Stepping Across Boundaries

ERIC Educational Resources Information Center

McLin, Jon

1972-01-01

Considers existing mechanisms for international action on environmental improvement and accomplishments of European organizations to date. Suggests some of the problems and difficulties relative to establishing international environmental controls. (BL)

Attentional focus and performance anxiety: effects on simulated race-driving performance and heart rate variability.

PubMed

Mullen, Richard; Faull, Andrea; Jones, Eleri S; Kingston, Kieran

2012-01-01

Previous studies have demonstrated that an external focus can enhance motor learning compared to an internal focus. The benefits of adopting an external focus are attributed to the use of less effortful automatic control processes, while an internal focus relies upon more effort-intensive consciously controlled processes. The aim of this study was to compare the effectiveness of a distal external focus with an internal focus in the acquisition of a simulated driving task and subsequent performance in a competitive condition designed to increase state anxiety. To provide further evidence for the automatic nature of externally controlled movements, the study included heart rate variability (HRV) as an index of mental effort. Sixteen participants completed eight blocks of four laps in either a distal external or internal focus condition, followed by two blocks of four laps in the competitive condition. During acquisition, the performance of both groups improved; however, the distal external focus group outperformed the internal focus group. The poorer performance of the internal focus group was accompanied by a larger reduction in HRV, indicating a greater investment of mental effort. In the competition condition, state anxiety increased, and for both groups, performance improved as a function of the increased anxiety. Increased heart rate and self-reported mental effort accompanied the performance improvement. The distal external focus group also outperformed the internal focus group across both neutral and competitive conditions and this more effective performance was again associated with lower levels of HRV. Overall, the results offer support for the suggestion that an external focus promotes a more automatic mode of functioning. In the competitive condition, both foci enhanced performance and while the improved performance may have been achieved at the expense of greater compensatory mental effort, this was not reflected in HRV scores.

Improving International-Level Chess Players' Performance with an Acceptance-Based Protocol: Preliminary Findings

ERIC Educational Resources Information Center

Ruiz, Francisco J.; Luciano, Carmen

2012-01-01

This study compared an individual, 4-hr intervention based on acceptance and commitment therapy (ACT) versus a no-contact control condition in improving the performance of international-level chess players. Five participants received the brief ACT protocol, with each matched to another chess player with similar characteristics in the control…

The effects of caudal mobilisation with movement (MWM) and caudal self-mobilisation with movement (SMWM) in relation to restricted internal rotation in the hip: A randomised control pilot study.

PubMed

Walsh, Riche; Kinsella, Sharon

2016-04-01

A loss of internal rotation (IR) of the hip is associated with hip pathology. Improving IR may improve hip range of motion (ROM) or prevent hip pathology. The purpose of this study was to compare the immediate effects of caudal mobilisation with movement (MWM) and caudal self-mobilisation with movement (SMWM) on young healthy male subjects with reduced IR of the hip. A randomised controlled trial was performed. Twenty-Two subjects were randomised into a MWM group (n = 6), SMWM group (n = 8) or a control group (n = 8). The primary outcome measures included the functional internal rotation test (FIRT) for the hip and the passive seated internal rotation test (SIRT) for the hip. Outcomes were captured at baseline and immediately after one treatment of MWMs, SMWMs or control. A two-way analysis of variance (ANOVA), group × time interaction was conducted. The ANOVA revealed the only significant improvement was in the MWM group for the FIRT (p = 0.01), over the control group. Subjects with reduced IR of the hip who receive a single session of MWMs exhibited significantly improved functional IR of their hip than the control group. From the data presented, it can be suggested that caudal MWMs of the hip appear to have a positive effect on functional IR of healthy young hips. This may be due to addressing the positional fault theory or the arthrogenic muscular inhibition theory. SMWMs may be effective in augmenting treatments for patients waiting for hip operations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Control installation for the proportioning of a secondary air quantity for improvement of the combustion in internal combustion engines or the afterburning of the exhaust gases of internal combustion engines

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

Bockelmann, W.; Groezinger, H.; Woebky, P.U.

1977-01-04

A control installation is described for the dosing or proportioning of a secondary air quantity for the improvement of combustion in internal combustion engines, or the after-burning of the exhaust gases of internal combustion engines. An auxiliary arrangement is responsive to an emergency signal for effecting the prompt shutting-off of the secondary air. The emergency signal may be initiated in response to a failure in the ignition voltage of the internal combustion engine; an increase in the hydrocarbon content of the exhaust gases; a disparity between the position of the mixture dosing element and the engine rotational speed; the exceedingmore » of a limiting temperature in the exhaust gas manifold; or the exceeding of a limiting temperature in the afterburner.« less

Blood glucose control and quality of health care in non-insulin-treated patients with Type 2 diabetes in Spain: a retrospective and cross-sectional observational study

PubMed Central

Rodríguez, A; Calle, A; Vázquez, L; Chacón, F; Polavieja, P; Reviriego, J

2011-01-01

Aims To assess blood glucose control and quality of health care provided to non-insulin-treated patients with Type 2 diabetes mellitus in routine clinical practice in Spain. Methods In this observational, retrospective, cross-sectional study, patients were grouped as either having good or suboptimal blood glucose control according to International Diabetes Federation or American Diabetes Association HbA1c goals. Clinical and socio-demographic data and compliance with the main standard level of care recommendations of the International Diabetes Federation were recorded during a routine visit. Correlates of glucose control were analysed by logistic regression. Results Many patients were grouped as having suboptimal control under International Diabetes Federation (61.9%) or American Diabetes Association (45.0%) criteria. The mean number of accomplished International Diabetes Federation recommendations (7.3 out of 11) was higher for endocrinologists (than for internists or primary care physicians), and significantly more patients under their care were in the good glucose control group (than with primary care physicians). More recommendations were associated with blood glucose control using International Diabetes Federation than American Diabetes Association criteria, demanding higher quality of health care for achieving stricter goals. Some recommendations were poorly observed, particularly those concerning patients’ education on diabetes, the prompt prescription of effective treatments and monitoring of complications. Diabetes complications were associated with being in the suboptimal control group. Patients’ education on diabetes and HbA1c monitoring were associated with being in the good control group. Conclusions These results demonstrate the need for improvement in the management of patients with non-insulin-treated Type 2 diabetes in actual clinical practice in Spain. Such improvement would entail a stricter adherence to International Diabetes Federation recommendations. PMID:21294772

The Effect of a CD-ROM Multimedia Tool on the Cardiac Auscultation Ability of Internal Medicine Residents

PubMed Central

Mangrulkar, Rajesh S.; Watt, John M.; Chapman, Chris M.; Judge, Richard D.; Stern, David T.

2001-01-01

In order to test the hypothesis that self study with a CD-ROM based cardiac auscultation tool would enhance knowledge and skills, we conducted a controlled trial of internal medicine residents and evaluated their performance on a test before and after exposure to the tool. Both intervention and control groups improved their auscultation knowledge and skills scores. However, subjects in the CD-ROM group had significantly higher improvements in skills, knowledge, and total scores than those not exposed to the intervention (all p<0.001). Therefore, protected time for internal medicine residents to use this multimedia computer program enhanced both facets of cardiac auscultation.

Reducing and preventing internalizing and externalizing behavior problems in children with type 1 diabetes: a randomized controlled trial of the Triple P-Positive Parenting Program.

PubMed

Westrupp, E M; Northam, E; Lee, K J; Scratch, S E; Cameron, F

2015-11-01

Children with type 1 diabetes are at increased risk of mental health problems, which in turn are associated with poor glycemic control, diabetes-related complications, and long-term psychiatric morbidity. We tested the efficacy of the Triple P-Positive Parenting Program in reducing or preventing mental health problems and improving glycemic control in children with type 1 diabetes in a randomized controlled trial. Participants were recruited from the Diabetes Clinic, Royal Children's Hospital, Melbourne, Australia, and randomized to Triple P or standard diabetes care. The primary outcome was child internalizing and externalizing behavior problems 3 and 12 months postrandomization. Secondary outcomes were glycemic control, parent mental health, parenting skills, and family functioning at 3 and 12 months, and glycemic control at 24 months. A total of 76 participants were randomized (38 to intervention and 38 to control), 60 completed 3-month, and 57 completed 12-month assessments. Benefits of Triple P were evident at 3 months for parent mental health, parenting skills, and family functioning (p < 0.05), but not for child mental health or glycemic control, with little effect at 12 months. Prespecified subgroup analyses for children with pre-existing internalizing or externalizing behavior problems indicated greater improvements in child mental health, parent mental health, parenting skills, and diabetes family conflict (p < 0.05), but lower parenting self-efficacy at 3 months. Improvements in parent mental health and parenting competency associated with Triple P were sustained to 12 months for children with pre-existing mental health problems. This study provides some support for the efficacy of Triple P in improving parent and family outcomes, and reducing child internalizing and externalizing behavior problems primarily in children who have pre-existing mental health problems. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Resistance to temptation: the interaction of external and internal control on alcohol use during residential treatment for alcohol use disorder.

PubMed

Soravia, Leila M; Schläfli, Katrin; Stutz, Sonja; Rösner, Susanne; Moggi, Franz

2015-11-01

There is evidence that drinking during residential treatment is related to various factors, such as patients' general control beliefs and self-efficacy, as well as to external control of alcohol use by program's staff and situations where there is temptation to drink. As alcohol use during treatment has been shown to be associated with the resumption of alcohol use after discharge from residential treatment, we aimed to investigate how these variables are related to alcohol use during abstinence-oriented residential treatment programs for alcohol use disorders (AUD). In total, 509 patients who entered 1 of 2 residential abstinence-oriented treatment programs for AUD were included in the study. After detoxification, patients completed a standardized diagnostic procedure including interviews and questionnaires. Drinking was assessed by patients' self-report of at least 1 standard drink or by positive breathalyzer testing. The 2 residential programs were categorized as high or low control according to the average number of tests per patient. Regression analysis revealed a significant interaction effect between internal and external control suggesting that patients with high internal locus of control and high frequency of control by staff demonstrated the least alcohol use during treatment (16.7%) while patients with low internal locus of control in programs with low external control were more likely to use alcohol during treatment (45.9%). No effects were found for self-efficacy and temptation. As alcohol use during treatment is most likely associated with poor treatment outcomes, external control may improve treatment outcomes and particularly support patients with low internal locus of control, who show the highest risk for alcohol use during treatment. High external control may complement high internal control to improve alcohol use prevention while in treatment. Copyright © 2015 The Authors. Alcoholism: Clinical and Experimental Research published by Wiley Periodicals, Inc. on behalf of Research Society on Alcoholism.

Plain packaging: an opportunity for improved international policy coherence?

PubMed

Lencucha, Raphael; Drope, Jeffrey

2015-06-01

This paper highlights two salient challenges at the intersection of tobacco control and macroeconomic policy-making: (i) the use of trade and investment disputes to undermine and/or stall tobacco control legislation and (ii) the inconsistency, and thus unpredictability, of country positions across the two spheres. In the interest of improving international policy coherence, the authors suggest possible solutions to these two challenges at the national and intergovernmental levels. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Randomized Cohort Controlled Trial to Compare Intern Sign-Out Training Interventions.

PubMed

Lee, Soo-Hoon; Terndrup, Christopher; Phan, Phillip H; Zaeh, Sandra E; Atsina, Kwame; Minkove, Nicole; Billioux, Alexander; Chatterjee, Souvik; Montague, Idoreyin; Clark, Bennett; Hughes, Andrew; Desai, Sanjay V

2017-12-01

Although previous studies have investigated the efficacy of specific sign-out protocols (such as the illness severity, patient summary, action list, situation awareness and contingency planning, and synthesis by reviewer [I-PASS] bundle), the implementation of a bundle can be time consuming and costly. We compared 4 sign-out training pedagogies on sign-out quality. To evaluate training interventions that best enhance multidimensional sign-out quality measured by information exchange, task accountability, and personal responsibility. Four general internal medicine firms were randomly assigned into 1 of the following 4 training interventions: didactics (control), I-PASS, policy mandate on task accountability, and Plan-Do-Study-Act (PDSA). First-year interns at a large, Mid-Atlantic internal medicine residency program. Eight trained observers examined 10 days each in the pre- and postintervention periods for each firm using a standardized sign-out checklist. Pre- and postintervention differences showed significant improvements in the transfer of patient information, task accountability, and personal responsibility for the I-PASS, policy mandate, and PDSA groups, respectively, in line with their respective training foci. Compared to the control, I-PASS reported the best improvements in sign-out quality, although there was room to improve in task accountability and responsibility. Different training emphases improved different dimensions of sign-out quality. A combination of training pedagogies is likely to yield optimal results. © 2017 Society of Hospital Medicine

Understanding Author Academic Disciplinary Background to Direct a More Effective Use of Standardized Testing within the School Community

ERIC Educational Resources Information Center

Jensen, Joseph N.; Hite, Steven J.; Hite, Julie M.; Randall, E. Vance

2017-01-01

Standardized testing is an external control mechanism for K-12 public schools. Principals, nested between internal and external influences, must manage the tension created by testing's roles as both an internal improvement tool and as an external control mechanism. Five competing narratives, each shaped by author academic background, significantly…

Effects of pivoting neuromuscular training on pivoting control and proprioception.

PubMed

Lee, Song Joo; Ren, Yupeng; Chang, Alison H; Geiger, François; Zhang, Li-Qun

2014-07-01

Pivoting neuromuscular control and proprioceptive acuity may play an important role in anterior cruciate ligament injuries. The goal of this study was to investigate whether pivoting off-axis intensity adjustable neuromuscular control training (POINT) could improve pivoting neuromuscular control, proprioceptive acuity, and functional performance. Among 41 subjects, 21 subjects participated in 18 sessions of POINT (three sessions per week for 6 wk), and 20 subjects served as controls who did their regular workout. Both groups received pre-, mid-, and postintervention evaluations. Propensity score analysis with multivariable regression adjustment was used to investigate the effect of training on pivoting neuromuscular control (pivoting instability, leg pivoting stiffness, maximum internal, and external pivoting angles), proprioceptive acuity, and functional performance in both groups. Compared with the control group, the training group significantly improved pivoting neuromuscular control as reduced pivoting instability, reduced maximum internal and external pivoting angles, increased leg pivoting stiffness, and decreased entropy of time to peak EMG in the gluteus maximus and lateral gastrocnemius under pivoting perturbations. Furthermore, the training group enhanced weight-bearing proprioceptive acuity and improved the single leg hop distance. Improvement of pivoting neuromuscular control in functional weight-bearing activities and task performances after POINT may help develop lower limb injury prevention and rehabilitation methods to reduce anterior cruciate ligament and other musculoskeletal injuries associated with pivoting sports.

Effects of a 6-week junior tennis conditioning program on service velocity.

PubMed

Fernandez-Fernandez, Jaime; Ellenbecker, Todd; Sanz-Rivas, David; Ulbricht, Alexander; Ferrautia, Alexander

2013-01-01

This study examined the effects of a 6-week strength-training program on serve velocity in youth tennis players. Thirty competitive healthy and nationally ranked male junior tennis players (13 years of age) were randomly and equally divided into control and training groups. The training group performed 3 sessions (60-70 min) weekly for 6 weeks, comprising core strength, elastic resistance and medicine ball exercises. Both groups (control and training) also performed a supervised stretching routine at the end of each training session, during the 6 week intervention. Service velocity, service accuracy and shoulder internal/external rotation were assessed initially and at the end of the 6-week conditioning program for both, control and training groups. There was a significant improvement in the serve velocity for the training group (p = 0. 0001) after the intervention, whereas in the control group there were no differences between pre and post-tests (p = 0.29). Serve accuracy was not affected in the training group (p = 0.10), nor in the control group (p = 0.15). Shoulder internal/external rotation ROM significantly improved in both groups, training (p = 0.001) and control (p = 0.0001). The present results showed that a short- term training program for young tennis players, using minimum equipment and effort, can result in improved tennis performance (i.e., serve velocity) and a reduction in the risk of a possible overuse injury, reflected by an improvement in shoulder external/internal range of motion. Key PointsA short-term training program for young tennis players, using minimum equipment and effort, can result in improved tennis performance and a reduction in the risk of a possible overuse injury, reflected by an improvement in shoulder external/internal range of motionA combination of core stabilization, elastic resistance exercises, and upper body plyometric exercises (i.e., medicine ball throws), focussing on the primary muscle groups and stabilizers involved in tennis specific movement patterns, could be appropriate for development tennis playersStretching exercises are recommended in the cool-down phase following matches or training sessions.

Effects of A 6-Week Junior Tennis Conditioning Program on Service Velocity

PubMed Central

Fernandez-Fernandez, Jaime; Ellenbecker, Todd; Sanz-Rivas, david; Ulbricht, Alexander; Ferrautia, lexander

2013-01-01

This study examined the effects of a 6-week strength-training program on serve velocity in youth tennis players. Thirty competitive healthy and nationally ranked male junior tennis players (13 years of age) were randomly and equally divided into control and training groups. The training group performed 3 sessions (60-70 min) weekly for 6 weeks, comprising core strength, elastic resistance and medicine ball exercises. Both groups (control and training) also performed a supervised stretching routine at the end of each training session, during the 6 week intervention. Service velocity, service accuracy and shoulder internal/external rotation were assessed initially and at the end of the 6-week conditioning program for both, control and training groups. There was a significant improvement in the serve velocity for the training group (p = 0. 0001) after the intervention, whereas in the control group there were no differences between pre and post-tests (p = 0.29). Serve accuracy was not affected in the training group (p = 0.10), nor in the control group (p = 0.15). Shoulder internal/external rotation ROM significantly improved in both groups, training (p = 0.001) and control (p = 0.0001). The present results showed that a short- term training program for young tennis players, using minimum equipment and effort, can result in improved tennis performance (i.e., serve velocity) and a reduction in the risk of a possible overuse injury, reflected by an improvement in shoulder external/internal range of motion. Key Points A short-term training program for young tennis players, using minimum equipment and effort, can result in improved tennis performance and a reduction in the risk of a possible overuse injury, reflected by an improvement in shoulder external/internal range of motion A combination of core stabilization, elastic resistance exercises, and upper body plyometric exercises (i.e., medicine ball throws), focussing on the primary muscle groups and stabilizers involved in tennis specific movement patterns, could be appropriate for development tennis players Stretching exercises are recommended in the cool-down phase following matches or training sessions. PMID:24149801

Technical skill improvement with surgical preparatory courses: What advantages are reflected in residency?

PubMed

Green, Courtney A; Huang, Emily; Zhao, Nina W; O'Sullivan, Patricia S; Kim, Edward; Chern, Hueylan

2017-11-01

Sustainability of skill acquisition gained from graduating medical student (GMS) preparatory courses remains uncertain. GMS skills were assessed before (T1) and after a preparatory course (T2) and then again 2 (T3) and 4 (T4) months into residency and compared to surgical interns without such a course. In April, GMS took the preparatory course. In July-August all interns participated in a basic skills curriculum. Learners completed four technical exercises pre/post each course. Three surgeons scored performances. GMS scores were compared across the 4 time points. Control interns were compared at T3 and T4. Thirty-two interns completed all pre/post course assessments (T3 and T4); seven of those were GMSs. GMS scores increased from 74.5%(T1) to 94.2%(T2) (p < 0.001), and were maintained into residency. Control interns also improved (65.8%(T3) to 91.8%(T4), p < 0.001). GMS-interns scored higher starting residency compared to control interns (T3, 89.08% vs 65.03%, p < 0.001). These findings support existing literature and demonstrate that students maintain their skills into residency. Preparatory courses provide a head start. Without such course, interns require a steep learning curve. Copyright © 2017 Elsevier Inc. All rights reserved.

Global partnerships are critical to advance the control of Neglected Zoonotic Diseases: The case of the Global Alliance for Rabies Control.

PubMed

Nel, Louis H; Taylor, Louise H; Balaram, Deepashree; Doyle, Kim A S

2017-01-01

There is a need for innovation to improve control of all Neglected Zoonotic Diseases (NZDs). The Global Alliance for Rabies Control was formed to prevent human deaths from rabies and relieve the burden of rabies in other animal populations, especially dogs. It aims to identify reasons for the neglect of rabies in developing countries and to develop strategies to improve rabies control. Through initiatives such as World Rabies Day and the Partners for Rabies Prevention, progress has been made towards increased awareness of the burden of rabies transmitted by dogs at scales from local to international. An evidence base of the feasibility of canine rabies elimination has been built up and now easier access to information and tools enables countries to design and implement rabies elimination strategies in a logical way, utilizing the structures of regional networks for rabies control. The body of evidence has built consensus amongst international stakeholders in rabies control and is now being used to encourage international policy change, attract investment and increase delivery of effective rabies control programmes in canine rabies endemic countries. Copyright © 2015 Elsevier B.V. All rights reserved.

Nonlinearity measure and internal model control based linearization in anti-windup design

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

Perev, Kamen

2013-12-18

This paper considers the problem of internal model control based linearization in anti-windup design. The nonlinearity measure concept is used for quantifying the control system degree of nonlinearity. The linearizing effect of a modified internal model control structure is presented by comparing the nonlinearity measures of the open-loop and closed-loop systems. It is shown that the linearization properties are improved by increasing the control system local feedback gain. However, it is emphasized that at the same time the stability of the system deteriorates. The conflicting goals of stability and linearization are resolved by solving the design problem in different frequencymore » ranges.« less

Impact of a Resident-as-Teacher Workshop on Teaching Behavior of Interns and Learning Outcomes of Medical Students

PubMed Central

Hill, Andrew G.; Srinivasa, Sanket; Hawken, Susan J.; Barrow, Mark; Farrell, Susan E.; Hattie, John; Yu, Tzu-Chieh

2012-01-01

Background Residents and interns are recognized as important clinical teachers and mentors. Resident-as-teacher training programs are known to improve resident attitudes and perceptions toward teaching, as well as their theoretical knowledge, skills, and teaching behavior. The effect of resident-as-teacher programs on learning outcomes of medical students, however, remains unknown. An intervention cohort study was conducted to prospectively investigate the effects of a teacher-training workshop on teaching behavior of participating interns and on the clerkship learning outcomes of instructed fourth-year medical students. Methods The House Officer-as-Teacher Training Workshop was implemented in November 2009 over 1.5 days and attended by all 34 interns from one teaching hospital. Subsequently, between February and August 2010, 124 fourth-year medical students rated the observable teaching behavior of interns during 6-week general surgery clerkships at this intervention hospital as well as at 2 comparable hospitals serving as control sites. Ratings were collected using an anonymous 15-item Intern Clinical Teaching Effectiveness Instrument. Student achievement of clerkship learning outcomes during this period was evaluated using a validated and centralized objective structured clinical examination. Results Medical students completed 101 intern clinical teaching effectiveness instruments. Intern teaching behavior at the intervention hospital was found to be significantly more positive, compared with observed behavior at the control hospitals. Objective structured clinical examination results, however, did not demonstrate any significant intersite differences in student achievement of general surgery clerkship learning outcomes. Conclusions The House Officer-as-Teacher Training Workshop noticeably improved teaching behavior of surgical interns during general surgery clerkships. This improvement did not, however, translate into improved achievement of clerkship learning outcomes by medical students during the study period. PMID:23451304

Women's perceived internal control of future pregnancy outcomes and its related factors.

PubMed

Maleki, Azam; Mazloomzadeh, Saeideh

2013-03-01

With regards to the importance of women's beliefs in improving pregnancy outcomes, this study was performed to determine the perceived internal control on future pregnancy outcomes and its related factors in women who participated in pre-marital counseling. In a cross-sectional study, women's perceived internal control was investigated. The study population comprised the women in reproductive age of whom 400 were selected by random sampling. Data collection instrument was a questionnaire consisting of demographic, pre-conceptional care, and internal control questions. Two categories of favorite and not favorite levels of internal control were defined based on the total score. The validity of the questionnaire was determined via content validity method by use of experts' opinion and its reliability was evaluated through the calculation of Cronbach's alpha coefficient which was 0.76. Data were analyzed through frequency tables, correlation coefficient, and Chi-square test at the confidence level of 0.95. Two hundred sixty-five (65%) women had a good perceived internal control and it was significantly associated with the age, educational level, and hearing about pre-conceptional care. The internal control score also showed a positive and significant correlation with both age and the subject knowledge about folic acid (r = 0.19 and r = 0.15, respectively). The majority of women had a favorite perceived internal control. Since age and educational level were the affecting factors on the perceived internal control of women, promoting the level of internal control in young women and those with low education in pre-marital counseling classes seems necessary.

Effects of Pivoting Neuromuscular Training on Pivoting Control and Proprioception

PubMed Central

Lee, Song Joo; Ren, Yupeng; Chang, Alison H.; Geiger, François; Zhang, Li-Qun

2014-01-01

Purpose Pivoting neuromuscular control and proprioceptive acuity may play an important role in ACL injuries. The goal of this study was to investigate whether pivoting neuromuscular training on an offaxis elliptical trainer (POINT) could improve pivoting neuromuscular control, proprioceptive acuity, and functional performance. Methods Among 41 subjects, 21 subjects participated in 18 sessions of POINT (3 sessions/week for 6 weeks), and 20 subjects served as controls who did their regular workout. Both groups received pre-, mid-, and post-intervention evaluations. Propensity score analysis with multivariable regression adjustment was used to investigate the effect of training on pivoting neuromuscular control (pivoting instability, leg pivoting stiffness, maximum internal and external pivoting angles), proprioceptive acuity, and functional performance in both groups. Results Compared to the control group, the training group significantly improved pivoting neuromuscular control as reduced pivoting instability, reduced maximum internal and external pivoting angles, increased leg pivoting stiffness, and decreased entropy of time to peak EMG in the gluteus maximus and lateral gastrocnemius under pivoting perturbations. Furthermore, the training group enhanced weight-bearing proprioceptive acuity and improved the single leg hop distance. Conclusion Improvement of pivoting neuromuscular control in functional weight-bearing activities and task performances following POINT may help develop lower limb injury prevention and rehabilitation methods to reduce ACL and other musculoskeletal injuries associated with pivoting sports. PMID:24389517

Intern pharmacists as change agents to improve the practice of nonprescription medication supply: provision of salbutamol to patients with asthma.

PubMed

Schneider, Carl R; Everett, Alan W; Geelhoed, Elizabeth; Padgett, Cale; Ripley, Scott; Murray, Kevin; Kendall, Peter A; Clifford, Rhonda M

2010-01-01

Earlier work established an evidence practice gap during provision of nonprescription salbutamol (albuterol). Pharmacist interns are hypothesized to be in a position to improve professional practice in the community pharmacy setting. To explore the potential of intern pharmacists to improve the professional practice of community pharmacy staff in the provision of nonprescription salbutamol. Intern pharmacists (n = 157) delivered an asthma intervention in 136 pharmacies consisting of an educational activity to pharmacy staff and a health promotion campaign to consumers. Post-intervention, simulated patients presented to 100 intervention and 100 control community pharmacies with a request for salbutamol. The appropriate outcome was medical referral for poor asthma control and correction of poor inhaler technique. Incidence and quantity of patient assessment and counseling provided during the visit were also assessed. Logistic regression was used to determine the predictors of medical referral. A doubling in the rate of medical referral was seen in the intervention group (19% vs 40%; p = 0.001). Assessment of reliever use frequency was the main predictor of medical referral (OR = 22.7; 95% CI 9.06 to 56.9). Correction of poor inhaler technique did not improve; however, a reduction in salbutamol supplied without patient assessment (23% vs 8%; p = 0.009) or counseling (75% vs 48%; p < 0.001) was noted. A doubling in the rate of medical referral showed a clear improvement in professional practice during the provision of nonprescription salbutamol. The improved patient outcome in the intervention group was due to increased assessment of reliever use frequency. Identification of poor inhaler technique remained near zero in both groups, which suggests that intern pharmacists were able to improve the current practice of community pharmacies yet were unable to establish a new practice behavior. This study provides evidence that intern pharmacists can act as change agents to improve pharmacy practice.

An attitude of gratitude: The effects of body-focused gratitude on weight bias internalization and body image.

PubMed

Dunaev, Jamie; Markey, Charlotte H; Brochu, Paula M

2018-06-01

Internalized weight bias and body dissatisfaction are associated with a number of negative psychological and physical health outcomes. The current study examined the effectiveness of body-focused gratitude, through a short writing exercise, as a strategy to reduce internalized weight bias and improve body image. Young adults (M age  = 22.71, SD = 2.08, 51.2% female) were randomly assigned to either a body gratitude condition (n = 185) or a control condition (n = 184). Results indicated that participants in the gratitude condition reported significantly lower weight bias internalization and significantly more favorable appearance evaluation and greater body satisfaction when compared to the control condition. These effects were in the small range (ds = 0.27-0.33), and neither gender nor BMI moderated these effects. These findings provide preliminary support for body-focused gratitude writing exercises as an effective individual-level strategy for both reducing internalized weight bias and improving body image. Copyright © 2018 Elsevier Ltd. All rights reserved.

Quantifying and Improving International Space Station Survivability Following Orbital Debris Penetration

NASA Technical Reports Server (NTRS)

Williamsen, Joel; Evans, Hilary; Bohl, Bill; Evans, Steven; Parker, Nelson (Technical Monitor)

2001-01-01

The increase of the orbital debris environment in low-earth orbit has prompted NASA to develop analytical tools for quantifying and lowering the likelihood of crew loss following orbital debris penetration of the International Space Station (ISS). NASA uses the Manned Spacecraft and Crew Survivability (MSCSurv) computer program to simulate the events that may cause crew loss following orbital debris penetration of ISS manned modules, including: (1) critical cracking (explosive decompression) of the module; (2) critical external equipment penetration (such as hydrazine and high pressure tanks); (3) critical internal system penetration (guidance, control, and other vital components); (4) hazardous payload penetration (furnaces, pressure bottles, and toxic substances); (5) crew injury (from fragments, overpressure, light flash, and temperature rise); (6) hypoxia from loss of cabin pressure; and (7) thrust from module hole causing high angular velocity (occurring only when key Guidance, Navigation, and Control (GN&C) equipment is damaged) and, thus, preventing safe escape vehicle (EV) departure. MSCSurv is also capable of quantifying the 'end effects' of orbital debris penetration, such as the likelihood of crew escape, the probability of each module depressurizing, and late loss of station control. By quantifying these effects (and their associated uncertainties), NASA is able to improve the likelihood of crew survivability following orbital debris penetration due to improved crew operations and internal designs.

International Atomic Energy Agency specialists meeting on experience in ageing, maintenance, and modernization of instrumentation and control systems for improving nuclear power plant availability

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

Not Available

1993-10-01

This report presents the proceedings of the Specialist`s Meeting on Experience in Aging, Maintenance and Modernization of Instrumentation and Control Systems for Improving Nuclear Power Plant Availability that was held at the Ramada Inn in Rockville, Maryland on May 5--7, 1993. The Meeting was presented in cooperation with the Electric Power Research Institute, Oak Ridge National Laboratory and the International Atomic Energy Agency. There were approximately 65 participants from 13 countries at the Meeting. Individual reports have been cataloged separately.

Implementation of "New Directions" in Development Assistance: Report to the Committee on International Relations on Implementation of Legislative Reforms in the Foreign Assistance Act of 1973.

ERIC Educational Resources Information Center

Agency for International Development (Dept. of State), Washington, DC.

This report discusses the many policy and procedural issues of the Agency for International Development (AID) in implementing the reforms included in the congressional Foreign Assistance Act of 1973. The act concentrated aid efforts on food and nutrition improvement, population control, health improvement, education, and human resource…

The Clash of Evaluations: In Search of the Missing Link between School Accountability and School Improvement--Experiences from Cyprus

ERIC Educational Resources Information Center

Brauckmann, Stefan; Pashiardis, Petros

2010-01-01

Purpose: The main purpose of this paper is to examine more closely the tension between, on the one hand, forms of internal school improvement based on internal evaluation measures and, on the other hand, control and legitimisation needs grounded on external evaluation measures. Design/methodology/approach: The clash of these forms of evaluation is…

Predictors of outcome of an Internet-based cognitive-behavioural therapy for post-traumatic stress disorder in older adults.

PubMed

Böttche, Maria; Kuwert, Philipp; Pietrzak, Robert H; Knaevelsrud, Christine

2016-03-01

The aim of this study was to evaluate the role of resource-oriented variables such as self-efficacy, locus of control (LOC) and post-traumatic growth (PTG) in predicting treatment response in older adults with post-traumatic stress. Fifty-eight older adults with subsyndromal or greater severity of war-associated post-traumatic stress disorder (PTSD) symptoms completed a randomized controlled Internet-based cognitive-behavioural therapy (CBT) with immediate and delayed treatment groups. Assessments of PTSD severity and resource-oriented variables of self-efficacy, LOC and PTG were conducted at baseline, post-treatment and at a 6-month follow-up. Results revealed that pre-treatment scores on measures of internal LOC and PTG predicted PTSD symptom severity at post-treatment, even after controlling for initial PTSD. At a 6-month follow-up, internal LOC continued to predict PTSD symptom severity. In addition, repeated-measures analyses of variance revealed that, relative to older adults with low internal LOC and PTG, older adults with high internal LOC and PTG, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. These findings suggest that greater locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Assessment of these constructs may be useful in identifying trauma survivors who are most likely to respond to CBT. Greater internal locus of control and post-traumatic growth is associated with greater improvement in PTSD symptoms following Internet-based CBT. Older adults with initial high internal locus of control and post-traumatic growth, respectively, did not differ with respect to initial PTSD severity, but they showed a more pronounced response to treatment. It could be assumed that patients with initial functional appraisals could benefit easier and faster from a trauma-focused cognitive-behavioural therapy compared to individuals with lower internal locus of control and post-traumatic growth. © 2015 The British Psychological Society.

The Clinical Nurse Leader--new nursing role with global implications.

PubMed

Baernholdt, M; Cottingham, S

2011-03-01

This paper describes the development of the Clinical Nurse Leader (CNL ©) role and education, the CNL's impact and potential to improve quality globally. The need for clinical nurse leadership to improve the quality of health care systems while controlling costs is recognized in reports internationally. In the USA, a new nursing role, the CNL, was developed in response to such reports. CNLs are master's level nurse graduates (although not necessarily recruited from a nursing background) with the skills and knowledge to create change within complex systems and improve outcomes while they remain direct care providers. This innovative role can be adapted worldwide to improve the quality of health care systems. © 2010 The Authors. International Nursing Review © 2010 International Council of Nurses.

Artificial neural networks in Space Station optimal attitude control

NASA Astrophysics Data System (ADS)

Kumar, Renjith R.; Seywald, Hans; Deshpande, Samir M.; Rahman, Zia

1992-08-01

Innovative techniques of using 'Artificial Neural Networks' (ANN) for improving the performance of the pitch axis attitude control system of Space Station Freedom using Control Moment Gyros (CMGs) are investigated. The first technique uses a feedforward ANN with multilayer perceptrons to obtain an on-line controller which improves the performance of the control system via a model following approach. The second techique uses a single layer feedforward ANN with a modified back propagation scheme to estimate the internal plant variations and the external disturbances separately. These estimates are then used to solve two differential Riccati equations to obtain time varying gains which improve the control system performance in successive orbits.

An analysis of landing rates and separations at the Dallas/Fort Worth International Airport

NASA Technical Reports Server (NTRS)

Ballin, Mark G.; Erzberger, Heinz

1996-01-01

Advanced air traffic management systems such as the Center/TRACON Automation System (CTAS) should yield a wide range of benefits, including reduced aircraft delays and controller workload. To determine the traffic-flow benefits achievable from future terminal airspace automation, live radar information was used to perform an analysis of current aircraft landing rates and separations at the Dallas/Fort Worth International Airport. Separation statistics that result when controllers balance complex control procedural constraints in order to maintain high landing rates are presented. In addition, the analysis estimates the potential for airport capacity improvements by determining the unused landing opportunities that occur during rush traffic periods. Results suggest a large potential for improving the accuracy and consistency of spacing between arrivals on final approach, and they support earlier simulation findings that improved air traffic management would increase capacity and reduce delays.

