques has steadily grown and they are becoming increasingly important to improve our understanding of human health. This paper gives the first detailed overview on the developments of RS applications for disease control in China. The problems, challenges and future directions are also discussed with an aim of guiding prospective studies. PMID:23311958

Automotive Technician II for ICT. Instructor's Guide, Curriculum Guide, and Student's Manual.

ERIC Educational Resources Information Center

Notgrass, Troy; Snider, Bob

The instructor's guide and curriculum guide contained in this packet are designed to help teachers provide future automotive technicians with some of the electronic skills they will need to service cars of the future. The instructor's guide is designed to help teachers make certain that each student gets the most benefit possible out of both the…

Multisensory Teaching of Basic Language Skills. Second Edition

ERIC Educational Resources Information Center

Birsh, Judith R., Ed.

2005-01-01

For students with dyslexia and other learning disabilities--and for their peers--creative teaching methods that use two or more senses can dramatically improve language skills and academic outcomes. That is why every current and future educator needs the second edition of this definitive guide to multisensory teaching. A core text for a variety of…

Career Pathways: Education with a Purpose

ERIC Educational Resources Information Center

Hull, Dan M.

2004-01-01

Hot off the press comes the guide to the next generation of education reform. Dan Hull and some of the nation's leading practitioners and educational leaders show how to remake high schools to improve academic outcomes, prepare students for today's high-skills workplace, and motivate them to learn because they see a pathway to their future.…

Complete to Compete: Common College Completion Metrics. Technical Guide

ERIC Educational Resources Information Center

Reyna, Ryan; Reindl, Travis; Witham, Keith; Stanley, Jeff

2010-01-01

Improved college completion rates are critical to the future of the United States, and states must have better data to understand the nature of the challenges they confront or target areas for policy change. The 2010-2011 National Governors Association (NGA) Chair's initiative, "Complete to Compete", recommends that all states collect data from…

Orbiter lessons learned: A guide to future vehicle development

NASA Technical Reports Server (NTRS)

Greenberg, Harry Stan

1993-01-01

Topics addressed are: (1) wind persistence loads methodology; (2) emphasize supportability in design of reusable vehicles; (3) design for robustness; (4) improved aerodynamic environment prediction methods for complex vehicles; (5) automated integration of aerothermal, manufacturing, and structures analysis; (6) continued electronic documentation of structural design and analysis; and (7) landing gear rollout load simulations.

Initial Teacher Education: Does Self-Efficacy Influence Candidate Teacher Academic Achievement and Future Career Performance?

ERIC Educational Resources Information Center

Shawer, Saad F.

2013-01-01

This quantitative investigation examined the influence of low and high self-efficacy on candidate teacher academic performance in a foreign language teaching methodology course through testing the speculation that high self-efficacy levels would improve pedagogical-content knowledge (PCK). Positivism guided the research design at the levels of…

Is Personalized Learning the Future of School?

ERIC Educational Resources Information Center

Paz-Albo, Jesús

2017-01-01

This article describes an innovative teaching approach that can offer the changes needed for school improvement. When entering an Education: Basic and Interactive (EBI) classroom, one will see students focused on accomplishing self-guided tasks and eager to move on to the next challenge in their self-paced learning. The EBI Project described here…

Guide to Evaluating the Essentials Training

ERIC Educational Resources Information Center

Education Development Center, Inc, 2006

2006-01-01

Countries that begin implementing the Intel[R] Teach to the Future Essentials course after March of 2006 are required to collect data using the Intel[R] Teach Essentials End of Training Survey to help support program improvement. This End of Training evaluation toolkit provides guidelines on: (1) End of Training Survey administration; (2) The…

Choosing the Future You Prefer. A Goal Setting Guide.

ERIC Educational Resources Information Center

Lindaman, Edward B.; Lippitt, Ronald O.

The guide, intended for group and organization leaders, presents activities and exercises to aid in personal and group goal-setting and planning for the future. The objective is to help groups choose goals which are sensitive to and oriented toward the evolving future with its rapid rate of change. The guide is presented in eight chapters.…

Implementing for Sustainability: Promoting Use of a Measurement Feedback System for Innovation and Quality Improvement.

PubMed

Douglas, Susan; Button, Suzanne; Casey, Susan E

2016-05-01

Measurement feedback systems (MFSs) are increasingly recognized as evidence-based treatments for improving mental health outcomes, in addition to being a useful administrative tool for service planning and reporting. Promising research findings have driven practice administrators and policymakers to emphasize the incorporation of outcomes monitoring into electronic health systems. To promote MFS integrity and protect against potentially negative outcomes, it is vital that adoption and implementation be guided by scientifically rigorous yet practical principles. In this point of view, the authors discuss and provide examples of three user-centered and theory-based principles: emphasizing integration with clinical values and workflow, promoting administrative leadership with the 'golden thread' of data-informed decision-making, and facilitating sustainability by encouraging innovation. In our experience, enacting these principles serves to promote sustainable implementation of MFSs in the community while also allowing innovation to occur, which can inform improvements to guide future MFS research.

Feasibility of real-time magnetic resonance imaging-guided endomyocardial biopsies: An in-vitro study.

PubMed

Lossnitzer, Dirk; Seitz, Sebastian A; Krautz, Birgit; Schnackenburg, Bernhard; André, Florian; Korosoglou, Grigorios; Katus, Hugo A; Steen, Henning

2015-07-26

To investigate if magnetic resonance (MR)-guided biopsy can improve the performance and safety of such procedures. A novel MR-compatible bioptome was evaluated in a series of in-vitro experiments in a 1.5T magnetic resonance imaging (MRI) system. The bioptome was inserted into explanted porcine and bovine hearts under real-time MR-guidance employing a steady state free precession sequence. The artifact produced by the metal element at the tip and the signal voids caused by the bioptome were visually tracked for navigation and allowed its constant and precise localization. Cardiac structural elements and the target regions for the biopsy were clearly visible. Our method allowed a significantly better spatial visualization of the bioptoms tip compared to conventional X-ray guidance. The specific device design of the bioptome avoided inducible currents and therefore subsequent heating. The novel MR-compatible bioptome provided a superior cardiovascular magnetic resonance (imaging) soft-tissue visualization for MR-guided myocardial biopsies. Not at least the use of MRI guidance for endomyocardial biopsies completely avoided radiation exposure for both patients and interventionalists. MRI-guided endomyocardial biopsies provide a better than conventional X-ray guided navigation and could therefore improve the specificity and reproducibility of cardiac biopsies in future studies.

A lack of standardization: the basis for the ethical issues surrounding quality and performance reports.

PubMed

Suchy, Kirsten

2010-01-01

Consumers in the United States are taking advantage of the proliferation of publicly available, internet-based performance reports and quality appraisals of health plans, healthcare organizations, hospitals, and physicians to aid in their healthcare decision making. However, these appraisal practices have given rise to controversy and debate over certain distinctive ethical issues. This article advocates a standardized ethical framework to guide current and future development and implementation of performance reports. This framework, which would resolve a number of the major issues, includes the following ethical principles to guide the practice of public reporting on the Internet and facilitate enhanced quality improvement in the healthcare industry: legitimacy, data integrity and quality, transparency, informed understanding, equity, privacy and confidentiality, collaboration, accountability, and evaluation and continuous improvement.

U of M Civil Service Wellness Survey: Finding Out Employees' Health and Wellness Needs. A Report of Key Findings.

ERIC Educational Resources Information Center

Matross, Ron; Roesler, Jon

Key findings from a wellness survey conducted with University of Minnesota civil service employees are discussed. The survey was designed to provide information to guide future campus health and wellness programming. Four topics were covered: physical fitness/exercise, nutrition, self-improvement/psychological health, and general health/preventive…

Improving the Health of Adolescents & Young Adults: A Guide for States and Communities

ERIC Educational Resources Information Center

Brindis, Claire D.; Park, M. Jane; Valderrama, L. Teresa; Lee, Caron M.; Margolis, Rebecca; Kolbe, Lloyd J.; Achrekar, Angeli P.; Hannan, Casey; Anglin, Trina M.

2004-01-01

Adolescence represents a unique period in the life cycle. No longer children and not yet adults, adolescents make significant choices about their health and develop attitudes and health practices that impact their current safety and well-being. Those choices also often influence their risk for future serious chronic disease. Adolescence also…

Modeling GHG Emissions and Carbon Changes in Agricultural and Forest Systems to Guide Mitigation and Adaptation: Synthesis and Future Needs

USDA-ARS?s Scientific Manuscript database

Agricultural production systems and land use change for agriculture and forestry are important sources of anthropogenic greenhouse gas (GHG) emissions. Recent commitments by the European Union, the United States, and China to reduce GHG emissions highlight the need to improve estimates of current em...

Handbook for a Commitment to America's Future: A Toolkit for Leaders of State-Level P-16

ERIC Educational Resources Information Center

Business-Higher Education Forum (NJ1), 2005

2005-01-01

This handbook provides P-16 council leaders with a toolkit of background information and proposed procedures for structuring and guiding implementation of Business-Higher Education Forum's (BHEF) proposed action plan. Specifically, it details a four-part nationwide action plan to improve overall pre-kindergarten through high school (P-12)…

Understanding Learners' Self-Assessment and Self-Feedback on Their Foreign Language Speaking Performance

ERIC Educational Resources Information Center

Huang, Shu-Chen

2016-01-01

This study examines university learners' self-assessment and self-feedback on performance as captured in audio files from a foreign language speaking test. The learners' were guided to listen, transcribe and analyse their own speaking samples, as well as propose future actions for improvement. Content of learners' self-feedback was scrutinised…

What Should Guide Health Policy? A Perspective Beyond Politics.

PubMed

Kirch, Darrell G; Ast, Cori

2017-09-01

As the U.S. electorate has become increasingly polarized, these divisions are poised to shape legislative and regulatory work in the years ahead. For those whose focus is on the public goods of health care for all, the advancement of science through rigorous research, and the contribution of higher education to the continual improvement of the nation's workforce, there is profound uncertainty about the future. There are several pressing questions facing the nation and academic medicine, including the future of affordable, accessible insurance; acceptance of scientific evidence; sustainable learning and teaching methodologies; and the well-being and preparation of the nation's health workforce to care for an increasingly diverse nation. For those in academic medicine and policy making alike, the authors propose a framework, grounded in scientific evidence and guided by clinical ethics, for designing and evaluating health policy solutions for these and other pressing questions.

Future methods in pharmacy practice research.

PubMed

Almarsdottir, A B; Babar, Z U D

2016-06-01

This article describes the current and future practice of pharmacy scenario underpinning and guiding this research and then suggests future directions and strategies for such research. First, it sets the scene by discussing the key drivers which could influence the change in pharmacy practice research. These are demographics, technology and professional standards. Second, deriving from this, it seeks to predict and forecast the future shifts in use of methodologies. Third, new research areas and availability of data impacting on future methods are discussed. These include the impact of aging information technology users on healthcare, understanding and responding to cultural and social disparities, implementing multidisciplinary initiatives to improve health care, medicines optimization and predictive risk analysis, and pharmacy as business and health care institution. Finally, implications of the trends for pharmacy practice research methods are discussed.

Progress with the lick adaptive optics system

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

Gavel, D T; Olivier, S S; Bauman, B

2000-03-01

Progress and results of observations with the Lick Observatory Laser Guide Star Adaptive Optics System are presented. This system is optimized for diffraction-limited imaging in the near infrared, 1-2 micron wavelength bands. We describe our development efforts in a number of component areas including, a redesign of the optical bench layout, the commissioning of a new infrared science camera, and improvements to the software and user interface. There is also an ongoing effort to characterize the system performance with both natural and laser guide stars and to fold this data into a refined system model. Such a model can bemore » used to help plan future observations, for example, predicting the point-spread function as a function of seeing and guide star magnitude.« less

Post-Flight EDL Entry Guidance Performance of the 2011 Mars Science Laboratory Mission

NASA Technical Reports Server (NTRS)

Mendeck, Gavin F.; McGrew, Lynn Craig

2013-01-01

The 2011 Mars Science Laboratory was the first Mars guided entry which safely delivered the rover to a landing within a touchdown ellipse of 19.1 km x 6.9 km. The Entry Terminal Point Controller guidance algorithm is derived from the final phase Apollo Command Module guidance and, like Apollo, modulates the bank angle to control the range flown. The guided entry performed as designed without any significant exceptions. The Curiosity rover was delivered about 2.2 km from the expected touchdown. This miss distance is attributed to little time to correct the downrange drift from the final bank reversal and a suspected tailwind during heading alignment. The successful guided entry for the Mars Science Laboratory lays the foundation for future Mars missions to improve upon.

Research Performed within the Non-Destructive Evaluation Team at NASA Glenn Research Center

NASA Technical Reports Server (NTRS)

Burns, Erin A.

2004-01-01

Non-destructive testing is essential in many fields of manufacturing and research in order to perform reliable examination of potentially damaged materials and parts without destroying the inherent structure of the materials. Thus, the Non-Destructive Evaluation (NDE) Team at NASA Glenn Research Center partakes in various projects to improve materials testing equipment as well as analyze materials, material defects, and material deficiencies. Due to the array of projects within the NDE Team at this time, five research aims were supplemental to some current projects. A literature survey of "DE and testing methodologies as related to rocks was performed. Also, Mars Expedition Rover technology was assessed to understand the requirements for instrumentation in harsh space environments (e.g. temperature). Potential instrumentation and technologies were also considered and documented. The literature survey provided background and potential sources for a proposal to acquire funding for ultrasonic instrumentation on board a future Mars expedition. The laboratory uses a Santec Systems AcousticScope AS200 acoustography system. Labview code was written within the current program in order to improve the current performance of the acoustography system. A sample of Reinforced Carbon/Carbon (RCC) material from the leading edge of the space shuttle underwent various non-destructive tests (guided wave scanning, thermography, computed tomography, real time x-ray, etc.) in order to characterize its structure and examine possible defects. Guided wave scan data of a ceramic matrix composite (CMC) panel was reanalyzed utilizing image correlations and signal processing variables. Additional guided wave scans and thermography were also performed on the CMC panel. These reevaluated data and images will be used in future presentations and publications. An additional axis for the guided wave scanner was designed, constructed, and implemented. This additional axis allowed incremental spacing of the previously fixed transducers for ultrasonic velocity measurements.

State of condom use in HIV prevention science and practice.

PubMed

Crosby, Richard A

2013-03-01

Condom use remains as the frontline defense against the HIV/AIDS pandemic. Fortunately, an ever-expanding body of empirical literature is currently guiding improvements in use of this prevention strategy. Recent advances include improved measurement of condom use behaviors, advances in condom effectiveness research, innovations in the design of condoms, and greater intervention efficiency for high-risk populations. After reviewing each of these four areas of research, this article will offer speculation about the future of condom use for HIV prevention.

The effects of using guided notes and review of science achievement for male and female students

NASA Astrophysics Data System (ADS)

Tyrrell, Diann Marie

2000-11-01

The National Science Foundation predicts a shortage of scientists and engineers within the next 15 years. Some agree that the participation of women in science will be required to help meet the future demand for scientists (Malcom, 1990). Consequently, conscientious teachers search for learning strategies that provide opportunities for young women to achieve success with others in their science classes. This research concerns a note taking and teaching strategy that involves seventh grade science students. The investigation measured student achievement under three prescribed conditions. The treatment conditions were reviewing, guided notes, and guided notes with reviewing. For this experiment, the Solomon four-group design was utilized. This 2 x 2 factorial design tested for treatment effect and pretest sensitivity. Data was collected on seventh grade boys (n = 119) and seventh grade girls (n = 139) in science. Comparisons were made between the boys and girls groups. The results showed that achievement improved significantly when reviewing car using guided notes independently. The results also shower that significant improvements in achievement were not observed when participants used guided notes and reviewing together. Analysis was completed to measure how well the participants performed according to gender. This research showed that both boys and girls significantly improved their achievement in science equally well for all treatment conditions. This research went a step further by factoring in cognitive ability test scores and comparing them to the treatment results. This provided the researcher with information on which treatment condition worked best for high or low achieving students.

Perspectives On Dilution Jet Mixing

NASA Technical Reports Server (NTRS)

Holdeman, J. D.; Srinivasan, R.

1990-01-01

NASA recently completed program of measurements and modeling of mixing of transverse jets with ducted crossflow, motivated by need to design or tailor temperature pattern at combustor exit in gas turbine engines. Objectives of program to identify dominant physical mechanisms governing mixing, extend empirical models to provide near-term predictive capability, and compare numerical code calculations with data to guide future analysis improvement efforts.

Intraoperative imaging-guided cancer surgery: from current fluorescence molecular imaging methods to future multi-modality imaging technology.

PubMed

Chi, Chongwei; Du, Yang; Ye, Jinzuo; Kou, Deqiang; Qiu, Jingdan; Wang, Jiandong; Tian, Jie; Chen, Xiaoyuan

2014-01-01

Cancer is a major threat to human health. Diagnosis and treatment using precision medicine is expected to be an effective method for preventing the initiation and progression of cancer. Although anatomical and functional imaging techniques such as radiography, computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) have played an important role for accurate preoperative diagnostics, for the most part these techniques cannot be applied intraoperatively. Optical molecular imaging is a promising technique that provides a high degree of sensitivity and specificity in tumor margin detection. Furthermore, existing clinical applications have proven that optical molecular imaging is a powerful intraoperative tool for guiding surgeons performing precision procedures, thus enabling radical resection and improved survival rates. However, detection depth limitation exists in optical molecular imaging methods and further breakthroughs from optical to multi-modality intraoperative imaging methods are needed to develop more extensive and comprehensive intraoperative applications. Here, we review the current intraoperative optical molecular imaging technologies, focusing on contrast agents and surgical navigation systems, and then discuss the future prospects of multi-modality imaging technology for intraoperative imaging-guided cancer surgery.

Intraoperative Imaging-Guided Cancer Surgery: From Current Fluorescence Molecular Imaging Methods to Future Multi-Modality Imaging Technology

PubMed Central

Chi, Chongwei; Du, Yang; Ye, Jinzuo; Kou, Deqiang; Qiu, Jingdan; Wang, Jiandong; Tian, Jie; Chen, Xiaoyuan

2014-01-01

Cancer is a major threat to human health. Diagnosis and treatment using precision medicine is expected to be an effective method for preventing the initiation and progression of cancer. Although anatomical and functional imaging techniques such as radiography, computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) have played an important role for accurate preoperative diagnostics, for the most part these techniques cannot be applied intraoperatively. Optical molecular imaging is a promising technique that provides a high degree of sensitivity and specificity in tumor margin detection. Furthermore, existing clinical applications have proven that optical molecular imaging is a powerful intraoperative tool for guiding surgeons performing precision procedures, thus enabling radical resection and improved survival rates. However, detection depth limitation exists in optical molecular imaging methods and further breakthroughs from optical to multi-modality intraoperative imaging methods are needed to develop more extensive and comprehensive intraoperative applications. Here, we review the current intraoperative optical molecular imaging technologies, focusing on contrast agents and surgical navigation systems, and then discuss the future prospects of multi-modality imaging technology for intraoperative imaging-guided cancer surgery. PMID:25250092

Consumer Education: Ecological Resource Management. Home & Family Life Curriculum Guide: H.E. Bulletin No. 43.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia.

The future ability of secondary students to interact in a progressively technologically-oriented society is the purpose of this curriculum guide on consumer education. The guide teaches consumer decision-making, resource management, and advocacy/action. The introduction discusses the future of society and technology. Each of three sections…

New Developments in CRISPR Technology: Improvements in Specificity and Efficiency.

PubMed

Safari, Fatemeh; Farajnia, Safar; Ghasemi, Younes; Zarghami, Nosratollah

2017-01-01

RNA-guided endonuclease as a versatile genome editing technology opened new windows in various fields of biology. The simplicity of this revolutionary technique provides a promising future for its application in a broad range of approaches from functional annotation of genes to diseases, to genetic manipulation and gene therapy. Besides the site-specific activity of Cas9 endonuclease, the unintended cleavage known as off-target effect is still a major challenge for this genome editing technique. Various strategies have been developed to resolve this bottleneck including development of new softwares for designing optimized guide RNA (gRNA), engineering Cas9 enzyme, improvement in off-target detection assays, etc. Results: This review dedicated to discuss on methods that have been used for optimizing Cas9, specificity with the aim of improving this technology for therapeutic applications. In addition, the applications and novel breakthroughs in the field of CRISPR technology will be described. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Scientific American Frontiers Teaching Guides for Shows 701-705, October 1996-April 1997.

ERIC Educational Resources Information Center

Connecticut Public Television, Hartford.

These teaching guides are meant to supplement the seventh season (1996-97) of the PBS Series "Scientific American Frontiers". Episode 701 is entitled "Inventing the Future: A Tour of the MIT Media Lab" and the teaching guide contains information and activities on a virtual pet dog, computers of the future, a smart car designed…

How the Army Runs: A Senior Leader Reference Handbook, 2015-2016

DTIC Science & Technology

2015-08-28

sector , creates a recruiting multiplier, improves employment prospects for transitioning personnel, reduces unemployment compensation costs to the Army...and the private sector . (3) Consider three general time frames of near-term (associate with the future-years defense program), mid-term (10-15...TRADOC Pamphlet 525-66 also guides Independent Research & Development (IR&D) efforts. By providing the private sector an unclassified, descriptive

Analyzing a Career. The Wisconsin Guide to Local Curriculum Improvement in Industrial Education, K-12.

ERIC Educational Resources Information Center

Loeffler, Gordon

The intent of this field tested instructional package is to acquaint the student with a method of career analysis to enable him to determine whether a career is in harmony with his future employment goals. The package provides behavioral objectives, a student self-test, a basic information section, and a career analysis study to aid the student in…

Space Shuttle Program Legacy Report

NASA Technical Reports Server (NTRS)

Johnson, Scott

2012-01-01

Share lessons learned on Space Shuttle Safety and Mission Assurance (S&MA) culture, processes, and products that can guide future enterprises to improve mission success and minimize the risk of catastrophic failures. Present the chronology of the Johnson Space Center (JSC) S&MA organization over the 40-year history of the Space Shuttle Program (SSP) and identify key factors and environments which contributed to positive and negative performance.

Facilitating comparative effectiveness research in cancer genomics: evaluating stakeholder perceptions of the engagement process.

PubMed

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O'Leary, James; Ruffner, B W; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D

2012-07-01

The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement.

The Annie E. Casey Foundation's New Futures Initiative: Strategic Planning Guide. (Revised).

ERIC Educational Resources Information Center

Center for the Study of Social Policy, Washington, DC.

Information in this guide is based on published research concerning effective strategies in dealing with at-risk youth. It was written for those communities invited to develop proposals under the Annie E. Casey Foundation's New Futures Initiative in an attempt to alleviate problems that compromise American children's futures. Each of three…

Programming Equity into Computer Education: Today's Guide to the Schools of the Future. A PEER Computer Equity Action Kit.

ERIC Educational Resources Information Center

Martin-McCormick, Lynda; And Others

An advocacy packet on educational equity in computer education consists of five separate materials. A booklet entitled "Today's Guide to the Schools of the Future" contains four sections. The first section, a computer equity assessment guide, includes interview questions about school policies and allocation of resources, student and teacher…

Using the HEADSSS guide to teach students diagnostic skills in adolescent health Views from students participating in interprofessional courses.

PubMed

Parisi, Vanessa; De Stadelhofen, Léo Meyer; Péchère, Benoit; Steimer, Sylvain; De Watteville, Aude; Haller, Dagmar M; Navarro, Carol; Szynalski-Morel, Murielle; Meynard, Anne

Over the past few years, an interprofessional team of lecturers in Geneva has developed courses entitled « adolescent health and development ». These courses are open to students in medicine, nursing and nutrition, as well as to other interested health professionals. Using vignettes, students who participated in the courses present their thoughts on the use of the HEADSSS interview guide in the diagnostic approach with adolescents. These optional courses provide an opportunity to explore infrequently taught domains of the curriculum in a creative way. They give students the chance to develop common practice skills providing the basis for improved inter-professional collaborations in the future.

[Research progress in mechanisms and clinical application for blonanserin and lurasidone in improving cognitive function of schizophrenia].

PubMed

Zheng, Qi; Liu, Bangshan; Xu, Shuyin; Liao, Mei; Zhang, Yan; Li, Lingjiang

2017-04-28

Cognition deficit is one of the most common symptoms of schizophrenia, including abstract thinking and memory, and attention deficits. Previous studies have suggested that the improvement of cognition is very important for the recovery of disease and social function for the patients. Recent studies indicated that two new atypical antipsychotics, blonanserin and lurasidone, are expected to improve the cognitive impairment in patients with schizophrenia. This review introduces pathogenesis of cognitive impairment in schizophrenia, mechanisms of blonanserin and lurasidone in the improvement of cognitive impairment and progress in their clinical application for schizophrenia. We hope that this review could guide clinical use of antipsychotics and provide new directions for future studies.

Clinical Diabetes Centers of Excellence: A Model for Future Adult Diabetes Care.

PubMed

Draznin, Boris; Kahn, Peter A; Wagner, Nicole; Hirsch, Irl B; Korytkowski, Mary; Harlan, David M; McDonnell, Marie E; Gabbay, Robert A

2018-03-01

Although diabetes research centers are well defined by National Institutes of Health, there is no clear definition for clinical Diabetes Centers of Excellence (DCOEs). There are multiple clinical diabetes centers across the United States, some established with philanthropic funding; however, it is not clear what defines a DCOE from a clinical perspective and what the future will be for these centers. In this Perspective we propose a framework to guide advancement for DCOEs. With the shift toward value-based purchasing and reimbursement and away from fee for service, defining the procedures for broader implementation of DCOEs as a way to improve population health and patient care experience (including quality and satisfaction) and reduce health care costs becomes critically important. It is prudent to implement new financial systems for compensating diabetes care that may not be provided by fiscally constrained private and academic medical centers. We envision that future clinical DCOEs would be composed of a well-defined infrastructure and six domains or pillars serving as the general guiding principles for developing expertise in diabetes care that can be readily demonstrated to stakeholders, including health care providers, patients, payers, and government agencies.

Ultrasound-guided percutaneous irrigation in rotator cuff calcific tendinopathy: what is the evidence? A systematic review with proposals for future reporting.

PubMed

Lanza, Ezio; Banfi, Giuseppe; Serafini, Giovanni; Lacelli, Francesca; Orlandi, Davide; Bandirali, Michele; Sardanelli, Francesco; Sconfienza, Luca Maria

2015-07-01

We performed a systematic review of current evidence regarding ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) in the shoulder aimed to: assess different published techniques; evaluate clinical outcome in a large combined cohort; and propose suggestions for homogeneous future reporting. Cochrane Collaboration for Systematic Reviews of Interventions Guidelines were followed. We searched MEDLINE/MEDLINE In-Process/EMBASE/Cochrane databases from 1992-2013 using the keywords 'ultrasound, shoulder, needling, calcification, lavage, rotator cuff' combined in appropriate algorithms. References of resulting papers were also screened. Risk of bias was assessed with a modified Newcastle-Ottawa Scale. Of 284 papers found, 15 were included, treating 1,450 shoulders in 1,403 patients (females, n = 838; mean age interval 40-63 years). There was no exclusion due to risk of bias. US-PICT of rotator cuff is a safe and effective procedure, with an estimated average 55% pain improvement at an average of 11 months, with a 10% minor complication rate. No evidence exists in favour of using a specific size/number of needles. Imaging follow-up should not be used routinely. Future studies should aim at structural uniformity, including the use of the Constant Score to assess outcomes and 1-year minimum follow-up. Alternatives to steroid injections should also be explored. • US-PICT of rotator cuff is a safe and effective procedure. • On average 55% pain improvement with 10% minor complication rate. • No evidence exists in favour of using a specific size/number of needles. • Future need to assess outcome using Constant Score with 1-year minimum follow-up.

N-acetylcysteine in a Double-Blind Randomized Placebo-Controlled Trial: Toward Biomarker-Guided Treatment in Early Psychosis

PubMed Central

Conus, Philippe; Seidman, Larry J; Fournier, Margot; Xin, Lijing; Cleusix, Martine; Baumann, Philipp S; Ferrari, Carina; Cousins, Ann; Alameda, Luis; Gholam-Rezaee, Mehdi; Golay, Philippe; Jenni, Raoul; Woo, T -U Wilson; Keshavan, Matcheri S; Eap, Chin B; Wojcik, Joanne; Cuenod, Michel; Buclin, Thierry; Gruetter, Rolf

2018-01-01

Abstract Biomarker-guided treatments are needed in psychiatry, and previous data suggest oxidative stress may be a target in schizophrenia. A previous add-on trial with the antioxidant N-acetylcysteine (NAC) led to negative symptom reductions in chronic patients. We aim to study NAC’s impact on symptoms and neurocognition in early psychosis (EP) and to explore whether glutathione (GSH)/redox markers could represent valid biomarkers to guide treatment. In a double-blind, randomized, placebo-controlled trial in 63 EP patients, we assessed the effect of NAC supplementation (2700 mg/day, 6 months) on PANSS, neurocognition, and redox markers (brain GSH [GSHmPFC], blood cells GSH levels [GSHBC], GSH peroxidase activity [GPxBC]). No changes in negative or positive symptoms or functional outcome were observed with NAC, but significant improvements were found in favor of NAC on neurocognition (processing speed). NAC also led to increases of GSHmPFC by 23% (P = .005) and GSHBC by 19% (P = .05). In patients with high-baseline GPxBC compared to low-baseline GPxBC, subgroup explorations revealed a link between changes of positive symptoms and changes of redox status with NAC. In conclusion, NAC supplementation in a limited sample of EP patients did not improve negative symptoms, which were at modest baseline levels. However, NAC led to some neurocognitive improvements and an increase in brain GSH levels, indicating good target engagement. Blood GPx activity, a redox peripheral index associated with brain GSH levels, could help identify a subgroup of patients who improve their positive symptoms with NAC. Thus, future trials with antioxidants in EP should consider biomarker-guided treatment. PMID:29462456

Dinosaurs and Power Plants. Energy from the Past for the Future. Teacher's Lesson Plan and Activity Guide; Teacher's Guide Supplement of Reproducible Graphics.

ERIC Educational Resources Information Center

Department of Energy, Washington, DC. Office of Fossil Energy.

This teacher's guide and its accompanying supplement were prepared for use with the U.S. Department of Energy's Dinosaurs and Power Plants, a publication designed for students in grades 5-8 about the history, detection, extraction, transportation, use, environmental problem/solutions, and future of fossil energy. The study of energy science shows…

The era of 3Rs implementation in developmental and reproductive toxicity (DART) testing: Current overview and future perspectives.

PubMed

Beekhuijzen, Manon

2017-09-01

Since adoption of the first globally implemented guidelines for developmental and reproductive toxicity (DART) testing for pharmaceuticals, industrial chemicals and agrochemicals, many years passed without major updates. However in recent years, significant changes in these guidelines have been made or are being implemented. These changes have been guided by the ethical drive to reduce, refine and replace (3R) animal testing, as well as the addition of endocrine disruptor relevant endpoints. Recent applied improvements have focused on reduction and refinement. Ongoing scientific and technical innovations will provide the means for replacement of animal testing in the future and will improve predictivity in humans. The aim of this review is to provide an overview of ongoing global DART endeavors in respect to the 3Rs, with an outlook towards future advances in DART testing aspiring to reduce animal testing to a minimum and the supreme ambition towards animal-free hazard and risk assessment. Copyright © 2017 Elsevier Inc. All rights reserved.

Use of an Innovative Personality-Mindset Profiling Tool to Guide Culture-Change Strategies among Different Healthcare Worker Groups.

PubMed

Grayson, M Lindsay; Macesic, Nenad; Huang, G Khai; Bond, Katherine; Fletcher, Jason; Gilbert, Gwendolyn L; Gordon, David L; Hellsten, Jane F; Iredell, Jonathan; Keighley, Caitlin; Stuart, Rhonda L; Xuereb, Charles S; Cruickshank, Marilyn

2015-01-01

Important culture-change initiatives (e.g. improving hand hygiene compliance) are frequently associated with variable uptake among different healthcare worker (HCW) categories. Inherent personality differences between these groups may explain change uptake and help improve future intervention design. We used an innovative personality-profiling tool (ColourGrid®) to assess personality differences among standard HCW categories at five large Australian hospitals using two data sources (HCW participant surveys [PS] and generic institution-wide human resource [HR] data) to: a) compare the relative accuracy of these two sources; b) identify differences between HCW groups and c) use the observed profiles to guide design strategies to improve uptake of three clinically-important initiatives (improved hand hygiene, antimicrobial stewardship and isolation procedure adherence). Results from 34,243 HCWs (HR data) and 1045 survey participants (PS data) suggest that HCWs were different from the general population, displaying more individualism, lower power distance, less uncertainty avoidance and greater cynicism about advertising messages. HR and PS data were highly concordant in identifying differences between the three key HCW categories (doctors, nursing/allied-health, support services) and predicting appropriate implementation strategies. Among doctors, the data suggest that key messaging should differ between full-time vs part-time (visiting) senior medical officers (SMO, VMO) and junior hospital medical officers (HMO), with SMO messaging focused on evidence-based compliance, VMO initiatives emphasising structured mandatory controls and prestige loss for non-adherence, and for HMOs focusing on leadership opportunity and future career risk for non-adherence. Compared to current standardised approaches, targeted interventions based on personality differences between HCW categories should result in improved infection control-related culture-change uptake. Personality profiling based on HR data may represent a useful means of developing a national culture-change "blueprint" for HCW education.

Use of Mobile Apps Among Medical and Nursing Students in Iran.

PubMed

Sheikhtaheri, Abbas; Kermani, Farzaneh

2018-01-01

Mobile technologies have a positive impact on patient care and cause to improved decision making, reduced medical errors and improved communication in care team. The purpose of this study was to investigate the use of mobile technologies by medical and nursing students and their tendency in future. This study was conducted among 372 medical and nursing students of Tehran University of Medical Science. Respectively, 60.8% and 62.4% of medical and nursing students use smartphone. The most commonly used apps among medical students were medical dictionary, drug apps, medical calculators and anatomical atlases and among nursing students were medical dictionary, anatomical atlases and nursing care guides. Also, the use of decision support systems, remote monitoring, patient imagery and remote diagnosis, patient records documentation, diagnostic guidelines and laboratory tests will be increased in the future.

The National Electronic Library: A Guide to the Future for Library Managers. The Greenwood Library Management Collection.

ERIC Educational Resources Information Center

Pitkin, Gary M., Ed.

As a reference guide for library professionals, this volume helps librarians prepare for the future in the growing electronic environment by examining the historical and theoretical background of the National Electronic Library and assessing the role of libraries in the past, present, and future. The book is divided in two sections: "The…

Ice detection and classification on an aircraft wing with ultrasonic shear horizontal guided waves.

PubMed

Gao, Huidong; Rose, Joseph L

2009-02-01

Ice accumulation on airfoils has been identified as a primary cause of many accidents in commercial and military aircraft. To improve aviation safety as well as reduce cost and environmental threats related to aircraft icing, sensitive, reliable, and aerodynamically compatible ice detection techniques are in great demand. Ultrasonic guided-wave-based techniques have been proved reliable for "go" and "no go" types of ice detection in some systems including the HALO system, in which the second author of this paper is a primary contributor. In this paper, we propose a new model that takes the ice layer into guided-wave modeling. Using this model, the thickness and type of ice formation can be determined from guided-wave signals. Five experimental schemes are also proposed in this paper based on some unique features identified from the guided- wave dispersion curves. A sample experiment is also presented in this paper, where a 1 mm thick glaze ice on a 2 mm aluminum plate is clearly detected. Quantitative match of the experiment data to theoretical prediction serves as a strong support for future implementation of other testing schemes proposed in this paper.

Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial

PubMed Central

Arias-Buría, José L.; Truyols-Domínguez, Sebastián; Valero-Alcaide, Raquel; Salom-Moreno, Jaime; Atín-Arratibel, María A.; Fernández-de-las-Peñas, César

2015-01-01

Objective. To compare effects of ultrasound- (US-) guided percutaneous electrolysis combined with an eccentric exercise program of the rotator cuff muscles in subacromial pain syndrome. Methods. Thirty-six patients were randomized and assigned into US-guided percutaneous electrolysis (n = 17) group or exercise (n = 19) group. Patients were asked to perform an eccentric exercise program of the rotator cuff muscles twice every day for 4 weeks. Participants assigned to US-guided percutaneous electrolysis group also received the application of galvanic current through acupuncture needle on each session once a week (total 4 sessions). Shoulder pain (NPRS) and disability (DASH) were assessed at baseline, after 2 sessions, and 1 week after the last session. Results. The ANOVA revealed significant Group∗Time interactions for shoulder pain and disability (all, P < 0.01): individuals receiving US-guided percutaneous electrolysis combined with the eccentric exercises experienced greater improvement than those receiving eccentric exercise alone. Conclusions. US-guided percutaneous electrolysis combined with eccentric exercises resulted in small better outcomes at short term compared to when only eccentric exercises were applied in subacromial pain syndrome. The effect was statistically and clinically significant for shoulder pain but below minimal clinical difference for function. Future studies should investigate the long-term effects and potential placebo effect of this intervention. PMID:26649058

Recent Progress in Chronic Neutrophilic Leukemia and Atypical Chronic Myeloid Leukemia.

PubMed

Dao, Kim-Hien T; Tyner, Jeffrey W; Gotlib, Jason

2017-10-01

We reviewed recent diagnostic and therapeutic progress in chronic neutrophilic leukemia (CNL) and atypical chronic myeloid leukemia (aCML). We summarized recent genetic data that may guide future efforts towards implementing risk-adapted therapy based on mutational profile and improving disease control and survival of affected patients. Recent genetic data in CNL and aCML prompted modifications to the World Health Organization (WHO) diagnostic criteria, which have improved our understanding of how CNL and aCML are different diseases despite sharing common findings of peripheral granulocytosis and marrow myeloid hyperplasia. The overlap of recurrently mutated genes between aCML and CMML support considering CSF3R-T618I mutated cases as a distinct entity, either as CNL or CNL with dysplasia. Ongoing preclinical and clinical studies will help to further inform the therapeutic approach to these diseases. Our understanding of CNL and aCML has greatly advanced over the last few years. This will improve clarity for the diagnosis of these diseases, provide a strategy for risk stratification, and guide risk-adapted therapy.

Wide-bore 1.5 T MRI-guided deep brain stimulation surgery: initial experience and technique comparison.

PubMed

Sillay, Karl A; Rusy, Deborah; Buyan-Dent, Laura; Ninman, Nancy L; Vigen, Karl K

2014-12-01

We report results of the initial experience with magnetic resonance image (MRI)-guided implantation of subthalamic nucleus (STN) deep brain stimulating (DBS) electrodes at the University of Wisconsin after having employed frame-based stereotaxy with previously available MR imaging techniques and microelectrode recording for STN DBS surgeries. Ten patients underwent MRI-guided DBS implantation of 20 electrodes between April 2011 and March 2013. The procedure was performed in a purpose-built intraoperative MRI suite configured specifically to allow MRI-guided DBS, using a wide-bore (70 cm) MRI system. Trajectory guidance was accomplished with commercially available system consisting of an MR-visible skull-mounted aiming device and a software guidance system processing intraoperatively acquired iterative MRI scans. A total of 10 patients (5 male, 5 female)-representative of the Parkinson Disease (PD) population-were operated on with standard technique and underwent 20 electrode placements under MRI-guided bilateral STN-targeted DBS placement. All patients completed the procedure with electrodes successfully placed in the STN. Procedure time improved with experience. Our initial experience confirms the safety of MRI-guided DBS, setting the stage for future investigations combining physiology and MRI guidance. Further follow-up is required to compare the efficacy of the MRI-guided surgery cohort to that of traditional frame-based stereotaxy. Copyright © 2014 Elsevier B.V. All rights reserved.

Using Uncertainty Quantification to Guide Development and Improvements of a Regional-Scale Model of the Coastal Lowlands Aquifer System Spanning Texas, Louisiana, Mississippi, Alabama and Florida

NASA Astrophysics Data System (ADS)

Foster, L. K.; Clark, B. R.; Duncan, L. L.; Tebo, D. T.; White, J.

2017-12-01

Several historical groundwater models exist within the Coastal Lowlands Aquifer System (CLAS), which spans the Gulf Coastal Plain in Texas, Louisiana, Mississippi, Alabama, and Florida. The largest of these models, called the Gulf Coast Regional Aquifer System Analysis (RASA) model, has been brought into a new framework using the Newton formulation for MODFLOW-2005 (MODFLOW-NWT) and serves as the starting point of a new investigation underway by the U.S. Geological Survey to improve understanding of the CLAS and provide predictions of future groundwater availability within an uncertainty quantification (UQ) framework. The use of an UQ framework will not only provide estimates of water-level observation worth, hydraulic parameter uncertainty, boundary-condition uncertainty, and uncertainty of future potential predictions, but it will also guide the model development process. Traditionally, model development proceeds from dataset construction to the process of deterministic history matching, followed by deterministic predictions using the model. This investigation will combine the use of UQ with existing historical models of the study area to assess in a quantitative framework the effect model package and property improvements have on the ability to represent past-system states, as well as the effect on the model's ability to make certain predictions of water levels, water budgets, and base-flow estimates. Estimates of hydraulic property information and boundary conditions from the existing models and literature, forming the prior, will be used to make initial estimates of model forecasts and their corresponding uncertainty, along with an uncalibrated groundwater model run within an unconstrained Monte Carlo analysis. First-Order Second-Moment (FOSM) analysis will also be used to investigate parameter and predictive uncertainty, and guide next steps in model development prior to rigorous history matching by using PEST++ parameter estimation code.

Developing a systematic strategy incorporating ethical , animal welfare and practice principles to guide the genetic improvement of dairy cattle.

PubMed

Fisher, M W; Mellor, D J

2008-06-01

People have complex and diverse relationships and interactions with, and expectations of, animals; relationships which are very important. In making sense of this complexity, we draw on our values. The objective of this study was to reflect upon, develop and articulate key values guiding the genetic improvement of dairy cattle. Animal husbandry is guided by the philosophy that while animals serve our needs, we must ensure that their needs are met, and any compromises to those needs justified and minimised. In applying modern technology to the genetic improvement of animals, this philosophy should be enacted through consideration of all the broader goals of agriculture, and the ecology and biology of the farming system. It should also be informed by the differing perspectives of interested parties, including stock handlers, veterinarians, animal welfare groups, consumers, and the public. Monitoring the consequences of technology applications, managing and avoiding any harms, and considering the future of animals and ourselves, should also be part of decision making in this area. Transparent consideration of these principles will help to ensure that any compromises to animal welfare resulting from trait selection are both reasonable and necessary, and that any harms are minimised, thereby helping to safeguard continuation of the important contribution that animal agriculture, and in particular the dairy sector, makes to society.

Development of a NRSE Spectrometer with the Help of McStas - Application to the Design of Present and Future Instruments

NASA Astrophysics Data System (ADS)

Kredler, L.; Häußler, W.; Martin, N.; Böni, P.

The flux is still a major limiting factor in neutron research. For instruments being supplied by cold neutrons using neutron guides, both at present steady-state and at new spallation neutron sources, it is therefore important to optimize the instrumental setup and the neutron guidance. Optimization of neutron guide geometry and of the instrument itself can be performed by numerical ray-tracing simulations using existing open-access codes. In this paper, we discuss how such Monte Carlo simulations have been employed in order to plan improvements of the Neutron Resonant Spin Echo spectrometer RESEDA (FRM II, Germany) as well as the neutron guides before and within the instrument. The essential components have been represented with the help of the McStas ray-tracing package. The expected intensity has been tested by means of several virtual detectors, implemented in the simulation code. Comparison between simulations and preliminary measurements results shows good agreement and demonstrates the reliability of the numerical approach. These results will be taken into account in the planning of new components installed in the guide system.

The Feasibility and Effectiveness of Online Guided Imagery Training for Health Professionals

PubMed Central

Rao, Nisha; Kemper, Kathi J.

2016-01-01

This study evaluated the feasibility and impact of brief online guided imagery training (up to 3 hours) for health professionals. Paired t tests were used to measure pre-to-post-training changes in stress (Perceived Stress Scale,), anxiety (Patient Reported Outcomes Measurement Information System–Anxiety Scale), empathy (Empathic Concern Scale, and Perspective-taking Scale), and self-efficacy (Self-Efficacy in providing Non-Drug Therapies Scale). Online guided imagery training attracted diverse health professionals and trainees (n = 273; 14% trainees; 34% registered nurses, 20% physicians, 14% social workers, 5% registered dititians, and 27% others). Participants reported small but significant pre-to-post-module improvements in stress (17.8 to 13.5), anxiety (T-scores 56.4 to 54.3), empathy (both empathic concern, 29.8 to 30.7, and perspective taking, 28.0 to 29.4), and self-efficacy in providing nondrug therapies for common symptoms (58.5 to 77.0) (P < .001 for all). Future studies will need to examine the clinical impact of online guided imagery training for health professionals. PMID:26879414

Environmental Issues and Sustainable Futures: A Critical Guide To Recent Books, Reports, and Periodicals. A "Future Survey" Guidebook.

ERIC Educational Resources Information Center

Marien, Michael

This guide seeks to sort the flood of information written about environmental issues and sustainable societies in recent years and order it in some way. A total of 450 document abstracts are presented here, most of which are on books and think tank reports. These items first appeared in "Future Survey" (journal) and were published…

Facilitating comparative effectiveness research in cancer genomics: evaluating stakeholder perceptions of the engagement process

PubMed Central

Deverka, Patricia A; Lavallee, Danielle C; Desai, Priyanka J; Armstrong, Joanne; Gorman, Mark; Hole-Curry, Leah; O’Leary, James; Ruffner, BW; Watkins, John; Veenstra, David L; Baker, Laurence H; Unger, Joseph M; Ramsey, Scott D

2013-01-01

Aims The Center for Comparative Effectiveness Research in Cancer Genomics completed a 2-year stakeholder-guided process for the prioritization of genomic tests for comparative effectiveness research studies. We sought to evaluate the effectiveness of engagement procedures in achieving project goals and to identify opportunities for future improvements. Materials & methods The evaluation included an online questionnaire, one-on-one telephone interviews and facilitated discussion. Responses to the online questionnaire were tabulated for descriptive purposes, while transcripts from key informant interviews were analyzed using a directed content analysis approach. Results A total of 11 out of 13 stakeholders completed both the online questionnaire and interview process, while nine participated in the facilitated discussion. Eighty-nine percent of questionnaire items received overall ratings of agree or strongly agree; 11% of responses were rated as neutral with the exception of a single rating of disagreement with an item regarding the clarity of how stakeholder input was incorporated into project decisions. Recommendations for future improvement included developing standard recruitment practices, role descriptions and processes for improved communication with clinical and comparative effectiveness research investigators. Conclusions Evaluation of the stakeholder engagement process provided constructive feedback for future improvements and should be routinely conducted to ensure maximal effectiveness of stakeholder involvement. PMID:23459832

[Impact of dissemination of a diet and physical activity pamphlet to 8th grade students in France].

PubMed

Mathiot, Hélène; Nugier, Angélique; Nguyen-Thanh, Viêt

"J'aime manger, j'aime bouger, le guide nutrition pour les adolescents", ("I love to eat and move, the nutrition pamphlet for teenagers"), which is one of the eight information guides of the French Nutritional and Health Programme, is distributed annually by Santé publique France, the national public health agency, to 8th grade students by their biology teachers. The aim of this study was to assess the impact of this dissemination plan and the way 8th grade students and biology teachers perceive the pamphlet. Teenagers' knowledge of the French Nutritional and Health Programme's recommendations was also assessed. This study was based on a mixed method and was conducted in 2015 on 432 8th grade students by face-to-face interviews at home and 20 8th grade biology teachers interviewed individually or during focus groups. The pamphlet obtained a recognition score of 40% among young people, who mostly saw it during a course at high school. 30% of teenagers reported having read or only skimmed through it and more than three-quarters reported that they liked the pamphlet. Teenagers and teachers found the pamphlet clear and accessible and globally appreciated the content, but they considered that it could be modernized. Systematic distribution of the guide to students of a specific school grade is an efficient strategy to reach a maximum number of young people. It should be continued in the future. Modernization of the guide and improved support to teachers to distribute the guide could improve the performance of the programme.

Academic/State/Federal collaborations and the improvement of practices in disaster mental health services and evaluation.

PubMed

Watson, Patricia J; Ruzek, Josef I

2009-05-01

Academic, state, and federal agencies collaborated over the last 9 years to improve disaster mental health services and evaluation. This process, which included literature reviews, a number of expert panels, and case studies, is described. The products resulting from this process have included the development of a systematic cross-site evaluation of the federally funded crisis counseling program and field guides for interventions aimed at providing services to distressed individuals in the immediate aftermath of disasters and to individuals needing resilience skills training weeks or months after the event. Future improvement of disaster mental health services calls for continued research, evaluation, training, and intervention development.

Future of operating rooms.

PubMed

Reijnen, Michel M P J; Zeebregts, Clark J; Meijerink, Wilhelmus J H J

2005-01-01

Operating-room design has not changed significantly since the modern era of surgery began. Minimal invasive, endoscopic, procedures, and evolution of technology will affect operating-room design in the near future. Poor ergonomics has always been one of the major drawbacks of endoscopic surgery. Use of retractable arms and monitors will improve ergonomics of the operating team. Developments in telecommunication will allow surgeons to communicate with colleagues and experts during the procedure in virtually any location around the world, which increases teaching possibilities and procedural safety. Introduction and further development of intraoperative imaging, including real-time, three-dimensional (3-D) reconstructions of patient, and computer-aided surgery offer surgeons the opportunity to train the planned surgical procedure. Moreover, they will improve control and supervision of the procedure in learning situations. The last decade's robotics have made their introduction into the operating rooms. They improve control over the operating-room environment and will facilitate the performance of more complex procedures. However, high costs and lack of force feedback remain its major drawbacks. Improvements of robotic techniques and its implementation into the operating rooms will further guide their design into highly specialized operating units.

Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease: developing a roadmap to improving quality care.

PubMed

Davison, Sara N; Levin, Adeera; Moss, Alvin H; Jha, Vivekanand; Brown, Edwina A; Brennan, Frank; Murtagh, Fliss E M; Naicker, Saraladevi; Germain, Michael J; O'Donoghue, Donal J; Morton, Rachael L; Obrador, Gregorio T

2015-09-01

Patients with advanced chronic kidney disease (CKD) have a high burden of physical and psychosocial symptoms, poor outcomes, and high costs of care. Current paradigms of care for this highly vulnerable population are variable, prognostic and assessment tools are limited, and quality of care, particularly regarding conservative and palliative care, is suboptimal. The KDIGO Controversies Conference on Supportive Care in CKD reviewed the current state of knowledge in order to define a roadmap to guide clinical and research activities focused on improving the outcomes of people living with advanced CKD, including those on dialysis. An international group of multidisciplinary experts in CKD, palliative care, methodology, economics, and education identified the key issues related to palliative care in this population. The conference led to a working plan to address outstanding issues in this arena, and this executive summary serves as an output to guide future work, including the development of globally applicable guidelines.

Molecular biomarkers to guide precision medicine in localized prostate cancer.

PubMed

Smits, Minke; Mehra, Niven; Sedelaar, Michiel; Gerritsen, Winald; Schalken, Jack A

2017-08-01

Major advances through tumor profiling technologies, that include next-generation sequencing, epigenetic, proteomic and transcriptomic methods, have been made in primary prostate cancer, providing novel biomarkers that may guide precision medicine in the near future. Areas covered: The authors provided an overview of novel molecular biomarkers in tissue, blood and urine that may be used as clinical tools to assess prognosis, improve selection criteria for active surveillance programs, and detect disease relapse early in localized prostate cancer. Expert commentary: Active surveillance (AS) in localized prostate cancer is an accepted strategy in patients with very low-risk prostate cancer. Many more patients may benefit from watchful waiting, and include patients of higher clinical stage and grade, however selection criteria have to be optimized and early recognition of transformation from localized to lethal disease has to be improved by addition of molecular biomarkers. The role of non-invasive biomarkers is challenging the need for repeat biopsies, commonly performed at 1 and 4 years in men under AS programs.

Magnetic Resonance-Guided High Intensity Focused Ultrasound Ablation of Breast Cancer.

PubMed

Knuttel, Floortje M; van den Bosch, Maurice A A J

2016-01-01

This chapter describes several aspects of MR-HIFU treatment for breast cancer. The current and future applications, technical developments and clinical results are discussed. MR-HIFU ablation is under investigation for the treatment of breast cancer, but is not yet ready for clinical implementation. Firstly, the efficacy of MR-HIFU ablation should be investigated in large trials. The existing literature shows that results of initial, small studies are moderate, but opportunities for improvement are available. Careful patient selection, taking treatment margins into account and using a dedicated breast system might improve treatment outcomes. MRI-guidance has proven to be beneficial for the accuracy and safety of HIFU treatments because of its usefulness before, during and after treatments. In conclusion, MR-HIFU is promising for the treatment of breast cancer and might lead to a change in breast cancer care in the future.

Launch Vehicle Propulsion Life Cycle Cost Lessons Learned

NASA Technical Reports Server (NTRS)

Zapata, Edgar; Rhodes, Russell E.; Robinson, John W.

2010-01-01

This paper will review lessons learned for space transportation systems from the viewpoint of the NASA, Industry and academia Space Propulsion Synergy Team (SPST). The paper provides the basic idea and history of "lessons learned". Recommendations that are extremely relevant to NASA's future investments in research, program development and operations are"'provided. Lastly, a novel and useful approach to documenting lessons learned is recommended, so as to most effectively guide future NASA investments. Applying lessons learned can significantly improve access to space for cargo or people by focusing limited funds on the right areas and needs for improvement. Many NASA human space flight initiatives have faltered, been re-directed or been outright canceled since the birth of the Space Shuttle program. The reasons given at the time have been seemingly unique. It will be shown that there are common threads as lessons learned in many a past initiative.

Futures in Business. Interim Guide.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg.

This guide is designed for use by instructors teaching a six-unit course on futures in business. Presented first is a diagram illustrating the place of the course in Manitoba's business education curriculum. The academic, personal management, and teamwork skills that have been deemed critical employability skills required of the Canadian work…

Precision Oncology and Genomically Guided Radiation Therapy: A Report From the American Society for Radiation Oncology/American Association of Physicists in Medicine/National Cancer Institute Precision Medicine Conference.

PubMed

Hall, William A; Bergom, Carmen; Thompson, Reid F; Baschnagel, Andrew M; Vijayakumar, Srinivasan; Willers, Henning; Li, X Allen; Schultz, Christopher J; Wilson, George D; West, Catharine M L; Capala, Jacek; Coleman, C Norman; Torres-Roca, Javier F; Weidhaas, Joanne; Feng, Felix Y

2018-06-01

To summarize important talking points from a 2016 symposium focusing on real-world challenges to advancing precision medicine in radiation oncology, and to help radiation oncologists navigate the practical challenges of precision, radiation oncology. The American Society for Radiation Oncology, American Association of Physicists in Medicine, and National Cancer Institute cosponsored a meeting on precision medicine in radiation oncology. In June 2016 numerous scientists, clinicians, and physicists convened at the National Institutes of Health to discuss challenges and future directions toward personalized radiation therapy. Various breakout sessions were held to discuss particular components and approaches to the implementation of personalized radiation oncology. This article summarizes the genomically guided radiation therapy breakout session. A summary of existing genomic data enabling personalized radiation therapy, ongoing clinical trials, current challenges, and future directions was collected. The group attempted to provide both a current overview of data that radiation oncologists could use to personalize therapy, along with data that are anticipated in the coming years. It seems apparent from the provided review that a considerable opportunity exists to truly bring genomically guided radiation therapy into clinical reality. Genomically guided radiation therapy is a necessity that must be embraced in the coming years. Incorporating these data into treatment recommendations will provide radiation oncologists with a substantial opportunity to improve outcomes for numerous cancer patients. More research focused on this topic is needed to bring genomic signatures into routine standard of care. Published by Elsevier Inc.

Mental health literacy as theory: current challenges and future directions.

PubMed

Spiker, Douglas A; Hammer, Joseph H

2018-02-13

Mental health literacy (MHL) is one increasingly researched factor thought to influence mental health behaviors. Researchers have argued for expanding the definition of MHL to include additional constructs, but no consensus has yet been reached on what constructs should be included as part of MHL. The purpose of this paper is to (i) elucidate how the expansion of the MHL construct has impeded the growth of MHL research and (ii) through the lens of construct and theory development, highlight how these challenges might be remedied. An inclusive search of the literature was undertaken to identify MHL studies. The principles of construct and theory development guided a critical analysis of MHL. The review of the literature found that MHL violates many principles of what constitutes an acceptable construct definition. To address these concerns, we proposed conceptualizing MHL as a theory and recommended principles of theory development that should be taken into consideration. A theory of MHL can guide future researchers to clearly delineate important constructs and their interrelationships. For practitioners, a theory of MHL can help inform how to improve MHL at both the individual and community level.

Application of synthetic scenarios to address water resource concerns: A management-guided case study from the Upper Colorado River Basin

USGS Publications Warehouse

McAfee, Stephanie A.; Pederson, Gregory T.; Woodhouse, Connie A.; McCabe, Gregory

2017-01-01

Water managers are increasingly interested in better understanding and planning for projected resource impacts from climate change. In this management-guided study, we use a very large suite of synthetic climate scenarios in a statistical modeling framework to simultaneously evaluate how (1) average temperature and precipitation changes, (2) initial basin conditions, and (3) temporal characteristics of the input climate data influence water-year flow in the Upper Colorado River. The results here suggest that existing studies may underestimate the degree of uncertainty in future streamflow, particularly under moderate temperature and precipitation changes. However, we also find that the relative severity of future flow projections within a given climate scenario can be estimated with simple metrics that characterize the input climate data and basin conditions. These results suggest that simple testing, like the analyses presented in this paper, may be helpful in understanding differences between existing studies or in identifying specific conditions for physically based mechanistic modeling. Both options could reduce overall cost and improve the efficiency of conducting climate change impacts studies.

The James Blundell Award Lecture 2006: transfusion and the treatment of haemorrhage: past, present and future.

PubMed

Dzik, W H

2007-10-01

In the early years of the 19th century, James Blundell reported in the Lancet the first clinical application of blood transfusion for the treatment of haemorrhage. Although these initial experiments may appear to us to have burst upon the medical world, Blundell had in fact done a decade of pre clinical research using animal models to establish principles to be brought to the clinic. His pivotal pre clinical experiments and the insights he gained are described in detail. Today, blood transfusion remains the cornerstone of treatment for serious bleeding - not only to restore oxygen carrying capacity but also to improve haemostasis, arrest and prevent bleeding. However, the indications for the use of blood components to treat bleeding remain ill-defined. In particular, despite the enormous volumes of fresh frozen plasma (FFP) transfused worldwide, the evidence that commonly used coagulation tests are reliable guides to transfusion with FFP is scant. Recent laboratory and clinical studies provide insight into the weaknesses of current coagulation tests as a guide to blood management. In the future, the application of genomics to haemostasis will uncover genetic polymorphisms leading to improved diagnostics and more tailored medical therapeutics. Examples of the emerging use of clinical genomics are presented. Ultimately, the application of widescale genomics testing will refresh our understanding of human physiology and will reassert the importance of the individual in patient care.

Optimizing the patient-centered environment: results of guided tours with health care providers and employees.

PubMed

Locatelli, Sara M; Turcios, Stephanie; LaVela, Sherri L

2015-01-01

To examine providers' perspectives on the care environment and patient-centered care (PCC) through the eyes of the veteran patient, using guided tours qualitative methodology. Environmental factors, such as attractiveness and function, have the potential to improve patients' experiences. Participatory qualitative methods allow researchers to explore the environment and facilitate discussion. Guided tours were conducted with 25 health care providers/employees at two Veterans Affairs (VA) health care facilities. In guided tours, participants lead the researcher through an environment, commenting on their surroundings, thoughts, and feelings. The researcher walks along with the participant, asking open-ended questions as needed to foster discussion and gain an understanding of the participant's view. Participants were asked to walk through the facility as though they were a veteran. Tours were audio recorded, with participant permission, and transcribed verbatim by research assistants. Three qualitative researchers were responsible for codebook development and coding transcripts and used data-driven coding approaches. Participants discussed physical appearance of the environment and how that influences perceptions about care. Overall, participants highlighted the need to shed the "institutional" appearance. Differences between VA and non-VA health care facilities were discussed, including availability of private rooms and staff to assist with navigating the facility. They reviewed resources in the facility, such as the information desk to assist patients and families. Finally, they offered suggestions for future improvements, including improvements to waiting areas and quiet areas for patients to relax and "get away" from their rooms. Participants highlighted many small changes to the care environment that could enhance the patient experience. Additionally, they examined the environment from the patient's perspective, to identify elements that enhance, or detract from, the patient's care experience. © The Author(s) 2015.

A Systematic Review of Relaxation, Meditation, and Guided Imagery Strategies for Symptom Management in Heart Failure.

PubMed

Kwekkeboom, Kristine L; Bratzke, Lisa C

2016-01-01

Pain, dyspnea, fatigue, and sleep disturbance are prevalent and distressing symptoms in persons with advanced heart failure. Although many lifestyle and self-care interventions have been developed to control heart failure progression, very few studies have explored treatments exclusively for symptom palliation. Cognitive-behavioral strategies may be effective treatment for these symptoms in advanced heart failure. A systemic review was conducted to describe the effect of cognitive-behavioral strategies on pain, dyspnea, fatigue, and sleep disturbance in patients with heart failure. CINAHL, Medline, and PsychINFO were searched from inception through December 2014. Articles were selected for inclusion if they tested a cognitive-behavioral strategy using a quasi-experimental or experimental design, involved a sample of adults with heart failure, and measured pain, dyspnea, fatigue, sleep disturbance, or symptom-related quality of life. The 2 authors evaluated study quality, abstracted data elements from each study, and synthesized findings. Thirteen articles describing 9 unique studies met criteria and were included in the review. Five studies tested relaxation strategies, 3 tested meditation strategies, and 1 tested a guided imagery strategy. Of the 9 studies, 7 demonstrated some improvement in symptom outcomes. Relaxation, meditation, guided imagery, or combinations of these strategies resulted in less dyspnea and better sleep compared with attention control or usual care conditions and reduced pain, dyspnea, fatigue, and sleep disturbance within treatment groups (pretreatment to posttreatment). Symptom-related quality of life was improved with meditation compared with attention control and usual care conditions and improved pre- to post-guided imagery. Studies exploring cognitive-behavioral symptom management strategies in heart failure vary in quality and report mixed findings but indicate potential beneficial effects of relaxation, meditation, and guided imagery on heart failure-related symptoms. Future research should test cognitive-behavioral strategies in rigorously designed efficacy trials, using samples selected for their symptom experience, and measure pain, dyspnea, fatigue, and sleep disturbance outcomes with targeted symptom measures.

A Systematic Review of Relaxation, Meditation, and Guided Imagery Strategies for Symptom Management in Heart Failure

PubMed Central

Kwekkeboom, Kristine L.; Bratzke, Lisa C.

2015-01-01

Background Pain, dyspnea, fatigue, and sleep disturbance are prevalent and distressing symptoms in persons with advanced heart failure. Although many lifestyle and self-care interventions have been developed to control heart failure progression, very few studies have explored treatments exclusively for symptom palliation. Cognitive-behavioral strategies may be effective treatment for these symptoms in advanced heart failure. Objective A systemic review was conducted to describe the effect of cognitive-behavioral strategies on pain, dyspnea, fatigue, and sleep disturbance in patients with heart failure. Methods CINAHL, Medline, and PsychINFO were searched from inception through December 2014. Articles were selected for inclusion if they tested a cognitive-behavioral strategy using a quasi-experimental or experimental design, involved a sample of adults with heart failure, and measured pain, dyspnea, fatigue, sleep disturbance, or symptom-related quality of life (QoL). The two authors evaluated study quality, abstracted data elements from each study, and synthesized findings. Results Thirteen articles describing nine unique studies met criteria and were included in the review. Five studies tested relaxation strategies, three tested meditation strategies, and one tested a guided imagery strategy. Seven of the nine studies demonstrated some improvement in symptom outcomes. Relaxation, meditation, guided imagery, or combinations of these strategies resulted in less dyspnea and better sleep compared to attention control or usual care conditions, and reduced pain, dyspnea, fatigue and sleep disturbance within treatment groups (pre- to post-treatment). Symptom-related QoL was improved with meditation compared to attention control and usual care conditions, and improved pre- to post-guided imagery. Conclusions Studies exploring cognitive-behavioral symptom management strategies in heart failure vary in quality and report mixed findings, but indicate potential beneficial effects of relaxation, meditation, and guided imagery on heart failure-related symptoms. Future research should test cognitive-behavioral strategies in rigorously designed efficacy trials, using samples selected for their symptom experience, and measure pain, dyspnea, fatigue, and sleep disturbance outcomes with targeted symptom measures. PMID:26065388

The development of a diversity mentoring program for faculty and trainees: A program at the Brown Clinical Psychology Training Consortium

PubMed Central

de Dios, Marcel A.; Kuo, Caroline; Hernandez, Lynn; Clark, Uraina S.; Wenze, Susan J.; Boisseau, Christina L.; Hunter, Heather L.; Reddy, Madhavi K.; Tolou-Shams, Marina; Zlotnick, Caron

2013-01-01

There is a critical need for increasing the diversity representation among clinicians and researchers in academic medicine, including departments of psychiatry and psychology. Mentorship of under-represented groups has been identified as an important way to remediate diversity-related barriers in the field. This paper outlines the early development and pilot implementation of a diversity mentorship program at Brown University. In an effort to inform and guide future diversity programs, we discuss the challenges faced in creating the program, the successes experienced during the first year, and the future directions undertaken as a means for improving the program. PMID:25346563

Using scenario analysis to determine managed care strategy.

PubMed

Krentz, S E; Gish, R S

2000-09-01

In today's volatile healthcare environment, traditional planning tools are inadequate to guide financial managers of provider organizations in developing managed care strategies. These tools often disregard the uncertainty surrounding market forces such as employee benefit structure, the future of Medicare managed care, and the impact of consumer behavior. Scenario analysis overcomes this limitation by acknowledging the uncertain healthcare environment and articulating a set of plausible alternative futures, thus supplying financial executives with the perspective to craft strategies that can improve the market position of their organizations. By being alert for trigger points that might signal the rise of a specific scenario, financial managers can increase their preparedness for changes in market forces.

Fiber Optic Force Sensors for MRI-Guided Interventions and Rehabilitation: A Review

PubMed Central

Iordachita, Iulian I.; Tokuda, Junichi; Hata, Nobuhiko; Liu, Xuan; Seifabadi, Reza; Xu, Sheng; Wood, Bradford; Fischer, Gregory S.

2017-01-01

Magnetic Resonance Imaging (MRI) provides both anatomical imaging with excellent soft tissue contrast and functional MRI imaging (fMRI) of physiological parameters. The last two decades have witnessed the manifestation of increased interest in MRI-guided minimally invasive intervention procedures and fMRI for rehabilitation and neuroscience research. Accompanying the aspiration to utilize MRI to provide imaging feedback during interventions and brain activity for neuroscience study, there is an accumulated effort to utilize force sensors compatible with the MRI environment to meet the growing demand of these procedures, with the goal of enhanced interventional safety and accuracy, improved efficacy and rehabilitation outcome. This paper summarizes the fundamental principles, the state of the art development and challenges of fiber optic force sensors for MRI-guided interventions and rehabilitation. It provides an overview of MRI-compatible fiber optic force sensors based on different sensing principles, including light intensity modulation, wavelength modulation, and phase modulation. Extensive design prototypes are reviewed to illustrate the detailed implementation of these principles. Advantages and disadvantages of the sensor designs are compared and analyzed. A perspective on the future development of fiber optic sensors is also presented which may have additional broad clinical applications. Future surgical interventions or rehabilitation will rely on intelligent force sensors to provide situational awareness to augment or complement human perception in these procedures. PMID:28652857

Improving the Quality of Survivorship for Older Adults with Cancer

PubMed Central

Mohile, Supriya G.; Hurria, Arti; Cohen, Harvey J.; Rowland, Julia H.; Leach, Corinne R.; Arora, Neeraj K.; Canin, Beverly; Muss, Hyman; Magnuson, Allison; Flannery, Marie; Lowenstein, Lisa; Allore, Heather; Mustian, Karen; Demark-Wahnefried, Wendy; Extermann, Martine; Ferrell, Betty; Inouye, Sharon; Studenski, Stephanie; Dale, William

2016-01-01

In May 2015, the Cancer and Aging Research Group (CARG), in collaboration with the National Cancer Institute and the National Institute on Aging through a U13 grant, convened a conference to identify research priorities to help design and implement intervention studies to improve the quality of life and survivorship of older, frailer adults with cancer. Conference attendees included researchers with multidisciplinary expertise and advocates. It was concluded that future intervention trials for older adults with cancer should: 1) rigorously test interventions to prevent decline or improve health status, especially interventions focused on optimizing physical performance, nutritional status, and cognition while undergoing cancer treatment; 2) utilize standardized care plans based on geriatric assessment findings to guide targeted interventions; and 3) incorporate the principles of geriatrics into survivorship care plans. Also highlighted was the need to integrate the expertise of interdisciplinary team members into geriatric oncology research, improve funding mechanisms to support geriatric oncology research, and disseminate high-impact results to the research and clinical community. In conjunction with the prior two U13 meetings, this conference provides the framework for future research to improve the evidence base for the clinical care of older adults with cancer. PMID:27172129

Computer-supported implant planning and guided surgery: a narrative review.

PubMed

Vercruyssen, Marjolein; Laleman, Isabelle; Jacobs, Reinhilde; Quirynen, Marc

2015-09-01

To give an overview of the workflow from examination to planning and execution, including possible errors and pitfalls, in order to justify the indications for guided surgery. An electronic literature search of the PubMed database was performed with the intention of collecting relevant information on computer-supported implant planning and guided surgery. Currently, different computer-supported systems are available to optimize and facilitate implant surgery. The transfer of the implant planning (in a software program) to the operative field remains however the most difficult part. Guided implant surgery clearly reduces the inaccuracy, defined as the deviation between the planned and the final position of the implant in the mouth. It might be recommended for the following clinical indications: need for minimal invasive surgery, optimization of implant planning and positioning (i.e. aesthetic cases), and immediate restoration. The digital technology rapidly evolves and new developments have resulted in further improvement of the accuracy. Future developments include the reduction of the number of steps needed from the preoperative examination of the patient to the actual execution of the guided surgery. The latter will become easier with the implementation of optical scans and 3D-printing. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Optimizing patient treatment decisions in an era of rapid technological advances: the case of hepatitis C treatment.

PubMed

Liu, Shan; Brandeau, Margaret L; Goldhaber-Fiebert, Jeremy D

2017-03-01

How long should a patient with a treatable chronic disease wait for more effective treatments before accepting the best available treatment? We develop a framework to guide optimal treatment decisions for a deteriorating chronic disease when treatment technologies are improving over time. We formulate an optimal stopping problem using a discrete-time, finite-horizon Markov decision process. The goal is to maximize a patient's quality-adjusted life expectancy. We derive structural properties of the model and analytically solve a three-period treatment decision problem. We illustrate the model with the example of treatment for chronic hepatitis C virus (HCV). Chronic HCV affects 3-4 million Americans and has been historically difficult to treat, but increasingly effective treatments have been commercialized in the past few years. We show that the optimal treatment decision is more likely to be to accept currently available treatment-despite expectations for future treatment improvement-for patients who have high-risk history, who are older, or who have more comorbidities. Insights from this study can guide HCV treatment decisions for individual patients. More broadly, our model can guide treatment decisions for curable chronic diseases by finding the optimal treatment policy for individual patients in a heterogeneous population.

Jobs for the Future.

ERIC Educational Resources Information Center

Business and Professional Women's Foundation, Washington, DC.

This guide is intended to assist women in selecting and preparing for occupations that will either be in demand or continue to be in demand in the future. The first part is a guide to evaluating an occupation. It covers the following topics: costs and benefits (skills needed, training requirements, availability of training, costs of training,…

Future Aspiring Aviators, Primary: An Aviation Curriculum Guide K-3

DOT National Transportation Integrated Search

1995-01-01

Prepared ca. 1995. The Federal Aviation Administration is pleased to present the Aviation Education Teacher's Guide Series. The series includes four publications specifically designed as resources to those interested in aviation education. The guides...

Using the Consolidated Framework for Implementation Research (CFIR) to produce actionable findings: a rapid-cycle evaluation approach to improving implementation.

PubMed

Keith, Rosalind E; Crosson, Jesse C; O'Malley, Ann S; Cromp, DeAnn; Taylor, Erin Fries

2017-02-10

Much research does not address the practical needs of stakeholders responsible for introducing health care delivery interventions into organizations working to achieve better outcomes. In this article, we present an approach to using the Consolidated Framework for Implementation Research (CFIR) to guide systematic research that supports rapid-cycle evaluation of the implementation of health care delivery interventions and produces actionable evaluation findings intended to improve implementation in a timely manner. To present our approach, we describe a formative cross-case qualitative investigation of 21 primary care practices participating in the Comprehensive Primary Care (CPC) initiative, a multi-payer supported primary care practice transformation intervention led by the Centers for Medicare and Medicaid Services. Qualitative data include observational field notes and semi-structured interviews with primary care practice leadership, clinicians, and administrative and medical support staff. We use intervention-specific codes, and CFIR constructs to reduce and organize the data to support cross-case analysis of patterns of barriers and facilitators relating to different CPC components. Using the CFIR to guide data collection, coding, analysis, and reporting of findings supported a systematic, comprehensive, and timely understanding of barriers and facilitators to practice transformation. Our approach to using the CFIR produced actionable findings for improving implementation effectiveness during this initiative and for identifying improvements to implementation strategies for future practice transformation efforts. The CFIR is a useful tool for guiding rapid-cycle evaluation of the implementation of practice transformation initiatives. Using the approach described here, we systematically identified where adjustments and refinements to the intervention could be made in the second year of the 4-year intervention. We think the approach we describe has broad application and encourage others to use the CFIR, along with intervention-specific codes, to guide the efficient and rigorous analysis of rich qualitative data. NCT02318108.

The AAV-mediated and RNA-guided CRISPR/Cas9 system for gene therapy of DMD and BMD.

PubMed

Wang, Jing-Zhang; Wu, Peng; Shi, Zhi-Min; Xu, Yan-Li; Liu, Zhi-Jun

2017-08-01

Mutations in the dystrophin gene (Dmd) result in Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD), which afflict many newborn boys. In 2016, Brain and Development published several interesting articles on DMD treatment with antisense oligonucleotide, kinase inhibitor, and prednisolone. Even more strikingly, three articles in the issue 6271 of Science in 2016 provide new insights into gene therapy of DMD and BMD via the clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9). In brief, adeno-associated virus (AAV) vectors transport guided RNAs (gRNAs) and Cas9 into mdx mouse model, gRNAs recognize the mutated Dmd exon 23 (having a stop codon), and Cas9 cut the mutated exon 23 off the Dmd gene. These manipulations restored expression of truncated but partially functional dystrophin, improved skeletal and cardiac muscle function, and increased survival of mdx mice significantly. This review concisely summarized the related advancements and discussed their primary implications in the future gene therapy of DMD, including AAV-vector selection, gRNA designing, Cas9 optimization, dystrophin-restoration efficiency, administration routes, and systemic and long-term therapeutic efficacy. Future orientations, including off-target effects, safety concerns, immune responses, precision medicine, and Dmd-editing in the brain (potentially blocked by the blood-brain barrier) were also elucidated briefly. Collectively, the AAV-mediated and RNA-guided CRISPR/Cas9 system has major superiorities compared with traditional gene therapy, and might contribute to the treatment of DMD and BMD substantially in the near future. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

The Effects of Coaching Using a Reflective Framework on Early Childhood Science Teachers' Depth of Reflection and Change in Practice

NASA Astrophysics Data System (ADS)

Bloomquist, Debra L.

This embedded-mixed methods study examined if the use of a reflective framework with guiding prompts could support early childhood science teachers in improving their reflective practice and subsequently changing their pedagogy. It further investigated whether type of cognitive coaching group, individual or collaborative, impacted teacher depth of reflection and change in practice. Data included teacher reflections that were rated using the Level of Reflection-On-Action Assessment, reflective codes and inductive themes, as well as videos of participants lessons coded using the SCIIENCE instrument. Findings demonstrated that through guided reflection, teachers developed reflective thinking skills, and through this reflection became more critical and began to improve their pedagogical practice. Further findings supported that collaborative cognitive coaching may not be the most effective professional development for all teachers; as some teachers in the study were found to have difficulty improving their reflectivity and thus their teaching practice. Based on these findings it is recommended that coaches and designers of professional development continue to use reflective frameworks with guiding prompts to support teachers in the reflective process, but take into consideration that coaching may need to be differentiated for the various reflective levels demonstrated by teachers. Future studies will be needed to establish why some teachers have difficulty with the reflective process and how coaches or designers of professional development can further assist these teachers in becoming more critical reflectors.

Safety Assurance Factors for Electronic Health Record Resilience (SAFER): study protocol

PubMed Central

2013-01-01

Background Implementation and use of electronic health records (EHRs) could lead to potential improvements in quality of care. However, the use of EHRs also introduces unique and often unexpected patient safety risks. Proactive assessment of risks and vulnerabilities can help address potential EHR-related safety hazards before harm occurs; however, current risk assessment methods are underdeveloped. The overall objective of this project is to develop and validate proactive assessment tools to ensure that EHR-enabled clinical work systems are safe and effective. Methods/Design This work is conceptually grounded in an 8-dimension model of safe and effective health information technology use. Our first aim is to develop self-assessment guides that can be used by health care institutions to evaluate certain high-risk components of their EHR-enabled clinical work systems. We will solicit input from subject matter experts and relevant stakeholders to develop guides focused on 9 specific risk areas and will subsequently pilot test the guides with individuals representative of likely users. The second aim will be to examine the utility of the self-assessment guides by beta testing the guides at selected facilities and conducting on-site evaluations. Our multidisciplinary team will use a variety of methods to assess the content validity and perceived usefulness of the guides, including interviews, naturalistic observations, and document analysis. The anticipated output of this work will be a series of self-administered EHR safety assessment guides with clear, actionable, checklist-type items. Discussion Proactive assessment of patient safety risks increases the resiliency of health care organizations to unanticipated hazards of EHR use. The resulting products and lessons learned from the development of the assessment guides are expected to be helpful to organizations that are beginning the EHR selection and implementation process as well as those that have already implemented EHRs. Findings from our project, currently underway, will inform future efforts to validate and implement tools that can be used by health care organizations to improve the safety of EHR-enabled clinical work systems. PMID:23587208

Reducing inequalities in cancer outcomes: what works?

PubMed

Bickell, Nina A; Paskett, Electra D

2013-01-01

Despite efforts to reduce disparities in cancer outcomes among vulnerable populations, certain subgroups do not experience the gains made in the reduction of cancer incidence and mortality. In this article, we review recent trial data reporting on patient-, physician-, and system-centered interventions to improve quality and reduce disparities in cancer care spanning patient navigation to health reform. We conclude with data from a state that implemented a multitiered approach, targeting patient and systems barriers, that serves as a guide for future endeavors.

Neuroimaging of neurocutaneous diseases.

PubMed

Nandigam, Kaveer; Mechtler, Laszlo L; Smirniotopoulos, James G

2014-02-01

An in-depth knowledge of the imaging characteristics of the common neurocutaneous diseases (NCD) described in this article will help neurologists understand the screening imaging modalities in these patients. The future of neuroimaging is geared towards developing and refining magnetic resonance imaging (MRI) sequences. The detection of tumors in NCD has greatly improved with availability of high-field strength 3T MRI machines. Neuroimaging will remain at the heart and soul of the multidisciplinary care of such complex diagnoses to guide early detection and monitor treatment. Published by Elsevier Inc.

TELECOM 2000: An Exploration of the Long-Term Development of Telecommunications in Australia.

ERIC Educational Resources Information Center

Australian Telecommunications Commission, Melbourne.

This document is intended as a guide to directions in Australia's social, economic, and technical future as related to likely trends in the demand for telecommunication facilities in the early Twenty-First Century. From this exploration of the future of telecommunications, nine policy recommendations were made to guide telecommunication research,…

Teens Working: Turning Earning into Learning. Facilitator Guide [and] Critical Workplace Issues [and] Student Guide.

ERIC Educational Resources Information Center

Northwest Regional Educational Lab., Portland, OR. Education, Career, and Community Program.

These guides are part of a toolkit designed to help young people make connections between the jobs they now hold, the classes they are taking, and the goals they may have for the near and distant future. The guides contain a variety of materials and activities appropriate for all skill levels. The activities in the student guide are grounded in…

Use of an Innovative Personality-Mindset Profiling Tool to Guide Culture-Change Strategies among Different Healthcare Worker Groups

PubMed Central

Grayson, M. Lindsay; Macesic, Nenad; Huang, G. Khai; Bond, Katherine; Fletcher, Jason; Gilbert, Gwendolyn L.; Gordon, David L.; Hellsten, Jane F.; Iredell, Jonathan; Keighley, Caitlin; Stuart, Rhonda L.; Xuereb, Charles S.; Cruickshank, Marilyn

2015-01-01

Introduction Important culture-change initiatives (e.g. improving hand hygiene compliance) are frequently associated with variable uptake among different healthcare worker (HCW) categories. Inherent personality differences between these groups may explain change uptake and help improve future intervention design. Materials and Methods We used an innovative personality-profiling tool (ColourGrid®) to assess personality differences among standard HCW categories at five large Australian hospitals using two data sources (HCW participant surveys [PS] and generic institution-wide human resource [HR] data) to: a) compare the relative accuracy of these two sources; b) identify differences between HCW groups and c) use the observed profiles to guide design strategies to improve uptake of three clinically-important initiatives (improved hand hygiene, antimicrobial stewardship and isolation procedure adherence). Results Results from 34,243 HCWs (HR data) and 1045 survey participants (PS data) suggest that HCWs were different from the general population, displaying more individualism, lower power distance, less uncertainty avoidance and greater cynicism about advertising messages. HR and PS data were highly concordant in identifying differences between the three key HCW categories (doctors, nursing/allied-health, support services) and predicting appropriate implementation strategies. Among doctors, the data suggest that key messaging should differ between full-time vs part-time (visiting) senior medical officers (SMO, VMO) and junior hospital medical officers (HMO), with SMO messaging focused on evidence-based compliance, VMO initiatives emphasising structured mandatory controls and prestige loss for non-adherence, and for HMOs focusing on leadership opportunity and future career risk for non-adherence. Discussion Compared to current standardised approaches, targeted interventions based on personality differences between HCW categories should result in improved infection control-related culture-change uptake. Personality profiling based on HR data may represent a useful means of developing a national culture-change “blueprint” for HCW education. PMID:26489012

Understanding the Impact of Interventions to Prevent Antimicrobial Resistant Infections in the Long-Term Care Facility: A Review and Practical Guide to Mathematical Modeling.

PubMed

Rosello, Alicia; Horner, Carolyne; Hopkins, Susan; Hayward, Andrew C; Deeny, Sarah R

2017-02-01

OBJECTIVES (1) To systematically search for all dynamic mathematical models of infectious disease transmission in long-term care facilities (LTCFs); (2) to critically evaluate models of interventions against antimicrobial resistance (AMR) in this setting; and (3) to develop a checklist for hospital epidemiologists and policy makers by which to distinguish good quality models of AMR in LTCFs. METHODS The CINAHL, EMBASE, Global Health, MEDLINE, and Scopus databases were systematically searched for studies of dynamic mathematical models set in LTCFs. Models of interventions targeting methicillin-resistant Staphylococcus aureus in LTCFs were critically assessed. Using this analysis, we developed a checklist for good quality mathematical models of AMR in LTCFs. RESULTS AND DISCUSSION Overall, 18 papers described mathematical models that characterized the spread of infectious diseases in LTCFs, but no models of AMR in gram-negative bacteria in this setting were described. Future models of AMR in LTCFs require a more robust methodology (ie, formal model fitting to data and validation), greater transparency regarding model assumptions, setting-specific data, realistic and current setting-specific parameters, and inclusion of movement dynamics between LTCFs and hospitals. CONCLUSIONS Mathematical models of AMR in gram-negative bacteria in the LTCF setting, where these bacteria are increasingly becoming prevalent, are needed to help guide infection prevention and control. Improvements are required to develop outputs of sufficient quality to help guide interventions and policy in the future. We suggest a checklist of criteria to be used as a practical guide to determine whether a model is robust enough to test policy. Infect Control Hosp Epidemiol 2017;38:216-225.

An annotated bibliography of selected guides for stream habitat improvement in the Pacific Northwest

USGS Publications Warehouse

Keim, R.F.; Price, A.B.; Hardin, T. S.; Skaugset, Arne E.; Bateman, D.S.; Gresswell, R.E.; Tesch, S. D.

2004-01-01

This annotated bibliography is a response to widespread interest in stream habitat improvement in the Pacific Northwest by land managers, governmental and nongovernmental organizations, and the lay public. Several guides to stream habitat improvement have been written in the past, but may not be easily accessible to people from diverse backgrounds. This annotated bibliography reviews 11 guides to stream habitat improvement so that readers can find literature appropriate to their needs. All reviews begin with summaries of the contents, stated audiences, and goals of each guide. Reviews also include subjective comments on the strengths and weaknesses of each guide. Finally, this bibliography includes recommendations of guides and combinations of guides judged most useful for a range of purposes. 

Development of Lidar Sensor Systems for Autonomous Safe Landing on Planetary Bodies

NASA Technical Reports Server (NTRS)

Amzajerdian, Farzin; Pierottet, Diego F.; Petway, Larry B.; Vanek, Michael D.

2010-01-01

Lidar has been identified by NASA as a key technology for enabling autonomous safe landing of future robotic and crewed lunar landing vehicles. NASA LaRC has been developing three laser/lidar sensor systems under the ALHAT project. The capabilities of these Lidar sensor systems were evaluated through a series of static tests using a calibrated target and through dynamic tests aboard helicopters and a fixed wing aircraft. The airborne tests were performed over Moon-like terrain in the California and Nevada deserts. These tests provided the necessary data for the development of signal processing software, and algorithms for hazard detection and navigation. The tests helped identify technology areas needing improvement and will also help guide future technology advancement activities.

Training the Translational Research Teams of the Future: UC Davis—HHMI Integrating Medicine into Basic Science Program

PubMed Central

Rainwater, Julie A.; Chiamvimonvat, Nipavan; Bonham, Ann C.; Robbins, John A.; Henderson, Stuart; Meyers, Frederick J.

2013-01-01

Abstract There is a need for successful models of how to recruit, train, and retain bench scientists at the earliest stages of their careers into translational research. One recent, promising model is the University of California Davis Howard Hughes Medical Institute Integrating Medicine into Basic Science (HHMI‐IMBS) program, part of the HHMI Med into Grad initiative. This paper outlines the HHMI‐IMBS program's logic, design, and curriculum that guide the goal of research that moves from bedside to bench. That is, a curriculum that provides graduate students with guided translational training, clinical exposure, team science competencies, and mentors from diverse disciplines that will advance the students careers in clinical translational research and re‐focusing of research to answer clinical dilemmas. The authors have collected data on 55 HHMI‐IMBS students to date. Many of these students are still completing their graduate work. In the current study the authors compare the initial two cohorts (15 students) with a group of 29 control students to examine the program success and outcomes. The data indicate that this training program provides an effective, adaptable model for training future translational researchers. HHMI‐IMBS students showed improved confidence in conducting translational research, greater interest in a future translational career, and higher levels of research productivity and collaborations than a comparable group of predoctoral students. PMID:24127920

School of the Future Handbook. A Guide for Technology Implementation. F. M. Black Middle School.

ERIC Educational Resources Information Center

Smith, Richard Alan; Sassi, Anthony

In 1985, Apple Computer, Inc., and the Houston Independent School District began a project to create a model School of the Future at the F. M. Black Middle School. As described in this guide, the project was designed to demonstrate how microcomputers and related technology can make the process of instruction more efficient and effective. The…

A Framework for Guiding Future Citizens to Think Critically about Nature of Science and Socioscientific Issues

ERIC Educational Resources Information Center

Yacoubian, Hagop A.

2015-01-01

In this article, I introduce a framework for guiding future citizens to think critically about nature of science (NOS) and "with" NOS as they engage in socioscientific decision making. The framework, referred to as the critical thinking--nature of science (CT-NOS) framework, explicates and targets both NOS as a learning objective and NOS…

Fidelity in Models-Based Practice Research in Sport Pedagogy: A Guide for Future Investigations

ERIC Educational Resources Information Center

Hastie, Peter A.; Casey, Ashley

2014-01-01

This paper provides a commentary on research on models-based practice within physical education and presents a tutorial that aims to guide the reporting of future research using pedagogical models. Three key elements are presented that could be considered as essential for inclusion in any methods section in order for readers to gain an accurate…

Space Shuttle Probabilistic Risk Assessment (SPRA) Iteration 3.2

NASA Technical Reports Server (NTRS)

Boyer, Roger L.

2010-01-01

The Shuttle is a very reliable vehicle in comparison with other launch systems. Much of the risk posed by Shuttle operations is related to fundamental aspects of the spacecraft design and the environments in which it operates. It is unlikely that significant design improvements can be implemented to address these risks prior to the end of the Shuttle program. The model will continue to be used to identify possible emerging risk drivers and allow management to make risk-informed decisions on future missions. Potential uses of the SPRA in the future include: - Calculate risk impact of various mission contingencies (e.g. late inspection, crew rescue, etc.). - Assessing the risk impact of various trade studies (e.g. flow control valves). - Support risk analysis on mission specific events, such as in flight anomalies. - Serve as a guiding star and data source for future NASA programs.

Substance abuse prevention intervention research with Hispanic populations.

PubMed

Castro, Felipe González; Barrera, Manuel; Pantin, Hilda; Martinez, Charles; Felix-Ortiz, Maria; Rios, Rebeca; Lopez, Vera A; Lopez, Cristy

2006-09-01

Selected studies with specific relevance to substance abuse prevention interventions with Hispanic youth and families were examined to identify prior findings and emerging issues that may guide the design of future substance abuse prevention intervention research and its implementation with Hispanic populations. The origins of prevention research and role of risk and protective factors are examined, including culturally-specific risk and protective factors for Hispanic populations. Correlational studies, non-experimental interventions, and randomized controlled trials were examined for the period of 1974-2003. The literature search yielded 15 articles selected for this review that exhibited adequate methodological rigor. An added search for more recent studies identified three additional articles, for a total of 18 prevention intervention articles that were reviewed. Theoretical and methodological issues and recommendations are presented for future research aimed at improving the efficacy and effectiveness of future prevention intervention studies and their cultural relevance for Hispanic populations.

Nanoscale Surface Modifications of Medical Implants for Cartilage Tissue Repair and Regeneration

PubMed Central

Griffin, MF; Szarko, M; Seifailan, A; Butler, PE

2016-01-01

Background: Natural cartilage regeneration is limited after trauma or degenerative processes. Due to the clinical challenge of reconstruction of articular cartilage, research into developing biomaterials to support cartilage regeneration have evolved. The structural architecture of composition of the cartilage extracellular matrix (ECM) is vital in guiding cell adhesion, migration and formation of cartilage. Current technologies have tried to mimic the cell’s nanoscale microenvironment to improve implants to improve cartilage tissue repair. Methods: This review evaluates nanoscale techniques used to modify the implant surface for cartilage regeneration. Results: The surface of biomaterial is a vital parameter to guide cell adhesion and consequently allow for the formation of ECM and allow for tissue repair. By providing nanosized cues on the surface in the form of a nanotopography or nanosized molecules, allows for better control of cell behaviour and regeneration of cartilage. Chemical, physical and lithography techniques have all been explored for modifying the nanoscale surface of implants to promote chondrocyte adhesion and ECM formation. Conclusion: Future studies are needed to further establish the optimal nanoscale modification of implants for cartilage tissue regeneration. PMID:28217208

Colour compatibility between teeth and dental shade guides in Quinquagenarians and Septuagenarians.

PubMed

Cocking, C; Cevirgen, E; Helling, S; Oswald, M; Corcodel, N; Rammelsberg, P; Reinelt, G; Hassel, A J

2009-11-01

The aim of this investigation was to determine colour compatibility between dental shade guides, namely, VITA Classical (VC) and VITA 3D-Master (3D), and human teeth in quinquagenarians and septuagenarians. Tooth colour, described in terms of L*a*b* values of the middle third of facial tooth surface of 1391 teeth, was measured using VITA Easyshade in 195 subjects (48% female). These were compared with the colours (L*a*b* values) of the shade tabs of VC and 3D. The mean coverage error and the percentage of tooth colours being within a given colour difference (DeltaE(ab)) from the tabs of VC and 3D were calculated. For comparison, hypothetical, optimized, population-specific shade guides were additionally calculated based on discrete optimization techniques for optimizing coverage. Mean coverage error was DeltaE(ab) = 3.51 for VC and DeltaE(ab) = 2.96 for 3D. Coverage of tooth colours by the tabs of VC and 3D within DeltaE(ab) = 2 was 23% and 24%, respectively, (DeltaE(ab)

Treading lightly on shifting ground: The direction and motivation of future geological research

USGS Publications Warehouse

Witt, A.C.

2011-01-01

The future of the geosciences and geological research will involve complex scientific challenges, primarily concerning global and regional environmental issues, in the next 20-30 years. It is quite reasonable to suspect, based on current political and socioeconomic events, that young geoscientists will be faced with and involved in helping to resolve some well defined problems: water and energy security, the effects of anthropogenic climate change, coastal sea level rise and development, and the mitigation of geohazards. It is how we choose to approach these challenges that will define our future. Interdisciplinary applied research, improved modeling and prediction augmented with faster and more sophisticated computing, and a greater role in creating and guiding public policy, will help us achieve our goals of a cleaner and safer Earth environment in the next 30 years. In the far future, even grander possibilities for eliminating the risk of certain geohazards and finding sustainable solutions to our energy needs can be envisioned. Looking deeper into the future, the possibilities for geoscience research push the limits of the imagination.

Dissemination and Implementation Science in Primary Care Research and Practice: Contributions and Opportunities.

PubMed

Holtrop, Jodi Summers; Rabin, Borsika A; Glasgow, Russell E

2018-01-01

Dissemination and Implementation Science (DIS) is a growing research field that seeks to inform how evidence-based interventions can be successfully adopted, implemented, and maintained in health care delivery and community settings. In this article, an overview of DIS and how it has contributed to primary care delivery improvement, future opportunities for its use, and DIS resources for learning are described. Case examples are provided to illustrate how DIS can be used to solve the complex implementation and dissemination problems that emerge in primary care. Finally, recommendations are made to guide the use of DIS to inform and drive improvements in primary care delivery. © Copyright 2018 by the American Board of Family Medicine.

Bringing health and social policy together: the case of the earned income tax credit.

PubMed

Arno, Peter S; Sohler, Nancy; Viola, Deborah; Schechter, Clyde

2009-07-01

The principal objective of our research is to examine whether the earned income tax credit (EITC), a broad-based income support program that has been shown to increase employment and income among poor working families, also improves their health and access to care. A finding that the EITC has a positive impact on the health of the American public may help guide deliberations about its future at the federal, state, and local levels. The authors contend that a better understanding of the relationship between major socioeconomic policies such as the EITC and the public's health will inform the fields of health and social policy in the pursuit of improving population health.

Advances and Future Applications of Augmented Peripheral Nerve Regeneration

PubMed Central

Jones, Salazar; Eisenberg, Howard M.; Jia, Xiaofeng

2016-01-01

Peripheral nerve injuries remain a significant source of long lasting morbidity, disability, and economic costs. Much research continues to be performed in areas related to improving the surgical outcomes of peripheral nerve repair. In this review, the physiology of peripheral nerve regeneration and the multitude of efforts to improve surgical outcomes are discussed. Improvements in tissue engineering that have allowed for the use of synthetic conduits seeded with neurotrophic factors are highlighted. Selected pre-clinical and available clinical data using cell based methods such as Schwann cell, undifferentiated, and differentiated stem cell transplantation to guide and enhance peripheral nerve regeneration are presented. The limitations that still exist in the utility of neurotrophic factors and cell-based therapies are outlined. Strategies that are most promising for translation into the clinical arena are suggested. PMID:27618010

Improving the quality of survivorship for older adults with cancer.

PubMed

Mohile, Supriya G; Hurria, Arti; Cohen, Harvey J; Rowland, Julia H; Leach, Corinne R; Arora, Neeraj K; Canin, Beverly; Muss, Hyman B; Magnuson, Allison; Flannery, Marie; Lowenstein, Lisa; Allore, Heather G; Mustian, Karen M; Demark-Wahnefried, Wendy; Extermann, Martine; Ferrell, Betty; Inouye, Sharon K; Studenski, Stephanie A; Dale, William

2016-08-15

In May 2015, the Cancer and Aging Research Group, in collaboration with the National Cancer Institute and the National Institute on Aging through a U13 grant, convened a conference to identify research priorities to help design and implement intervention studies to improve the quality of life and survivorship of older, frailer adults with cancer. Conference attendees included researchers with multidisciplinary expertise and advocates. It was concluded that future intervention trials for older adults with cancer should: 1) rigorously test interventions to prevent the decline of or improve health status, especially interventions focused on optimizing physical performance, nutritional status, and cognition while undergoing cancer treatment; 2) use standardized care plans based on geriatric assessment findings to guide targeted interventions; and 3) incorporate the principles of geriatrics into survivorship care plans. Also highlighted was the need to integrate the expertise of interdisciplinary team members into geriatric oncology research, improve funding mechanisms to support geriatric oncology research, and disseminate high-impact results to the research and clinical community. In conjunction with the 2 prior U13 meetings, this conference provided the framework for future research to improve the evidence base for the clinical care of older adults with cancer. Cancer 2016;122:2459-68. © 2016 American Cancer Society. © 2016 American Cancer Society.

Improving Support for America's Hidden Heroes

PubMed Central

Terri, Tanielian; Kathryn E., Bouskill; Rajeev, Ramchand; Esther M., Friedman; Thomas E., Trail; Angela, Clague

2018-01-01

Abstract The United States is home to more than 21 million veterans, many of whom deployed to support combat operations around the globe during their military service and sustained service-related conditions or disabilities. Supporting these wounded, ill, and injured warriors once home are millions of informal caregivers—individuals who provide unpaid support with activities that enable the service member or veteran to live in a noninstitutionalized setting. In this study, researchers describe elements of a research blueprint to inform future efforts to improve support for military and veteran caregivers. To construct this blueprint, researchers inventoried currently available research on caregiving for disabled adults and children and gathered stakeholder input by conducting a survey and facilitating an online panel. The study highlights the need for more studies that examine how military and veteran caregiver needs evolve over time, how programs are working, and how caregiving affects specific subgroups. The resulting blueprint should serve as a guide for the caregiver support community to use in prioritizing and facilitating future research. PMID:29416949

Future directions for the development of virtual reality within an automotive manufacturer.

PubMed

Lawson, Glyn; Salanitri, Davide; Waterfield, Brian

2016-03-01

Virtual Reality (VR) can reduce time and costs, and lead to increases in quality, in the development of a product. Given the pressure on car companies to reduce time-to-market and to continually improve quality, the automotive industry has championed the use of VR across a number of applications, including design, manufacturing, and training. This paper describes interviews with 11 engineers and employees of allied disciplines from an automotive manufacturer about their current physical and virtual properties and processes. The results guided a review of research findings and scientific advances from the academic literature, which formed the basis of recommendations for future developments of VR technologies and applications. These include: develop a greater range of virtual contexts; use multi-sensory simulation; address perceived differences between virtual and real cars; improve motion capture capabilities; implement networked 3D technology; and use VR for market research. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Improving Support for America's Hidden Heroes: A Research Blueprint.

PubMed

Terri, Tanielian; Kathryn E, Bouskill; Rajeev, Ramchand; Esther M, Friedman; Thomas E, Trail; Angela, Clague

2018-01-01

The United States is home to more than 21 million veterans, many of whom deployed to support combat operations around the globe during their military service and sustained service-related conditions or disabilities. Supporting these wounded, ill, and injured warriors once home are millions of informal caregivers-individuals who provide unpaid support with activities that enable the service member or veteran to live in a noninstitutionalized setting. In this study, researchers describe elements of a research blueprint to inform future efforts to improve support for military and veteran caregivers. To construct this blueprint, researchers inventoried currently available research on caregiving for disabled adults and children and gathered stakeholder input by conducting a survey and facilitating an online panel. The study highlights the need for more studies that examine how military and veteran caregiver needs evolve over time, how programs are working, and how caregiving affects specific subgroups. The resulting blueprint should serve as a guide for the caregiver support community to use in prioritizing and facilitating future research.

Achievable future conditions as a framework for guiding forest conservation and management

Treesearch

S.W. Golladay; K.L. Martin; J. M. Vose; D. N. Wear; A.P. Covich; R.J. Hobbs; Kier Klepzig; G.E. Likens; R.J. Naiman; A.W. Shearer

2016-01-01

We contend that traditional approaches to forest conservation and management will be inadequate given the predicted scale of social-economic and biophysical changes in the 21st century. New approaches, focused on anticipating and guiding ecological responses to change, are urgently needed to ensure the full value of forest ecosystem services for future generations....

Shaping up Your Financial Future, Grades 6-8. Teacher Guide [and] Student Workouts. Financial Fitness for Life.

ERIC Educational Resources Information Center

Flowers, Barbara; Gallaher, Sheryl Szot

Middle school students enjoy personal finance because it involves making decisions about their lives, both in the present and in the future. This teacher's guide and student workouts package consists of 17 economics lessons for students at grades 6-8 that are divided into 5 theme areas: the economic way of thinking; earning an income; saving;…

Futuring for Future Ready Librarians

ERIC Educational Resources Information Center

Figueroa, Miguel A.

2018-01-01

Futurists and foresight professionals offer several guiding principles for thinking about the future. These principles can help people to think about the future and become more powerful players in shaping the preferred futures they want for themselves and their communities. The principles also fit in well as strategies to support the Future Ready…

Simultaneous MRI and PET imaging of a rat brain

NASA Astrophysics Data System (ADS)

Raylman, Raymond R.; Majewski, Stan; Lemieux, Susan K.; Sendhil Velan, S.; Kross, Brian; Popov, Vladimir; Smith, Mark F.; Weisenberger, Andrew G.; Zorn, Carl; Marano, Gary D.

2006-12-01

Multi-modality imaging is rapidly becoming a valuable tool in the diagnosis of disease and in the development of new drugs. Functional images produced with PET fused with anatomical structure images created by MRI will allow the correlation of form with function. Our group is developing a system to acquire MRI and PET images contemporaneously. The prototype device consists of two opposed detector heads, operating in coincidence mode. Each MRI-PET detector module consists of an array of LSO detector elements coupled through a long fibre optic light guide to a single Hamamatsu flat panel position-sensitive photomultiplier tube (PSPMT). The use of light guides allows the PSPMTs to be positioned outside the bore of a 3T MRI scanner where the magnetic field is relatively small. To test the device, simultaneous MRI and PET images of the brain of a male Sprague Dawley rat injected with FDG were successfully obtained. The images revealed no noticeable artefacts in either image set. Future work includes the construction of a full ring PET scanner, improved light guides and construction of a specialized MRI coil to permit higher quality MRI imaging.

Intensive care unit quality improvement: a "how-to" guide for the interdisciplinary team.