75 FR 43917 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-27

...: International Trade Administration. Title: U.S. Government Trade Event Information Request. OMB Control Number... priority essential to improving U.S. trade performance. The International Trade Administration's (ITA... procurements worldwide. The Advocacy Center works closely with the Trade Promotion Coordination Committee...

Does Internal Quality Management Contribute to More Control or to Improvement of Higher Education?: A Survey on Faculty's Perceptions

ERIC Educational Resources Information Center

Kleijnen, Jan; Dolmans, Diana; Willems, Jos; van Hout, Hans

2011-01-01

Purpose: The purpose of this paper is to explore faculty's perceptions of quality management activities (QMA) within their departments, attention being paid to relevant quality aspects and whether quality management contributes to control or improvement of higher education. Furthermore, it examines differences between departments and relationships…

Simulation improves procedural protocol adherence during central venous catheter placement: a randomized-controlled trial

PubMed Central

Peltan, Ithan D.; Shiga, Takashi; Gordon, James A.; Currier, Paul F.

2015-01-01

Background Simulation training may improve proficiency at and reduces complications from central venous catheter (CVC) placement, but the scope of simulation’s effect remains unclear. This randomized controlled trial evaluated the effects of a pragmatic CVC simulation program on procedural protocol adherence, technical skill, and patient outcomes. Methods Internal medicine interns were randomized to standard training for CVC insertion or standard training plus simulation-based mastery training. Standard training involved a lecture, a video-based online module, and instruction by the supervising physician during actual CVC insertions. Intervention-group subjects additionally underwent supervised training on a venous access simulator until they demonstrated procedural competence. Raters evaluated interns’ performance during internal jugular CVC placement on actual patients in the medical intensive care unit. Generalized estimating equations were used to account for outcome clustering within trainees. Results We observed 52 interns place 87 CVCs. Simulation-trained interns exhibited better adherence to prescribed procedural technique than interns who received only standard training (p=0.024). There were no significant differences detected in first-attempt or overall cannulation success rates, mean needle passes, global assessment scores or complication rates. Conclusions Simulation training added to standard training improved protocol adherence during CVC insertion by novice practitioners. This study may have been too small to detect meaningful differences in venous cannulation proficiency and other clinical outcomes, highlighting the difficulty of patient-centered simulation research in settings where poor outcomes are rare. For high-performing systems, where protocol deviations may provide an important proxy for rare procedural complications, simulation may improve CVC insertion quality and safety. PMID:26154250

Development of internal models and predictive abilities for visual tracking during childhood

PubMed Central

Ego, Caroline; Yüksel, Demet

2015-01-01

The prediction of the consequences of our own actions through internal models is an essential component of motor control. Previous studies showed improvement of anticipatory behaviors with age for grasping, drawing, and postural control. Since these actions require visual and proprioceptive feedback, these improvements might reflect both the development of internal models and the feedback control. In contrast, visual tracking of a temporarily invisible target gives specific markers of prediction and internal models for eye movements. Therefore, we recorded eye movements in 50 children (aged 5–19 yr) and in 10 adults, who were asked to pursue a visual target that is temporarily blanked. Results show that the youngest children (5–7 yr) have a general oculomotor behavior in this task, qualitatively similar to the one observed in adults. However, the overall performance of older subjects in terms of accuracy at target reappearance and variability in their behavior was much better than the youngest children. This late maturation of predictive mechanisms with age was reflected into the development of the accuracy of the internal models governing the synergy between the saccadic and pursuit systems with age. Altogether, we hypothesize that the maturation of the interaction between smooth pursuit and saccades that relies on internal models of the eye and target displacement is related to the continuous maturation of the cerebellum. PMID:26510757

Development of internal models and predictive abilities for visual tracking during childhood.

PubMed

Ego, Caroline; Yüksel, Demet; Orban de Xivry, Jean-Jacques; Lefèvre, Philippe

2016-01-01

The prediction of the consequences of our own actions through internal models is an essential component of motor control. Previous studies showed improvement of anticipatory behaviors with age for grasping, drawing, and postural control. Since these actions require visual and proprioceptive feedback, these improvements might reflect both the development of internal models and the feedback control. In contrast, visual tracking of a temporarily invisible target gives specific markers of prediction and internal models for eye movements. Therefore, we recorded eye movements in 50 children (aged 5-19 yr) and in 10 adults, who were asked to pursue a visual target that is temporarily blanked. Results show that the youngest children (5-7 yr) have a general oculomotor behavior in this task, qualitatively similar to the one observed in adults. However, the overall performance of older subjects in terms of accuracy at target reappearance and variability in their behavior was much better than the youngest children. This late maturation of predictive mechanisms with age was reflected into the development of the accuracy of the internal models governing the synergy between the saccadic and pursuit systems with age. Altogether, we hypothesize that the maturation of the interaction between smooth pursuit and saccades that relies on internal models of the eye and target displacement is related to the continuous maturation of the cerebellum. Copyright © 2016 the American Physiological Society.

Artificial neural networks in Space Station optimal attitude control

NASA Astrophysics Data System (ADS)

Kumar, Renjith R.; Seywald, Hans; Deshpande, Samir M.; Rahman, Zia

1995-01-01

Innovative techniques of using "artificial neural networks" (ANN) for improving the performance of the pitch axis attitude control system of Space Station Freedom using control moment gyros (CMGs) are investigated. The first technique uses a feed-forward ANN with multi-layer perceptrons to obtain an on-line controller which improves the performance of the control system via a model following approach. The second technique uses a single layer feed-forward ANN with a modified back propagation scheme to estimate the internal plant variations and the external disturbances separately. These estimates are then used to solve two differential Riccati equations to obtain time varying gains which improve the control system performance in successive orbits.

I Spy with My Little Eye: Jurors' Detection of Internal Validity Threats in Expert Evidence

PubMed Central

McAuliff, Bradley D.; Duckworth, Tejah D.

2010-01-01

This experiment examined whether jury-eligible community members (N = 223) were able to detect internally invalid psychological science presented at trial. Participants read a simulated child sexual abuse case in which the defense expert described a study he had conducted on witness memory and suggestibility. We varied the study's internal validity (valid, missing control group, confound, and experimenter bias) and publication status (published, unpublished). Expert evidence quality ratings were higher for the valid versus missing control group version only. Publication increased ratings of defendant guilt when the study was missing a control group. Variations in internal validity did not influence perceptions of child victim credibility or police interview quality. Participants' limited detection of internal validity threats underscores the need to examine the effectiveness of traditional legal safeguards against junk science in court and improve the scientific reasoning ability of lay people and legal professionals. PMID:20162342

Targeting Interventions: Moderators of the Effects of Expressive Writing and Assertiveness Training on the Adjustment of International University Students

PubMed Central

Hijazi, Alaa M.; Tavakoli, Shedeh; Slavin-Spenny, Olga M.; Lumley, Mark A.

2011-01-01

Acculturative stress is a common experience for international students and is associated with psychological and physical problems. In a previous study, the authors reported that two stress reduction interventions—expressive writing (EW) and assertiveness training (AT)—had limited overall benefits among international students at an American University. The current analyses of data from that study investigated whether individual differences moderated the effects of EW and AT. Results indicate that greater acculturative stress at baseline predicted greater improvement from both interventions, compared with control. Women benefited more from AT than EW, except that EW improved women’s physical symptoms. Men benefited more from EW than AT. Students with limited emotional awareness and expression tended to benefit from both interventions, relative to control. Finally, nation of origin cultural differences generally did not predict outcomes. It is concluded that the benefits of EW and AT and can be enhanced by targeting these interventions to specific subgroups of international students. PMID:21660220

[Study of continuous quality improvement for clinical laboratory processes via the platform of Hospital Group].

PubMed

Song, Wenqi; Shen, Ying; Peng, Xiaoxia; Tian, Jian; Wang, Hui; Xu, Lili; Nie, Xiaolu; Ni, Xin

2015-05-26

The program of continuous quality improvement in clinical laboratory processes for complete blood count (CBC) was launched via the platform of Beijing Children's Hospital Group in order to improve the quality of pediatric clinical laboratories. Fifteen children's hospitals of Beijing Children's Hospital group were investigated using the method of Chinese adapted continuous quality improvement with PDCA (Plan-Do-Check-Action). The questionnaire survey and inter-laboratory comparison was conducted to find the existing problems, to analyze reasons, to set forth quality targets and to put them into practice. Then, targeted training was conducted to 15 children's hospitals and the second questionnaire survey, self examinations by the clinical laboratories was performed. At the same time, the Group's online internal quality control platform was established. Overall effects of the program were evaluated so that lay a foundation for the next stage of PDCA. Both quality of control system documents and CBC internal quality control scheme for all of clinical laboratories were improved through this program. In addition, standardization of performance verification was also improved, especially with the comparable verification rate of precision and internal laboratory results up to 100%. In terms of instrument calibration and mandatory diagnostic rates, only three out of the 15 hospitals (20%) failed to pass muster in 2014 from 46.67% (seven out of the 15 hospitals) in 2013. The abnormal data of intraday precision variance coefficients of the five CBC indicator parameters (WBC, RBC, Hb, Plt and Hct) of all the 15 laboratories accounted for 1.2% (2/165) in 2014, a marked decrease from 9.6% (14/145) in 2013. While the number of the hospitals using only one horizontal quality control object for daily quality control has dropped to three from five. The 15 hospitals organized a total of 263 times of training in 2014 from 101 times in 2013, up 160%. The quality improvement program for the clinical laboratories launched via the Hospital Group platform can promote the joint development of the pediatric clinical laboratory discipline of all the member hospitals with remarkable improvement results, and the experience is recommendable for further rollout.

Quality control and assurance in hematopoietic stem cell transplantation data registries in Japan and other countries.

PubMed

Kuwatsuka, Yachiyo

2016-01-01

Observational studies from national and international registries with large volumes of patients are commonly performed to identify superior strategies for hematopoietic stem cell transplantation. Major international and national stem cell transplant registries collect outcome data using electronic data capture systems, and a systematic study support process has been developed. Statistical support for studies is available from some major international registries, and international and national registries also mutually collaborate to promote stem cell transplant outcome studies and transplant-related activities. Transplant registries additionally take measures to improve data quality to further improve the quality of outcome studies by utilizing data capture systems and manual data management. Data auditing can potentially even further improve data quality; however, human and budgetary resources can be limiting factors in system construction and audits of the Japanese transplant registry are not currently performed.

Improving public health through mycotoxin control

USDA-ARS?s Scientific Manuscript database

This book from the International Agency for Research on Cancer, a part of the World Health Organization, aims to sensitize the international community to the mycotoxin problem in a format which is accessible to a wide audience and is useful to decision-makers across a broad spectrum of disciplines i...

Reducing risk for anxiety and depression in adolescents: Effects of a single-session intervention teaching that personality can change

PubMed Central

Schleider, Jessica L.; Weisz, John R.

2016-01-01

Efforts to reduce youth mental health problems have advanced greatly but have not lowered overall rates of youth mental illness. Thus, a need exists for disseminable, mechanism-targeted approaches to reducing risk of youth psychopathology. Accordingly, we conducted a randomized-controlled trial testing whether a single-session intervention teaching growth personality mindsets (the belief that personality is malleable) reduced known risk factors for anxiety and depression in adolescents experiencing or at risk for internalizing problems (N=96, ages 12-15). Compared to a supportive-therapy control, a 30-minute computer-guided mindset intervention strengthened adolescents’ perceived control; this improvement was associated with increases in growth mindsets. Further, electrodermal activity recovery slopes showed that youths receiving the mindset intervention recovered from a lab-based social stressor over three times as fast as control group youths. Improvements in growth mindsets and perceived control were linked with faster stress recovery. Results suggest a disseminable strategy for reducing internalizing problem risk among adolescents. PMID:27697671

Laparoscopic Skills Are Improved With LapMentor™ Training

PubMed Central

Andreatta, Pamela B.; Woodrum, Derek T.; Birkmeyer, John D.; Yellamanchilli, Rajani K.; Doherty, Gerard M.; Gauger, Paul G.; Minter, Rebecca M.

2006-01-01

Objective: To determine if prior training on the LapMentor™ laparoscopic simulator leads to improved performance of basic laparoscopic skills in the animate operating room environment. Summary Background Data: Numerous influences have led to the development of computer-aided laparoscopic simulators: a need for greater efficiency in training, the unique and complex nature of laparoscopic surgery, and the increasing demand that surgeons demonstrate competence before proceeding to the operating room. The LapMentor™ simulator is expensive, however, and its use must be validated and justified prior to implementation into surgical training programs. Methods: Nineteen surgical interns were randomized to training on the LapMentor™ laparoscopic simulator (n = 10) or to a control group (no simulator training, n = 9). Subjects randomized to the LapMentor™ trained to expert criterion levels 2 consecutive times on 6 designated basic skills modules. All subjects then completed a series of laparoscopic exercises in a live porcine model, and performance was assessed independently by 2 blinded reviewers. Time, accuracy rates, and global assessments of performance were recorded with an interrater reliability between reviewers of 0.99. Results: LapMentor™ trained interns completed the 30° camera navigation exercise in significantly less time than control interns (166 ± 52 vs. 220 ± 39 seconds, P < 0.05); they also achieved higher accuracy rates in identifying the required objects with the laparoscope (96% ± 8% vs. 82% ± 15%, P < 0.05). Similarly, on the two-handed object transfer exercise, task completion time for LapMentor™ trained versus control interns was 130 ± 23 versus 184 ± 43 seconds (P < 0.01) with an accuracy rate of 98% ± 5% versus 80% ± 13% (P < 0.001). Additionally, LapMentor™ trained interns outperformed control subjects with regard to camera navigation skills, efficiency of motion, optimal instrument handling, perceptual ability, and performance of safe electrocautery. Conclusions: This study demonstrates that prior training on the LapMentor™ laparoscopic simulator leads to improved resident performance of basic skills in the animate operating room environment. This work marks the first prospective, randomized evaluation of the LapMentor™ simulator, and provides evidence that LapMentor™ training may lead to improved operating room performance. PMID:16772789

Strengthening the management of ESA - the Inter-Directorate Reform of Corporate and Risk Management

NASA Astrophysics Data System (ADS)

Feustel-Büechl, Jörg; Arend, Harald; Derio, Eric; Infante, Giovanni; Kreiner, Gerhard; Phaler, Jesse; Tabbert, Michael

2007-02-01

ESA has undertaken the Inter-Directorate Reform of Corporate and Risk Management to strengthen the Agency's internal operations. The reform was completed at the end of 2006, encompassing five dedicated projects on Risk Management, Agency-Wide Controlling System, Project Plan and Integrated Project Review, General Budget Structure and Charging Policy, and Corporate Information Systems. It has contributed to improved management of the Agency's internal operations by engaging all internal stakeholders in a common objective, introducing improvements to planning and management methods, elaborating consolidated information structures and tools, contributing to enhanced transparency and accountability, and by providing qualified new policies, processes and tools.

Decreasing Internal Focus of Attention Improves Postural Control during Quiet Standing in Young Healthy Adults

ERIC Educational Resources Information Center

Nafati, Gilel; Vuillerme, Nicolas

2011-01-01

This experiment was designed to investigate whether and how decreasing the amount of attentional focus invested in postural control could affect bipedal postural control. Twelve participants were asked to stand upright as immobile as possible on a force platform in one control condition and one cognitive condition. In the latter condition, they…

Innovative web-based multimedia curriculum improves cardiac examination competency of residents.

PubMed

Criley, Jasminka M; Keiner, Jennifer; Boker, John R; Criley, Stuart R; Warde, Carole M

2008-03-01

Proper diagnosis of cardiac disorders is a core competency of internists. Yet numerous studies have documented that the cardiac examination (CE) skills of physicians have declined compared with those of previous generations of physicians, attributed variously to inadequate exposure to cardiac patients and lack of skilled bedside teaching. With growing concerns about ensuring patient safety and quality of care, public and professional organizations are calling for a renewed emphasis on the teaching and evaluation of clinical skills in residency training. The objective of the study was to determine whether Web training improves CE competency, whether residents retain what they learn, and whether a Web-based curriculum plus clinical training is better than clinical training alone. Journal of Hospital Medicine 2008;3:124-133. (c) 2008 Society of Hospital Medicine. This was a controlled intervention study. The intervention group (34 internal and family medicine interns) participated in self-directed use of a Web-based tutorial and three 1-hour teaching sessions taught by a hospitalist. Twenty-five interns from the prior year served as controls. We assessed overall CE competency and 4 subcategories of CE competency: knowledge, audio skills, visual skills, and audio-visual integration. The over mean score of the intervention group significantly improved, from 54 to 66 (P = .002). This improvement was retained (63.5, P = .05). When compared with end-of-year controls, the intervention group had significantly higher end-of-year CE scores (57 vs. 63.5, P = .05), knowledge (P = .04), and audio skills (P = .01). At the end of the academic year, all improvements were retained (P

Air Force Internal Control Systems: A Proposal for Improvement.

DTIC Science & Technology

1986-09-01

Wrong. Idea Paper, LD 51636A, PMCS 82-C, August 1982. 66. Marler , Kenneth E. Implementation of the Federal Managers’ Financial Integrity Act of 1982 in... Eric V. Can Internal Review Support A Manage- ment Development Program? Idea Paper, LD 47951A, PMCS 81-A, December 1980. 91. Trimble, Robert C., Jr

An international nomenclature for forest work study

Treesearch

Rolf Bjorheden; Michael A. Thompson

2000-01-01

Knowledge gained in the study of forest work is used to improve operational efficiency through better planning and control of future work. Internationally recognized standard methods for recording, evaluating and reporting performance in forest work will greatly enhance the usefulness of this information to managers and planners. A subcommittee of IUFRO Working Party...

An international nomenclature for forest work study

Treesearch

Rolf Björheden; Michael A.  Thompson

2000-01-01

Knowledge gained in the study of forest work is used to improve operational efficiency through better planning and control of future work. Internationally recognized standard methods for recording, evaluating and reporting performance in forest work will greatly enhance the usefulness of this information to managers and planners. A subcommittee of IUFRO Working Party $...

Improved quality monitoring of multi-center acupuncture clinical trials in China

PubMed Central

2009-01-01

Background In 2007, the Chinese Science Division of the State Administration of Traditional Chinese Medicine(TCM) convened a special conference to discuss quality control for TCM clinical research. Control and assurance standards were established to guarantee the quality of clinical research. This paper provides practical guidelines for implementing strict and reproducible quality control for acupuncture randomized controlled trials (RCTs). Methods A standard quality control program (QCP) was established to monitor the quality of acupuncture trials. Case report forms were designed; qualified investigators, study personnel and data management personnel were trained. Monitors, who were directly appointed by the project leader, completed the quality control programs. They guaranteed data accuracy and prevented or detected protocol violations. Clinical centers and clinicians were audited, the randomization system of the centers was inspected, and the treatment processes were audited as well. In addition, the case report forms were reviewed for completeness and internal consistency, the eligibility and validity of the patients in the study was verified, and data was monitored for compliance and accuracy. Results and discussion The monitors complete their reports and submit it to quality assurance and the sponsors. Recommendations and suggestions are made for improving performance. By holding regular meetings to discuss improvements in monitoring standards, the monitors can improve quality and efficiency. Conclusions Supplementing and improving the existed guidelines for quality monitoring will ensure that large multi-centre acupuncture clinical trials will be considered as valid and scientifically stringent as pharmaceutical clinical trials. It will also develop academic excellence and further promote the international recognition of acupuncture. PMID:20035630

NRRI summary of New York Public Service Commission: Staff investigation of Orange and Rockland Utilities, Inc.

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

NONE

1995-12-31

In June 1995, the New York Public Service Commission (NYPSC) released a Staff investigation of Orange and Rockland Utilities, Inc. (O&R). The primary focus of the Staffs investigation was the Corporate Policy and External Affairs Department, a restricted disbursements account, the Internal Auditing Department, and O&R officer malfeasance. The Staffs` investigation uncovered widespread, alleged instances of lax internal controls, unethical and illegal actions, and lavish officer behavior. In addition, the Staff investigated O&R`s internal control and purchasing functions. The Staff proposed a series of recommendations to improve the Company`s internal control, purchasing, ethical, climate and addressed the issue of amore » New York ratepayer reimbursement. The Staffs findings and recommendations were presented in the form of a report, entitled Staff Investigation of Orange and Rockland Utilities, Inc. This article summarizes the Report.« less

Refinement and evaluation of helicopter real-time self-adaptive active vibration controller algorithms

NASA Technical Reports Server (NTRS)

Davis, M. W.

1984-01-01

A Real-Time Self-Adaptive (RTSA) active vibration controller was used as the framework in developing a computer program for a generic controller that can be used to alleviate helicopter vibration. Based upon on-line identification of system parameters, the generic controller minimizes vibration in the fuselage by closed-loop implementation of higher harmonic control in the main rotor system. The new generic controller incorporates a set of improved algorithms that gives the capability to readily define many different configurations by selecting one of three different controller types (deterministic, cautious, and dual), one of two linear system models (local and global), and one or more of several methods of applying limits on control inputs (external and/or internal limits on higher harmonic pitch amplitude and rate). A helicopter rotor simulation analysis was used to evaluate the algorithms associated with the alternative controller types as applied to the four-bladed H-34 rotor mounted on the NASA Ames Rotor Test Apparatus (RTA) which represents the fuselage. After proper tuning all three controllers provide more effective vibration reduction and converge more quickly and smoothly with smaller control inputs than the initial RTSA controller (deterministic with external pitch-rate limiting). It is demonstrated that internal limiting of the control inputs a significantly improves the overall performance of the deterministic controller.

Preparing Interns for Anesthesiology Residency Training: Development and Assessment of the Successful Transition to Anesthesia Residency Training (START) E-Learning Curriculum

PubMed Central

Chu, Larry F.; Ngai, Lynn K.; Young, Chelsea A.; Pearl, Ronald G.; Macario, Alex; Harrison, T. Kyle

2013-01-01

Background The transition from internship to residency training may be a stressful time for interns, particularly if it involves a change among programs or institutions after completing a preliminary year. Objective We explored whether an e-learning curriculum would increase interns' preparedness for the transition to the first year of clinical anesthesiology training and reduce stress by improving confidence and perceived competence in performing professional responsibilities. Intervention We tested a 10-month e-learning program, Successful Transition to Anesthesia Residency Training (START), as a longitudinal intervention to increase interns' self-perceived preparedness to begin anesthesiology residency training in a prospective, observational study and assessed acceptance and sustainability. After a needs assessment, we administered the START modules to 22 interns, once a month, using an integrated learning management and lecture-capture system. We surveyed interns' self-assessed preparedness to begin anesthesiology residency before and after completing the START modules. Interns from the prior year's class, who did not participate in the online curriculum, served as controls. Results After participation in the START intervention, self-assessed preparedness to begin residency improved by 72% (P  =  .02). Interns also felt more connected to, and had improved positive feelings toward, their new residency program and institution. Conclusion Participation in our novel 10-month e-learning curriculum and virtual mentorship program improved interns' impression of their residency program and significantly increased interns' subjective assessment of their preparedness to begin anesthesiology residency. This e-learning concept could be more broadly applied and useful to other residency programs. PMID:24404239

The UK Stem Cell Bank: a UK government-funded, international resource center for stem cell research.

PubMed

Stacey, Glyn; Hunt, Charles J

2006-01-01

The UK Stem Cell Bank is a UK Research Council-funded initiative that aims to provide ethically sourced and quality controlled stocks of cells for researchers and also establish seed stocks of cell lines for clinical trials. Whilst the Bank is prohibited from carrying out basic stem cell research (to avoid conflicts of interest) it is working to improve stem cell banking procedures including cryopreservation, characterization and quality control. The Bank also supports training activities and has provided the hub for the International Stem Cell Initiative, which includes 17 expert stem cell centers aiming to characterize a large number of human embryonic stem cell lines in a standardized way to improve our understanding of the characteristics of these cells.

Effect of saw palmetto soft gel capsule on lower urinary tract symptoms associated with benign prostatic hyperplasia: a randomized trial in Shanghai, China.

PubMed

Shi, Rong; Xie, Qiungwen; Gang, X; Lun, Jing; Cheng, Life; Pantuck, Allan; Rao, Jianyu

2008-02-01

We determined the effect of Prostataplex in men with lower urinary tract symptoms associated with benign prostatic hyperplasia. A total of 92 Chinese men between 49 and 75 years old with lower urinary tract symptoms were randomly assigned in this double-blind, placebo controlled trial. The 46 patients in the intervention group were given 2 Prostataplex soft gels daily for 12 weeks, while the 46 in the control group were given 2 placebo soft gels for the same time. The treated and control groups appeared to have more than a 95% compliance rate, as judged by counting the remaining pills in the bottle collected at the end of trial months 1 to 3. After 12 weeks of intervention the mean +/- SD maximum urinary flow rate was significantly higher in the treatment group than in the control group (14.07 +/- 2.56 vs 11.74 +/- 1.23 ml per second, p <0.001), while relative urinary resistance was significantly lower in the treatment group than in the control group (2.35 +/- 0.83 vs 3.02 +/- 1.18, p = 0.002). While there was no significant difference in mean prostate volume or International Prostate Symptom Score between the 2 groups, 18 of 46 patients (39.1%) in the treatment group showed an International Prostate Symptom Score improvement (decrease of 3 or greater) after intervention, whereas only 1 of 46 (2.2%) in the control group showed an International Prostate Symptom Score improvement (chi-square test p <0.001). Prostataplex may have short-term effects in improving symptoms and objective measures in Chinese men with lower urinary tract symptoms associated with benign prostatic hyperplasia.

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams.

PubMed

Körner, Mirjam; Luzay, Leonie; Plewnia, Anne; Becker, Sonja; Rundel, Manfred; Zimmermann, Linda; Müller, Christian

2017-01-01

Although the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness. A multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters) of different indication fields before (t1) and after (t2) the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis. In order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010-.017), whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions. The TCC improved dimensions that were addressed directly by the approach and were linked to the clinics' needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual factors and processes regarding the implementation of the intervention.

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

PubMed Central

Körner, Mirjam; Luzay, Leonie; Plewnia, Anne; Becker, Sonja; Rundel, Manfred; Zimmermann, Linda; Müller, Christian

2017-01-01

Purpose Although the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness. Method A multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters) of different indication fields before (t1) and after (t2) the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis. Results In order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010–.017), whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions. Conclusion The TCC improved dimensions that were addressed directly by the approach and were linked to the clinics’ needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual factors and processes regarding the implementation of the intervention. PMID:28704377

Customized Internal Reference Controls for Improved Assessment of Circulating MicroRNAs in Disease.

PubMed

Schlosser, Kenny; McIntyre, Lauralyn A; White, R James; Stewart, Duncan J

2015-01-01

Altered levels of circulating extracellular miRNA in plasma and serum have shown promise as non-invasive biomarkers of disease. However, unlike the assessment of cellular miRNA levels for which there are accepted housekeeping genes, analogous reference controls for normalization of circulating miRNA are lacking. Here, we provide an approach to identify and validate circulating miRNA reference controls on a de novo basis, and demonstrate the advantages of these customized internal controls in different disease settings. Importantly, these internal controls overcome key limitations of external spike-in controls. Using a global RT-qPCR screen of 1066 miRNAs in plasma from pulmonary hypertension patients (PAH) and healthy subjects as a case example, we identified a large pool of initial candidate miRNAs that were systematically ranked according to their plasma level stability using a predefined algorithm. The performance of the top candidates was validated against multiple comparators, and in a second independent cohort of PAH and control subjects. The broader utility of this approach was demonstrated in a completely different disease setting with 372 miRNAs screened in plasma from septic shock patients and healthy controls. Normalization of data with specific internal reference controls significantly reduced the overall variation in circulating miRNA levels between subjects (relative to raw data), provided a more balanced distribution of up- and down-regulated miRNAs, replicated the results obtained by the benchmark geometric averaging of all detected miRNAs, and outperformed the commonly used external spike-in strategy. We demonstrate the feasibility of identifying circulating reference controls that can reduce extraneous technical variations, and improve the assessment of disease-related changes in plasma miRNA levels. This study provides a novel conceptual framework that addresses a critical and previously unmet need if circulating miRNAs are to advance as reliable diagnostic tools in medicine.

Customized Internal Reference Controls for Improved Assessment of Circulating MicroRNAs in Disease

PubMed Central

Schlosser, Kenny; McIntyre, Lauralyn A.; White, R. James; Stewart, Duncan J.

2015-01-01

Background Altered levels of circulating extracellular miRNA in plasma and serum have shown promise as non-invasive biomarkers of disease. However, unlike the assessment of cellular miRNA levels for which there are accepted housekeeping genes, analogous reference controls for normalization of circulating miRNA are lacking. Here, we provide an approach to identify and validate circulating miRNA reference controls on a de novo basis, and demonstrate the advantages of these customized internal controls in different disease settings. Importantly, these internal controls overcome key limitations of external spike-in controls. Methods Using a global RT-qPCR screen of 1066 miRNAs in plasma from pulmonary hypertension patients (PAH) and healthy subjects as a case example, we identified a large pool of initial candidate miRNAs that were systematically ranked according to their plasma level stability using a predefined algorithm. The performance of the top candidates was validated against multiple comparators, and in a second independent cohort of PAH and control subjects. The broader utility of this approach was demonstrated in a completely different disease setting with 372 miRNAs screened in plasma from septic shock patients and healthy controls. Results Normalization of data with specific internal reference controls significantly reduced the overall variation in circulating miRNA levels between subjects (relative to raw data), provided a more balanced distribution of up- and down-regulated miRNAs, replicated the results obtained by the benchmark geometric averaging of all detected miRNAs, and outperformed the commonly used external spike-in strategy. Conclusions We demonstrate the feasibility of identifying circulating reference controls that can reduce extraneous technical variations, and improve the assessment of disease-related changes in plasma miRNA levels. This study provides a novel conceptual framework that addresses a critical and previously unmet need if circulating miRNAs are to advance as reliable diagnostic tools in medicine. PMID:26010841

Smart Drug Delivery Systems in Cancer Therapy.

PubMed

Unsoy, Gozde; Gunduz, Ufuk

2018-02-08

Smart nanocarriers have been designed for tissue-specific targeted drug delivery, sustained or triggered drug release and co-delivery of synergistic drug combinations to develop safer and more efficient therapeutics. Advances in drug delivery systems provide reduced side effects, longer circulation half-life and improved pharmacokinetics. Smart drug delivery systems have been achieved successfully in the case of cancer. These nanocarriers can serve as an intelligent system by considering the differences of tumor microenvironment from healthy tissue, such as low pH, low oxygen level, or high enzymatic activity of matrix metalloproteinases. The performance of anti-cancer agents used in cancer diagnosis and therapy is improved by enhanced cellular internalization of smart nanocarriers and controlled drug release. Here, we review targeting, cellular internalization; controlled drug release and toxicity of smart drug delivery systems. We are also emphasizing the stimulus responsive controlled drug release from smart nanocarriers. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Continuous Cognitive Task Promotes Greater Postural Stability than an Internal or External Focus of Attention in Older Adults.

PubMed

Richer, Natalie; Polskaia, Nadia; Lajoie, Yves

2017-01-01

Background/Study Context: Recent evidence suggests that removing attention from postural control using either an external focus or a cognitive task will improve stability in healthy young adults. Due to increases in attentional requirements of upright stance in older adults, it is unclear if similar benefits would be observed in this population. The aim of the present study was to examine the effect of attentional focus and of a continuous cognitive task on postural control in older adults. Sixteen healthy older adults (71.9 ± 4.32 years) were asked to stand quietly on a force platform with feet together in three different conditions: internal focus (minimizing movement of the hips), external focus (minimizing movement of markers placed on the hips), and cognitive task (silently counting the occurrence of a single digit in a 3-digit number sequence). A one-way analysis of variance with repeated measures on condition was performed for each postural control measure. Hypotheses were partially supported because the cognitive task led to greater stability than both focus conditions, as evidenced by a smaller sway area (p < .01, η p 2 = .41), reduced sway variability (anterior-posterior: p = .001, η p 2 = .37; medial-lateral: p < .0001, η p 2 = .49), and higher mean power frequency in the anterior-posterior direction (p = .01, η p 2 = .78). However, no difference was observed between internal and external focus conditions. A continuous, attention-demanding cognitive task significantly improved stability in older adults compared with an internal or external focus of attention. This suggests that older adults were able to effectively allocate their attention away from postural control, allowing a more automatic type of control to operate. Future studies should investigate a variety of cognitive tasks to determine the degree of postural improvement that can be observed in older adults.

Locus of Control or Self-Esteem; Which One is the Best Predictor of Academic Achievement in Iranian College Students.

PubMed

Hosseini, Seyyed Nasrollah; Mirzaei Alavijeh, Mehdi; Karami Matin, Behzad; Hamzeh, Behrooz; Ashtarian, Hossein; Jalilian, Farzad

2016-03-01

Self-esteem and behavioral consequences, which are due to external or internal locus of control, are effective on academic achievement of students. The aim of this study was to determine the prediction of locus of control and self-esteem in academic achievement among the students. This cross-sectional study was conducted on 300 college students in Kermanshah University of Medical Sciences in 2014. Data collection tools were in three sections: demographic, Rotter internal-external locus of control scale and Coopersmith self-esteem inventory. Data were analyzed using the SPSS software version 21. Results showed that 29.8% and 76.2% of the participants had internal locus of control, and high self-esteem, respectively. There was a significant correlation between self-esteem, locus of control and academic achievement of the students. Self-esteem accounted for 39.5% of the variation in academic achievement. It seems that interventions to increase self-esteem among student can help improve academic achievement among them.

Collaboration between infection control and occupational health in three continents: a success story with international impact.

PubMed

Yassi, Annalee; Bryce, Elizabeth A; Breilh, Jaime; Lavoie, Marie-Claude; Ndelu, Lindiwe; Lockhart, Karen; Spiegel, Jerry

2011-11-08

Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work.The products developed have been widely heralded as innovative and interactive, leading to their inclusion into "toolkits" used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between occupational health and infection control researchers led to the improvement of the research framework and development of tools, guidelines and information systems. Furthermore, the research and knowledge-transfer experience highlighted the value of partnership amongst Northern and Southern researchers in terms of sharing resources, experiences and knowledge.

Collaboration between infection control and occupational health in three continents: a success story with international impact

PubMed Central

2011-01-01

Globalization has been accompanied by the rapid spread of infectious diseases, and further strain on working conditions for health workers globally. Post-SARS, Canadian occupational health and infection control researchers got together to study how to better protect health workers, and found that training was indeed perceived as key to a positive safety culture. This led to developing information and communication technology (ICT) tools. The research conducted also showed the need for better workplace inspections, so a workplace audit tool was also developed to supplement worker questionnaires and the ICT. When invited to join Ecuadorean colleagues to promote occupational health and infection control, these tools were collectively adapted and improved, including face-to-face as well as on-line problem-based learning scenarios. The South African government then invited the team to work with local colleagues to improve occupational health and infection control, resulting in an improved web-based health information system to track incidents, exposures, and occupational injury and diseases. As the H1N1 pandemic struck, the online infection control course was adapted and translated into Spanish, as was a novel skill-building learning tool that permits health workers to practice selecting personal protective equipment. This tool was originally developed in collaboration with the countries from the Caribbean region and the Pan American Health Organization (PAHO). Research from these experiences led to strengthened focus on building capacity of health and safety committees, and new modules are thus being created, informed by that work. The products developed have been widely heralded as innovative and interactive, leading to their inclusion into “toolkits” used internationally. The tools used in Canada were substantially improved from the collaborative adaptation process for South and Central America and South Africa. This international collaboration between occupational health and infection control researchers led to the improvement of the research framework and development of tools, guidelines and information systems. Furthermore, the research and knowledge-transfer experience highlighted the value of partnership amongst Northern and Southern researchers in terms of sharing resources, experiences and knowledge. PMID:22166059

A randomised trial into the effect of an isolated hip abductor strengthening programme and a functional motor control programme on knee kinematics and hip muscle strength.