PubMed

Curtis, J Randall; Cook, Deborah J; Wall, Richard J; Angus, Derek C; Bion, Julian; Kacmarek, Robert; Kane-Gill, Sandra L; Kirchhoff, Karin T; Levy, Mitchell; Mitchell, Pamela H; Moreno, Rui; Pronovost, Peter; Puntillo, Kathleen

2006-01-01

Quality improvement is an important activity for all members of the interdisciplinary critical care team. Although an increasing number of resources are available to guide clinicians, quality improvement activities can be overwhelming. Therefore, the Society of Critical Care Medicine charged this Outcomes Task Force with creating a "how-to" guide that focuses on critical care, summarizes key concepts, and outlines a practical approach to the development, implementation, evaluation, and maintenance of an interdisciplinary quality improvement program in the intensive care unit. The task force met in person twice and by conference call twice to write this document. We also conducted a literature search on "quality improvement" and "critical care or intensive care" and searched online for additional resources. DATA SYNTHESIS AND OVERVIEW: We present an overview of quality improvement in the intensive care unit setting and then describe the following steps for initiating or improving an interdisciplinary critical care quality improvement program: a) identify local motivation, support teamwork, and develop strong leadership; b) prioritize potential projects and choose the first target; c) operationalize the measures, build support for the project, and develop a business plan; d) perform an environmental scan to better understand the problem, potential barriers, opportunities, and resources for the project; e) create a data collection system that accurately measures baseline performance and future improvements; f) create a data reporting system that allows clinicians and others to understand the problem; g) introduce effective strategies to change clinician behavior. In addition, we identify four steps for evaluating and maintaining this program: a) determine whether the target is changing with periodic data collection; b) modify behavior change strategies to improve or sustain improvements; c) focus on interdisciplinary collaboration; and d) develop and sustain support from the hospital leadership. We also identify a number of online resources to complement this overview. This Society of Critical Care Medicine Task Force report provides an overview for clinicians interested in developing or improving a quality improvement program using a step-wise approach. Success depends not only on committed interdisciplinary work that is incremental and continuous but also on strong leadership. Further research is needed to refine the methods and identify the most cost-effective means of improving the quality of health care received by critically ill patients and their families.

Ten questions concerning future buildings beyond zero energy and carbon neutrality

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

Wang, Na; Phelan, Patrick E.; Gonzalez, Jorge

2017-07-01

Architects, planners, and building scientists have been at the forefront of envisioning a future built environment for centuries. However, fragmental views that emphasize one facet of the built environment, such as energy, environment, or groundbreaking technologies, often do not achieve expected outcomes. Buildings are responsible for approximately one-third of worldwide carbon emissions and account for over 40% of primary energy consumption in the U.S. In addition to achieving the ambitious goal of reducing building greenhouse gas emissions by 75% by 2050, buildings must improve their functionality and performance to meet current and future human, societal, and environmental needs in amore » changing world. In this article, we introduce a new framework to guide potential evolution of the building stock in the next century, based on greenhouse gas emissions as the common thread to investigate the potential implications of new design paradigms, innovative operational strategies, and disruptive technologies. This framework emphasizes integration of multidisciplinary knowledge, scalability for mainstream buildings, and proactive approaches considering constraints and unknowns. The framework integrates the interrelated aspects of the built environment through a series of quantitative metrics that aim to improve environmental outcomes while optimizing building performance to achieve healthy, adaptive, and productive buildings.« less

[Preoperational study for the improvement of hygiene conditions in long-term care facilities].

PubMed

Adler, A C; Spegel, H; Kolb, S; Hierl, W; Müller, C; Höller, C; Liebl, B; Rudolph, P; Herr, C

2014-12-01

Hygiene is becoming more and more important in long-term care facilities. Long-term care facilities are subject to monitoring by the Public Health Service (PHS) and other authorities. For the PHS in Bavaria the Bavarian Health and Food Safety Authority (Landesamt für Gesundheit und Lebensmittelsicherheit, LGL) published a hygiene monitoring concept and there exists an inspection guide developed by a specialist department for nursing homes and institutions for the handicapped (Fachstelle für Pflege und Behinderteneinrichtungen, FQA). Because inspections are performed in multiprofessional teams, it makes sense to use a coordinated inspection catalog. The aim was to integrate hygienic requirements specified in the Bavarian guidelines for hygiene by the LGL into the inspection guide published by the FQA to obtain a quality assured surveillance. The involved parties were questioned about the inspection guide and their hygiene management and then the hygiene criteria of the LGL were implemented into the inspection guide. Questions dealing with hygiene requirements concerning intensive care, management of multidrug resistant bacteria and interviews with the person responsible for infection control in the facility itself were developed for the first time and were integrated into the inspection guide. The revised inspection guide was tested for its applicability. With the revised inspection guide there now exists a tool which allows not only comprehensive inspections of the facilities including hygiene issues but also a good cooperation of the various parties involved. There are many actions which have to be conveyed into the future, especially programs to train staff to apply the inspection guide and to enhance the ability of all participants to act in cooperation. The guide will also allow the facilities to cooperate more easily and more closely, as the guide takes the respective problems and challenges of the different facilities into consideration. Additionally the development of legal guidelines regarding hygiene can support general healthcare of residents.

Home Economics Education Career Path Guide and Model Curriculum Standards.

ERIC Educational Resources Information Center

California State Univ., Northridge.

This curriculum guide developed in California and organized in 10 chapters, provides a home economics education career path guide and model curriculum standards for high school home economics programs. The first chapter contains information on the following: home economics education in California, home economics careers for the future, home…

Nutrition and Food Science. Teacher's Instructional Guide.

ERIC Educational Resources Information Center

Hays, Tricia

This teaching, guide for a high school nutrition and food science course, includes introductory information about the course, course design, facilities and equipment, Future Homemakers of America, and use of the guide. The course addresses nutrition and food science from the perspective of food habits and wellness; menu planning; special dietary…

Confronting Global Issues: A Multipurpose IR Simulation

ERIC Educational Resources Information Center

Shellman, Stephen M.; Turan, Kursad

2006-01-01

This article describes an international relations simulation that focuses on threats of transnational insurgent organizations, the future of the Iraqi regime, and the effect of globalization on foreign policies. It contains both the Simulation Director's Guide and the Participant's Guide. The guides explain the steps taken to run the simulation…

Canine Breed-Specific Hepatopathies.

PubMed

Watson, Penny

2017-05-01

Canine hepatopathies, both congenital and acquired, arise from an interaction between genes and environment. Many show increased breed prevalences. This article reviews the current understanding on breed predispositions for congenital portosystemic shunts; microvascular dysplasia and portal vein hypoplasia; ductal plate abnormalities (congenital hepatic fibrosis and Caroli disease); chronic hepatitis (both copper associated and idiopathic); vacuolar hepatopathies; and gallbladder mucocele. Although all these diseases can occur in many breeds and crossbreeds, understanding breed predispositions helps recognition and will guide future research to improve understanding of causes and treatments. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Advances in nonlinear optical materials and devices

NASA Technical Reports Server (NTRS)

Byer, Robert L.

1991-01-01

The recent progress in the application of nonlinear techniques to extend the frequency of laser sources has come from the joint progress in laser sources and in nonlinear materials. A brief summary of the progress in diode pumped solid state lasers is followed by an overview of progress in nonlinear frequency extension by harmonic generation and parametric processes. Improved nonlinear materials including bulk crystals, quasiphasematched interactions, guided wave devices, and quantum well intersubband studies are discussed with the idea of identifying areas of future progress in nonlinear materials and devices.

Towards a successful clinical implementation of fluorescence-guided surgery.

PubMed

Snoeks, T J A; van Driel, P B A A; Keereweer, S; Aime, S; Brindle, K M; van Dam, G M; Löwik, C W G M; Ntziachristos, V; Vahrmeijer, A L

2014-04-01

During the European Molecular Imaging Meeting (EMIM) 2013, the fluorescence-guided surgery study group held its inaugural session to discuss the clinical implementation of fluorescence-guided surgery. The general aim of this study group is to discuss and identify the steps required to successfully and safely bring intraoperative fluorescence imaging to the clinics. The focus group intends to use synergies between interested groups as a tool to address regulatory and implementation hurdles in Europe and operates within the intraoperative focus group of the World Molecular Imaging Society (WMIS) that promotes the same interests at the WMIS level. The major topics on the critical path of implementation identified within the study group were quality controls and standards for ensuring accurate imaging and the ability to compare results from different studies, regulatory affairs, and strategies to increase awareness among physicians, regulators, insurance companies, and a broader audience. These hurdles, and the possible actions discussed to overcome them, are summarized in this report. Furthermore, a number of recommendations for the future shape of the fluorescence-guided study group are discussed. A main driving conclusion remains that intraoperative imaging has great clinical potential and that many of the solutions required are best addressed with the community working together to optimally promote and accelerate the clinical implementation of fluorescence imaging towards improving surgical procedures.

Synthesis of walking sounds for alleviating gait disturbances in Parkinson's disease.

PubMed

Rodger, Matthew W M; Young, William R; Craig, Cathy M

2014-05-01

Managing gait disturbances in people with Parkinson's disease is a pressing challenge, as symptoms can contribute to injury and morbidity through an increased risk of falls. While drug-based interventions have limited efficacy in alleviating gait impairments, certain nonpharmacological methods, such as cueing, can also induce transient improvements to gait. The approach adopted here is to use computationally-generated sounds to help guide and improve walking actions. The first method described uses recordings of force data taken from the steps of a healthy adult which in turn were used to synthesize realistic gravel-footstep sounds that represented different spatio-temporal parameters of gait, such as step duration and step length. The second method described involves a novel method of sonifying, in real time, the swing phase of gait using real-time motion-capture data to control a sound synthesis engine. Both approaches explore how simple but rich auditory representations of action based events can be used by people with Parkinson's to guide and improve the quality of their walking, reducing the risk of falls and injury. Studies with Parkinson's disease patients are reported which show positive results for both techniques in reducing step length variability. Potential future directions for how these sound approaches can be used to manage gait disturbances in Parkinson's are also discussed.

Overcoming Hurdles: Teaching Guides To Interpret Biodiversity Conservation.

ERIC Educational Resources Information Center

Kohl, Jon; Brown, Cynthia; Humke, Matt

2001-01-01

Highlights the development and use of bilingual nature guide training. Examines work at the RARE Center for tropical conservation in Central America. Speculates about the future of conservation interpretation. (DDR)

Transportation Acronym Guide, 1994

DOT National Transportation Integrated Search

1994-11-01

This report compiles and identifies transportation and transportation-related acronyms throughout the Department of Transportation and other related U.S. government agencies. This is the second edition of the Transportation Acronym Guide (TAG); futur...

Transportation Acronym Guide, 1996

DOT National Transportation Integrated Search

1996-06-01

This report compiles and identifies transportation and transportation-related acronyms throughout the Department of Transportation and other related U.S. government agencies. This is the second edition of the Transportation Acronym Guide (TAG); futur...

Thinking about internal states, a qualitative investigation into metacognitions in women with eating disorders

PubMed Central

2013-01-01

Background There is a need for qualitative research to help develop case conceptualisations to guide the development of Metacognitive Therapy interventions for Eating Disorders. Method A qualitative study informed by grounded theory methodology was conducted involving open-ended interviews with 27 women aged 18–55 years, who were seeking or receiving treatment for a diagnosed ED. Results The categories identified in this study appeared to be consistent with a metacognitive model including constructs of a Cognitive Attentional Syndrome and metacognitive beliefs. These categories appear to be transdiagnostic, and the interaction between the categories is proposed to explain the maintenance of EDs. Conclusions The transdiagnostic model proposed may be useful to guide the development of future metacognitive therapy interventions for EDs with the hope that this will lead to improved outcomes for individuals with EDs. PMID:24999403

CNTRICS Final Task Selection: Control of Attention

PubMed Central

Nuechterlein, Keith H.; Luck, Steven J.; Lustig, Cindy; Sarter, Martin

2009-01-01

The construct of attention has many facets that have been examined in human and animal research and in healthy and psychiatrically disordered conditions. The Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) group concluded that control of attention—the processes that guide selection of task-relevant inputs—is particularly impaired in schizophrenia and could profit from further work with refined measurement tools. Thus, nominations for cognitive tasks that provide discrete measures of control of attention were sought and were then evaluated at the third CNTRICS meeting for their promise for future use in treatment development. This article describes the 5 nominated measures and their strengths and weaknesses for cognitive neuroscience work relevant to treatment development. Two paradigms, Guided Search and the Distractor Condition Sustained Attention Task, were viewed as having the greatest immediate promise for development into tools for treatment research in schizophrenia and are described in more detail by their nominators. PMID:19074499

Managing Your Money. Leader's Guide [and] Participant's Workbook.

ERIC Educational Resources Information Center

Nieuwenhuis, Ann; Hathaway, Irene

This document contains both a leader's guide and participant's workbook on money management. The leader's and participant's guides contain 10 parts each: (1) danger signs in money management; (2) what's important to you; (3) spending for the future; (4) financial fitness; (5) use credit wisely; (6) decisions, decisions; (7) shopping basics; (8)…

Nonmelanoma skin cancer in mountain guides: high prevalence and lack of awareness warrant development of evidence-based prevention tools.

PubMed

Zink, Alexander; Koch, Elisabeth; Seifert, Florian; Rotter, Markus; Spinner, Christoph D; Biedermann, Tilo

2016-01-01

Nonmelanoma skin cancer (NMSC) is the most common cancer in Switzerland and Europe. The main causative factor is exposure to ultraviolet radiation, which puts outdoor workers in general at a higher risk of developing NMSC than indoor workers. However, few studies have clinically examined the risk of developing NMSC to outdoor workers, especially mountain guides. We aimed to investigate the prevalence of NMSC and corresponding precancerous lesions, and the associated risk behaviour of mountain and ski guides in order to develop future prevention programmes. We conducted a cross-sectional study including mountain and ski guides from southern Germany, who underwent a full-body skin check-up by a dermatologist. We assessed their NMSC awareness and risk behaviour using a paper-based questionnaire. Of the 62 state-certified mountain and ski guides (55 men, 7 women; mean age 52.9 ± 13.4 years) included in this study, 27 (43.5%) were diagnosed with NMSC or its premalignant stages. In addition, 59.7% of the participants expressed the opinion that their protection from ultraviolet radiation exposure needs to be improved; 83.6% requested further information on NMSC, and 48.5% had never undergone a skin check-up or consulted a dermatologist before. Mountain and ski guides are at a high risk for developing NMSC. Their unmet medical needs indicate an underestimation of NMSC prevalence, which is usually based on reports by insurance companies, and offer the chance for developing evidence-based awareness and prevention tools that can be promoted to individuals with other outdoor jobs.

Governance: The Mission Ingredient in Security Cooperation

DTIC Science & Technology

2017-06-09

assistance guiding principle of “do-no-harm,” should be included in the future DOS guidance. Seven do-no-harm lessons include: (1) norms and... principle of “do-no-harm.” 15. SUBJECT TERMS Security cooperation, security assistance, defense institution building, USAID, best practices...foreign assistance guiding principle of “do-no-harm,” should be included in the future DOS guidance. Seven do-no-harm lessons include: (1) norms and

Image-guided urologic surgery: intraoperative optical imaging and tissue interrogation (Conference Presentation)

NASA Astrophysics Data System (ADS)

Liao, Joseph C.

2017-02-01

Emerging optical imaging technologies can be integrated in the operating room environment during minimally invasive and open urologic surgery, including oncologic surgery of the bladder, prostate, and kidney. These technologies include macroscopic fluorescence imaging that provides contrast enhancement between normal and diseased tissue and microscopic imaging that provides tissue characterization. Optical imaging technologies that have reached the clinical arena in urologic surgery are reviewed, including photodynamic diagnosis, near infrared fluorescence imaging, optical coherence tomography, and confocal laser endomicroscopy. Molecular imaging represents an exciting future arena in conjugating cancer-specific contrast agents to fluorophores to improve the specificity of disease detection. Ongoing efforts are underway to translate optimal targeting agents and imaging modalities, with the goal to improve cancer-specific and functional outcomes.

Autism and Equine-Assisted Interventions: A Systematic Mapping Review.

PubMed

McDaniel Peters, B Caitlin; Wood, Wendy

2017-10-01

This systematic mapping review mapped current knowledge of equine-assisted interventions for people with autism to help guide future practice and research. Thirty-three studies including children and adolescents with autism, 3 of which confirmed diagnoses, were reviewed. Five types of equine-assisted activities were identified across 25 studies, with reported improvements in behavior, social interaction, and communication. Four types of equine-assisted therapies were identified across 8 studies, with reported improvements in motor control and self-care. Different approaches to therapeutic riding and hippotherapy, the most studied interventions, were evident. While this literature reflected early scientific development, it offered broad proof of concept that equine-assisted interventions can benefit children and adolescents with autism. Promising outcomes support continued investigation focused on standardization, appropriateness, and efficacy.

Bringing health and social policy together: The case of the earned income tax credit

PubMed Central

Arno, Peter S.; Sohler, Nancy; Viola, Deborah; Schechter, Clyde

2011-01-01

The principal objective of our research is to examine whether the earned income tax credit (EITC), a broad-based income support program that has been shown to increase employment and income among poor working families, also improves their health and access to care. A finding that the EITC has a positive impact on the health of the American public may help guide deliberations about its future at the federal, state, and local levels. The authors contend that a better understanding of the relationship between major socioeconomic policies such as the EITC and the public’s health will inform the fields of health and social policy in the pursuit of improving population health. PMID:19597453

Emergency medical services : agenda for the future

DOT National Transportation Integrated Search

1996-08-01

The purpose of the EMS Agenda for the Future is to determine the most important directions for future EMS development, incorporating input from a broad, multidisciplinary spectrum of EMS stakeholders. This document provides guiding principles for the...

Application of the U.S. EPA Mode of Action Framework for Purposes of Guiding Future Research: A Case Study Involving the Oral Carcinogenicity of Hexavalent Chromium

PubMed Central

Thompson, Chad M.; Haws, Laurie C.; Harris, Mark A.; Gatto, Nicole M.; Proctor, Deborah M.

2011-01-01

Mode of action (MOA) analysis provides a systematic description of key events leading to adverse health effects in animal bioassays for the purpose of informing human health risk assessment. Uncertainties and data gaps identified in the MOA analysis may also be used to guide future research to improve understanding of the MOAs underlying a specific toxic response and foster development of toxicokinetic and toxicodynamic models. An MOA analysis, consistent with approaches outlined in the MOA Framework as described in the Guidelines for Carcinogen Risk Assessment, was conducted to evaluate small intestinal tumors observed in mice chronically exposed to relatively high concentrations of hexavalent chromium (Cr(VI)) in drinking water. Based on review of the literature, key events in the MOA are hypothesized to include saturation of the reductive capacity of the upper gastrointestinal tract, absorption of Cr(VI) into the intestinal epithelium, oxidative stress and inflammation, cell proliferation, direct and/or indirect DNA modification, and mutagenesis. Although available data generally support the plausibility of these key events, several unresolved questions and data gaps were identified, highlighting the need for obtaining critical toxicokinetic and toxicodynamic data in the target tissue and in the low-dose range. Experimental assays that can address these data gaps are discussed along with strategies for comparisons between responsive and nonresponsive tissues and species. This analysis provides a practical application of MOA Framework guidance and is instructive for the design of studies to improve upon the information available for quantitative risk assessment. PMID:20947717

Endoscopic ultrasound elastography: Current status and future perspectives

PubMed Central

Cui, Xin-Wu; Chang, Jian-Min; Kan, Quan-Cheng; Chiorean, Liliana; Ignee, Andre; Dietrich, Christoph F

2015-01-01

Elastography is a new ultrasound modality that provides images and measurements related to tissue stiffness. Endoscopic ultrasound (EUS) has played an important role in the diagnosis and management of numerous abdominal and mediastinal diseases. Elastography by means of EUS examination can assess the elasticity of tumors in the proximity of the digestive tract that are hard to reach with conventional transcutaneous ultrasound probes, such as pancreatic masses and mediastinal or abdominal lymph nodes, thus improving the diagnostic yield of the procedure. Results from previous studies have promised benefits for EUS elastography in the differential diagnosis of lymph nodes, as well as for assessing masses with pancreatic or gastrointestinal (GI) tract locations. It is important to mention that EUS elastography is not considered a modality that can replace biopsy. However, it may be a useful adjunct, improving the accuracy of EUS-fine needle aspiration biopsy (EUS-FNAB) by selecting the most suspicious area to be targeted. Even more, it may be useful for guiding further clinical management when EUS-FNAB is negative or inconclusive. In the present paper we will discuss the current knowledge of EUS elastography, including the technical aspects, along with its applications in the differential diagnosis between benign and malignant solid pancreatic masses and lymph nodes, as well as its aid in the differentiation between normal pancreatic tissues and chronic pancreatitis. Moreover, the emergent indication and future perspectives are summarized, such as the benefit of EUS elastography in EUS-guided fine needle aspiration biopsy, and its uses for characterization of lesions in liver, biliary tract, adrenal glands and GI tract. PMID:26715804

UKIRT fast guide system improvements

NASA Astrophysics Data System (ADS)

Balius, Al; Rees, Nicholas P.

1997-09-01

The United Kingdom Infra-Red Telescope (UKIRT) has recently undergone the first major upgrade program since its construction. One part of the upgrade program was an adaptive tip-tilt secondary mirror closed with a CCD system collectively called the fast guide system. The installation of the new secondary and associated systems was carried out in the first half of 1996. Initial testing of the fast guide system has shown great improvement in guide accuracy. The initial installation included a fixed integration time CCD. In the first part of 1997 an integration time controller based on computed guide star luminosity was implemented in the fast guide system. Also, a Kalman type estimator was installed in the image tracking loop based on a dynamic model and knowledge of the statistical properties of the guide star position error measurement as a function of computed guide star magnitude and CCD integration time. The new configuration was tested in terms of improved guide performance nd graceful degradation when tracking faint guide stars. This paper describes the modified fast guide system configuration and reports the results of performance tests.

Analyzing the impacts of global trade and investment on non-communicable diseases and risk factors: a critical review of methodological approaches used in quantitative analyses.

PubMed

Cowling, Krycia; Thow, Anne Marie; Pollack Porter, Keshia

2018-05-24

A key mechanism through which globalization has impacted health is the liberalization of trade and investment, yet relatively few studies to date have used quantitative methods to investigate the impacts of global trade and investment policies on non-communicable diseases and risk factors. Recent reviews of this literature have found heterogeneity in results and a range of quality across studies, which may be in part attributable to a lack of conceptual clarity and methodological inconsistencies. This study is a critical review of methodological approaches used in the quantitative literature on global trade and investment and diet, tobacco, alcohol, and related health outcomes, with the objective of developing recommendations and providing resources to guide future robust, policy relevant research. A review of reviews, expert review, and reference tracing were employed to identify relevant studies, which were evaluated using a novel quality assessment tool designed for this research. Eight review articles and 34 quantitative studies were identified for inclusion. Important ways to improve this literature were identified and discussed: clearly defining exposures of interest and not conflating trade and investment; exploring mechanisms of broader relationships; increasing the use of individual-level data; ensuring consensus and consistency in key confounding variables; utilizing more sector-specific versus economy-wide trade and investment indicators; testing and adequately adjusting for autocorrelation and endogeneity when using longitudinal data; and presenting results from alternative statistical models and sensitivity analyses. To guide the development of future analyses, recommendations for international data sources for selected trade and investment indicators, as well as key gaps in the literature, are presented. More methodologically rigorous and consistent approaches in future quantitative studies on the impacts of global trade and investment policies on non-communicable diseases and risk factors can help to resolve inconsistencies of existing research and generate useful information to guide policy decisions.

Improving the Impact of Extension through the Use of Anticipation Guides

ERIC Educational Resources Information Center

Smith, Rebecca C.; Lemley, Stephanie M.

2017-01-01

In this article, we present the anticipation guide as a tool for preparing Extension audiences to learn the main points of Extension materials. Anticipation guides improve learner comprehension by appealing to an individual's natural curiosity and helping the individual focus on key ideas. Anticipation guides can be used with all types of…

Assessment of Dog Guides by Users in Japan and Suggestions for Improvement

ERIC Educational Resources Information Center

Koda, Naoko; Kubo, Masumi; Ishigami, Tomomi; Furuhashi, Hiroaki

2011-01-01

Dog guide users in Japan were mostly satisfied with and used their dogs frequently; however, they requested some improvements in training and in basic guiding work. The findings of the study suggest the need for further improvement of training methods, considering cultural factors and individual users' needs. (Contains 3 tables.)

Guide for Improving NRS Data Quality: Procedures for Data Collection and Training.

ERIC Educational Resources Information Center

Condelli, Larry; Castillo, Laura; Seburn, Mary; Deveaux, Jon

This guide for improving the quality of National Reporting System for Adult Education (NRS) data through improved data collection and training is intended for local providers and state administrators. Chapter 1 explains the guide's purpose, contents, and use and defines the following components of data quality: objectivity; integrity;…

Improving Student Motivation. A Guide for Teachers and School Improvement Teams.

ERIC Educational Resources Information Center

Meece, Judith; McColskey, Wendy

This guide provides a general overview of research on student motivation in classroom and school settings and a guide to help teachers and school teams to analyze the sources of students motivational problems and consider changes that will improve motivation. Chapter 1 defines motivation, considers the extent of the motivation problem, and…

Career/Vocational Preparation for Students with Disabilities: A Program Improvement Guide.

ERIC Educational Resources Information Center

Stodden, Robert A.

This program improvement guide is designed to assist district and school level interdisciplinary planning teams to improve career/vocational programs for students with disabilities. Its focus is on the integration of best practices within the educational program continuum to achieve positive student outcomes. The guide includes three sections.…

Using the Delphi questionnaire technique to create a reading comprehension resource guide for middle school science teachers

NASA Astrophysics Data System (ADS)

Wegner, Molly F.

As students begin middle school, they are expected to possess and apply a wide array of nonfiction reading strategies if they are to comprehend new concepts from nonfiction texts. Although strategies and resource guides for fiction reading are available, an effective nonfiction reading comprehension resource guide tailored to middle school science teachers is lacking. The conceptual framework guiding this study is based on schema theory that supports the use of prior knowledge as a foundation for learning. The purpose of this project study was to address this local problem by providing middle school science teachers with a user-friendly resource for nonfiction reading comprehension strategies in a science context. The research question examined nonfiction reading comprehension strategies that could supplement middle school science teachers' instructional practices to increase student comprehension in science, as reflected on the results of state standardized tests. This project study consulted science and language arts teachers using a Delphi questionnaire technique to achieve a consensus through multiple iterations of questionnaires. Science teachers identified 7 areas of concern as students read nonfiction texts, and language arts teachers suggested effective reading comprehension strategies to address these areas. Based on the consensus of reading comprehension strategies and review of literature, a resource guide for middle school science teachers was created. By improving reading comprehension in content areas, teachers may not only increase student learning, but also underscore the importance of literacy relating to life-long learning through future occupations, academic endeavors, and society as well.

Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments.

PubMed

Bakker, David; Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

2016-03-01

The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems.

Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments

PubMed Central

Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki

2016-01-01

Background The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. Objective To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. Methods A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. Results Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. Conclusions Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems. PMID:26932350

Food Production Worker. Dietetic Support Personnel Training Program.

ERIC Educational Resources Information Center

Barker, Ellen; And Others

This curriculum guide, part of a multi-volume dietetic support personnel training program, consists of materials (15 units) for use in training future food production workers. Covered in the first part of the guide are nutrition in food production and diet therapy. The second part of the guide deals with sanitation and safety in food production.…

Local Libraries: Global Awareness. A Librarian's Guide to Global Programming for a Sustainable Future.

ERIC Educational Resources Information Center

Global Learning, Inc., Union, NJ.

This guide seeks to provide public and school librarians with a variety of practical resources and activities for contributing to the public's understanding of major global trends and relationships that affect local communities. The guide contains four sections geared towards children, young adults, adults, and school settings. The children's…

Learning for the Future: Neighborhood Renewal through Adult and Community Learning. A Guide for Local Authorities.

ERIC Educational Resources Information Center

Merton, Bryan; Turner, Cheryl; Ward, Jane; White, Lenford

This guide is intended to assist managers within England's local authority adult and community education services in supporting neighborhood renewal through adult and community learning (ACL). The guide's overall aim is to promote the skills, knowledge, and understanding that underpin the following items: (1) identification and development of…

Pathways to a Sustainable Future: A Curriculum Guide for Maine Schools Exploring Waste Management Issues.

ERIC Educational Resources Information Center

Chewonki Foundation, Wiscasset, ME.

This action guide is designed to help students and teachers become aware of the concepts and issues of waste management, and to motivate them to action in the classroom, school, home, and community. The guide emphasizes interdisciplinary activities that concentrate on the process of problem solving. Activities are identified by appropriate grade…

National Positioning, Navigation, and Timing Architecture Study

NASA Astrophysics Data System (ADS)

van Dyke, K.; Vicario, J.; Hothem, L.

2007-12-01

The purpose of the National Positioning, Navigation and Timing (PNT) Architecture effort is to help guide future PNT system-of-systems investment and implementation decisions. The Assistant Secretary of Defense for Networks and Information Integration and the Under Secretary of Transportation for Policy sponsored a National PNT Architecture study to provide more effective and efficient PNT capabilities focused on the 2025 timeframe and an evolutionary path for government provided systems and services. U.S. Space-Based PNT Policy states that the U.S. must continue to improve and maintain GPS, augmentations to GPS, and back-up capabilities to meet growing national, homeland, and economic security needs. PNT touches almost every aspect of people´s lives today. PNT is essential for Defense and Civilian applications ranging from the Department of Defense´s Joint network centric and precision operations to the transportation and telecommunications sectors, improving efficiency, increasing safety, and being more productive. Absence of an approved PNT architecture results in uncoordinated research efforts, lack of clear developmental paths, potentially wasteful procurements and inefficient deployment of PNT resources. The national PNT architecture effort evaluated alternative future mixes of global (space and non space-based) and regional PNT solutions, PNT augmentations, and autonomous PNT capabilities to address priorities identified in the DoD PNT Joint Capabilities Document (JCD) and civil equivalents. The path to achieving the Should-Be architecture is described by the National PNT Architecture's Guiding Principles, representing an overarching Vision of the US' role in PNT, an architectural Strategy to fulfill that Vision, and four Vectors which support the Strategy. The National PNT Architecture effort has developed nineteen recommendations. Five foundational recommendations are tied directly to the Strategy while the remaining fourteen individually support one of the Vectors, as will be described in this presentation. The results of this effort will support future decisions of bodies such as the DoD PNT and Civil Pos/Nav Executive Committees, as well as the National Space-Based PNT Executive Committee (EXCOM).

Assistive technology for ultrasound-guided central venous catheter placement.

PubMed

Ikhsan, Mohammad; Tan, Kok Kiong; Putra, Andi Sudjana

2018-01-01

This study evaluated the existing technology used to improve the safety and ease of ultrasound-guided central venous catheterization. Electronic database searches were conducted in Scopus, IEEE, Google Patents, and relevant conference databases (SPIE, MICCAI, and IEEE conferences) for related articles on assistive technology for ultrasound-guided central venous catheterization. A total of 89 articles were examined and pointed to several fields that are currently the focus of improvements to ultrasound-guided procedures. These include improving needle visualization, needle guides and localization technology, image processing algorithms to enhance and segment important features within the ultrasound image, robotic assistance using probe-mounted manipulators, and improving procedure ergonomics through in situ projections of important information. Probe-mounted robotic manipulators provide a promising avenue for assistive technology developed for freehand ultrasound-guided percutaneous procedures. However, there is currently a lack of clinical trials to validate the effectiveness of these devices.

Aesops Guide to Space Acquisition: Glimpses of Past and Future

DTIC Science & Technology

2015-04-01

Defense AT&L: March–April 2015 6 Aesop’s Guide to Space Acquisition Glimpses of Past and Future John Krieger n William “Lance” Krieger n Rick...U.S.C.) § 2273—Policy regarding assured access to space : national security payloads, establishes the requirement for the President to ensure our...access to space . (a) Policy—It is the policy of the United States for the President to undertake actions appropriate to ensure, to the maximum

Psychiatric Emergency Services for the U.S. Elderly: 2008 and Beyond

PubMed Central

Walsh, Patrick G.; Currier, Glenn; Shah, Manish N.; Lyness, Jeffrey M.; Friedman, Bruce

2008-01-01

In 2011 the oldest baby boomers will turn age 65. Although healthcare researchers have started to examine the future preparedness of the healthcare system for the elderly, psychiatric emergency services (PES) have been widely overlooked. Research is needed to address PES need and demand by older patients, assess the consequences of this need/demand, and establish recommendations to guide PES planning and practice. The authors examined journal articles, review papers, textbooks, and electronic databases related to these topics. We outline the current PES environment in terms of facilities, characteristics, and visits, and discuss current geriatric patient PES use. Factors expected to impact future use are examined, including sociodemographic characteristics, psychiatric illness prevalence, cohort effects, medical comorbidity, mental healthcare resources and utilization, and stigma. Consequences of these on future psychiatric care and well-being of the elderly are then explored, specifically, greater acute services need, more suicide, strained delivery systems, increased hospitalization, and greater costs. The following are proposed to address likely future PES shortcomings: enhance service delivery, increase training, standardize and improve PES, prioritize finances, and promote research. The degree to which the geriatric mental healthcare “crisis” develops will be inversely related to the current system's response to predictable future needs. PMID:18757766

Teacher's Guide to the Future.

ERIC Educational Resources Information Center

Murphy, Elaine M.; Cancellier, Patricia

1982-01-01

A brief introduction to futures education, an annotated listing of resources, and three ready-to-use student activities are provided. The introduction discusses the benefits of futures education; for example, it encourages students to make responsible decisions about the future. Next, it lists a variety of techniques developed by futurists to…

Reporting Sexual Victimization During Incarceration: Using Ecological Theory as a Framework to Inform and Guide Future Research.

PubMed

Kubiak, Sheryl Pimlott; Brenner, Hannah; Bybee, Deborah; Campbell, Rebecca; Fedock, Gina

2016-03-08

The U.S. Department of Justice estimates that between 149,200 and 209,400 incidents of sexual victimization occur annually in prisons and jails. However, very few individuals experiencing sexual victimization during incarceration report these incidents to correctional authorities. Federal-level policy recommendations derived from the Prison Rape Elimination Act suggest mechanisms for improving reporting as well as standards for the prevention, investigation, and prosecution of prison-based sexual victimization. Despite these policy recommendations, sexual assault persists in prisons and jails, with only 8% of prisoners who experience sexual assault reporting their victimization. This review focuses on gaps in the existing research about what factors influence whether adult victims in incarcerated systems will report that they have been sexually assaulted. Using ecological theory to guide this review, various levels of social ecology are incorporated, illuminating a variety of factors influencing the reporting of sexual victimization during incarceration. These factors include the role of individual-level behavior, assault characteristics, the unique aspects and processes of the prison system, and the social stigma that surrounds individuals involved in the criminal/legal system. This review concludes with recommendations for future research, policy, and practice, informed by an ecological conceptualization of reporting. © The Author(s) 2016.

The Gut Microbiota, Food Science, and Human Nutrition: A Timely Marriage.

PubMed

Barratt, Michael J; Lebrilla, Carlito; Shapiro, Howard-Yana; Gordon, Jeffrey I

2017-08-09

Analytic advances are enabling more precise definitions of the molecular composition of key food staples incorporated into contemporary diets and how the nutrient landscapes of these staples vary as a function of cultivar and food processing methods. This knowledge, combined with insights about the interrelationship between consumer microbiota configurations and biotransformation of food ingredients, should have a number of effects on agriculture, food production, and strategies for improving the nutritional value of foods and health status. These effects include decision-making about which cultivars of current or future food staples to incorporate into existing and future food systems, and which components of waste streams from current or future food manufacturing processes have nutritional value that is worth capturing. They can also guide which technologies should be applied, or need to be developed, to produce foods that support efficient microbial biotransformation of their ingredients into metabolic products that sustain health. Copyright © 2017 Elsevier Inc. All rights reserved.

Future role of endoscopic ultrasound in personalized management of pancreatic cancer

PubMed Central

Ooi, Marie; Phan, An; Nguyen, Nam Q.

2017-01-01

Pancreatic ductal adenocarcinoma (PDAC) is aggressive and lethal with the majority of cases presenting with advanced unresectable disease due to delayed diagnosis. Despite improvement in surgery, chemotherapies, and intensive care medicine, the outcome of PDAC remains poor, which may relate to the tumor biology. Recent data suggest that PDAC is a “systemic cancer” with complex molecular or genomics derangement with marked heterogeneity. The ability to characterize the PDAC better by detailed evaluation of tissue biomarkers or genomics allows for improved prediction of prognosis and stratification of treatment, a concept known as “personalized cancer therapy.” Using tissue from resected PDAC specimens has several weaknesses and is only possible in 20% of patients with PDAC. Endoscopic ultrasound (EUS)-guided biopsy overcomes these weaknesses, and with recent advancements in needle technology, tissue can be obtained for personalized cancer therapy for all patients with PDAC. This review aims to outline our current understanding of the molecular biology of PDAC specifically focusing on how EUS-guided biopsy may play a fundamental role in tissue acquisition, allowing for assessment and stratify therapy according to the individual cancer biology as we move toward the era of precision medicine. PMID:29063873

Echocardiography and cardiac resynchronisation therapy, friends or foes?

PubMed

van Everdingen, W M; Schipper, J C; van 't Sant, J; Ramdat Misier, K; Meine, M; Cramer, M J

2016-01-01

Echocardiography is used in cardiac resynchronisation therapy (CRT) to assess cardiac function, and in particular left ventricular (LV) volumetric status, and prediction of response. Despite its widespread applicability, LV volumes determined by echocardiography have inherent measurement errors, interobserver and intraobserver variability, and discrepancies with the gold standard magnetic resonance imaging. Echocardiographic predictors of CRT response are based on mechanical dyssynchrony. However, parameters are mainly tested in single-centre studies or lack feasibility. Speckle tracking echocardiography can guide LV lead placement, improving volumetric response and clinical outcome by guiding lead positioning towards the latest contracting segment. Results on optimisation of CRT device settings using echocardiographic indices have so far been rather disappointing, as results suffer from noise. Defining response by echocardiography seems valid, although re-assessment after 6 months is advisable, as patients can show both continuous improvement as well as deterioration after the initial response. Three-dimensional echocardiography is interesting for future implications, as it can determine volume, dyssynchrony and viability in a single recording, although image quality needs to be adequate. Deformation patterns from the septum and the derived parameters are promising, although validation in a multicentre trial is required. We conclude that echocardiography has a pivotal role in CRT, although clinicians should know its shortcomings.

Dissemination and implementation science in program evaluation: A telemental health clinical consultation case example.

PubMed

Arora, Prerna G; Connors, Elizabeth H; Blizzard, Angela; Coble, Kelly; Gloff, Nicole; Pruitt, David

2017-02-01

Increased attention has been placed on evaluating the extent to which clinical programs that support the behavioral health needs of youth have effective processes and result in improved patient outcomes. Several theoretical frameworks from dissemination and implementation (D&I) science have been put forth to guide the evaluation of behavioral health program implemented in the context of real-world settings. Although a strong rationale for the integration of D&I science in program evaluation exists, few examples exist available to guide the evaluator in integrating D&I science in the planning and execution of evaluation activities. This paper seeks to inform program evaluation efforts by outlining two D&I frameworks and describing their integration in program evaluation design. Specifically, this paper seeks to support evaluation efforts by illustrating the use of these frameworks via a case example of a telemental health consultation program in pediatric primary care designed to improve access to behavioral health care for children and adolescents in rural settings. Lessons learned from this effort, as well as recommendations regarding the future evaluation of programs using D&I science to support behavioral health care in community-based settings are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Self-Study Guide for Florida VPK Provider Improvement Plan Development

ERIC Educational Resources Information Center

Phillips, Beth M.; Mazzeo, Debbie; Smith, Kevin

2016-01-01

This Self-Study Guide has been developed to support Florida Voluntary Prekindergarten Providers (VPK) who are required to complete an improvement plan process (i.e., low-performing providers). The guide has sections that can be used during both the process of selecting target areas for an improvement plan and the process of implementing new or…

What is the role of combination drug therapy in the treatment of overactive bladder? ICI-RS 2014.

PubMed

Visco, Anthony G; Fraser, Matthew O; Newgreen, Donald; Oelke, Matthias; Cardozo, Linda

2016-02-01

The role of combination therapy using oral antimuscarinic medications for the treatment of overactive bladder was proposed at the 2014 International Consultation on Incontinence-Research Society in Bristol, UK to identify key factors to consider when making clinical decisions and to guide future research design. Combination therapy is justified if monotherapy is associated with suboptimal efficacy or bothersome side effects. Combination therapy has the potential to improve efficacy with fewer side effects than monotherapy. Two Phase 2 studies comparing combination therapy that included an antimuscarinic demonstrated improvement in mean voided volume, the primary outcome chosen, with some combinations showing improved micturition frequency and quality of life. The two studies found no evidence of an increased safety risk with combination therapy compared to monotherapy. Future studies should use clinically meaningful or patient reported outcomes such as incontinence episodes when comparing efficacy. If surrogate measures are used, a clear justification should be provided. Cost analyses should be planned for clinical research trials evaluating combination drug therapy. Combination therapy is reasonable when monotherapy has suboptimal efficacy or bothersome side effects. Future research studies evaluating combination therapy for urgency urinary incontinence should ideally(1) be performed as part of a randomized clinical trial,(2) evaluate non-responders to monotherapy,(3) evaluate combination therapy using medications with different mechanisms of action,(4) include clinically meaningful and patient reported outcomes when evaluating efficacy, and(5) include cost-effectiveness analyses to justify any increased cost by showing improvement in efficacy or reduction in side effects. © 2016 Wiley Periodicals, Inc.

Building electronic data infrastructure for comparative effectiveness research: accomplishments, lessons learned and future steps.

PubMed

Randhawa, Gurvaneet S

2014-11-01

There are large gaps in our knowledge on the potential impact of diagnostics and therapeutics on outcomes of patients treated in the real world. Comparative effectiveness research aims to fill these gaps to maximize effectiveness of these interventions. Health information technology has the potential to dramatically improve the practice of medicine and of research. This is an overview of about US$100 million of American Recovery and Reinvestment Act investment in 12 projects managed by the Agency for Healthcare Research and Quality to build an electronic clinical data infrastructure that connects research with healthcare delivery. The achievements and lessons learned from these projects provided a foundation for the National Patient-Centered Clinical Research Network (PCORnet)and will help to guide future infrastructure development needed to build an efficient, scalable and sustainable learning health system.

The Future of Clinical Education: Using Futuristic Scenarios to Explore Allied Health Deans' Perspectives on Clinical Education.

PubMed

Romig, Barbara D; Tucker, Ann W; Hewitt, Anne M; O'Sullivan Maillet, Julie

2017-01-01

There is limited information and consensus on the future of clinical education. The Delphi technique was selected to identify agreement among Association of Schools of Allied Health Professions' (ASAHP) allied health deans on the future (2018-2023) of allied health (AH) clinical education. Sixty-one AH deans, 54.9% (61 of 111) of the ASAHP membership, expressed opinions about clinical education through a three-round Delphi study. In conjunction with a conceptual model, four futuristic scenarios were used to encourage deans' feedback on the key factors impacting the future of clinical education. The responses to the four scenarios showed ways the external environment influences which activities the deans recommend. The results presented, by individual scenario and in totality, provide relevant and timely information on the importance and transformation of AH clinical education and its future. Futuristic scenarios, in combination with the Delphi technique, generated information where little exists specific to AH deans' perspectives on AH clinical education. The results offer deans opportunities for future strategic improvements. The use of the futuristic scenarios was suitable for guiding deans' responses and reaching agreement on the future of AH clinical education. These contributions reflect the imminent conditions and healthcare environment identified in the various scenarios and provide additional insight on key factors impacting the future for AH clinical education.

Memory states influence value-based decisions.

PubMed

Duncan, Katherine D; Shohamy, Daphna

2016-11-01

Using memory to guide decisions allows past experience to improve future outcomes. However, the circumstances that modulate how and when memory influences decisions are not well understood. Here, we report that the use of memories to guide decisions depends on the context in which these decisions are made. We show that decisions made in the context of familiar images are more likely to be influenced by past events than are decisions made in the context of novel images (Experiment 1), that this bias persists even when a temporal gap is introduced between the image presentation and the decision (Experiment 2), and that contextual novelty facilitates value learning whereas familiarity facilitates the retrieval and use of previously learned values (Experiment 3). These effects are consistent with neurobiological and computational models of memory, which propose that familiar images evoke a lingering "retrieval state" that facilitates the recollection of other episodic memories. Together, these experiments highlight the importance of episodic memory for decision-making and provide an example of how computational and neurobiological theories can lead to new insights into how and when different types of memories guide our choices. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Using Dual Process Models to Examine Impulsivity Throughout Neural Maturation.

PubMed

Leshem, Rotem

2016-01-01

The multivariate construct of impulsivity is examined through neural systems and connections that comprise the executive functioning system. It is proposed that cognitive and behavioral components of impulsivity can be divided into two distinct groups, mediated by (1) the cognitive control system: deficits in top-down cognitive control processes referred to as action/cognitive impulsivity and (2) the socioemotional system: related to bottom-up affective/motivational processes referred to as affective impulsivity. Examination of impulsivity from a developmental viewpoint can guide future research, potentially enabling the selection of more effective interventions for impulsive individuals, based on the cognitive components requiring improvement.

Policy analysis for prenatal genetic diagnosis.

PubMed

Thompson, M; Milunsky, A

1979-01-01

Consideration of the analytic difficulties faced in estimating the benefits and costs of prenatal genetic diagnosis, coupled with a brief review of existing benefit-cost studies, leads to the conclusion that public subsidy of prenatal testing can yield benefits substantially in excess of costs. The practical obstacles to such programs include the attitudes of prospective parents, a lack of knowledge, monetary barriers, inadequately organized medical resources, and the political issue of abortion. Policy analysis can now nevertheless formulate principles and guide immediate actions to improve present utilization of prenatal testing and to facilitate possible future expansion of these diagnostic techniques.

Improving Responses to Individual and Family Crises. Secondary Learning Guide 10. Project Connect. Linking Self-Family-Work.

ERIC Educational Resources Information Center

Emily Hall Tremaine Foundation, Inc., Hartford, CT.

This competency-based secondary learning guide on improving responses to crises is part of a series that are adaptations of guides developed for adult consumer and homemaking education programs. The guides provide students with experiences that help them learn to do the following: make decisions; use creative approaches to solve problems;…

Improving Individual, Child, and Family Nutrition, Health and Wellness. Secondary Learning Guide 8. Project Connect. Linking Self-Family-Work.

ERIC Educational Resources Information Center

Emily Hall Tremaine Foundation, Inc., Hartford, CT.

This competency-based secondary learning guide on improving individual, child, and family nutrition is part of a series that are adaptations of guides developed for adult consumer and homemaking education programs. The guides provide students with experiences that help them learn to do the following: make decisions; use creative approaches to…

Core review: physician-performed ultrasound: the time has come for routine use in acute care medicine.

PubMed

Royse, Colin F; Canty, David J; Faris, John; Haji, Darsim L; Veltman, Michael; Royse, Alistair

2012-11-01

The use of ultrasound in the acute care specialties of anesthesiology, intensive care, emergency medicine, and surgery has evolved from discrete, office-based echocardiographic examinations to the real-time or point-of-care clinical assessment and interventions. "Goal-focused" transthoracic echocardiography is a limited scope (as compared with comprehensive examination) echocardiographic examination, performed by the treating clinician in acute care medical practice, and is aimed at addressing specific clinical concerns. In the future, the practice of surface ultrasound will be integrated into the everyday clinical practice as ultrasound-assisted examination and ultrasound-guided procedures. This evolution should start at the medical student level and be reinforced throughout specialist training. The key to making ultrasound available to every physician is through education programs designed to facilitate uptake, rather than to prevent access to this technology and education by specialist craft groups. There is evidence that diagnosis is improved with ultrasound examination, yet data showing change in management and improvement in patient outcome are few and an important area for future research.

Improving Environmental Health Literacy and Justice through Environmental Exposure Results Communication

PubMed Central

Ramirez-Andreotta, Monica D.; Brody, Julia Green; Lothrop, Nathan; Loh, Miranda; Beamer, Paloma I.; Brown, Phil

2016-01-01

Understanding the short- and long-term impacts of a biomonitoring and exposure project and reporting personal results back to study participants is critical for guiding future efforts, especially in the context of environmental justice. The purpose of this study was to evaluate learning outcomes from environmental communication efforts and whether environmental health literacy goals were met in an environmental justice community. We conducted 14 interviews with parents who had participated in the University of Arizona’s Metals Exposure Study in Homes and analyzed their responses using NVivo, a qualitative data management and analysis program. Key findings were that participants used the data to cope with their challenging circumstances, the majority of participants described changing their families’ household behaviors, and participants reported specific interventions to reduce family exposures. The strength of this study is that it provides insight into what people learn and gain from such results communication efforts, what participants want to know, and what type of additional information participants need to advance their environmental health literacy. This information can help improve future report back efforts and advance environmental health and justice. PMID:27399755

Space Flight. Teacher Resources.

ERIC Educational Resources Information Center

2001

This teacher's guide contains information, lesson plans, and diverse student learning activities focusing on space flight. The guide is divided into seven sections: (1) "Drawing Activities" (Future Flight; Space Fun; Mission: Draw); (2) "Geography" (Space Places); (3) "History" (Space and Time); (4)…

2013 Vehicle Theft Prevention Quick Reference Guide for the Law Enforcement Community

DOT National Transportation Integrated Search

2013-08-01

"This and future versions of the Vehicle TheftPrevention Quick Reference Guide for the Law Enforcement Community will provide comprehensive information for vehicle lines. The parts-marking requirements have been : extended to include: : all passe...

A step-by-step guide to systematically identify all relevant animal studies.

PubMed

Leenaars, Marlies; Hooijmans, Carlijn R; van Veggel, Nieky; ter Riet, Gerben; Leeflang, Mariska; Hooft, Lotty; van der Wilt, Gert Jan; Tillema, Alice; Ritskes-Hoitinga, Merel

2012-01-01

Before starting a new animal experiment, thorough analysis of previously performed experiments is essential from a scientific as well as from an ethical point of view. The method that is most suitable to carry out such a thorough analysis of the literature is a systematic review (SR). An essential first step in an SR is to search and find all potentially relevant studies. It is important to include all available evidence in an SR to minimize bias and reduce hampered interpretation of experimental outcomes. Despite the recent development of search filters to find animal studies in PubMed and EMBASE, searching for all available animal studies remains a challenge. Available guidelines from the clinical field cannot be copied directly to the situation within animal research, and although there are plenty of books and courses on searching the literature, there is no compact guide available to search and find relevant animal studies. Therefore, in order to facilitate a structured, thorough and transparent search for animal studies (in both preclinical and fundamental science), an easy-to-use, step-by-step guide was prepared and optimized using feedback from scientists in the field of animal experimentation. The step-by-step guide will assist scientists in performing a comprehensive literature search and, consequently, improve the scientific quality of the resulting review and prevent unnecessary animal use in the future.

A step-by-step guide to systematically identify all relevant animal studies

PubMed Central

Leenaars, Marlies; Hooijmans, Carlijn R; van Veggel, Nieky; ter Riet, Gerben; Leeflang, Mariska; Hooft, Lotty; van der Wilt, Gert Jan; Tillema, Alice; Ritskes-Hoitinga, Merel

2012-01-01

Before starting a new animal experiment, thorough analysis of previously performed experiments is essential from a scientific as well as from an ethical point of view. The method that is most suitable to carry out such a thorough analysis of the literature is a systematic review (SR). An essential first step in an SR is to search and find all potentially relevant studies. It is important to include all available evidence in an SR to minimize bias and reduce hampered interpretation of experimental outcomes. Despite the recent development of search filters to find animal studies in PubMed and EMBASE, searching for all available animal studies remains a challenge. Available guidelines from the clinical field cannot be copied directly to the situation within animal research, and although there are plenty of books and courses on searching the literature, there is no compact guide available to search and find relevant animal studies. Therefore, in order to facilitate a structured, thorough and transparent search for animal studies (in both preclinical and fundamental science), an easy-to-use, step-by-step guide was prepared and optimized using feedback from scientists in the field of animal experimentation. The step-by-step guide will assist scientists in performing a comprehensive literature search and, consequently, improve the scientific quality of the resulting review and prevent unnecessary animal use in the future. PMID:22037056

Future Studies in the K-12 Curriculum.

ERIC Educational Resources Information Center

Haas, John D.

This guide is designed to help elementary and secondary school teachers and curriculum developers plan units on the future. It is presented in five sections. Section I discusses the origins of the modern futures movement and the concepts of future studies, time dimensions, global approach, self-fulfilling and self-defeating forecasts, and types of…

Resource Letter AFHEP-1: Accelerators for the Future of High-Energy Physics

NASA Astrophysics Data System (ADS)

Barletta, William A.

2012-02-01

This Resource Letter provides a guide to literature concerning the development of accelerators for the future of high-energy physics. Research articles, books, and Internet resources are cited for the following topics: motivation for future accelerators, present accelerators for high-energy physics, possible future machine, and laboratory and collaboration websites.

Atmospheric turbulence compensation with laser phase shifting interferometry

NASA Astrophysics Data System (ADS)

Rabien, S.; Eisenhauer, F.; Genzel, R.; Davies, R. I.; Ott, T.

2006-04-01

Laser guide stars with adaptive optics allow astronomical image correction in the absence of a natural guide star. Single guide star systems with a star created in the earth's sodium layer can be used to correct the wavefront in the near infrared spectral regime for 8-m class telescopes. For possible future telescopes of larger sizes, or for correction at shorter wavelengths, the use of a single guide star is ultimately limited by focal anisoplanatism that arises from the finite height of the guide star. To overcome this limitation we propose to overlap coherently pulsed laser beams that are expanded over the full aperture of the telescope, traveling upwards along the same path which light from the astronomical object travels downwards. Imaging the scattered light from the resultant interference pattern with a camera gated to a certain height above the telescope, and using phase shifting interferometry we have found a method to retrieve the local wavefront gradients. By sensing the backscattered light from two different heights, one can fully remove the cone effect, which can otherwise be a serious handicap to the use of laser guide stars at shorter wavelengths or on larger telescopes. Using two laser beams multiconjugate correction is possible, resulting in larger corrected fields. With a proper choice of laser, wavefront correction could be expanded to the visible regime and, due to the lack of a cone effect, the method is applicable to any size of telescope. Finally the position of the laser spot could be imaged from the side of the main telescope against a bright background star to retrieve tip-tilt information, which would greatly improve the sky coverage of the system.

Guide to enable health charities to increase recruitment to clinical trials on dementia.

PubMed

Chambers, Larry W; Harris, Megan; Lusk, Elizabeth; Benczkowski, Debbie

2017-11-01

The Alzheimer Society embarked on a project to improve ways that the 60 provincial and local Societies in Canada can work with local researchers to support recruitment of volunteers to clinical trials and studies. A Guide to assist these offices was produced to design ethical recruitment of research volunteers within their client populations. Consultations with individuals from provincial and local Societies, as well as researchers and leaders from health-related organizations, were conducted to identify in what ways these organizations are involved in study volunteer recruitment, what is and is not working, and what would be helpful to support future efforts. The Guide prototype used scenarios to illustrate study volunteer recruitment practices as they have been or could be applied in Societies. An implementable version of the Guide was produced with input from multiple internal and external reviewers including subject-matter experts and target users from Societies. Society staff reported that benefits of using the Guide were that it served as a catalyst for conversation and reflection and identified the need for a policy. Also, it enabled Society readiness to respond to requests by persons with dementia and their caregivers wishing to participate in research. A majority (94%) of participating Society staff across Canada agreed that they would increase their capacity to support research recruitment. Charitable organizations that raise funds for research have a role in promoting the recruitment of persons with dementia and their caregivers into clinical trials and studies. The Guide was produced to facilitate organizational change to both create a positive culture regarding research as well as practical solutions that can help organizations achieve this goal.

Nasopharyngeal colonization by potentially pathogenic bacteria found in healthy semi-captive wild-born chimpanzees in Uganda.

PubMed

Mugisha, Lawrence; Köndgen, Sophie; Kaddu-Mulindwa, Deogratias; Gaffikin, Lynne; Leendertz, Fabian H

2014-02-01

Information on the chimpanzee nasopharygeal colonization in captive sanctuaries and in the wild is rare. This study was undertaken to establish the nasopharygeal colonization and potential bacterial pathogens in sanctuary chimpanzees as a basis for improving chimpanzee and employee health. Nasopharygeal colonization of 39 healthy chimpanzees were analyzed by microbiological cultivation method and polymerase chain reaction (PCR) targeting the bacterial 16S rRNA gene. We report four major phyla dominated by Proteobacteria (50%), Fermicutes (35.7%), Bacteriodes (7.1%), and Cynobacteria (7.1%) in healthy semi-captive chimpanzees. Further classification based on 7-base oligomers revealed the following genera: Streptococcus, Veillonella, Neisseria, Prevotella, Kingella and unclassified Cynobacteria, Actinobacillus, Bacteriodes and Pasteurellaceae. On microbiological cultivation we were able to identify and characterize some of the bacteria to species level as Klebsiella pneumonie and Pseudomonas aeruginosa being dominant bacteria with 54.7% and 50% colonization, respectively. Of these, Streptococcus, Neisseria, Klebsiella, and Haemophillus have representatives known to potentially cause severe respiratory disease. Our data present important information on chimpanzee nasopharygeal colonization as a guide to understanding disease processes and pharmaceutical therapies required for improving the health of chimpanzees. The results from this study will guide the processes to improve procedures for routine management of sanctuary chimpanzees and use it as a basis for evaluation of future reintroduction possibilities. © 2013 Wiley Periodicals, Inc.

Outcomes-focused knowledge translation: a framework for knowledge translation and patient outcomes improvement.

PubMed

Doran, Diane M; Sidani, Souraya

2007-01-01

Regularly accessing information that is current and reliable continues to be a challenge for front-line staff nurses. Reconceptualizing how nurses access information and designing appropriate decision support systems to facilitate timely access to information may be important for increasing research utilization. An outcomes-focused knowledge translation framework was developed to guide the continuous improvement of patient care through the uptake of research evidence and feedback data about patient outcomes. The framework operationalizes the three elements of the PARIHS framework at the point of care. Outcomes-focused knowledge translation involves four components: (a) patient outcomes measurement and real-time feedback about outcomes achievement; (b) best-practice guidelines, embedded in decision support tools that deliver key messages in response to patient assessment data; (c) clarification of patients' preferences for care; and (d) facilitation by advanced practice nurses and practice leaders. In this paper the framework is described and evidence is provided to support theorized relationships among the concepts in the framework. The framework guided the design of a knowledge translation intervention aimed at continuous improvement of patient care and evidence-based practice, which are fostered through real-time feedback data about patient outcomes, electronic access to evidence-based resources at the point of care, and facilitation by advanced practice nurses. The propositions in the framework need to be empirically tested through future research.

SA19. N-Acetyl-Cysteine in a Double-Blind Randomized Placebo-Controlled Trial: Toward Biomarker-Guided Treatment in Early Psychosis

PubMed Central

Do, Kim; Seidman, Larry J.; Fournier, Margot; Xin, Lijing; Cleusix, Martine; Baumann, Philipp S.; Ferrari, Carina; Cousins, Ann; Alameda, Luis; Gholam-Rezaee, Mehdi; Golay, Philippe; Jenni, Raoul; Woo, T-U Wilson; Keshavan, Matcheri S.; Eap, Chin B.; Wojcik, Joanne; Cuenod, Michel; Buclin, Thierry; Gruetter, Rolf; Conus, Philippe

2017-01-01

Abstract Background: Biomarker-guided treatments are needed in psychiatry and previous data suggest redox dysregulation / oxidative stress may be a target in schizophrenia (1,2). A previous add-on trial with the antioxidant N-Acetyl-Cysteine (NAC) led to negative symptoms reductions in chronic patients (3). We aim to study NAC impact on symptoms and neurocognition in early psychosis (EP) and to explore whether glutathione (GSH)/redox markers could represent valid biomarkers to guide treatment. Methods: In a double-blind, randomized, placebo-controlled trial in 63 EP patients, we assessed the effect of NAC supplementation (2700 mg/day, 6 months) on PANSS, neurocognition (MATRICS Consensus Cognitive Battery [MCCB]), and redox markers (brain GSH [GSH-mPFC], blood cells GSH [GSH-BC] levels, and GSH peroxidase activity [GPx-BC]). Results: No changes in negative, positive symptoms, or functional outcome were observed with NAC, but significant improvements were found in favor of NAC on the MCCB Processing Speed factor and two of its components: Trail Making and Verbal Fluency. NAC leads to increases in GSH-mPFC by 23% (P = .005) and GSH-BC by 19% (P = .05). In patients with high-baseline GPx-BC (>22.3U/gHb), subgroup explorations revealed an improvement with NAC of positive symptoms when compared to patients with low-baseline GPx (P = .02), with an improvement of positive symptoms in parallel with that of the redox status. Conclusion: In conclusion, NAC supplementation in a limited sample of EP patients did not improve negative symptoms, which were at modest levels at baseline. However, NAC leads to neurocognition improvement as well as to brain GSH levels increases, pointing to good target engagement. Blood GPx activity, a redox peripheral index associated with brain GSH levels, could help to identify a subgroup of patients who improve their positive symptoms with NAC. Future trials with antioxidant in EP should consider biomarker-guided treatment. References 1. Steullet P et al. 2016, Redox dysregulation, neuroinflammation, and NMDA receptor hypofunction: A “central hub” in schizophrenia pathophysiology? Schizophr Res. 176:41. 2. Hardingham GE, Do KQ, 2016, Linking early-life NMDAR hypofunction and oxidative stress in schizophrenia pathogenesis. Nat Rev Neurosci. 17:125. 3. Berk M et al. 2008, N-acetyl cysteine as a glutathione precursor for schizophrenia--a double-blind, randomized, placebo-controlled trial. Biol Psychiatry, 64:361.

MRI-guided brachytherapy

PubMed Central

Tanderup, Kari; Viswanathan, Akila; Kirisits, Christian; Frank, Steven J.

2014-01-01

The application of MRI-guided brachytherapy has demonstrated significant growth during the last two decades. Clinical improvements in cervix cancer outcomes have been linked to the application of repeated MRI for identification of residual tumor volumes during radiotherapy. This has changed clinical practice in the direction of individualized dose administration, and mounting evidence of improved clinical outcome with regard to local control, overall survival as well as morbidity. MRI-guided prostate HDR and LDR brachytherapy has improved the accuracy of target and organs-at-risk (OAR) delineation, and the potential exists for improved dose prescription and reporting for the prostate gland and organs at risk. Furthermore, MRI-guided prostate brachytherapy has significant potential to identify prostate subvolumes and dominant lesions to allow for dose administration reflecting the differential risk of recurrence. MRI-guided brachytherapy involves advanced imaging, target concepts, and dose planning. The key issue for safe dissemination and implementation of high quality MRI-guided brachytherapy is establishment of qualified multidisciplinary teams and strategies for training and education. PMID:24931089

Assessing and Improving Student Organizations: Resources for Facilitators CD-ROM. The Assessing and Improving Student Organization (AISO) Program

ERIC Educational Resources Information Center

Nolfi, Tricia; Ruben, Brent D.

2010-01-01

This companion to the "Guide for Students" and "Student Workbook" includes the complete set of PowerPoint slides, a PDF of the Facilitator's Guide in PPT (PowerPoint) slide show format, and PDFs of all scoring sheets, handouts and project planning guides needed for the AISO (Assessing and Improving Student Organization) process. The Assessing and…

Pharmacotherapy of bone metastases in breast cancer patients.

PubMed

Petrut, Bianca; Simmons, Christine; Broom, Reuben; Trinkaus, Mateya; Clemons, Mark

2008-04-01

A diagnosis of bone metastases is often a devastating occurrence in breast cancer patients. Bone metastases are associated with increased morbidity as reflected through pain, reduced quality of life and skeletal-related events. This paper reviews the role of different pharmacotherapeutic agents in the treatment of bone metastases from breast cancer. Randomised controlled trials of osteoclast-inhibiting agents, that is the bisphosphonates, have shown significant patient benefit. The aims of bisphosphonates are to prevent and delay skeletal-related events, reduce bone pain and improve quality of life. However, there are some limitations with bisphosphonate treatment. Biochemical markers of bone turnover seem to be a promising tool in guiding bisphosphonate treatment and future research directions. Hopefully, patient management will be further improved as new agents become available such as denosumab, osteoprotegerin analogues and anti-angiogenic agents.

Creating a better picture of chronic pain: improving pain pictogram designs through systematic evaluation of user responses

PubMed Central

Stones, Catherine; Knapp, Peter; Closs, S Jose

2016-01-01

This article discusses the challenges of visually representing pain qualities in pictogram design. An existing set of 12 pictograms designed for people with literacy problems was evaluated to understand more about misunderstandings of pictogram interpretation. Two sets of university students from different disciplines were asked to interpret the pictograms, and a novel classification system was developed to categorise answer types, as ‘location’, ‘affective’, temporal’ or ‘literal’. Several design recommendations are made as a result that will help improve the design of pain pictograms as a whole as well as guide designers of related pictogram work. We demonstrate how, through the robust classification of incorrect responses, it is possible to extract useful comprehension error patterns to inform future design. PMID:27867507

Future Scenarios in Communications. Teacher's Guide. Preparing for Tomorrow's World.

ERIC Educational Resources Information Center

Iozzi, Louis A.; And Others

"Future Scenarios in Communications" is one of the "Preparing for Tomorrow's World" (PTW) program modules. PTW is an interdisciplinary, future-oriented program incorporating information from the sciences and social sciences and addressing societal concerns which interface science/technology/society. The program promotes…

Imaging the Ways to a Preferred Future.

ERIC Educational Resources Information Center

MacKenzie, Terri; Frommelt, Nancy

1985-01-01

Presents a series of exercises that can be used with any age level to stimulate visioning skills (e.g., dreaming, creating, intuiting, and imaging). The exercises focus on building imagination skills, guided imaging, envisioning the future that students would prefer, and creating a futures wheel. (DMM)

Propagating modes in gain-guided optical fibers.

PubMed

Siegman, A E

2003-08-01

Optical fibers in which gain-guiding effects are significant or even dominant compared with conventional index guiding may become of practical interest for future high-power single-mode fiber lasers. I derive the propagation characteristics of symmetrical slab waveguides and cylindrical optical fibers having arbitrary amounts of mixed gain and index guiding, assuming a single uniform transverse profile for both the gain and the refractive-index steps. Optical fibers of this type are best characterized by using a complex-valued v-squared parameter in place of the real-valued v parameter commonly used to describe conventional index-guided optical fibers.

Population health management guiding principles to stimulate collaboration and improve pharmaceutical care.

PubMed

Steenkamer, Betty; Baan, Caroline; Putters, Kim; van Oers, Hans; Drewes, Hanneke

2018-04-09

Purpose A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate. Design/methodology/approach The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes. Findings In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem. Practical implications The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes. Originality/value This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.

Guiding People to Interpret Their Experienced Difficulty as Importance Highlights Their Academic Possibilities and Improves Their Academic Performance

PubMed Central

Oyserman, Daphna; Elmore, Kristen; Novin, Sheida; Fisher, Oliver; Smith, George C.

2018-01-01

Does experiencing difficulty bolster or undermine future self-images, strategies to get there and actual performance? We build on four insights from prior research to predict that accessible interpretation-of-experienced-difficulty mindset shapes identity and performance. First, people have two different interpretation-of-experienced-difficulty mindsets available in memory; their difficulty-as-impossibility mindset focuses attention on difficulty as implying low odds and their difficulty-as-importance mindset focuses attention on difficulty as implying high value. Second, people are sensitive to contextual cues as to which mindset to apply to understand their experienced difficulty. Third, people apply the mindset that comes to mind unless they have reason to question why it is “on-the-mind.” Fourth, social class can be thought of as a chronic context influencing how much people endorse each interpretation-of-experienced-difficulty mindset. We used subtle primes to guide participants’ attention toward either a difficulty-as-importance or a difficulty-as-impossibility mindset (N = 591). Participants guided toward a difficulty-as-importance mindset performed better on difficult academic tasks (Studies 1, 2) than participants guided toward a difficulty-as-impossibility mindset; whether they had more school-focused possible identities and linked strategies depended on sample (Studies 3, 4). For college students, the effect of guided interpretation-of-experienced-difficulty mindset was not moderated by how much participants agreed with that mindset (Studies 1, 3, 4). College students mostly disagreed with a difficulty-as-impossibility mindset, but making that mindset accessible undermined their performance and sometimes their possible identities anyway. In contrast, middle school students (a younger and lower social class sample) were more likely to agree with a difficulty-as-impossibility mindset. In this sample (Study 2), we found an effect of mindset endorsement: agreeing that difficulty implies importance and disagreeing that difficulty implies impossibility improved performance. This study had a control group. Control group participants not guided to use a particular interpretation-of-experienced-difficulty mindset performed no differently than participants guided toward a difficulty-as-impossibility mindset. Results suggest that people may chronically act as if they are using a difficulty-as-impossibility mindset and may benefit from being guided to consider that experienced difficulty might imply task importance. Effect of accessible mindset on salience of academic possible selves was not stable, accessible mindset mattered in one university sample but not the other. PMID:29887819

Improvement Guides for I.A. Curriculum

ERIC Educational Resources Information Center

Ritz, John M.; Wright, Lawrence S.

1977-01-01

Describes a project to revise "The Wisconsin Guide to Local Curriculum Improvement in Industrial Education, K-12", originally prepared in 1973. Four figures from the guide are included: (1) model of a field objective, (2) curriculum planning model, (3) instructional development process, and (4) process for developing objectives. (MF)

A new resource for developing and strengthening large-scale community health worker programs.

PubMed

Perry, Henry; Crigler, Lauren; Lewin, Simon; Glenton, Claire; LeBan, Karen; Hodgins, Steve

2017-01-12

Large-scale community health worker programs are now growing in importance around the world in response to the resurgence of interest and growing evidence of the importance of community-based primary health care for improving the health of populations in resource-constrained, high-mortality settings. These programs, because of their scale and operational challenges, merit special consideration by the global health community, national policy-makers, and program implementers. A new online resource is now available to assist in that effort: Developing and Strengthening Community Health Worker Programs at Scale: A Reference Guide and Case Studies for Program Managers and Policymakers ( http://www.mchip.net/CHWReferenceGuide ). This CHW Reference Guide is the product of 27 different collaborators who, collectively, have a formidable breadth and depth of experience and knowledge about CHW programming around the world. It provides a thoughtful discussion about the many operational issues that large-scale CHW programs need to address as they undergo the process of development, expansion or strengthening. Detailed case studies of 12 national CHW programs are included in the Appendix-the most current and complete cases studies as a group that are currently available. Future articles in this journal will highlight many of the themes in the CHW Reference Guide and provide an update of recent advances and experiences. These articles will serve, we hope, to (1) increase awareness about the CHW Reference Guide and its usefulness and (2) connect a broader audience to the critical importance of strengthening large-scale CHW programs for the health benefits that they can bring to underserved populations around the world.

Initial tests of a prototype MRI-compatible PET imager

NASA Astrophysics Data System (ADS)

Raylman, Raymond R.; Majewski, Stan; Lemieux, Susan; Velan, S. Sendhil; Kross, Brain; Popov, Vladimir; Smith, Mark F.; Weisenberger, Andrew G.; Wojcik, Randy

2006-12-01

Multi-modality imaging is rapidly becoming a valuable tool in the diagnosis of disease and in the development of new drugs. Functional images produced with PET fused with anatomical structure images created by MRI, will allow the correlation of form with function. Our group (a collaboration of West Virginia University and Jefferson Lab) is developing a system to acquire MRI and PET images contemporaneously. The prototype device consists of two opposed detector heads, operating in coincidence mode with an active FOV of 5×5×4 cm 3. Each MRI-PET detector module consists of an array of LSO detector elements (2.5×2.5×15 mm 3) coupled through a long fiber optic light guide to a single Hamamatsu flat panel PSPMT. The fiber optic light guide is made of a glued assembly of 2 mm diameter acrylic fibers with a total length of 2.5 m. The use of a light guides allows the PSPMTs to be positioned outside the bore of the 3 T General Electric MRI scanner used in the tests. Photon attenuation in the light guides resulted in an energy resolution of ˜60% FWHM, interaction of the magnetic field with PSPMT further reduced energy resolution to ˜85% FWHM. Despite this effect, excellent multi-plane PET and MRI images of a simple disk phantom were acquired simultaneously. Future work includes improved light guides, optimized magnetic shielding for the PSPMTs, construction of specialized coils to permit high-resolution MRI imaging, and use of the system to perform simultaneous PET and MRI or MR-spectroscopy .

Future of medical physics: Real-time MRI-guided proton therapy.

PubMed

Oborn, Bradley M; Dowdell, Stephen; Metcalfe, Peter E; Crozier, Stuart; Mohan, Radhe; Keall, Paul J

2017-08-01

With the recent clinical implementation of real-time MRI-guided x-ray beam therapy (MRXT), attention is turning to the concept of combining real-time MRI guidance with proton beam therapy; MRI-guided proton beam therapy (MRPT). MRI guidance for proton beam therapy is expected to offer a compelling improvement to the current treatment workflow which is warranted arguably more than for x-ray beam therapy. This argument is born out of the fact that proton therapy toxicity outcomes are similar to that of the most advanced IMRT treatments, despite being a fundamentally superior particle for cancer treatment. In this Future of Medical Physics article, we describe the various software and hardware aspects of potential MRPT systems and the corresponding treatment workflow. Significant software developments, particularly focused around adaptive MRI-based planning will be required. The magnetic interaction between the MRI and the proton beamline components will be a key area of focus. For example, the modeling and potential redesign of a magnetically compatible gantry to allow for beam delivery from multiple angles towards a patient located within the bore of an MRI scanner. Further to this, the accuracy of pencil beam scanning and beam monitoring in the presence of an MRI fringe field will require modeling, testing, and potential further development to ensure that the highly targeted radiotherapy is maintained. Looking forward we envisage a clear and accelerated path for hardware development, leveraging from lessons learnt from MRXT development. Within few years, simple prototype systems will likely exist, and in a decade, we could envisage coupled systems with integrated gantries. Such milestones will be key in the development of a more efficient, more accurate, and more successful form of proton beam therapy for many common cancer sites. © 2017 American Association of Physicists in Medicine.

Case study of evaluations that go beyond clinical outcomes to assess quality improvement diabetes programmes using the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE).

PubMed

Paquette-Warren, Jann; Harris, Stewart B; Naqshbandi Hayward, Mariam; Tompkins, Jordan W

2016-10-01

Investments in efforts to reduce the burden of diabetes on patients and health care are critical; however, more evaluation is needed to provide evidence that informs and supports future policies and programmes. The newly developed Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE) incorporates the theoretical concepts needed to facilitate the capture of critical information to guide investments, policy and programmatic decision making. The aim of the study is to assess the applicability and value of DEFINE in comprehensive real-world evaluation. Using a critical and positivist approach, this intrinsic and collective case study retrospectively examines two naturalistic evaluations to demonstrate how DEFINE could be used when conducting real-world comprehensive evaluations in health care settings. The variability between the cases and the evaluation designs are described and aligned to the DEFINE goals, steps and sub-steps. The majority of the theoretical steps of DEFINE were exemplified in both cases, although limited for knowledge translation efforts. Application of DEFINE to evaluate diverse programmes that target various chronic diseases is needed to further test the inclusivity and built-in flexibility of DEFINE and its role in encouraging more comprehensive knowledge translation. This case study shows how DEFINE could be used to structure or guide comprehensive evaluations of programmes and initiatives implemented in health care settings and support scale-up of successful innovations. Future use of the framework will continue to strengthen its value in guiding programme evaluation and informing health policy to reduce the burden of diabetes and other chronic diseases. © 2016 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Case study of evaluations that go beyond clinical outcomes to assess quality improvement diabetes programmes using the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE)

PubMed Central

Harris, Stewart B.; Naqshbandi Hayward, Mariam; Tompkins, Jordan W.

2016-01-01

Abstract Rationale, aims and objectives Investments in efforts to reduce the burden of diabetes on patients and health care are critical; however, more evaluation is needed to provide evidence that informs and supports future policies and programmes. The newly developed Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE) incorporates the theoretical concepts needed to facilitate the capture of critical information to guide investments, policy and programmatic decision making. The aim of the study is to assess the applicability and value of DEFINE in comprehensive real‐world evaluation. Method Using a critical and positivist approach, this intrinsic and collective case study retrospectively examines two naturalistic evaluations to demonstrate how DEFINE could be used when conducting real‐world comprehensive evaluations in health care settings. Results The variability between the cases and the evaluation designs are described and aligned to the DEFINE goals, steps and sub‐steps. The majority of the theoretical steps of DEFINE were exemplified in both cases, although limited for knowledge translation efforts. Application of DEFINE to evaluate diverse programmes that target various chronic diseases is needed to further test the inclusivity and built‐in flexibility of DEFINE and its role in encouraging more comprehensive knowledge translation. Conclusions This case study shows how DEFINE could be used to structure or guide comprehensive evaluations of programmes and initiatives implemented in health care settings and support scale‐up of successful innovations. Future use of the framework will continue to strengthen its value in guiding programme evaluation and informing health policy to reduce the burden of diabetes and other chronic diseases. PMID:26804339

The Urgent Need for Improved Climate Models and Predictions

NASA Astrophysics Data System (ADS)

Goddard, Lisa; Baethgen, Walter; Kirtman, Ben; Meehl, Gerald

2009-09-01

An investment over the next 10 years of the order of US$2 billion for developing improved climate models was recommended in a report (http://wcrp.wmo.int/documents/WCRP_WorldModellingSummit_Jan2009.pdf) from the May 2008 World Modelling Summit for Climate Prediction, held in Reading, United Kingdom, and presented by the World Climate Research Programme. The report indicated that “climate models will, as in the past, play an important, and perhaps central, role in guiding the trillion dollar decisions that the peoples, governments and industries of the world will be making to cope with the consequences of changing climate.” If trillions of dollars are going to be invested in making decisions related to climate impacts, an investment of $2 billion, which is less than 0.1% of that amount, to provide better climate information seems prudent. One example of investment in adaptation is the World Bank's Climate Investment Fund, which has drawn contributions of more than $6 billion for work on clean technologies and adaptation efforts in nine pilot countries and two pilot regions. This is just the beginning of expenditures on adaptation efforts by the World Bank and other mechanisms, focusing on only a small fraction of the nations of the world and primarily aimed at anticipated anthropogenic climate change. Moreover, decisions are being made now, all around the world—by individuals, companies, and governments—that affect people and their livelihoods today, not just 50 or more years in the future. Climate risk management, whether related to projects of the scope of the World Bank's or to the planning and decisions of municipalities, will be best guided by meaningful climate information derived from observations of the past and model predictions of the future.

Laboratory study of concrete properties to support implementation of the new AASHTO mechanistic-empirical pavement design guide.

DOT National Transportation Integrated Search

2012-09-01

Properties of concrete embodying materials typically used in Wisconsin paving projects were evaluated in support of future : implementation of the AASHTO Mechanistic-Empirical Pavement Design Guide (MEPDG). The primary concrete : properties studied w...

Laboratory study of concrete properties to support implementation of the new AASHTO mechanistic empirical pavement design guide.

DOT National Transportation Integrated Search

2012-09-01

Properties of concrete embodying materials typically used in Wisconsin paving projects were evaluated in support of future : implementation of the AASHTO Mechanistic-Empirical Pavement Design Guide (MEPDG). The primary concrete : properties studied w...

V-TECS Guide for Automobile Engine Performance Technician.

ERIC Educational Resources Information Center

Meyer, Calvin F.; Benson, Robert T.

This guide is intended to assist teachers responsible for instructing future auto engine performance technicians. The following topics are covered: diagnosing engine performance problems, ignition system problems, fuel system problems, mechanically related performance problems, emission control system problems, and electronic control systems;…

A behavior change model for internet interventions.

PubMed

Ritterband, Lee M; Thorndike, Frances P; Cox, Daniel J; Kovatchev, Boris P; Gonder-Frederick, Linda A

2009-08-01

The Internet has become a major component to health care and has important implications for the future of the health care system. One of the most notable aspects of the Web is its ability to provide efficient, interactive, and tailored content to the user. Given the wide reach and extensive capabilities of the Internet, researchers in behavioral medicine have been using it to develop and deliver interactive and comprehensive treatment programs with the ultimate goal of impacting patient behavior and reducing unwanted symptoms. To date, however, many of these interventions have not been grounded in theory or developed from behavior change models, and no overarching model to explain behavior change in Internet interventions has yet been published. The purpose of this article is to propose a model to help guide future Internet intervention development and predict and explain behavior changes and symptom improvement produced by Internet interventions. The model purports that effective Internet interventions produce (and maintain) behavior change and symptom improvement via nine nonlinear steps: the user, influenced by environmental factors, affects website use and adherence, which is influenced by support and website characteristics. Website use leads to behavior change and symptom improvement through various mechanisms of change. The improvements are sustained via treatment maintenance. By grounding Internet intervention research within a scientific framework, developers can plan feasible, informed, and testable Internet interventions, and this form of treatment will become more firmly established.

Strategic plan : our guide to the future

DOT National Transportation Integrated Search

1997-01-01

The Federal Aviation Administration Logistics Center's strategic plan provides a direction for the future based on analysis of factors affecting current Logistics Center business operations. The FAA Logistics Center management team analyzed the curre...

Image-guided radiation therapy in lymphoma management

PubMed Central

Eng, Tony

2015-01-01

Image-guided radiation therapy (IGRT) is a process of incorporating imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), Positron emission tomography (PET), and ultrasound (US) during radiation therapy (RT) to improve treatment accuracy. It allows real-time or near real-time visualization of anatomical information to ensure that the target is in its position as planned. In addition, changes in tumor volume and location due to organ motion during treatment can be also compensated. IGRT has been gaining popularity and acceptance rapidly in RT over the past 10 years, and many published data have been reported on prostate, bladder, head and neck, and gastrointestinal cancers. However, the role of IGRT in lymphoma management is not well defined as there are only very limited published data currently available. The scope of this paper is to review the current use of IGRT in the management of lymphoma. The technical and clinical aspects of IGRT, lymphoma imaging studies, the current role of IGRT in lymphoma management and future directions will be discussed. PMID:26484299

Ultrasonic image analysis and image-guided interventions.

PubMed

Noble, J Alison; Navab, Nassir; Becher, H

2011-08-06

The fields of medical image analysis and computer-aided interventions deal with reducing the large volume of digital images (X-ray, computed tomography, magnetic resonance imaging (MRI), positron emission tomography and ultrasound (US)) to more meaningful clinical information using software algorithms. US is a core imaging modality employed in these areas, both in its own right and used in conjunction with the other imaging modalities. It is receiving increased interest owing to the recent introduction of three-dimensional US, significant improvements in US image quality, and better understanding of how to design algorithms which exploit the unique strengths and properties of this real-time imaging modality. This article reviews the current state of art in US image analysis and its application in image-guided interventions. The article concludes by giving a perspective from clinical cardiology which is one of the most advanced areas of clinical application of US image analysis and describing some probable future trends in this important area of ultrasonic imaging research.

The use of reflection in medical education: AMEE Guide No. 44.

PubMed

Sandars, John

2009-08-01

Reflection is a metacognitive process that creates a greater understanding of both the self and the situation so that future actions can be informed by this understanding. Self-regulated and lifelong learning have reflection as an essential aspect, and it is also required to develop both a therapeutic relationship and professional expertise. There are a variety of educational approaches in undergraduate, postgraduate and continuing medical education that can be used to facilitate reflection, from text based reflective journals and critical incident reports to the creative use of digital media and storytelling. The choice of approach varies with the intended outcomes, but it should also be determined by the user since everyone has a preferred style. Guided reflection, with supportive challenge from a mentor or facilitator, is important so that underlying assumptions can be challenged and new perspectives considered. Feedback also has an important role to enhance reflection. There is little research evidence to suggest that reflection improves quality of care but the process of care can be enhanced.

Understanding and treatment of chronic abdominal pain in pediatric primary care.

PubMed

Schurman, Jennifer Verrill; Kessler, Emily D; Friesen, Craig A

2014-10-01

This study examined the practices used by primary care pediatricians to assess and treat chronic abdominal pain (CAP), as an initial step in guiding clinical practice guideline (CPG) development. A survey was mailed to a random sample of office-based pediatrician members (primary care pediatricians [PCPs]) of the American Medical Association. PCPs (n = 470) provided information about the typical presentation of CAP, assessment/treatment approaches used in their own practice, their definition of a functional gastrointestinal disorder (FGID), and their familiarity with the Rome Criteria for diagnosing FGIDs. Substantial variability among PCPs was noted across all these areas. Results suggest that perceptions and practices of pediatric CAP vary widely among PCPs; no single standard of care emerged to guide development of a CPG for this population. Future research should evaluate the efficacy of specific strategies currently in use to identify potential opportunities for improving assessment and treatment of CAP in pediatric primary care. © The Author(s) 2014.

Remote telepresence surgery: the Canadian experience.

PubMed

Anvari, M

2007-04-01

On 28 February 2003, the world's first telerobotic surgical service was established between St. Joseph's Healthcare Hamilton, a teaching hospital affiliated with McMaster University, and North Bay General Hospital, a community hospital 400 km away. The service was designed to provide telerobotic surgery and assistance by expert surgeons to local surgeons in North Bay, and to improve the range and quality of advanced laparoscopic surgeries offered locally. The two surgeons have collaboratively performed 22 remote telepresence surgeries including laparoscopic fundoplications, laparoscopic colon resections, and laparoscopic inguinal hernia repairs. This article describes the important lessons learned, including the telecommunication requirements, the impact from lack of haptic feedback, surgeons' adaptation to latency, and ethical and medicolegal issues. This is currently the largest clinical experience with assisted robotic telepresence surgery (ARTS) in the world, and the lessons learned will help guide the future design and development of telesurgical robotic platforms. It also will guide the establishment of telesurgical networks connecting various centers in the world, allowing for rapid and safe dissemination of new surgical techniques.

3D printing strategies for peripheral nerve regeneration.

PubMed

Petcu, Eugen B; Midha, Rajiv; McColl, Erin; Popa-Wagner, Aurel; Chirila, Traian V; Dalton, Paul D

2018-03-23

After many decades of biomaterials research for peripheral nerve regeneration, a clinical product (the nerve guide), is emerging as a proven alternative for relatively short injury gaps. This review identifies aspects where 3D printing can assist in improving long-distance nerve guide regeneration strategies. These include (1) 3D printing of the customizable nerve guides, (2) fabrication of scaffolds that fill nerve guides, (3) 3D bioprinting of cells within a matrix/bioink into the nerve guide lumen and the (4) establishment of growth factor gradients along the length a nerve guide. The improving resolution of 3D printing technologies will be an important factor for peripheral nerve regeneration, as fascicular-like guiding structures provide one path to improved nerve guidance. The capability of 3D printing to manufacture complex structures from patient data based on existing medical imaging technologies is an exciting aspect that could eventually be applied to treating peripheral nerve injury. Ultimately, the goal of 3D printing in peripheral nerve regeneration is the automated fabrication, potentially customized for the patient, of structures within the nerve guide that significantly outperform the nerve autograft over large gap injuries.

Time perspective and physical activity among central Appalachian adolescents.

PubMed

Gulley, Tauna

2013-04-01

Time perspective is a cultural behavioral concept that reflects individuals' orientations or attitudes toward the past, present, or future. Individuals' time perspectives influence their choices regarding daily activities. Time perspective is an important consideration when teaching adolescents about the importance of being physically active. However, little is known about the relationship between time perspective and physical activity among adolescents. The purpose of this study was to determine the time perspective of central Appalachian adolescents and explore the relationship between time perspective and physical activity. This study was guided by The theory of planned behavior (TPB). One hundred and ninety-three students completed surveys to examine time perspective and physical activity behaviors. Data were collected in one school. Results of this study can inform school nurses and high school guidance counselors about the importance of promoting a future-oriented time perspective to improve physical activity and educational outcomes.

Neuroimaging of Pain: Human Evidence and Clinical Relevance of Central Nervous System Processes and Modulation.

PubMed

Martucci, Katherine T; Mackey, Sean C

2018-06-01

Neuroimaging research has demonstrated definitive involvement of the central nervous system in the development, maintenance, and experience of chronic pain. Structural and functional neuroimaging has helped elucidate central nervous system contributors to chronic pain in humans. Neuroimaging of pain has provided a tool for increasing our understanding of how pharmacologic and psychologic therapies improve chronic pain. To date, findings from neuroimaging pain research have benefitted clinical practice by providing clinicians with an educational framework to discuss the biopsychosocial nature of pain with patients. Future advances in neuroimaging-based therapeutics (e.g., transcranial magnetic stimulation, real-time functional magnetic resonance imaging neurofeedback) may provide additional benefits for clinical practice. In the future, with standardization and validation, brain imaging could provide objective biomarkers of chronic pain, and guide treatment for personalized pain management. Similarly, brain-based biomarkers may provide an additional predictor of perioperative prognoses.

The future of surgical training in the context of the 'Shape of Training' Review: Consensus recommendations by the Association of Surgeons in Training.

PubMed

Harries, Rhiannon L; Williams, Adam P; Ferguson, Henry J M; Mohan, Helen M; Beamish, Andrew J; Gokani, Vimal J

2016-11-01

ASiT has long maintained that in order to provide the best quality care to patients in the UK and Republic of Ireland, it is critical that surgeons are trained to the highest standards. In addition, it is imperative that surgery remains an attractive career choice, with opportunities for career progression and job satisfaction to attract and retain the best candidates. In 2013, the Shape of Training review report set out recommendations for the structure and delivery of postgraduate training in light of an ever increasingly poly-morbid and ageing population. This consensus statement outlines ASIT's position regarding recommendations for improving surgical training and aims to help guide discussions with regard to future proposed changes to surgical training. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Future WGCEP Models and the Need for Earthquake Simulators

NASA Astrophysics Data System (ADS)

Field, E. H.

2008-12-01

The 2008 Working Group on California Earthquake Probabilities (WGCEP) recently released the Uniform California Earthquake Rupture Forecast version 2 (UCERF 2), developed jointly by the USGS, CGS, and SCEC with significant support from the California Earthquake Authority. Although this model embodies several significant improvements over previous WGCEPs, the following are some of the significant shortcomings that we hope to resolve in a future UCERF3: 1) assumptions of fault segmentation and the lack of fault-to-fault ruptures; 2) the lack of an internally consistent methodology for computing time-dependent, elastic-rebound-motivated renewal probabilities; 3) the lack of earthquake clustering/triggering effects; and 4) unwarranted model complexity. It is believed by some that physics-based earthquake simulators will be key to resolving these issues, either as exploratory tools to help guide the present statistical approaches, or as a means to forecast earthquakes directly (although significant challenges remain with respect to the latter).

Minimally invasive abdominal surgery: lux et veritas past, present, and future.

PubMed

Harrell, Andrew G; Heniford, B Todd

2005-08-01

Laparoscopic surgery has developed out of multiple technology innovations and the desire to see beyond the confines of the human body. As the instrumentation became more advanced, the application of this technique followed. By revisiting the historical developments that now define laparoscopic surgery, we can possibly foresee its future. A Medline search was performed of all the English-language literature. Further references were obtained through cross-referencing the bibliography cited in each work and using books from the authors' collection. Minimally invasive surgery is becoming important in almost every facet of abdominal surgery. Optical improvements, miniaturization, and robotic technology continue to define the frontier of minimally invasive surgery. Endoluminal resection surgery, image-guided surgical navigation, and remotely controlled robotics are not far from becoming reality. These and advances yet to be described will change laparoscopic surgery just as the electric light bulb did over 100 years ago.

Creating Futures Activity Cards and Teacher Guide.

ERIC Educational Resources Information Center

Klenzman, Elizabeth; Taylor, Paula

Teachers can use these learning activities to teach about the future in elementary and secondary social studies, science, math, language arts, and arts courses. The purpose of the activities is to help students practice creative-thinking skills, investigate problems relevant to their personal futures, experience the concept of change, and evaluate…

Jobs for Indiana's Future. Executive Report.

ERIC Educational Resources Information Center

Jobs for the Future, Inc., West Somerville, MA.

This report summarizes the work of the Jobs for Indiana's Future (JIF) program, designed to provide the Indiana Commission on Vocational and Technical Education (ICVTE) with assistance in planning for the future by enhancing ICVTE's capacity to guide Indiana's human capital investment strategy. The JIF program undertook an extensive analysis of…

Making It Happen: A Positive Guide to the Future.

ERIC Educational Resources Information Center

Richardson, John M., Jr., Ed.

This compilation of articles, photographs, commentaries, diagrams, and political cartoons presents positive, practical, and action-oriented core ideas on which to base future-oriented thinking and creative activity. The first of 10 parts presents articles on traditional American principles, ways of facing the future, America's character and…

Visions to Guide Performance: A Typology of Multiple Future Organizational Images

ERIC Educational Resources Information Center

Margolis, Sheila L.; Hansen, Carol D.

2003-01-01

Organizational performance is highly influenced by how employees envision the future. To date, many scholars have emphasized the importance of an overarching future vision that unites all stakeholders, while acknowledging the presence of divergent perspectives among members. This variety in perspectives may be further complicated in organizations…

Retirement Preparation Guide.

ERIC Educational Resources Information Center

Maddron, Edith, Ed.

This guide consists of ten articles, each introducing a separate issue important to retirement planning. The series discusses a wide range of information about critical retirement issues and explores the uncertainties, expectations, and decisions that confront the future retiree. The articles also contain suggestions and planning aids, worksheets,…

Public Health England's Migrant Health Guide: an online resource for primary care practitioners.

PubMed

Crawshaw, A F; Kirkbride, H

2018-05-01

Approximately 13% of the UK population in 2015 was born overseas. Most migrants have come to the UK to work or study although there has been a small increase in the number of asylum applications in the UK in recent years, reflective of the ongoing humanitarian situation across Europe. Migrants in the UK tend to be young and healthy, but some may face unique health needs as a result of their experiences before, during and after migration. For these needs to be appropriately recognised and addressed, evidence-based advice is needed for UK professionals. The Migrant Health Guide is a free online tool for healthcare professionals. It was launched in 2011 and is widely used in the UK and internationally. It has four sections: 1) Migrants and the NHS-information on access and entitlements to the National Health Service (NHS); 2) Assessing patients-includes a checklist for initial healthcare assessments and advice for patients travelling abroad to visit friends and relatives; 3) Countries-country-specific advice on infectious diseases, women's health and nutritional and metabolic concerns; and 4) Health topics-information about communicable and non-communicable diseases and other health issues. The guide has undergone an extensive update in 2017. In particular, the pages on mental health and human trafficking have been expanded. A formal evaluation will obtain feedback on the guide and measure changes in awareness, knowledge, opinions, attitudes and behaviour of end users. Findings will inform future revisions and updates to the guide. Public Health England's Migrant Health Guide is a valuable resource for healthcare professionals. The relaunched guide builds on the previous version in raising awareness of key issues and providing evidence-based advice to improve the health of migrants and refugees internationally and in the UK. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

A Synthesis of the Basal Thermal State of the Greenland Ice Sheet

NASA Technical Reports Server (NTRS)

Macgregor, J. A.; Fahnestock, M. A.; Catania, G. A.; Aschwanden, A.; Clow, G. D.; Colgan, W. T.; Gogineni, S. P.; Morlighem, M.; Nowicki, S. M. J.; Paden, J. D.;

Indiana rail plan

DOT National Transportation Integrated Search

2009-07-08

The 2009 Indiana Rail Plan was developed as part of the Indiana Multimodal Freight and Mobility Plan to direct the State of Indianas future freight and passenger rail policy, provide a framework to guide future decisions regarding rail system inve...

Metabolic cartography: experimental quantification of metabolic fluxes from isotopic labelling studies.

PubMed

O'Grady, John; Schwender, Jörg; Shachar-Hill, Yair; Morgan, John A

2012-03-01

For the past decade, flux maps have provided researchers with an in-depth perspective on plant metabolism. As a rapidly developing field, significant headway has been made recently in computation, experimentation, and overall understanding of metabolic flux analysis. These advances are particularly applicable to the study of plant metabolism. New dynamic computational methods such as non-stationary metabolic flux analysis are finding their place in the toolbox of metabolic engineering, allowing more organisms to be studied and decreasing the time necessary for experimentation, thereby opening new avenues by which to explore the vast diversity of plant metabolism. Also, improved methods of metabolite detection and measurement have been developed, enabling increasingly greater resolution of flux measurements and the analysis of a greater number of the multitude of plant metabolic pathways. Methods to deconvolute organelle-specific metabolism are employed with increasing effectiveness, elucidating the compartmental specificity inherent in plant metabolism. Advances in metabolite measurements have also enabled new types of experiments, such as the calculation of metabolic fluxes based on (13)CO(2) dynamic labelling data, and will continue to direct plant metabolic engineering. Newly calculated metabolic flux maps reveal surprising and useful information about plant metabolism, guiding future genetic engineering of crops to higher yields. Due to the significant level of complexity in plants, these methods in combination with other systems biology measurements are necessary to guide plant metabolic engineering in the future.

Blinded by Beauty: Attractiveness Bias and Accurate Perceptions of Academic Performance

PubMed Central

Talamas, Sean N.; Mavor, Kenneth I.; Perrett, David I.

2016-01-01

Despite the old adage not to ‘judge a book by its cover’, facial cues often guide first impressions and these first impressions guide our decisions. Literature suggests there are valid facial cues that assist us in assessing someone’s health or intelligence, but such cues are overshadowed by an ‘attractiveness halo’ whereby desirable attributions are preferentially ascribed to attractive people. The impact of the attractiveness halo effect on perceptions of academic performance in the classroom is concerning as this has shown to influence students’ future performance. We investigated the limiting effects of the attractiveness halo on perceptions of actual academic performance in faces of 100 university students. Given the ambiguity and various perspectives on the definition of intelligence and the growing consensus on the importance of conscientiousness over intelligence in predicting actual academic performance, we also investigated whether perceived conscientiousness was a more accurate predictor of academic performance than perceived intelligence. Perceived conscientiousness was found to be a better predictor of actual academic performance when compared to perceived intelligence and perceived academic performance, and accuracy was improved when controlling for the influence of attractiveness on judgments. These findings emphasize the misleading effect of attractiveness on the accuracy of first impressions of competence, which can have serious consequences in areas such as education and hiring. The findings also have implications for future research investigating impression accuracy based on facial stimuli. PMID:26885976

Blinded by Beauty: Attractiveness Bias and Accurate Perceptions of Academic Performance.

PubMed

Talamas, Sean N; Mavor, Kenneth I; Perrett, David I

2016-01-01

Despite the old adage not to 'judge a book by its cover', facial cues often guide first impressions and these first impressions guide our decisions. Literature suggests there are valid facial cues that assist us in assessing someone's health or intelligence, but such cues are overshadowed by an 'attractiveness halo' whereby desirable attributions are preferentially ascribed to attractive people. The impact of the attractiveness halo effect on perceptions of academic performance in the classroom is concerning as this has shown to influence students' future performance. We investigated the limiting effects of the attractiveness halo on perceptions of actual academic performance in faces of 100 university students. Given the ambiguity and various perspectives on the definition of intelligence and the growing consensus on the importance of conscientiousness over intelligence in predicting actual academic performance, we also investigated whether perceived conscientiousness was a more accurate predictor of academic performance than perceived intelligence. Perceived conscientiousness was found to be a better predictor of actual academic performance when compared to perceived intelligence and perceived academic performance, and accuracy was improved when controlling for the influence of attractiveness on judgments. These findings emphasize the misleading effect of attractiveness on the accuracy of first impressions of competence, which can have serious consequences in areas such as education and hiring. The findings also have implications for future research investigating impression accuracy based on facial stimuli.

75 FR 45171 - Notice of Issuance of Regulatory Guide

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... Engineering, Office of Nuclear Regulatory Research, U.S. Nuclear Regulatory Commission, Washington, DC 20555...-3040. This guide describes some engineering practices and methods generally considered by the NRC to be... they reflect the latest general engineering approaches that are acceptable to the NRC staff. If future...

Guide to the measurement of tree characteristics important to the quality classification for young hardwood trees

Treesearch

David L. Sonderman

1979-01-01

A procedure is shown for measuring external tree characteristics that are important in determining the current and future quality of young hardwood trees. This guide supplements a precious study which describes the quality classification system for young hardwood trees

Electricity: Today's Technologies, Tomorrow's Alternatives. Teacher's Guide.

ERIC Educational Resources Information Center

Electric Power Research Inst., Palo Alto, CA.

This teaching guide is designed to help teachers develop lesson plans around nine chapters provided in the student textbook. Chapters focus on energy use, energy demand, energy supply, principles of electric power generation, today's generating options, future generating options, electricity storage and delivery, environmental concerns, and making…

State-of-the-Art Review of 3D Bioprinting for Cardiovascular Tissue Engineering.

PubMed

Duan, Bin

2017-01-01

3D bioprinting is a group of rapidly growing techniques that allows building engineered tissue constructs with complex and hierarchical structures, mechanical and biological heterogeneity. It enables implementation of various bioinks through different printing mechanisms and precise deposition of cell and/or biomolecule laden biomaterials in predefined locations. This review briefly summarizes applicable bioink materials and various bioprinting techniques, and presents the recent advances in bioprinting of cardiovascular tissues, with focusing on vascularized constructs, myocardium and heart valve conduits. Current challenges and further perspectives are also discussed to help guide the bioink and bioprinter development, improve bioprinting strategies and direct future organ bioprinting and translational applications.

Obstacle detectors for automated transit vehicles: A technoeconomic and market analysis

NASA Technical Reports Server (NTRS)

Lockerby, C. E.

1979-01-01

A search was conducted to identify the technical and economic characteristics of both NASA and nonNASA obstacle detectors. The findings, along with market information were compiled and analyzed for consideration by DOT and NASA in decisions about any future automated transit vehicle obstacle detector research, development, or applications project. Currently available obstacle detectors and systems under development are identified by type (sonic, capacitance, infrared/optical, guided radar, and probe contact) and compared with the three NASA devices selected as possible improvements or solutions to the problems in existing obstacle detection systems. Cost analyses and market forecasts individually for the AGT and AMTV markets are included.

Review of magnetostrictive vibration energy harvesters

NASA Astrophysics Data System (ADS)

Deng, Zhangxian; Dapino, Marcelo J.

2017-10-01

The field of energy harvesting has grown concurrently with the rapid development of portable and wireless electronics in which reliable and long-lasting power sources are required. Electrochemical batteries have a limited lifespan and require periodic recharging. In contrast, vibration energy harvesters can supply uninterrupted power by scavenging useful electrical energy from ambient structural vibrations. This article reviews the current state of vibration energy harvesters based on magnetostrictive materials, especially Terfenol-D and Galfenol. Existing magnetostrictive harvester designs are compared in terms of various performance metrics. Advanced techniques that can reduce device size and improve performance are presented. Models for magnetostrictive devices are summarized to guide future harvester designs.