PubMed

Palmer, Kathryn; Hebron, Clair; Williams, Jonathan M

2015-05-03

Dynamic knee valgus and internal femoral rotation are proposed to be contributory risk factors for patellofemoral pain and anterior cruciate ligament injuries. Multimodal interventions including hip abductor strengthening or functional motor control programmes have a positive impact of pain, however their effect on knee kinematics and muscle strength is less clear. The aim of this study was to examine the effect of isolated hip abductor strengthening and a functional motor control exercise on knee kinematics and hip abductor strength. This prospective, randomised, repeated measures design included 29 asymptomatic volunteers presenting with increase knee valgus and femoral internal rotation. Participants completed either isolated hip abductor strengthening or a functional motor control exercise for 5 weeks. Knee kinematics were measured using inertial sensors during 2 functional activities and hip abductor strength measured using a load cell during isometric hip abduction. There were no significant differences in dynamic knee valgus and internal rotation following the isolated hip abductor or functional motor control intervention, and no significant differences between the groups for knee angles. Despite this, the actual magnitude of reduction in valgus was 10° and 5° for the functional motor control group and strengthening group respectively. The actual magnitude of reduction in internal rotation was 9° and 18° for the functional motor control group and strengthening group respectively. Therefore there was a tendency towards clinically significant improvements in knee kinematics in both exercise groups. A statistically significant improvement in hip abductor strength was evident for the functional motor control group (27% increase; p = 0.008) and strengthening group (35% increase; p = 0.009) with no significant difference between the groups being identified (p = 0.475). Isolated hip strengthening and functional motor control exercises resulted in non-statistically significant changes in knee kinematics, however there was a clear trend towards clinically meaningful reductions in valgus and internal rotation. Both groups demonstrated similar significant gains in hip abductor strength suggesting either approach could be used to strengthen the hip abductors.

Child Passenger Safety Training for Pediatric Interns: Does it Work?

PubMed

Morrissey, Dina; Riese, Alison; Violano, Pina; Lapidus, Garry; Baird, Janette; Mello, Michael J

2016-03-01

Evaluate the efficacy of a child passenger safety (CPS) educational intervention on the CPS-related knowledge, attitude and anticipatory guidance behaviors of pediatric interns. All subjects were surveyed at baseline and 6 months. Intervention interns attended a CPS training module which included viewing an educational video, observing a car seat inspection appointment, hands-on practice and completion of a post-intervention survey. All 16 intervention interns completed the initial survey, the intervention and the immediate-post questionnaire. Thirteen (81%) completed the 6-month follow-up. The baseline survey was completed by 27/40 (67%) of control interns, 28/40 (70%) submitted a follow-up. The proportion of intervention interns who self-reported giving CPS guidance at all well-child visits increased by 31.3% (95% CI 6.1,56.5%); the control group had no change. Similar results were seen with self-reported knowledge and attitude. A CPS training module increases pediatric interns' knowledge, improves attitudes, and self-reported behaviors regarding CPS-related anticipatory guidance.

Controlling liver cancer internationally: A qualitative study of clinicians' perceptions of current public policy needs.

PubMed

Bridges, John Fp; Gallego, Gisselle; Blauvelt, Barri M

2011-07-28

Liver cancer is the fifth most common cancer in men and the seventh for women. Usually because of late diagnosis, the prognosis for liver cancer remains poor, resulting in liver cancer being the third most common cause of death from cancer. While some countries have treatment guidelines, little is known or understood about the strategies needed for liver cancer control internationally. To explore leading liver cancer clinician's perceptions of the current public policy needs to control liver cancer internationally. Key informant interviews were conducted with a range of liver cancer clinicians involved in policy in eleven countries. Interviews were digitally recorded, transcribed verbatim, translated (where necessary), de-identified and analyzed by two researchers using a constant comparative method. Twenty in-depth semi-structured interviews were conducted in: Australia, China, France, Germany, Italy, Japan, Spain, South Korea, Taiwan, Turkey and the United States. Nine themes were identified and cluster into three groups: 1) Promoting prevention via early risk assessment, focusing on viral hepatitis and other lifestyle factors; 2) Increasing political, public and medical community awareness; and 3) Improving funding for screening, liver cancer surveillance and treatment. This study is an important step towards developing an evidence-based approach to assessing preparedness for implementing comprehensive liver cancer control strategies. Evaluation mechanisms to assess countries' performance on the needs described are needed. Future research will concentrate of understanding how these needs vary across countries and the optimal strategies to improve the diagnosis and prognosis of patients with liver cancer internationally.

The Effect of Attentional Focus Cues on Object Control Performance in Elementary Children

ERIC Educational Resources Information Center

Palmer, Kara K.; Matsuyama, Abigail L.; Irwin, J. Megan; Porter, Jared M.; Robinson, Leah E.

2017-01-01

Background and purpose: Attentional focus cues have been shown to impact motor performance of adults and children. Specifically, an external focus of attention results in improved motor learning and performance as compared to adopting an internal focus of attention. The purpose of this study was to determine the effects of an internal and external…

Analytical Assessment of a Gross Leakage Event Within the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS)

NASA Technical Reports Server (NTRS)

Holt, James M.; Clanton, Stephen E.

1999-01-01

Results of the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS) gross leakage analysis are presented for evaluating total leakage flowrates and volume discharge caused by a gross leakage event (i.e. open boundary condition). A Systems Improved Numerical Differencing Analyzer and Fluid Integrator (SINDA/FLUINT) thermal hydraulic mathematical model (THMM) representing the Node 2 IATCS was developed to simulate system performance under steady-state nominal conditions as well as the transient flow effects resulting from an open line exposed to ambient. The objective of the analysis was to determine the adequacy of the leak detection software in limiting the quantity of fluid lost during a gross leakage event to within an acceptable level.

Analytical Assessment of a Gross Leakage Event Within the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS)

NASA Technical Reports Server (NTRS)

Holt, James M.; Clanton, Stephen E.

2001-01-01

Results of the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS) gross leakage analysis are presented for evaluating total leakage flow rates and volume discharge caused by a gross leakage event (i.e. open boundary condition). A Systems Improved Numerical Differencing Analyzer and Fluid Integrator (SINDA85/FLUINT) thermal hydraulic mathematical model (THMM) representing the Node 2 IATCS was developed to simulate system performance under steady-state nominal conditions as well as the transient flow effect resulting from an open line exposed to ambient. The objective of the analysis was to determine the adequacy of the leak detection software in limiting the quantity of fluid lost during a gross leakage event to within an acceptable level.

Impact of locus of control on clinical outcomes in renal dialysis.

PubMed

Dec, Elaine

2006-01-01

This study focused on the relationship between patients' locus of control and their ability to improve selected clinical outcomes related to kidney dialysis. The main hypothesis of this study stated that patients who viewed themselves as having control over their situation would be more successful at improving targeted clinical outcomes than those who believed someone other than themselves had control over their situation. The study found that interventions aimed at increasing awareness of who has control and reducing the aspect of chance had a more significant positive impact on outcomes than did pure cognitive or educational interventions geared mainly toward emotional issues or educational deficits. Interventions that work with the dominant locus of control to increase awareness of where control lies appeared to be more effective in assisting the patients to improve their targeted clinical outcomes rather than are interventions to change the locus of control between internal and powerful others (external).

Experimental infection of calves by two genetically-distinct strains of rift valley fever virus

USDA-ARS?s Scientific Manuscript database

Recent outbreaks of Rift Valley fever in ruminant livestock, characterized by mass abortion and high mortality rates in neonates, have raised international interest in improving vaccine control strategies. Previously we developed a reliable challenge model for sheep that improves the evaluation of ...

Balancing Treatment and Control Groups in Quasi-Experiments: An Introduction to Propensity Scoring

ERIC Educational Resources Information Center

Connelly, Brian S.; Sackett, Paul R.; Waters, Shonna D.

2013-01-01

Organizational and applied sciences have long struggled with improving causal inference in quasi-experiments. We introduce organizational researchers to propensity scoring, a statistical technique that has become popular in other applied sciences as a means for improving internal validity. Propensity scoring statistically models how individuals in…

Enhanced squeezing of a collective spin via control of its qudit subsystems.

PubMed

Norris, Leigh M; Trail, Collin M; Jessen, Poul S; Deutsch, Ivan H

2012-10-26

Unitary control of qudits can improve the collective spin squeezing of an atomic ensemble. Preparing the atoms in a state with large quantum fluctuations in magnetization strengthens the entangling Faraday interaction. The resulting increase in interatomic entanglement can be converted into metrologically useful spin squeezing. Further control can squeeze the internal atomic spin without compromising entanglement, providing an overall multiplicative factor in the collective squeezing. We model the effects of optical pumping and study the tradeoffs between enhanced entanglement and decoherence. For realistic parameters we see improvements of ~10 dB.

Medium-term effectiveness of online behavioral training in migraine self-management: A randomized trial controlled over 10 months.

PubMed

Sorbi, M J; Kleiboer, A M; van Silfhout, H G; Vink, G; Passchier, J

2015-06-01

This randomized, controlled trial examined the medium-term effectiveness of online behavioral training in migraine self-management (oBT; N = 195) versus waitlist control (WLC; N = 173) on attack frequency, indicators of self-management (primary outcomes), headache top intensity, use of rescue medications, quality of life and disability (secondary outcomes). An online headache diary following the ICHD-II and questionnaires were completed at baseline (T0), post-training (T1) and six months later (T2). Missing data (T1: 24%; T2: 37%) were handled by multiple imputation. We established effect sizes (ES) and tested between-group differences over time with linear mixed modelling techniques based on the intention-to-treat principle. At T2, attack frequency had improved significantly in oBT (-23%, ES = 0.66) but also in WLC (-19%; ES = 0.52). Self-efficacy, internal and external control in migraine management--and triptan use--improved only in oBT, however. This indicates different processes in both groups and could signify (the start of) active self-management in oBT. Also, only oBT improved migraine-specific quality of life to a sizable extent. oBT produced self-management gains but could not account for improved attack frequency, because WLC improved as well. The perspective that BT effects develop gradually, and that online delivery will boost BT outreach, justifies further research. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Gait and balance of transfemoral amputees using passive mechanical and microprocessor-controlled prosthetic knees.

PubMed

Kaufman, K R; Levine, J A; Brey, R H; Iverson, B K; McCrady, S K; Padgett, D J; Joyner, M J

2007-10-01

Microprocessor-controlled knee joints appeared on the market a decade ago. These joints are more sophisticated and more expensive than mechanical ones. The literature is contradictory regarding changes in gait and balance when using these sophisticated devices. This study employed a crossover design to assess the comparative performance of a passive mechanical knee prosthesis compared to a microprocessor-controlled knee joint in 15 subjects with an above-knee amputation. Objective measurements of gait and balance were obtained. Subjects demonstrated significantly improved gait characteristics after receiving the microprocessor-controlled prosthetic knee joint (p<0.01). Improvements in gait were a transition from a hyperextended knee to a flexed knee during loading response which resulted in a change from an internal knee flexor moment to a knee extensor moment. The participants' balance also improved (p<0.01). All conditions of the Sensory Organization Test (SOT) demonstrated improvements in equilibrium score. The composite score also increased. Transfemoral amputees using a microprocessor-controlled knee have significant improvements in gait and balance.

Do transportation subsidies and living allowances improve tuberculosis control outcomes among internal migrants in urban Shanghai, China?

PubMed

Lu, Hui; Yan, Fei; Wang, Wei; Wu, Laiwa; Ma, Weiping; Chen, Jing; Shen, Xin; Mei, Jian

2013-01-01

Tuberculosis (TB) in internal migrants is one of three threats for TB control in China. To address this threat, a project was launched in eight of the 19 districts of Shanghai in 2007 to provide transportation subsidies and living allowances for all migrant TB cases. This study aims to determine if this project contributed to improved TB control outcomes among migrants in urban Shanghai. This was a community intervention study. The data were derived from the TB Management Information System in three project districts and three non-project districts in Shanghai between 2006 and 2010. The impact of the project was estimated in a difference-in-difference (DID) analysis framework, and a multivariable binary logistic regression analysis. A total of 1872 pulmonary TB (PTB) cases in internal migrants were included in the study. The treatment success rate (TSR) for migrant smear-positive cases in project districts increased from 59.9% in 2006 to 87.6% in 2010 (P < 0.001). The crude DID improvement of TSR was 18.9%. There was an increased probability of TSR in the project group before and after the project intervention period (coefficient = 1.156, odds ratio = 3.178, 95% confidence interval: 1.305-7.736, P = 0.011). The study showed the project could improve treatment success in migrant PTB cases. This was a short-term programme using special financial subsidies for all migrant PTB cases. It is recommended that project funds be continuously invested by governments with particular focus on the more vulnerable PTB cases among migrants.

Government Actions to Control Terrorist Violence: A Case Study on Northern Ireland

DTIC Science & Technology

1988-03-01

Continue on reverse if necessary and identify by block number) E~~0! G~P I -OP ITerrorism; Government Legislation to Control Terrorism; Irish Re...of the British government’s efforts to legislate improvements in Northern Ireland. It appears that only through this process can peace and...international attention and has been the focus of much of the British government’s efforts to legislate improvements in Northern Ireland. It appears that

Spaceport Command and Control System User Interface Testing

NASA Technical Reports Server (NTRS)

Huesman, Jacob

2016-01-01

The Spaceport Command and Control System will be the National Aeronautics and Space Administration's newest system for launching commercial and government owned spacecraft. It's a large system with many parts all in need of testing. To improve upon testing already done by NASA engineers, the Engineering Directorate, Electrical Division (NE-E) of Kennedy Space Center has hired a group of interns each of the last few semesters to develop novel ways of improving the testing process.

Method of controlling crystallite size in nuclear-reactor fuels

DOEpatents

Lloyd, Milton H.; Collins, Jack L.; Shell, Sam E.

1985-01-01

Improved spherules for making enhanced forms of nuclear-reactor fuels are prepared by internal gelation procedures within a sol-gel operation and are accomplished by first boiling the concentrated HMTA-urea feed solution before engaging in the spherule-forming operation thereby effectively controlling crystallite size in the product spherules.

TEST DESIGN FOR ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) OF ADD-ON NOX CONTROL UTILIZING OZONE INJECTION

EPA Science Inventory

The paper discusses the test design for environmental technology verification (ETV) of add-0n nitrogen oxides (NOx) control utilizing ozone injection. (NOTE: ETV is an EPA-established program to enhance domestic and international market acceptance of new or improved commercially...

Method of controlling crystallite size in nuclear-reactor fuels

DOEpatents

Lloyd, M.H.; Collins, J.L.; Shell, S.E.

Improved spherules for making enhanced forms of nuclear-reactor fuels are prepared by internal gelation procedures within a sol-gel operation and are accomplished by first boiling the concentrated HMTA-urea feed solution before engaging in the spherule-forming operation thereby effectively controlling crystallite size in the product spherules.

Impact of online education on intern behaviour around joint commission national patient safety goals: a randomised trial.

PubMed

Shaw, Tim J; Pernar, Luise I; Peyre, Sarah E; Helfrick, John F; Vogelgesang, Kaitlin R; Graydon-Baker, Erin; Chretien, Yves; Brown, Elizabeth J; Nicholson, James C; Heit, Jeremy J; Co, John Patrick T; Gandhi, Tejal

2012-10-01

To compare the effectiveness of two types of online learning methodologies for improving the patient-safety behaviours mandated in the Joint Commission National Patient Safety Goals (NPSG). This randomised controlled trial was conducted in 2010 at Massachusetts General Hospital and Brigham and Women's Hospital (BWH) in Boston USA. Incoming interns were randomised to either receive an online Spaced Education (SE) programme consisting of cases and questions that reinforce over time, or a programme consisting of an online slide show followed by a quiz (SQ). The outcome measures included NPSG-knowledge improvement, NPSG-compliant behaviours in a simulation scenario, self-reported confidence in safety and quality, programme acceptability and programme relevance. Both online learning programmes improved knowledge retention. On four out of seven survey items measuring satisfaction and self-reported confidence, the proportion of SE interns responding positively was significantly higher (p<0.05) than the fraction of SQ interns. SE interns demonstrated a mean 4.79 (36.6%) NPSG-compliant behaviours (out of 13 total), while SQ interns completed a mean 4.17 (32.0%) (p=0.09). Among those in surgical fields, SE interns demonstrated a mean 5.67 (43.6%) NPSG-compliant behaviours, while SQ interns completed a mean 2.33 (17.9%) (p=0.015). Focus group data indicates that SE was more contextually relevant than SQ, and significantly more engaging. While both online methodologies improved knowledge surrounding the NPSG, SE was more contextually relevant to trainees and was engaging. SE impacted more significantly on both self-reported confidence and the behaviour of surgical residents in a simulated scenario.

Modeling of R/C Servo Motor and Application to Underactuated Mechanical Systems

NASA Astrophysics Data System (ADS)

Ishikawa, Masato; Kitayoshi, Ryohei; Wada, Takashi; Maruta, Ichiro; Sugie, Toshiharu

An R/C servo motor is a compact package of a DC geard-motor associated with a position servo controller. They are widely used in small-sized robotics and mechatronics by virtue of their compactness, easiness-to-use and high/weight ratio. However, it is crucial to clarify their internal model (including the embedded position servo) in order to improve control performance of mechatronic systems using R/C servo motors, such as biped robots or underactuted sysyems. In this paper, we propose a simple and realistic internal model of the R/C servo motors including the embedded servo controller, and estimate their physical parameters using continuous-time system identification method. We also provide a model of reference-to-torque transfer function so that we can estimate the internal torque acting on the load.

A quality improvement project using statistical process control methods for type 2 diabetes control in a resource-limited setting.

PubMed

Flood, David; Douglas, Kate; Goldberg, Vera; Martinez, Boris; Garcia, Pablo; Arbour, MaryCatherine; Rohloff, Peter

2017-08-01

Quality improvement (QI) is a key strategy for improving diabetes care in low- and middle-income countries (LMICs). This study reports on a diabetes QI project in rural Guatemala whose primary aim was to improve glycemic control of a panel of adult diabetes patients. Formative research suggested multiple areas for programmatic improvement in ambulatory diabetes care. This project utilized the Model for Improvement and Agile Global Health, our organization's complementary healthcare implementation framework. A bundle of improvement activities were implemented at the home, clinic and institutional level. Control charts of mean hemoglobin A1C (HbA1C) and proportion of patients meeting target HbA1C showed improvement as special cause variation was identified 3 months after the intervention began. Control charts for secondary process measures offered insights into the value of different components of the intervention. Intensity of home-based diabetes education emerged as an important driver of panel glycemic control. Diabetes QI work is feasible in resource-limited settings in LMICs and can improve glycemic control. Statistical process control charts are a promising methodology for use with panels or registries of diabetes patients. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

[Health locus of control of patients in disease management programmes].

PubMed

Schnee, M; Grikscheit, F

2013-06-01

Health locus of control beliefs plays a major role in improving self-management skills of the chronically ill - a main goal in disease management programmes (DMP). This study aims at characterising participants in disease management regarding their health locus of control. Data are based on 4 cross-sectional postal surveys between spring and autumn of 2006 and 2007 within the Health Care Monitor of the Bertelsmann Foundation. Among the 6 285 respondents, 1 266 are chronically ill and not enrolled in a DMP and 327 are participating in a DMP. A high internal locus of control (HLC) occurs significantly less often in DMP patients than in normal chronically ill patients (and healthy people) controlling for age, gender and social class. With increasing age, a high internal locus of control is also significantly less likely. When comparing healthy people, the chronically ill and the DMP participants a social gradient of a high internal locus of control belief can be observed. The weaker internal and higher doctor-related external locus of control of DMP participants should be carefully observed by the physician when trying to strengthen the patients' self-management skills. Evaluators of DMP should take into account the different baselines of DMP patients and relevant control groups and incorporate these differences into the evaluation. © Georg Thieme Verlag KG Stuttgart · New York.

Internal stresses in pre-stressed micron-scale aluminum core-shell particles and their improved reactivity

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

Levitas, Valery I., E-mail: vlevitas@iastate.edu; McCollum, Jena; Pantoya, Michelle L.

2015-09-07

Dilatation of aluminum (Al) core for micron-scale particles covered by alumina (Al{sub 2}O{sub 3}) shell was measured utilizing x-ray diffraction with synchrotron radiation for untreated particles and particles after annealing at 573 K and fast quenching at 0.46 K/s. Such a treatment led to the increase in flame rate for Al + CuO composite by 32% and is consistent with theoretical predictions based on the melt-dispersion mechanism of reaction for Al particles. Experimental results confirmed theoretical estimates and proved that the improvement of Al reactivity is due to internal stresses. This opens new ways of controlling particle reactivity through creating and monitoringmore » internal stresses.« less

Assessment of the iodine concentration in table salt at the production stage in South Africa.

PubMed Central

Jooste, Pieter L.

2003-01-01

OBJECTIVE: To determine the iodine content of iodized salt at the production stage, to assess the perceptions and knowledge of salt producers about the prevention and control of iodine deficiency, and to examine the internal quality control procedures used during iodization in South Africa. METHOD: Salt samples were collected for iodine analysis by titration from the 12 producers iodizing salt in South Africa. Information on the producers' knowledge of iodine deficiency disorders and on internal quality control was obtained by means of questionnaires. FINDINGS: The legal requirement of 40-60 ppm iodine was met in 30.9% of salt samples; 57.9% contained more than 30 ppm iodine; 34.8% contained under 20 ppm iodine. There were shortcomings in perceptions and knowledge about iodine deficiency disorders and in the internal quality control procedures of a substantial proportion of the producers. CONCLUSION: In order to encourage and support salt producers to achieve optimal iodization there should be an information, education and communication strategy aimed at improving knowledge of iodine deficiency disorders and at raising the standard of internal quality control procedures. External monitoring should continue. PMID:12973644

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved toward its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-26

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved toward its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

Autologous platelet gel and platelet-poor plasma reduce pain with total shoulder arthroplasty.

PubMed

Zavadil, Douglas P; Satterlee, C Craig; Costigan, Jaime M; Holt, David W; Shostrom, Valerie K

2007-09-01

The recovery of patients undergoing total shoulder arthroplasty (TSA) can be adversely affected by a number of complications. Autologous platelet gel (APG), produced by activating platelet-rich plasma (PRP), has been shown to improve hemostasis and wound healing and reduce infections in some surgical procedures. Activated platelet-poor plasma (PPP) has also been used as a hemostatic agent. This study examines the effects of APG and PPP treatment on TSA patients postoperatively. After Institutional Review Board (IRB) approval, 40 patients undergoing TSA at our institution were prospectively enrolled in our study. They were randomized into either a control (n = 20) or study (n = 20) group, with the study group receiving APG and PPP treatment. Preoperative demographic data, pre- and postoperative laboratory data, pain scores, pain medication, complications, pre- and postoperative range of motion measurements, and postoperative lengths of stay were recorded for each group. The preoperative internal rotation index was significantly higher in the control group compared with treatment patients (4.64 +/- 4.46 vs. 1.88 +/- 2.44, p < .05). The percent hemoglobin retained postoperatively was higher in the treatment group at 24 (84.54 +/- 5.32 vs. 79.87 +/- 8.73) and 72 hours (87.46 +/- 16.03 vs. 76.70 vs. 5.96), but neither difference reached statistical significance. The treatment group had significantly lower pain scores (p = .007) and total fentanyl requirements (p < .05) compared with control patients. The internal rotation index improvement factor (postoperative internal rotation index/preoperative internal rotation index) was significantly higher in the treatment group vs. the control group (p < .05). Although it did not reach statistical significance, the treatment group was discharged almost 9 hours earlier than the control group (64.44 +/- 15.23 vs. 73.39 +/- 15.37). APG and PPP treatment decreased pain and provided a greater increase in internal rotation measurements postoperatively.

Controlled carrier screening in p-n NiO/GaN piezoelectric generators by an Al2O3 insertion layer

NASA Astrophysics Data System (ADS)

Johar, Muhammad Ali; Jeong, Dae Kyung; Afifi Hassan, Mostafa; Kang, Jin-Ho; Ha, Jun-Seok; Key Lee, June; Ryu, Sang-Wan

2017-12-01

The performance of a piezoelectric generator (PG) depends significantly on the internal screening process inside the device. As piezoelectric charges appear on both ends of the piezoelectric crystal, internal screening starts to decrease the piezoelectric bias. Therefore, the piezoelectric energy generated by external stress is not fully utilized by external circuit, which is the most challenging aspect of high-efficiency PGs. In this work, the internal screening effect of a NiO/GaN p-n PG was analyzed and controlled with an Al2O3 insertion layer. Internal screening in the p-n diode PG was categorized into free-carrier screening in neutral regions and junction screening due to charge drift across the junction. It was observed that junction screening could be significantly suppressed by inserting an Al2O3 layer and that effect was dominant in a leaky diode PG. With this implementation, the piezoelectric bias of the NiO/GaN PG was improved by a factor of ~100 for high-leakage diodes and a factor of ~1.6 for low-leakage diodes. Consequently, NiO/Al2O3/GaN PGs under a stress of 5 MPa provided a piezoelectric bias of 12.1 V and a current density of 2.25 µA cm-2. The incorporation of a highly resistive Al2O3 layer between p-NiO and n-GaN layers in NiO/GaN heterojunctions provides an efficient means of improving the piezoelectric performance by controlling the internal screening of the piezoelectric field.

Locus of Control or Self-Esteem; Which One is the Best Predictor of Academic Achievement in Iranian College Students

PubMed Central

Hosseini, Seyyed Nasrollah; Mirzaei Alavijeh, Mehdi; Karami Matin, Behzad; Hamzeh, Behrooz; Ashtarian, Hossein; Jalilian, Farzad

2016-01-01

Background Self-esteem and behavioral consequences, which are due to external or internal locus of control, are effective on academic achievement of students. Objectives The aim of this study was to determine the prediction of locus of control and self-esteem in academic achievement among the students. Materials and Methods This cross-sectional study was conducted on 300 college students in Kermanshah University of Medical Sciences in 2014. Data collection tools were in three sections: demographic, Rotter internal-external locus of control scale and Coopersmith self-esteem inventory. Data were analyzed using the SPSS software version 21. Results Results showed that 29.8% and 76.2% of the participants had internal locus of control, and high self-esteem, respectively. There was a significant correlation between self-esteem, locus of control and academic achievement of the students. Self-esteem accounted for 39.5% of the variation in academic achievement. Conclusions It seems that interventions to increase self-esteem among student can help improve academic achievement among them. PMID:27284277

Internal and External Imagery Effects on Tennis Skills Among Novices.

PubMed

Dana, Amir; Gozalzadeh, Elmira

2017-10-01

The purpose of this study was to determine the effects of internal and external visual imagery perspectives on performance accuracy of open and closed tennis skills (i.e., serve, forehand, and backhand) among novices. Thirty-six young male novices, aged 15-18 years, from a summer tennis program participated. Following initial skill acquisition (12 sessions), baseline assessments of imagery ability and imagery perspective preference were used to assign participants to one of three groups: internal imagery ( n = 12), external imagery ( n = 12), or a no-imagery (mental math exercise) control group ( n = 12). The experimental interventions of 15 minutes of mental imagery (internal or external) or mental math exercises followed by 15 minutes of physical practice were held three times a week for six weeks. The performance accuracy of the groups on the serve, forehand, and backhand strokes was measured at pre- and post-test using videotaping. Results showed significant increases in the performance accuracy of all three tennis strokes in all three groups, but serve accuracy in the internal imagery group and forehand accuracy in the external imagery group showed greater improvements, while backhand accuracy was similarly improved in all three groups. These findings highlight differential efficacy of internal and external visual imagery for performance improvement on complex sport skills in early stage motor learning.

International Experiences with Economic Incentives for Protecting the Environment (2004)

EPA Pesticide Factsheets

This 2001 report finds that over the last 20 years, and particularly during the past decade, economic incentives have been increasingly used to control pollution and improve environmental and health protection.

Self-Instructional Training with an Adolescent Schizophrenic.

ERIC Educational Resources Information Center

Gumaer, Jim; Headspeth, Tanya

1985-01-01

Presents a case study involving the use of self-instructional training with an adolescent schizophrenic boy. Changes initiated in his internal and external dialog with himself improved his self-control and task performance. (JAC)

Can a combination of average of normals and "real time" External Quality Assurance replace Internal Quality Control?

PubMed

Badrick, Tony; Graham, Peter

2018-03-28

Internal Quality Control and External Quality Assurance are separate but related processes that have developed independently in laboratory medicine over many years. They have different sample frequencies, statistical interpretations and immediacy. Both processes have evolved absorbing new understandings of the concept of laboratory error, sample material matrix and assay capability. However, we do not believe at the coalface that either process has led to much improvement in patient outcomes recently. It is the increasing reliability and automation of analytical platforms along with improved stability of reagents that has reduced systematic and random error, which in turn has minimised the risk of running less frequent IQC. We suggest that it is time to rethink the role of both these processes and unite them into a single approach using an Average of Normals model supported by more frequent External Quality Assurance samples. This new paradigm may lead to less confusion for laboratory staff and quicker responses to and identification of out of control situations.

Cryptanalysis and improvement of a quantum communication-based online shopping mechanism

NASA Astrophysics Data System (ADS)

Huang, Wei; Yang, Ying-Hui; Jia, Heng-Yue

2015-06-01

Recently, Chou et al. (Electron Commer Res 14:349-367, 2014) presented a novel controlled quantum secure direct communication protocol which can be used for online shopping. The authors claimed that their protocol was immune to the attacks from both external eavesdropper and internal betrayer. However, we find that this protocol is vulnerable to the attack from internal betrayer. In this paper, we analyze the security of this protocol to show that the controller in this protocol is able to eavesdrop the secret information of the sender (i.e., the customer's shopping information), which indicates that it cannot be used for secure online shopping as the authors expected. Accordingly, an improvement of this protocol, which could resist the controller's attack, is proposed. In addition, we present another protocol which is more appropriate for online shopping. Finally, a discussion about the difference in detail of the quantum secure direct communication process between regular quantum communications and online shopping is given.

DOD Financial Management: Greater Visibility Needed to Better Assess Audit Readiness for Property, Plant, and Equipment

DTIC Science & Technology

2016-05-01

with U.S. generally accepted accounting principles and establish and maintain effective internal control over financial reporting and compliance with... Accountability Office Highlights of GAO-16-383, a report to congressional committees May 2016 DOD FINANCIAL MANAGEMENT Greater Visibility... Accounting Standards Advisory Board FIAR Financial Improvement and Audit Readiness IUS internal-use software NDAA National Defense Authorization Act

Evaluation program for secondary spacecraft cells: Initial evaluation tests of General Electric Company 6.0 ampere-hour nickel-cadmium spacecraft cells for the Improved Tiros Operational Satellite (ITOS)

NASA Technical Reports Server (NTRS)

Harkness, J. D.

1975-01-01

Quality control measures for Ni-Cd spacecraft cells were analyzed. Cells were examined for electrolyte leakage, internal shorts, low capacity, or inability of any cell to recover its open circuit voltage above 1.50 volts during the internal short test. Test results are given in tabular form.

Unhappy with internal corporate search? : learn tips and tricks for building a controlled vocabulary ontology.

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

Arpin, Bettina Karin Schimanski; Jones, Brian S.; Bemesderfer, Joy

2010-06-01

Are your employees unhappy with internal corporate search? Frequent complaints include: too many results to sift through; results are unrelated/outdated; employees aren't sure which terms to search for. One way to improve intranet search is to implement a controlled vocabulary ontology. Employing this takes the guess work out of searching, makes search efficient and precise, educates employees about the lingo used within the corporation, and allows employees to contribute to the corpus of terms. It promotes internal corporate search to rival its superior sibling, internet search. We will cover our experiences, lessons learned, and conclusions from implementing a controlled vocabularymore » ontology at Sandia National Laboratories. The work focuses on construction of this ontology from the content perspective and the technical perspective. We'll discuss the following: (1) The tool we used to build a polyhierarchical taxonomy; (2) Examples of two methods of indexing the content: traditional 'back of the book' and folksonomy word-mapping; (3) Tips on how to build future search capabilities while building the basic controlled vocabulary; (4) How to implement the controlled vocabulary as an ontology that mimics Google's search suggestions; (5) Making the user experience more interactive and intuitive; and (6) Sorting suggestions based on preferred, alternate and related terms using SPARQL queries. In summary, future improvements will be presented, including permitting end-users to add, edit and remove terms, and filtering on different subject domains.« less

A New Performance Improvement Model: Adding Benchmarking to the Analysis of Performance Indicator Data.

PubMed

Al-Kuwaiti, Ahmed; Homa, Karen; Maruthamuthu, Thennarasu

2016-01-01

A performance improvement model was developed that focuses on the analysis and interpretation of performance indicator (PI) data using statistical process control and benchmarking. PIs are suitable for comparison with benchmarks only if the data fall within the statistically accepted limit-that is, show only random variation. Specifically, if there is no significant special-cause variation over a period of time, then the data are ready to be benchmarked. The proposed Define, Measure, Control, Internal Threshold, and Benchmark model is adapted from the Define, Measure, Analyze, Improve, Control (DMAIC) model. The model consists of the following five steps: Step 1. Define the process; Step 2. Monitor and measure the variation over the period of time; Step 3. Check the variation of the process; if stable (no significant variation), go to Step 4; otherwise, control variation with the help of an action plan; Step 4. Develop an internal threshold and compare the process with it; Step 5.1. Compare the process with an internal benchmark; and Step 5.2. Compare the process with an external benchmark. The steps are illustrated through the use of health care-associated infection (HAI) data collected for 2013 and 2014 from the Infection Control Unit, King Fahd Hospital, University of Dammam, Saudi Arabia. Monitoring variation is an important strategy in understanding and learning about a process. In the example, HAI was monitored for variation in 2013, and the need to have a more predictable process prompted the need to control variation by an action plan. The action plan was successful, as noted by the shift in the 2014 data, compared to the historical average, and, in addition, the variation was reduced. The model is subject to limitations: For example, it cannot be used without benchmarks, which need to be calculated the same way with similar patient populations, and it focuses only on the "Analyze" part of the DMAIC model.