Laser Ablation for Cancer: Past, Present and Future

PubMed Central

Schena, Emiliano; Saccomandi, Paola; Fong, Yuman

2017-01-01

Laser ablation (LA) is gaining acceptance for the treatment of tumors as an alternative to surgical resection. This paper reviews the use of lasers for ablative and surgical applications. Also reviewed are solutions aimed at improving LA outcomes: hyperthermal treatment planning tools and thermometric techniques during LA, used to guide the surgeon in the choice and adjustment of the optimal laser settings, and the potential use of nanoparticles to allow biologic selectivity of ablative treatments. Promising technical solutions and a better knowledge of laser-tissue interaction should allow LA to be used in a safe and effective manner as a cancer treatment. PMID:28613248

Development of algae biorefinery concepts for biofuels and bioproducts; a perspective on process-compatible products and their impact on cost-reduction

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

Laurens, Lieve M. L.; Markham, Jennifer; Templeton, David W.

Identifying and addressing critical improvements in biomass, bioproduct and biofuel productivity is a priority for the nascent algae-based bioeconomy. Economic and sustainability principles should guide these developing improvements and help to unravel the contentious water–food–energy–environment nexus that algae inhabit. Understanding the biochemistry of the storage carbon metabolism of algae to produce biofuels and bioproducts can bring to light the key barriers that currently limit the overall carbon efficiency and the photosynthetic efficiency, and ultimately guide productivity and commercial viability in the context of limiting resources. In the analysis reported here, we present different potential pathways for a conceptual algae biorefinerymore » framework, with each pathway addressing one of the main identified barriers to future deployment. We highlight the molecular identification, in the form of an extensive literature review, of potential bioproducts that may be derived directly from both biomass and fractions produced through a conversion pathway, for three important commercially-relevant genera of algae, Scenedesmus, Chlorella and Nannochloropsis. Here, we establish a relationship between each of the potential bioproducts, describe relevant conversion and extraction processes, and discuss market opportunities with values and sizes as they relate to commercial development of the products.« less

Theoretical design of multi-colored semi-transparent organic solar cells with both efficient color filtering and light harvesting

PubMed Central

Wen, Long; Chen, Qin; Sun, Fuhe; Song, Shichao; Jin, Lin; Yu, Yan

2014-01-01

Solar cells incorporated with multi-coloring capability not only offer an aesthetic solution to bridge the gap between solar modules and building decorations but also open up the possibility for self-powered colorful display. In this paper, we proposed a multi-colored semi-transparent organic solar cells (TOSCs) design containing metallic nanostructures with the both high color purity and efficiency based on theoretical considerations. By employing guided mode resonance effect, the multi-colored TOSC behave like an efficient color filter that selectively transmits light with the desired wavelengths and generates electricity with light of other wavelengths. Broad range of coloring and luminosity adjusting for the transmission light can be achieved by simply tuning the period and the duty cycle of the metallic nanostructures. Furthermore, accompanying with the efficient color filtering characteristics, the optical absorption of TOSCs was improved due to the marked suppression of transmission loss at the off-resonance wavelengths and the increased light trapping in TOSCs. The mechanisms of the light guiding in photoactive layer and broadband backward scattering from the metallic nanostructures were identified to make an essential contribution to the improved light-harvesting. By enabling efficient color control and high efficiency simultaneously, this approach holds great promise for future versatile photovoltaic energy utilization. PMID:25391756

Development of algae biorefinery concepts for biofuels and bioproducts; a perspective on process-compatible products and their impact on cost-reduction

DOE PAGES

Laurens, Lieve M. L.; Markham, Jennifer; Templeton, David W.; ...

2017-07-10

Identifying and addressing critical improvements in biomass, bioproduct and biofuel productivity is a priority for the nascent algae-based bioeconomy. Economic and sustainability principles should guide these developing improvements and help to unravel the contentious water–food–energy–environment nexus that algae inhabit. Understanding the biochemistry of the storage carbon metabolism of algae to produce biofuels and bioproducts can bring to light the key barriers that currently limit the overall carbon efficiency and the photosynthetic efficiency, and ultimately guide productivity and commercial viability in the context of limiting resources. In the analysis reported here, we present different potential pathways for a conceptual algae biorefinerymore » framework, with each pathway addressing one of the main identified barriers to future deployment. We highlight the molecular identification, in the form of an extensive literature review, of potential bioproducts that may be derived directly from both biomass and fractions produced through a conversion pathway, for three important commercially-relevant genera of algae, Scenedesmus, Chlorella and Nannochloropsis. Here, we establish a relationship between each of the potential bioproducts, describe relevant conversion and extraction processes, and discuss market opportunities with values and sizes as they relate to commercial development of the products.« less

Theoretical design of multi-colored semi-transparent organic solar cells with both efficient color filtering and light harvesting.

PubMed

Wen, Long; Chen, Qin; Sun, Fuhe; Song, Shichao; Jin, Lin; Yu, Yan

2014-11-13

Solar cells incorporated with multi-coloring capability not only offer an aesthetic solution to bridge the gap between solar modules and building decorations but also open up the possibility for self-powered colorful display. In this paper, we proposed a multi-colored semi-transparent organic solar cells (TOSCs) design containing metallic nanostructures with the both high color purity and efficiency based on theoretical considerations. By employing guided mode resonance effect, the multi-colored TOSC behave like an efficient color filter that selectively transmits light with the desired wavelengths and generates electricity with light of other wavelengths. Broad range of coloring and luminosity adjusting for the transmission light can be achieved by simply tuning the period and the duty cycle of the metallic nanostructures. Furthermore, accompanying with the efficient color filtering characteristics, the optical absorption of TOSCs was improved due to the marked suppression of transmission loss at the off-resonance wavelengths and the increased light trapping in TOSCs. The mechanisms of the light guiding in photoactive layer and broadband backward scattering from the metallic nanostructures were identified to make an essential contribution to the improved light-harvesting. By enabling efficient color control and high efficiency simultaneously, this approach holds great promise for future versatile photovoltaic energy utilization.

Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice.

PubMed

Scholten, H J; Pourtaherian, A; Mihajlovic, N; Korsten, H H M; A Bouwman, R

2017-07-01

Ultrasound guidance is becoming standard practice for needle-based interventions in anaesthetic practice, such as vascular access and peripheral nerve blocks. However, difficulties in aligning the needle and the transducer can lead to incorrect identification of the needle tip, possibly damaging structures not visible on the ultrasound screen. Additional techniques specifically developed to aid alignment of needle and probe or identification of the needle tip are now available. In this scoping review, advantages and limitations of the following categories of those solutions are presented: needle guides; alterations to needle or needle tip; three- and four-dimensional ultrasound; magnetism, electromagnetic or GPS systems; optical tracking; augmented (virtual) reality; robotic assistance; and automated (computerised) needle detection. Most evidence originates from phantom studies, case reports and series, with few randomised clinical trials. Improved first-pass success and reduced performance time are the most frequently cited benefits, whereas the need for additional and often expensive hardware is the greatest limitation to widespread adoption. Novice ultrasound users seem to benefit most and great potential lies in education. Future research should focus on reporting relevant clinical parameters to learn which technique will benefit patients most in terms of success and safety. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Future Air Traffic Growth and Schedule Model User's Guide

NASA Technical Reports Server (NTRS)

Kimmel, William M. (Technical Monitor); Smith, Jeremy C.; Dollyhigh, Samuel M.

2004-01-01

The Future Air Traffic Growth and Schedule Model was developed as an implementation of the Fratar algorithm to project future traffic flow between airports in a system and of then scheduling the additional flights to reflect current passenger time-of-travel preferences. The methodology produces an unconstrained future schedule from a current (or baseline) schedule and the airport operations growth rates. As an example of the use of the model, future schedules are projected for 2010 and 2022 for all flights arriving at, departing from, or flying between all continental United States airports that had commercial scheduled service for May 17, 2002. Inter-continental US traffic and airports are included and the traffic is also grown with the Fratar methodology to account for their arrivals and departures to the continental US airports. Input data sets derived from the Official Airline Guide (OAG) data and FAA Terminal Area Forecast (TAF) are included in the examples of the computer code execution.

Autonomous Diagnostic Imaging Performed by Untrained Operators using Augmented Reality as a Form of "Just-in-Time" Training

NASA Technical Reports Server (NTRS)

Martin, D. S.; Wang, L.; Laurie, S. S.; Lee, S. M. C.; Fleischer, A. C.; Gibson, C. R.; Stenger, M. B.

2017-01-01

We will address the Human Factors and Performance Team, "Risk of performance errors due to training deficiencies" by improving the JIT training materials for ultrasound and OCT imaging by providing advanced guidance in a detailed, timely, and user-friendly manner. Specifically, we will (1) develop an audio-visual tutorial using AR that guides non-experts through an abdominal trauma ultrasound protocol; (2) develop an audio-visual tutorial using AR to guide an untrained operator through the acquisition of OCT images; (3) evaluate the quality of abdominal ultrasound and OCT images acquired by untrained operators using AR guidance compared to images acquired using traditional JIT techniques (laptop-based training conducted before image acquisition); and (4) compare the time required to complete imaging studies using AR tutorials with images acquired using current JIT practices to identify areas for time efficiency improvements. Two groups of subjects will be recruited to participate in this study. Operator-subjects, without previous experience in ultrasound or OCT, will be asked to perform both procedures using either the JIT training with AR technology or the traditional JIT training via laptop. Images acquired by inexperienced operator-subjects will be scored by experts in that imaging modality for diagnostic and research quality; experts will be blinded to the form of JIT used to acquire the images. Operator-subjects also will be asked to submit feedback to improve the training modules used during the scans to improve future training modules. Scanned-subjects will be a small group individuals from whom all images will be acquired.

Autonomous Diagnostic Imaging Performed by Untrained Operator Using Augmented Reality as a Form of "Just-in-Time" Training

NASA Technical Reports Server (NTRS)

Martin, David S.; Wang, Lui; Laurie, Steven S.; Lee, Stuart M. C.; Stenger, Michael B.

2017-01-01

We will address the Human Factors and Performance Team, "Risk of performance errors due to training deficiencies" by improving the JIT training materials for ultrasound and OCT imaging by providing advanced guidance in a detailed, timely, and user-friendly manner. Specifically, we will (1) develop an audio-visual tutorial using AR that guides non-experts through an abdominal trauma ultrasound protocol; (2) develop an audio-visual tutorial using AR to guide an untrained operator through the acquisition of OCT images; (3) evaluate the quality of abdominal ultrasound and OCT images acquired by untrained operators using AR guidance compared to images acquired using traditional JIT techniques (laptop-based training conducted before image acquisition); and (4) compare the time required to complete imaging studies using AR tutorials with images acquired using current JIT practices to identify areas for time efficiency improvements. Two groups of subjects will be recruited to participate in this study. Operator-subjects, without previous experience in ultrasound or OCT, will be asked to perform both procedures using either the JIT training with AR technology or the traditional JIT training via laptop. Images acquired by inexperienced operator-subjects will be scored by experts in that imaging modality for diagnostic and research quality; experts will be blinded to the form of JIT used to acquire the images. Operator-subjects also will be asked to submit feedback to improve the training modules used during the scans to improve future training modules. Scanned-subjects will be a small group individuals from whom all images will be acquired.

Sex Differences in Clinical Predictors of Suicidal Acts After Major Depression: A Prospective Study

PubMed Central

Oquendo, Maria A.; Bongiovi-Garcia, Mary E.; Galfalvy, Hanga; Goldberg, Pablo H.; Grunebaum, Michael F.; Burke, Ainsley K.; Mann, J. John

2013-01-01

Objective Whether sex differences exist in clinical risk factors associated with suicidal behavior is unknown. The authors postulated that among men with a major depressive episode, aggression, hostility, and history of substance misuse increase risk for future suicidal behavior, while depressive symptoms, childhood history of abuse, fewer reasons for living, and borderline personality disorder do so in depressed women. Method Patients with DSM-III-R major depression or bipolar disorder seeking treatment for a major depressive episode (N=314) were followed for 2 years. Putative predictors were tested with Cox proportional hazards regression analysis. Results During follow-up, 16.6% of the patients attempted or committed suicide. Family history of suicidal acts, past drug use, cigarette smoking, borderline personality disorder, and early parental separation each more than tripled the risk of future suicidal acts in men. For women, the risk for future suicidal acts was sixfold greater for prior suicide attempters; each past attempt increased future risk threefold. Suicidal ideation, lethality of past attempts, hostility, subjective depressive symptoms, fewer reasons for living, comorbid borderline personality disorder, and cigarette smoking also increased the risk of future suicidal acts for women. Conclusions These findings suggest that the importance of risk factors for suicidal acts differs in depressed men and women. This knowledge may improve suicide risk evaluation and guide future research on suicide assessment and prevention. PMID:17202555

Imagine HEALTH: results from a randomized pilot lifestyle intervention for obese Latino adolescents using Interactive Guided ImagerySM

PubMed Central

2014-01-01

Background There is an urgent need for innovative and developmentally appropriate lifestyle interventions to promote healthy lifestyle behaviors and to prevent the early onset of type 2 diabetes and cardiovascular disease risk in obese Latino adolescents. Guided imagery offers promise to reduce stress and promote lifestyle behavior change to reduce disease risk in obese adolescents. Our objectives were: 1) To pilot test a new 12-wk lifestyle intervention using a randomized trial design in obese Latino adolescents, in order to determine the effects of the mind-body modality of Interactive Guided ImagerySM (IGI), over and above those of a didactic lifestyle education, on insulin resistance, eating and physical activity behaviors, stress and stress biomarkers; and 2) To explore the role of intervention-related changes in stress and stress biomarkers on changes in metabolic outcomes, particularly insulin resistance. Methods Obese (BMI > 95th percentile), Latino adolescents (n = 35, age 14-17) were randomized to receive either 12 weekly sessions of a lifestyle education plus guided imagery program (GI), or lifestyle education plus a digital storytelling computer program (DS). Between-group differences in behavioral, biological, and psychological outcomes were assessed using unpaired T-tests and ANCOVA in the 29 subjects who completed the intervention. Results The GI group demonstrated significant reductions in leisure sedentary behavior (p < .05) and increases in moderate physical activity (p < .05) compared to DS group, and a trend toward reduced caloric intake in GI vs DS (p = .09). Salivary cortisol was acutely reduced by stress-reduction guided imagery (p < .01). There were no group differences in adiposity, insulin resistance, perceived stress, or stress biomarkers across the 12-week intervention, though decrease in serum cortisol over the course of the intervention was associated with improved insulin sensitivity (p = .03) independent of intervention group and other relevant co-variates. Conclusions The improvements in physical activity and stress biomarkers following this pilot intervention support the role of guided imagery in promoting healthy lifestyle behavior change and reducing metabolic disease risk in obese Latino adolescent populations. Future investigations will be needed to determine the full effects of the Imagine HEALTH intervention on insulin resistance, stress, and stress biomarkers. Trial registration Clinicaltrials.gov Registry #: NCT01895595 PMID:24433565

Assessment Environment for Complex Systems Software Guide

NASA Technical Reports Server (NTRS)

2013-01-01

This Software Guide (SG) describes the software developed to test the Assessment Environment for Complex Systems (AECS) by the West Virginia High Technology Consortium (WVHTC) Foundation's Mission Systems Group (MSG) for the National Aeronautics and Space Administration (NASA) Aeronautics Research Mission Directorate (ARMD). This software is referred to as the AECS Test Project throughout the remainder of this document. AECS provides a framework for developing, simulating, testing, and analyzing modern avionics systems within an Integrated Modular Avionics (IMA) architecture. The purpose of the AECS Test Project is twofold. First, it provides a means to test the AECS hardware and system developed by MSG. Second, it provides an example project upon which future AECS research may be based. This Software Guide fully describes building, installing, and executing the AECS Test Project as well as its architecture and design. The design of the AECS hardware is described in the AECS Hardware Guide. Instructions on how to configure, build and use the AECS are described in the User's Guide. Sample AECS software, developed by the WVHTC Foundation, is presented in the AECS Software Guide. The AECS Hardware Guide, AECS User's Guide, and AECS Software Guide are authored by MSG. The requirements set forth for AECS are presented in the Statement of Work for the Assessment Environment for Complex Systems authored by NASA Dryden Flight Research Center (DFRC). The intended audience for this document includes software engineers, hardware engineers, project managers, and quality assurance personnel from WVHTC Foundation (the suppliers of the software), NASA (the customer), and future researchers (users of the software). Readers are assumed to have general knowledge in the field of real-time, embedded computer software development.

Future disability projections could be improved by connecting to the theory of a dynamic equilibrium.

PubMed

Klijs, Bart; Mackenbach, Johan P; Kunst, Anton E

2011-04-01

Projections of future trends in the burden of disability could be guided by models linking disability to life expectancy, such as the dynamic equilibrium theory. This article tests the key assumption of this theory that severe disability is associated with proximity to death, whereas mild disability is not. Using data from the GLOBE study (Gezondheid en Levensomstandigheden Bevolking Eindhoven en omstreken), the association of three levels of self-reported disabilities in activities of daily living with age and proximity to death was studied using logistic regression models. Regression estimates were used to estimate the number of life years with disability for life spans of 75 and 85 years. Odds ratios of 0.976 (not significant) for mild disability, 1.137 for moderate disability, and 1.231 for severe disability showed a stronger effect of proximity to death for more severe levels of disability. A 10-year increase of life span was estimated to result in a substantial expansion of mild disability (4.6 years) compared with a small expansion of moderate (0.7 years) and severe (0.9 years) disability. These findings support the theory of a dynamic equilibrium. Projections of the future burden of disability could be substantially improved by connecting to this theory and incorporating information on proximity to death. Copyright © 2011 Elsevier Inc. All rights reserved.

The epidemiologic surveillance of dengue-fever in French Guiana: when achievements trigger higher goals.

PubMed

Flamand, Claude; Quenel, Philippe; Ardillon, Vanessa; Carvalho, Luisiane; Bringay, Sandra; Teisseire, Maguelonne

2011-01-01

The epidemiology of dengue fever in French Guiana is marked by a combination of permanent transmission of the virus in the whole country and the occurrence of regular epidemics. Since 2006, a multi data source surveillance system was implemented to monitor dengue fever patterns, to improve early detection of outbreaks and to allow a better provision of information to health authorities, in order to guide and evaluate prevention activities and control measures. This report illustrates the validity and the performances of the system. We describe the experience gained by such a surveillance system and outline remaining challenges. Future works will consist in the use of other data sources such as environmental factors in order to improve knowledge on virus transmission mechanisms and determine how to use them for outbreaks prediction.

Uncover it, students would learn leadership from Team-Based Learning (TBL): The effect of guided reflection and feedback.

PubMed

Alizadeh, Maryam; Mirzazadeh, Azim; Parmelee, Dean X; Peyton, Elizabeth; Janani, Leila; Hassanzadeh, Gholamreza; Nedjat, Saharnaz

2017-04-01

Little is known about best practices for teaching and learning leadership through Team-Based learning™ (TBL™) with medical students. We hypothesized that guided reflection and feedback would improve shared leadership and shared leadership capacity, and enhance team decision quality in TBL teams. We used the Kolb experiential learning theory as the theoretical framework. The study was conducted at Tehran University of Medical Sciences. Three TBL sessions with 206 students (39 teams) participated in the study. Using a quasi-experimental design, one batch received guided reflection and feedback on their team leadership processes (n = 20 teams) and the other received only TBL (n = 19 teams). Observers measured shared leadership using a checklist. Shared leadership capacity was measured using a questionnaire. Scores on a team application exercise were used to assess quality of team decisions. Evidence did not support our first hypothesis that reflection and feedback enhance shared leadership in TBL teams. Percentages of teams displaying shared leadership did not differ between intervention and control groups in sessions 1 (p = 0.6), 2 (p = 1) or 3 (p = 1). The results did not support the second hypothesis. We found no difference in quality of decision making between the intervention and control groups for sessions 1 (p = 0.77), 2 (p = 0.23), or 3 (p = 0.07). The third hypothesis that the reflection and feedback would have an effect on shared leadership capacity was supported (T = -8.55, p > 0.001 adjusted on baseline; T = -8.55, p > 0.001 adjusted on gender). We found that reflection and feedback improved shared leadership capacity but not shared leadership behaviors or team decision quality. We propose medical educators who apply TBL, should provide guided exercise in reflection and feedback so that students may better understand the benefits of working in teams as preparation for their future roles as leaders and members of health care teams.

Potential impact of future climate change on sugarcane under dryland conditions in Mexico

USDA-ARS?s Scientific Manuscript database

Assessments of impacts of future climate change on widely grown sugarcane varieties can guide decision-making at various levels and help ensure the economic stability of numerous rural households. This study assessed the potential impact of future climatic change on CP 72-2086 the most widely grown...

Washington State Guide to Planning, Implementing and Improving Work-based Learning. A Guide for Educators at All Levels.

ERIC Educational Resources Information Center

Highline Community Coll., Des Moines, WA.

This guide, which is intended primarily for school and college personnel interested in initiating or improving work-based learning, examines the development and implementation of work-based education programs in Washington. The following topics are discussed: the rationale for work-based learning (legislative and educational change information,…

Improving Responses to Individual and Family Crises. Learning Guide 10. Project Connect. Linking Self-Family-Work.

ERIC Educational Resources Information Center

Emily Hall Tremaine Foundation, Inc., Hartford, CT.

This learning guide on improving responses to individual and family crises is part of a series of learning guides developed for competency-based adult consumer and homemaking education programs in community colleges, adult education centers, community centers, and the workplace. Focus is on the connections among personal, family, and job…

Optimizing Patient Treatment Decisions in an Era of Rapid Technological Advances: The Case of Hepatitis C Treatment

PubMed Central

Liu, Shan; Goldhaber-Fiebert, Jeremy D.; Brandeau, Margaret L.

2015-01-01

How long should a patient with a treatable chronic disease wait for more effective treatments before accepting the best available treatment? We develop a framework to guide optimal treatment decisions for a deteriorating chronic disease when treatment technologies are improving over time. We formulate an optimal stopping problem using a discrete-time, finite-horizon Markov decision process. The goal is to maximize a patient’s quality-adjusted life expectancy. We derive structural properties of the model and analytically solve a three-period treatment decision problem. We illustrate the model with the example of treatment for chronic hepatitis C virus (HCV). Chronic HCV affects 3–4 million Americans and has been historically difficult to treat, but increasingly effective treatments have been commercialized in the past few years. We show that the optimal treatment decision is more likely to be to accept currently available treatment—despite expectations for future treatment improvement—for patients who have high-risk history, who are older, or who have more comorbidities. Insights from this study can guide HCV treatment decisions for individual patients. More broadly, our model can guide treatment decisions for curable chronic diseases by finding the optimal treatment policy for individual patients in a heterogeneous population. PMID:26188961

Brownfield to Brightfield Initiative in Oak Ridge, TN - 12346

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

Hough, Gil; Fairless, Chad

Experience characterizing, permitting, and restoring 'Brownfield' sites-government or industrial sites with restricted future use due to the presence or potential presence of hazardous substances, pollutants, or contaminants-is being leveraged to identify opportunities for redevelopment into solar power generating facilities which, in this context, are called 'Brightfields'. Brownfield sites offer the expansive land necessary for large photovoltaic (PV) solar farms, but require an in-depth working knowledge of complicated regulatory restrictions and environmental constraints to develop them. As a part of the effort to identify opportunities for redevelopment of Brownfield sites for solar applications, a technical guide, was composed specifically for themore » development of solar generation on restricted use sites. The basis of the technical guide gives specific consideration to environmental requirements and installation methods breaking that into three areas for assessing: 1) levels of contamination, 2) ground penetration requirements, and 3) the requirements for aesthetics and maintenance. Brightfield projects are underway to support the technical guide and expand re-industrialization efforts for the former DOE Gaseous Diffusion Plant in Oak Ridge, TN. There are exciting opportunities to turn Brownfields into Brightfield solar energy solutions for meeting the future renewable energy needs of our country. Brownfields that offer the large surface area required for solar PV farms coupled with the technical guide for the installation of solar farms on restricted use sites supports efforts to develop the solar capacities and expertise to tap this future market. The initial projects designed following the technical guide will provide verification of the installation requirements and beneficial reuse of restricted use sites. (authors)« less

National Audubon Society Specials. Teacher's Guide I.

ERIC Educational Resources Information Center

WETA - TV, Washington, DC.

Since no civilization can survive without a healthy environment, people must learn to live in harmony with their natural ecosystems and build for future generations. This guide describes six award-winning programs on the condor, black-footed ferret, panthers and cheetahs, ducks, farming and wildlife, and the Galapagos Islands. Although each…

A Guide to the Identification of Training Needs. Second Edition.

ERIC Educational Resources Information Center

Boydell, T. H.

This guide is intended to help planners and trainers assess the training needs of industrial organizations. Addressed in the individual chapters are the following topics: types of training needs (three levels of needs--organizational, occupational, individual, organizational training needs and objectives, and present and future needs); present…

Citizen Action. Teacher's Guide to World Resources. Comprehensive Coursework on the Global Environment.

ERIC Educational Resources Information Center

Snyder, Sarah A.

This teacher's guide presents teaching suggestions and presentation materials about citizen action in the global environment. Focusing on the nongovernmental organizations (NGOs), the lessons describe the roles NGOs play in positively influencing future trends in social development, natural resources management, and environmental quality. NGOs are…

Strategic Planning in Education: A Guide for Policymakers.

ERIC Educational Resources Information Center

Cooper, Harry A.

As defined in chapter I of this guide for policymakers, strategic planning is the method by which an organization identifies relevant trends in its environment, analyzes their potential implications, and projects an integrated strategy to address these future events and their contingencies. This process differs from formalized planning, based on…

Forecasting the Future: Exploring Evidence for Global Climate Change.

ERIC Educational Resources Information Center

California Univ., San Diego, La Jolla. Inst. of Marine Resources.

This curriculum and classroom activity guide considers evidence gathered in answer to questions concerning global environmental change. It describes methods that biologists, chemists, geologists, meteorologists, and physicists use to gather and interpret their findings. The activities and approaches in this guide were developed to meet the skill…

CNC Turning Technician. A Competency-Based Instructional System.

ERIC Educational Resources Information Center

Sloan, Kelly; Hilley, Robert

This competency-based curriculum guide for instructing students in using computer numerically controlled (CNC) turning machines is one of a series of instructional guides for the machinist field developed in Oklahoma. Although developed jointly with Baxter Technologies Corporation and oriented toward the Baxter Vo-Tec 2000 Future Builder CNC…

Secondary School Curriculum Guide: Industrial Arts.

ERIC Educational Resources Information Center

Cranston School Dept., RI.

The Cranston Secondary School Curriculum Guide (9-12) for Industrial Arts is intended to serve as a resource for teachers, students, department chairman, guidance personnel, curriculum planners, and others involved in present or future curriculum planning. At least one broadly stated major objective is provided for each section, encompassing the…

Scanning the Future: Preparing for Employment through Career Development.

ERIC Educational Resources Information Center

South Carolina State Dept. of Education, Columbia. Office of Occupational Education.

This curriculum guide, developed in South Carolina, provides opportunities for students to develop positive attitudes toward work, learn about occupations, and seek and retain employment. It is based on the competencies and foundations identified by the Secretary's Commission on Achieving Necessary Skills (SCANS). The guide's four units cover…

Secondary School Curriculum Guide: Business: Grades 9-12.

ERIC Educational Resources Information Center

Cranston School Dept., RI.

The Cranston Secondary School Curriculum Guide (9-12) for Business Education is intended to serve as a resource for teachers, students, department chairman, guidance personnel, curriculum planners, and others involved in present or future curriculum planning. At least one broadly stated major objective is provided for each section, encompassing…

Image-guided filtering for improving photoacoustic tomographic image reconstruction.

PubMed

Awasthi, Navchetan; Kalva, Sandeep Kumar; Pramanik, Manojit; Yalavarthy, Phaneendra K

2018-06-01

Several algorithms exist to solve the photoacoustic image reconstruction problem depending on the expected reconstructed image features. These reconstruction algorithms promote typically one feature, such as being smooth or sharp, in the output image. Combining these features using a guided filtering approach was attempted in this work, which requires an input and guiding image. This approach act as a postprocessing step to improve commonly used Tikhonov or total variational regularization method. The result obtained from linear backprojection was used as a guiding image to improve these results. Using both numerical and experimental phantom cases, it was shown that the proposed guided filtering approach was able to improve (as high as 11.23 dB) the signal-to-noise ratio of the reconstructed images with the added advantage being computationally efficient. This approach was compared with state-of-the-art basis pursuit deconvolution as well as standard denoising methods and shown to outperform them. (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application.

PubMed

Barkhausen, Jörg; Kahn, Thomas; Krombach, Gabriele A; Kuhl, Christiane K; Lotz, Joachim; Maintz, David; Ricke, Jens; Schönberg, Stefan O; Vogl, Thomas J; Wacker, Frank K

2017-07-01

Background  MRI is attractive for the guiding and monitoring of interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure physiologic parameters like flow and cardiac function. Method  The current status of interventional MRI for the clinical routine was analyzed. Results  The effort needed for the development of MR-safe monitoring systems and instruments initially resulted in the application of interventional MRI only for procedures that could not be performed by other means. Accordingly, biopsy of lesions in the breast, which are not detectable by other modalities, has been performed under MRI guidance for decades. Currently, biopsies of the prostate under MRI guidance are established in a similar fashion. At many sites blind biopsy has already been replaced by MR-guided biopsy or at least by the fusion of MR images with ultrasound. Cardiovascular interventions are performed at several centers for ablation as a treatment for atrial fibrillation. Conclusion  Interventional MRI has been established in the clinical routine for a variety of indications. Broader application can be expected in the clinical routine in the future owing to the multiple advantages compared to other techniques. Key points   · Due to the significant technical effort, MR-guided interventions are only recommended in the long term for regions in which MRI either facilitates or greatly improves the intervention.. · Breast biopsy of otherwise undetectable target lesions has long been established in the clinical routine. Prostate biopsy is currently being introduced in the clinical routine for similar reasons. Other methods such as MR-guided focused ultrasound for the treatment of uterine fibroids or tumor ablation of metastases represent alternative methods and are offered in many places.. · Endovascular MR-guided interventions offer advantages for a number of indications and have already been clinically established for the treatment of children with congenital heart defects and for atrial ablation at individual centers. Greater application can be expected in the future.. Citation format · Barkhausen J, Kahn T, Krombach GA et al. White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application. Fortschr Röntgenstr 2017; 189: 611 - 623. © Georg Thieme Verlag KG Stuttgart · New York.

Weathering the storm: Improving therapeutic interventions for cytokine storm syndromes by targeting disease pathogenesis.

PubMed

Weaver, Lehn K; Behrens, Edward M

2017-03-01

Cytokine storm syndromes require rapid diagnosis and treatment to limit the morbidity and mortality caused by the hyperinflammatory state that characterizes these devastating conditions. Herein, we discuss the current knowledge that guides our therapeutic decision-making and personalization of treatment for patients with cytokine storm syndromes. Firstly, ICU-level supportive care is often required to stabilize patients with fulminant disease while additional diagnostic evaluations proceed to determine the underlying cause of cytokine storm. Pharmacologic interventions should be focused on removing the inciting trigger of inflammation and initiation of an individualized immunosuppressive regimen when immune activation is central to the underlying disease pathophysiology. Monitoring for a clinical response is required to ensure that changes in the therapeutic regimen can be made as clinically warranted. Escalation of immunosuppression may be required if patients respond poorly to the initial therapeutic interventions, while a slow wean of immunosuppression in patients who improve can limit medication-related toxicities. In certain scenarios, a decision must be made whether an individual patient requires hematopoietic cell transplantation to prevent recurrence of disease. Despite these interventions, significant morbidity and mortality remains for cytokine storm patients. Therefore, we use this review to propose a clinical schema to guide current and future attempts to design rational therapeutic interventions for patients suffering from these devastating conditions, which we believe speeds the diagnosis of disease, limits medication-related toxicities, and improves clinical outcomes by targeting the heterogeneous and dynamic mechanisms driving disease in each individual patient.

Peer support to improve diabetes care: an implementation evaluation of the Australasian Peers for Progress Diabetes Program.

PubMed

Aziz, Zahra; Riddell, Michaela A; Absetz, Pilvikki; Brand, Margaret; Oldenburg, Brian

2018-02-17

Several studies have now demonstrated the benefits of peer support in promoting diabetes control. The aim of this study is to evaluate the implementation of a cluster randomised controlled trial of a group-based, peer support program to improve diabetes self-management and thereby, diabetes control in people with Type 2 Diabetes in Victoria, Australia. The intervention program was designed to address four key peer support functions i.e. 1) assistance in daily management, 2) social and emotional support, 3) regular linkage to clinical care, and 4) ongoing and sustained support to assist with the lifelong needs of diabetes self-care management. The intervention participants attended monthly group meetings facilitated by a trained peer leader for 12 months. Data was collected on the intervention's reach, participation, implementation fidelity, groups' effectiveness and participants' perceived support and satisfaction with the intervention. The RE-AIM and PIPE frameworks were used to guide this evaluation. The trial reached a high proportion (79%) of its target population through mailed invitations. Out of a total of 441 eligible individuals, 273 (61.9%) were willing to participate. The intervention fidelity was high (92.7%). The proportion of successful participants who demonstrated a reduction in 5 years cardiovascular disease risk score was 65.1 and 44.8% in the intervention and control arm respectively. Ninety-four percent (94%) of the intervention participants stated that the program helped them manage their diabetes on a day to day basis. Overall, attending monthly group meetings provided 'a lot of support' to 57% and 'moderate' support to 34% of the participants. Peer support programs are feasible, acceptable and can be used to supplement treatment for patients motivated to improve behaviours related to diabetes. However, program planners need to focus on the participation component in designing future programs. The use of two evaluation frameworks allowed a comprehensive evaluation of the trial from the provider-, participant- and public health perspective. The learnings gained from this evaluation will guide and improve future implementation by improving program feasibility for adoption and acceptability among participants, and will ultimately increase the likelihood of program effectiveness for the participants. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12609000469213 . Registered 16 June 2009.

History of intelligent transportation systems.

DOT National Transportation Integrated Search

2016-05-01

ITS capabilities have matured significantly over the past 25 years since the ITS Joint Program Office was created, and this document celebrates the advances in this field and explore its exciting future, while also serving as a guide for future ITS r...

How Well Does LCA Model Land Use Impacts on Biodiversity?--A Comparison with Approaches from Ecology and Conservation.

PubMed

Curran, Michael; de Souza, Danielle Maia; Antón, Assumpció; Teixeira, Ricardo F M; Michelsen, Ottar; Vidal-Legaz, Beatriz; Sala, Serenella; Milà i Canals, Llorenç

2016-03-15

The modeling of land use impacts on biodiversity is considered a priority in life cycle assessment (LCA). Many diverging approaches have been proposed in an expanding literature on the topic. The UNEP/SETAC Life Cycle Initiative is engaged in building consensus on a shared modeling framework to highlight best-practice and guide model application by practitioners. In this paper, we evaluated the performance of 31 models from both the LCA and the ecology/conservation literature (20 from LCA, 11 from non-LCA fields) according to a set of criteria reflecting (i) model completeness, (ii) biodiversity representation, (iii) impact pathway coverage, (iv) scientific quality, and (v) stakeholder acceptance. We show that LCA models tend to perform worse than those from ecology and conservation (although not significantly), implying room for improvement. We identify seven best-practice recommendations that can be implemented immediately to improve LCA models based on existing approaches in the literature. We further propose building a "consensus model" through weighted averaging of existing information, to complement future development. While our research focuses on conceptual model design, further quantitative comparison of promising models in shared case studies is an essential prerequisite for future informed model choice.

Modeling paradigms for medical diagnostic decision support: a survey and future directions.

PubMed

Wagholikar, Kavishwar B; Sundararajan, Vijayraghavan; Deshpande, Ashok W

2012-10-01

Use of computer based decision tools to aid clinical decision making, has been a primary goal of research in biomedical informatics. Research in the last five decades has led to the development of Medical Decision Support (MDS) applications using a variety of modeling techniques, for a diverse range of medical decision problems. This paper surveys literature on modeling techniques for diagnostic decision support, with a focus on decision accuracy. Trends and shortcomings of research in this area are discussed and future directions are provided. The authors suggest that-(i) Improvement in the accuracy of MDS application may be possible by modeling of vague and temporal data, research on inference algorithms, integration of patient information from diverse sources and improvement in gene profiling algorithms; (ii) MDS research would be facilitated by public release of de-identified medical datasets, and development of opensource data-mining tool kits; (iii) Comparative evaluations of different modeling techniques are required to understand characteristics of the techniques, which can guide developers in choice of technique for a particular medical decision problem; and (iv) Evaluations of MDS applications in clinical setting are necessary to foster physicians' utilization of these decision aids.

The future vision of simulation in health care

PubMed Central

Gaba, D

2004-01-01

Simulation is a technique—not a technology—to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner. The diverse applications of simulation in health care can be categorised by 11 dimensions: aims and purposes of the simulation activity; unit of participation; experience level of participants; health care domain; professional discipline of participants; type of knowledge, skill, attitudes, or behaviours addressed; the simulated patient's age; technology applicable or required; site of simulation; extent of direct participation; and method of feedback used. Using simulation to improve safety will require full integration of its applications into the routine structures and practices of health care. The costs and benefits of simulation are difficult to determine, especially for the most challenging applications, where long term use may be required. Various driving forces and implementation mechanisms can be expected to propel simulation forward, including professional societies, liability insurers, health care payers, and ultimately the public. The future of simulation in health care depends on the commitment and ingenuity of the health care simulation community to see that improved patient safety using this tool becomes a reality. PMID:15465951

Current perspectives in the use of molecular imaging to target surgical treatments for genitourinary cancers.

PubMed

Greco, Francesco; Cadeddu, Jeffrey A; Gill, Inderbir S; Kaouk, Jihad H; Remzi, Mesut; Thompson, R Houston; van Leeuwen, Fijs W B; van der Poel, Henk G; Fornara, Paolo; Rassweiler, Jens

2014-05-01

Molecular imaging (MI) entails the visualisation, characterisation, and measurement of biologic processes at the molecular and cellular levels in humans and other living systems. Translating this technology to interventions in real-time enables interventional MI/image-guided surgery, for example, by providing better detection of tumours and their dimensions. To summarise and critically analyse the available evidence on image-guided surgery for genitourinary (GU) oncologic diseases. A comprehensive literature review was performed using PubMed and the Thomson Reuters Web of Science. In the free-text protocol, the following terms were applied: molecular imaging, genitourinary oncologic surgery, surgical navigation, image-guided surgery, and augmented reality. Review articles, editorials, commentaries, and letters to the editor were included if deemed to contain relevant information. We selected 79 articles according to the search strategy based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis criteria and the IDEAL method. MI techniques included optical imaging and fluorescent techniques, the augmented reality (AR) navigation system, magnetic resonance imaging spectroscopy, positron emission tomography, and single-photon emission computed tomography. Experimental studies on the AR navigation system were restricted to the detection and therapy of adrenal and renal malignancies and in the relatively infrequent cases of prostate cancer, whereas fluorescence techniques and optical imaging presented a wide application of intraoperative GU oncologic surgery. In most cases, image-guided surgery was shown to improve the surgical resectability of tumours. Based on the evidence to date, image-guided surgery has promise in the near future for multiple GU malignancies. Further optimisation of targeted imaging agents, along with the integration of imaging modalities, is necessary to further enhance intraoperative GU oncologic surgery. Copyright © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Future HIV Mentoring Programs to Enhance Diversity.

PubMed

Stoff, David M; Cargill, Victoria A

2016-09-01

This paper proposes a general template to guide future mentoring program development addressing: (i) considerations to ensure an adequate research workforce; (ii) key guidelines and principles of mentoring; and (iii) use of a logic model to develop program milestones, outcomes and evaluation. We focus on these areas to guide and inform the most effective mentoring program components, which we find to be more helpful than identifying specific features and ingredients. Although the focus is on the development of a new generation of investigators from diverse backgrounds, this template may also apply to mentoring programs for other investigators and for disciplines beyond HIV.

Image-guided surgery and therapy: current status and future directions

NASA Astrophysics Data System (ADS)

Peters, Terence M.

2001-05-01

Image-guided surgery and therapy is assuming an increasingly important role, particularly considering the current emphasis on minimally-invasive surgical procedures. Volumetric CT and MR images have been used now for some time in conjunction with stereotactic frames, to guide many neurosurgical procedures. With the development of systems that permit surgical instruments to be tracked in space, image-guided surgery now includes the use of frame-less procedures, and the application of the technology has spread beyond neurosurgery to include orthopedic applications and therapy of various soft-tissue organs such as the breast, prostate and heart. Since tracking systems allow image- guided surgery to be undertaken without frames, a great deal of effort has been spent on image-to-image and image-to- patient registration techniques, and upon the means of combining real-time intra-operative images with images acquired pre-operatively. As image-guided surgery systems have become increasingly sophisticated, the greatest challenges to their successful adoption in the operating room of the future relate to the interface between the user and the system. To date, little effort has been expended to ensure that the human factors issues relating to the use of such equipment in the operating room have been adequately addressed. Such systems will only be employed routinely in the OR when they are designed to be intuitive, unobtrusive, and provide simple access to the source of the images.

Industrial Enterprise Handbook. The Wisconsin Guide to Local Curriculum Improvement in Industrial Education, K-12.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Public Instruction, Madison. Div. of Instructional Services.

This handbook is designed to aid industrial educators in developing a private enterprise component in their programs in order to help students learn how business and industry work. It is a guide to implementing The Wisconsin Guide to Local Curriculum Improvement in Industrial Education, K-12. The book contains the following three sections: (1)…

Improved understanding of human anatomy through self-guided radiological anatomy modules.

PubMed

Phillips, Andrew W; Smith, Sandy G; Ross, Callum F; Straus, Christopher M

2012-07-01

To quantifiably measure the impact of self-instructed radiological anatomy modules on anatomy comprehension, demonstrated by radiology, gross, and written exams. Study guides for independent use that emphasized structural relationships were created for use with two online radiology atlases. A guide was created for each module of the first year medical anatomy course and incorporated as an optional course component. A total of 93 of 96 eligible students participated. All exams were normalized to control for variances in exam difficulty and body region tested. An independent t-test was used to compare overall exam scores with respect to guide completion or incompletion. To account for aptitude differences between students, a paired t-test of each student's exam scores with and without completion of the associated guide was performed, thus allowing students to serve as their own controls. Twenty-one students completed no study guides; 22 completed all six guides; and 50 students completed between one and five guides. Aggregate comparisons of all students' exam scores showed significantly improved mean performance when guides were used (radiology, 57.8% [percentile] vs. 45.1%, P < .001; gross, 56.9% vs. 46.5%, P = .001; written, 57.8% vs. 50.2%, P = .011). Paired comparisons among students who completed between one and five guides demonstrated significantly higher mean practical exam scores when guides were used (radiology, 49.3% [percentile] vs. 36.0%, P = .001; gross, 51.5% vs. 40.4%, P = .005), but not higher written scores. Radiological anatomy study guides significantly improved anatomy comprehension on radiology, gross, and written exams. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Quick Reference Guide: Working with Stakeholders to Identify Potential Improvement Strategies for Program Improvement (Including the SSIP)

ERIC Educational Resources Information Center

Center for IDEA Early Childhood Data Systems (DaSy), 2015

2015-01-01

This 2015 quick reference guide is designed to assist states in understanding what information needs to be available in order for stakeholders to assist in selecting potential improvement strategies that will increase capacity of Local Education Agencies (LEAs), Early Intervention Services (EIS) programs, and practitioners to improve results for…

Monitoring and evaluation of disaster response efforts undertaken by local health departments: a rapid realist review.

PubMed

Gossip, Kate; Gouda, Hebe; Lee, Yong Yi; Firth, Sonja; Bermejo, Raoul; Zeck, Willibald; Jimenez Soto, Eliana

2017-06-29

Local health departments are often at the forefront of a disaster response, attending to the immediate trauma inflicted by the disaster and also the long term health consequences. As the frequency and severity of disasters are projected to rise, monitoring and evaluation (M&E) efforts are critical to help local health departments consolidate past experiences and improve future response efforts. Local health departments often conduct M&E work post disaster, however, many of these efforts fail to improve response procedures. We undertook a rapid realist review (RRR) to examine why M&E efforts undertaken by local health departments do not always result in improved disaster response efforts. We aimed to complement existing frameworks by focusing on the most basic and pragmatic steps of a M&E cycle targeted towards continuous system improvements. For these purposes, we developed a theoretical framework that draws on the quality improvement literature to 'frame' the steps in the M&E cycle. This framework encompassed a M&E cycle involving three stages (i.e., document and assess, disseminate and implement) that must be sequentially completed to learn from past experiences and improve future disaster response efforts. We used this framework to guide our examination of the literature and to identify any context-mechanism-outcome (CMO) configurations which describe how M&E may be constrained or enabled at each stage of the M&E cycle. This RRR found a number of explanatory CMO configurations that provide valuable insights into some of the considerations that should be made when using M&E to improve future disaster response efforts. Firstly, to support the accurate documentation and assessment of a disaster response, local health departments should consider how they can: establish a culture of learning within health departments; use embedded training methods; or facilitate external partnerships. Secondly, to enhance the widespread dissemination of lessons learned and facilitate inter-agency learning, evaluation reports should use standardised formats and terminology. Lastly, to increase commitment to improvement processes, local health department leaders should possess positive leadership attributes and encourage shared decision making. This study is among the first to conduct a synthesis of the CMO configurations which facilitate or hinder M&E efforts aimed at improving future disaster responses. It makes a significant contribution to the disaster literature and provides an evidence base that can be used to provide pragmatic guidance for improving M&E efforts of local health departments. PROSPERO 2015: CRD42015023526 .

Bimanual coordination: A missing piece of arm rehabilitation after stroke.

PubMed

Kantak, Shailesh; Jax, Steven; Wittenberg, George

2017-01-01

Inability to use the arm in daily actions significantly lowers quality of life after stroke. Most contemporary post-stroke arm rehabilitation strategies that aspire to re-engage the weaker arm in functional activities have been greatly limited in their effectiveness. Most actions of daily life engage the two arms in a highly coordinated manner. In contrast, most rehabilitation approaches predominantly focus on restitution of the impairments and unilateral practice of the weaker hand alone. We present a perspective that this misalignment between real world requirements and intervention strategies may limit the transfer of unimanual capability to spontaneous arm use and functional recovery. We propose that if improving spontaneous engagement and use of the weaker arm in real life is the goal, arm rehabilitation research and treatment need to address the coordinated interaction between arms in targeted theory-guided interventions. Current narrow focus on unimanual deficits alone, difficulty in quantifying bimanual coordination in real-world actions and limited theory-guided focus on control and remediation of different coordination modes are some of the biggest obstacles to successful implementation of effective interventions to improve bimanual coordination in the real world. We present a theory-guided taxonomy of bimanual actions that will facilitate quantification of coordination for different real-world tasks and provide treatment targets for addressing coordination deficits. We then present evidence in the literature that points to bimanual coordination deficits in stroke survivors and demonstrate how current rehabilitation approaches are limited in their impact on bimanual coordination. Importantly, we suggest theory-based areas of future investigation that may assist quantification, identification of neural mechanisms and scientifically-based training/remediation approaches for bimanual coordination deficits post-stroke. Advancing the science and practice of arm rehabilitation to incorporate bimanual coordination will lead to a more complete functional recovery of the weaker arm, thus improving the effectiveness of rehabilitation interventions and augmenting quality of life after stroke.

Exoplanet Biosignatures: Future Directions

PubMed Central

Bains, William; Cronin, Leroy; DasSarma, Shiladitya; Danielache, Sebastian; Domagal-Goldman, Shawn; Kacar, Betul; Kiang, Nancy Y.; Lenardic, Adrian; Reinhard, Christopher T.; Moore, William; Schwieterman, Edward W.; Shkolnik, Evgenya L.; Smith, Harrison B.

2018-01-01

Abstract We introduce a Bayesian method for guiding future directions for detection of life on exoplanets. We describe empirical and theoretical work necessary to place constraints on the relevant likelihoods, including those emerging from better understanding stellar environment, planetary climate and geophysics, geochemical cycling, the universalities of physics and chemistry, the contingencies of evolutionary history, the properties of life as an emergent complex system, and the mechanisms driving the emergence of life. We provide examples for how the Bayesian formalism could guide future search strategies, including determining observations to prioritize or deciding between targeted searches or larger lower resolution surveys to generate ensemble statistics and address how a Bayesian methodology could constrain the prior probability of life with or without a positive detection. Key Words: Exoplanets—Biosignatures—Life detection—Bayesian analysis. Astrobiology 18, 779–824. PMID:29938538

Exoplanet Biosignatures: Future Directions.

PubMed

Walker, Sara I; Bains, William; Cronin, Leroy; DasSarma, Shiladitya; Danielache, Sebastian; Domagal-Goldman, Shawn; Kacar, Betul; Kiang, Nancy Y; Lenardic, Adrian; Reinhard, Christopher T; Moore, William; Schwieterman, Edward W; Shkolnik, Evgenya L; Smith, Harrison B

2018-06-01

We introduce a Bayesian method for guiding future directions for detection of life on exoplanets. We describe empirical and theoretical work necessary to place constraints on the relevant likelihoods, including those emerging from better understanding stellar environment, planetary climate and geophysics, geochemical cycling, the universalities of physics and chemistry, the contingencies of evolutionary history, the properties of life as an emergent complex system, and the mechanisms driving the emergence of life. We provide examples for how the Bayesian formalism could guide future search strategies, including determining observations to prioritize or deciding between targeted searches or larger lower resolution surveys to generate ensemble statistics and address how a Bayesian methodology could constrain the prior probability of life with or without a positive detection. Key Words: Exoplanets-Biosignatures-Life detection-Bayesian analysis. Astrobiology 18, 779-824.

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

Kim, D; Kang, S; Kim, T

Purpose: Patient breathing-related sorting method of projections in 4D digital tomosythesis (DTS) can be suffered from severe artifacts due to non-uniform angle distribution of projections and noncoplanar reconstructed images for each phase. In this study, we propose a method for optimally acquiring projection images in 4D DTS. Methods: In this method every pair of projections at x-ray tube’s gantry angles symmetrical with respect to the center of the range of gantry rotation is obtained at the same respiration amplitude. This process is challenging but becomes feasible with visual-biofeedback using a patient specific respiration guide wave which is in sinusoidal shapemore » (i.e., smooth and symmetrical enough). Depending on scan parameters such as the number of acquisition points per cycle, total scan angle and projections per acquisition amplitude, acquisition sequence is pre-determined. A simulation study for feasibility test was performed. To mimic actual situation closely, a group of volunteers were recruited and breathing data were acquired both with/without biofeedback. Then, x-ray projections for a humanoid phantom were virtually performed following (1) the breathing data from volunteers without guide, (2) the breathing data with guide and (3) the planned breathing data (i.e., ideal situation). Images from all of 3 scenarios were compared. Results: Scenario #2 showed significant artifact reduction compared to #1 while did minimal increase from the ideal situation (i.e., scenario #3). We verified the performance of the method with regard to the degree of inaccuracy during respiratory guiding. Also, the scan angle dependence-related differences in the DTS images could reduce between using the proposed method and the established patient breathing-related sorting method. Conclusion: Through the proposed 4D DTS method, it is possible to improve the accuracy of image guidance between intra/inter fractions with relatively low imaging dose. This research was supported by the Mid-career Researcher Program through NRF funded by the Ministry of Science, ICT & Future Planning of Korea (NRF-2014R1A2A1A10050270) and by the Radiation Technology R&D program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (No. 2013M2A2A7038291)« less

Northern Forest Futures reporting tools and database guide

Treesearch

Patrick D. Miles; Robert J. Huggett; W. Keith Moser

2015-01-01

The Northern Forest Futures database (NFFDB) supports the reporting of both current and projected future forest conditions for the 20 states that make up the U.S. North, an area bounded by Maine, Maryland, Missouri, and Minnesota. The NFFDB database and attendant reporting tools are available to the public as a Microsoft AccessTM database. The...

Conclusions: The Future of Family Involvement in Schools in African-American Communities

ERIC Educational Resources Information Center

Juhasz, Anne

2004-01-01

This article talks about the future of family involvement in schools in African-American communities. The future of family involvement in the schools rests with today's teachers and parents who will take what they learned from the past, establish the philosophical foundations to guide their interactions, incorporate child and family theory and…

Improving Education Together: A Guide to Labor-Management­-Community Collaboration

ERIC Educational Resources Information Center

Marietta, Geoff; d'Entremont, Chad; Murphy Kaur, Emily

2017-01-01

"Improving Education Together" offers a step-by-step guide to Labor-Management-Community (LMC) collaboration, an intervention that has successfully improved student outcomes in a wide variety of school districts across the country. The authors illustrate how a culture of collaboration between labor, management, and community stakeholders…

Improving Education Together: A Guide to Labor-Management-Community Collaboration

ERIC Educational Resources Information Center

Marietta, Geoff; d'Entremont, Chad; Kaur, Emily Murphy

2017-01-01

"Improving Education Together" offers a step-by-step guide to Labor-Management-Community (LMC) collaboration, an intervention that has successfully improved student outcomes in a wide variety of school districts across the country. The authors illustrate how a culture of collaboration between labor, management, and community stakeholders…

Design, Modeling, Fabrication, and Evaluation of the Air Amplifier for Improved Detection of Biomolecules by Electrospray Ionization Mass Spectrometry

PubMed Central

Robichaud, Guillaume; Dixon, R. Brent; Potturi, Amarnatha S.; Cassidy, Dan; Edwards, Jack R.; Sohn, Alex; Dow, Thomas A.; Muddiman, David C.

2010-01-01

Through a multi-disciplinary approach, the air amplifier is being evolved as a highly engineered device to improve detection limits of biomolecules when using electrospray ionization. Several key aspects have driven the modifications to the device through experimentation and simulations. We have developed a computer simulation that accurately portrays actual conditions and the results from these simulations are corroborated by the experimental data. These computer simulations can be used to predict outcomes from future designs resulting in a design process that is efficient in terms of financial cost and time. We have fabricated a new device with annular gap control over a range of 50 to 70 μm using piezoelectric actuators. This has enabled us to obtain better aerodynamic performance when compared to the previous design (2× more vacuum) and also more reproducible results. This is allowing us to study a broader experimental space than the previous design which is critical in guiding future directions. This work also presents and explains the principles behind a fractional factorial design of experiments methodology for testing a large number of experimental parameters in an orderly and efficient manner to understand and optimize the critical parameters that lead to obtain improved detection limits while minimizing the number of experiments performed. Preliminary results showed that several folds of improvements could be obtained for certain condition of operations (up to 34 folds). PMID:21499524

Automated Circulation Systems in Libraries Serving the Blind and Physically Handicapped: A Reference Guide for Planning.

ERIC Educational Resources Information Center

Wanger, Judith; And Others

Designed to facilitate communications in future automation projects between library and data processing personnel, especially those projects involving the use of automated systems in the service of disabled patrons, this guide identifies and describes a master set of major circulation system requirements and design considerations, and illustrates…

Conservation in a World of Six Billion: A Grassroots Action Guide.

ERIC Educational Resources Information Center

Hren, Benedict J.

This grassroots action guide features a conservation initiative working to bring the impacts of human population growth, economic development, and natural resource consumption into balance with the limits of nature for the benefit of current and future generations. Contents include information sheets entitled "Six Billion People and Growing,""The…

Science 9. DeSoto Parish Curriculum Guide.

ERIC Educational Resources Information Center

DeSoto Parish School Board, Mansfield, LA.

This guide is designed to aid the teacher in planning and teaching a ninth-grade science course. It should provide students with a functional system of knowledge which is applicable to new situations and will serve as the basis for future decisions. Five units outlined are entitled: Introduction to Service; The Earth's Storehouse; The Earth's…

Employment in Agribusiness. Teacher Edition. Second Edition.

ERIC Educational Resources Information Center

Crummett, Dan M.; Newport, Alan K.

This curriculum guide is designed to help teachers prepare students with the variety of skills that will help them obtain jobs that can turn into rewarding careers in agribusiness. The guide also serves as a resource for students participating in agricultural sales and service competitions sponsored by student organizations such as Future Farmers…

Building for the Future: Nutrition Guidance for the Child Nutrition Programs.

ERIC Educational Resources Information Center

Food and Nutrition Service (USDA), Washington, DC.

This publication offers practical guidance to help food service professionals provide sound nutrition to America's children and serves as a basis for the revision of U.S. Department of Agriculture meal patterns, menu planning guides, and the development of new recipes. The guide is organized into two sections. The first, "Implementation of…

Business and Personal Services Marketing, With an Emphasis on Entrepreneurial Opportunities. A Guide.

ERIC Educational Resources Information Center

Luter, Robert R.

This publication, one of a series of self-contained instructional manuals for students in marketing and distribution, deals with the field of personal services marketing and covers job opportunities, career possibilities, and future planning for entrepreneurship. Addressed in the individual units of the guide are the following topics: the business…

X-Rays: The Inside Story (Secondary). Teacher's Guide.

ERIC Educational Resources Information Center

Royal Australasian Coll. of Radiologists, Sydney (Australia).

The goals of this unit are to explore the magic, history, and development of imaging technology, clarify what X-rays and radiation are, examine the issues involved in imaging technology, understand basic anatomy, explore careers related to radiology, and promote future good health. Included in the unit are the teacher's guide, a collection of…

Recycle Alaska: Reduce, Reuse, Recycle. Activities Handbook, Teacher's Guide, and Student Worksheets.

ERIC Educational Resources Information Center

Alaska State Dept. of Education, Juneau.

Recycling is a very important aspect of conserving the environment for future generations. This guide addresses the topic of litter prevention for the Alaskan environment and contains 42 activities. Activity topics covered include Natural Cycles, Human Interruption of Natural Cycles, Reduce, Reuse, Recycle and Recycled Classroom. Grade level,…

A Plan to the Future in Home Economics Education. Draft Curriculum.

ERIC Educational Resources Information Center

Ruckes, Nina Tiglio; Mongillo, Michael

This curriculum guide was prepared to help Connecticut high schools offer an opportunity to disadvantaged high school students who are interested in home economics education to earn some college credit toward a degree in dietetic technology. The curriculum guide includes an overview of the course with a course description, recommended textbooks,…

A Guide to Assessing Urban Forests

Treesearch

David Nowak

2013-01-01

Urban forests provide numerous ecosystem services. To quantify these services and guide management to sustain these services for future generations, the structure or composition of the forest must be assessed. There are two basic ways of assessing the structure or composition of the urban forest: Bottom-up approach. Field-based assessments to measure the physical...

NED-2 User's Guide

Treesearch

Mark J. Twery; Peter D. Knopp; Scott A. Thomasma; Donald E. Nute

2011-01-01

This is the user's guide for NED-2, which is the latest version of NED, a forest ecosystem management decision support system. This software is part of a family of software products intended to help resource managers develop goals, assess current and future conditions, and produce sustainable management plans for forest properties. Designed for stand-alone Windows...

NED-2 reference guide

Treesearch

Mark J. Twery; Peter D. Knopp; Scott A. Thomasma; Donald E. Nute

2012-01-01

This is the reference guide for NED-2, which is the latest version of NED, a forest ecosystem management decision support system. This software is part of a family of software products intended to help resource managers develop goals, assess current and future conditions, and produce sustainable management plans for forest properties. Designed for stand-alone Windows-...

Ohio Environmental Education Areas.

ERIC Educational Resources Information Center

Melvin, Ruth W.

This is a guide to regional sites in Ohio which can be studied in regard to resource management; land use; the quality of air, water, soil; and reclamation. The first section of the guide includes brief descriptions of Ohio's natural features at the present time, accounts of past appearances and events, and predictions for the future. In the…

Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research

PubMed Central

Carter-Harris, Lisa; Davis, Lorie L.; Rawl, Susan M.

2017-01-01

Purpose To describe the development of a conceptual model to guide research focused on lung cancer screening participation from the perspective of the individual in the decision-making process. Methods Based on a comprehensive review of empirical and theoretical literature, a conceptual model was developed linking key psychological variables (stigma, medical mistrust, fatalism, worry, and fear) to the health belief model and precaution adoption process model. Results Proposed model concepts have been examined in prior research of either lung or other cancer screening behavior. To date, a few studies have explored a limited number of variables that influence screening behavior in lung cancer specifically. Therefore, relationships among concepts in the model have been proposed and future research directions presented. Conclusion This proposed model is an initial step to support theoretically based research. As lung cancer screening becomes more widely implemented, it is critical to theoretically guide research to understand variables that may be associated with lung cancer screening participation. Findings from future research guided by the proposed conceptual model can be used to refine the model and inform tailored intervention development. PMID:28304262

Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research.

PubMed

Carter-Harris, Lisa; Davis, Lorie L; Rawl, Susan M

2016-11-01

To describe the development of a conceptual model to guide research focused on lung cancer screening participation from the perspective of the individual in the decision-making process. Based on a comprehensive review of empirical and theoretical literature, a conceptual model was developed linking key psychological variables (stigma, medical mistrust, fatalism, worry, and fear) to the health belief model and precaution adoption process model. Proposed model concepts have been examined in prior research of either lung or other cancer screening behavior. To date, a few studies have explored a limited number of variables that influence screening behavior in lung cancer specifically. Therefore, relationships among concepts in the model have been proposed and future research directions presented. This proposed model is an initial step to support theoretically based research. As lung cancer screening becomes more widely implemented, it is critical to theoretically guide research to understand variables that may be associated with lung cancer screening participation. Findings from future research guided by the proposed conceptual model can be used to refine the model and inform tailored intervention development.

Theory of constraints for publicly funded health systems.

PubMed

Sadat, Somayeh; Carter, Michael W; Golden, Brian

2013-03-01

Originally developed in the context of publicly traded for-profit companies, theory of constraints (TOC) improves system performance through leveraging the constraint(s). While the theory seems to be a natural fit for resource-constrained publicly funded health systems, there is a lack of literature addressing the modifications required to adopt TOC and define the goal and performance measures. This paper develops a system dynamics representation of the classical TOC's system-wide goal and performance measures for publicly traded for-profit companies, which forms the basis for developing a similar model for publicly funded health systems. The model is then expanded to include some of the factors that affect system performance, providing a framework to apply TOC's process of ongoing improvement in publicly funded health systems. Future research is required to more accurately define the factors affecting system performance and populate the model with evidence-based estimates for various parameters in order to use the model to guide TOC's process of ongoing improvement.

Whole brain radiotherapy for brain metastasis

PubMed Central

McTyre, Emory; Scott, Jacob; Chinnaiyan, Prakash

2013-01-01

Whole brain radiotherapy (WBRT) is a mainstay of treatment in patients with both identifiable brain metastases and prophylaxis for microscopic disease. The use of WBRT has decreased somewhat in recent years due to both advances in radiation technology, allowing for a more localized delivery of radiation, and growing concerns regarding the late toxicity profile associated with WBRT. This has prompted the development of several recent and ongoing prospective studies designed to provide Level I evidence to guide optimal treatment approaches for patients with intracranial metastases. In addition to defining the role of WBRT in patients with brain metastases, identifying methods to improve WBRT is an active area of investigation, and can be classified into two general categories: Those designed to decrease the morbidity of WBRT, primarily by reducing late toxicity, and those designed to improve the efficacy of WBRT. Both of these areas of research show diversity and promise, and it seems feasible that in the near future, the efficacy/toxicity ratio may be improved, allowing for a more diverse clinical application of WBRT. PMID:23717795

Coronary Artery Calcium Scoring: Is It Time for a Change in Methodology?

PubMed

Blaha, Michael J; Mortensen, Martin Bødtker; Kianoush, Sina; Tota-Maharaj, Rajesh; Cainzos-Achirica, Miguel

2017-08-01

Quantification of coronary artery calcium (CAC) has been shown to be reliable, reproducible, and predictive of cardiovascular risk. Formal CAC scoring was introduced in 1990, with early scoring algorithms notable for their simplicity and elegance. Yet, with little evidence available on how to best build a score, and without a conceptual model guiding score development, these scores were, to a large degree, arbitrary. In this review, we describe the traditional approaches for clinical CAC scoring, noting their strengths, weaknesses, and limitations. We then discuss a conceptual model for developing an improved CAC score, reviewing the evidence supporting approaches most likely to lead to meaningful score improvement (for example, accounting for CAC density and regional distribution). After discussing the potential implementation of an improved score in clinical practice, we follow with a discussion of the future of CAC scoring, asking the central question: do we really need a new CAC score? Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Heritability of targeted gene modifications induced by plant-optimized CRISPR systems.

PubMed

Mao, Yanfei; Botella, Jose Ramon; Zhu, Jian-Kang

2017-03-01

The Streptococcus-derived CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats)/Cas9 (CRISPR-associated protein 9) system has emerged as a very powerful tool for targeted gene modifications in many living organisms including plants. Since the first application of this system for plant gene modification in 2013, this RNA-guided DNA endonuclease system has been extensively engineered to meet the requirements of functional genomics and crop trait improvement in a number of plant species. Given its short history, the emphasis of many studies has been the optimization of the technology to improve its reliability and efficiency to generate heritable gene modifications in plants. Here we review and analyze the features of customized CRISPR/Cas9 systems developed for plant genetic studies and crop breeding. We focus on two essential aspects: the heritability of gene modifications induced by CRISPR/Cas9 and the factors affecting its efficiency, and we provide strategies for future design of systems with improved activity and heritability in plants.

Reductions in the variations of respiration signals for respiratory-gated radiotherapy when using the video-coaching respiration guiding system

NASA Astrophysics Data System (ADS)

Lee, Hyun Jeong; Yea, Ji Woon; Oh, Se An

2015-07-01

Respiratory-gated radiation therapy (RGRT) has been used to minimize the dose to normal tissue in lung-cancer radiotherapy. The present research aims to improve the regularity of respiration in RGRT by using a video-coached respiration guiding system. In the study, 16 patients with lung cancer were evaluated. The respiration signals of the patients were measured by using a realtime position management (RPM) respiratory gating system (Varian, USA), and the patients were trained using the video-coaching respiration guiding system. The patients performed free breathing and guided breathing, and the respiratory cycles were acquired for ~5 min. Then, Microsoft Excel 2010 software was used to calculate the mean and the standard deviation for each phase. The standard deviation was computed in order to analyze the improvement in the respiratory regularity with respect to the period and the displacement. The standard deviation of the guided breathing decreased to 48.8% in the inhale peak and 24.2% in the exhale peak compared with the values for the free breathing of patient 6. The standard deviation of the respiratory cycle was found to be decreased when using the respiratory guiding system. The respiratory regularity was significantly improved when using the video-coaching respiration guiding system. Therefore, the system is useful for improving the accuracy and the efficiency of RGRT.

Experimental Investigation on Design Enhancement of Axial Fan Using Fixed Guide Vane

NASA Astrophysics Data System (ADS)

Munisamy, K. M.; Govindasamy, R.; Thangaraju, S. K.

2015-09-01

Airflow passes through the rotating blade in an axial flow fan will experience a helical flow pattern. This swirling effect leads the system to experience swirl energy losses or pressure drop yet reducing the total efficiency of the fan system. A robust tool to encounter this air spin past the blade is by introducing guide vane to the system. Owing to its importance, a new approach in designing outlet guide vane design for a commercial usage 1250mm diameter axial fan with a 30° pitch angle impeller has been introduced in this paper. A single line metal of proper curvature guide vane design technique has been adopted for this study. By choosing fan total efficiency as a target variable to be improved, the total and static pressure on the design point were set to be constraints. Therefore, the guide vane design was done based on the improvement target on the static pressure in system. The research shows that, with the improvement in static pressure by 29.63% through guide vane installation, the total fan efficiency is increased by 5.12%, thus reduces the fan power by 5.32%. Good agreement were found, that when the fan total efficiency increases, the power consumption of the fan is reduced. Therefore, this new approach of guide vane design can be applied to improve axial fan performance.

Assessing and Improving Student Organizations: A Guide for Students. The Assessing and Improving Student Organization (AISO) Program

ERIC Educational Resources Information Center

Ruben, Brent D.; Nolfi, Tricia

2010-01-01

This "Assessing and Improving Student Organization" (AISO) program is intended as a guide for leaders of student-led college organizations. It is designed to promote the assessment of their organization by leaders and members, help them with planning and improvement, and assist them in responding to reviews by governing bodies and national…

The fundamental role of subcellular topography in peripheral nerve repair therapies.

PubMed

Spivey, Eric C; Khaing, Zin Z; Shear, Jason B; Schmidt, Christine E

2012-06-01

Clinical evidence suggests that nano- and microtopography incorporated into scaffolds does not merely improve peripheral nerve regeneration, but is in fact a prerequisite for meaningful restoration of nerve function. Although the biological mechanisms involved are not fully understood, grafts incorporating physical guides that mimic microscopic nerve tissue features (e.g., basal laminae) appear to provide a significant advantage over grafts that rely on purely chemical or macroscopic similarities to nerve tissue. Investigators consistently demonstrate the fundamental importance of nano- and micro-scale physical features for appropriate cell response in a wide range of biological scenarios. Additionally, recent in vivo research demonstrates that nerve regeneration scaffolds with cell-scale physical features are more effective than those that rely only on chemical or macro-scale features. Physical guidance at the cell-scale is especially important for long (>20 mm) nerve defects, for which the only reliable treatment is the autologous nerve graft. The lack of other available options exposes a clear need for the application of nano- and microfabrication techniques that will allow the next generation of engineered nerve guides to more closely mimic native tissue at those scales. This review examines current research to determine what elements of cell-scale topography in experimental scaffolds are most effective at stimulating functional recovery, and then presents an overview of fabrication techniques that could potentially improve future treatment paradigms. Relative advantages and disadvantages of these techniques are discussed, with respect to both clinical adaptation and likely effectiveness. Our intent is to more clearly delineate the remaining obstacles in the development of a next generation nerve guide, particularly for long defects, and offer new perspectives on steering current technologies towards clinically viable solutions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Accuracy assessment of surgical planning and three-dimensional-printed patient-specific guides for orthopaedic osteotomies.

PubMed

Sys, Gwen; Eykens, Hannelore; Lenaerts, Gerlinde; Shumelinsky, Felix; Robbrecht, Cedric; Poffyn, Bart

2017-06-01

This study analyses the accuracy of three-dimensional pre-operative planning and patient-specific guides for orthopaedic osteotomies. To this end, patient-specific guides were compared to the classical freehand method in an experimental setup with saw bones in two phases. In the first phase, the effect of guide design and oscillating versus reciprocating saws was analysed. The difference between target and performed cuts was quantified by the average distance deviation and average angular deviations in the sagittal and coronal planes for the different osteotomies. The results indicated that for one model osteotomy, the use of guides resulted in a more accurate cut when compared to the freehand technique. Reciprocating saws and slot guides improved accuracy in all planes, while oscillating saws and open guides lead to larger deviations from the planned cut. In the second phase, the accuracy of transfer of the planning to the surgical field with slot guides and a reciprocating saw was assessed and compared to the classical planning and freehand cutting method. The pre-operative plan was transferred with high accuracy. Three-dimensional-printed patient-specific guides improve the accuracy of osteotomies and bony resections in an experimental setup compared to conventional freehand methods. The improved accuracy is related to (1) a detailed and qualitative pre-operative plan and (2) an accurate transfer of the planning to the operation room with patient-specific guides by an accurate guidance of the surgical tools to perform the desired cuts.

State-of-the-art and emerging technologies for atrial fibrillation ablation.

PubMed

Dewire, Jane; Calkins, Hugh

2010-03-01

Catheter ablation is an important treatment modality for patients with atrial fibrillation (AF). Although the superiority of catheter ablation over antiarrhythmic drug therapy has been demonstrated in middle-aged patients with paroxysmal AF, the role the procedure in other patient subgroups-particularly those with long-standing persistent AF-has not been well defined. Furthermore, although AF ablation can be performed with reasonable efficacy and safety by experienced operators, long-term success rates for single procedures are suboptimal. Fortunately, extensive ongoing research will improve our understanding of the mechanisms of AF, and considerable funds are being invested in developing new ablation technologies to improve patient outcomes. These technologies include ablation catheters designed to electrically isolate the pulmonary veins with improved safety, efficacy, and speed, catheters designed to deliver radiofrequency energy with improved precision, robotic systems to address the technological demands of the procedure, improved imaging and electrical mapping systems, and MRI-guided ablation strategies. The tools, technologies, and techniques that will ultimately stand the test of time and become the standard approach to AF ablation in the future remain unclear. However, technological advances are sure to result in the necessary improvements in the safety and efficacy of AF ablation procedures.

Metabolomics for Plant Improvement: Status and Prospects

PubMed Central

Kumar, Rakesh; Bohra, Abhishek; Pandey, Arun K.; Pandey, Manish K.; Kumar, Anirudh

2017-01-01

Post-genomics era has witnessed the development of cutting-edge technologies that have offered cost-efficient and high-throughput ways for molecular characterization of the function of a cell or organism. Large-scale metabolite profiling assays have allowed researchers to access the global data sets of metabolites and the corresponding metabolic pathways in an unprecedented way. Recent efforts in metabolomics have been directed to improve the quality along with a major focus on yield related traits. Importantly, an integration of metabolomics with other approaches such as quantitative genetics, transcriptomics and genetic modification has established its immense relevance to plant improvement. An effective combination of these modern approaches guides researchers to pinpoint the functional gene(s) and the characterization of massive metabolites, in order to prioritize the candidate genes for downstream analyses and ultimately, offering trait specific markers to improve commercially important traits. This in turn will improve the ability of a plant breeder by allowing him to make more informed decisions. Given this, the present review captures the significant leads gained in the past decade in the field of plant metabolomics accompanied by a brief discussion on the current contribution and the future scope of metabolomics to accelerate plant improvement. PMID:28824660

Space Launch System (SLS) Mission Planner's Guide

NASA Technical Reports Server (NTRS)

Smith, David Alan

2017-01-01

The purpose of this Space Launch System (SLS) Mission Planner's Guide (MPG) is to provide future payload developers/users with sufficient insight to support preliminary SLS mission planning. Consequently, this SLS MPG is not intended to be a payload requirements document; rather, it organizes and details SLS interfaces/accommodations in a manner similar to that of current Expendable Launch Vehicle (ELV) user guides to support early feasibility assessment. Like ELV Programs, once approved to fly on SLS, specific payload requirements will be defined in unique documentation.

Using the Whole School, Whole Community, Whole Child Model: Implications for Practice

PubMed Central

Rooney, Laura E; Videto, Donna M; Birch, David A

2015-01-01

BACKGROUND Schools, school districts, and communities seeking to implement the Whole School, Whole Community, Whole Child (WSCC) model should carefully and deliberately select planning, implementation, and evaluation strategies. METHODS In this article, we identify strategies, steps, and resources within each phase that can be integrated into existing processes that help improve health outcomes and academic achievement. Implementation practices may vary across districts depending upon available resources and time commitments. RESULTS Obtaining and maintaining administrative support at the beginning of the planning phase is imperative for identifying and implementing strategies and sustaining efforts to improve student health and academic outcomes. Strategy selection hinges on priority needs, community assets, and resources identified through the planning process. Determining the results of implementing the WSCC is based upon a comprehensive evaluation that begins during the planning phase. Evaluation guides success in attaining goals and objectives, assesses strengths and weaknesses, provides direction for program adjustment, revision, and future planning, and informs stakeholders of the effect of WSCC, including the effect on academic indicators. CONCLUSIONS With careful planning, implementation, and evaluation efforts, use of the WSCC model has the potential of focusing family, community, and school education and health resources to increase the likelihood of better health and academic success for students and improve school and community life in the present and in the future. PMID:26440824

A user-centered model for designing consumer mobile health (mHealth) applications (apps).

PubMed

Schnall, Rebecca; Rojas, Marlene; Bakken, Suzanne; Brown, William; Carballo-Dieguez, Alex; Carry, Monique; Gelaude, Deborah; Mosley, Jocelyn Patterson; Travers, Jasmine

2016-04-01

Mobile technologies are a useful platform for the delivery of health behavior interventions. Yet little work has been done to create a rigorous and standardized process for the design of mobile health (mHealth) apps. This project sought to explore the use of the Information Systems Research (ISR) framework as guide for the design of mHealth apps. Our work was guided by the ISR framework which is comprised of 3 cycles: Relevance, Rigor and Design. In the Relevance cycle, we conducted 5 focus groups with 33 targeted end-users. In the Rigor cycle, we performed a review to identify technology-based interventions for meeting the health prevention needs of our target population. In the Design Cycle, we employed usability evaluation methods to iteratively develop and refine mock-ups for a mHealth app. Through an iterative process, we identified barriers and facilitators to the use of mHealth technology for HIV prevention for high-risk MSM, developed 'use cases' and identified relevant functional content and features for inclusion in a design document to guide future app development. Findings from our work support the use of the ISR framework as a guide for designing future mHealth apps. Results from this work provide detailed descriptions of the user-centered design and system development and have heuristic value for those venturing into the area of technology-based intervention work. Findings from this study support the use of the ISR framework as a guide for future mHealth app development. Use of the ISR framework is a potentially useful approach for the design of a mobile app that incorporates end-users' design preferences. Copyright © 2016 Elsevier Inc. All rights reserved.

Adaptation of the European Commission-recommended user testing method to patient medication information leaflets in Japan.

PubMed

Yamamoto, Michiko; Doi, Hirohisa; Yamamoto, Ken; Watanabe, Kazuhiro; Sato, Tsugumichi; Suka, Machi; Nakayama, Takeo; Sugimori, Hiroki

2017-01-01

The safe use of drugs relies on providing accurate drug information to patients. In Japan, patient leaflets called Drug Guide for Patients are officially available; however, their utility has never been verified. This is the first attempt to improve Drug Guide for Patients via user testing in Japan. To test and improve communication of drug information to minimize risk for patients via user testing of the current and revised versions of Drug Guide for Patients, and to demonstrate that this method is effective for improving Drug Guide for Patients in Japan. We prepared current and revised versions of the Drug Guide for Patients and performed user testing via semi-structured interviews with consumers to compare these versions for two guides for Mercazole and Strattera. We evenly divided 54 participants into two groups with similar distributions of sex, age, and literacy level to test the differing versions of the Mercazole guide. Another group of 30 participants were divided evenly to test the versions of the Strattera guide. After completing user testing, the participants evaluated both guides in terms of amount of information, readability, usefulness of information, and layout and appearance. Participants were also asked for their opinions on the leaflets. Response rates were 100% for both Mercazole and Strattera. The revised versions of both Guides were superior or equal to the current versions in terms of accessibility and understandability. The revised version of the Mercazole guide showed better ratings for readability, usefulness of information, and layout ( p <0.01) than did the current version, while that for Strattera showed superior readability and layout ( p <0.01). User testing was effective for evaluating the utility of Drug Guide for Patients. Additionally, the revised version had superior accessibility and understandability.

School Improvement: A Resource and Planning Guide. Bulletin No. 8448.

ERIC Educational Resources Information Center

Gomoll, Robert; Burke, Peter J.

This guide describes a design for building-level school improvement in the state of Wisconsin. Summarized is effective-schools research that is designed to encourage schools and districts to become familiar with and engage in the improvement process. The first section describes what a school district needs to consider when beginning the school…

Update on modern neuraxial analgesia in labour: a review of the literature of the last 5 years.

PubMed

Loubert, C; Hinova, A; Fernando, R

2011-03-01

Several strategies and alternative therapies have been used to provide analgesia for labour pain. Over the last few years, a number of improvements have enhanced the efficacy and safety of neuraxial analgesia and ultimately have improved mothers' satisfaction with their birth experience. As labour analgesia is a field of obstetric anaesthesia that is rapidly evolving, this review is an update, from a clinical point of view, of developments over the last 5-7 years. We discuss advantages and controversies related to combined spinal-epidural analgesia, patient controlled epidural analgesia and the integration of computer systems into analgesic modalities. We also review the recent literature on future clinical and research perspectives including ultrasound guided neuraxial block placement, epidural adjuvants and pharmacogenetics. We finally look at the latest work with regards to epidural analgesia and breastfeeding. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

POVME 2.0: An Enhanced Tool for Determining Pocket Shape and Volume Characteristics

PubMed Central

2015-01-01

Analysis of macromolecular/small-molecule binding pockets can provide important insights into molecular recognition and receptor dynamics. Since its release in 2011, the POVME (POcket Volume MEasurer) algorithm has been widely adopted as a simple-to-use tool for measuring and characterizing pocket volumes and shapes. We here present POVME 2.0, which is an order of magnitude faster, has improved accuracy, includes a graphical user interface, and can produce volumetric density maps for improved pocket analysis. To demonstrate the utility of the algorithm, we use it to analyze the binding pocket of RNA editing ligase 1 from the unicellular parasite Trypanosoma brucei, the etiological agent of African sleeping sickness. The POVME analysis characterizes the full dynamics of a potentially druggable transient binding pocket and so may guide future antitrypanosomal drug-discovery efforts. We are hopeful that this new version will be a useful tool for the computational- and medicinal-chemist community. PMID:25400521

Virtual reality rehabilitation for stroke patients: Recent review and research issues

NASA Astrophysics Data System (ADS)

Arip, Eza Surya Mohd; Ismail, Waidah; Nordin, Md Jan; Radman, Abduljalil

2017-11-01

Stroke is one of the main causes of disability in the world. In order for stroke survivors to reduce their disability, they need to go through a rehabilitation process to regain back their independence and improve their quality of life. To guide patients in their rehabilitation process and improve their receptiveness in performing repetitive exercises, a new rehabilitation training program using Virtual Reality (VR) technology has been introduced. This has attracted many researchers to explore more on VR technology as a new tool for stroke patient's rehabilitation. This paper presents a review on existing VR systems that have been developed for stroke rehabilitation. First, recent VR systems utilized for rehabilitation after stroke are delineated and categorized. Each of these categories concludes with a discussion on limitations and any issues that arise from it. Finally, a concise summary with significant findings and future possibilities in VR rehabilitation research is presented in table format.

Management of CAD/CAM information: Key to improved manufacturing productivity

NASA Technical Reports Server (NTRS)

Fulton, R. E.; Brainin, J.

1984-01-01

A key element to improved industry productivity is effective management of CAD/CAM information. To stimulate advancements in this area, a joint NASA/Navy/Industry project designated Integrated Programs for Aerospace-Vehicle Design (IPAD) is underway with the goal of raising aerospace industry productivity through advancement of technology to integrate and manage information involved in the design and manufacturing process. The project complements traditional NASA/DOD research to develop aerospace design technology and the Air Force's Integrated Computer-Aided Manufacturing (ICAM) program to advance CAM technology. IPAD research is guided by an Industry Technical Advisory Board (ITAB) composed of over 100 repesentatives from aerospace and computer companies. The IPAD accomplishments to date in development of requirements and prototype software for various levels of company-wide CAD/CAM data management are summarized and plans for development of technology for management of distributed CAD/CAM data and information required to control future knowledge-based CAD/CAM systems are discussed.

Narrative thematic analysis of baccalaureate nursing students' reflections: critical thinking in the clinical education context.

PubMed

Naber, Jessica L; Hall, Joanne; Schadler, Craig Matthew

2014-09-01

This study sought to identify characteristics of clinically situated critical thinking in nursing students' reflections, originally part of a study guided by Richard Paul's model of critical thinking. Nurses are expected to apply critical thinking in all practice situations to improve health outcomes, including patient safety and satisfaction. In a previous study, Paul's model of critical thinking was used to develop questions for reflective writing assignments. Within that study, 30 nursing students completed six open-ended narratives of nurse-patient clinical encounters during an 8-week period. Improvements were seen in critical thinking scores after the intervention. This article reports the qualitative analysis of the content of six open-ended narratives. Six overarching themes were identified and combined into a tentative conceptual model. Faculty's understanding of the characteristics of critical thinking in the context of clinical education will help them to teach and evaluate students' progress and competencies for future practice.

Challenges towards Revitalizing Hemp: A Multifaceted Crop.

PubMed

Schluttenhofer, Craig; Yuan, Ling

2017-11-01

Hemp has been an important crop throughout human history for food, fiber, and medicine. Despite significant progress made by the international research community, the basic biology of hemp plants remains insufficiently understood. Clear objectives are needed to guide future research. As a semi-domesticated plant, hemp has many desirable traits that require improvement, including eliminating seed shattering, enhancing the quantity and quality of stem fiber, and increasing the accumulation of phytocannabinoids. Methods to manipulate the sex of hemp plants will also be important for optimizing yields of seed, fiber, and cannabinoids. Currently, research into trait improvement is hindered by the lack of molecular techniques adapted to hemp. Here we review how addressing these limitations will help advance our knowledge of plant biology and enable us to fully domesticate and maximize the agronomic potential of this promising crop. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The first decade of the National Drug Abuse Treatment Clinical Trials Network: bridging the gap between research and practice to improve drug abuse treatment.

PubMed

Tai, Betty; Straus, Michele M; Liu, David; Sparenborg, Steven; Jackson, Ron; McCarty, Dennis

2010-06-01

The National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN) in 1999 to improve the quality of addiction treatment using science as the vehicle. The network brings providers from community-based drug abuse treatment programs and scientists from university-based research centers together in an alliance that fosters bidirectional communication and collaboration. Collaboration enhanced the relevance of research to practice and facilitated the development and implementation of evidence-based treatments in community practice settings. The CTN's 20 completed trials tested pharmacological, behavioral, and integrated treatment interventions for adolescents and adults; more than 11,000 individuals participated in the trials. This article reviews the rationale for the CTN, describes the translation of its guiding principles into research endeavors, and anticipates the future evolution of clinical research within the Network.

The First Decade of the National Drug Abuse Treatment Clinical Trials Network: Bridging the Gap Between Research and Practice to Improve Drug Abuse Treatment

PubMed Central

Tai, Betty; Straus, Michele M.; Liu, David; Sparenborg, Steven; Jackson, Ron; McCarty, Dennis

2010-01-01

The National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN) in 1999 to improve the quality of addiction treatment using science as the vehicle. The network brings providers from community-based drug abuse treatment programs and scientists from university-based research centers together in an alliance that fosters bi-directional communication and collaboration. Collaboration enhanced the relevance of research to practice and facilitated the development and implementation of evidence-based treatments in community practice settings. The CTN’s 20 completed trials tested pharmacological, behavioral, and integrated treatment interventions for adolescents and adults; more than 11,000 individuals participated in the trials. This paper reviews the rationale for the CTN, describes the translation of its guiding principles into research endeavors, and anticipates the future evolution of clinical research within the Network. PMID:20307794

The Perioperative Surgical Home: Improving the Value and Quality of Care in Total Joint Replacement.

PubMed

Chimento, George F; Thomas, Leslie C

2017-09-01

The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH. The PSH model guides the patient throughout the pre and perioperative process and into the postoperative phase. It has been shown in multiple studies to decrease length of stay, improve functional outcomes, allow more home discharges, and lower costs. There is no increase in complications or readmission rates. The PSH pathway is a safe and effective method of providing value-based care to patients undergoing hip and knee arthroplasty.

Structure-based energetics of protein interfaces guide Foot-and-Mouth Disease virus vaccine design

PubMed Central

Scott, Katherine; Burman, Alison; Loureiro, Silvia; Ren, Jingshan; Porta, Claudine; Ginn, Helen M.; Jackson, Terry; Perez-Martin, Eva; Siebert, C. Alistair; Paul, Guntram; Huiskonen, Juha T.; Jones, Ian M.; Esnouf, Robert M.; Fry, Elizabeth E.; Maree, Francois F.; Charleston, Bryan; Stuart, David I.

2018-01-01

Summary Virus capsids are primed for disassembly yet capsid integrity is key to generating a protective immune response. Here we devise a computational method to assess relative stability of protein-protein interfaces and use it to design improved candidate vaccines for two of the least stable, but globally important, serotypes of Foot-and-Mouth Disease virus (FMDV), O and SAT2. FMDV capsids comprise identical pentameric protein subunits held together by tenuous non-covalent interactions, and are often unstable. Chemically inactivated or recombinant empty capsids, which could form the basis of future vaccines, are even less stable than live virus. We use a novel restrained molecular dynamics strategy, to rank mutations predicted to strengthen the pentamer interfaces to produce stabilized capsids. Structural analyses and stability assays confirmed the predictions, and vaccinated animals generated improved neutralising antibody responses to stabilised particles over parental viruses and wild-type capsids. PMID:26389739

NIH initiative to balance sex of animals in preclinical studies: generative questions to guide policy, implementation, and metrics

PubMed Central

2014-01-01

In May of 2014, the NIH Director together with the Director of the Office of Research on Women’s Health announced plans to take a multi-dimensional approach to address the over reliance on male cells and animals in preclinical research. The NIH is engaging the scientific community in the development of policies to improve the sex balance in research. The present, past, and future presidents of the Organization for the Study of Sex Differences, in order to encourage thoughtful discussion among scientists, pose a series of questions to generate ideas in three areas: 1. research strategies, 2. educational strategies, and 3. strategies to monitor effectiveness of policies to improve the sex balance in research. By promoting discussion within the scientific community, a consensus will evolve that will move science forward in a productive and effective manner. PMID:25780556

Scientific and social landscapes: New frameworks and forums for water management and sustainability

USGS Publications Warehouse

Turner, Christine; Karl, Herman A.

2001-01-01

The Two Decades of Water Law and Policy Reform conference examines the agenda for reforming and improving water law that has developed during the past two decades in the West, assesses what has (and has not) been accomplished by pursuing these reforms, and explores lessons and implications for future water law and policy. The papers and discussion provide analysis and lessons that can guide the new administration, Congress, federal agencies, state governments, and communities as they seek to find policy solutions to the challenges posed by the tremendous economic and demographic changes occurring in the West, in order to ensure the sustainability of the region’s unique environment. Specific sessions focus on reforms such as improving the scientific and technical basis for water management, water conservation and efficiency, protecting environmental values in meeting water demands, and creating new models of governance for water issues.

Transdisciplinary Research and Evaluation for Community Health Initiatives

PubMed Central

Harper, Gary W.; Neubauer, Leah C.; Bangi, Audrey K.; Francisco, Vincent T.

2010-01-01

Transdisciplinary research and evaluation projects provide valuable opportunities to collaborate on interventions to improve the health and well-being of individuals and communities. Given team members’ diverse backgrounds and roles or responsibilities in such projects, members’ perspectives are significant in strengthening a project’s infrastructure and improving its organizational functioning. This article presents an evaluation mechanism that allows team members to express the successes and challenges incurred throughout their involvement in a multisite transdisciplinary research project. Furthermore, their feedback is used to promote future sustainability and growth. Guided by a framework known as organizational development, the evaluative process was conducted by a neutral entity, the Quality Assurance Team. A mixed-methods approach was utilized to garner feedback and clarify how the research project goals could be achieved more effectively and efficiently. The multiple benefits gained by those involved in this evaluation and implications for utilizing transdisciplinary research and evaluation teams for health initiatives are detailed. PMID:18936267

Light and Energy Based Therapeutics for Genitourinary Syndrome of Menopause: Consensus and Controversies

PubMed Central

Tadir, Yona; Gaspar, Adrian; Lev-Sagie, Ahinoam; Alexiades, Macrene; Alinsod, Red; Bader, Alex; Calligaro, Alberto; Elias, Jorge A.; Gambaciani, Marco; Gaviria, Jorge E.; Iglesia, Cheryl B.; Selih-Martinec, Ksenija; Mwesigwa, Patricia L.; Ogrinc, Urska B.; Salvatore, Stefano; Scollo, Paolo; Zerbinati, Nicola; Nelson, John Stuart

2018-01-01

Gynecologist and plastic surgeons pioneered the application of lasers in medicine and surgery almost 5 decades ago, initially used to treat cervical and vaginal pathologies. Ever since, energy-based devices have been deployed to treat pelvic pathologies and improve fertility. Recent technological developments triggered an unprecedented wave of publications, assessing the efficacy of fractional laser, and radiofrequency on the vaginal wall in reversing natural aging processes. Studies have shown that a certain degree of thermal energy deposited on the vaginal wall stimulates proliferation of the glycogen-enriched epithelium, neovascularization, and collagen formation in the lamina propria, and improves natural lubrication and control of urination. This review aimed to review such data and to guide future research. A unique assembly of experts from around the globe, compiled and edited this manuscript based on a thorough literature review and personal experience. Lasers Surg. Med. 49:137–159, 2017. PMID:28220946

Evaluation of a Participatory Ergonomics Intervention in Small Commercial Construction Firms

PubMed Central

Dale, Ann Marie; Jaegers, Lisa; Welch, Laura; Gardner, Bethany T.; Buchholz, Bryan; Weaver, Nancy; Evanoff, Bradley A.

2017-01-01

Background Work-related musculoskeletal disorders (WMSD) among construction workers remain high. Participatory ergonomics (PE) interventions that engage workers and employers in reducing work injury risks have shown mixed results. Methods Eight-six workers from seven contractors participated in a PE program. A logic model guided the process evaluation and summative evaluation of short term and intermediate impacts and long term outcomes from surveys and field records. Results Process measures showed good delivery of training, high worker engagement, and low contractor participation. Workers’ knowledge improved and workers reported changes to work practices and tools used; contractor provision of appropriate equipment was low (33%). No changes were seen in symptoms or reported physical effort. Conclusions The PE program produced many worker-identified ergonomic solutions, but lacked needed support from contractors. Future interventions should engage higher levels of the construction organizational system to improve contractor involvement for reducing WMSD. PMID:27094450

[The history and development of computer assisted orthopaedic surgery].

PubMed

Jenny, J-Y

2006-10-01

Computer assisted orthopaedic surgery (CAOS) was developed to improve the accuracy of surgical procedures. It has improved dramatically over the last years, being transformed from an experimental, laboratory procedure into a routine procedure theoretically available to every orthopaedic surgeon. The first field of application of computer assistance was neurosurgery. After the application of computer guided spinal surgery, the navigation of total hip and knee joints became available. Currently, several applications for computer assisted surgery are available. At the beginning of navigation, a preoperative CT-scan or several fluoroscopic images were necessary. The imageless systems allow the surgeon to digitize patient anatomy at the beginning of surgery without any preoperative imaging. The future of CAOS remains unknown, but there is no doubt that its importance will grow in the next 10 years, and that this technology will probably modify the conventional practice of orthopaedic surgery.

Improved nurse-parent communication in neonatal intensive care unit: evaluation and adjustment of an implementation strategy.

PubMed

Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid

2014-12-01

To evaluate and adjust systematic implementation of guided family-centred care in a neonatal intensive care unit. Family-centred care is valued in neonatal intensive care units internationally, but innovative strategies are needed to realise the principles. Guided family-centred care was developed to facilitate person-centred communication by bridging the gap between theory and practice in family-centred care. Main mechanisms of guided family-centred care are structured dialogue, reflection and person-centred communication. Qualitative and quantitative data were used to monitor participatory implementation of a systematic approach to training and certification of nurses delivering guided family-centred care. Systematic implementation of guided family-centred care included workshops, supervised delivery and certification. Evaluation and adjustment of nurse adherence to guided family-centred care was conducted by monitoring (1) knowledge, (2) delivery, (3) practice uptake and (4) certification. Implementation was improved by the development of a strategic framework and by adjusting the framework according to the real-life context of a busy neonatal care unit. Promoting practice uptake was initially underestimated, but nurse guided family-centred care training was improved by increasing the visibility of the study in the unit, demonstrating intervention progress to the nurses and assuring a sense of ownership among nurse leaders and nonguided-family-centred-care-trained nurses. An adjusted framework for guided family-centred care implementation was successful in overcoming barriers and promoting facilitators. Insights gained from our pioneering work might help nurses in a similar context to reach their goals of improving family-centred care. © 2014 John Wiley & Sons Ltd.

Educational Planning for the Future Development of Pasco-Hernando Community College.

ERIC Educational Resources Information Center

McGuffey, C. W.; And Others

The purpose of this study was to develop a long-range educational plan for the future development and expansion of the current program and facilities of Pasco-Hernando Community College. An analysis has been made of available data and related information as a basis for the preparation of a generalized plan to guide the future development of the…

Application of the coastal generalized ecosystem model (CGEM) to assess the impacts of a potential future climate scenario on northern Gulf of Mexico hypoxia

EPA Science Inventory

Mechanistic hypoxia models for the northern Gulf of Mexico are being used to guide policy goals for Mississippi River nutrient loading reductions. However, to date, these models have not examined the effects of both nutrient loads and future climate. Here, we simulate a future c...

Reaching the Future Teachers in Your Classroom: New Directions in Pre-Service Education

NASA Astrophysics Data System (ADS)

Grier, Jennifer A.; Ruberg, L.

2006-09-01

We will present results and progress from initiatives seeking to improve the experiences of future teachers in college level science classes. A future teacher (pre-service teacher) is inspired to teach science based on personal experiences with college science classes. The most critical opportunity to make a real difference in science education in schools comes when the teachers themselves are first being educated. Given the difficulties in identifying future teachers and the wide variations in their needs, how can we best help future teachers in training? What critical thinking skills are most important for them to absorb from their exposure to science as undergraduates and graduate students? What teaching and learning experiences can we offer that will help science teachers in training confidently assess the relationship between evidence and explanations and then bring that understanding and experience effectively into their own classroom? Recent initiatives in pre-service education have identified several key strategies for improving teacher preparation at the post-secondary level: - Using a constructivist approach to teach physical science concepts and guided inquiry - Knowing common misconceptions about key scientific concepts that students bring to college-level science classrooms - Applying documented strategies for identifying and addressing student misconceptions; and - Knowing how to select and adapt curriculum materials based on common preconceptions held by students. The challenge of reaching these outcomes is complex and cannot be addressed with simple solutions. Teaching strategies that help prepare future teachers include modeling effective teaching of science, understanding the relationship between student/teacher misconceptions, designing and implementing evaluation and assessment, appropriate use of technology tools, and tapping into the existing community of learners to provide ongoing education opportunities and support as the pre-service teacher progresses. Several examples of student preconceptions and a description of the teaching strategies used to help address specific misconceptions will be provided.

Using the International Directory Network and connected information systems for research in the Earth and space sciences

NASA Technical Reports Server (NTRS)

Thieman, J. R.

1994-01-01

Many researchers are becoming aware of the International Directory Network (IDN), an interconnected federation of international directories to Earth and space science data. Are you aware, however, of the many Earth-science-relevant information systems which can be accessed automatically from the directories? After determining potentially useful data sets in various disciplines through directories such as the Global Change Master Directory, it is becoming increasingly possible to get detailed information about the correlative possibilities of these data sets through the connected guide/catalog and inventory systems. Such capabilities as data set browse, subsetting, analysis, etc. are available now and will be improving in the future.

Beyond Moore's Law: Harnessing spatial-digital disruptive technologies for Digital Earth

NASA Astrophysics Data System (ADS)

Foresman, Timothy W.

2016-11-01

Moore's law will reach its plateau by 2020. Big data, however, will continue to increase as the Internet of Things and social media converge into the new era of ‘huge data’. Disruptive technologies, including big data and cloud computing are forces impacting business and government communities. The truth of our collective future is suggested to align with the Digital Earth (DE) vision. Benefits of technological advances will be manifested from business performance improvements based on capitalizing the locational attributes of corporate and government assets - the foundation of big data. Better governance and better business represents a key foundation for sustainability and therefore should be explicit DE guiding principles.

Findings from a strength-based moderate-intensity exercise interventions for individuals with dementia (innovative practice).

PubMed

Dawson, Nicole; Gerhart, Hayden; Judge, Katherine S

2017-01-01

Limited evidence exists regarding exercise interventions with individuals with dementia, which is often due to heterogeneity of methodology and outcomes being assessed. This led to the development and evaluation of a moderate-intensity home-based functional exercise program guided by theories from exercise science and the Strength-Based Approach. Data indicated excellent treatment adherence (99.04%) along with high levels of acceptability and feasibility in this sample (age 76.63 years (9.84); Mini Mental State Exam 18.87 (6.40)). This article informs future practice by highlighting the merits of a Strength-Based Approach in research examining exercise and physical rehabilitation to improve adherence and compliance with individuals with dementia.

Robotics and artificial intelligence: Jewish ethical perspectives.

PubMed

Rappaport, Z H

2006-01-01

In 16th Century Prague, Rabbi Loew created a Golem, a humanoid made of clay, to protect his community. When the Golem became too dangerous to his surroundings, he was dismantled. This Jewish theme illustrates some of the guiding principles in its approach to the moral dilemmas inherent in future technologies, such as artificial intelligence and robotics. Man is viewed as having received the power to improve upon creation and develop technologies to achieve them, with the proviso that appropriate safeguards are taken. Ethically, not-harming is viewed as taking precedence over promoting good. Jewish ethical thinking approaches these novel technological possibilities with a cautious optimism that mankind will derive their benefits without coming to harm.

Networks to Strengthen Health Systems for Chronic Disease Prevention

PubMed Central

Riley, Barbara L.; Herbert, Carol P.; Best, Allan

2013-01-01

Interorganizational networks that harness the priorities, capacities, and skills of various agencies and individuals have emerged as useful approaches for strengthening preventive services in public health systems. We use examples from the Canadian Heart Health Initiative and Alberta’s Primary Care Networks to illustrate characteristics of networks, describe the limitations of existing frameworks for assessing the performance of prevention-oriented networks, and propose a research agenda for guiding future efforts to improve the performance of these initiatives. Prevention-specific assessment strategies that capture relevant aspects of network performance need to be identified, and feedback mechanisms are needed that make better use of these data to drive change in network activities. PMID:24028225

Application of single-cell technology in cancer research.

PubMed

Liang, Shao-Bo; Fu, Li-Wu

2017-07-01

In this review, we have outlined the application of single-cell technology in cancer research. Single-cell technology has made encouraging progress in recent years and now provides the means to detect rare cancer cells such as circulating tumor cells and cancer stem cells. We reveal how this technology has advanced the analysis of intratumor heterogeneity and tumor epigenetics, and guided individualized treatment strategies. The future prospects now are to bring single-cell technology into the clinical arena. We believe that the clinical application of single-cell technology will be beneficial in cancer diagnostics and treatment, and ultimately improve survival in cancer patients. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Simulator for multilevel optimization research

NASA Technical Reports Server (NTRS)

Padula, S. L.; Young, K. C.

1986-01-01

A computer program designed to simulate and improve multilevel optimization techniques is described. By using simple analytic functions to represent complex engineering analyses, the simulator can generate and test a large variety of multilevel decomposition strategies in a relatively short time. This type of research is an essential step toward routine optimization of large aerospace systems. The paper discusses the types of optimization problems handled by the simulator and gives input and output listings and plots for a sample problem. It also describes multilevel implementation techniques which have value beyond the present computer program. Thus, this document serves as a user's manual for the simulator and as a guide for building future multilevel optimization applications.

Nuclear-bound quarkonia and heavy-flavor hadrons

NASA Astrophysics Data System (ADS)

Krein, G.; Thomas, A. W.; Tsushima, K.

2018-05-01

In our quest to win a deeper understanding of how QCD actually works, the study of the binding of heavy quarkonia and heavy-flavor hadrons to atomic nuclei offers enormous promise. Modern experimental facilities such as FAIR, Jefferson Lab at 12 GeV and J-PARC offer exciting new experimental opportunities to study such systems. These experimental advances are complemented by new theoretical approaches and predictions, which will both guide these experimental efforts and be informed and improved by them. This review will outline the main theoretical approaches, beginning with QCD itself, summarize recent theoretical predictions and relate them both to past experiments and those from which we may expect results in the near future.

Ride quality and international standard ISO 2631 (Guide for the evaluation of human exposure to whole-body vibration)

NASA Technical Reports Server (NTRS)

Allen, G. R.

1975-01-01

The evolution of the standard, which is aimed at promoting research and production of more data, and providing some design guidance, is outlined and its contents summarized. Some of the assumptions and information on which it is based are analyzed. Its application to vehicle ride quality is considered in the context of the safety, efficiency and comfort of crew and passengers. The importance of establishing the precise criteria against which vibration limits are required is underlined, particularly the difficulties of first defining comfort and then postulating appropriate levels. Some current and future work related to improving the standard is outlined and additional suggestions offered.