Impact of online education on intern behaviour around Joint Commission National Patient Safety Goals: A randomised trial

PubMed Central

TJ, Shaw; LIM, Pernar; SE, Peyre; JF, Helfrick; K, Vogelgesang; E, Graydon-Baker; Y, Chretien; EJ, Brown; J, Nicholson; JJ, Heit; JP, Co; TK, Gandhi

2014-01-01

Purpose To compare the effectiveness of 2 types of online learning methodologies for improving the patient-safety behaviours mandated in the Joint Commission National Patient Safety Goals (NPSG). Methods This randomized controlled trial was conducted in 2010 at Massachusetts General Hospital (MGH) and Brigham & Women’s Hospital (BWH) in Boston USA. Incoming interns were randomised to either receive an online Spaced Education program (SE) consisting of cases and questions that reinforce over time, or a program consisting of an online slide show followed by a quiz (SQ). The outcome measures included NPSG-knowledge improvement, NPSG-compliant behaviors in a simulation scenario, self reported confidence in safety and quality, program acceptability and program relevance. Results Both online learning programs improved knowledge retention. On four out of seven survey items measuring satisfaction and self reported confidence, the proportion of SE interns responding positively was significantly higher (p<0.05) than the fraction of SQ interns. SE interns demonstrated a mean 4.79 (36.6%) NPSG-compliant behaviors (out of 13 total), while SQ interns completed a mean 4.17 (32.0%) (p=0.09). Among those in surgical fields, SE interns demonstrated a mean 5.67 (43.6%) NPSG-compliant behaviors, while SQ interns completed a mean 2.33 (17.9%) (p=0.015). Focus group data indicates that SE was more contextually relevant than SQ and significantly more engaging. Conclusion While both online methodologies improved knowledge surrounding the NPSG, SE was more contextually relevant to trainees and engaging. SE impacted more significantly on both self reported confidence and the behaviour of surgical residents in a simulated scenario. PMID:22706930

A pilot controlled trial of a cognitive dissonance-based body dissatisfaction intervention with young British men.

PubMed

Jankowski, Glen S; Diedrichs, Phillippa C; Atkinson, Melissa J; Fawkner, Helen; Gough, Brendan; Halliwell, Emma

2017-12-01

This pilot study evaluated a body image intervention for men, Body Project M. Seventy-four British undergraduate men took part in two 90-min intervention sessions, and completed standardised assessments of body image, bulimic pathology, and related outcomes at baseline, post-intervention, and 3-month follow-up. Fifty-three other men completed the questionnaires as an assessment-only control group. Per-protocol analysis showed that Body Project M improved men's dissatisfaction with body fat and muscularity, body appreciation, muscularity enhancing behaviours, appearance comparisons, and internalization (ds=0.46-0.80) at post-intervention. All except dissatisfaction with muscularity and internalization were sustained at 3-month follow-up. No effects were found for bulimic pathology. Post-intervention effects for dissatisfaction with muscularity and internalization only were retained under intention-to-treat analysis. Participants were favourable towards the intervention. This study provides preliminary evidence for the acceptability and post-intervention efficacy of Body Project M. Further development of the intervention is required to improve and sustain effects. Copyright © 2017 Elsevier Ltd. All rights reserved.

Global Health Initiatives of the International Oncology Community.

PubMed

Al-Sukhun, Sana; de Lima Lopes, Gilberto; Gospodarowicz, Mary; Ginsburg, Ophira; Yu, Peter Paul

2017-01-01

Cancer has become one of the leading causes of morbidity and mortality in low- and middle-income countries (LMICs), where 60% of the world's total new cases are diagnosed. The challenge for effective control of cancer is multifaceted. It mandates integration of effective cancer prevention, encouraging early detection, and utilization of resource-adapted therapeutic and supportive interventions. In the resource-constrained setting, it becomes challenging to deliver each service optimally, and efficient allocation of resources is the best way to improve the outcome. This concept was translated into action through development of resource-stratified guidelines, pioneered by the Breast Health Global Initiative (BHGI), and later adopted by most oncology societies in an attempt to help physicians deliver the best possible care in a limited-resource setting. Improving outcome entails collaboration between key stakeholders, including the pharmaceutical industry, local and national health authorities, the World Health Organization (WHO), and other nonprofit, patient-oriented organizations. Therefore, we started to observe global health initiatives-led by ASCO, the Union for International Cancer Control (UICC), and the WHO-to address these challenges at the international level. This article discusses some of these initiatives.

KENNEDY SPACE CENTER, FLA. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved toward its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-27

KENNEDY SPACE CENTER, FLA. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved toward its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

KENNEDY SPACE CENTER, FLA. - The Pegasus launch vehicle is moved back to its hangar at Vandenberg Air Force Base, Calif. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-27

KENNEDY SPACE CENTER, FLA. - The Pegasus launch vehicle is moved back to its hangar at Vandenberg Air Force Base, Calif. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

KENNEDY SPACE CENTER, FLA. - The SciSat-1 spacecraft is uncrated at Vandenberg Air Force Base, Calif. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-26

KENNEDY SPACE CENTER, FLA. - The SciSat-1 spacecraft is uncrated at Vandenberg Air Force Base, Calif. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

KENNEDY SPACE CENTER, FLA. - The SciSat-1 spacecraft is revealed after being uncrated at Vandenberg Air Force Base, Calif. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-26

KENNEDY SPACE CENTER, FLA. - The SciSat-1 spacecraft is revealed after being uncrated at Vandenberg Air Force Base, Calif. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

KENNEDY SPACE CENTER, FLA. - Workers at Vandenberg Air Force Base, Calif., prepare to move the SciSat-1 spacecraft. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-26

KENNEDY SPACE CENTER, FLA. - Workers at Vandenberg Air Force Base, Calif., prepare to move the SciSat-1 spacecraft. SciSat-1 weighs approximately 330 pounds and will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

KENNEDY SPACE CENTER, FLA. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved into its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-27

KENNEDY SPACE CENTER, FLA. - At Vandenberg Air Force Base, Calif., the Pegasus launch vehicle is moved into its hangar. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis: A retrospective case-control study.

PubMed

Sun, Yapeng; Zhang, Wei; Qie, Suhui; Zhang, Nan; Ding, Wenyuan; Shen, Yong

2017-07-01

The study was to comprehensively compare the postoperative outcome and imaging parameter characters in a short/middle period between the percutaneous endoscopic lumbar discectomy (PELD) and the internal fixation of bone graft fusion (the most common form is posterior lumbar interbody fusion [PLIF]) for the treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis after a previous lumbar internal fixation surgery.In this retrospective case-control study, we collected the medical records from 11 patients who received PELD operation (defined as PELD group) for and from 13 patients who received the internal fixation of bone graft fusion of lumbar posterior vertebral lamina decompression (defined as control group) for the treatment of the lumbar disc prolapse combined with stable retrolisthesis at Department of Spine Surgery, the Third Hospital of Hebei Medical University (Shijiazhuang, China) from May 2010 to December 2015. The operation time, the bleeding volume of perioperation, and the rehabilitation days of postoperation were compared between 2 groups. Before and after surgery at different time points, ODI, VAS index, and imaging parameters (including Taillard index, inter-vertebral height, sagittal dislocation, and forward bending angle of lumbar vertebrae) were compared.The average operation time, the blooding volume, and the rehabilitation days of postoperation were significantly less in PELD than in control group. The ODI and VAS index in PELD group showed a significantly immediate improving on the same day after the surgery. However, Taillard index, intervertebral height, sagittal dislocation in control group showed an immediate improving after surgery, but no changes in PELD group till 12-month after surgery. The forward bending angle of lumbar vertebrae was significantly increased and decreased in PELD and in control group, respectively.PELD operation was superior in terms of operation time, bleeding volume, recovery period, and financial support, if compared with lumbar internal fixation operation. Radiographic parameters reflect lumber structure changes, which could be observed immediately after surgery in both methods; however, the recoveries on nerve function and pain relief required a longer time, especially after PLIF operation.

Implementation of asthma guidelines to West Australian community pharmacies: an exploratory, quasi-experimental study

PubMed Central

Trevenen, Michelle; Murray, Kevin; Kendall, Peter A; Schneider, Carl R; Clifford, Rhonda

2016-01-01

Objectives Pharmacy assistants are often the first point of contact for patients presenting in community pharmacies. The current role of pharmacy assistants in the supply of asthma-reliever medications (short-acting β-agonists) was identified as a barrier to appropriate guideline-based care. The aim of this research was to devise and evaluate a team-based intervention to formalise the role of pharmacy assistants and to improve asthma guideline-based care in community pharmacy. Design A controlled pre-post intervention study was conducted in 336 metropolitan pharmacies located in Perth, Western Australia. Pharmacies were stratified into 2 groups (187 intervention and 149 control) based on known confounders for asthma control. The intervention was designed using a common-sense approach and resources developed included a checklist, videos and web page. Delivery was via workshops (25 pharmacies) or academic detailing (162 pharmacies). Pharmacy practice was assessed preintervention and postintervention via covert simulated patient methodology. Primary outcome measures included patient medical referral, device use demonstration and counselling, internal referral and/or direct involvement of a pharmacist in consultations. Results There was a significant increase in patient medical referral in intervention pharmacies from 32% to 47% (p=0.0007) from preintervention to postintervention, while control pharmacies showed a non-significant decrease from 50% to 44% (p=0.22). Device counselling was not routinely carried out at any stage or in any cohort of this research and no significant changes in internal referral were observed. Conclusions Increases in medical referral indicate that asthma guideline compliance can be improved in community pharmacy if implementation employs a team-based approach and involves pharmacy assistants. However, results were variable and the intervention did not improve practice related to device counselling or internal referral/pharmacist involvement. Undertaking more workshops may have improved results. Guideline implementation in community pharmacy should consider the role of pharmacy assistants and how to overcome logistical barriers to pharmacy participation in implementation activities. PMID:27580836

Interventions to Improve the Breaking of Bad or Difficult News by Physicians, Medical Students, and Interns/Residents: A Systematic Review and Meta-Analysis.

PubMed

Johnson, Judith; Panagioti, Maria

2018-06-05

To assess the effectiveness of news delivery interventions to improve observer-rated skills, physician confidence, and patient-reported depression/anxiety. MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Register of Controlled Trials databases were searched from inception to September 5, 2016 (updated February 2017). Eligible studies included randomized controlled trials (RCTs), non-RCTs, and controlled before-after studies of interventions to improve the communication of bad or difficult news by physicians, medical students, and residents/interns. The EPOC risk of bias tool was used to conduct a risk of bias assessment. Main and secondary meta-analyses examined the effectiveness of the identified interventions for improving observer-rated news delivery skills and for improving physician confidence in delivering news and patient-reported depression/anxiety, respectively. Seventeen studies were included in the systematic review and meta-analysis, including 19 independent comparisons on 1,322 participants and 9 independent comparisons on 985 participants for the main and secondary (physician confidence) analyses (mean [SD] age = 35 [7] years; 46% male), respectively. Interventions were associated with large, significant improvements in observer-rated news delivery skills (19 comparisons: standardized mean difference [SMD] = 0.74, 95% CI = 0.47-1.01) and moderate, significant improvements in physician confidence (9 comparisons: SMD = 0.60, 95% CI = 0.26-0.95). One study reported intervention effects on patient-reported depression/anxiety. The risk of bias findings did not influence the significance of the results. Interventions are effective for improving news delivery and physician confidence. Further research is needed to test the impact of interventions on patient outcomes and determine optimal components and length.

International Space Station Sustaining Engineering: A Ground-Based Test Bed for Evaluating Integrated Environmental Control and Life Support System and Internal Thermal Control System Flight Performance

NASA Technical Reports Server (NTRS)

Ray, Charles D.; Perry, Jay L.; Callahan, David M.

2000-01-01

As the International Space Station's (ISS) various habitable modules are placed in service on orbit, the need to provide for sustaining engineering becomes increasingly important to ensure the proper function of critical onboard systems. Chief among these are the Environmental Control and Life Support System (ECLSS) and the Internal Thermal Control System (ITCS). Without either, life onboard the ISS would prove difficult or nearly impossible. For this reason, a ground-based ECLSS/ITCS hardware performance simulation capability has been developed at NASA's Marshall Space Flight Center. The ECLSS/ITCS Sustaining Engineering Test Bed will be used to assist the ISS Program in resolving hardware anomalies and performing periodic performance assessments. The ISS flight configuration being simulated by the test bed is described as well as ongoing activities related to its preparation for supporting ISS Mission 5A. Growth options for the test facility are presented whereby the current facility may be upgraded to enhance its capability for supporting future station operation well beyond Mission 5A. Test bed capabilities for demonstrating technology improvements of ECLSS hardware are also described.

The Usefulness of Quality Assurance for University Management and Academic Staff: A Case Study of Finland and Iceland

ERIC Educational Resources Information Center

Haapakorpi, Arja; Geirsdóttir, Guðrún; Jóhannsdóttir, Gyða

2013-01-01

With quality assurance related to the Bologna goals, universities are required to fulfil internationally accepted standardized criteria of quality. This tends to reinforce control in assessment. However, control-oriented evaluations seem to lack meaning for academic staff. The article explored the possibilities and space for improvement-oriented…

EVALUATION OF INTERNALLY STAGED COAL BURNERS AND SORBENT JET AERODYNAMICS FOR COMBINED SO2/NOX CONTROL IN UTILITY BOILERS, VOLUME 1, TESTING IN A 10 MILLION BTU/HR EXPERIMENTAL FURNACE

EPA Science Inventory

The document gives results of tests conducted in a 2 MWt experimental furnace to: (1) investigate ways to reduce NOx emissions from utility coal burners without external air ports (i.e., with internal fuel/air staging); and (2) improve the performance of calcium-based sorbents fo...

Defense Nuclear Facilities Safety Board: Improvements Needed to Strengthen Internal Control and Promote Transparency

DTIC Science & Technology

2015-01-01

results of those steps. GAO reviewed relevant federal laws, regulations , and guidance; analyzed DNFSB documents, including records of internal...agencies’ regulations on Sunshine Act meetings.11 We also interviewed a representative of the Sunlight Foundation, an organization focused on...Secretary’s role as operator and regulator of DOE’s defense nuclear facilities—to ensure adequate protection of public health and safety at these

Disintegrated care: the Achilles heel of international health policies in low and middle-income countries

PubMed Central

Unger, Jean-Pierre; De Paepe, Pierre; Ghilbert, Patricia; Soors, Werner; Green, Andrew

2006-01-01

Abstract Purpose To review the evidence basis of international aid and health policy. Context of case Current international aid policy is largely neoliberal in its promotion of commoditization and privatisation. We review this policy's responsibility for the lack of effectiveness in disease control and poor access to care in low and middle-income countries. Data sources National policies, international programmes and pilot experiments are examined in both scientific and grey literature. Conclusions and discussion We document how health care privatisation has led to the pool of patients being cut off from public disease control interventions—causing health care disintegration—which in turn resulted in substandard performance of disease control. Privatisation of health care also resulted in poor access. Our analysis consists of three steps. Pilot local contracting-out experiments are scrutinized; national health care records of Colombia and Chile, two countries having adopted contracting-out as a basis for health care delivery, are critically examined against Costa Rica; and specific failure mechanisms of the policy in low and middle-income countries are explored. We conclude by arguing that the negative impact of neoliberal health policy on disease control and health care in low and middle-income countries justifies an alternative aid policy to improve both disease control and health care. PMID:17006553

Pivoting neuromuscular control and proprioception in females and males.

PubMed

Lee, Song Joo; Ren, Yupeng; Kang, Sang Hoon; Geiger, François; Zhang, Li-Qun

2015-04-01

Noncontact ACL injuries occur most commonly in pivoting sports and are much more frequent in females than in males. However, information on sex differences in proprioceptive acuity under weight-bearing and leg neuromuscular control in pivoting is scarce. The objective of this study was to investigate sex differences in pivoting neuromuscular control during strenuous stepping tasks and proprioceptive acuity under weight-bearing. 21 male and 22 female subjects were recruited to evaluate pivoting proprioceptive acuity under weight-bearing, and pivoting neuromuscular control (in terms of leg pivoting instability, stiffness, maximum internal and external pivoting angles, and entropy of time-to-peak EMG in lower limb muscles) during strenuous stepping tasks performed on a novel offaxis elliptical trainer. Compared to males, females had significantly lower proprioceptive acuity under weight-bearing in both internal and external pivoting directions, higher pivoting instability, larger maximum internal pivoting angle, lower leg pivoting stiffness, and higher entropy of time-to-peak EMG in the gastrocnemius muscles during strenuous stepping tasks with internal and external pivoting perturbations. Results of this study may help us better understand factors contributing to ACL injuries in females and males, develop training strategies to improve pivoting neuromuscular control and proprioceptive acuity, and potentially reduce ACL and lower-limb musculoskeletal injuries.

Improving Logistics Processes in Industry Using Web Technologies

NASA Astrophysics Data System (ADS)

Jánošík, Ján; Tanuška, Pavol; Václavová, Andrea

2016-12-01

The aim of this paper is to propose the concept of a system that takes advantage of web technologies and integrates them into the management process and management of internal stocks which may relate to external applications and creates the conditions to transform a Computerized Control of Warehouse Stock (CCWS) in the company. The importance of implementing CCWS is in the elimination of the claims caused by the human factor, as well as to allow the processing of information for analytical purposes and their subsequent use to improve internal processes. Using CCWS in the company would also facilitate better use of the potential tools Business Intelligence and Data Mining.

Identifying Procurement Fraud in Defense Agencies: An Analysis of the Government Purchase Card Program

DTIC Science & Technology

2011-04-30

fielding, contracting, interoperability, organizational behavior, risk management , cost estimating, and many others. Approaches range from... COSO ), (Whittington & Pany, 2012). In addition, the Federal Financial Management Improvement Act of 1996 identified internal control as an...fraud indicators within the DoD Government Purchase Card Programs and provides recommendations for improving the management of Government Purchase

Bio-Defense Now: 56 Suggestions for Immediate Improvements

DTIC Science & Technology

2005-05-01

Air Education and Training Command HVAC Heating, Ventilation and Air Conditioning ICAM Improved Chemical Agent Monitor ICD-9-CM Internal...conditioning ( HVAC ) system capabilities, making a big difference in removal of many BW agents. High Efficiency Particulate Air (HEPA) filters are also...agents. This program has developed biological sensor-activated heating, ventilation, and air conditioning ( HVAC ) control sys- tems, high efficiency

VANDENBERG AIR FORCE BASE, CALIF. - Workers mate the Pegasus , with its cargo of the SciSat-1 payload to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-08-09

VANDENBERG AIR FORCE BASE, CALIF. - Workers mate the Pegasus , with its cargo of the SciSat-1 payload to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg AFB, Calif., a solar array is tested before installing on the SciSat-1 spacecraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-07-29

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg AFB, Calif., a solar array is tested before installing on the SciSat-1 spacecraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg AFB, Calif., a solar array is installed on the SciSat-1 spacecraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-07-29

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg AFB, Calif., a solar array is installed on the SciSat-1 spacecraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - The SciSat-1 payload and Pegasus launch vehicle are lifted and mated to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-08-09

VANDENBERG AIR FORCE BASE, CALIF. - The SciSat-1 payload and Pegasus launch vehicle are lifted and mated to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

Transport Properties of Bulk Thermoelectrics An International Round-Robin Study, Part I: Seebeck Coefficient and Electrical Resistivity

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

Wang, Hsin; Porter, Wallace D; Bottner, Harold

2013-01-01

Recent research and development of high temperature thermoelectric materials has demonstrated great potential of converting automobile exhaust heat directly into electricity. Thermoelectrics based on classic bismuth telluride have also started to impact the automotive industry by enhancing air conditioning efficiency and integrated cabin climate control. In addition to engineering challenges of making reliable and efficient devices to withstand thermal and mechanical cycling, the remaining issues in thermoelectric power generation and refrigeration are mostly materials related. The figure-of-merit, ZT, still needs to improve from the current value of 1.0 - 1.5 to above 2 to be competitive to other alternative technologies.more » In the meantime, the thermoelectric community could greatly benefit from the development of international test standards, improved test methods and better characterization tools. Internationally, thermoelectrics have been recognized by many countries as an important area for improving energy efficiency. The International Energy Agency (IEA) group under the implementing agreement for Advanced Materials for Transportation (AMT) identified thermoelectric materials as an important area in 2009. This paper is Part I of the international round-robin testing of transport properties of bulk thermoelectrics. The main focuses in Part I are on two electronic transport properties: Seebeck coefficient and electrical resistivity.« less

Transport Properties of Bulk Thermoelectrics—An International Round-Robin Study, Part I: Seebeck Coefficient and Electrical Resistivity

NASA Astrophysics Data System (ADS)

Wang, Hsin; Porter, Wallace D.; Böttner, Harald; König, Jan; Chen, Lidong; Bai, Shengqiang; Tritt, Terry M.; Mayolet, Alex; Senawiratne, Jayantha; Smith, Charlene; Harris, Fred; Gilbert, Patricia; Sharp, Jeff W.; Lo, Jason; Kleinke, Holger; Kiss, Laszlo

2013-04-01

Recent research and development of high-temperature thermoelectric materials has demonstrated great potential for converting automobile exhaust heat directly into electricity. Thermoelectrics based on classic bismuth telluride have also started to impact the automotive industry by enhancing air-conditioning efficiency and integrated cabin climate control. In addition to engineering challenges of making reliable and efficient devices to withstand thermal and mechanical cycling, the remaining issues in thermoelectric power generation and refrigeration are mostly materials related. The dimensionless figure of merit, ZT, still needs to be improved from the current value of 1.0 to 1.5 to above 2.0 to be competitive with other alternative technologies. In the meantime, the thermoelectric community could greatly benefit from the development of international test standards, improved test methods, and better characterization tools. Internationally, thermoelectrics have been recognized by many countries as a key component for improving energy efficiency. The International Energy Agency (IEA) group under the Implementing Agreement for Advanced Materials for Transportation (AMT) identified thermoelectric materials as an important area in 2009. This paper is part I of the international round-robin testing of transport properties of bulk thermoelectrics. The main foci in part I are the measurement of two electronic transport properties: Seebeck coefficient and electrical resistivity.

Reducing Internalizing Symptoms among High-Risk, Hispanic Adolescents: Mediators of a Preventive Family Intervention

PubMed Central

Perrino, Tatiana; Brincks, Ahnalee; Howe, George; Brown, C. Hendricks; Prado, Guillermo; Pantin, Hilda

2016-01-01

Familias Unidas is a family-focused preventive intervention that has been found to reduce drug use and sexual risk behaviors among Hispanic adolescents. In some trials, Familias Unidas has also been found to be efficacious in reducing adolescent internalizing symptoms (i.e., depressive and anxiety symptoms), even though the intervention did not specifically target internalizing symptoms. This study examines potential mediators or mechanisms by which Familias Unidas influences internalizing symptoms, specifically the role of intervention-targeted improvements in parent-adolescent communication and reductions in youth externalizing behaviors. A total of 213 Hispanic eighth grade students with a history of externalizing behavior problems and their primary caregivers were recruited from the public school system. Participants, with a mean age of 13.8 years, were randomized into the Familias Unidas intervention or community practice control condition, and assessed at baseline, 6-months, 18-months, and 30-months post-baseline. A cascading mediation model was tested in which the Familias Unidas intervention was hypothesized to decrease adolescent internalizing symptoms through two mediators: improvements in parent-adolescent communication leading to decreases in externalizing behaviors. Findings show that the intervention had significant direct effects on youth internalizing symptoms at 30-months post-baseline. In addition, the cascading mediation model was supported in which the Familias Unidas intervention predicted significant improvements in parent-adolescent communication at 6-months, subsequently decreasing externalizing behaviors at 18-months, and ultimately reducing youth internalizing symptoms at 30-months post-baseline. Implications for prevention interventions are discussed. PMID:27154768

Unlabeled oligonucleotides as internal temperature controls for genotyping by amplicon melting.

PubMed

Seipp, Michael T; Durtschi, Jacob D; Liew, Michael A; Williams, Jamie; Damjanovich, Kristy; Pont-Kingdon, Genevieve; Lyon, Elaine; Voelkerding, Karl V; Wittwer, Carl T

2007-07-01

Amplicon melting is a closed-tube method for genotyping that does not require probes, real-time analysis, or allele-specific polymerase chain reaction. However, correct differentiation of homozygous mutant and wild-type samples by melting temperature (Tm) requires high-resolution melting and closely controlled reaction conditions. When three different DNA extraction methods were used to isolate DNA from whole blood, amplicon Tm differences of 0.03 to 0.39 degrees C attributable to the extractions were observed. To correct for solution chemistry differences between samples, complementary unlabeled oligonucleotides were included as internal temperature controls to shift and scale the temperature axis of derivative melting plots. This adjustment was applied to a duplex amplicon melting assay for the methylenetetrahydrofolate reductase variants 1298A>C and 677C>T. High- and low-temperature controls bracketing the amplicon melting region decreased the Tm SD within homozygous genotypes by 47 to 82%. The amplicon melting assay was 100% concordant to an adjacent hybridization probe (HybProbe) melting assay when temperature controls were included, whereas a 3% error rate was observed without temperature correction. In conclusion, internal temperature controls increase the accuracy of genotyping by high-resolution amplicon melting and should also improve results on lower resolution instruments.

Results of a Regional Effort to Improve Warfarin Management.

PubMed

Rose, Adam J; Park, Angela; Gillespie, Christopher; Van Deusen Lukas, Carol; Ozonoff, Al; Petrakis, Beth Ann; Reisman, Joel I; Borzecki, Ann M; Benedict, Ashley J; Lukesh, William N; Schmoke, Timothy J; Jones, Ellen A; Morreale, Anthony P; Ourth, Heather L; Schlosser, James E; Mayo-Smith, Michael F; Allen, Arthur L; Witt, Daniel M; Helfrich, Christian D; McCullough, Megan B

2017-05-01

Improved anticoagulation control with warfarin reduces adverse events and represents a target for quality improvement. No previous study has described an effort to improve anticoagulation control across a health system. To describe the results of an effort to improve anticoagulation control in the New England region of the Veterans Health Administration (VA). Our intervention encompassed 8 VA sites managing warfarin for more than 5000 patients in New England (Veterans Integrated Service Network 1 [VISN 1]). We provided sites with a system to measure processes of care, along with targeted audit and feedback. We focused on processes of care associated with site-level anticoagulation control, including prompt follow-up after out-of-range international normalized ratio (INR) values, minimizing loss to follow-up, and use of guideline-concordant INR target ranges. We used a difference-in-differences (DID) model to examine changes in anticoagulation control, measured as percentage time in therapeutic range (TTR), as well as process measures and compared VISN 1 sites with 116 VA sites located outside VISN 1. VISN 1 sites improved on TTR, our main indicator of quality, from 66.4% to 69.2%, whereas sites outside VISN 1 improved from 65.9% to 66.4% (DID 2.3%, P < 0.001). Improvement in TTR correlated strongly with the extent of improvement on process-of-care measures, which varied widely across VISN 1 sites. A regional quality improvement initiative, using performance measurement with audit and feedback, improved TTR by 2.3% more than control sites, which is a clinically important difference. Improving relevant processes of care can improve outcomes for patients receiving warfarin.

Internal resources among informal caregivers: trajectories and associations with well-being.

PubMed

Litzelman, Kristin; Tesauro, Gina; Ferrer, Rebecca

2017-12-01

The experiences, skills, and internal resources that informal caregivers bring into their role may play a critical part in their mental health and well-being. This study examined how caregiver internal resources changed over a 10 year period, and how this was related to caregivers' well-being. Data are from the Midlife in the United States (MIDUS) study, a national sample of adults, at two time points: 1995-1996 (T1) and 2004-2006 (T2). We identified subjects who reported being a caregiver at T2 and starting care after T1 (mean age = 56; 65% female). We examined internal resources: sense of control (personal mastery); primary and secondary control strategies (persistence in goal striving, positive reappraisal, and lowering expectations); and social support seeking, and psychological and subjective well-being. We evaluated how internal resources changed over time, and how these trajectories were associated with well-being at T2 using multivariable linear regressions. Most caregivers had stable levels of internal resources (between 4 and 13% showed an increase or decrease). Caregivers with increasing or high-stable levels of personal mastery had significantly better well-being scores on 6 out of 8 subscales compared with low-stable levels [effect sizes (ES) between 0.39 and 0.79]. Increasing persistence was associated with better personal growth and environmental mastery (ES = 0.96 and 0.91), and increasing and high-stable positive reappraisals were associated with better affect (ES = 0.63 and 0.48) compared with low-stable levels. Lowering aspirations and support seeking were not associated with well-being outcomes. Practices or interventions that support or improve internal resources could potentially improve caregiver well-being.

CERT Resilience Management Model, Version 1.0

DTIC Science & Technology

2010-05-01

practice such as ISO 27000 , COBIT, or ITIL. If you are a member of an established process improvement community, particularly one centered on CMMI...Systems Audit and Control Association ISO International Organization for Standardization ISSA Information Systems Security Association IT

The impact of the improvement in internal medicine consultation process on ED length of stay.

PubMed

Shin, Sangheon; Lee, Soo Hoon; Kim, Dong Hoon; Kim, Seong Chun; Kim, Tae Yun; Kang, Changwoo; Jeong, Jin Hee; Lim, Daesung; Park, Yong Joo; Lee, Sang Bong

2018-04-01

Although consultations are essential for delivering safe, high-quality care to patients in emergency departments, they contribute to emergency department patient flow problems and overcrowding which is associated with several adverse outcomes, such as increases in patient mortality and poor quality care. This study aimed to investigate how time flow metrics including emergency department length of stay is influenced by changes to the internal medicine consultation policy. This study is a pre- and post-controlled interventional study. We attempted to improve the internal medicine consultation process to be more concise. After the intervention, only attending emergency physicians consult internal medicine chief residents, clinical fellows, or junior staff of each internal medicine subspecialty who were on duty when patients required special care or an admission to internal medicine. Emergency department length of stay of patients admitted to the department of internal medicine prior to and after the intervention decreased from 996.94min to 706.62min. The times from consultation order to admission order and admission order to emergency department departure prior to and after the intervention were decreased from 359.59min to 180.38min and from 481.89min to 362.37min, respectively. The inpatient mortality rates and Inpatient bed occupancy rates prior to and after the intervention were similar. The improvements in the internal medicine consultation process affected the flow time metrics. Therefore, more comprehensive and cooperative strategies need to be developed to reduce the time cycle metrics and overcrowding of all patients in the emergency department. Copyright © 2017 Elsevier Inc. All rights reserved.

Reducing the Risk of Internalizing Symptoms among High-risk Hispanic Youth through a Family Intervention: A Randomized Controlled Trial.

PubMed

Perrino, Tatiana; Pantin, Hilda; Huang, Shi; Brincks, Ahnalee; Brown, C Hendricks; Prado, Guillermo

2016-03-01

Familias Unidas is an intervention that has been found to be efficacious in preventing and reducing substance use, sexual risk, and problem behaviors among Hispanic youth. While it does not specifically target youth internalizing symptoms, the intervention works to strengthen parenting and family factors associated with reduced risk of internalizing symptoms (i.e., depression, anxiety symptoms). This study examines the effects of Familias Unidas on internalizing symptoms among high-risk youth, as well as the role of family level factors in the intervention's effects. A total of 242 12-17-year-old Hispanic youth with a history of delinquency and their primary caregivers were recruited from the school and juvenile justice systems, and randomly assigned to the Familias Unidas intervention or community practice control. A linear latent growth model was used to examine intervention effects on the trajectory of adolescent internalizing symptoms from baseline to 6 and 12 months post-baseline. Results show that the Familias Unidas intervention was more efficacious than control in reducing youth internalizing symptoms. Baseline youth externalizing and internalizing symptoms did not moderate the intervention's effects on the trajectory of youth internalizing symptoms. While parent-adolescent communication did not significantly moderate the intervention's effects, changes in parent-adolescent communication mediated the intervention's effects on internalizing symptoms, showing stronger intervention effects for youth starting with poorer communication. Findings indicate that the Familias Unidas intervention can reduce internalizing symptoms among high-risk Hispanic youth, and that improving parent-youth communication, a protective family factor, may be one of the mechanisms by which the intervention influences youth internalizing symptoms. © 2015 Family Process Institute.

Recalibrating disparities in perceived and actual balance abilities in older adults: a mixed-methods evaluation of a novel exergaming intervention.

PubMed

Ellmers, Toby J; Paraskevopoulos, Ioannis Th; Williams, A Mark; Young, William R

2018-03-22

Published reports suggest a disparity between perceived and actual balance abilities, a trait associated with increased fall-risk in older adults. We investigate whether it is possible to 'recalibrate' these disparities using a novel gaming intervention. We recruited 26 older adults for a 4-week intervention in which they participated in 8-sessions using a novel gaming intervention designed to provide explicit, augmented feedback related to postural control. Measures of perceived balance abilities (Falls Efficacy Scale-International) and actual postural control (limits of stability) were assessed pre- and post-intervention. We used focus groups to elicit the opinions of participants about how the game may have influenced balance abilities and confidence. A stronger alignment was observed between postural control and perceived balance capabilities post-intervention (i.e., significant correlations between Falls Efficacy Scale-International scores and limits of stability which were not present pre-intervention). Also, significant improvements in measures of postural control were observed, with these improvements confined to the aspects of postural control for which the exergame provided explicit, augmented feedback. Qualitative data revealed that the intervention made participants more "aware" of their balance abilities. Our results demonstrate that it is possible to recalibrate the perceptions of older adults relating to their balance abilities through a targeted, short-term intervention. We propose that the post-intervention improvements in postural control may have been, in part, the result of this recalibration; with altered perceptions leading to changes in balance performance. Findings support the application of novel interventions aimed at addressing the psychological factors associated with elderly falls.

Variance analysis refines overhead cost control.

PubMed

Cooper, J C; Suver, J D

1992-02-01

Many healthcare organizations may not fully realize the benefits of standard cost accounting techniques because they fail to routinely report volume variances in their internal reports. If overhead allocation is routinely reported on internal reports, managers can determine whether billing remains current or lost charges occur. Healthcare organizations' use of standard costing techniques can lead to more realistic performance measurements and information system improvements that alert management to losses from unrecovered overhead in time for corrective action.

Internal quality control indicators of cervical cytopathology exams performed in laboratories monitored by the External Quality Control Laboratory.

PubMed

Ázara, Cinara Zago Silveira; Manrique, Edna Joana Cláudio; Tavares, Suelene Brito do Nascimento; de Souza, Nadja Lindany Alves; Amaral, Rita Goreti

2014-09-01

To evaluate the impact of continued education provided by an external quality control laboratory on the indicators of internal quality control of cytopathology exams. The internal quality assurance indicators for cytopathology exams from 12 laboratories monitored by the External Quality Control Laboratory were evaluated. Overall, 185,194 exams were included, 98,133 of which referred to the period preceding implementation of a continued education program, while 87,061 referred to the period following this intervention. Data were obtained from the Cervical Cancer Database of the Brazilian National Health Service. Following implementation of the continued education program, the positivity index (PI) remained within recommended limits in four laboratories. In another four laboratories, the PI progressed from below the limits to within the recommended standards. In one laboratory, the PI remained low, in two laboratories, it remained very low, and in one, it increased from very low to low. The percentage of exams compatible with a high-grade squamous intraepithelial lesion (HSIL) remained within the recommended limits in five laboratories, while in three laboratories it progressed from below the recommended levels to >0.4% of the total number of satisfactory exams, and in four laboratories it remained below the standard limit. Both the percentage of atypical squamous cells of undetermined significance (ASC-US) in relation to abnormal exams, and the ratio between ASC-US and intraepithelial lesions remained within recommended levels in all the laboratories investigated. An improvement was found in the indicators represented by the positivity index and the percentage of exams compatible with a high-grade squamous intraepithelial lesion, showing that the role played by the external quality control laboratory in providing continued education contributed towards improving laboratory staff skills in detecting cervical cancer precursor lesions.

Attitude control of an orbiting space vehicle.

NASA Technical Reports Server (NTRS)

Sutherlin, D. W.; Boland, J. S. , III; Borelli, M. T.

1971-01-01

Study of the normal and clamped modes of operation and dynamic response characteristics of the gimbaled control moment gyro (CMG) designed to fulfill the stringent pointing requirements of the Skylab telescope mount when the spacecraft is under the influence of both external and internal torques. The results indicate that the clamped mode of operation provides a feasible approach for significantly improving the system characteristics.

Locus of control, quality of life, anxiety, and depression among Malaysian breast cancer patients: The mediating role of uncertainty.

PubMed

Pahlevan Sharif, Saeed

2017-04-01

The main objective of this study was to investigate the mediating role of uncertainty in the relationship between locus of control with quality of life, anxiety, and depression. A descriptive and correlational survey was conducted in a private hospital in Kuala Lumpur, Malaysia. A convenience sample of 118 Malaysian breast cancer patients voluntarily participated in the study and responded to a set of questionnaires including: socio-demographic questionnaire, the short form of Locus of Control Scale, the Functional Assessment of Cancer Therapy-Breast (FACT-B), the Hospital Anxiety and Depression Scale (HADS), and the Short-Form Mishel Uncertainty in Illness Scale (SF-MUIS). The results revealed that breast cancer patients with higher internal locus of control and lower external locus of control experience a higher quality of life, lower anxiety, and lower depression. Also, uncertainty mediated the relationship between locus of control with quality of life and depression (quasi-significant). The findings indicated the need for early, targeted psychological interventions seeking to gradually shift cancer patients' locus of control from external to internal in order to improve their quality of life and reduce their depression and anxiety. Moreover, health care providers by providing relevant information to cancer patients, especially for externally oriented patients, can reduce their uncertainty which in turn would improve their quality of life. Copyright © 2017 Elsevier Ltd. All rights reserved.

Malignants In The Body Politic: Redefining War Through Metaphor

DTIC Science & Technology

2002-06-01

not display a currently valid OMB control number. 1. REPORT DATE 00 JUN 2002 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE...check it from infecting our societies or damaging our lives. We need, for instance, better border control regimes and improved international...innate immune response.4 “Present and ready to resist an invader at any time,” generally within minutes, the innate system can control or

Environmental Assessment for Terminal Area Improvements, Charleston International Airport

DTIC Science & Technology

2011-11-17

Resources and/or USFWS . 7. An erosion and sedimentation control plan that includes the use of construction controls to prevent degradation of water...CCAA property and surrounding lands were historically used for phosphate fertilizer mining. Prior to the development of this property as an airport...number of zoning classifications which control land use within the city limits. The Airport is in an area zoned as "Light Industrial District" a

A Wind Tunnel Model to Explore Unsteady Circulation Control for General Aviation Applications

NASA Technical Reports Server (NTRS)

Cagle, Christopher M.; Jones, Gregory S.

2002-01-01

Circulation Control airfoils have been demonstrated to provide substantial improvements in lift over conventional airfoils. The General Aviation Circular Control model is an attempt to address some of the concerns of this technique. The primary focus is to substantially reduce the amount of air mass flow by implementing unsteady flow. This paper describes a wind tunnel model that implements unsteady circulation control by pulsing internal pneumatic valves and details some preliminary results from the first test entry.

International Lighting in Controlled Environments Workshop

NASA Technical Reports Server (NTRS)

Tibbits, Ted W. (Editor)

1994-01-01

Lighting is a central and critical aspect of control in environmental research for plant research and is gaining recognition as a significant factor to control carefully for animal and human research. Thus this workshop was convened to reevaluate the technology that is available today and to work toward developing guidelines for the most effective use of lighting in controlled environments with emphasis on lighting for plants but also to initiate interest in the development of improved guidelines for human and animal research.

KENNEDY SPACE CENTER, FLA. - Inside the hangar at Vandenberg Air Force Base, Calif., workers wait for the Pegasus launch vehicle to be moved inside. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-27

KENNEDY SPACE CENTER, FLA. - Inside the hangar at Vandenberg Air Force Base, Calif., workers wait for the Pegasus launch vehicle to be moved inside. The Pegasus will carry the SciSat-1 spacecraft in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The scientific mission of SciSat-1 is to measure and understand the chemical processes that control the distribution of ozone in the Earth’s atmosphere, particularly at high altitudes. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

An improved method to quantitate mature plant microRNA in biological matrices using modified periodate treatment and inclusion of internal controls.

PubMed

Huang, Haiqiu; Roh, Jamin; Davis, Cindy D; Wang, Thomas T Y

2017-01-01

MicroRNAs (miRNAs) ubiquitously exist in microorganisms, plants, and animals, and appear to modulate a wide range of critical biological processes. However, no definitive conclusion has been reached regarding the uptake of exogenous dietary small RNAs into mammalian circulation and organs and cross-kingdom regulation. One of the critical issues is our ability to assess and distinguish the origin of miRNAs. Although periodate oxidation has been used to differentiate mammalian and plant miRNAs, validation of treatment efficiency and the inclusion of proper controls for this method were lacking in previous studies. This study aimed to address: 1) the efficiency of periodate treatment in a plant or mammalian RNA matrix, and 2) the necessity of inclusion of internal controls. We designed and tested spike-in synthetic miRNAs in various plant and mammalian matrices and showed that they can be used as a control for the completion of periodate oxidation. We found that overloading the reaction system with high concentration of RNA resulted in incomplete oxidation of unmethylated miRNA. The abundant miRNAs from soy and corn were analyzed in the plasma, liver, and fecal samples of C57BL/6 mice fed a corn and soy-based chow diet using our improved methodology. The improvement resulted in the elimination of the false positive detection in the liver, and we did not detect plant miRNAs in the mouse plasma or liver samples. In summary, an improved methodology was developed for plant miRNA detection that appears to work well in different sample matrices.

Evaluation and Improvement of the Nurse Satisfactory Status in a Tertiary Hospital using the Professional Practice Environment Scale.

PubMed

Liu, Jun; Zhou, Hui; Yang, Xiaoqin

2017-02-18

The present study was performed to quantitatively examine nurse satisfaction, to investigate the associated factors influencing satisfaction, and to evaluate the effect of improvement measures based on these factors. A survey using the 38-item Chinese version of the Practice Environment Scale (CPPE-38) was performed in a university-affiliated tertiary hospital in Shanghai, China in 2013. Linear regression analysis was performed to screen for associated factors related to each CPPE-3 score and the total satisfaction score. Several improvement measures were established to improve nurse satisfaction, and the CPPE-38 survey was again performed in 2015 to evaluate the effect of these improvement measures. A total of 1,050 respondents were recruited in 2013, with a response rate of 87.6%. The total satisfaction score of the CPPE-38 was 2.99±0.64. The lowest score in a subscale of the CPPE-38 was 2.40±0.59 for interpersonal interaction and the highest score was 3.15±0.40 for internal work motivation. Work location was associated with scores for work motivation and total satisfaction, while the highest education degree was associated with scores for internal relationship and autonomy. The scores for internal work motivation, control over practice, interpersonal interaction, and internal relationship and autonomy were significantly improved in 2015 after two years of improvement efforts, while the total satisfaction score was not significantly different compared to the 2013 score. Working location and education degree were two factors correlated with CPPE-38 scores in our hospital. Humanistic concerns, continuing education, and pay raise may improve the practice satisfaction of nurses.

Validation of Modifications to the ANSR for Listeria Method for Improved Internal Positive Control Performance.

PubMed

Alles, Susan; Meister, Evan; Hosking, Edan; Tovar, Eric; Shaulis, Rebecca; Schonfeld, Mark; Zhang, Lei; Li, Lin; Biswas, Preetha; Mozola, Mark; Donofrio, Robert; Chen, Yi

2018-03-01

A study was conducted to validate a minor reagent formulation change to the ANSR for Listeria method, Performance Tested MethodSM 101202. This change involves increasing the master mix volume prelyophilization by 40% and addition of salmon sperm DNA (nontarget DNA) to the master mix. These changes improve the robustness of the internal positive control response and reduce the possibility of obtaining invalid results due to weak-positive control curves. When three foods (hot dogs, Mexican-style cheese, and cantaloupe) and sponge samples taken from a stainless steel surface were tested, no significant differences in performance between the ANSR and U.S. Food and Drug Administration Bacteriological Analytical Manual or U.S. Department of Agriculture-Food Safety and Inspection Service Microbiology Laboratory Guidebook reference culture procedures were observed for any of the matrixes as determined by probability of detection analysis. Inclusivity and exclusivity testing yielded 100% expected results for target and nontarget bacteria. Accelerated stability testing was carried out over a 7 week period and showed no decrease in assay performance over time.

Ebola virus disease in Africa: epidemiology and nosocomial transmission.

PubMed

Shears, P; O'Dempsey, T J D

2015-05-01

The 2014 Ebola outbreak in West Africa, primarily affecting Guinea, Sierra Leone, and Liberia, has exceeded all previous Ebola outbreaks in the number of cases and in international response. There have been 20 significant outbreaks of Ebola virus disease in Sub-Saharan Africa prior to the 2014 outbreak, the largest being that in Uganda in 2000, with 425 cases and a mortality of 53%. Since the first outbreaks in Sudan and Zaire in 1976, transmission within health facilities has been of major concern, affecting healthcare workers and acting as amplifiers of spread into the community. The lack of resources for infection control and personal protective equipment are the main reasons for nosocomial transmission. Local strategies to improve infection control, and a greater understanding of local community views on the disease, have helped to bring outbreaks under control. Recommendations from previous outbreaks include improved disease surveillance to enable more rapid health responses, the wider availability of personal protective equipment, and greater international preparedness. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Case-Control Studies of Sporadic Enteric Infections: A Review and Discussion of Studies Conducted Internationally from 1990 to 2009

PubMed Central

Fullerton, Kathleen E.; Scallan, Elaine; Kirk, Martyn D.; Mahon, Barbara E.; Angulo, Frederick J.; de Valk, Henriette; van Pelt, Wilfrid; Gauci, Charmaine; Hauri, Anja M.; Majowicz, Shannon; O’Brien, Sarah J.

2015-01-01

Epidemiologists have used case-control studies to investigate enteric disease outbreaks for many decades. Increasingly, case-control studies are also used to investigate risk factors for sporadic (not outbreak-associated) disease. While the same basic approach is used, there are important differences between outbreak and sporadic disease settings that need to be considered in the design and implementation of the case-control study for sporadic disease. Through the International Collaboration on Enteric Disease “Burden of Illness” Studies (the International Collaboration), we reviewed 79 case-control studies of sporadic enteric infections caused by nine pathogens that were conducted in 22 countries and published from 1990 through to 2009. We highlight important methodological and study design issues (including case definition, control selection, and exposure assessment) and discuss how approaches to the study of sporadic enteric disease have changed over the last 20 years (e.g., making use of more sensitive case definitions, databases of controls, and computer-assisted interviewing). As our understanding of sporadic enteric infections grows, methods and topics for case-control studies are expected to continue to evolve; for example, advances in understanding of the role of immunity can be used to improve control selection, the apparent protective effects of certain foods can be further explored, and case-control studies can be used to provide population-based measures of the burden of disease. PMID:22443481

State reference design and saturated control of doubly-fed induction generators under voltage dips

NASA Astrophysics Data System (ADS)

Tilli, Andrea; Conficoni, Christian; Hashemi, Ahmad

2017-04-01

In this paper, the stator/rotor currents control problem of doubly-fed induction generator under faulty line voltage is carried out. Common grid faults cause a steep decline in the line voltage profile, commonly denoted as voltage dip. This point is critical for such kind of machines, having their stator windings directly connected to the grid. In this respect, solid methodological nonlinear control theory arguments are exploited and applied to design a novel controller, whose main goal is to improve the system behaviour during voltage dips, endowing it with low voltage ride through capability, a fundamental feature required by modern Grid Codes. The proposed solution exploits both feedforward and feedback actions. The feedforward part relies on suitable reference trajectories for the system internal dynamics, which are designed to prevent large oscillations in the rotor currents and command voltages, excited by line perturbations. The feedback part uses state measurements and is designed according to Linear Matrix Inequalities (LMI) based saturated control techniques to further reduce oscillations, while explicitly accounting for the system constraints. Numerical simulations verify the benefits of the internal dynamics trajectory planning, and the saturated state feedback action, in crucially improving the Doubly-Fed Induction Machine response under severe grid faults.

Single-Lever Power Control for General Aviation Aircraft Promises Improved Efficiency and Simplified Pilot Controls

NASA Technical Reports Server (NTRS)

Musgrave, Jeffrey L.

1997-01-01

General aviation research is leading to major advances in internal combustion engine control systems for single-engine, single-pilot aircraft. These advances promise to increase engine performance and fuel efficiency while substantially reducing pilot workload and increasing flight safety. One such advance is a single-lever power control (SLPC) system, a welcome departure from older, less user-friendly, multilever engine control systems. The benefits of using single-lever power controls for general aviation aircraft are improved flight safety through advanced engine diagnostics, simplified powerplant operations, increased time between overhauls, and cost-effective technology (extends fuel burn and reduces overhaul costs). The single-lever concept has proven to be so effective in preliminary studies that general aviation manufacturers are making plans to retrofit current aircraft with the technology and are incorporating it in designs for future aircraft.

Evaluation of medical record quality and communication skills among pediatric interns after standardized parent training history-taking in China.

PubMed

Yu, Mu Xue; Jiang, Xiao Yun; Li, Yi Juan; Shen, Zhen Yu; Zhuang, Si Qi; Gu, Yu Fen

2018-02-01

The effect of using standardized parent training history-taking on the quality of medical records and communication skills among pediatric interns was determined. Fifth-year interns who were undertaking a pediatric clinical practice rotation were randomized to intervention and control groups. All of the pediatric interns received history-taking training by lecture and bedside teaching. The pediatric interns in the intervention group also received standardized parent history-taking training. The following two outcome measures were used: the scores of medical records, which were written by the pediatric interns after history-taking from real parents of pediatric patients; and the communication assessment tool (CAT) assessed by real parents. The general information, history of present illness (HPI), past medical history, personal history, family history, diagnosis, diagnostic analysis, and differential diagnosis scores in the intervention group were significantly higher than the control group (p < 0.05). Assessment of the CAT indicated that the real parents were more satisfied with the pediatric interns in the intervention group. Standardized parent training history-taking is effective in improving the quality of medical records by pediatric interns. Standardized parent training history-taking is a superior teaching tool for clinical reasoning ability, as well as communication skills in clinical pediatric practice.

Guidelines for conducting vulnerability assessments. [Susceptibility of programs to unauthorized use of resources

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

Not Available

1982-06-01

The US General Accounting Office and executive agency Inspectors General have reported losses of millions of dollars in government funds resulting from fraud, waste and error. The Administration and the Congress have initiated determined efforts to eliminate such losses from government programs and activities. Primary emphasis in this effort is on the strengthening of accounting and administrative controls. Accordingly, the Office of Management and Budget (OMB) issued Circular No. A-123, Internal Control Systems, on October 28, 1981. The campaign to improve internal controls was endorsed by the Secretary of Energy in a memorandum to Heads of Departmental Components, dated Marchmore » 13, 1981, Subject: Internal Control as a Deterrent to Fraud, Waste and Error. A vulnerability assessment is a review of the susceptibility of a program or function to unauthorized use of resources, errors in reports and information, and illegal or unethical acts. It is based on considerations of the environment in which the program or function is carried out, the inherent riskiness of the program or function, and a preliminary evaluation as to whether adequate safeguards exist and are functioning.« less

Associations between cognition and internalizing problems in young adults with early-onset schizophrenia: A 13-year follow-up study.

PubMed

Strugstad, Benedicte; Lau, Bjørn; Glenne Øie, Merete

2018-04-12

The present follow-up study examines the associations between cognition and parent-rated internalizing problems among adolescents with early-onset schizophrenia (EOS) at baseline (T1) and self-rated internalizing problems 13 years later (T2). Twelve individuals (8 male/4 female) with EOS and 30 healthy controls (16 male/14 female) were included in the study. All were between 12 and 18 years of age at T1. Internalizing problems were measured with the Achenbach System of Empirically Based Assessment Internalizing Scale. Cognition was examined with a neuropsychological test battery measuring auditory attention/working memory, visuomotor processing, cognitive flexibility and verbal memory. Compared to healthy controls, the EOS group had significant cognitive deficits and more internalizing problems both at T1 and T2. There was no correlation between parent-rated internalizing problems at T1 and self-rated internalizing problems at T2 in the EOS group. However, deficits in auditory attention/working memory at T1 were significantly associated with internalizing problems at T2. A focus on improving the treatment of cognitive impairments may be important in preventing the development of internalizing problems in young patients with schizophrenia. The small sample size of the study is a limitation and further research is recommended. Copyright © 2018 Elsevier B.V. All rights reserved.

Assessing Individual Lessons Using a Generic Teacher Observation Instrument: How Useful Is the International System for Teacher Observation and Feedback (ISTOF)?

ERIC Educational Resources Information Center

Muijs, Daniel; Reynolds, David; Sammons, Pamela; Kyriakides, Leonidas; Creemers, Bert P. M.; Teddlie, Charles

2018-01-01

Teacher effectiveness, which impacts student attainment even when controlling for student characteristics, is of key importance as a factor in educational effectiveness and improvement. Improving the quality of teaching is thus the primary means by which we can enhance student learning outcomes. Thus there has long been great interest in the…

The Contribution of the International Pain Policy Fellowship in Improving Opioid Availability in Georgia.

PubMed

Dzotsenidze, Pati; Maurer, Martha A; Kordzaia, Dimitri; Abesadze, Ioseb; Skemp Brown, Mary M; Gilson, Aaron M; Cleary, James F

2017-11-01

In the Republic of Georgia, the incidence and prevalence of cancer are increasing, signifying a growing need for palliative care and pain relief, including with controlled opioid medicines. As a signatory to the Single Convention, the Georgian government has a responsibility to ensure the adequate availability of controlled medicines for medical purposes; however, the consumption of morphine is very low, suggesting a high occurrence of unrelieved pain. In Georgia, palliative care development began in the 2000s including the adoption of a policy document in 2005, the creation of the National Palliative Care Coordinator in 2006, and important changes in Georgian legislation in 2007 and 2008, which served to lay a foundation for improving opioid availability. In 2008, a neurologist from the Sarajishvili Institute of Neurology and Neurosurgery in Tbilisi, and member of the Georgia National Association for Palliative Care, was selected to be an International Pain Policy Fellow to focus on improving opioid availability. Working with colleagues, government officials, and international experts, the Fellow contributed to several improvements to opioid availability, such as 1) positive changes to opioid prescribing legislation, 2) clarification of legislative terminology regarding dependence syndrome, 3) initiating the importation of both sustained-release and immediate-release oral morphine, and 4) improvements in the availability of sustained-release morphine. Despite these varied achievements, morphine consumption remains low in Georgia relative to the estimated amounts needed. The Fellow is continuing to study and understand the barriers that are impeding physician's prescription of opioids and patient's acceptance of them. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Duplex scanning diagnosis of internal carotid artery dissections. A case control study.

PubMed

Alecu, C; Fortrat, J O; Ducrocq, X; Vespignani, H; de Bray, J M

2007-01-01

The reliability of duplex scanning (DS) for the diagnosis of internal carotid artery dissections (ICAD) is not clear. Nine DS signs known to be suggestive for the diagnosis of ICAD were compared between 70 patients with ICAD and 70 matched patients without dissection. Visible internal tapering occlusion, regular eccentric narrowing channel, ectasia beyond the carotid bulb, resistive index asymmetry, blood flow slowdown, ophthalmic artery blood flow inversion, and biphasic flow are more frequent in cases than in controls (p < 0.001). Atheroma plaques were absent in 80% of ICAD. When DS direct signs and hemodynamic signs were studied, sensitivity was 90% and specificity 60%. Diagnosis of ICAD by DS could be improved if direct signs were combined with hemodynamic signs, giving a high sensitivity and a rather good specificity. Copyright 2007 S. Karger AG, Basel.

[Treatment of early-onset generalized dystonia by chronic bilateral stimulation of the internal globus pallidus. Apropos of a case].

PubMed

Coubes, P; Echenne, B; Roubertie, A; Vayssière, N; Tuffery, S; Humbertclaude, V; Cambonie, G; Claustres, M; Frerebeau, P

1999-05-01

Dystonia musculorum deformans is an inherited severe disease, with a wide clinical polymorphism. The most severe clinical forms with early onset carry a high risk of life-threatening complications. In the absence of any efficient medical treatment, bilateral pallidotomy has previously been reported to be of value in the management of this disease. We report the first clinical case of a severe early-onset generalized dystonia dramatically improved by a bilateral stimulation of the internal globus pallidus. In November 1996, we proposed this neurosurgical procedure for a 8-year-old girl, who had suffered since the age of 3 from severe generalized dystonia, and who progressively became totally dependent and bedridden. She had been under sedation and permanent controlled respiratory assistance for the last two months. The etiology of the disease remained unknown (the DYT1 mutation was absent). Under general anesthesia, we bilaterally implanted a four-contacts electrode in the internal globus pallidus, using the Leksell's stereotactic frame and a 1.5 tesla MRI control. A dramatic improvement was noted 6 weeks later and led us to connect the two electrodes to neurostimulators inserted under the abdominal skin.

The Health Impact of Rabies in Haiti and Recent Developments on the Path Toward Elimination, 2010–2015

PubMed Central

Wallace, Ryan; Etheart, Melissa; Ludder, Fleurinord; Augustin, Pierre; Fenelon, Natael; Franka, Richard; Crowdis, Kelly; Dely, Patrick; Adrien, Paul; Pierre-Louis, J.; Osinubi, Modupe; Orciari, Lillian; Vigilato, Marco; Blanton, Jesse; Patel, Roopal; Lowrance, David; Liverdieu, Andrecy; Coetzer, Andre; Boone, John; Lindenmayer, Joanne; Millien, M.

2017-01-01

Abstract. Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs, surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health and Population and key health development partners (including the Pan-American Health Organization) to provide technical expertise and funding for general disease surveillance systems, laboratory capacity, and selected disease control programs; including rabies. In 2011, a cross-ministerial rabies consortium was convened with participation from multiple international rabies experts to develop a strategy for successful rabies control in Haiti. The consortium focused on seven pillars: 1) enhancement of laboratory diagnostic capacity, 2) development of comprehensive animal surveillance system, 3) development of comprehensive human rabies surveillance system, 4) educational outreach, 5) sustainable human rabies biologics supply, 6) achievement of sustained canine vaccination rates of ≥ 70%, and 7) finalization of a national rabies control strategy. From 2010 until 2015, Haiti has seen improvements in the program infrastructure for canine rabies control. The greatest improvements were seen in the area of animal rabies surveillance, in support of which an internationally recognized rabies laboratory was developed thereby leading to an 18-fold increase in the detection of rabid animals. Canine rabies vaccination practices also improved, from a 2010 level of approximately 12% to a 2015 dog population coverage level estimated to be 45%. Rabies vaccine coverage is still below the goal of 70%, however, the positive trend is encouraging. Gaps exist in the capacity to conduct national surveillance for human rabies cases and access to human rabies vaccine is lacking in many parts of the country. However, control has improved over the past 5 years as a result of the efforts of Haiti’s health and agriculture sectors with assistance from multiple international organizations. Haiti is well situated to eliminate canine-mediated human rabies deaths in the near future and should serve as a great example to many developing countries struggling with similar barriers and limitations. PMID:29064363

The Health Impact of Rabies in Haiti and Recent Developments on the Path Toward Elimination, 2010-2015.

PubMed

Wallace, Ryan; Etheart, Melissa; Ludder, Fleurinord; Augustin, Pierre; Fenelon, Natael; Franka, Richard; Crowdis, Kelly; Dely, Patrick; Adrien, Paul; Pierre-Louis, J; Osinubi, Modupe; Orciari, Lillian; Vigilato, Marco; Blanton, Jesse; Patel, Roopal; Lowrance, David; Liverdieu, Andrecy; Coetzer, Andre; Boone, John; Lindenmayer, Joanne; Millien, M

2017-10-01

Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs, surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health and Population and key health development partners (including the Pan-American Health Organization) to provide technical expertise and funding for general disease surveillance systems, laboratory capacity, and selected disease control programs; including rabies. In 2011, a cross-ministerial rabies consortium was convened with participation from multiple international rabies experts to develop a strategy for successful rabies control in Haiti. The consortium focused on seven pillars: 1) enhancement of laboratory diagnostic capacity, 2) development of comprehensive animal surveillance system, 3) development of comprehensive human rabies surveillance system, 4) educational outreach, 5) sustainable human rabies biologics supply, 6) achievement of sustained canine vaccination rates of ≥ 70%, and 7) finalization of a national rabies control strategy. From 2010 until 2015, Haiti has seen improvements in the program infrastructure for canine rabies control. The greatest improvements were seen in the area of animal rabies surveillance, in support of which an internationally recognized rabies laboratory was developed thereby leading to an 18-fold increase in the detection of rabid animals. Canine rabies vaccination practices also improved, from a 2010 level of approximately 12% to a 2015 dog population coverage level estimated to be 45%. Rabies vaccine coverage is still below the goal of 70%, however, the positive trend is encouraging. Gaps exist in the capacity to conduct national surveillance for human rabies cases and access to human rabies vaccine is lacking in many parts of the country. However, control has improved over the past 5 years as a result of the efforts of Haiti's health and agriculture sectors with assistance from multiple international organizations. Haiti is well situated to eliminate canine-mediated human rabies deaths in the near future and should serve as a great example to many developing countries struggling with similar barriers and limitations.

Effect of Sahaja yoga meditation on quality of life, anxiety, and blood pressure control.

PubMed

Chung, Sheng-Chia; Brooks, Maria M; Rai, Madhur; Balk, Judith L; Rai, Sandeep

2012-06-01

The present study investigates the effect of Sahaja yoga meditation on quality of life, anxiety, and blood pressure control. The prospective observational cohort study enrolled two study groups: those receiving treatment from the International Sahaja Yoga Research and Health Center (meditation group) and those receiving treatment from the Mahatma Gandhi Mission Hospital (control group). Researchers measured quality of life, anxiety, and blood pressure before and after treatment. Sixty-seven (67) participants in the meditation group and 62 participants in the control group completed the study. The two groups were comparable in demographic and clinical characteristics. At baseline, the meditation group had higher quality of life (p<0.001) than controls but similar anxiety level (p=0.74) to controls. Within-group pre- versus post-treatment comparisons showed significant improvement in quality of life, anxiety, and blood pressure in the meditation group (p<0.001), while in controls, quality of life deteriorated and there was no improvement in blood pressure. The improvement in quality of life, anxiety reduction, and blood pressure control was greater in the meditation group. The beneficial effect of meditation remained significant after adjusting for confounders. Meditation treatment was associated with significant improvements in quality of life, anxiety reduction, and blood pressure control.

Multiple Time-of-Flight/Time-of-Flight Events in a Single Laser Shot for Improved Matrix-Assisted Laser Desorption/Ionization Tandem Mass Spectrometry Quantification.

PubMed

Prentice, Boone M; Chumbley, Chad W; Hachey, Brian C; Norris, Jeremy L; Caprioli, Richard M

2016-10-04

Quantitative matrix-assisted laser desorption/ionization time-of-flight (MALDI TOF) approaches have historically suffered from poor accuracy and precision mainly due to the nonuniform distribution of matrix and analyte across the target surface, matrix interferences, and ionization suppression. Tandem mass spectrometry (MS/MS) can be used to ensure chemical specificity as well as improve signal-to-noise ratios by eliminating interferences from chemical noise, alleviating some concerns about dynamic range. However, conventional MALDI TOF/TOF modalities typically only scan for a single MS/MS event per laser shot, and multiplex assays require sequential analyses. We describe here new methodology that allows for multiple TOF/TOF fragmentation events to be performed in a single laser shot. This technology allows the reference of analyte intensity to that of the internal standard in each laser shot, even when the analyte and internal standard are quite disparate in m/z, thereby improving quantification while maintaining chemical specificity and duty cycle. In the quantitative analysis of the drug enalapril in pooled human plasma with ramipril as an internal standard, a greater than 4-fold improvement in relative standard deviation (<10%) was observed as well as improved coefficients of determination (R 2 ) and accuracy (>85% quality controls). Using this approach we have also performed simultaneous quantitative analysis of three drugs (promethazine, enalapril, and verapamil) using deuterated analogues of these drugs as internal standards.

Sildenafil citrate improves self-esteem, confidence, and relationships in men with erectile dysfunction: Results from an international, multi-center, double-blind, placebo-controlled trial.

PubMed

Althof, Stanley E; O'leary, Michael P; Cappelleri, Joseph C; Hvidsten, Kyle; Stecher, Vera J; Glina, Sidney; King, Rosie; Siegel, Richard L

2006-05-01

Erectile dysfunction (ED) can significantly impact a man's relationships and well-being. We assessed changes in self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction in men with ED using the validated Self-Esteem And Relationship questionnaire (SEAR). This was a 12-week, double-blind, placebo-controlled, flexible-dose (25, 50, 100 mg, as needed) international study of sildenafil in men > or =18 years of age in Mexico, Brazil, Australia, and Japan. The primary study outcome was change in self-esteem from baseline to the end of treatment. Secondary study measures were changes in other SEAR components, International Index of Erectile Function (IIEF) domains, percentage of intercourse attempts that were successful, and the response to a global efficacy question at the end of treatment. Patients were well balanced for age and duration of ED (placebo = 149 and sildenafil = 151). Compared with placebo, sildenafil significantly improved self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction (P < 0.0001). The psychosocial measures of well-being assessed with the SEAR were positively correlated (range 0.60-0.86, P < 0.0001) with erectile function, the frequency of achieving erections that allowed satisfactory sexual intercourse, the percentage of successful sexual intercourse attempts, and global treatment efficacy. Significant improvements in self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction after treatment of ED with sildenafil were consistent among countries. These data suggest a substantial cross-cultural improvement in well-being after successful treatment of ED with sildenafil.

DOD Financial Management: The Defense Finance and Accounting Service Needs to Fully Implement Financial Improvements for Contract Pay

DTIC Science & Technology

2014-06-01

effectiveness of controls that would prevent, or detect and correct, potential misstatements in the financial statements. cMisstatements are the result...reporting. For example, a system edit used to prevent or detect a duplicate entry is an application control. gA material weakness is a deficiency, or...combination of deficiencies, in internal control, such that there is a reasonable possibility that a material misstatement of the entity’s financial

Assuring reliability program effectiveness.

NASA Technical Reports Server (NTRS)

Ball, L. W.

1973-01-01

An attempt is made to provide simple identification and description of techniques that have proved to be most useful either in developing a new product or in improving reliability of an established product. The first reliability task is obtaining and organizing parts failure rate data. Other tasks are parts screening, tabulation of general failure rates, preventive maintenance, prediction of new product reliability, and statistical demonstration of achieved reliability. Five principal tasks for improving reliability involve the physics of failure research, derating of internal stresses, control of external stresses, functional redundancy, and failure effects control. A final task is the training and motivation of reliability specialist engineers.

Introduction to Quality Control in a Compounding Pharmacy.

PubMed

Allen, Loyd V

2016-01-01

A quality-based program is vital in every compounding pharmacy to ensure that each preparation is compounded properly and is stable for its expected duration of use. This article discusses quality control, quality assurance, continuous quality improvement, and also describes the components of an in-house (in-pharmacy) quality program, as well as the role of outside laboratories. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

Improving U.S. Trade.

ERIC Educational Resources Information Center

Bentsen, Lloyd

1982-01-01

Discusses the need to formulate a coherent trade policy in response to international economic realities. The author argues against a return to trade protectionism and supports efforts to establish workable reciprocity agreements. Increasing import tariffs on high technology products would control access to American markets. (AM)

Report: EPA Needs to Improve Internal Controls to Increase Cost Recovery

EPA Pesticide Factsheets

Report #09-P-0144, April 27, 2009. Within a sample of removal actions we reviewed, EPA collected from responsible parties approximately 11 percent ($31.4 of $294.5 million) of the Federal Government’s costs for conducting the removal actions.

Report: EPA Region 9 Needs to Improve Oversight Over Commonwealth of the Northern Mariana Islands Consolidated Cooperative Agreements

EPA Pesticide Factsheets

Report #16-P-0207, June 20, 2016. More than $58 million in consolidated cooperative agreement funds is not being administered efficiently and effectively due to inadequate oversight and a lack of internal controls.

National continuous surveys on internal quality control for HbA1c in 306 clinical laboratories of China from 2012 to 2016: Continual improvement.

PubMed

Li, Tingting; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

2017-09-01

This study aimed to evaluate whether the quality performance of clinical laboratories in China has been greatly improved and whether Internal Quality Control (IQC) practice of HbA1c has also been changed since National Center for Clinical Laboratories (NCCL) of China organized laboratories to report IQC data for HbA1c in 2012. Internal Quality Control information of 306 External Quality Assessment (EQA) participant laboratories which kept reporting IQC data in February from 2012 to 2016 were collected by Web-based EQA system. Then percentages of laboratories meeting four different imprecision specifications for current coefficient of variations (CVs) of HbA1c measurements were calculated. Finally, we comprehensively analyzed analytical systems and IQC practice of HbA1c measurements. The current CVs of HbA1c tests have decreased significantly from 2012 to 2016. And percentages of laboratories meeting four imprecision specifications for CVs all showed the increasing tendency year by year. As for analytical system, 52.1% (159/306) laboratories changed their systems with the change in principle of assay. And many laboratories began to use cation exchange high-performance liquid chromatography (CE-HPLC) instead of Immunoturbidimetry, because CE-HPLC owed a lower intra-laboratory CVs. The data of IQC practice, such as IQC rules and frequency, also showed significant variability among years with overall tendency of meeting requirements. The imprecision performance of HbA1c tests has been improved in these 5 years with the change in IQC practice, but it is still disappointing in China. Therefore, laboratories should actively find existing problems and take action to promote performance of HbA1c measurements. © 2016 Wiley Periodicals, Inc.

Cardiovascular simulator improvement: pressure versus volume loop assessment.

PubMed

Fonseca, Jeison; Andrade, Aron; Nicolosi, Denys E C; Biscegli, José F; Leme, Juliana; Legendre, Daniel; Bock, Eduardo; Lucchi, Julio Cesar

2011-05-01

This article presents improvement on a physical cardiovascular simulator (PCS) system. Intraventricular pressure versus intraventricular volume (PxV) loop was obtained to evaluate performance of a pulsatile chamber mimicking the human left ventricle. PxV loop shows heart contractility and is normally used to evaluate heart performance. In many heart diseases, the stroke volume decreases because of low heart contractility. This pathological situation must be simulated by the PCS in order to evaluate the assistance provided by a ventricular assist device (VAD). The PCS system is automatically controlled by a computer and is an auxiliary tool for VAD control strategies development. This PCS system is according to a Windkessel model where lumped parameters are used for cardiovascular system analysis. Peripheral resistance, arteries compliance, and fluid inertance are simulated. The simulator has an actuator with a roller screw and brushless direct current motor, and the stroke volume is regulated by the actuator displacement. Internal pressure and volume measurements are monitored to obtain the PxV loop. Left chamber internal pressure is directly obtained by pressure transducer; however, internal volume has been obtained indirectly by using a linear variable differential transformer, which senses the diaphragm displacement. Correlations between the internal volume and diaphragm position are made. LabVIEW integrates these signals and shows the pressure versus internal volume loop. The results that have been obtained from the PCS system show PxV loops at different ventricle elastances, making possible the simulation of pathological situations. A preliminary test with a pulsatile VAD attached to PCS system was made. © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Individual Differences Influencing Immediate Effects of Internal and External Focus Instructions on Children's Motor Performance.