IMPROVING TACONITE PROCESSING PLANT EFFICIENCY BY COMPUTER SIMULATION, Final Report

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

William M. Bond; Salih Ersayin

2007-03-30

This project involved industrial scale testing of a mineral processing simulator to improve the efficiency of a taconite processing plant, namely the Minorca mine. The Concentrator Modeling Center at the Coleraine Minerals Research Laboratory, University of Minnesota Duluth, enhanced the capabilities of available software, Usim Pac, by developing mathematical models needed for accurate simulation of taconite plants. This project provided funding for this technology to prove itself in the industrial environment. As the first step, data representing existing plant conditions were collected by sampling and sample analysis. Data were then balanced and provided a basis for assessing the efficiency ofmore » individual devices and the plant, and also for performing simulations aimed at improving plant efficiency. Performance evaluation served as a guide in developing alternative process strategies for more efficient production. A large number of computer simulations were then performed to quantify the benefits and effects of implementing these alternative schemes. Modification of makeup ball size was selected as the most feasible option for the target performance improvement. This was combined with replacement of existing hydrocyclones with more efficient ones. After plant implementation of these modifications, plant sampling surveys were carried out to validate findings of the simulation-based study. Plant data showed very good agreement with the simulated data, confirming results of simulation. After the implementation of modifications in the plant, several upstream bottlenecks became visible. Despite these bottlenecks limiting full capacity, concentrator energy improvement of 7% was obtained. Further improvements in energy efficiency are expected in the near future. The success of this project demonstrated the feasibility of a simulation-based approach. Currently, the Center provides simulation-based service to all the iron ore mining companies operating in northern Minnesota, and future proposals are pending with non-taconite mineral processing applications.« less

Strategies for Achieving Whole-Practice Engagement and Buy-in to the Patient-Centered Medical Home

PubMed Central

Bleser, William K.; Miller-Day, Michelle; Naughton, Dana; Bricker, Patricia L.; Cronholm, Peter F.; Gabbay, Robert A.

2014-01-01

PURPOSE The current model of primary care in the United States limits physicians’ ability to offer high-quality care. The patient-centered medical home (PCMH) shows promise in addressing provision of high-quality care, but achieving a PCMH practice model often requires comprehensive organizational change. Guided by Solberg’s conceptual framework for practice improvement, which argues for shared prioritization of improvement and change, we describe strategies for obtaining organizational buy-in to and whole-staff engagement of PCMH transformation and practice improvement. METHODS Semistructured interviews with 136 individuals and 7 focus groups involving 48 individuals were conducted in 20 small- to mid-sized medical practices in Pennsylvania during the first regional rollout of a statewide PCMH initiative. For this study, we analyzed interview transcripts, monthly narrative reports, and observer notes from site visits to identify discourse pertaining to organizational buy-in and strategies for securing buy-in from personnel. Using a consensual qualitative research approach, data were reduced, synthesized, and managed using qualitative data management and analysis software. RESULTS We identified 13 distinct strategies used to obtain practice buy-in, reflecting 3 overarching lessons that facilitate practice buy-in: (1) effective communication and internal PCMH campaigns, (2) effective resource utilization, and (3) creation of a team environment. CONCLUSION Our study provides a list of strategies useful for facilitating PCMH transformation in primary care. These strategies can be investigated empirically in future research, used to guide medical practices undergoing or considering PCMH transformation, and used to inform health care policy makers. Our study findings also extend Solberg’s conceptual framework for practice improvement to include buy-in as a necessary condition across all elements of the change process. PMID:24445102

Future directions in 3-dimensional imaging and neurosurgery: stereoscopy and autostereoscopy.

PubMed

Christopher, Lauren A; William, Albert; Cohen-Gadol, Aaron A

2013-01-01

Recent advances in 3-dimensional (3-D) stereoscopic imaging have enabled 3-D display technologies in the operating room. We find 2 beneficial applications for the inclusion of 3-D imaging in clinical practice. The first is the real-time 3-D display in the surgical theater, which is useful for the neurosurgeon and observers. In surgery, a 3-D display can include a cutting-edge mixed-mode graphic overlay for image-guided surgery. The second application is to improve the training of residents and observers in neurosurgical techniques. This article documents the requirements of both applications for a 3-D system in the operating room and for clinical neurosurgical training, followed by a discussion of the strengths and weaknesses of the current and emerging 3-D display technologies. An important comparison between a new autostereoscopic display without glasses and current stereo display with glasses improves our understanding of the best applications for 3-D in neurosurgery. Today's multiview autostereoscopic display has 3 major benefits: It does not require glasses for viewing; it allows multiple views; and it improves the workflow for image-guided surgery registration and overlay tasks because of its depth-rendering format and tools. Two current limitations of the autostereoscopic display are that resolution is reduced and depth can be perceived as too shallow in some cases. Higher-resolution displays will be available soon, and the algorithms for depth inference from stereo can be improved. The stereoscopic and autostereoscopic systems from microscope cameras to displays were compared by the use of recorded and live content from surgery. To the best of our knowledge, this is the first report of application of autostereoscopy in neurosurgery.

How to Co-Teach: A Guide for General and Special Educators

ERIC Educational Resources Information Center

Potts, Elizabeth A.; Howard, Lori A.

2011-01-01

What does good co-teaching look like in an inclusive classroom, and how can a general and special educator build a strong, respectful, and productive partnership? Find out in this introductory how-to guide, ideal for helping current and future co-teachers minimize conflict, maximize teamwork, and ensure the best outcomes for all students in Grades…

Sustainable Development. Teacher's Guide to World Resources. Comprehensive Coursework on the Global Environment.

ERIC Educational Resources Information Center

Snyder, Sarah A.

This teacher's guide presents teaching suggestions and presentation materials about sustainable development, important trends that could lead to human and environmental disasters in the future if they continue unchecked, and how each country has a different path to sustainable development. The lesson is divided into six parts and may be completed…

A Guide for Planning Facilities for Vocational Agriculture in Texas.

ERIC Educational Resources Information Center

Hindman, Neal; Eggenberger, Lewis

A guide to assist those concerned in planning adequate, well-designed facilities for departments of vocational agriculture that will serve their communities in the future. The program of vocational agriculture is an integral part of the total educational program of a school and considerable thought and careful study should be given to locating the…

Learning with Intangible Heritage for a Sustainable Future: Guidelines for Educators in the Asia-Pacific Region

ERIC Educational Resources Information Center

Pillai, Janet; Achilles, Vanessa

2015-01-01

The guide provides teacher educators and teachers with an understanding of the concept of intangible cultural heritage (ICH) and explains why ICH should be integrated into the curriculum in tandem with the principles and perspectives of Education for Sustainable Development (ESD). This guide explains how the strategic incorporation of ICH elements…

The Energy Films Index. An Educator's Guide to Current Energy Films.

ERIC Educational Resources Information Center

Scherner, Sharon; And Others

This guide cites and describes 241 films on energy. The categories are: general films on energy, conservation of energy, history of energy development, coal, electricity, food and energy, geothermal, natural gas, nuclear energy, oil/petroleum, oil shale, solar energy, tar sands, tidal energy, wind, impacts of energy, and future of energy. For each…

Advancing Universities: The Global City as Guide for Change

ERIC Educational Resources Information Center

Frost, Susan; Chopp, Rebecca; Pozorski, Aimee L.

2004-01-01

The paper considers the past development of the research university in the United States and argues that one way to guide future change is to embrace a new cultural model. Using Emory University as a case study, along with the more general perspectives offered through a close study of eleven other private US universities and data assimilated from…

Kids Food CyberClub. Teacher's Guide. First Edition.

ERIC Educational Resources Information Center

Belyea, Monica

This guide is designed to help teachers educate students to be healthier now and in the future. It presents fun, learner-centered activities about nutrition, food, hunger, and food sources. It offers an overview of each section of the Kids Food CyberClub web site, and classroom activities teachers can use to expand on information students will…

Dorsal Striatal-Midbrain Connectivity in Humans Predicts How Reinforcements Are Used to Guide Decisions

ERIC Educational Resources Information Center

Kahnt, Thorsten; Park, Soyoung Q.; Cohen, Michael X.; Beck, Anne; Heinz, Andreas; Wrase, Jana

2009-01-01

It has been suggested that the target areas of dopaminergic midbrain neurons, the dorsal (DS) and ventral striatum (VS), are differently involved in reinforcement learning especially as actor and critic. Whereas the critic learns to predict rewards, the actor maintains action values to guide future decisions. The different midbrain connections to…

21st Century Skills, Education & Competitiveness: A Resource and Policy Guide

ERIC Educational Resources Information Center

Partnership for 21st Century Skills, 2008

2008-01-01

Americans are deeply concerned about their present and future prospects in a time of economic uncertainty. Policymakers have a make-or-break opening--and an obligation--to chart a new path for public education that will secure the nation's economic competitiveness. This guide summarizes the challenges and opportunities that, if left unaddressed,…

Rise to the Challenge: A Business Guide to Creating a Workforce Investment System That Makes Sense.

ERIC Educational Resources Information Center

2000

This document explains how employers can participate in creating a new workforce investment system that is market driven, comprehensive, portable, accountable, customer focused, responsive, flexible, and customized. The guide details immediate and future steps employers can take at the state and local levels to influence the process of creating a…

Forest pest management in a changing world

Treesearch

Andrew M. Liebhold

2012-01-01

The scope, context and science guiding forest pest management have evolved and are likely to continue changing into the future. Here, I present six areas of advice to guide practitioners in the implementation of forest pest management. First, human dimensions will continue to play a key role in most pest problems and should always be a primary consideration in...

Retailing. Instructor's Guide Sheets and Instructor's Package, Modules R 1-45. Competency-Based Education.

ERIC Educational Resources Information Center

Kentucky State Dept. of Education, Frankfort.

This package contains instructor's guide sheets and student task assignment sheets for Modules R 1-45 of the competency-based curriculum in retailing developed for use in secondary and postsecondary schools in Kentucky. Some of the topics covered in the modules include the following: retailing--past, present, and future; retailing occupations;…

Car Trouble. Teacher's Guide to World Resources. Comprehensive Coursework on the Global Environment.

ERIC Educational Resources Information Center

Snyder, Sarah A.

This teacher's guide presents teaching suggestions and presentation materials on the hidden environmental costs of driving automobiles through examining the history of the automobile and looking to the future for alternatives. The lesson is divided into six parts and may be completed in four or more class periods. Student handouts include: (1)…

The Energy Future Today: Grades 7, 8, 9, Social Studies.

ERIC Educational Resources Information Center

National Science Teachers Association, Washington, DC.

This teacher's guide contains a unit of study for teaching about energy in grades seven, eight, and nine. The guide is self-contained and includes the handouts students need to work out the activity problems. The unit is developed around the concepts of shortage, scarcity, tradeoffs, investment, and decision making. Students develop these concepts…

Measurement of historical cliff-top changes and estimation of future trends using GIS data between Bridlington and Hornsea - Holderness Coast (UK)

NASA Astrophysics Data System (ADS)

Castedo, Ricardo; de la Vega-Panizo, Rogelio; Fernández-Hernández, Marta; Paredes, Carlos

2015-02-01

A key requirement for effective coastal zone management is good knowledge of historical rates of change and the ability to predict future shoreline evolution, especially for rapidly eroding areas. Historical shoreline recession analysis was used for the prediction of future cliff shoreline positions along a section of 9 km between Bridlington and Hornsea, on the northern area of the Holderness Coast, UK. The analysis was based on historical maps and aerial photographs dating from 1852 to 2011 using the Digital Shoreline Analysis System (DSAS) 4.3, extension of ESRI's ArcInfo 10.×. The prediction of future shorelines was performed for the next 40 years using a variety of techniques, ranging from extrapolation from historical data, geometric approaches like the historical trend analysis, to a process-response numerical model that incorporates physically-based equations and geotechnical stability analysis. With climate change and sea-level rise implying that historical rates of change may not be a reliable guide for the future, enhanced visualization of the evolving coastline has the potential to improve awareness of these changing conditions. Following the IPCC, 2013 report, two sea-level rise rates, 2 mm/yr and 6 mm/yr, have been used to estimate future shoreline conditions. This study illustrated that good predictive models, once their limitations are estimated or at least defined, are available for use by managers, planners, engineers, scientists and the public to make better decisions regarding coastal management, development, and erosion-control strategies.

Unifying theory for terrestrial research infrastructures

NASA Astrophysics Data System (ADS)

Mirtl, Michael

2016-04-01

The presentation will elaborate on basic steps needed for building a common theoretical base between Research Infrastructures focusing on terrestrial ecosystems. This theoretical base is needed for developing a better cooperation and integrating in the near future. An overview of different theories will be given and ways to a unifying approach explored. In the second step more practical implications of a theory-guided integration will be developed alongside the following guiding questions: • How do the existing and planned European environmental RIs map on a possible unifying theory on terrestrial ecosystems (covered structures and functions, scale; overlaps and gaps) • Can a unifying theory improve the consistent definition of RÍs scientific scope and focal science questions? • How could a division of tasks between RIs be organized in order to minimize parallel efforts? • Where concretely do existing and planned European environmental RIs need to interact to respond to overarching questions (top down component)? • What practical fora and mechanisms (across RIs) would be needed to bridge the gap between PI driven (bottom up) efforts and the centralistic RI design and operations?

Assessment of the Reconstructed Aerodynamics of the Mars Science Laboratory Entry Vehicle

NASA Technical Reports Server (NTRS)

Schoenenberger, Mark; Van Norman, John W.; Dyakonov, Artem A.; Karlgaard, Christopher D.; Way, David W.; Kutty, Prasad

2013-01-01

On August 5, 2012, the Mars Science Laboratory entry vehicle successfully entered Mars atmosphere, flying a guided entry until parachute deploy. The Curiosity rover landed safely in Gale crater upon completion of the Entry Descent and Landing sequence. This paper compares the aerodynamics of the entry capsule extracted from onboard flight data, including Inertial Measurement Unit (IMU) accelerometer and rate gyro information, and heatshield surface pressure measurements. From the onboard data, static force and moment data has been extracted. This data is compared to preflight predictions. The information collected by MSL represents the most complete set of information collected during Mars entry to date. It allows the separation of aerodynamic performance from atmospheric conditions. The comparisons show the MSL aerodynamic characteristics have been identified and resolved to an accuracy better than the aerodynamic database uncertainties used in preflight simulations. A number of small anomalies have been identified and are discussed. This data will help revise aerodynamic databases for future missions and will guide computational fluid dynamics (CFD) development to improved prediction codes.

Precision Medicine for Tobacco Dependence: Development and Validation of the Nicotine Metabolite Ratio.

PubMed

Allenby, Cheyenne E; Boylan, Kelly A; Lerman, Caryn; Falcone, Mary

2016-09-01

Quitting smoking significantly reduces the risk of tobacco-related morbidity and mortality, yet there is a high rate of relapse amongst smokers who try to quit. Phenotypic biomarkers have the potential to improve smoking cessation outcomes by identifying the best available treatment for an individual smoker. In this review, we introduce the nicotine metabolite ratio (NMR) as a reliable and stable phenotypic measure of nicotine metabolism that can guide smoking cessation treatment among smokers who wish to quit. We address how the NMR accounts for sources of variation in nicotine metabolism including genotype and other biological and environmental factors such as estrogen levels, alcohol use, body mass index, or menthol exposure. Then, we highlight clinical trials that validate the NMR as a biomarker to predict therapeutic response to different pharmacotherapies for smoking cessation. Current evidence supports the use of nicotine replacement therapy for slow metabolizers, and non-nicotine treatments such as varenicline for normal metabolizers. Finally, we discuss future research directions to elucidate mechanisms underlying NMR associations with treatment response, and facilitate the implementation of the NMR as biomarker in clinical practice to guide smoking cessation.

Recent advances in near-infrared fluorescence-guided imaging surgery using indocyanine green.

PubMed

Namikawa, Tsutomu; Sato, Takayuki; Hanazaki, Kazuhiro

2015-12-01

Near-infrared (NIR) fluorescence imaging has better tissue penetration, allowing for the effective rejection of excitation light and detection deep inside organs. Indocyanine green (ICG) generates NIR fluorescence after illumination by an NIR ray, enabling real-time intraoperative visualization of superficial lymphatic channels and vessels transcutaneously. The HyperEye Medical System (HEMS) can simultaneously detect NIR rays under room light to provide color imaging, which enables visualization under bright light. Thus, NIR fluorescence imaging using ICG can provide for excellent diagnostic accuracy in detecting sentinel lymph nodes in cancer and microvascular circulation in various ischemic diseases, to assist us with intraoperative decision making. Including HEMS in this system could further improve the sentinel lymph node mapping and intraoperative identification of blood supply in reconstructive organs and ischemic diseases, making it more attractive than conventional imaging. Moreover, the development of new laparoscopic imaging systems equipped with NIR will allow fluorescence-guided surgery in a minimally invasive setting. Future directions, including the conjugation of NIR fluorophores to target specific cancer markers might be realistic technology with diagnostic and therapeutic benefits.

The Contextualized Technology Adaptation Process (CTAP): Optimizing Health Information Technology to Improve Mental Health Systems.

PubMed

Lyon, Aaron R; Wasse, Jessica Knaster; Ludwig, Kristy; Zachry, Mark; Bruns, Eric J; Unützer, Jürgen; McCauley, Elizabeth

2016-05-01

Health information technologies have become a central fixture in the mental healthcare landscape, but few frameworks exist to guide their adaptation to novel settings. This paper introduces the contextualized technology adaptation process (CTAP) and presents data collected during Phase 1 of its application to measurement feedback system development in school mental health. The CTAP is built on models of human-centered design and implementation science and incorporates repeated mixed methods assessments to guide the design of technologies to ensure high compatibility with a destination setting. CTAP phases include: (1) Contextual evaluation, (2) Evaluation of the unadapted technology, (3) Trialing and evaluation of the adapted technology, (4) Refinement and larger-scale implementation, and (5) Sustainment through ongoing evaluation and system revision. Qualitative findings from school-based practitioner focus groups are presented, which provided information for CTAP Phase 1, contextual evaluation, surrounding education sector clinicians' workflows, types of technologies currently available, and influences on technology use. Discussion focuses on how findings will inform subsequent CTAP phases, as well as their implications for future technology adaptation across content domains and service sectors.

Integrated Tokamak modeling: When physics informs engineering and research planning

NASA Astrophysics Data System (ADS)

Poli, Francesca Maria

2018-05-01

Modeling tokamaks enables a deeper understanding of how to run and control our experiments and how to design stable and reliable reactors. We model tokamaks to understand the nonlinear dynamics of plasmas embedded in magnetic fields and contained by finite size, conducting structures, and the interplay between turbulence, magneto-hydrodynamic instabilities, and wave propagation. This tutorial guides through the components of a tokamak simulator, highlighting how high-fidelity simulations can guide the development of reduced models that can be used to understand how the dynamics at a small scale and short time scales affects macroscopic transport and global stability of plasmas. It discusses the important role that reduced models have in the modeling of an entire plasma discharge from startup to termination, the limits of these models, and how they can be improved. It discusses the important role that efficient workflows have in the coupling between codes, in the validation of models against experiments and in the verification of theoretical models. Finally, it reviews the status of integrated modeling and addresses the gaps and needs towards predictions of future devices and fusion reactors.

Integrated Tokamak modeling: When physics informs engineering and research planning

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

Poli, Francesca Maria

Modeling tokamaks enables a deeper understanding of how to run and control our experiments and how to design stable and reliable reactors. We model tokamaks to understand the nonlinear dynamics of plasmas embedded in magnetic fields and contained by finite size, conducting structures, and the interplay between turbulence, magneto-hydrodynamic instabilities, and wave propagation. This tutorial guides through the components of a tokamak simulator, highlighting how high-fidelity simulations can guide the development of reduced models that can be used to understand how the dynamics at a small scale and short time scales affects macroscopic transport and global stability of plasmas. Itmore » discusses the important role that reduced models have in the modeling of an entire plasma discharge from startup to termination, the limits of these models, and how they can be improved. It discusses the important role that efficient workflows have in the coupling between codes, in the validation of models against experiments and in the verification of theoretical models. Finally, it reviews the status of integrated modeling and addresses the gaps and needs towards predictions of future devices and fusion reactors.« less

Providing Culturally Competent Care for LGBTQ Youth in School-Based Health Centers: A Needs Assessment to Guide Quality of Care Improvements.

PubMed

Garbers, Samantha; Heck, Craig J; Gold, Melanie A; Santelli, John S; Bersamin, Melina

2017-01-01

School-based health centers (SBHCs) can take specific steps to provide culturally competent care for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, potentially impacting well-being. A needs assessment survey was conducted among a convenience sample of SBHC administrators and medical directors to assess climates and actions supportive of LGBTQ quality medical care. Half (53%) of the SBHCs surveyed ( N = 66) reviewed print materials for negative LGBTQ stereotypes, and 27.3% conducted exhaustive materials review. Regional differences were detected: 46.2% of Southern SBHCs conducted any materials review compared to 91.3% in the West and all in the East and Midwest (χ 2 , p < .001). In the last academic year, 45.5% conducted no medical provider trainings, and 54.5% conducted no general staff trainings on providing care for LGBTQ youth. On intake forms, 85.4% included preferred names, but only 23.5% included preferred pronoun. There are significant gaps in the extent to which SBHCs provide culturally competent care. These findings can guide future training and advocacy.

Utilizing Structures of CYP2D6 and BACE1 Complexes To Reduce Risk of Drug–Drug Interactions with a Novel Series of Centrally Efficacious BACE1 Inhibitors

PubMed Central

2016-01-01

In recent years, the first generation of β-secretase (BACE1) inhibitors advanced into clinical development for the treatment of Alzheimer’s disease (AD). However, the alignment of drug-like properties and selectivity remains a major challenge. Herein, we describe the discovery of a novel class of potent, low clearance, CNS penetrant BACE1 inhibitors represented by thioamidine 5. Further profiling suggested that a high fraction of the metabolism (>95%) was due to CYP2D6, increasing the potential risk for victim-based drug–drug interactions (DDI) and variable exposure in the clinic due to the polymorphic nature of this enzyme. To guide future design, we solved crystal structures of CYP2D6 complexes with substrate 5 and its corresponding metabolic product pyrazole 6, which provided insight into the binding mode and movements between substrate/inhibitor complexes. Guided by the BACE1 and CYP2D6 crystal structures, we designed and synthesized analogues with reduced risk for DDI, central efficacy, and improved hERG therapeutic margins. PMID:25781223

Wearable ultrasonic guiding device with white cane for the visually impaired: A preliminary verisimilitude experiment.

PubMed

Cheng, Po-Hsun

2016-01-01

Several assistive technologies are available to help visually impaired individuals avoid obstructions while walking. Unfortunately, white canes and medical walkers are unable to detect obstacles on the road or react to encumbrances located above the waist. In this study, I adopted the cyber-physical system approach in the development of a cap-connected device to compensate for gaps in detection associated with conventional aids for the visually impaired. I developed a verisimilar, experimental route involving the participation of seven individuals with visual impairment, including straight sections, left turns, right turns, curves, and suspended objects. My aim was to facilitate the collection of information required for the practical use of the device. My findings demonstrate the feasibility of the proposed guiding device in alerting walkers to the presence of some kinds of obstacles from the small number of subjects. That is, it shows promise for future work and research with the proposed device. My findings provide a valuable reference for the further improvement of these devices as well as the establishment of experiments involving the visually impaired.

Integrated Tokamak modeling: When physics informs engineering and research planning

DOE PAGES

Poli, Francesca Maria

2018-05-01

Modeling tokamaks enables a deeper understanding of how to run and control our experiments and how to design stable and reliable reactors. We model tokamaks to understand the nonlinear dynamics of plasmas embedded in magnetic fields and contained by finite size, conducting structures, and the interplay between turbulence, magneto-hydrodynamic instabilities, and wave propagation. This tutorial guides through the components of a tokamak simulator, highlighting how high-fidelity simulations can guide the development of reduced models that can be used to understand how the dynamics at a small scale and short time scales affects macroscopic transport and global stability of plasmas. Itmore » discusses the important role that reduced models have in the modeling of an entire plasma discharge from startup to termination, the limits of these models, and how they can be improved. It discusses the important role that efficient workflows have in the coupling between codes, in the validation of models against experiments and in the verification of theoretical models. Finally, it reviews the status of integrated modeling and addresses the gaps and needs towards predictions of future devices and fusion reactors.« less

Development and evaluation of the See Me Smoke-Free multi-behavioral mHealth app for women smokers.

PubMed

Gordon, Judith S; Armin, Julie; D Hingle, Melanie; Giacobbi, Peter; Cunningham, James K; Johnson, Thienne; Abbate, Kristopher; Howe, Carol L; Roe, Denise J

2017-06-01

Women face particular challenges when quitting smoking, especially those with weight concerns. A multi-behavioral smoking cessation intervention addressing these concerns and incorporating guided imagery may assist women to engage in healthy lifestyle behaviors. An mHealth app can easily disseminate such an intervention. The goals of this pilot study were to develop and test the feasibility and potential of the See Me Smoke-Free ™ mHealth app to address smoking, diet, and physical activity among women smokers. We used pragmatic, direct-to-consumer methods to develop and test program content, functionality, and the user interface and conduct a pre-/post-test, 90-day pilot study. We enrolled 151 participants. Attrition was 52%, leaving 73 participants. At 90 days, 47% of participants reported 7-day abstinence and significant increases in physical activity and fruit consumption. Recruitment methods worked well, but similar to other mHealth studies, we experienced high attrition. This study suggests that a guided imagery mHealth app has the potential to address multiple behaviors. Future research should consider different methods to improve retention and assess efficacy.

Nanotopography-guided tissue engineering and regenerative medicine☆

PubMed Central

Kim, Hong Nam; Jiao, Alex; Hwang, Nathaniel S.; Kim, Min Sung; Kang, Do Hyun; Kim, Deok-Ho; Suh, Kahp-Yang

2017-01-01

Human tissues are intricate ensembles of multiple cell types embedded in complex and well-defined structures of the extracellular matrix (ECM). The organization of ECM is frequently hierarchical from nano to macro, with many proteins forming large scale structures with feature sizes up to several hundred microns. Inspired from these natural designs of ECM, nanotopography-guided approaches have been increasingly investigated for the last several decades. Results demonstrate that the nanotopography itself can activate tissue-specific function in vitro as well as promote tissue regeneration in vivo upon transplantation. In this review, we provide an extensive analysis of recent efforts to mimic functional nanostructures in vitro for improved tissue engineering and regeneration of injured and damaged tissues. We first characterize the role of various nanostructures in human tissues with respect to each tissue-specific function. Then, we describe various fabrication methods in terms of patterning principles and material characteristics. Finally, we summarize the applications of nanotopography to various tissues, which are classified into four types depending on their functions: protective, mechano-sensitive, electro-active, and shear stress-sensitive tissues. Some limitations and future challenges are briefly discussed at the end. PMID:22921841

Application of CRISPR/Cas9 genome editing to the study and treatment of disease.

PubMed

Pellagatti, Andrea; Dolatshad, Hamid; Valletta, Simona; Boultwood, Jacqueline

2015-07-01

CRISPR/Cas is a microbial adaptive immune system that uses RNA-guided nucleases to cleave foreign genetic elements. The CRISPR/Cas9 method has been engineered from the type II prokaryotic CRISPR system and uses a single-guide RNA to target the Cas9 nuclease to a specific genomic sequence. Cas9 induces double-stranded DNA breaks which are repaired either by imperfect non-homologous end joining to generate insertions or deletions (indels) or, if a repair template is provided, by homology-directed repair. Due to its specificity, simplicity and versatility, the CRISPR/Cas9 system has recently emerged as a powerful tool for genome engineering in various species. This technology can be used to investigate the function of a gene of interest or to correct gene mutations in cells via genome editing, paving the way for future gene therapy approaches. Improvements to the efficiency of CRISPR repair, in particular to increase the rate of gene correction and to reduce undesired off-target effects, and the development of more effective delivery methods will be required for its broad therapeutic application.

Populations, Teacher's Guide.

ERIC Educational Resources Information Center

Conard, David; Lawson, Chester A.

This Teacher's Guide is designed for use with the Science Curriculum Improvement Study's (SCIS) unit Population. Populations is the third of a six-unit sequence of SCIS's Life Science Program for grades K-6. The Populations guide consists of activity outlines along with suggestions for guiding children's observation and manipulations of living…

EHealth: self-management in inflammatory bowel disease and in irritable bowel syndrome using novel constant-care web applications. EHealth by constant-care in IBD and IBS.

PubMed

Pedersen, Natalia

2015-12-01

Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are chronic gastrointestinal disorders of unknown aetiology of increasing incidence and changing disease activity or severity. Approximately 60-80% of IBD patients suffer from IBS. Monitoring and treatment goals of IBD are to optimise the disease course by prolonging remission periods and preventing or shortening periods of active disease. Constant-care web-monitoring and treatment approaches with active patient involvement have been proven effective in UC, increasing patients' adherence and improving the disease outcomes.   To assess the feasibility and efficacy of the novel constant-care eHealth applications in: i) CD patients treated with infliximab (IFX), ii) UC patients with active disease on mesalazine, iii) IBS patients and iv) IBD patients with IBS on a low FODMAP diet (LFD).   New constant-care web applications www.cd.constant-care.dk, www.meza.constant-care.dk and www.ibs.constant-care.dk in IBD patients were developed and assessed in this thesis. An integrated inflammatory burden measure of disease activity, consisting of a subjective (clinical indices) and of an objective (faecal calprotectin) part and a treatment guide to drug doses and intervals, was incorporated into the web applications and used by patients. Web-guided IFX treatment in CD demonstrated patients' inter- and intra-individual variability in infusion intervals and provided patients with individualised treatment according to their needs. Web-guided treatment with multimatrix mesalazine was efficacious in a majority of UC patients with mild-to-moderate disease activity. Web-guided IBS-monitoring in IBD and in IBS patients on LFD was shown to be a feasible method that actively involved patients in their disease management and had a positive short-term impact on the disease. Moreover, the new constant-care concepts were demonstrated to be safe and to have a positive impact on quality of life and adherence to treatment and helped to reduce the costs.   The novel constant-care web applications have proven feasible in improving the disease outcomes in CD patients on IFX, in UC patients on mesalazine, and in monitoring IBS. These applications are expected to be implemented in the clinical practice of gastroenterology in Denmark in the coming years. Future studies will help to assess whether the natural disease course can be improved in the long-term.

Overhead guide sign retroreflectivity and illumination.

DOT National Transportation Integrated Search

2015-01-01

Roadway guide sign visibility during darkness is fundamental to driver safety, especially elderly drivers. Guide : sign visibility can be improved by external sign illumination or the use of retroreflective sheeting on signs. Because : energy conserv...

The role of motivation in family-based guided self-help treatment for pediatric obesity.

PubMed

Accurso, Erin C; Norman, Gregory J; Crow, Scott J; Rock, Cheryl L; Boutelle, Kerri N

2014-10-01

Identifying factors associated with effective treatment for childhood obesity is important to improving weight loss outcomes. The current study investigated whether child or parent motivation throughout the course of treatment predicted reductions in BMI. Fifty 8- to 12-year-old children with overweight and obesity (BMI percentiles 85-98%) and their parents participated in a guided self-help weight loss program, which included 12 brief sessions across 5 months. Parents and interventionists reported on child and parent motivation level at each session. Multilevel slopes-as-outcome models were used to examine growth trajectories for both child and parent BMI across sessions. Greater interventionist-rated child motivation predicted greater reductions in child BMI; parent motivation did not. However, interventionist-rated parent motivation predicted greater reductions in parent BMI, and its impact on BMI became more pronounced over the course of treatment, such that sustained motivation was more important than initial motivation. Children who were older, Latino, or who had lower initial BMIs had slower reductions in BMI. This study suggests that motivation may be an important predictor of reduced BMI in child obesity treatment, with sustained motivation being more important than initial motivation. In particular, interventionist-rated, but not parent-rated, motivation is a robust predictor of child and parent BMI outcomes. Future research may evaluate whether motivational interventions can enhance outcome, with particular attention to improving outcomes for Latino children.

MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes.

PubMed

Fasano, Alfonso; Llinas, Maheleth; Munhoz, Renato P; Hlasny, Eugen; Kucharczyk, Walter; Lozano, Andres M

2017-08-22

To report the 6-month single-blinded results of unilateral thalamotomy with MRI-guided focused ultrasound (MRgFUS) in patients with tremors other than essential tremor. Three patients with tremor due to Parkinson disease, 2 with dystonic tremor in the context of cervicobrachial dystonia and writer's cramp, and 1 with dystonia gene-associated tremor underwent MRgFUS targeting the ventro-intermedius nucleus (Vim) of the dominant hemisphere. The primary endpoint was the reduction of lateralized items of the Tremor Rating Scale of contralateral hemibody assessed by a blinded rater. All patients achieved a statistically significant, immediate, and sustained improvement of the contralateral tremor score by 42.2%, 52.0%, 55.9%, and 52.9% at 1 week and 1, 3, and 6 months after the procedure, respectively. All patients experienced transient side effects and 2 patients experienced persistent side effects at the time of last evaluation: hemitongue numbness and hemiparesis with hemihypoesthesia. Vim MRgFUS is a promising, incision-free, but nevertheless invasive technique to effectively treat tremors other than essential tremor. Future studies on larger samples and longer follow-up will further define its effectiveness and safety. NCT02252380. This study provides Class IV evidence that for patients with tremor not caused by essential tremor, MRgFUS of the Vim improves the tremor of the contralateral hemibody at 6 months. © 2017 American Academy of Neurology.

Improving Translation from Preclinical Studies to Clinical Trials in Acute Kidney Injury.

PubMed

Fiorentino, Marco; Kellum, John A

2018-05-23

Several cellular and molecular targets and mechanisms have been investigated in preclinical studies of acute kidney injury (AKI), but translation in successful clinical studies has failed to date. This article reviews many issues that have limited this and the potential future perspectives in AKI prevention and treatment. Preclinical models of AKI should closely mimic the complexity of human AKI, considering the importance of several comorbidities in determining the clinical course and outcomes in the human disease. Moreover, studies should test novel interventions in models where AKI is already established, instead of focusing only at primary prevention. AKI definitions and endpoints in animal studies should be similar to those applied in clinical studies; in particular, AKI biomarkers should be implemented to guide patient selection for clinical trials and monitor intervention efficacy. In this scenario, cell-cycle arrest biomarkers have been widely investigated as AKI predictors in both preclinical and clinical studies and they serve as useful tools for future interventional studies. A better understanding of human AKI through a large collection of biological samples and kidney biopsies and omics applications, and an iterative relationship between preclinical and clinical studies are critical steps to improve future preclinical models and clinical trials. Finally, given the great variability in clinical manifestation of AKI, a strong collaboration between research centers and industry is recommended. Key messages: Several methodological issues have hampered the translation of basic research findings in clinical studies, and overcoming these obstacles is necessary to achieve success. © 2018 S. Karger AG, Basel.

Using Reading Guides and On-Line Quizzes to Improve Reading Compliance and Quiz Scores

ERIC Educational Resources Information Center

Maurer, Trent W.; Longfield, Judith

2015-01-01

This study compared students' daily in-class reading quiz scores in an introductory Child Development course across five conditions: control, reading guide only, reading guide and on-line practice quiz, reading guide and on-line graded quiz, and reading guide and both types of on-line quizzes. At the beginning of class, students completed a 5-item…

Are Genetic Tests for Atherosclerosis Ready for Routine Clinical Use?

PubMed

Paynter, Nina P; Ridker, Paul M; Chasman, Daniel I

2016-02-19

In this review, we lay out 3 areas currently being evaluated for incorporation of genetic information into clinical practice related to atherosclerosis. The first, familial hypercholesterolemia, is the clearest case for utility of genetic testing in diagnosis and potentially guiding treatment. Already in use for confirmatory testing of familial hypercholesterolemia and for cascade screening of relatives, genetic testing is likely to expand to help establish diagnoses and facilitate research related to most effective therapies, including new agents, such as PCSK9 inhibitors. The second area, adding genetic information to cardiovascular risk prediction for primary prevention, is not currently recommended. Although identification of additional variants may add substantially to prediction in the future, combining known variants has not yet demonstrated sufficient improvement in prediction for incorporation into commonly used risk scores. The third area, pharmacogenetics, has utility for some therapies today. Future utility for pharmacogenetics will wax or wane depending on the nature of available drugs and therapeutic strategies. © 2016 American Heart Association, Inc.

PIP-II Transfer Line Design

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

Vivoli, A.

The U.S. Particle Physics Project Prioritization Panel (P5) report encouraged the realization of Fermilab's Proton Improvement Plan II (PIP-II) to support future neutrino programs in the United States. PIP-II aims at enhancing the capabilities of the Fermilab existing accelerator complex while simultaneously providing a flexible platform for its future upgrades. The central part of PIP-II project is the construction of a new 800 MeV H- Superconducting (SC) Linac together with upgrades of the Booster and Main Injector synchrotrons. New transfer lines will also be needed to deliver beam to the down-stream accelerators and facilities. In this paper we present themore » recent development of the design of the transfer lines discussing the principles that guided their design, the constraints and requirements imposed by the existing accelerator complex and the following modifications implemented to comply with a better understanding of the limitations and further requirements that emerged during the development of the project.« less

Rehabilitation Practitioners' Prioritized Care Processes in Hip Fracture Post-Acute Care

PubMed Central

Kim, Lauren H.; Leland, Natalie E.

2017-01-01

Aims Occupational and physical therapy in post-acute care (PAC) has reached the point where quality indicators for hip fracture are needed. This study characterizes the practitioners' prioritized hip fracture rehabilitation practices, which can guide future quality improvement initiatives. Methods Ninety-two practitioners participating in a parent mixed methods study were asked to rank a series of evidence-based best practices across five clinical domains (assessment, intervention, discharge planning, caregiver training and patient education). Results Prioritized practices reflected patient-practitioner collaboration, facilitating an effective discharge, and preventing adverse events. The highest endorsed care processes include: developing meaningful goals with patient input (84%) in assessment, using assistive devices in intervention (75%) and patient education (65%), engaging the patient and caregiver (50%) in discharge planning, and fall prevention (60%) in caregiver education. Conclusions Practitioners identified key care priorities. This study lays the foundation for future work evaluating the extent to which these practices are delivered in PAC. PMID:28989216

CABINS: Case-based interactive scheduler

NASA Technical Reports Server (NTRS)

Miyashita, Kazuo; Sycara, Katia

1992-01-01

In this paper we discuss the need for interactive factory schedule repair and improvement, and we identify case-based reasoning (CBR) as an appropriate methodology. Case-based reasoning is the problem solving paradigm that relies on a memory for past problem solving experiences (cases) to guide current problem solving. Cases similar to the current case are retrieved from the case memory, and similarities and differences of the current case to past cases are identified. Then a best case is selected, and its repair plan is adapted to fit the current problem description. If a repair solution fails, an explanation for the failure is stored along with the case in memory, so that the user can avoid repeating similar failures in the future. So far we have identified a number of repair strategies and tactics for factory scheduling and have implemented a part of our approach in a prototype system, called CABINS. As a future work, we are going to scale up CABINS to evaluate its usefulness in a real manufacturing environment.

West Virginia Interpretive Guide Training: A Collaborative Effort

ERIC Educational Resources Information Center

Balcarczyk, Kelly; McKenney, Kathryn; Smaldone, Dave; Arborgast, Doug

2013-01-01

West Virginia University's Extension Service partnered with the Recreation, Parks, and Tourism Resources Program to improve guide performance in West Virginia's tourism industry. The result of this partnership is a West Virginia Interpretive Guide Training program aimed at providing low-cost, widely available training to guides throughout the…

New Jersey Industrial Arts Education Safety Guide.

ERIC Educational Resources Information Center

Kobylarz, Joseph D.; Olender, Francis B.

This guide was developed to assist the teacher in planning, implementing, revising, or improving safety instruction in industrial arts classes in New Jersey, and has as its theme, "Safety Is Everyone's Responsibility." The guide is organized in seven major sections. The first section explains the purpose of the guide, outlines the…

Future Educators' Explaining Voices

ERIC Educational Resources Information Center

de Oliveira, Janaina Minelli; Caballero, Pablo Buenestado; Camacho, Mar

2013-01-01

Teacher education programs must offer pre-service students innovative technology-supported learning environments, guiding them in the revision of their preconceptions on literacy and technology. This present paper presents a case study that uses podcast to inquiry into future educators' views on technology and the digital age. Results show future…

7 CFR 1710.300 - General.

Code of Federal Regulations, 2014 CFR

2014-01-01

... board of directors and the manager to guide the system towards its financial goals. (b) A borrower must... in support of a loan application shall include: (1) The projected results of future actions planned... DSC; (5) Current and projected cash flows; (6) Projections of future borrowings and the associated...

7 CFR 1710.300 - General.

Code of Federal Regulations, 2012 CFR

2012-01-01

... forecast. The forecast should be used by the board of directors and the manager to guide the system towards... projected results of future actions planned by the borrower's board of directors; (2) The financial goals... type of large power loads, projections of future borrowings and the associated interest, projected...

7 CFR 1710.300 - General.

Code of Federal Regulations, 2013 CFR

2013-01-01

... forecast. The forecast should be used by the board of directors and the manager to guide the system towards... projected results of future actions planned by the borrower's board of directors; (2) The financial goals... type of large power loads, projections of future borrowings and the associated interest, projected...

Training Cambodian Village Health Support Guides in Diabetes Prevention: Effects on Guides' Knowledge and Teaching Activities Over 6 Months.

PubMed

Wagner, Julie; Keuky, Lim; Fraser-King, Lorraine; Kuoch, Theanvy; Scully, Mary

2016-04-01

Type 2 diabetes is a pressing public health concern in Cambodia, a country with limited human resource capacity due to genocide. Cambodian village health support guides (Guides) promote health at the local level. This paper reports preliminary results of training Guides in diabetes prevention. The curriculum, called Eat, Walk, Sleep was delivered to Guides in Siem Reap province once over 3 h. Participants completed a pretest and posttest on diabetes knowledge. Guides were offered continuing education through Eat, Walk, Sleep resources and were encouraged to teach Eat, Walk, Sleep in their villages. For each of 6 months following their training, Guides completed a checklist regarding their activities. One hundred eighty-five Guides attended one of ten trainings. Knowledge scores increased significantly from pretest to posttest. During 6 months of follow-up, n = 159 Guides (85 %) completed at least one monthly checklist. Guides reported high rates of uptake and delivery of the Eat, Walk, Sleep curriculum and moderate rates of continuing education about diabetes. Diabetes prevention in Cambodia is nascent. Guides show excellent uptake and dissemination of the curriculum. Future research should examine effect of support for Guide activities and the effect of the curriculum on villager health behaviors, and ultimately, on rates of type 2 diabetes.

CRISPR/Cas9-mediated gene knockout is insensitive to target copy number but is dependent on guide RNA potency and Cas9/sgRNA threshold expression level

PubMed Central

Yuen, Garmen; Khan, Fehad J.; Gao, Shaojian; Stommel, Jayne M.; Batchelor, Eric; Wu, Xiaolin

2017-01-01

Abstract CRISPR/Cas9 is a powerful gene editing tool for gene knockout studies and functional genomic screens. Successful implementation of CRISPR often requires Cas9 to elicit efficient target knockout in a population of cells. In this study, we investigated the role of several key factors, including variation in target copy number, inherent potency of sgRNA guides, and expression level of Cas9 and sgRNA, in determining CRISPR knockout efficiency. Using isogenic, clonal cell lines with variable copy numbers of an EGFP transgene, we discovered that CRISPR knockout is relatively insensitive to target copy number, but is highly dependent on the potency of the sgRNA guide sequence. Kinetic analysis revealed that most target mutation occurs between 5 and 10 days following Cas9/sgRNA transduction, while sgRNAs with different potencies differ by their knockout time course and by their terminal-phase knockout efficiency. We showed that prolonged, low level expression of Cas9 and sgRNA often fails to elicit target mutation, particularly if the potency of the sgRNA is also low. Our findings provide new insights into the behavior of CRISPR/Cas9 in mammalian cells that could be used for future improvement of this platform. PMID:29036671

CRISPR/Cas9-mediated gene knockout is insensitive to target copy number but is dependent on guide RNA potency and Cas9/sgRNA threshold expression level.

PubMed

Yuen, Garmen; Khan, Fehad J; Gao, Shaojian; Stommel, Jayne M; Batchelor, Eric; Wu, Xiaolin; Luo, Ji

2017-11-16

CRISPR/Cas9 is a powerful gene editing tool for gene knockout studies and functional genomic screens. Successful implementation of CRISPR often requires Cas9 to elicit efficient target knockout in a population of cells. In this study, we investigated the role of several key factors, including variation in target copy number, inherent potency of sgRNA guides, and expression level of Cas9 and sgRNA, in determining CRISPR knockout efficiency. Using isogenic, clonal cell lines with variable copy numbers of an EGFP transgene, we discovered that CRISPR knockout is relatively insensitive to target copy number, but is highly dependent on the potency of the sgRNA guide sequence. Kinetic analysis revealed that most target mutation occurs between 5 and 10 days following Cas9/sgRNA transduction, while sgRNAs with different potencies differ by their knockout time course and by their terminal-phase knockout efficiency. We showed that prolonged, low level expression of Cas9 and sgRNA often fails to elicit target mutation, particularly if the potency of the sgRNA is also low. Our findings provide new insights into the behavior of CRISPR/Cas9 in mammalian cells that could be used for future improvement of this platform. Published by Oxford University Press on behalf of Nucleic Acids Research 2017.

Status of ARGOS - The Laser Guide Star System for the LBT

NASA Astrophysics Data System (ADS)

Raab, Walfried; Rabien, Sebastian; Gaessler, Wolfgang; Esposito, Simone; Antichi, Jacopo; Lloyd-Hart, Michael; Barl, Lothar; Beckmann, Udo; Bonaglia, Marco; Borelli, Jose; Brynnel, Joar; Buschkamp, Peter; Busoni, Lorenzo; Carbonaro, Luca; Christou, Julian; Connot, Claus; Davies, Richard; Deysenroth, Matthias; Durney, Olivier; Green, Richard; Gemperlein, Hans; Gasho, Victor; Haug, Marcus; Hubbard, Pete; Ihle, Sebastian; Kulas, Martin; Loose, Christina; Lehmitz, Michael; Noenickx, Jamison; Nussbaum, Edmund; Orban De Xivry, Gilles; Quirrenbach, Andreas; Peter, Diethard; Rahmer, Gustavo; Rademacher, Matt; Storm, Jesper; Schwab, Christian; Vaitheeswaran, Vidhya; Ziegleder, Julian

2013-12-01

ARGOS is an innovative multiple laser guide star adaptive optics system for the Large Binocular Telescope (LBT), designed to perform effective GLAO correction over a very wide field of view. The system is using high powered pulsed green (532 nm) lasers to generate a set of three guide stars above each of the LBT mirrors. The laser beams are launched through a 40 cm telescope and focused at an altitude of 12 km, creating laser beacons by means of Rayleigh scattering. The returning scattered light, primarily sensitive to the turbulences close to the ground, is detected by a gated wavefront sensor system. The derived ground layer correction signals are directly driving the adaptive secondary mirror of the LBT. ARGOS is especially designed for operation with the multiple object spectrograph Luci, which will benefit from both, the improved spatial resolution, as well as the strongly enhanced flux. In addition to the GLAO Rayleigh beacon system, ARGOS was also designed for a possible future upgrade with a hybrid sodium laser - Rayleigh beacon combination, enabling diffraction limited operation. The ARGOS laser system has undergone extensive tests during Summer 2012 and is scheduled for installation at the LBT in Spring 2013. The remaining sub-systems will be installed during the course of 2013. We report on the overall status of the ARGOS system and the results of the sub-system characterizations carried out so far.

Translational Medicine Guide transforms drug development processes: the recent Merck experience.

PubMed

Dolgos, Hugues; Trusheim, Mark; Gross, Dietmar; Halle, Joern-Peter; Ogden, Janet; Osterwalder, Bruno; Sedman, Ewen; Rossetti, Luciano

2016-03-01

Merck is implementing a question-based Translational Medicine Guide (TxM Guide) beginning as early as lead optimization into its stage-gate drug development process. Initial experiences with the TxM Guide, which is embedded into an integrated development plan tailored to each development program, demonstrated opportunities to improve target understanding, dose setting (i.e., therapeutic index), and patient subpopulation selection with more robust and relevant early human-based evidence, and increased use of biomarkers and simulations. The TxM Guide is also helping improve organizational learning, costs, and governance. It has also shown the need for stronger external resources for validating biomarkers, demonstrating clinical utility, tracking natural disease history, and biobanking. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Two-dimensional mapping of needle visibility with linear and curved array for ultrasound-guided interventional procedure

NASA Astrophysics Data System (ADS)

Susanti, Hesty; Suprijanto, Kurniadi, Deddy

2018-02-01

Needle visibility in ultrasound-guided technique has been a crucial factor for successful interventional procedure. It has been affected by several factors, i.e. puncture depth, insertion angle, needle size and material, and imaging technology. The influences of those factors made the needle not always well visible. 20 G needles of 15 cm length (Nano Line, facet) were inserted into water bath with variation of insertion angles and depths. Ultrasound measurements are performed with BK-Medical Flex Focus 800 using 12 MHz linear array and 5 MHz curved array in Ultrasound Guided Regional Anesthesia mode. We propose 3 criteria to evaluate needle visibility, i.e. maximum intensity, mean intensity, and the ratio between minimum and maximum intensity. Those criteria were then depicted into representative maps for practical purpose. The best criterion candidate for representing the needle visibility was criterion 1. Generally, the appearance pattern of the needle from this criterion was relatively consistent, i.e. for linear array, it was relatively poor visibility in the middle part of the shaft, while for curved array, it is relatively better visible toward the end of the shaft. With further investigations, for example with the use of tissue-mimicking phantom, the representative maps can be built for future practical purpose, i.e. as a tool for clinicians to ensure better needle placement in clinical application. It will help them to avoid the "dead" area where the needle is not well visible, so it can reduce the risks of vital structures traversing and the number of required insertion, resulting in less patient morbidity. Those simple criteria and representative maps can be utilized to evaluate general visibility patterns of the needle in vast range of needle types and sizes in different insertion media. This information is also important as an early investigation for future research of needle visibility improvement, i.e. the development of beamforming strategies and ultrasound enhanced (echogenic) needle.

Probing the structural dynamics of the CRISPR-Cas9 RNA-guided DNA-cleavage system by coarse-grained modeling.