PubMed

van Abswoude, Femke; Nuijen, Nienke B; van der Kamp, John; Steenbergen, Bert

2018-06-01

A large pool of evidence supports the beneficial effect of an external focus of attention on motor skill performance in adults. In children, this effect has been studied less and results are inconclusive. Importantly, individual differences are often not taken into account. We investigated the role of working memory, conscious motor control, and task-specific focus preferences on performance with an internal and external focus of attention in children. Twenty-five children practiced a golf putting task in both an internal focus condition and external focus condition. Performance was defined as the average distance toward the hole in 3 blocks of 10 trials. Task-specific focus preference was determined by asking how much effort it took to apply the instruction in each condition. In addition, working memory capacity and conscious motor control were assessed. Children improved performance in both the internal focus condition and external focus condition (ŋ p 2  = .47), with no difference between conditions (ŋ p 2  = .01). Task-specific focus preference was the only factor moderately related to the difference between performance with an internal focus and performance with an external focus (r = .56), indicating better performance for the preferred instruction in Block 3. Children can benefit from instruction with both an internal and external focus of attention to improve short-term motor performance. Individual, task-specific focus preference influenced the effect of the instructions, with children performing better with their preferred focus. The results highlight that individual differences are a key factor in the effectiveness in children's motor performance. The precise mechanisms underpinning this effect warrant further research.

Veterinary infection control in Australia: is there control?

PubMed

Attard, K; Burrows, E; Kotiranta-Harris, K; Hedlefs, R; Ketheesan, N; Govan, B

2012-11-01

There is little information relating to infection control procedures in Australian veterinary practices. This review summarises the findings of international studies in the area of zoonoses and infection control, and discusses potential reasons for the apparent complacency about these issues in veterinary practice. It is the authors' opinion that legislative changes governing veterinary practice in Australia should be implemented. The curricula in veterinary schools should also emphasise infection control. These measures would significantly improve safety issues associated with the control of zoonoses in veterinary practice. © 2012 The Authors. Australian Veterinary Journal © 2012 Australian Veterinary Association.

Cultural Challenges Faced by American Mission Control Personnel Working with International Partners

NASA Technical Reports Server (NTRS)

Clement, J. L.; Ritsher, J. B.

2006-01-01

Operating the International Space Station (ISS) involves an indefinite, continuous series of long-duration international missions, and this requires an unprecedented degree of cooperation across multiple sites, organizations, and nations. Both junior and senior mission control personnel have had to find ways to address the cultural challenges inherent in such work, but neither have had systematic training in how to do so. The goals of this study were to identify and evaluate the major cultural challenges faced by ISS mission control personnel and to highlight the approaches that they have found most effective to surmount these challenges. We pay particular attention to the approaches successfully employed by the senior personnel and the training needs identified by the junior personnel. We also evaluate the extent to which the identified approaches and needs are consistent across the two samples. METHODS: Participants included a sample of 14 senior ISS flight controllers and a contrasting sample of 12 more junior controllers. All participants were mission operations specialists chosen on the basis of having worked extensively with international partners. Data were collected using a semi-structured qualitative interview and content analyzed using an iterative process with multiple coders and consensus meetings to resolve discrepancies. RESULTS: The senior respondents had substantial consensus on several cultural challenges and on key strategies for dealing with them, and they offered a wide range of specific tactics for implementing these strategies. Data from the junior respondents will be presented for the first time at the meeting. DISCUSSION: Although specific to American ISS personnel, our results are consistent with recent management, cultural, and aerospace research on other populations. We aim to use our results to improve training for current and future mission control personnel working in international or multicultural mission operations teams.

Interventions to improve hemodialysis adherence: a systematic review of randomized-controlled trials.

PubMed

Matteson, Michelle L; Russell, Cynthia

2010-10-01

Over 485,000 people in the United States have chronic kidney disease, a progressive kidney disease that may lead to hemodialysis. Hemodialysis involves a complex regimen of treatment, medication, fluid, and diet management. In 2005, over 312,000 patients were undergoing hemodialysis in the United States. Dialysis nonadherence rates range from 8.5% to 86%. Dialysis therapy treatment nonadherence, including treatment, medication, fluid, and diet nonadherence, significantly increases the risk of morbidity and mortality. The purpose of this paper is to systematically review randomized-controlled trial intervention studies designed to increase treatment, medication, fluid, and diet adherence in adult hemodialysis patients. A search of Cumulative Index of Nursing and Allied Health Literature (CINAHL) (1982 to May 2008), MEDLINE (1950 to May 2008), PsycINFO (1806 to May 2008), and all Evidence-Based Medicine (EBM) Reviews (Cochran DSR, ACP Journal Club, DARE, and CCTR) was conducted to identify randomized-controlled studies that tested the efficacy of interventions to improve adherence in adult hemodialysis patients. Eight randomized-controlled trials met criteria for inclusion. Six of the 8 studies found statistically significant improvement in adherence with the intervention. Of these 6 intervention studies, all studies had a cognitive component, with 3 studies utilizing cognitive/behavioral intervention strategies. Based on this systematic review, interventions utilizing a cognitive or cognitive/behavioral component appear to show the most promise for future study. © 2010 The Authors. Hemodialysis International © 2010 International Society for Hemodialysis.

Food control and a citizen science approach for improving teaching of Genetics in universities.

PubMed

Borrell, Y J; Muñoz-Colmenero, A M; Dopico, E; Miralles, L; Garcia-Vazquez, E

2016-09-10

A Citizen Science approach was implemented in the laboratory practices of Genetics at the University of Oviedo, related with the engaging topic of Food Control. Real samples of food products consumed by students at home (students as samplers) were employed as teaching material in three different courses of Genetics during the academic year 2014-2015: Experimental Methods in Food Production (MBTA) (Master level), and Applied Molecular Biology (BMA) and Conservation Genetics and Breeding (COMGE) (Bachelor/Degree level). Molecular genetics based on PCR amplification of DNA markers was employed for species identification of 22 seafood products in COMGE and MBTA, and for detection of genetically modified (GM) maize from nine products in BMA. In total six seafood products incorrectly labeled (27%), and two undeclared GM maize (22%) were found. A post-Laboratory survey was applied for assessing the efficacy of the approach for improving motivation in the Laboratory Practices of Genetics. Results confirmed that students that worked on their own samples from local markets were significantly more motivated and better evaluated their Genetic laboratory practices than control students (χ(2)  = 12.11 p = 0.033). Our results suggest that citizen science approaches could not be only useful for improving teaching of Genetics in universities but also to incorporate students and citizens as active agents in food control. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(5):450-462, 2016. © 2016 The International Union of Biochemistry and Molecular Biology.

The Influence of Microbiology on Spacecraft Design and Controls: A Historical Perspective of the Shuttle and International Space Station Programs

NASA Technical Reports Server (NTRS)

Castro, Victoria A.; Bruce, Rebekah J.; Ott, C. Mark; Pierson, D. L.

2006-01-01

For over 40 years, NASA has been putting humans safely into space in part by minimizing microbial risks to crew members. Success of the program to minimize such risks has resulted from a combination of engineering and design controls as well as active monitoring of the crew, food, water, hardware, and spacecraft interior. The evolution of engineering and design controls is exemplified by the implementation of HEPA filters for air treatment, antimicrobial surface materials, and the disinfection regimen currently used on board the International Space Station. Data from spaceflight missions confirm the effectiveness of current measures; however, fluctuations in microbial concentrations and trends in contamination events suggest the need for continued diligence in monitoring and evaluation as well as further improvements in engineering systems. The knowledge of microbial controls and monitoring from assessments of past missions will be critical in driving the design of future spacecraft.

Study on Trailing Edge Ramp of Supercritical Airfoil

DTIC Science & Technology

2016-03-30

7 th Asia-Pacific International Symposium on Aerospace Technology, 25 – 27 November 2015, Cairns Study on Trailing Edge Ramp of Supercritical...China Abstract Trailing edge flow control method could improve the performance of supercritical airfoil with a small modification on the original...airfoil. In this paper, a ramp of 2%~7% chord length is sliced near the trailing edge to improve airfoil performance. The trailing edge ramp is

Geotechnical Centrifuge Experiments to Evaluate Piping in Foundation Soils

DTIC Science & Technology

2014-05-01

verifiable results. These tests were successful in design , construction, and execution of a realistic simulation of internal erosion leading to failure...possible “scale effects,” “modeling of models” testing protocol should be included in the test program. Also, the model design should minimize the scale...recommendations for improving the centrifuge tests include the following: • Design improved system for reservoir control to provide definitive and

VANDENBERG AIR FORCE BASE, CALIF. - The SciSat-1 spacecraft is revealed at Vandenberg Air Force Base, Calif. Sci-Sat, which will undergo instrument checkout and spacecraft functional testing, weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-26

VANDENBERG AIR FORCE BASE, CALIF. - The SciSat-1 spacecraft is revealed at Vandenberg Air Force Base, Calif. Sci-Sat, which will undergo instrument checkout and spacecraft functional testing, weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - The Pegasus transporter, with its cargo of the SciSat-1 payload and Pegasus launch vehicle, moves under the L-1011 carrier aircraft for matting. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-08-09

VANDENBERG AIR FORCE BASE, CALIF. - The Pegasus transporter, with its cargo of the SciSat-1 payload and Pegasus launch vehicle, moves under the L-1011 carrier aircraft for matting. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - The L-1011 carrier aircraft is in flight with its cargo underneath of the Pegasus launch vehicle and SciSat-1 spacecraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-08-12

VANDENBERG AIR FORCE BASE, CALIF. - The L-1011 carrier aircraft is in flight with its cargo underneath of the Pegasus launch vehicle and SciSat-1 spacecraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - The L-1011 carrier aircraft is in flight with its cargo of the Pegasus launch vehicle and SciSat-1 spacecraft underneath. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-08-12

VANDENBERG AIR FORCE BASE, CALIF. - The L-1011 carrier aircraft is in flight with its cargo of the Pegasus launch vehicle and SciSat-1 spacecraft underneath. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - The SciSat-1 payload, with fairing installed and attached to its Pegasus launch vehicle, arrives at the pad for mating to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-08-09

VANDENBERG AIR FORCE BASE, CALIF. - The SciSat-1 payload, with fairing installed and attached to its Pegasus launch vehicle, arrives at the pad for mating to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - With its cover removed, the SciSat-1 spacecraft is rotated. The solar arrays will be attached and the communications systems checked out. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-07-29

VANDENBERG AIR FORCE BASE, CALIF. - With its cover removed, the SciSat-1 spacecraft is rotated. The solar arrays will be attached and the communications systems checked out. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF.- The cover is being lifted off SciSat-1 spacecraft at Vandenberg Air Force Base, Calif. Sci-Sat, which will undergo instrument checkout and spacecraft functional testing, weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-26

VANDENBERG AIR FORCE BASE, CALIF.- The cover is being lifted off SciSat-1 spacecraft at Vandenberg Air Force Base, Calif. Sci-Sat, which will undergo instrument checkout and spacecraft functional testing, weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

A survey of coagulation laboratory practices and satisfaction ratings of member laboratories of the Thailand National External Quality Assessment Scheme for blood coagulation.

PubMed

Chuntarut, A; Tientadakul, P; Wongkrajang, P

2016-06-01

The Thailand National External Quality Assessment Scheme (NEQAS) for blood coagulation was established in 2005. The objective of this study was to collect data of coagulation laboratory practices and satisfaction of NEQAS member. Two hundred seventy-six questionnaires were sent to laboratories that are members of NEQAS to obtain data relating to coagulation laboratory practice and satisfaction in 2014. Data from this survey were compared with data from the survey conducted in 2005 to evaluate levels of improvement. Of 276 questionnaires sent, 212 (76.8%) were returned. Improvements were characterized by the number of laboratories that (i) decreased use of 3.8% sodium citrate as anticoagulant; (ii) implemented use of at least two control levels for internal quality control; and (iii) implemented reporting of reference values with results, as well as establishing their own reference range and using geometric mean as the denominator for international normalized ratio calculation. For overall satisfaction, 179 of 206 (86.9%) participant laboratories reported being satisfied or very satisfied. Improvements in coagulation laboratory practices in Thailand were observed in every step of the total testing process. However, additional improvements are still needed, such as determination and use of a local reference range. © 2016 John Wiley & Sons Ltd.

Unlabeled Oligonucleotides as Internal Temperature Controls for Genotyping by Amplicon Melting

PubMed Central

Seipp, Michael T.; Durtschi, Jacob D.; Liew, Michael A.; Williams, Jamie; Damjanovich, Kristy; Pont-Kingdon, Genevieve; Lyon, Elaine; Voelkerding, Karl V.; Wittwer, Carl T.

2007-01-01

Amplicon melting is a closed-tube method for genotyping that does not require probes, real-time analysis, or allele-specific polymerase chain reaction. However, correct differentiation of homozygous mutant and wild-type samples by melting temperature (Tm) requires high-resolution melting and closely controlled reaction conditions. When three different DNA extraction methods were used to isolate DNA from whole blood, amplicon Tm differences of 0.03 to 0.39°C attributable to the extractions were observed. To correct for solution chemistry differences between samples, complementary unlabeled oligonucleotides were included as internal temperature controls to shift and scale the temperature axis of derivative melting plots. This adjustment was applied to a duplex amplicon melting assay for the methylenetetrahydrofolate reductase variants 1298A>C and 677C>T. High- and low-temperature controls bracketing the amplicon melting region decreased the Tm SD within homozygous genotypes by 47 to 82%. The amplicon melting assay was 100% concordant to an adjacent hybridization probe (HybProbe) melting assay when temperature controls were included, whereas a 3% error rate was observed without temperature correction. In conclusion, internal temperature controls increase the accuracy of genotyping by high-resolution amplicon melting and should also improve results on lower resolution instruments. PMID:17591926

Implementation of asthma guidelines to West Australian community pharmacies: an exploratory, quasi-experimental study.

PubMed

Watkins, Kim; Trevenen, Michelle; Murray, Kevin; Kendall, Peter A; Schneider, Carl R; Clifford, Rhonda

2016-08-31

Pharmacy assistants are often the first point of contact for patients presenting in community pharmacies. The current role of pharmacy assistants in the supply of asthma-reliever medications (short-acting β-agonists) was identified as a barrier to appropriate guideline-based care. The aim of this research was to devise and evaluate a team-based intervention to formalise the role of pharmacy assistants and to improve asthma guideline-based care in community pharmacy. A controlled pre-post intervention study was conducted in 336 metropolitan pharmacies located in Perth, Western Australia. Pharmacies were stratified into 2 groups (187 intervention and 149 control) based on known confounders for asthma control. The intervention was designed using a common-sense approach and resources developed included a checklist, videos and web page. Delivery was via workshops (25 pharmacies) or academic detailing (162 pharmacies). Pharmacy practice was assessed preintervention and postintervention via covert simulated patient methodology. Primary outcome measures included patient medical referral, device use demonstration and counselling, internal referral and/or direct involvement of a pharmacist in consultations. There was a significant increase in patient medical referral in intervention pharmacies from 32% to 47% (p=0.0007) from preintervention to postintervention, while control pharmacies showed a non-significant decrease from 50% to 44% (p=0.22). Device counselling was not routinely carried out at any stage or in any cohort of this research and no significant changes in internal referral were observed. Increases in medical referral indicate that asthma guideline compliance can be improved in community pharmacy if implementation employs a team-based approach and involves pharmacy assistants. However, results were variable and the intervention did not improve practice related to device counselling or internal referral/pharmacist involvement. Undertaking more workshops may have improved results. Guideline implementation in community pharmacy should consider the role of pharmacy assistants and how to overcome logistical barriers to pharmacy participation in implementation activities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Improved hypertension management and control: results from the health survey for England 1998.

PubMed

Primatesta, P; Brookes, M; Poulter, N R

2001-10-01

A survey in 1994 showed that among the 20% of the adult English population who were identified as hypertensive, approximately 30% had their blood pressures controlled to <160 mm Hg systolic and <95 mm Hg diastolic. The 1998 Health Survey for England data update the 1994 findings in light of new thresholds and targets for treatment outlined in recent national and international guidelines. This cross-sectional survey is analyzed to describe the prevalence, awareness, treatment, and control of hypertension in a random, nationally representative sample of 11 529 English adults (>/=16 years) living in noninstitutional households in 1998 and to compare these rates with those from 1994. In 1998, 20% and 37% of adults were hypertensive according to the old (systolic >/=160 mm Hg or diastolic >/=95 mm Hg) and new (systolic >/=140 mm Hg or diastolic >/=90 mm Hg) definitions, respectively. Corresponding values in 1994 were 20% and 38%. Treatment and control rates among hypertensive adults (new definition) improved from 26% to 32% and from 6% to 9%, respectively, although 60% of those on treatment received only 1 antihypertensive drug in both years. Among persons with controlled hypertension, 59% reported having received nonpharmacological advice from their physicians in 1998 compared with 30% in 1994. Rates of hypertension treatment and control have increased significantly (P=0.05 and P<0.01, respectively) since 1994 but remain low by international standards. The 1998 data suggest that improved detection, greater use of nonpharmacological measures, and increased use of >1 antihypertensive agent per patient would produce greater success in achieving target levels. This could lead to major reductions in fatal and nonfatal cardiovascular events.

Teaching surgical skills using video internet communication in a resource-limited setting.

PubMed

Autry, Amy M; Knight, Sharon; Lester, Felicia; Dubowitz, Gerald; Byamugisha, Josaphat; Nsubuga, Yosam; Muyingo, Mark; Korn, Abner

2013-07-01

To study the feasibility and acceptability of using video Internet communication to teach and evaluate surgical skills in a low-resource setting. This case-controlled study used video Internet communication for surgical skills teaching and evaluation. We randomized intern physicians rotating in the Obstetrics and Gynecology Department at Mulago Hospital at Makerere University in Kampala, Uganda, to the control arm (usual practice) or intervention arm (three video teaching sessions with University of California, San Francisco faculty). We made preintervention and postintervention videos of all interns tying knots using a small video camera and uploaded the files to a file hosting service that offers cloud storage. A blinded faculty member graded all of the videos. Both groups completed a survey at the end of the study. We randomized 18 interns with complete data for eight in the intervention group and seven in the control group. We found score improvement of 50% or more in six of eight (75%) interns in the intervention group compared with one of seven (14%) in the control group (P=.04). Scores declined in five of the seven (71%) controls but in none in the intervention group. Both intervention and control groups used attendings, colleagues, and the Internet as sources for learning about knot-tying. The control group was less likely to practice knot-tying than the intervention group. The trainees and the instructors felt this method of training was enjoyable and helpful. Remote teaching in low-resource settings, where faculty time is limited and access to visiting faculty is sporadic, is feasible, effective, and well-accepted by both learner and teacher. II.

An Ongoing Revolution: Resource Sharing and OCLC.

ERIC Educational Resources Information Center

Nevins, Kate

1998-01-01

Discusses early developments in the Online Computer Library Center (OCLC) interlibrary loan, including use of OCLC for verification and request transmittal, improved service to patrons, internal cost control, affect on work flow and borrowing patterns. Describes advances in OCLC, including internationalization, electronic information access,…

Robust state preparation in quantum simulations of Dirac dynamics

NASA Astrophysics Data System (ADS)

Song, Xue-Ke; Deng, Fu-Guo; Lamata, Lucas; Muga, J. G.

2017-02-01

A nonrelativistic system such as an ultracold trapped ion may perform a quantum simulation of a Dirac equation dynamics under specific conditions. The resulting Hamiltonian and dynamics are highly controllable, but the coupling between momentum and internal levels poses some difficulties to manipulate the internal states accurately in wave packets. We use invariants of motion to inverse engineer robust population inversion processes with a homogeneous, time-dependent simulated electric field. This exemplifies the usefulness of inverse-engineering techniques to improve the performance of quantum simulation protocols.

International Federation of Head Neck Oncology Society 5(th) World Congress/American Head Neck Society 2014 update.

PubMed

Sharma, Shilpi; Chaukar, Devendra A

2014-07-01

Head neck cancer is an important health problem with high morbidity and mortality. Early detection and adequate treatment improve prognosis significantly. Thus creating awareness among clinicians is an important step toward control of head neck cancer and reducing its overall burden. We here provide an update on the International Federation of Head Neck Oncology Society/American Head Neck Society 2014 held between July 26, 2014 and July 30, 2014 in New York.

The estimation of the measurement results with using statistical methods

NASA Astrophysics Data System (ADS)

Velychko, O.; Gordiyenko, T.

2015-02-01

The row of international standards and guides describe various statistical methods that apply for a management, control and improvement of processes with the purpose of realization of analysis of the technical measurement results. The analysis of international standards and guides on statistical methods estimation of the measurement results recommendations for those applications in laboratories is described. For realization of analysis of standards and guides the cause-and-effect Ishikawa diagrams concerting to application of statistical methods for estimation of the measurement results are constructed.

Maintenance of Certification Part IV Quality-Improvement Project for Hypertension Control: A Preliminary Retrospective Analysis

PubMed Central

Kolasinski, Vallerie A; Price, David W

2015-01-01

Context: A Maintenance of Certification Part IV project was created on the basis of an existing, multifaceted hypertension improvement program. Objective: To evaluate the impact of the Maintenance of Certification project, the effects of the improvement options on blood pressure control in hypertensive patients, and the participants’ perception of the workload related to participation in the project. Design: Nonexperimental retrospective analysis. Setting: Kaiser Permanente hospitals and medical office buildings in Northern California. Intervention: Participants used one or more options from a defined menu of strategies to attempt to increase the percentage of hypertensive patients on their patient panels who had controlled blood pressure. Main Outcome Measure: Proportion of hypertensive patients with blood pressure ≤ 139/89 mm Hg. Results: Fifty-two American Board of Family Medicine and 19 American Board of Internal Medicine certified physicians completed projects. Mean panel blood pressure control improved from 79.49% (standard deviation [SD] = 11.32) to 84.64% (SD = 7.80). The choice of improvement option was not associated with the level of improvement or with the participants’ perception of the workload related to completing the project. Conclusion: Project participants improved the care of their patients without an increased perceived burden to their practice. We found no association between the choice of improvement option and either the level of improvement or the perception of workload. PMID:25785642

An improved method to quantitate mature plant microRNA in biological matrices using modified periodate treatment and inclusion of internal controls

PubMed Central

Roh, Jamin; Davis, Cindy D.; Wang, Thomas T. Y.

2017-01-01

MicroRNAs (miRNAs) ubiquitously exist in microorganisms, plants, and animals, and appear to modulate a wide range of critical biological processes. However, no definitive conclusion has been reached regarding the uptake of exogenous dietary small RNAs into mammalian circulation and organs and cross-kingdom regulation. One of the critical issues is our ability to assess and distinguish the origin of miRNAs. Although periodate oxidation has been used to differentiate mammalian and plant miRNAs, validation of treatment efficiency and the inclusion of proper controls for this method were lacking in previous studies. This study aimed to address: 1) the efficiency of periodate treatment in a plant or mammalian RNA matrix, and 2) the necessity of inclusion of internal controls. We designed and tested spike-in synthetic miRNAs in various plant and mammalian matrices and showed that they can be used as a control for the completion of periodate oxidation. We found that overloading the reaction system with high concentration of RNA resulted in incomplete oxidation of unmethylated miRNA. The abundant miRNAs from soy and corn were analyzed in the plasma, liver, and fecal samples of C57BL/6 mice fed a corn and soy-based chow diet using our improved methodology. The improvement resulted in the elimination of the false positive detection in the liver, and we did not detect plant miRNAs in the mouse plasma or liver samples. In summary, an improved methodology was developed for plant miRNA detection that appears to work well in different sample matrices. PMID:28399134

The effect of educational intervention on prevention of postpartum depression: an application of health locus of control.

PubMed

Moshki, Mahdi; Baloochi Beydokhti, Tahereh; Cheravi, Khadijeh

2014-08-01

To assess the effectiveness of application of health locus of control in pregnant women for prevention of postpartum depression in Iran. Nearly 10-15% of women suffer postnatal depression by the end of the second week after delivery, which creates problems in caring for the child that may affect child's future learning and concentration. Pre-post experimental design. Two hundred and thirty volunteer women were randomly divided into experimental and control groups. The data collection tools included a demographic questionnaire, the Multidimensional Health Locus of Control Scale and the Edinburg Depression Scale. Based on the associations found in the pretest, intervention programme was planned and carried out in the focused group discussion method. Data were collected after the end of scheduled sessions, immediately and one month later. The data were analysed with SPSS-16 using statistical methods including anova, chi-square test, Student's t-test and paired t-test. Chance health locus of control significantly reduced and internal health locus of control significantly increased, immediately after intervention. Also, a month after intervention, a significant difference was observed between the two groups in reducing postpartum depression. The planned participatory intervention led to empowerment and increased awareness and internalisation of health control beliefs and less tendency towards external health control beliefs, especially chance, improvement in general health leading to improved psychological health for prevention of postpartum depression in mothers. Clinicians might assess chance and internal health locus of control to identify the women at risk of developing depression during their pregnancy and to develop prevention and treatment plans. © 2013 John Wiley & Sons Ltd.

Aerodynamic Shutoff Valve

NASA Technical Reports Server (NTRS)

Horstman, Raymond H.

1992-01-01

Aerodynamic flow achieved by adding fixed fairings to butterfly valve. When valve fully open, fairings align with butterfly and reduce wake. Butterfly free to turn, so valve can be closed, while fairings remain fixed. Design reduces turbulence in flow of air in internal suction system. Valve aids in development of improved porous-surface boundary-layer control system to reduce aerodynamic drag. Applications primarily aerospace. System adapted to boundary-layer control on high-speed land vehicles.

Pocket change: a simple educational intervention increases hospitalist documentation of comorbidities and improves hospital quality performance measures.

PubMed

Sparks, Rachel; Salskov, Alex H; Chang, Anita S; Wentworth, Kelly L; Gupta, Pritha P; Staiger, Thomas O; Anawalt, Bradley D

2015-01-01

Complete documentation of patient comorbidities in the medical record is important for clinical care, hospital reimbursement, and quality performance measures. We designed a pocket card reminder and brief educational intervention aimed at hospitalists with the goal of improving documentation of 6 common comorbidities present on admission: coagulation abnormalities, metastatic cancer, anemia, fluid and electrolyte abnormalities, malnutrition, and obesity. Two internal medicine inpatient teams led by 10 hospitalist physicians at an academic medical center received the educational intervention and pocket card reminder (n = 520 admissions). Two internal medicine teams led by nonhospitalist physicians served as a control group (n = 590 admissions). Levels of documentation of 6 common comorbidities, expected length of stay, and expected mortality were measured at baseline and during the 9-month study period. The intervention was associated with increased documentation of anemia, fluid and electrolyte abnormalities, malnutrition, and obesity in the intervention group, both compared to baseline and compared to the control group during the study period. The expected length of stay increased in the intervention group during the study period. A simple educational intervention and pocket card reminder were associated with improved documentation and hospital quality measures at an academic medical center.

Can I get me out of my head? Exploring strategies for controlling the self-referential aspects of the mind-wandering state during reading.

PubMed

Sanders, Jet G; Wang, Hao-Ting; Schooler, Jonathan; Smallwood, Jonathan

2017-06-01

Trying to focus on a piece of text and keep unrelated thoughts at bay can be a surprisingly futile experience. The current study explored the effects of different instructions on participants' capacity to control their mind-wandering and maximize reading comprehension, while reading. Participants were instructed to (a) enhance focus on what was read (external) or (b) enhance meta-awareness of mind-wandering (internal). To understand when these strategies were important, we induced a state of self-focus in half of our participants at the beginning of the experiment. Results replicated the negative association between mind-wandering and comprehension and demonstrated that both internal and external instructions impacted on the efficiency of reading following a period of induced self-focus. Techniques that foster meta-awareness improved task focus but did so at the detriment of reading comprehension, while promoting a deeper engagement while reading improved comprehension with no changes in reported mind-wandering. These data provide insight into how we can control mind-wandering and improve comprehension, and they underline that a state of self-focus is a condition under which they should be employed. Furthermore, these data support component process models that propose that the self-referent mental contents that arise during mind-wandering are distinguishable from those processes that interfere with comprehension.

The association between controlled interpersonal affect regulation and resource depletion.

PubMed

Martínez-Íñigo, David; Poerio, Giulia Lara; Totterdell, Peter

2013-07-01

This investigation focuses on what occurs to individuals' self-regulatory resource during controlled Interpersonal Affect Regulation (IAR) which is the process of deliberately influencing the internal feeling states of others. Combining the strength model of self-regulation and the resources conservation model, the investigation tested whether: (1) IAR behaviors are positively related to ego-depletion because goal-directed behaviors demand self-regulatory processes, and (2) the use of affect-improving strategies benefits from a source of resource-recovery because it initiates positive feedback from targets, as proposed from a resource-conservation perspective. To test this, a lab study based on an experimental dual-task paradigm using a sample of pairs of friends in the UK and a longitudinal field study of a sample of healthcare workers in Spain were conducted. The experimental study showed a depleting effect of interpersonal affect-improving IAR on a subsequent self-regulation task. The field study showed that while interpersonal affect-worsening was positively associated with depletion, as indicated by the level of emotional exhaustion, interpersonal affect-improving was only associated with depletion after controlling for the effect of positive feedback from clients. The findings indicate that IAR does have implications for resource depletion, but that social reactions play a role in the outcome. © 2013 The Authors. Applied Psychology: Health and Well-Being © 2013 The International Association of Applied Psychology.

[A control study of a school-based life skills education on prevention of behavior problems in third-grade schoolchildren].

PubMed

Lin, Hong; Wang, Yu-feng; Wu, Ye-ping

2007-06-18

To evaluate the effectiveness on the prevention of behavior problems of life skills education combining school-based and parent-involved approaches for third-grade students in China. This research was targeted at the population of third-grade children in two elementary schools in Qinhuangdao City, Hebei Province. Nine regular school classrooms were randomly divided into three groups: the intervention group (n=208), internal control group (n=209) and external control group (n=204). The intervention included 26-hour competence promotion for students and 5-hour parent training. The Rutter Scale by parent and teacher were used to evaluate the effects at pretest, posttest and 6-month follow-up. Improvement was observed among children in the intervention group than those in the control groups. The statistical difference was significant (P<0.05).1.The prevalence of total behavior problems, antisocial behavior and neurotic behavior problem at home: At termination, the prevalence in intervention group(11.2%,3.6% and 6.1%)was lower (except neurotic behavior) than those in internal control group (19.4%,5.6% and 6.1%)and external control group (18.9%,8.9% and 5.3%). At 6-month follow-up, the prevalence in intervention group (10.2%,2.5% and 3.6%)was still lower than those in internal control group (17.2%,6.8% and 6.8%)and external control group (17.8%,7.8% and 6.7%).2. The prevalence of total behavior problems and antisocial behavior problem at school: At termination, the prevalence in intervention group(5.3% and 4.3%)was lower than those in internal control group(10.1% and 7.7%)and external control group(14.9% and 12.4%). At 6-month follow-up, the prevalence in intervention group(2.9% and 2.4%)was still lower than those in internal control group (10.2% and 9.7%)and external control group(11.3% and 10.3%). Life skills education could reduce the children's home and school behavior problems, especially for antisocial behavior. The effects of intervention maintained during the 6-month follow-up study.

A compound control strategy combining velocity compensation with ADRC of electro-hydraulic position servo control system.

PubMed

Gao, Bingwei; Shao, Junpeng; Yang, Xiaodong

2014-11-01

In order to enhance the anti-jamming ability of electro-hydraulic position servo control system at the same time improve the control precision of the system, a compound control strategy that combines velocity compensation with Active Disturbance Rejection Controller (ADRC) is proposed, and the working principle of the compound control strategy is given. ADRC controller is designed, and the extended state observer is used for observing internal parameters uncertainties and external disturbances, so that the disturbances of the system are suppressed effectively. Velocity compensation controller is designed and the compensation model is derived to further improve the positioning accuracy of the system and to achieve the velocity compensation without disturbance. The compound control strategy is verified by the simulation and experiment respectively, and the simulation and experimental results show that the electro-hydraulic position servo control system with ADRC controller can effectively inhibit the external disturbances, the precise positioning control is realized after introducing the velocity compensation controller, and verify that the compound control strategy is effective. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

Spot and Runway Departure Advisor

NASA Technical Reports Server (NTRS)

Jung, Yoon Chul

2013-01-01

The Spot and Runway Departure Advisor (SARDA) is a research prototype of a decision support tool for ATC tower controllers to assist in manging and controlling traffic on the surface of an airport. SARDA employs a scheduler to generate an optimal runway schedule and gate push-back - spot release sequence and schedule that improves efficiency of surface operations. The advisories for ATC tower controllers are displayed on an Electronic Flight Strip (EFS) system. The human-in-the-loop simulation of the SARDA tool was conducted for east operations of Dallas-Ft. Worth International Airport (DFW) to evaluate performance of the SARDA tool and human factors, such as situational awareness and workload. The results indicates noticeable taxi delay reduction and fuel savings by using the SARDA tool. Reduction in controller workload were also observed throughout the scenario runs. The future plan includes modeling and simulation of the ramp operations of the Charlotte International Airport, and develop a decision support tool for the ramp controllers.

A robust internal control for high-precision DNA methylation analyses by droplet digital PCR.

PubMed

Pharo, Heidi D; Andresen, Kim; Berg, Kaja C G; Lothe, Ragnhild A; Jeanmougin, Marine; Lind, Guro E

2018-01-01

Droplet digital PCR (ddPCR) allows absolute quantification of nucleic acids and has potential for improved non-invasive detection of DNA methylation. For increased precision of the methylation analysis, we aimed to develop a robust internal control for use in methylation-specific ddPCR. Two control design approaches were tested: (a) targeting a genomic region shared across members of a gene family and (b) combining multiple assays targeting different pericentromeric loci on different chromosomes. Through analyses of 34 colorectal cancer cell lines, the performance of the control assay candidates was optimized and evaluated, both individually and in various combinations, using the QX200™ droplet digital PCR platform (Bio-Rad). The best-performing control was tested in combination with assays targeting methylated CDO1 , SEPT9 , and VIM . A 4Plex panel consisting of EPHA3 , KBTBD4 , PLEKHF1 , and SYT10 was identified as the best-performing control. The use of the 4Plex for normalization reduced the variability in methylation values, corrected for differences in template amount, and diminished the effect of chromosomal aberrations. Positive Droplet Calling (PoDCall), an R-based algorithm for standardized threshold determination, was developed, ensuring consistency of the ddPCR results. Implementation of a robust internal control, i.e., the 4Plex, and an algorithm for automated threshold determination, PoDCall, in methylation-specific ddPCR increase the precision of DNA methylation analysis.

Compact vibration isolation and suspension for Australian International Gravitational Observatory: Local control system

NASA Astrophysics Data System (ADS)

Dumas, Jean-Charles; Barriga, Pablo; Zhao, Chunnong; Ju, Li; Blair, David G.

2009-11-01

High performance vibration isolators are required for ground based gravitational wave detectors. To attain very high performance at low frequencies we have developed multistage isolators for the proposed Australian International Gravitational Observatory detector in Australia. New concepts in vibration isolation including self-damping, Euler springs, LaCoste springs, Roberts linkages, and double preisolation require novel sensors and actuators. Double preisolation enables internal feedback to be used to suppress low frequency seismic noise. Multidegree of freedom control systems are required to attain high performance. Here we describe the control components and control systems used to control all degrees of freedom. Feedback forces are injected at the preisolation stages and at the penultimate suspension stage. There is no direct actuation on test masses. A digital local control system hosted on a digital signal processor maintains alignment and position, corrects drifts, and damps the low frequency linear and torsional modes without exciting the very high Q-factor test mass suspension. The control system maintains an optical cavity locked to a laser with a high duty cycle even in the absence of an autoalignment system. An accompanying paper presents the mechanics of the system, and the optical cavity used to determine isolation performance. A feedback method is presented, which is expected to improve the residual motion at 1 Hz by more than one order of magnitude.

Compact vibration isolation and suspension for Australian International Gravitational Observatory: local control system.

PubMed

Dumas, Jean-Charles; Barriga, Pablo; Zhao, Chunnong; Ju, Li; Blair, David G

2009-11-01

High performance vibration isolators are required for ground based gravitational wave detectors. To attain very high performance at low frequencies we have developed multistage isolators for the proposed Australian International Gravitational Observatory detector in Australia. New concepts in vibration isolation including self-damping, Euler springs, LaCoste springs, Roberts linkages, and double preisolation require novel sensors and actuators. Double preisolation enables internal feedback to be used to suppress low frequency seismic noise. Multidegree of freedom control systems are required to attain high performance. Here we describe the control components and control systems used to control all degrees of freedom. Feedback forces are injected at the preisolation stages and at the penultimate suspension stage. There is no direct actuation on test masses. A digital local control system hosted on a digital signal processor maintains alignment and position, corrects drifts, and damps the low frequency linear and torsional modes without exciting the very high Q-factor test mass suspension. The control system maintains an optical cavity locked to a laser with a high duty cycle even in the absence of an autoalignment system. An accompanying paper presents the mechanics of the system, and the optical cavity used to determine isolation performance. A feedback method is presented, which is expected to improve the residual motion at 1 Hz by more than one order of magnitude.

An Assessment of the International Space Station's Trace Contaminant Control Subassembly Process Economics

NASA Technical Reports Server (NTRS)

Perry J. L.; Cole, H. E.; El-Lessy, H. N.

2005-01-01

The International Space Station (ISS) Environmental Control and Life Support System includes equipment speci.cally designed to actively remove trace chemical contamination from the cabin atmosphere. In the U.S. on-orbit segment, this function is provided by the trace contaminant control subassembly (TCCS) located in the atmosphere revitalization subsystem rack housed in the laboratory module, Destiny. The TCCS employs expendable adsorbent beds to accomplish its function leading to a potentially signi.cant life cycle cost over the life of the ISS. Because maintaining the TCCSs proper can be logistically intensive, its performance in .ight has been studied in detail to determine where savings may be achieved. Details of these studies and recommendations for improving the TCCS s process economics without compromising its performance or crew health and safety are presented and discussed.

Auto-calibrated scanning-angle prism-type total internal reflection microscopy for nanometer-precision axial position determination and optional variable-illumination-depth pseudo total internal reflection microscopy

DOEpatents

Fang, Ning; Sun, Wei

2015-04-21

A method, apparatus, and system for improved VA-TIRFM microscopy. The method comprises automatically controlled calibration of one or more laser sources by precise control of presentation of each laser relative a sample for small incremental changes of incident angle over a range of critical TIR angles. The calibration then allows precise scanning of the sample for any of those calibrated angles for higher and more accurate resolution, and better reconstruction of the scans for super resolution reconstruction of the sample. Optionally the system can be controlled for incident angles of the excitation laser at sub-critical angles for pseudo TIRFM. Optionally both above-critical angle and sub critical angle measurements can be accomplished with the same system.

Robotics, motor learning, and neurologic recovery.

PubMed

Reinkensmeyer, David J; Emken, Jeremy L; Cramer, Steven C

2004-01-01

Robotic devices are helping shed light on human motor control in health and injury. By using robots to apply novel force fields to the arm, investigators are gaining insight into how the nervous system models its external dynamic environment. The nervous system builds internal models gradually by experience and uses them in combination with impedance and feedback control strategies. Internal models are robust to environmental and neural noise, generalized across space, implemented in multiple brain regions, and developed in childhood. Robots are also being used to assist in repetitive movement practice following neurologic injury, providing insight into movement recovery. Robots can haptically assess sensorimotor performance, administer training, quantify amount of training, and improve motor recovery. In addition to providing insight into motor control, robotic paradigms may eventually enhance motor learning and rehabilitation beyond the levels possible with conventional training techniques.

National Survey on Internal Quality Control for HbA(1c) Analytical Instruments in 331 Hospital Laboratories of China.

PubMed

Zeng, Rong; Wang, Wei; Zhao, Haijian; Fei, Yang; Wang, Zhiguo

2015-01-01

The narrow gap of HbA1 value of mass fraction between "normal" (< 6.0%) and "diabetes" (≥ 6.5%) necessitates tight control of inter-assay standardization, assay precision, and trueness. This survey was initiated to obtain knowledge of the current situation of internal quality control (IQC) practice for HbA(1c) in China and find out the most appropriate quality specifications. Data of IQC for HbA(1c) in 331 institutions participating in the national proficiency testing (PT) programs in China were evaluated using four levels of quality specifications, and the percentages of laboratories meeting the quality requirement were calculated to find out the most appropriate quality specifications for control materials of HbA(1c) in China. The IQC data varied vastly among 331 clinical laboratories in China. The measurement of control materials covered a wide range from 4.52% to 12.24% (inter-quartile range) and there were significant differences among the CVs of different methods, including LPLC, CE-HPLC, AC-HPLC, immunoturbidimetry, and others. Among the four main methods, CE-HPLC and AC-HPLC achieved a better precision. As we can see, the performance of laboratories for HbA(1c) has yet to be improved. Clinical laboratories in China should improve their performance with a stricter imprecision criteria.

[Internal and external quality controls for Elisa techniques of aspergillosis serodiagnosis: proposals of the group "sérodiagnostic fongique" of the Société française de mycologie médicale].

PubMed

Persat, F; Lachaud, L; Rabérin, H; Poggi, B; Roques, C; Gangneux, J P

2013-03-01

In the end of May 2012, a meeting of the group "sérodiagnostic fongique" of the "Société française de mycologie médicale" had concerned quality controls to use, in particular, in the follow-up of Elisa techniques. A preliminary investigation showed that the internal quality controls (CIQ), according to the terms defined by the accreditation, were not systematically used. In June, was published the new guide of the COFRAC SH-GTA-06 on quality controls, this text being applicable on July 1st, 2012. It incited the working group to formulate proposals on the choice of the CIQ for antigen and antibody Elisa in the aspergillosis serodiagnosis. Informations on the external evaluations of the quality (EEQ) have also been given to better define for what we can expect from it. All these controls will allow every laboratory to better master the used techniques and their conditions of realization. A strengthened dialogue between the users and the manufacturers should incite these last actors to improve the supplied kits. It will drive later to an improvement of the reliability of the results obtained by these techniques and their interest in the aspergillosis diagnosis. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Computer science: Key to a space program renaissance. The 1981 NASA/ASEE summer study on the use of computer science and technology in NASA. Volume 2: Appendices

NASA Technical Reports Server (NTRS)

Freitas, R. A., Jr. (Editor); Carlson, P. A. (Editor)

1983-01-01

Adoption of an aggressive computer science research and technology program within NASA will: (1) enable new mission capabilities such as autonomous spacecraft, reliability and self-repair, and low-bandwidth intelligent Earth sensing; (2) lower manpower requirements, especially in the areas of Space Shuttle operations, by making fuller use of control center automation, technical support, and internal utilization of state-of-the-art computer techniques; (3) reduce project costs via improved software verification, software engineering, enhanced scientist/engineer productivity, and increased managerial effectiveness; and (4) significantly improve internal operations within NASA with electronic mail, managerial computer aids, an automated bureaucracy and uniform program operating plans.

SpaceOps 1992: Proceedings of the Second International Symposium on Ground Data Systems for Space Mission Operations

NASA Technical Reports Server (NTRS)

1993-01-01

The Second International Symposium featured 135 oral presentations in these 12 categories: Future Missions and Operations; System-Level Architectures; Mission-Specific Systems; Mission and Science Planning and Sequencing; Mission Control; Operations Automation and Emerging Technologies; Data Acquisition; Navigation; Operations Support Services; Engineering Data Analysis of Space Vehicle and Ground Systems; Telemetry Processing, Mission Data Management, and Data Archiving; and Operations Management. Topics focused on improvements in the productivity, effectiveness, efficiency, and quality of mission operations, ground systems, and data acquisition. Also emphasized were accomplishments in management of human factors; use of information systems to improve data retrieval, reporting, and archiving; design and implementation of logistics support for mission operations; and the use of telescience and teleoperations.

[Health threats and health system crises. An approach to early warning and response. 2008 SESPAS Report].

PubMed

Simón Soria, Fernando; Guillén Enríquez, Francisco Javier

2008-04-01

The world is changing more and faster than ever before. New diseases are coming to light each year, controlled diseases are reemerging as potential threats, and natural or man-made disasters are increasingly affecting human health. The "International Health Regulations (2005)" reflect the changes in the response of public health to this new situation. Surveillance of specific diseases and predefined control measures have been replaced by surveillance of public health events of international concern and control measures adapted to each situation. The public health events of international interest are characterized by their seriousness, predictability, the risk of international spread and potential for travel or trade restrictions. The development of the European Early Warning and Response System in 1998 and the creation of the European Center for Disease Prevention and Control in 2005 demonstrate political commitment in Europe, with early detection of and response to public health threats. However, timely risk evaluation and response at a national level requires improved data digitalization and accessibility, automatic notification processes, data analysis and dissemination of information, the combination of information from multiple sources and adaptation of public health services. The autonomous regions in Spain are initiating this adaptation process, but interoperability between systems and the development of guidelines for a coordinated response should be steered by the National Interregional Health Council and coordinated by the Ministry of Health. Efficient early warning systems of health threats that allow for a timely response and reduce uncertainty about information would help to minimize the risk of public health crises. The profile of public health threats is nonspecific. Early detection of threats requires access to information from multiple sources and efficient risk assessment. Key factors for improving the response to public health threats are the development of surveillance methods and operational research in public health.

Transboundary Movements of Hazardous Wastes. A Comparative Analysis of Policy Options to Control the International Waste Trade.

ERIC Educational Resources Information Center

Hilz, Christoph; Ehrenfeld, John R.

1991-01-01

Several policy frameworks for managing hazardous waste import/export are examined with respect to economic issues, environmental sustainability, and administrative feasibility and effectiveness. Several recommendations for improving the present instrument and implementing process are offered. (Author/CW)

Alining Large Cylinders for Welding

NASA Technical Reports Server (NTRS)

Ehl, J. H.

1985-01-01

Special tooling alines and holds internally-stiffened large-diameter cylindrical parts for welding. Alinement brackets attached to strengthening fins on insides of cylindrical tank sections. Jackscrews on brackets raised or lowered to eliminate mismatches between adjacent sections. Tooling substantially reduces costs while allowing more precise control and improved quality.

Notification: EPA’s Use of Science and Research Federal Advisory Committees to Improve Agency Performance

EPA Pesticide Factsheets

Project #OPE-FY16-0024, May 9, 2016.The EPA OIG plans to begin preliminary research on internal controls the EPA has in place to engage science and research Federal Advisory Committee Act (FACA) committees and utilize their recommendations.

Student Financial Aid Delivery System.

ERIC Educational Resources Information Center

O'Neal, John R.; Carpenter, Catharine A.

1983-01-01

Ohio University's use of computer programing for the need analysis and internal accounting functions in financial aid is described. A substantial improvement of services resulted, with 6,000-10,000 students and the offices of financial aid, bursar, registration, student records, housing, admissions, and controller assisted in the process. Costs…

Problems and Opportunities in School Financial Management: A Consultant's Perspective.

ERIC Educational Resources Information Center

Chabotar, Kent John

1987-01-01

Summarizes major problems in school financial management and suggests practical improvements to aid external reporting of financial data and internal management. Sections of the article describe these categories of problems: (1) budget presentation; (2) management control; (3) cost accounting; and (4) financial reporting. (PS)

District of Columbia Public Education: Agencies Have Enhanced Internal Controls over Federal Payments for School Improvement, but More Consistent Monitoring Needed. Report to Congressional Requesters. GAO-11-16

ERIC Educational Resources Information Center

Ashby, Cornelia M.

2010-01-01

Between fiscal years 2004 and 2009, Congress appropriated nearly $190 million in federal payments for school improvement to the District of Columbia (D.C.). This includes $85 million to the state education office--currently the Office of the State Superintendent of Education (OSSE)--to expand public charter schools and $105 million to D.C. Public…

Current harmonics elimination control method for six-phase PM synchronous motor drives.

PubMed

Yuan, Lei; Chen, Ming-liang; Shen, Jian-qing; Xiao, Fei

2015-11-01

To reduce the undesired 5th and 7th stator harmonic current in the six-phase permanent magnet synchronous motor (PMSM), an improved vector control algorithm was proposed based on vector space decomposition (VSD) transformation method, which can control the fundamental and harmonic subspace separately. To improve the traditional VSD technology, a novel synchronous rotating coordinate transformation matrix was presented in this paper, and only using the traditional PI controller in d-q subspace can meet the non-static difference adjustment, the controller parameter design method is given by employing internal model principle. Moreover, the current PI controller parallel with resonant controller is employed in x-y subspace to realize the specific 5th and 7th harmonic component compensation. In addition, a new six-phase SVPWM algorithm based on VSD transformation theory is also proposed. Simulation and experimental results verify the effectiveness of current decoupling vector controller. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Dietary interventions in overweight and obese pregnant women: a systematic review of the content, delivery, and outcomes of randomized controlled trials.

PubMed

Flynn, Angela C; Dalrymple, Kathryn; Barr, Suzanne; Poston, Lucilla; Goff, Louise M; Rogozińska, Ewelina; van Poppel, Mireille N M; Rayanagoudar, Girish; Yeo, SeonAe; Barakat Carballo, Ruben; Perales, Maria; Bogaerts, Annick; Cecatti, Jose G; Dodd, Jodie; Owens, Julie; Devlieger, Roland; Teede, Helena; Haakstad, Lene; Motahari-Tabari, Narges; Tonstad, Serena; Luoto, Riitta; Guelfi, Kym; Petrella, Elisabetta; Phelan, Suzanne; Scudeller, Tânia T; Hauner, Hans; Renault, Kristina; Sagedal, Linda Reme; Stafne, Signe N; Vinter, Christina; Astrup, Arne; Geiker, Nina R W; McAuliffe, Fionnuala M; Mol, Ben W; Thangaratinam, Shakila

2016-05-01

Interventions targeting maternal obesity are a healthcare and public health priority. The objective of this review was to evaluate the adequacy and effectiveness of the methodological designs implemented in dietary intervention trials for obesity in pregnancy. A systematic review of the literature, consistent with PRISMA guidelines, was performed as part of the International Weight Management in Pregnancy collaboration. Thirteen randomized controlled trials, which aimed to modify diet and physical activity in overweight and obese pregnant women, were identified. There was significant variability in the content, delivery, and dietary assessment methods of the dietary interventions examined. A number of studies demonstrated improved dietary behavior in response to diet and/or lifestyle interventions. Nine studies reduced gestational weight gain. This review reveals large methodological variability in dietary interventions to control gestational weight gain and improve clinical outcomes in overweight and obese pregnant women. This lack of consensus limits the ability to develop clinical guidelines and apply the evidence in clinical practice. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Continuous cognitive task promotes greater postural stability than an internal or external focus of attention.

PubMed

Polskaia, Nadia; Richer, Natalie; Dionne, Eliane; Lajoie, Yves

2015-02-01

Research has demonstrated clear advantages of using an external focus of attention in postural control tasks, presumably since it allows a more automatic control of posture to emerge. However, the influence of cognitive tasks on postural stability has produced discordant results. This study aimed to compare the effects of an internal focus of attention, an external focus of attention and a continuous cognitive task on postural control. Twenty healthy participants (21.4±2.6 years) were recruited for this study. They were asked to stand quietly on a force platform with their feet together in three different attentional focus conditions: an internal focus condition (minimizing movements of the hips), an external focus condition (minimizing movements of markers placed on the hips) and a cognitive task condition (silently counting the total number of times a single digit was verbalized in a 3-digit sequence comprised of 30 numbers). Results demonstrated improved stability while performing the cognitive task as opposed to the internal and external focus conditions, as evidenced by a reduction in sway area, sway variability in the anterior-posterior (AP) and medial-lateral (ML) directions, and mean velocity (ML only). Results suggest that the use of a continuous cognitive task permits attention to be withdrawn from the postural task, thereby facilitating a more automatic control of posture. Copyright © 2014 Elsevier B.V. All rights reserved.

Boundary layer and separation control on wings at low Reynolds numbers

NASA Astrophysics Data System (ADS)

Yang, Shanling

Results on boundary layer and separation control through acoustic excitation at low Re numbers are reported. The Eppler 387 profile is specifically chosen because of its pre-stall hysteresis and bi-stable state behavior in the transitional Re regime, which is a result of flow separation and reattachment. External acoustic forcing on the wing yields large improvements (more than 70%) in lift-to-drag ratio and flow reattachment at forcing frequencies that correlate with the measured anti-resonances in the wind tunnel. The optimum St/Re1/2 range for Re = 60,000 matches the proposed optimum range in the literature, but there is less agreement for Re = 40,000, which suggests that correct St scaling has not been determined. The correlation of aerodynamic improvements to wind tunnel resonances implies that external acoustic forcing is facility-dependent, which inhibits practical application. Therefore, internal acoustic excitation for the same wing profile is also pursued. Internal acoustic forcing is designed to be accomplished by embedding small speakers inside a custom-designed wing that contains many internal cavities and small holes in the suction surface. However, initial testing of this semi-porous wing model shows that the presence of the small holes in the suction surface completely transforms the aerodynamic performance by changing the mean chordwise separation location and causing an originally separated, low-lift state flow to reattach into a high-lift state. The aerodynamic improvements are not caused by the geometry of the small holes themselves, but rather by Helmholtz resonance that occurs in the cavities, which generate tones that closely match the intrinsic flow instabilities. Essentially, opening and closing holes in the suction surface of a wing, perhaps by digital control, can be used as a means of passive separation control. Given the similarity of wing-embedded pressure tap systems to Helmholtz resonators, particular attention must be given to the setup of pressure taps in wings in order to avoid acoustic resonance effects. Local acoustic forcing is achieved through the activation of internally embedded speakers in combination with thin diaphragms placed across the holes in the suction surface to eliminate Helmholtz resonance effects. Activating various speakers in different spanwise and chordwise distributions successfully controls local flow separation on the wing at Re = 40,000 and 60,000. The changes in aerodynamic performance differ from those observed through external acoustic forcing, indicating that internal acoustic forcing is facility-independent. Combining the effect of Helmholtz resonance and the effect of pure internal acoustic forcing yields a completely different set of performance improvements. Since the internal acoustic forcing studies in the literature did not separate these two effects, there is reason to question the validity of the true nominal performance of the wings in previously reported internal acoustic studies. Stability analysis is performed on experimental velocity profiles by means of a numerical Orr-Sommerfeld solver, which extracts the initially least stable frequencies in the boundary layer using parallel and 2-d flow assumptions. Velocity profiles of the E387 wing are chosen at a condition where acoustic excitation at various chordwise locations and frequencies promotes the originally separated, low-lift state flow into a reattached, high-lift state. Preliminary stability analysis of the flow at different chordwise stations for the wing in its nominal state (without acoustic excitation) indicates that the flow is initially stable. The least stable frequencies are found to be equal to, and sub harmonics of, the preferential acoustic forcing frequencies determined in experiments. However, potentially improper and oversimplified flow assumptions are most likely sources of inaccuracy since the Orr-Sommerfeld equation is not generally used for separated flows or for boundary layers that grow significantly over the chord length. The reported numerical results serve as a basis for further validation. (Abstract shortened by UMI.)

Process evaluation improves delivery of a nutrition-sensitive agriculture programme in Burkina Faso.

PubMed

Nielsen, Jennifer N; Olney, Deanna K; Ouedraogo, Marcellin; Pedehombga, Abdoulaye; Rouamba, Hippolyte; Yago-Wienne, Fanny

2017-12-26

Evidence is emerging from rigorous evaluations about the effectiveness of nutrition-sensitive agriculture programmes in improving nutritional outcomes. Additional evidence can elucidate how different programme components and pathways contribute and can be optimized for impact. The International Food Policy Research Institute, with Helen Keller International, designed a comprehensive framework to evaluate the delivery, utilization, and impact of Helen Keller International's enhanced homestead food production programme in Burkina Faso. After 18 months of implementation, a process evaluation was conducted to examine programme impact pathways, using key informant and semistructured interviews with implementing agents and beneficiaries, and with residents of control communities. Data were analyzed by International Food Policy Research Institute and reviewed with project managers and partners through multiple workshops to identify opportunities to strengthen implementation. Findings illuminated gaps between intended and actual delivery schemes, including input constraints, knowledge gaps among community agents in agriculture and young child nutrition practices, and lower than expected activity by community volunteers. In response, staff developed measures to overcome water constraints and expand vegetable and poultry production, retrained volunteers in certain techniques of food production and counselling for nutrition behaviour change, added small incentives to motivate volunteers, and shaped both immediate and long-term changes to the programme model. Working closely with International Food Policy Research Institute on the evaluation activities also expanded the repertoire of research methods and skills of Helen Keller International staff. Process evaluation can strengthen programme delivery, utilization, and design. Collaboration between researchers and implementers can improve programme effectiveness, project staff capacity, and advance delivery science. © 2017 John Wiley & Sons Ltd.

Development and inter-laboratory validation study of an improved new real-time PCR assay with internal control for detection and laboratory diagnosis of African swine fever virus.

PubMed

Tignon, Marylène; Gallardo, Carmina; Iscaro, Carmen; Hutet, Evelyne; Van der Stede, Yves; Kolbasov, Denis; De Mia, Gian Mario; Le Potier, Marie-Frédérique; Bishop, Richard P; Arias, Marisa; Koenen, Frank

2011-12-01

A real-time polymerase chain reaction (PCR) assay for the rapid detection of African swine fever virus (ASFV), multiplexed for simultaneous detection of swine beta-actin as an endogenous control, has been developed and validated by four National Reference Laboratories of the European Union for African swine fever (ASF) including the European Union Reference Laboratory. Primers and a TaqMan(®) probe specific for ASFV were selected from conserved regions of the p72 gene. The limit of detection of the new real-time PCR assay is 5.7-57 copies of the ASFV genome. High accuracy, reproducibility and robustness of the PCR assay (CV ranging from 0.7 to 5.4%) were demonstrated both within and between laboratories using different real-time PCR equipments. The specificity of virus detection was validated using a panel of 44 isolates collected over many years in various geographical locations in Europe, Africa and America, including recent isolates from the Caucasus region, Sardinia, East and West Africa. Compared to the OIE-prescribed conventional and real-time PCR assays, the sensitivity of the new assay with internal control was improved, as demonstrated by testing 281 field samples collected in recent outbreaks and surveillance areas in Europe and Africa (170 samples) together with samples obtained through experimental infections (111 samples). This is particularly evident in the early days following experimental infection and during the course of the disease in pigs sub-clinically infected with strains of low virulence (from 35 up to 70dpi). The specificity of the assay was also confirmed on 150 samples from uninfected pigs and wild boar from ASF-free areas. Measured on the total of 431 tested samples, the positive deviation of the new assay reaches 21% or 26% compared to PCR and real-time PCR methods recommended by OIE. This improved and rigorously validated real-time PCR assay with internal control will provide a rapid, sensitive and reliable molecular tool for ASFV detection in pigs in newly infected areas, control in endemic areas and surveillance in ASF-free areas. Copyright © 2011 Elsevier B.V. All rights reserved.

Ferroelectric Fluid Flow Control Valve

NASA Technical Reports Server (NTRS)

Jalink, Antony, Jr. (Inventor); Hellbaum, Richard F. (Inventor); Rohrbach, Wayne W. (Inventor)

1999-01-01

An active valve is controlled and driven by external electrical actuation of a ferroelectric actuator to provide for improved passage of the fluid during certain time periods and to provide positive closure of the valve during other time periods. The valve provides improved passage in the direction of flow and positive closure in the direction against the flow. The actuator is a dome shaped internally prestressed ferroelectric actuator having a curvature, said dome shaped actuator having a rim and an apex. and a dome height measured from a plane through said rim said apex that varies with an electric voltage applied between an inside and an outside surface of said dome shaped actuator.

Union for International Cancer Control International Session: healthcare economics: the significance of the UN Summit non-communicable diseases political declaration in Asia.

PubMed

Akaza, Hideyuki; Kawahara, Norie; Masui, Tohru; Takeyama, Kunihiko; Nogimori, Masafumi; Roh, Jae Kyung

2013-06-01

The Japan National Committee for the Union for International Cancer Control (UICC) and UICC-Asia Regional Office (ARO) organized an international session as part of the official program of the 71st Annual Meeting of the Japanese Cancer Association to discuss the topic "Healthcare Economics: The Significance of the UN Summit non-communicable diseases (NCDs) Political Declaration in Asia." The presenters and participants discussed the growing cost of cancer in the Asian region and the challenges that are faced by the countries of Asia, all of which face budgetary and other systemic constraints in tackling and controlling cancer in the region. The session benefited from the participation of various stakeholders, including cancer researchers and representatives of the pharmaceutical industry. They discussed the significance of the UN Political Declaration on the prevention and control of NCDs (2011) as a means of boosting awareness of cancer in the Asian region and also addressed the ways in which stakeholders can cooperate to improve cancer control and treatment. Other issues that were covered included challenges relating to pharmaceutical trials in Asia and how to link knowledge and research outcomes. The session concluded with the recognition that with the onset of a super-aged society in most countries in Asia and an increasing focus on quality of life rather than quantity of life, it is more important than ever for all stakeholders to continue to share information and promote policy dialogue on cancer control and treatment. © 2013 Japanese Cancer Association.

Tuberculosis in a South African prison – a transmission modelling analysis

PubMed Central

Johnstone-Robertson, Simon; Lawn, Stephen D; Welte, Alex; Bekker, Linda-Gail; Wood, Robin

2015-01-01

Background Prisons are recognised internationally as institutions with very high tuberculosis (TB) burdens where transmission is predominantly determined by contact between infectious and susceptible prisoners. A recent South African court case described the conditions under which prisoners awaiting trial were kept. With the use of these data, a mathematical model was developed to explore the interactions between incarceration conditions and TB control measures. Methods Cell dimensions, cell occupancy, lock-up time, TB incidence and treatment delays were derived from court evidence and judicial reports. Using the Wells-Riley equation and probability analyses of contact between prisoners, we estimated the current TB transmission probability within prison cells, and estimated transmission probabilities of improved levels of case finding in combination with implementation of national and international minimum standards for incarceration. Results Levels of overcrowding (230%) in communal cells and poor TB case finding result in annual TB transmission risks of 90% per annum. Implementing current national or international cell occupancy recommendations would reduce TB transmission probabilities by 30% and 50%, respectively. Improved passive case finding, modest ventilation increase or decreased lock-up time would minimally impact on transmission if introduced individually. However, active case finding together with implementation of minimum national and international standards of incarceration could reduce transmission by 50% and 94%, respectively. Conclusions Current conditions of detention for awaiting-trial prisoners are highly conducive for spread of drug-sensitive and drug-resistant TB. Combinations of simple well-established scientific control measures should be implemented urgently. PMID:22272961

Virtual hybrid test control of sinuous crack

NASA Astrophysics Data System (ADS)

Jailin, Clément; Carpiuc, Andreea; Kazymyrenko, Kyrylo; Poncelet, Martin; Leclerc, Hugo; Hild, François; Roux, Stéphane

2017-05-01

The present study aims at proposing a new generation of experimental protocol for analysing crack propagation in quasi brittle materials. The boundary conditions are controlled in real-time to conform to a predefined crack path. Servo-control is achieved through a full-field measurement technique to determine the pre-set fracture path and a simple predictor model based on linear elastic fracture mechanics to prescribe the boundary conditions on the fly so that the actual crack path follows at best the predefined trajectory. The final goal is to identify, for instance, non-local damage models involving internal lengths. The validation of this novel procedure is performed via a virtual test-case based on an enriched damage model with an internal length scale, a prior chosen sinusoidal crack path and a concrete sample. Notwithstanding the fact that the predictor model selected for monitoring the test is a highly simplified picture of the targeted constitutive law, the proposed protocol exhibits a much improved sensitivity to the sought parameters such as internal lengths as assessed from the comparison with other available experimental tests.

Needs and availability of snake antivenoms: relevance and application of international guidelines

PubMed Central

Scheske, Laura; Ruitenberg, Joost; Bissumbhar, Balram

2015-01-01

Background: Snakebite has recently been declared a global public health emergency. Empirical data showing the true burden of snakebite is lacking. Treatment with specific antivenoms is considered the only cure. However, several factors have led to an ongoing antivenom crisis. This study offers recommendations concerning the improvement of antivenom access and control, by providing an overview of the factors limiting the successful implementation of international guidelines within the international industry and state institutions. It further investigates the reasons for the epidemiological knowledge gap regarding snakebites. Methods: Data for this study was collected using surveys with closed- and open-ended questions, which allowed for descriptive and thematic analysis, respectively. Participants for this study were selected as follows: 46 manufacturers were contacted from the open-access World Health Organization (WHO) Database for antivenom producers; 23 National Health Authorities (NHAs) of high-burden countries were contacted; and 11 poison centers or experts were randomly contacted. Results: In total, responses from 6/46 (13%) manufacturers, 10/23 (43%) NHAs, and 3/11 (27%) poison centers were received. The low response rates had a limiting effect on the coverage of this study, allowing only exploratory conclusions to be drawn. Based on the gathered information, a probable reason for the epidemiological knowledge gap is the low priority given to snakebites on public health agendas, driving interest and funding away from research in this field. As a consequence, the ensuing lack in funding is preventing state institutions and manufacturers from implementing international guidelines to the highest standards. Furthermore, manufacturers indicated that international guidelines were often not applicable in the field, lacking technical information and protocols. Conclusion: Snakebite ranks low on international public health agendas, and partially due to this low priority, NHAs have shown limited efforts in conducting epidemiological studies, training health workers on snakebite management and creating national snakebite management strategies. The lack of NHA involvement is reflected in poor access to appropriate antivenoms as well as a lack of antivenom regulation. Manufacturers are taking positive steps toward full implementation of international guidelines and are improving quality control procedures. However, in order for international guidelines to become truly useful in the field, more technical guidance is required. This study reflects that there is a general lack of knowledge transfer amongst various actors: most producers, health authorities, and experts expect increased and improved communication and guidance from leading international bodies. Due to the low response rates observed in this study, conclusions drawn herein are not representative of the global situation; yet provide an exploratory insight on the difficulties facing antivenom management. PMID:26188809

Variable Speed CMG Control of a Dual-Spin Stabilized Unconventional VTOL Air Vehicle

NASA Technical Reports Server (NTRS)

Lim, Kyong B.; Moerder, Daniel D.; Shin, J-Y.

2004-01-01

This paper describes an approach based on using both bias momentum and multiple control moment gyros for controlling the attitude of statically unstable thrust-levitated vehicles in hover or slow translation. The stabilization approach described in this paper uses these internal angular momentum transfer devices for stability, augmented by thrust vectoring for trim and other outer loop control functions, including CMG stabilization/ desaturation under persistent external disturbances. Simulation results show the feasibility of (1) improved vehicle performance beyond bias momentum assisted vector thrusting control, and (2) using control moment gyros to significantly reduce the external torque required from the vector thrusting machinery.

Seeing Is Believing: Using Imagery to Enhance Your Coaching

ERIC Educational Resources Information Center

Finch, Laura M.

2011-01-01

Imagery is a powerful sport psychology tool easily accessible to coaches. These reminders can help coaches improve their athletes' images and performance: (1) Create vivid and controllable images; (2) Use polysensory images and instructional cues, delivered, ideally, in real time; (3) Use internal and external perspectives; (4) Use imagery during…

INTER-SITE COMPARISON OF AMBIENT AEROSOLS IN THE HOUSTON AREA DURING TEXAQS-2000

EPA Science Inventory

During the late summer of 2000 (8/15 - 9/15/00), the Texas Air Quality Study - 2000 (TEXAQS-2000) was conducted to improve understanding of the factors that control the formation and transport of air pollutants along the Gulf Coast of southeastern Texas. An international team ...

Aflatoxin control measures: A basis for improved health in developing countries

USDA-ARS?s Scientific Manuscript database

The goal of this IARC Working Group Report is to produce a document, based on expertly evaluated scientific evidence, which provides a set of clear, concise and focused messages to inform policymakers, international organizations and funders in their decision-making with regards to appropriate aflat...

20 CFR 411.595 - What oversight procedures are planned for the EN payment systems?

Code of Federal Regulations, 2013 CFR

2013-04-01

... EN payment systems? 411.595 Section 411.595 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.595 What oversight... activities to identify areas for improvement. Internal reviews of our systems security controls are regularly...

20 CFR 411.595 - What oversight procedures are planned for the EN payment systems?

Code of Federal Regulations, 2012 CFR

2012-04-01

... EN payment systems? 411.595 Section 411.595 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.595 What oversight... activities to identify areas for improvement. Internal reviews of our systems security controls are regularly...

20 CFR 411.595 - What oversight procedures are planned for the EN payment systems?

Code of Federal Regulations, 2014 CFR

2014-04-01

... EN payment systems? 411.595 Section 411.595 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.595 What oversight... activities to identify areas for improvement. Internal reviews of our systems security controls are regularly...

20 CFR 411.595 - What oversight procedures are planned for the EN payment systems?

Code of Federal Regulations, 2010 CFR

2010-04-01

... EN payment systems? 411.595 Section 411.595 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.595 What oversight... activities to identify areas for improvement. Internal reviews of our systems security controls are regularly...

20 CFR 411.595 - What oversight procedures are planned for the EN payment systems?

Code of Federal Regulations, 2011 CFR

2011-04-01

... EN payment systems? 411.595 Section 411.595 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM Employment Network Payment Systems § 411.595 What oversight... activities to identify areas for improvement. Internal reviews of our systems security controls are regularly...

Reclaiming Rapid Cognition: Improving Decision-making in Command and Control Agencies by Understanding and Enabling Rapid Cognition

DTIC Science & Technology

2007-06-01

Cognition Topics : Intro What is Rapid Cognition? Training Rapid Cognition Decision-Makers Getting Back to Basics—Enabling the Executors Why It...for public release; distribution unlimited 13. SUPPLEMENTARY NOTES Twelfth International Command and Control Research and Technology Symposium (12th...making process . . . when you have the time to do it. Scientists have found that high -stress, quick reaction jobs like firefighting, police officers, ER

ITC/USA/'90; Proceedings of the International Telemetering Conference, Las Vegas, NV, Oct. 29-Nov. 2, 1990

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

Not Available

1990-01-01

This conference presents papers in the fields of airborne telemetry, measurement technology, video instrumentation and monitoring, tracking and receiving systems, and real-time processing in telemetry. Topics presented include packet telemetry ground station simulation, a predictable performance wideband noise generator, an improved drone tracking control system transponder, the application of neural networks to drone control, and an integrated real-time turbine engine flight test system.

Practical Software Measurement: Measuring for Process Management and Improvement,

DTIC Science & Technology

1997-04-01

Ishikawa , Kaoru . Guide to Quality Control, Second Revised Edition. White Plains, N.Y.: UNIPUB-Kraus International Publications, 1986. CMU/SEI-97...begin, you may want to assemble a group of people who work within the process to brainstorm possible reasons for the unusual behavior. Ishikawa charts...control limits and center line. • Cause-and-effect diagrams (also know as Ishikawa charts) allow you to probe for, map, and prioritize a set of factors

Commander’s (Executive officer’s) Guide for Detecting and Deterring Procurement Frauds in Military Unit (Organization) of Armed Forces of Ukraine

DTIC Science & Technology

2009-06-01

suggest various explanations of the nature of fraud. The most significant , from their perspectives, are psychological and sociological explanations. 2...performing managerial functions. To improve the economic management of the military unit, managerial control offers significant advantages. A...models. First, over the last decades, federal agencies have been the subject of significant internal control discussions and legislation. The “Office

Developing and implementing a computerized nursing quality control system in a tertiary general medical center in Israel.