PubMed

Zheng, Wenjun

2017-02-01

In the adaptive immune systems of many bacteria and archaea, the Cas9 endonuclease forms a complex with specific guide/scaffold RNA to identify and cleave complementary target sequences in foreign DNA. This DNA targeting machinery has been exploited in numerous applications of genome editing and transcription control. However, the molecular mechanism of the Cas9 system is still obscure. Recently, high-resolution structures have been solved for Cas9 in different structural forms (e.g., unbound forms, RNA-bound binary complexes, and RNA-DNA-bound tertiary complexes, corresponding to an inactive state, a pre-target-bound state, and a cleavage-competent or product state), which offered key structural insights to the Cas9 mechanism. To further probe the structural dynamics of Cas9 interacting with RNA and DNA at the amino-acid level of details, we have performed systematic coarse-grained modeling using an elastic network model and related analyses. Our normal mode analysis predicted a few key modes of collective motions that capture the observed conformational changes featuring large domain motions triggered by binding of RNA and DNA. Our flexibility analysis identified specific regions with high or low flexibility that coincide with key functional sites (such as DNA/RNA-binding sites, nuclease cleavage sites, and key hinges). We also identified a small set of hotspot residues that control the energetics of functional motions, which overlap with known functional sites and offer promising targets for future mutagenesis efforts to improve the specificity of Cas9. Finally, we modeled the conformational transitions of Cas9 from the unbound form to the binary complex and then the tertiary complex, and predicted a distinct sequence of domain motions. In sum, our findings have offered rich structural and dynamic details relevant to the Cas9 machinery, and will guide future investigation and engineering of the Cas9 systems. Proteins 2017; 85:342-353. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Quantitative CMMI Assessment for Offshoring through the Analysis of Project Management Repositories

NASA Astrophysics Data System (ADS)

Sunetnanta, Thanwadee; Nobprapai, Ni-On; Gotel, Olly

The nature of distributed teams and the existence of multiple sites in offshore software development projects pose a challenging setting for software process improvement. Often, the improvement and appraisal of software processes is achieved through a turnkey solution where best practices are imposed or transferred from a company’s headquarters to its offshore units. In so doing, successful project health checks and monitoring for quality on software processes requires strong project management skills, well-built onshore-offshore coordination, and often needs regular onsite visits by software process improvement consultants from the headquarters’ team. This paper focuses on software process improvement as guided by the Capability Maturity Model Integration (CMMI) and proposes a model to evaluate the status of such improvement efforts in the context of distributed multi-site projects without some of this overhead. The paper discusses the application of quantitative CMMI assessment through the collection and analysis of project data gathered directly from project repositories to facilitate CMMI implementation and reduce the cost of such implementation for offshore-outsourced software development projects. We exemplify this approach to quantitative CMMI assessment through the analysis of project management data and discuss the future directions of this work in progress.

Interface Prostheses With Classifier-Feedback-Based User Training.

PubMed

Fang, Yinfeng; Zhou, Dalin; Li, Kairu; Liu, Honghai

2017-11-01

It is evident that user training significantly affects performance of pattern-recognition-based myoelectric prosthetic device control. Despite plausible classification accuracy on offline datasets, online accuracy usually suffers from the changes in physiological conditions and electrode displacement. The user ability in generating consistent electromyographic (EMG) patterns can be enhanced via proper user training strategies in order to improve online performance. This study proposes a clustering-feedback strategy that provides real-time feedback to users by means of a visualized online EMG signal input as well as the centroids of the training samples, whose dimensionality is reduced to minimal number by dimension reduction. Clustering feedback provides a criterion that guides users to adjust motion gestures and muscle contraction forces intentionally. The experiment results have demonstrated that hand motion recognition accuracy increases steadily along the progress of the clustering-feedback-based user training, while conventional classifier-feedback methods, i.e., label feedback, hardly achieve any improvement. The result concludes that the use of proper classifier feedback can accelerate the process of user training, and implies prosperous future for the amputees with limited or no experience in pattern-recognition-based prosthetic device manipulation.It is evident that user training significantly affects performance of pattern-recognition-based myoelectric prosthetic device control. Despite plausible classification accuracy on offline datasets, online accuracy usually suffers from the changes in physiological conditions and electrode displacement. The user ability in generating consistent electromyographic (EMG) patterns can be enhanced via proper user training strategies in order to improve online performance. This study proposes a clustering-feedback strategy that provides real-time feedback to users by means of a visualized online EMG signal input as well as the centroids of the training samples, whose dimensionality is reduced to minimal number by dimension reduction. Clustering feedback provides a criterion that guides users to adjust motion gestures and muscle contraction forces intentionally. The experiment results have demonstrated that hand motion recognition accuracy increases steadily along the progress of the clustering-feedback-based user training, while conventional classifier-feedback methods, i.e., label feedback, hardly achieve any improvement. The result concludes that the use of proper classifier feedback can accelerate the process of user training, and implies prosperous future for the amputees with limited or no experience in pattern-recognition-based prosthetic device manipulation.

Forming Attitudes that Predict Future Behavior: A Meta-Analysis of the Attitude-Behavior Relation

ERIC Educational Resources Information Center

Glasman, Laura R.; Albarracin, Dolores

2006-01-01

A meta-analysis (k of conditions = 128; N = 4,598) examined the influence of factors present at the time an attitude is formed on the degree to which this attitude guides future behavior. The findings indicated that attitudes correlated with a future behavior more strongly when they were easy to recall (accessible) and stable over time. Because of…

A practical guide to epidemiological practice and standards in the identification and validation of diagnostic markers using a bladder cancer example.

PubMed

Behrens, T; Bonberg, N; Casjens, S; Pesch, B; Brüning, T

2014-01-01

Technical advances to analyze biological markers have generated a plethora of promising new marker candidates for early detection of cancer. However, in subsequent analyses only few could be successfully validated as being predictive, clinically useful, or effective. This failure is partially due to rapid publication of results that were detected in early stages of biomarker research. Methodological considerations are a major concern when carrying out molecular epidemiological studies of diagnostic markers to avoid errors that increase the potential for bias. Although guidelines for conducting studies and reporting of results have been published to improve the quality of marker studies, their planning and execution still need to be improved. We will discuss different sources of bias in study design, handling of specimens, and statistical analysis to illustrate possible pitfalls associated with marker research, and present legal, ethical, and technical considerations associated with storage and handling of specimens. This article presents a guide to epidemiological standards in marker research using bladder cancer as an example. Because of the possibility to detect early cancer stages due to leakage of molecular markers from the target organ or exfoliation of tumor cells into the urine, bladder cancer is particularly useful to study diagnostic markers. To improve the overall quality of marker research, future developments should focus on networks of studies and tissue banks according to uniform legal, ethical, methodological, and technical standards. This article is part of a Special Issue entitled: Computational Proteomics in the Post-Identification Era. Guest Editors: Martin Eisenacher and Christian Stephan. © 2013.

A major trauma course based on posters, audio-guides and simulation improves the management skills of medical students: Evaluation via medical simulator.

PubMed

Cuisinier, Adrien; Schilte, Clotilde; Declety, Philippe; Picard, Julien; Berger, Karine; Bouzat, Pierre; Falcon, Dominique; Bosson, Jean Luc; Payen, Jean-François; Albaladejo, Pierre

2015-12-01

Medical competence requires the acquisition of theoretical knowledge and technical skills. Severe trauma management teaching is poorly developed during internship. Nevertheless, the basics of major trauma management should be acquired by every future physician. For this reason, the major trauma course (MTC), an educational course in major traumatology, has been developed for medical students. Our objective was to evaluate, via a high fidelity medical simulator, the impact of the MTC on medical student skills concerning major trauma management. The MTC contains 3 teaching modalities: posters with associated audio-guides, a procedural workshop on airway management and a teaching session using a medical simulator. Skills evaluation was performed 1 month before (step 1) and 1 month after (step 3) the MTC (step 2). Nineteen students were individually evaluated on 2 different major trauma scenarios. The primary endpoint was the difference between steps 1 and 3, in a combined score evaluating: admission, equipment, monitoring and safety (skill set 1) and systematic clinical examinations (skill set 2). After the course, the combined primary outcome score improved by 47% (P<0.01). Scenario choice or the order of use had no significant influence on the skill set evaluations. This study shows improvement in student skills for major trauma management, which we attribute mainly to the major trauma course developed in our institution. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Artificial guide stars for adaptive optics using unmanned aerial vehicles

NASA Astrophysics Data System (ADS)

Basden, A. G.; Brown, Anthony M.; Chadwick, P. M.; Clark, P.; Massey, R.

2018-06-01

Astronomical adaptive optics (AO) systems are used to increase effective telescope resolution. However, they cannot be used to observe the whole sky since one or more natural guide stars of sufficient brightness must be found within the telescope field of view for the AO system to work. Even when laser guide stars are used, natural guide stars are still required to provide a constant position reference. Here, we introduce a technique to overcome this problem by using rotary unmanned aerial vehicles (UAVs) as a platform from which to produce artificial guide stars. We describe the concept that relies on the UAV being able to measure its precise relative position. We investigate the AO performance improvements that can be achieved, which in the cases presented here can improve the Strehl ratio by a factor of at least 2 for a 8 m class telescope. We also discuss improvements to this technique, which is relevant to both astronomical and solar AO systems.

Defining Quality in Cardiovascular Imaging: A Scientific Statement From the American Heart Association.

PubMed

Shaw, Leslee J; Blankstein, Ron; Jacobs, Jill E; Leipsic, Jonathon A; Kwong, Raymond Y; Taqueti, Viviany R; Beanlands, Rob S B; Mieres, Jennifer H; Flamm, Scott D; Gerber, Thomas C; Spertus, John; Di Carli, Marcelo F

2017-12-01

The aims of the current statement are to refine the definition of quality in cardiovascular imaging and to propose novel methodological approaches to inform the demonstration of quality in imaging in future clinical trials and registries. We propose defining quality in cardiovascular imaging using an analytical framework put forth by the Institute of Medicine whereby quality was defined as testing being safe, effective, patient-centered, timely, equitable, and efficient. The implications of each of these components of quality health care are as essential for cardiovascular imaging as they are for other areas within health care. Our proposed statement may serve as the foundation for integrating these quality indicators into establishing designations of quality laboratory practices and developing standards for value-based payment reform for imaging services. We also include recommendations for future clinical research to fulfill quality aims within cardiovascular imaging, including clinical hypotheses of improving patient outcomes, the importance of health status as an end point, and deferred testing options. Future research should evolve to define novel methods optimized for the role of cardiovascular imaging for detecting disease and guiding treatment and to demonstrate the role of cardiovascular imaging in facilitating healthcare quality. © 2017 American Heart Association, Inc.

The new face of space - exciting the next generation

NASA Astrophysics Data System (ADS)

Sanchez, M.; The, W.

This paper will describe the education and public outreach activities being conducted in conjunction with the World Space Congress. The World Space Congress brings together international space leaders and decision makers to share their knowledge and experiences, providing a guiding vision for an improved future. The very people who will populate that future and serve as its leaders are the world's brightest and best young students and young space professionals. Who better than the young people to share in the enthusiasm and knowledge, and participate in the shaping of that future? This World Space Congress intends to engage the young people in educational activities, introduce them to their international counterparts and the idea of collaboration, and provide them with an international experience to remember. This paper provides specifics regarding the planned events for young people. A truly "global" event is being planned for over 2500 students, educators and young professionals from more than 30 countries. Activities and events will target the spectrum of ages including K-12 up to young professionals, as well as the educators whose touch continues to develop the minds and influence the lives of the world's students on a daily basis.

Predicting consumer behavior with Web search.

PubMed

Goel, Sharad; Hofman, Jake M; Lahaie, Sébastien; Pennock, David M; Watts, Duncan J

2010-10-12

Recent work has demonstrated that Web search volume can "predict the present," meaning that it can be used to accurately track outcomes such as unemployment levels, auto and home sales, and disease prevalence in near real time. Here we show that what consumers are searching for online can also predict their collective future behavior days or even weeks in advance. Specifically we use search query volume to forecast the opening weekend box-office revenue for feature films, first-month sales of video games, and the rank of songs on the Billboard Hot 100 chart, finding in all cases that search counts are highly predictive of future outcomes. We also find that search counts generally boost the performance of baseline models fit on other publicly available data, where the boost varies from modest to dramatic, depending on the application in question. Finally, we reexamine previous work on tracking flu trends and show that, perhaps surprisingly, the utility of search data relative to a simple autoregressive model is modest. We conclude that in the absence of other data sources, or where small improvements in predictive performance are material, search queries provide a useful guide to the near future.

Predicting consumer behavior with Web search

PubMed Central

Goel, Sharad; Hofman, Jake M.; Lahaie, Sébastien; Pennock, David M.; Watts, Duncan J.

2010-01-01

Recent work has demonstrated that Web search volume can “predict the present,” meaning that it can be used to accurately track outcomes such as unemployment levels, auto and home sales, and disease prevalence in near real time. Here we show that what consumers are searching for online can also predict their collective future behavior days or even weeks in advance. Specifically we use search query volume to forecast the opening weekend box-office revenue for feature films, first-month sales of video games, and the rank of songs on the Billboard Hot 100 chart, finding in all cases that search counts are highly predictive of future outcomes. We also find that search counts generally boost the performance of baseline models fit on other publicly available data, where the boost varies from modest to dramatic, depending on the application in question. Finally, we reexamine previous work on tracking flu trends and show that, perhaps surprisingly, the utility of search data relative to a simple autoregressive model is modest. We conclude that in the absence of other data sources, or where small improvements in predictive performance are material, search queries provide a useful guide to the near future. PMID:20876140

Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria.

PubMed

Luckett, Tim; Bhattarai, Priyanka; Phillips, Jane; Agar, Meera; Currow, David; Krastev, Yordanka; Davidson, Patricia M

2015-11-01

A drive to promote advance care planning at a population level has led to a proliferation of online advance care directive (ACD) templates but little information to guide consumer choice. The current study aimed to appraise the quality of online ACD templates promoted for use in Australia. A systematic review of online Australian ACD templates was conducted in February 2014. ACD templates were identified via Google searches, and quality was independently appraised by two reviewers against criteria from the 2011 report A National Frameworkfor Advance Care Directives. Bias either towards or against future medical treatment was assessed using criteria designed to limit subjectivity. Fourteen online ACD templates were included, all of which were available only in English. Templates developed by Southern Cross University best met the framework criteria. One ACD template was found to be biased against medical treatment--the Dying with Dignity Victoria Advance Healthcare Directive. More research is needed to understand how online resources can optimally elicit and record consumers' individual preferences for future care. Future iterations of the framework should address online availability and provide a simple rating system to inform choice and drive quality improvement.

Ultrasound-Guided Treatment of Peripheral Nerve Pathology.

PubMed

Dettori, Nathan; Choudur, Hema; Chhabra, Avneesh

2018-07-01

High-resolution ultrasound serves as a fast, accessible, reliable, and radiation-free tool for anatomical and dynamic evaluation of various peripheral nerves. It can be used not only to identify and diagnose peripheral nerve and perineural pathology accurately but also to guide various nerve and perineural interventions. We describe the normal and pathologic appearances of peripheral nerves, the pathologies commonly affecting the individual peripheral nerves, and the current ultrasound-guided peripheral nerve interventions and techniques. Future directions are also highlighted. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Crops in silico: A community wide multi-scale computational modeling framework of plant canopies

NASA Astrophysics Data System (ADS)

Srinivasan, V.; Christensen, A.; Borkiewic, K.; Yiwen, X.; Ellis, A.; Panneerselvam, B.; Kannan, K.; Shrivastava, S.; Cox, D.; Hart, J.; Marshall-Colon, A.; Long, S.

2016-12-01

Current crop models predict a looming gap between supply and demand for primary foodstuffs over the next 100 years. While significant yield increases were achieved in major food crops during the early years of the green revolution, the current rates of yield increases are insufficient to meet future projected food demand. Furthermore, with projected reduction in arable land, decrease in water availability, and increasing impacts of climate change on future food production, innovative technologies are required to sustainably improve crop yield. To meet these challenges, we are developing Crops in silico (Cis), a biologically informed, multi-scale, computational modeling framework that can facilitate whole plant simulations of crop systems. The Cis framework is capable of linking models of gene networks, protein synthesis, metabolic pathways, physiology, growth, and development in order to investigate crop response to different climate scenarios and resource constraints. This modeling framework will provide the mechanistic details to generate testable hypotheses toward accelerating directed breeding and engineering efforts to increase future food security. A primary objective for building such a framework is to create synergy among an inter-connected community of biologists and modelers to create a realistic virtual plant. This framework advantageously casts the detailed mechanistic understanding of individual plant processes across various scales in a common scalable framework that makes use of current advances in high performance and parallel computing. We are currently designing a user friendly interface that will make this tool equally accessible to biologists and computer scientists. Critically, this framework will provide the community with much needed tools for guiding future crop breeding and engineering, understanding the emergent implications of discoveries at the molecular level for whole plant behavior, and improved prediction of plant and ecosystem responses to the environment.

Considerations for Future IGS Receivers

NASA Astrophysics Data System (ADS)

Humphreys, T. E.; Young, L. E.; Pany, T.

2008-12-01

Future International GNSS Service (IGS) receivers are considered against the backdrop of GNSS signal modernization and the IGS's goal of further improving the accuracy of its products. The purpose of this paper is to provide the IGS ---and any other group that uses geodetic-quality GNSS receivers---with a guide to making decisions about GNSS receivers. Modernized GNSS signals are analyzed with a view toward IGS applications. A schedule for minimum IGS receiver requirements is proposed. Features of idealized conceptual receivers are discussed. The prospects for standard commercial receivers and for software-defined GNSS receivers are examined. Recommendations are given for how the IGS should proceed in order to maximally benefit from the transformation in GNSS that will occur over the next decade. There are two reasons why it makes sense for the IGS to study GNSS receivers that will be integrated into its network in the coming years. First, the new GNSS signals that will come on line over the next decade will render current IGS receivers obsolete, so it is prudent to examine receiver options going forward. Second, the push to improve the accuracy of IGS products beyond current limits demands greater accuracy in the models used to describe receiver measurements. As a result, the IGS must demand from vendors more transparency into receiver firmware or adoption of user-specified algorithms. This paper considers future IGS receivers from four different points of view. Section 2 looks at modernized GNSS signals and their benefits for the IGS. Section 3 surveys the range of expected receiver capability. Section 4 considers current and future commercial geodetic-quality receivers. Section 5 considers software GNSS receivers as an alternative to less reconfigurable traditional receivers. Section 6 lays out the authors' recommendations to the IGS.

Ion guiding in macro-size insulating capillaries: straight, tapered, and curved shapes

NASA Astrophysics Data System (ADS)

Kojima, Takao M.

2018-02-01

When keV energy ions are injected into a tilted insulating capillary, a certain fraction of the injected ions are transported through the tilt angle of the capillary. This ion guiding phenomenon is considered to be caused by a self-organizing charge distribution, where the inner wall of the capillary becomes charged by initial incoming ions. The charge distribution, which is formed, can guide following ions toward the exit of the capillary. Since the initial discovery of this effect, studies of ion guiding by insulating capillaries have been extended to various materials, and different sizes and shapes of capillaries. In recent years, some investigations of the guiding effect of macro-size curved capillaries have also been reported. In this review, relevant studies in a history of ion guiding in curved capillaries are discussed and future directions in this field are considered.

Isolated thoughts and feelings and unsolved concerns: adolescents' and parents' perspectives on living with type 1 diabetes - a qualitative study using visual storytelling.

PubMed

Castensøe-Seidenfaden, Pernille; Teilmann, Grete; Kensing, Finn; Hommel, Eva; Olsen, Birthe Susanne; Husted, Gitte Reventlov

2017-10-01

To explore and describe the experiences of adolescents and their parents living with type 1 diabetes, to identify their needs for support to improve adolescents' self-management skills in the transition from child- to adulthood. Adolescents with type 1 diabetes often experience deteriorating glycaemic control and distress. Parents are important in adolescents' ability to self-manage type 1 diabetes, but they report anxiety and frustrations. A better understanding of the challenges adolescents and parents face, in relation to the daily self-management of type 1 diabetes, is important to improve clinical practice. A qualitative explorative study using visual storytelling as part of individual interviews. A purposive sample of nine adolescents and their parents (seven mothers, six fathers) took photographs illustrating their experiences living with type 1 diabetes. Subsequently, participants were interviewed individually guided by participants' photographs and a semistructured interview guide. Interviews were analysed using thematic analysis. Four major themes were consistent across adolescents and their parents: (1) striving for safety, (2) striving for normality, (3) striving for independence and (4) worrying about future. Although adolescents and parents had same concerns and challenges living with type 1 diabetes, they were experienced differently. Their thoughts and feelings mostly remained isolated and their concerns and challenges unsolved. The concerns and challenges adolescents and their parents face in the transition from child- to adulthood are still present despite new treatment modalities. Parents are fundamental in supporting the adolescents' self-management-work; however, the parties have unspoken concerns and challenges. Healthcare providers should address the parties' challenges and concerns living with type 1 diabetes to diminish worries about future including fear of hypoglycaemia, the burden of type 1 diabetes and the feeling of being incompetent in diabetes self-management. It is important to focus on supporting both adolescents and their parents, and to provide a shared platform for communication. © 2016 John Wiley & Sons Ltd.

Setting the top 10 research priorities to improve the health of people with Type 2 diabetes: a Diabetes UK-James Lind Alliance Priority Setting Partnership.

PubMed

Finer, S; Robb, P; Cowan, K; Daly, A; Shah, K; Farmer, A

2018-07-01

To describe processes and outcomes of a priority setting partnership to identify the 'top 10 research priorities' in Type 2 diabetes, involving people living with the condition, their carers, and healthcare professionals. We followed the four-step James Lind Alliance Priority Setting Partnership process which involved: gathering uncertainties using a questionnaire survey distributed to 70 000 people living with Type 2 diabetes and their carers, and healthcare professionals; organizing the uncertainties; interim priority setting by resampling of participants with a second survey; and final priority setting in an independent group of participants, using the nominal group technique. At each step the steering group closely monitored and guided the process. In the first survey, 8227 uncertainties were proposed by 2587 participants, of whom 18% were from black, Asian and minority ethnic groups. Uncertainties were formatted and collated into 114 indicative questions. A total of 1506 people contributed to a second survey, generating a shortlist of 24 questions equally weighted to the contributions of people living with diabetes and their carers and those of healthcare professionals. In the final step the 'top 10 research priorities' were selected, including questions on cure and reversal, risk identification and prevention, and self-management approaches in Type 2 diabetes. Systematic and transparent methodology was used to identify research priorities in a large and genuine partnership of people with lived and professional experience of Type 2 diabetes. The top 10 questions represent consensus areas of research priority to guide future research, deliver responsive and strategic allocation of research resources, and improve the future health and well-being of people living with, and at risk of, Type 2 diabetes. © 2018 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

21st Century Readers' Aids: Past History and Future Directions

ERIC Educational Resources Information Center

Smith, Michael M.

2008-01-01

This article provides a brief history of the development of library subject guides (often referred to as pathfinders) from the late 1800s to the present. During this period, subject guides have changed both their focus and format. The needs of academic institutions at the turn of the 20th century were very different than they are today, and…

Exploring the Moon: A Teacher's Guide with Activities for Earth and Space Sciences.

ERIC Educational Resources Information Center

National Aeronautics and Space Administration, Washington, DC.

This educational guide concerns exploring the moon. Activities are divided into three units: Pre-Apollo, Learning from Apollo, and The Future. These correspond, at least roughly, to exercises that can be done before the Lunar Sample Disk (available from NASA) arrives to the school (Pre-Apollo), while it is there (Learning from Apollo), and after…

A Manual for Trainers of Small Scale Beekeeping Development Workers.

ERIC Educational Resources Information Center

Gentry, Curtis; And Others

This manual is intended to serve as a guide for those who are helping future Peace Corps Volunteers to acquire basic beekeeping skills. Included in the guide are lesson outlines and handouts for use in each of the 52 sessions of the course. Representative topics discussed in the individual sessions are family live-in, training site investigation,…

Making Changes: A Futures-Oriented Course in Inventive Problem Solving. Teacher's Guide.

ERIC Educational Resources Information Center

Thomas, John W.

This 1981 guide is designed to be used with a workbook offering students opportunities to engage in creative problem solving. The book contains four units with 23 lessons. Unit 1 addresses problem solving and contains nine lessons: (1) "New and Different Thinking"; (2) "Open and Closed Problems"; (3) "Stating a Problem"; (4) "Defining a Problem";…

Keyboarding and Computer Application. Technology Learning Activity. Teacher Edition. Technology Education Series.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This curriculum guide is designed to prepare students in grades 6-10 to work in the world of the future. The 8-day course provides exploratory, hands-on learning activities and information that can enhance the education of students of all types in an integrated curriculum that provides practical applications of academic skills. The guide contains…

Guiding Future Research on the Community College Transfer Function: Summary of a National Seminar (Washington, D.C., September 21-22, 1992).

ERIC Educational Resources Information Center

Ludwig, Meredith J.; Palmer, James C.

1993-01-01

In September 1992, a small group of experienced researchers met to identify areas of research and specific research hypotheses to guide further inquiry into transfer. Specifically, participants examined transfer as it relates to institutional mission, institutional organization, and access to education and identified various premises upon which…

The Effectiveness of Guided Inquiry-based Learning Material on Students’ Science Literacy Skills

NASA Astrophysics Data System (ADS)

Aulia, E. V.; Poedjiastoeti, S.; Agustini, R.

2018-01-01

The purpose of this research is to describe the effectiveness of guided inquiry-based learning material to improve students’ science literacy skills on solubility and solubility product concepts. This study used Research and Development (R&D) design and was implemented to the 11th graders of Muhammadiyah 4 Senior High School Surabaya in 2016/2017 academic year with one group pre-test and post-test design. The data collection techniques used were validation, observation, test, and questionnaire. The results of this research showed that the students’ science literacy skills are different after implementation of guided inquiry-based learning material. The guided inquiry-based learning material is effective to improve students’ science literacy skills on solubility and solubility product concepts by getting N-gain score with medium and high category. This improvement caused by the developed learning material such as lesson plan, student worksheet, and science literacy skill tests were categorized as valid and very valid. In addition, each of the learning phases in lesson plan has been well implemented. Therefore, it can be concluded that the guided inquiry-based learning material are effective to improve students’ science literacy skills on solubility and solubility product concepts in senior high school.

17 CFR 30.4 - Registration required.

Code of Federal Regulations, 2010 CFR

2010-04-01

... foreign options customers. (d) To solicit or enter into an agreement to direct, or to guide such customer... Section 30.4 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION FOREIGN FUTURES AND FOREIGN OPTIONS TRANSACTIONS § 30.4 Registration required. Except as provided in § 30.5 of this part, it...

Discerning the Future of Early Childhood Intervention.

ERIC Educational Resources Information Center

Zigler, Edward; Berman, Winnie

1983-01-01

Examines the recent history of early childhood intervention efforts; discusses principles that guided the formation of intervention programs in the 1960s and 1970s; describes the Head Start program and lessons learned from its development; considers issues in evaluating intervention programs; and presents suggestions for future directions in early…

A Guide to Personal, Business and Social Forecasting and Survival.

ERIC Educational Resources Information Center

Loye, David

1983-01-01

By thinking about and trying to predict the future, we force ourselves to articulate our feelings and thoughts about that future. A technique using intuitive and logical thinking based on right brain-left brain differences is proposed to aid in decision making by both groups and individuals. (Author/IS)

77 FR 35917 - Medicare Program; Medicare Secondary Payer and “Future Medicals”

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

... injured individual. We are interested in whether this type of approach is useful in guiding a determination as to whether future medical care will be required and if other approaches are available. Chronic... limitation, including asthma and chronic bronchitis; cancer, diabetes; quadriplegia; and nephrogenic systemic...

Population, Education, and Children's Futures. Fastback 150.

ERIC Educational Resources Information Center

Bjork, Robert M.; Fraser, Stewart E.

This monograph discusses world population problems, examines the underlying concepts and issues in population education, and looks at the future. The monograph begins by describing an attempt at population education in a village of India. Eight guiding concepts that are considered to be essential for population educators are then discussed. These…

The Future of Women's Athletics: Entertainment or Education?

ERIC Educational Resources Information Center

Park, Roberta J.

A well-rounded program of extramural opportunities for females which provides experience between the intramural model and the existing male intercollegiate models is presently nonexistent. Five possible alternatives to guide the future of athletics are suggested: (a) women could demand access to the existing model of male athletics; (b) women…

Using Data to Improve Student Outcomes: Learning from Leading Colleges. Education Trust Higher Education Practice Guide #2

ERIC Educational Resources Information Center

Education Trust, 2016

2016-01-01

All across the country, leaders in colleges and universities are asking the same question: What can we do to improve student success, especially for the low-income students and students of color whose graduation rates often lag behind? This second practice guide: "Using Data to Improve Student Outcomes: Learning from Leading Colleges"…

Assessing and Improving Student Organizations: Student Workbook. The Assessing and Improving Student Organization (AISO) Program

ERIC Educational Resources Information Center

Nolfi, Tricia; Ruben, Brent D.

2010-01-01

This "Workbook" is intended for student participants during the AISO (Assessing and Improving Student Organization) assessment and planning sessions, and to be used in tandem with the "Guide for Students". Each page presents an action or reflection slide from the "Guide" with a space below for participants to note their own ideas, outcomes of…

Making a Difference: Leading and Managing for Quality Improvement in Adult and Community Learning.

ERIC Educational Resources Information Center

Ravenhall, Mark; Kenway, Mike

This guide looks at demands on leaders and managers in adult and community learning (ACL) in the roles and issues they face in the context of quality improvement (QI). It suggests practical approaches for improving the quality of provision for adults. The guide's design builds on current practice toward the desired state of excellence in all…

Impact of a guide dog on glycemia regulation in blind/visually impaired persons due to diabetes mellitus.

PubMed

Korljan-Babić, Betty; Barsić-Ostojić, Sanja; Metelko, Zeljko; Car, Nikica; Prasek, Manja; Skrabić, Veselin; Kokić, Slaven

2011-06-01

The aim was to assess glycemia regulation in a blind diabetic patient after getting a guide dog. Glycosylated hemoglobin (HbA1c) results of a blind patient before and after getting the guide dog were retrospectively collected. The paired t-test results yielded a two-tailed P value of 0.0925, a difference considered not statistically significant; the 95% confidence interval of this difference varied from -0.2494 to 1.889. An improvement of glycemia regulation was observed with the guide dog compared to previous glycemia regulation, however, the difference was not statistically significant. The moderate improvement could probably be attributed to the mobility of the blind person having a guide dog. Standard quality of life tests should be included in the evaluation of diabetic blind persons, especially the impact of a guide dog on glycemic control or other chronic complications of diabetes.

A Revised Guide for Improving Teacher Education in Human Rights.

ERIC Educational Resources Information Center

Phi Delta Kappa, Bloomington, IN. Commission of Education, Human Rights, and Responsibilities.

This document serves as a guide for teacher education institutions and programs designed to prepare educators for meeting their responsibilities in the area of human rights and human relations. This second edition of the guide represents a substantial modification of the original guide, and includes many activities, experiences, and suggestions…

The Effects of Guided Notes on Pre-Lecture Quiz Scores in Introductory Psychology

ERIC Educational Resources Information Center

Glodowski, Kathryn; Thompson, Rachel

2018-01-01

Guided notes covering lectures have been shown to improve note quality and increase scores on quizzes covering lecture material. We sought to determine whether guided notes would also be beneficial in helping students prepare for quizzes covering assigned readings. We evaluated the efficacy of guided notes for reading assignments on…

Graphical correlation of gaging-station records

USGS Publications Warehouse

Searcy, James K.

1960-01-01

A gaging-station record is a sample of the rate of flow of a stream at a given site. This sample can be used to estimate the magnitude and distribution of future flows if the record is long enough to be representative of the long-term flow of the stream. The reliability of a short-term record for estimating future flow characteristics can be improved through correlation with a long-term record. Correlation can be either numerical or graphical, but graphical correlation of gaging-station records has several advantages. The graphical correlation method is described in a step-by-step procedure with an illustrative problem of simple correlation, illustrative problems of three examples of multiple correlation--removing seasonal effect--and two examples of correlation of one record with two other records. Except in the problem on removal of seasonal effect, the same group of stations is used in the illustrative problems. The purpose of the problems is to illustrate the method--not to show the improvement that can result from multiple correlation as compared with simple correlation. Hydrologic factors determine whether a usable relation exists between gaging-station records. Statistics is only a tool for evaluating and using an existing relation, and the investigator must be guided by a knowledge of hydrology.

Recent early clinical drug development for acute kidney injury.

PubMed

Gallagher, Kevin M; O'neill, Stephen; Harrison, Ewen M; Ross, James A; Wigmore, Stephen J; Hughes, Jeremy

2017-02-01

Despite significant need and historical trials, there are no effective drugs in use for the prevention or treatment of acute kidney injury (AKI). There are several promising agents in early clinical development for AKI and two trials have recently been terminated. There are also exciting new findings in pre-clinical AKI research. There is a need to take stock of current progress in the field to guide future drug development for AKI. Areas covered: The main clinical trial registries, PubMed and pharmaceutical company website searches were used to extract the most recent clinical trials for sterile, transplant and sepsis-associated AKI. We summarise the development of the agents recently in clinical trial, update on their trial progress, consider reasons for failed efficacy of two agents, and discuss new paradigms in pre-clinical targets for AKI. Agents covered include- QPI-1002, THR-184, BB-3, heme arginate, human recombinant alkaline phosphatase (recAP), ciclosporin A, AB103, levosimendan, AC607 and ABT-719. Expert opinion: Due to the heterogenous nature of AKI, agents with the widest pleiotropic effects on multiple pathophysiological pathways are likely to be most effective. Linking preclinical models to clinical indication and improving AKI definition and diagnosis are key areas for improvement in future clinical trials.

The future of obstetrics/gynecology in 2020: a clearer vision. Transformational forces and thriving in the new system.

PubMed

Lagrew, David C; Jenkins, Todd R

2015-01-01

Revamping the delivery of women's health care to meet future demands will require a number of changes. In the first 2 articles of this series, we introduced the reasons for change, suggested the use of the 'Triple Aim' concept to (1) improve the health of a population, (2) enhance the patient experience, and (3) control costs as a guide post for changes, and reviewed the transformational forces of payment and care system reform. In the final article, we discuss the valuable use of information technology and disruptive clinical technologies. The new health care system will require a digital transformation so that there can be increased communication, availability of information, and ongoing assessment of clinical care. This will allow for more cost-effective and individualized treatments as data are securely shared between patients and providers. Scientific advances that radically change clinical practice are coming at an accelerated pace as the underlying technologies of genetics, robotics, artificial intelligence, and molecular biology are translated into tools for diagnosis and treatment. Thriving in the new system not only will require time-honored traits such as leadership and compassion but also will require the obstetrician/gynecologist to become comfortable with technology, care redesign, and quality improvement. Copyright © 2015 Elsevier Inc. All rights reserved.

Strategies proposed by Healthy Kids, Healthy Communities partnerships to prevent childhood obesity.

PubMed

Ohri-Vachaspati, Punam; Leviton, Laura; Bors, Philip; Brennan, Laura K; Brenan, Laura; Brownson, Ross C; Strunk, Sarah

2012-01-01

Healthy Kids, Healthy Communities (HKHC) is an initiative of the Robert Wood Johnson Foundation to prevent obesity among high-risk children by changing local policies, systems, and environments. In 2009, 105 community partnerships applied for funding from HKHC. Later that year, the Centers for Disease Control and Prevention (CDC) released recommended community strategies to prevent obesity by changing environments and policies. The objective of this analysis was to describe the strategies proposed by the 41 HKHC partnerships that received funding and compare them to the CDC recommendations. We analyzed the funded proposals to assess the types and prevalence of the strategies proposed and mapped them onto the CDC recommendations. The most prevalent strategies proposed by HKHC-funded partnerships were providing incentives to retailers to locate and serve healthier foods in underserved areas, improving mechanisms for purchasing food from farms, enhancing infrastructure that supports walking and cycling, and improving access to outdoor recreational facilities. The strategies proposed by HKHC partnerships were well aligned with the CDC recommendations. The popular strategies proposed by HKHC partnerships were those for which there were existing examples of successful implementation. Our analysis provides an example of how information from communities, obtained through grant-writing efforts, can be used to assess the status of the field, guide future research, and provide direction for future investments.

Traditional Chinese Medicines in Treatment of Patients with Type 2 Diabetes Mellitus

PubMed Central

Xie, Weidong; Zhao, Yunan; Zhang, Yaou

2011-01-01

Type 2 diabetes mellitus (T2DM) occurs in 95% of the diabetic populations. Management of T2DM is a challenge. Traditional Chinese medicines (TCM) are usually served as adjuvants used to improve diabetic syndromes in combination of routine antidiabetic drugs. For single-herb prescriptions, Ginseng, Bitter melon, Golden Thread, Fenugreek, Garlic, and Cinnamon might have antidiabetic effects in T2DM patients. Among 30 antidiabetic formulas approved by the State Food and Drugs Administrator of China, top 10 of the most frequently prescribed herbs are Membranous Milkvetch Root, Rehmannia Root, Mongolian Snakegourd Root, Ginseng, Chinese Magnoliavine Fruit, Kudzuvine Root, Dwarf Lilyturf Tuber, Common Anemarrhena Rhizome, Barbary Wolfberry Fruit, and India Bread, which mainly guided by the theory of TCM. Their action mechanisms are related to improve insulin sensitivity, stimulate insulin secretion, protect pancreatic islets, and even inhibit intake of intestinal carbohydrates. However, it is very difficult to determine antihyperglycemic components of TCM. Nevertheless, TCM are becoming popular complementary and alternative medicine in treatment of syndromes of T2DM. In the future, it requires further validation of phytochemical, pharmacological, and clinical natures of TCM in T2DM in the future studies, especially for those herbs with a high prescription frequency. PMID:21584252

Addressing "Nature-Deficit Disorder": A Mixed Methods Pilot Study of Young Adults Attending a Wilderness Camp.

PubMed

Warber, Sara L; DeHudy, Ashley A; Bialko, Matthew F; Marselle, Melissa R; Irvine, Katherine N

2015-01-01

Background and Objectives. Rapid urbanization raises concern about chronic human health issues along with less frequent interaction with the natural world. "Nature-deficit disorder," a nonclinical term, describes this potential impact on the well-being of youth. We conducted a mixed methods pilot study of young adults attending a four-week wilderness camp to investigate whether nature-based camp experiences would increase connection to nature and promote multiple dimensions of well-being. Methods. Participants completed precamp (n = 46) and postcamp (n = 36) online questionnaires including nature-related and holistic well-being measures. Differences were investigated using paired t-tests. Interviews (n = 16) explored camp experiences and social relations. Results. All nature-related measures-exposure, knowledge, skills, willingness to lead, perceived safety, sense of place, and nature connection-significantly increased. Well-being outcomes also significantly improved, including perceived stress, relaxation, positive and negative emotions, sense of wholeness, and transcendence. Physical activity and psychological measures showed no change. Interviews described how the wilderness environment facilitated social connections. Conclusion. Findings illustrate the change in nature relations and well-being that wilderness camp experiences can provide. Results can guide future research agendas and suggest that nature immersion experiences could address the risk of "nature-deficit disorder," improve health, and prepare future environmental leaders.

Ultrasound-guided versus fluoroscopy-guided sacroiliac joint intra-articular injections in the noninflammatory sacroiliac joint dysfunction: a prospective, randomized, single-blinded study.

PubMed

Jee, Haemi; Lee, Ji-Hae; Park, Ki Deok; Ahn, Jaeki; Park, Yongbum

2014-02-01

To compare the short-term effects and safety of ultrasound (US)-guided sacroiliac joint (SIJ) injections with fluoroscopy (FL)-guided SIJ injections in patients with noninflammatory SIJ dysfunction. Prospective, randomized controlled trial. University hospital. Patients (N=120) with noninflammatory sacroiliac arthritis were enrolled. All procedures were performed using an FL or US apparatus. Subjects were randomly assigned to either the FL or US group. Immediately after the SIJ injections, fluoroscopy was applied to verify the correct placement of the injected medication and intravascular injections. Treatment effects and functional improvement were compared at 2 and 12 weeks after the procedures. The verbal numeric pain scale and Oswestry Disability Index improved at 2 and 12 weeks after the injections without statistical significances between groups. Of 55 US-guided injections, 48 (87.3%) were successful and 7 (12.7%) were missed. The FL-guided SIJ approach exhibited a greater accuracy (98.2%) than the US-guided approach. Vascularization around the SIJ was seen in 34 of 55 patients. Among the 34 patients, 7 had vascularization inside the joint, 23 had vascularization around the joint, and 4 had vascularization both inside and around the joint. Three cases of intravascular injections occurred in the FL group. The US-guided approach may facilitate the identification and avoidance of the critical vessels around or within the SIJ. Function and pain relief significantly improved in both groups without significant differences between groups. The US-guided approach was shown to be as effective as the FL-guided approach in treatment effects. However, diagnostic application in the SIJ may be limited because of the significantly lower accuracy rate (87.3%). Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A randomized, double-blind, controlled study of ultrasound-guided corticosteroid injection into the joint of patients with inflammatory arthritis.

PubMed

Cunnington, Joanna; Marshall, Nicola; Hide, Geoff; Bracewell, Claire; Isaacs, John; Platt, Philip; Kane, David

2010-07-01

Most corticosteroid injections into the joint are guided by the clinical examination (CE), but up to 70% are inaccurately placed, which may contribute to an inadequate response. The aim of this study was to investigate whether ultrasound (US) guidance improves the accuracy and clinical outcome of joint injections as compared with CE guidance in patients with inflammatory arthritis. A total of 184 patients with inflammatory arthritis and an inflamed joint (shoulder, elbow, wrist, knee, or ankle) were randomized to receive either US-guided or CE-guided corticosteroid injections. Visual analog scales (VAS) for assessment of function, pain, and stiffness of the target joint, a modified Health Assessment Questionnaire, and the EuroQol 5-domain questionnaire were obtained at baseline and at 2 weeks and 6 weeks postinjection. The erythrocyte sedimentation rate and C-reactive protein level were measured at baseline and 2 weeks. Contrast injected with the steroid was used to assess the accuracy of the joint injection. One-third of CE-guided injections were inaccurate. US-guided injections performed by a trainee rheumatologist were more accurate than the CE-guided injections performed by more senior rheumatologists (83% versus 66%; P = 0.010). There was no significant difference in clinical outcome between the group receiving US-guided injections and the group receiving CE-guided injections. Accurate injections led to greater improvement in joint function, as determined by VAS scores, at 6 weeks, as compared with inaccurate injections (30.6 mm versus 21.2 mm; P = 0.030). Clinicians who used US guidance reliably assessed the accuracy of joint injection (P < 0.001), whereas those who used CE guidance did not (P = 0.29). US guidance significantly improves the accuracy of joint injection, allowing a trainee to rapidly achieve higher accuracy than more experienced rheumatologists. US guidance did not improve the short-term outcome of joint injection.

User-Centered Design of the eyeGuide, a Tailored Glaucoma Behavior Change Program

PubMed Central

Killeen, Olivia; MacKenzie, Chamisa; Heisler, Michele; Resnicow, Ken; Lee, Paul P.; Newman-Casey, Paula Anne

2016-01-01

PURPOSE We employed user-centered design to refine a prototype of the eyeGuide, a novel, tailored behavior change program intended to improve medication adherence among glaucoma patients. PATIENTS Glaucoma patients ≥ age 40 prescribed ≥1 glaucoma medication were included. METHODS The eyeGuide consists of tailored educational content and tailored testimonials in which patients share how they were able to overcome barriers to improve their medication adherence. A hybrid of semi-structured diagnostic and pre-testing interviews were used to refine the content of the eyeGuide. Purposeful sampling was used to recruit a study population representative of the glaucoma patient population. Interviews were conducted until thematic saturation was reached. Interviews were audio recorded and transcribed verbatim. Three researchers analyzed the transcripts, generated a codebook and identified key themes using NVivo 10.0 to further refine the eyeGuide. RESULTS Twenty-one glaucoma patients were interviewed; mean age 72 ± 12.4 years, five (24%) African-Americans, nine (43%) with poor self-reported adherence, ten (47.6%) ≥ age 75, ten (47.6%) with poor vision and nine (42.9%) women. Qualitative analysis identified five important themes for improving glaucoma self-management: social support, patient-provider relationship, medication routine, patients’ beliefs about disease and treatment, and eye drop instillation. All participants expressed satisfaction with in-person delivery of the eyeGuide and preferred this to a web-based module. Participant feedback resulted in revised content. CONCLUSIONS User-centered design generated improvements in the eyeGuide that would not have been possible without patient input. Participants expressed satisfaction with the tailored content. PMID:27096721

User-centered Design of the eyeGuide: A Tailored Glaucoma Behavior Change Program.

PubMed

Killeen, Olivia J; MacKenzie, Chamisa; Heisler, Michele; Resnicow, Ken; Lee, Paul P; Newman-Casey, Paula Anne

2016-10-01

We employed user-centered design to refine a prototype of the eyeGuide, a novel, tailored behavior change program intended to improve medication adherence among glaucoma patients. Glaucoma patients age 40 years and above prescribed ≥1 glaucoma medication were included. The eyeGuide consists of tailored educational content and tailored testimonials in which patients share how they were able to overcome barriers to improve their medication adherence. A hybrid of semistructured diagnostic and pretesting interviews were used to refine the content of the eyeGuide. Purposeful sampling was used to recruit a study population representative of the glaucoma patient population. Interviews were conducted until thematic saturation was reached. Interviews were audiorecorded and transcribed verbatim. Three researchers analyzed the transcripts, generated a codebook, and identified key themes using NVivo 10.0 to further refine the eyeGuide. Twenty-one glaucoma patients were interviewed; mean age 72±12.4 years, 5 (24%) African Americans, 9 (43%) with poor self-reported adherence, 10 (47.6%) age 75 years and above, 10 (47.6%) with poor vision, and 9 (42.9%) women. Qualitative analysis identified 5 important themes for improving glaucoma self-management: social support, patient-provider relationship, medication routine, patients' beliefs about disease and treatment, and eye drop instillation. All participants expressed satisfaction with in-person delivery of the eyeGuide and preferred this to a Web-based module. Participant feedback resulted in revised content. User-centered design generated improvements in the eyeGuide that would not have been possible without patient input. Participants expressed satisfaction with the tailored content.

Technological advances in the surgical treatment of movement disorders.

PubMed

Gross, Robert E; McDougal, Margaret E

2013-08-01

Technological innovations have driven the advancement of the surgical treatment of movement disorders, from the invention of the stereotactic frame to the adaptation of deep brain stimulation (DBS). Along these lines, this review will describe recent advances in inserting neuromodulation modalities, including DBS, to the target, and in the delivery of therapy at the target. Recent radiological advances are altering the way that DBS leads are targeted and inserted, by refining the ability to visualize the subcortical targets using high-field strength magnetic resonance imaging and other innovations, such as diffusion tensor imaging, and the development of novel targeting devices enabling purely anatomical implantations without the need for neurophysiological monitoring. New portable computed tomography scanners also are facilitating lead implantation without monitoring, as well as improving radiological verification of DBS lead location. Advances in neurophysiological mapping include efforts to develop automatic target verification algorithms, and probabilistic maps to guide target selection. The delivery of therapy at the target is being improved by the development of the next generation of internal pulse generators (IPGs). These include constant current devices that mitigate the variability introduced by impedance changes of the stimulated tissue and, in the near future, devices that deliver novel stimulation patterns with improved efficiency. Closed-loop adaptive IPGs are being tested, which may tailor stimulation to ongoing changes in the nervous system, reflected in biomarkers continuously recorded by the devices. Finer-grained DBS leads, in conjunction with new IPGs and advanced programming tools, may offer improved outcomes via current steering algorithms. Finally, even thermocoagulation-essentially replaced by DBS-is being advanced by new minimally-invasive approaches that may improve this therapy for selected patients in whom it may be preferred. Functional neurosurgery has a history of being driven by technological innovation, a tradition that continues into its future.

Framing quality improvement tools and techniques in healthcare the case of improvement leaders' guides.

PubMed

Millar, Ross

2013-01-01

The purpose of this paper is to present a study of how quality improvement tools and techniques are framed within healthcare settings. The paper employs an interpretive approach to understand how quality improvement tools and techniques are mobilised and legitimated. It does so using a case study of the NHS Modernisation Agency Improvement Leaders' Guides in England. Improvement Leaders' Guides were framed within a service improvement approach encouraging the use of quality improvement tools and techniques within healthcare settings. Their use formed part of enacting tools and techniques across different contexts. Whilst this enactment was believed to support the mobilisation of tools and techniques, the experience also illustrated the challenges in distributing such approaches. The paper provides an important contribution in furthering our understanding of framing the "social act" of quality improvement. Given the ongoing emphasis on quality improvement in health systems and the persistent challenges involved, it also provides important information for healthcare leaders globally in seeking to develop, implement or modify similar tools and distribute leadership within health and social care settings.

Improving safety on rural local and tribal roads site safety analysis - user guide #1.

DOT National Transportation Integrated Search

2014-08-01

This User Guide presents an example of how rural local and Tribal practitioners can study conditions at a preselected site. It demonstrates the step-by-step safety analysis process presented in Improving Safety on Rural Local and Tribal Roads Saf...

Improving Student Retention: A Guide to Successful Strategies.

ERIC Educational Resources Information Center

Martinez, Paul

This guide is designed to share the experiences of 25 British further education colleges and adult education services that have developed demonstrably successful strategies to improve student retention. An introduction discusses the report's background, content, and format. The format mixes thematic presentation with mini-case studies and…

Medical Interpreting: Improving Communication with Your Patients.

ERIC Educational Resources Information Center

Tebble, Helen

The guide is designed for physicians and other medical practitioners who need to work with medical interpreters to improve communication with patients. Special attention is given to the Australian context. An introductory section discusses the need for medical interpreters and explains the guide's organization. Subsequent sections address these…

WE-EF-BRD-01: Past, Present and Future: MRI-Guided Radiotherapy From 2005 to 2025

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

Lagendijk, J.

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapymore » from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.« less

Artificial intelligence guides system's best practices, cutting costs and improving services.

PubMed

1999-06-01

One for the history books. Clinical care improvement initiatives guided by a sophisticated artificial intelligence program have helped a major Virginia integrated health system make dramatic improvements in the cost and quality of its health care services. Find out how the technological innovation has earned Sentara Health System a place in the permanent collection of the Smithsonian's National Museum of American History.

Principles of effective USA federal fire management plans

USGS Publications Warehouse

Meyer, Marc D.; Roberts, Susan L.; Wills, Robin; Brooks, Matthew L.; Winford, Eric M.

2015-01-01

Federal fire management plans are essential implementation guides for the management of wildland fire on federal lands. Recent changes in federal fire policy implementation guidance and fire science information suggest the need for substantial changes in federal fire management plans of the United States. Federal land management agencies are also undergoing land management planning efforts that will initiate revision of fire management plans across the country. Using the southern Sierra Nevada as a case study, we briefly describe the underlying framework of fire management plans, assess their consistency with guiding principles based on current science information and federal policy guidance, and provide recommendations for the development of future fire management plans. Based on our review, we recommend that future fire management plans be: (1) consistent and compatible, (2) collaborative, (3) clear and comprehensive, (4) spatially and temporally scalable, (5) informed by the best available science, and (6) flexible and adaptive. In addition, we identify and describe several strategic guides or “tools” that can enhance these core principles and benefit future fire management plans in the following areas: planning and prioritization, science integration, climate change adaptation, partnerships, monitoring, education and communication, and applied fire management. These principles and tools are essential to successfully realize fire management goals and objectives in a rapidly changing world.

Preventing & Managing Communicable Diseases. Training Guides for the Head Start Learning Community.

ERIC Educational Resources Information Center

Bowman (James) Associates, San Francisco, CA.

This training guide is intended to improve the skills of Head Start staff and families in dealing with communicable diseases. The guide addresses attitudes toward communicable diseases, how to reduce the spread of disease, and how to recognize and manage illnesses more effectively. The guide consists of six working sections. The first three are…

Families and Futures 2000. A Resource for Planning Comprehensive Home and Family Life Education Programs. Working Papers.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia.

This curriculum guide is the first step in a total home and family life curriculum revision in the state of Washington aimed at helping students solve problems and study issues that have an impact on home and family life. The guide contains two model, nonsequential, comprehensive courses that may be adopted or adapted by school districts. The…

Project EFFECT. Energy for the Future: Education, Conservation, Training. Curriculum Guides for the Training of Energy Extension Agents. A Working Paper, Section II: Technical Training.

ERIC Educational Resources Information Center

Indiana Univ., South Bend. Center for Energy Conservation.

This second of four sections in a curriculum guide for training energy extension agents contains general introductory materials, an overview of the total curriculum, and eight modules: Alternative Energy Sources (Solar and Wood), Basic Graphics and Blueprint Reading, Building Materials, Electricity, Introduction to Cooling Systems, Introduction to…