PubMed

Kagan, Ilya; Cohen, Rachel; Fish, Miri; Mezare, Henia Perry

2014-01-01

This article describes the development and implementation of the Nursing Quality Indicators Scale and a quality control system for hospital nursing care, which allows universal access to all external and internal audit results, thus ensuring complete data transparency. Standardized indicators make departments' performance comparable. Key to the new system is nurses' self-audit and responsibility for making quality improvements at the ward level.

Approaches to quality management and accreditation in a genetic testing laboratory

PubMed Central

Berwouts, Sarah; Morris, Michael A; Dequeker, Elisabeth

2010-01-01

Medical laboratories, and specifically genetic testing laboratories, provide vital medical services to different clients: clinicians requesting a test, patients from whom the sample was collected, public health and medical-legal instances, referral laboratories and authoritative bodies. All expect results that are accurate and obtained in an efficient and effective manner, within a suitable time frame and at acceptable cost. There are different ways of achieving the end results, but compliance with International Organization for Standardization (ISO) 15189, the international standard for the accreditation of medical laboratories, is becoming progressively accepted as the optimal approach to assuring quality in medical testing. We present recommendations and strategies designed to aid genetic testing laboratories with the implementation of a quality management system, including key aspects such as document control, external quality assessment, internal quality control, internal audit, management review, validation, as well as managing the human side of change. The focus is on pragmatic approaches to attain the levels of quality management and quality assurance required for accreditation according to ISO 15189, within the context of genetic testing. Attention is also given to implementing efficient and effective quality improvement. PMID:20720559

Transcultural Diabetes Nutrition Algorithm: A Malaysian Application

PubMed Central

Hamdy, Osama; Chin Chia, Yook; Lin Lim, Shueh; Kumari Natkunam, Santha; Yeong Tan, Ming; Sulaiman, Ridzoni; Nisak, Barakatun; Chee, Winnie Siew Swee; Marchetti, Albert; Hegazi, Refaat A.; Mechanick, Jeffrey I.

2013-01-01

Glycemic control among patients with prediabetes and type 2 diabetes mellitus (T2D) in Malaysia is suboptimal, especially after the continuous worsening over the past decade. Improved glycemic control may be achieved through a comprehensive management strategy that includes medical nutrition therapy (MNT). Evidence-based recommendations for diabetes-specific therapeutic diets are available internationally. However, Asian patients with T2D, including Malaysians, have unique disease characteristics and risk factors, as well as cultural and lifestyle dissimilarities, which may render international guidelines and recommendations less applicable and/or difficult to implement. With these thoughts in mind, a transcultural Diabetes Nutrition Algorithm (tDNA) was developed by an international task force of diabetes and nutrition experts through the restructuring of international guidelines for the nutritional management of prediabetes and T2D to account for cultural differences in lifestyle, diet, and genetic factors. The initial evidence-based global tDNA template was designed for simplicity, flexibility, and cultural modification. This paper reports the Malaysian adaptation of the tDNA, which takes into account the epidemiologic, physiologic, cultural, and lifestyle factors unique to Malaysia, as well as the local guidelines recommendations. PMID:24385984

Transcultural diabetes nutrition algorithm: a malaysian application.

PubMed

Hussein, Zanariah; Hamdy, Osama; Chin Chia, Yook; Lin Lim, Shueh; Kumari Natkunam, Santha; Hussain, Husni; Yeong Tan, Ming; Sulaiman, Ridzoni; Nisak, Barakatun; Chee, Winnie Siew Swee; Marchetti, Albert; Hegazi, Refaat A; Mechanick, Jeffrey I

2013-01-01

Glycemic control among patients with prediabetes and type 2 diabetes mellitus (T2D) in Malaysia is suboptimal, especially after the continuous worsening over the past decade. Improved glycemic control may be achieved through a comprehensive management strategy that includes medical nutrition therapy (MNT). Evidence-based recommendations for diabetes-specific therapeutic diets are available internationally. However, Asian patients with T2D, including Malaysians, have unique disease characteristics and risk factors, as well as cultural and lifestyle dissimilarities, which may render international guidelines and recommendations less applicable and/or difficult to implement. With these thoughts in mind, a transcultural Diabetes Nutrition Algorithm (tDNA) was developed by an international task force of diabetes and nutrition experts through the restructuring of international guidelines for the nutritional management of prediabetes and T2D to account for cultural differences in lifestyle, diet, and genetic factors. The initial evidence-based global tDNA template was designed for simplicity, flexibility, and cultural modification. This paper reports the Malaysian adaptation of the tDNA, which takes into account the epidemiologic, physiologic, cultural, and lifestyle factors unique to Malaysia, as well as the local guidelines recommendations.

The effects of mechanical transparency on adjustment to a complex visuomotor transformation at early and late working age.

PubMed

Heuer, Herbert; Hegele, Mathias

2010-12-01

Mechanical tools are transparent in the sense that their input-output relations can be derived from their perceptible characteristics. Modern technology creates more and more tools that lack mechanical transparency, such as in the control of the position of a cursor by means of a computer mouse or some other input device. We inquired whether an enhancement of transparency by means of presenting the shaft of a virtual sliding lever, which governed the transformation of hand position into cursor position, supports performance of aimed cursor movement and the acquisition of an internal model of the transformation in both younger and older adults. Enhanced transparency resulted in an improvement of visual closed-loop control in terms of movement time and curvature of cursor paths. The movement-time improvement was more pronounced at older working age than at younger working age, so that the enhancement of transparency can serve as a means to mitigate age-related declines in performance. Benefits for the acquisition of an internal model of the transformation and of explicit knowledge were absent. Thus, open-loop control in this task did not profit from enhanced mechanical transparency. These findings strongly suggest that environmental support of transparency of the effects of input devices on controlled systems might be a powerful tool to support older users. Enhanced transparency may also improve simulator-based training by increasing motivation, even if training benefits do not transfer to situations without enhanced transparency. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Health locus of control theory in diabetes: a worthwhile approach in managing diabetic foot ulcers?

PubMed

Przybylski, M

2010-06-01

The current global epidemic of type two diabetes mellitus has led to an accompanying increase in both foot ulceration and amputations, which pose significant health problems to populations worldwide. If improved treatment options are to be offered, then we clearly need a better understanding of all aspects of this disease. To date the major focus of diabetes research has been on physical factors, which are undeniably important, but there has been little acknowledgement of the significant psychological effects that can influence health and delay wound healing. The 'health locus of control' (HLC) theory, a psychological theory concerning patients' perceptions of how much control they have over life events (both positive and negative) may well be of use in this patient group. It has been suggested that concordance with treatment is improved when patients have a high 'internal' HLC (as measured by a questionnaire), which aligns with the belief that they have greater control over their health. It has further been suggested that through the implementation of 'group-care' education programmes, patients' attitudes can change, with a shift towards higher 'internal' HLC values. Thus a new approach in patient management might be to implement such education programmes, in the hope of improving adherence to treatment regimens and, hence, patient outcomes. To date there has been little conclusive evidence of the application of this theory, and although various studies have been performed in diabetic populations, only one study has been conducted specifically regarding diabetic foot ulcers. Clearly more research is needed.

Impact of a stance phase microprocessor-controlled knee prosthesis on level walking in lower functioning individuals with a transfemoral amputation.

PubMed

Eberly, Valerie J; Mulroy, Sara J; Gronley, JoAnne K; Perry, Jacquelin; Yule, William J; Burnfield, Judith M

2014-12-01

For individuals with transfemoral amputation, walking with a prosthesis presents challenges to stability and increases the demand on the hip of the prosthetic limb. Increasing age or comorbidities magnify these challenges. Computerized prosthetic knee joints improve stability and efficiency of gait, but are seldom prescribed for less physically capable walkers who may benefit from them. To compare level walking function while wearing a microprocessor-controlled knee (C-Leg Compact) prosthesis to a traditionally prescribed non-microprocessor-controlled knee prosthesis for Medicare Functional Classification Level K-2 walkers. Crossover. Stride characteristics, kinematics, kinetics, and electromyographic activity were recorded in 10 participants while walking with non-microprocessor-controlled knee and Compact prostheses. Walking with the Compact produced significant increase in velocity, cadence, stride length, single-limb support, and heel-rise timing compared to walking with the non-microprocessor-controlled knee prosthesis. Hip and thigh extension during late stance improved bilaterally. Ankle dorsiflexion, knee extension, and hip flexion moments of the prosthetic limb were significantly improved. Improvements in walking function and stability on the prosthetic limb were demonstrated by the K-2 level walkers when using the C-Leg Compact prosthesis. Understanding the impact of new prosthetic designs on gait mechanics is essential to improve prescription guidelines for deconditioned or older persons with transfemoral amputation. Prosthetic designs that improve stability for safety and walking function have the potential to improve community participation and quality of life. © The International Society for Prosthetics and Orthotics 2013.

A Multifaceted Approach to Improve the Availability and Accessibility of Opioids for the Treatment of Cancer Pain in Serbia: Results From the International Pain Policy Fellowship (2006-2012) and Recommendations for Action.

PubMed

Bosnjak, Snezana M; Maurer, Martha A; Ryan, Karen M; Popovic, Ivana; Husain, S Asra; Cleary, James F; Scholten, Willem

2016-08-01

Cancer is the second leading cause of death in Serbia, and at least 14,000-16,000 patients experience moderate-to-severe cancer pain every year. Cancer pain relief has been impeded by inadequate availability of opioid analgesics and barriers to their accessibility. In 2006, a Serbian oncologist was selected as an International Pain Policy Fellow. The fellow identified barriers to opioid availability in Serbia and implemented an action plan to address the unavailability of oral morphine, attitudinal and knowledge barriers about opioids, and barriers in the national opioid control policy, in collaboration with the government, local partners, and international experts, including those from the World Health Organization. Collaborative efforts resulted in availability of immediate-release oral morphine, registration of controlled-release hydromorphone, and reimbursement of oral methadone for cancer pain; numerous educational activities aimed at changing inadequate knowledge and negative attitudes toward opioids; recognition of opioids as essential medicines for palliative care in a new National Palliative Care Strategy; and recognition of the medical use of opioids as psychoactive-controlled substances for the relief of pain included in a new national law on psychoactive-controlled substances, and the development of recommendations for updating regulations on prescribing and dispensing opioids. An increase in opioid consumption at the institutional and national levels also was observed. This article outlines a multifaceted approach to improving access to strong opioids for cancer pain management and palliative care in a middle-income country and offers a potential road map to success. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2012-03-01

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

Selecting and Improving Quasi-Experimental Designs in Effectiveness and Implementation Research.

PubMed

Handley, Margaret A; Lyles, Courtney R; McCulloch, Charles; Cattamanchi, Adithya

2018-04-01

Interventional researchers face many design challenges when assessing intervention implementation in real-world settings. Intervention implementation requires holding fast on internal validity needs while incorporating external validity considerations (such as uptake by diverse subpopulations, acceptability, cost, and sustainability). Quasi-experimental designs (QEDs) are increasingly employed to achieve a balance between internal and external validity. Although these designs are often referred to and summarized in terms of logistical benefits, there is still uncertainty about (a) selecting from among various QEDs and (b) developing strategies to strengthen the internal and external validity of QEDs. We focus here on commonly used QEDs (prepost designs with nonequivalent control groups, interrupted time series, and stepped-wedge designs) and discuss several variants that maximize internal and external validity at the design, execution and implementation, and analysis stages.

VANDENBERG AIR FORCE BASE, CALIF. - The SciSat-1 payload, with fairing installed and attached to its Pegasus launch vehicle, begins rollout to the hot pad and mating to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-08-09

VANDENBERG AIR FORCE BASE, CALIF. - The SciSat-1 payload, with fairing installed and attached to its Pegasus launch vehicle, begins rollout to the hot pad and mating to the L-1011 carrier aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - The L-1011 carrier aircraft is ready for flight after undergoing a Combined Systems Test, an integrated test involving the Pegasus launch vehicle, SciSat-1 spacecraft and L-1011 aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-08-09

VANDENBERG AIR FORCE BASE, CALIF. - The L-1011 carrier aircraft is ready for flight after undergoing a Combined Systems Test, an integrated test involving the Pegasus launch vehicle, SciSat-1 spacecraft and L-1011 aircraft. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF.- At Vandenberg Air Force Base, Calif., spacecraft functional testing is underway on the SciSat-1. The solar arrays are being attached and the communications systems are also being checked out. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-07-12

VANDENBERG AIR FORCE BASE, CALIF.- At Vandenberg Air Force Base, Calif., spacecraft functional testing is underway on the SciSat-1. The solar arrays are being attached and the communications systems are also being checked out. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg Air Force Base, Calif. a covered SciSat-1 spacecraft is lifted onto a rotation stand. The solar arrays will be attached and the communications systems checked out. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-07-29

VANDENBERG AIR FORCE BASE, CALIF. - At Vandenberg Air Force Base, Calif. a covered SciSat-1 spacecraft is lifted onto a rotation stand. The solar arrays will be attached and the communications systems checked out. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF.- The covered SciSat-1 spacecraft is lowered onto a test stand at Vandenberg Air Force Base, Calif., for functional testing. The solar arrays will be attached and the communications systems checked out. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-07-29

VANDENBERG AIR FORCE BASE, CALIF.- The covered SciSat-1 spacecraft is lowered onto a test stand at Vandenberg Air Force Base, Calif., for functional testing. The solar arrays will be attached and the communications systems checked out. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

VANDENBERG AIR FORCE BASE, CALIF.- A covered SciSat-1 spacecraft sits on a test stand at Vandenberg Air Force Base, Calif. The solar arrays will be attached and the communications systems checked out. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-07-29

VANDENBERG AIR FORCE BASE, CALIF.- A covered SciSat-1 spacecraft sits on a test stand at Vandenberg Air Force Base, Calif. The solar arrays will be attached and the communications systems checked out. The SciSat-1 weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

Evaluation of carcinogenic hazard of diesel engine exhaust needs to consider revolutionary changes in diesel technology.

PubMed

McClellan, Roger O; Hesterberg, Thomas W; Wall, John C

2012-07-01

Diesel engines, a special type of internal combustion engine, use heat of compression, rather than electric spark, to ignite hydrocarbon fuels injected into the combustion chamber. Diesel engines have high thermal efficiency and thus, high fuel efficiency. They are widely used in commerce prompting continuous improvement in diesel engines and fuels. Concern for health effects from exposure to diesel exhaust arose in the mid-1900s and stimulated development of emissions regulations and research to improve the technology and characterize potential health hazards. This included epidemiological, controlled human exposure, laboratory animal and mechanistic studies to evaluate potential hazards of whole diesel exhaust. The International Agency for Research on Cancer (1989) classified whole diesel exhaust as - "probably carcinogenic to humans". This classification stimulated even more stringent regulations for particulate matter that required further technological developments. These included improved engine control, improved fuel injection system, enhanced exhaust cooling, use of ultra low sulfur fuel, wall-flow high-efficiency exhaust particulate filters, exhaust catalysts, and crankcase ventilation filtration. The composition of New Technology Diesel Exhaust (NTDE) is qualitatively different and the concentrations of particulate constituents are more than 90% lower than for Traditional Diesel Exhaust (TDE). We recommend that future reviews of carcinogenic hazards of diesel exhaust evaluate NTDE separately from TDE. Copyright © 2012 Elsevier Inc. All rights reserved.

A case study: application of statistical process control tool for determining process capability and sigma level.

PubMed

Chopra, Vikram; Bairagi, Mukesh; Trivedi, P; Nagar, Mona

2012-01-01

Statistical process control is the application of statistical methods to the measurement and analysis of variation process. Various regulatory authorities such as Validation Guidance for Industry (2011), International Conference on Harmonisation ICH Q10 (2009), the Health Canada guidelines (2009), Health Science Authority, Singapore: Guidance for Product Quality Review (2008), and International Organization for Standardization ISO-9000:2005 provide regulatory support for the application of statistical process control for better process control and understanding. In this study risk assessments, normal probability distributions, control charts, and capability charts are employed for selection of critical quality attributes, determination of normal probability distribution, statistical stability, and capability of production processes, respectively. The objective of this study is to determine tablet production process quality in the form of sigma process capability. By interpreting data and graph trends, forecasting of critical quality attributes, sigma process capability, and stability of process were studied. The overall study contributes to an assessment of process at the sigma level with respect to out-of-specification attributes produced. Finally, the study will point to an area where the application of quality improvement and quality risk assessment principles for achievement of six sigma-capable processes is possible. Statistical process control is the most advantageous tool for determination of the quality of any production process. This tool is new for the pharmaceutical tablet production process. In the case of pharmaceutical tablet production processes, the quality control parameters act as quality assessment parameters. Application of risk assessment provides selection of critical quality attributes among quality control parameters. Sequential application of normality distributions, control charts, and capability analyses provides a valid statistical process control study on process. Interpretation of such a study provides information about stability, process variability, changing of trends, and quantification of process ability against defective production. Comparative evaluation of critical quality attributes by Pareto charts provides the least capable and most variable process that is liable for improvement. Statistical process control thus proves to be an important tool for six sigma-capable process development and continuous quality improvement.

On-Orbit Propulsion and Methods of Momentum Management for the International Space Station

NASA Technical Reports Server (NTRS)

Russell, Samuel P.; Spencer, Victor; Metrocavage, Kevin; Swanson, Robert A.; Krajchovich, Mark; Beisner, Matthew; Kamath, Ulhas P.

2010-01-01

Since the first documented design of a space station in 1929, it has been a dream of many to sustain a permanent presence in space. Russia and the US spent several decades competing for a sustained human presence in low Earth orbit. In the 1980 s, Russia and the US began to openly collaborate to achieve this goal. This collaboration lead to the current design of the ISS. Continuous improvement of procedures for controlling the ISS have lead to more efficient propellant management over the years. Improved efficiency combined with the steady use of cargo vehicles has kept ISS propellant levels well above their defined thresholds in all categories. The continuing evolution of propellant and momentum management operational strategies demonstrates the capability and flexibility of the ISS propulsion system. The hard work and cooperation of the international partners and the evolving operational strategies have made the ISS safe and successful. The ISS s proven success is the foundation for the future of international cooperation for sustaining life in space.

Statistical tools and control of internal lubricant content of inhalation grade HPMC capsules during manufacture.

PubMed

Ayala, Guillermo; Díez, Fernando; Gassó, María T; Jones, Brian E; Martín-Portugués, Rafael; Ramiro-Aparicio, Juan

2016-04-30

The internal lubricant content (ILC) of inhalation grade HPMC capsules is a key factor to ensure good powder release when the patient inhales a medicine from a dry powder inhaler (DPI). Powder release from capsules has been shown to be influenced by the ILC. The characteristics used to measure this are the emitted dose, fine particle fraction and mass median aerodynamic diameter. In addition the ILC level is critical for capsule shell manufacture because it is an essential part of the process that cannot work without it. An experiment has been applied to the manufacture of inhalation capsules with the required ILC. A full factorial model was used to identify the controlling factors and from this a linear model has been proposed to improve control of the process. Copyright © 2016 Elsevier B.V. All rights reserved.

Spheres: from Ground Development to ISS Operations

NASA Technical Reports Server (NTRS)

Katterhagen, A.

2016-01-01

SPHERES (Synchronized Position Hold Engage and Reorient Experimental Satellites) is an internal International Space Station (ISS) Facility that supports multiple investigations for the development of multi-spacecraft and robotic control algorithms. The SPHERES National Lab Facility aboard ISS is managed and operated by NASA Ames Research Center (ARC) at Moffett Field California. The SPHERES Facility on ISS consists of three self-contained eight-inch diameter free-floating satellites which perform the various flight algorithms and serve as a platform to support the integration of experimental hardware. SPHERES has served to mature the adaptability of control algorithms of future formation flight missions in microgravity (6 DOF (Degrees of Freedom) / long duration microgravity), demonstrate key close-proximity formation flight and rendezvous and docking maneuvers, understand fault diagnosis and recovery, improve the field of human telerobotic operation and control, and lessons learned on ISS have significant impact on ground robotics, mapping, localization, and sensing in three-dimensions - among several other areas of study.

Analysis and improvement measures of flight delay in China

NASA Astrophysics Data System (ADS)

Zang, Yuhang

2017-03-01

Firstly, this paper establishes the principal component regression model to analyze the data quantitatively, based on principal component analysis to get the three principal component factors of flight delays. Then the least square method is used to analyze the factors and obtained the regression equation expression by substitution, and then found that the main reason for flight delays is airlines, followed by weather and traffic. Aiming at the above problems, this paper improves the controllable aspects of traffic flow control. For reasons of traffic flow control, an adaptive genetic queuing model is established for the runway terminal area. This paper, establish optimization method that fifteen planes landed simultaneously on the three runway based on Beijing capital international airport, comparing the results with the existing FCFS algorithm, the superiority of the model is proved.

Cholera studies*

PubMed Central

Pollitzer, R.

1957-01-01

In discussing prevention, the author deals first with the provision of permanently safe water, supplied from waterworks or wells, and with other improvements in environmental sanitation. Control of food and drinks, public health propaganda and education, and vaccination are also considered under this heading. The greater part of this study is devoted to suppressive measures, affecting the individual, the environment, and persons in the mass. Discussion of the isolation, detection and management of cholera patients, the management of contacts, and the management and treatment of carriers is followed by sections on, inter alia, disinfection, temporary improvements in water supplies, fly control, and personal prophylaxis. In dealing with mass prophylaxis, the author pays particular attention to vaccination. In the concluding sections he goes into the control of pilgrimages and local and international quarantine measures. PMID:13479774

Robonaut 2 (R2) Overview

NASA Technical Reports Server (NTRS)

Diftler, Myron

2010-01-01

This slide presentation reviews the development and uses of the second robot designed to work in space. The presentation reviews the motivation for developing Robonaut, the cooperative commercial relationship with General Motors, the evolution design of Robonaut Robonaut 2 improvements over the first robonaut (R1), Robonaut 2's hand dexterity, finger impedance control, tactile system, finger haptics, arm control, strength, neck movement and head sensors, human interaction, and the controller. Also the plans for use on board the International Space Station are reviewed. The patent for the Phalange Tactile Load Cell is included.

Helicopter internal noise control: Three case histories

NASA Technical Reports Server (NTRS)

Edwards, B. D.; Cox, C. R.

1978-01-01

Case histories are described in which measurable improvements in the cabin noise environments of the Bell 214B, 206B, and 222 were realized. These case histories trace the noise control efforts followed in each vehicle. Among the design approaches considered, the addition of a fluid pulsation damper in a hydraulic system and the installation of elastomeric engine mounts are highlighted. It is concluded that substantial weight savings result when the major interior noise sources are controlled by design, both in altering the noise producing mechanism and interrupting the sound transmission paths.

Tuberculosis in the tropics.

PubMed

Krause, V L; Britton, W J

1993-09-20

Until recently tuberculosis was considered a well controlled disease, at least in developed countries. In developing countries, more than seven million people are affected by active tuberculosis. This situation is exacerbated by poor infrastructure to support tuberculosis control measures and the interaction between tuberculosis and infection with the human immunodeficiency virus. The three major strategies for controlling tuberculosis remain BCG vaccination in children, appropriate preventive therapy and, most importantly, reducing the sources of infection through case finding and curative treatment. Research and resources to improve on these strategies should be given high priority by the international health community.

Protocol for the validation of microbiological control of cellular products according to German regulators recommendations--Boon and Bane for the manufacturer.

PubMed

Störmer, M; Radojska, S; Hos, N J; Gathof, B S

2015-04-01

In order to generate standardized conditions for the microbiological control of HPCs, the PEI recommended defined steps for validation that will lead to extensive validation as shown in this study, where a possible validation principle for the microbiological control of allogeneic SCPs is presented. Although it could be demonstrated that automated culture improves microbial safety of cellular products, the requirement for extensive validation studies needs to be considered. © 2014 International Society of Blood Transfusion.

Characteristics of patients with internal diseases who use relaxation techniques as a coping strategy.

PubMed

Cramer, Holger; Lauche, Romy; Langhorst, Jost; Dobos, Gustav; Paul, Anna

2013-10-01

To assess sociodemographic, clinical, and psychological characteristics of patients with internal diseases who use relaxation techniques as a coping strategy. Cross-sectional analysis among patients with internal diseases. Department of Internal and Integrative Medicine at an academic teaching hospital in Germany. Prior use of relaxation techniques (e.g. meditation, autogenic training), perceived benefit, and perceived harm. Potential predictors of relaxation techniques use (sociodemographic characteristics, health behavior, internal medicine diagnosis, general health status, mental health, satisfaction, and health locus of control) were tested using multiple logistic regression analysis. Of 2486 participants, 1075 (43.2%) reported to have used relaxation techniques, 648 (60.3%) reported benefits, and 11 (1.0%) reported harms. Use of relaxation techniques was independently associated with female gender (Odds ratio [OR]=1.43; 95% confidence interval [CI]=1.08-1.89), higher education (OR=1.32; 95%CI=1.03-1.71), fibromyalgia (OR=1.78; 95%CI=1.22-2.61), and internal health locus of control (OR=1.27; 95%CI=1.01-1.60). Use of relaxation techniques was negatively associated with age below 30 (OR=0.32; 95%CI=0.20-0.52) or above 64 (OR=0.65; 95%CI=0.49-0.88), full-time employment (OR=0.75; 95%CI=0.57-0.98), current smoking (OR=0.72; 95%CI=0.54-0.95), osteoarthritis (OR=0.51; 95%CI=0.34-0.77), rheumatic arthritis (OR=0.59; 95%CI=0.37-0.93), good to excellent health status (OR=0.70; 95%CI=0.52-0.96), and high life satisfaction (OR=0.78; 95%CI=0.62-0.98). In a German sample of patients with internal diseases, relaxation techniques were used as a coping strategy by about 43%. Users were more likely to be middle-aged, female, well-educated, diagnosed with fibromyalgia, not smoking, not full-time employed, and not to have a good health status or high life satisfaction. A high internal health locus of control predicted relaxation techniques use. Considering health locus of control might improve adherence to relaxation techniques in internal medicine patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

The International Polar year 2007-2008; the Arctic human health legacy.

PubMed

Parkinson, Alan J

2007-01-01

Life expectancy in Arctic populations has greatly improved over the last 50 years. Much of this improvement can be attributed health research that has resulted in a reduction in morbidity and mortality from infectious diseases, such as tuberculosis, and the vaccine-preventable diseases of childhood. However, despite these improvements in health indicators of Arctic residents, life expectancy and infant mortality remain higher in indigenous Arctic residents in the US Arctic, northern Canada, and Greenland when compared to Arctic residents of Nordic countries. The International Polar Year (IPY) represents a unique opportunity to focus world attention on Arctic human health and to further stimulate Circumpolar cooperation on emerging Arctic human health concerns. The Arctic Human Health Initiative (AHHI) is an Arctic Council IPY initiative that aims to build and expand on existing Arctic Council and International Union for Circumpolar Health (IUCH) human health research activities. The human health legacy of the IPY will be increased visibility of the human health concerns of Arctic communities, revitalization of cooperative Arctic human health research focused on those concerns, the development of health policies based on research findings, and the subsequent implementation of appropriate interventions, prevention and control measures at the community level.

International Dengue Vaccine Communication and Advocacy: Challenges and Way Forward.

PubMed

Carvalho, Ana; Van Roy, Rebecca; Andrus, Jon

2016-01-01

Dengue vaccine introduction will likely occur soon. However, little has been published on international dengue vaccine communication and advocacy. More effort at the international level is required to review, unify and strategically disseminate dengue vaccine knowledge to endemic countries' decision makers and potential donors. Waiting to plan for the introduction of new vaccines until licensure may delay access in developing countries. Concerted efforts to communicate and advocate for vaccines prior to licensure are likely challenged by unknowns of the use of dengue vaccines and the disease, including uncertainties of vaccine impact, vaccine access and dengue's complex pathogenesis and epidemiology. Nevertheless, the international community has the opportunity to apply previous best practices for vaccine communication and advocacy. The following key strategies will strengthen international dengue vaccine communication and advocacy: consolidating existing coalitions under one strategic umbrella, urgently convening stakeholders to formulate the roadmap for integrated dengue prevention and control, and improving the dissemination of dengue scientific knowledge.

Teaching residents about practice-based learning and improvement.

PubMed

Morrison, Laura J; Headrick, Linda A

2008-08-01

The Accreditation Council for Graduate Medical Education has endorsed practice-based learning and improvement (PBLI) as a core competency for residents. Health professions educators have sought since the early 1990s to incorporate quality improvement principles, methods, and skills into training programs. A literature review indicates that questions remain regarding how to best train physicians to lead the improvement of patient care. The efficacy of two PBLI educational interventions was examined by comparing the performance of participating residents with that of controls. Personal improvement projects (PIPs) and a workshop were implemented to teach PBLI to internal medicine residents. Residents in an ambulatory block rotation were required to complete a PIP. All residents were invited to attend the workshop. Those participating in neither served as controls. An instrument was used to assess applied improvement knowledge for PIP participants at project completion and all residents six to eight months later. Analysis of variance showed no difference between the performance of PIP participants at project completion and PIP participants and controls six to eight months later. A second analysis compared six- to eight-month follow-up data for residents doing PIP only, workshop only, both PIP and workshop, and controls. No significant differences were detected among groups. Interrater reliability for the tool was good. No difference was found between intervention residents and controls in the assessment of their ability to apply improvement knowledge. This suggests that workshops and PIPs alone will not lead to competence in PBLI. Building this competency likely will require more emphasis on experiential learning and resident participation in health care improvement projects.

An energy-saving nonlinear position control strategy for electro-hydraulic servo systems.

PubMed

Baghestan, Keivan; Rezaei, Seyed Mehdi; Talebi, Heidar Ali; Zareinejad, Mohammad

2015-11-01

The electro-hydraulic servo system (EHSS) demonstrates numerous advantages in size and performance compared to other actuation methods. Oftentimes, its utilization in industrial and machinery settings is limited by its inferior efficiency. In this paper, a nonlinear backstepping control algorithm with an energy-saving approach is proposed for position control in the EHSS. To achieve improved efficiency, two control valves including a proportional directional valve (PDV) and a proportional relief valve (PRV) are used to achieve the control objectives. To design the control algorithm, the state space model equations of the system are transformed to their normal form and the control law through the PDV is designed using a backstepping approach for position tracking. Then, another nonlinear set of laws is derived to achieve energy-saving through the PRV input. This control design method, based on the normal form representation, imposes internal dynamics on the closed-loop system. The stability of the internal dynamics is analyzed in special cases of operation. Experimental results verify that both tracking and energy-saving objectives are satisfied for the closed-loop system. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

Self concepts, health locus of control and cognitive functioning associated with health-promoting lifestyles in schizophrenia.

PubMed

Chuang, Shu Ping; Wu, Jo Yung Wei; Wang, Chien Shu; Liu, Chia Hsuan; Pan, Li Hsiang

2016-10-01

The study aimed to investigate the relationship among self concepts, health locus of control, cognitive functioning and health-promoting lifestyles in patients diagnosed with schizophrenia. We examined health-promoting lifestyles through self-efficacy, self-esteem, health locus of control and neurocognitive factors. Fifty-six people with schizophrenia were enrolled in the study group. All subjects participated in the self-esteem (Rosenberg Self-Esteem Scale), self-efficacy (General Self-Efficacy Scale), health locus of control (The Multidimensional Health Locus of Control Scales), health-promoting lifestyles (Health Promotion Life-style Profile-II) and a series of neurocognitive measures. Stepwise regression analysis revealed that self-efficacy, internal health locus of control and attentional set-shifting accounted for 42% of the variance in total health-promoting lifestyles scores. Self-efficacy, self-esteem, internal and powerful others health locus of control and attentional set-shifting were significant predictors for domains of health-promoting lifestyles, respectively. Study findings can help mental health professionals maintain and improve health-promoting behaviors through a better understanding of self-esteem, self-efficacy, health locus of control and neurocognitive functioning among people with schizophrenia. Copyright © 2016 Elsevier Inc. All rights reserved.

Effectiveness of Adherence Therapy for People With Schizophrenia in Turkey: A Controlled Study.

PubMed

Dikec, Gul; Kutlu, Yasemin

2016-04-01

This study used a quasi-experimental design with a pretest-posttest control group and follow-up to determine the efficacy of adherence therapy in patients with schizophrenia in Turkey. The sample of this study consisted of patients with schizophrenia (n=30). The Questionnaire Form, Medication Adherence Rating Scale, Internalized Stigma of Mental Illness Scale, and Beck Cognitive Insight Scale were used. The patients were assigned to experimental (n=15) and control (n=15) groups using the randomization method. The experimental group received adherence therapy in eight sessions. When the scores of the patients in the experimental and control groups were compared at the pretest, posttest, and 3- and 6-months follow ups, a significant difference was only found in the Medication Adherence Rating Scale posttest scores. Adherence therapy is effective in improving adherence to treatment but is not effective with regard to insight and internalized stigma in patients with schizophrenia. Copyright © 2015 Elsevier Inc. All rights reserved.

Improved nutrient removal using in situ continuous on-line sensors with short response time.

PubMed

Ingildsen, P; Wendelboe, H

2003-01-01

Nutrient sensors that can be located directly in the activated sludge processes are gaining in number at wastewater treatment plants. The in situ location of the sensors means that they can be located close to the processes that they aim to control and hence are perfectly suited for automatic process control. Compared to the location of automatic analysers in the effluent from the sedimentation reactors the in situ location means a large reduction in the response time. The settlers typically work as a first-order delay on the signal with a retention time in the range of 4-12 hours depending on the size of the settlers. Automatic process control of the nitrogen and phosphorus removal processes means that considerable improvements in the performance of aeration, internal recirculation, carbon dosage and phosphate precipitation dosage can be reached by using a simple control structure as well as simple PID controllers. The performance improvements can be seen in decreased energy and chemicals consumption and less variation in effluent concentrations of ammonium, total nitrogen and phosphate. Simple control schemes are demonstrated for the pre-denitrification and the post precipitation system by means of full-scale plant experiments and model simulations.

International normalized ratio self-testing and self-management: improving patient outcomes.

PubMed

Pozzi, Matteo; Mitchell, Julia; Henaine, Anna Maria; Hanna, Najib; Safi, Ola; Henaine, Roland

2016-01-01

Long term oral anti-coagulation with vitamin K antagonists is a risk factor of hemorrhagic or thromebomlic complications. Periodic laboratory testing of international normalized ratio (INR) and a subsequent dose adjustment are therefore mandatory. The use of home testing devices to measure INR has been suggested as a potential way to improve the comfort and compliance of the patients and their families, the frequency of monitoring and, finally, the management and safety of long-term oral anticoagulation. In pediatric patients, increased doses to obtain and maintain the therapeutic target INR, more frequent adjustments and INR testing, multiple medication, inconstant nutritional intake, difficult venepunctures, and the need to go to the laboratory for testing (interruption of school and parents' work attendance) highlight those difficulties. After reviewing the most relevant published studies of self-testing and self-management of INR for adult patients and children on oral anticoagulation, it seems that these are valuable and effective strategies of INR control. Despite an unclear relationship between INR control and clinical effects, these self-strategies provide a better control of the anticoagulant effect, improve patients and their family quality of life, and are an appealing solution in term of cost-effectiveness. Structured education and knowledge evaluation by trained health care professionals is required for children, to be able to adjust their dose treatment safely and accurately. However, further data are necessary in order to best define those patients who might better benefit from this multidisciplinary approach.

A Proven Method for Meeting Export Control Objectives in Postal and Shipping Sectors

DTIC Science & Technology

2015-02-01

Mellon University for the operation of the Software Engineering Institute, a federally funded research and development center sponsored by the United...Export Control at USPS 5 3.3 Objectives for Improving Export Screening at USPS 6 4 Development of the New Screening Process 7 4.1 “Walking the Model...Export Screening Development Process 10 Figure 2: Induction and Processing of International Mail 10 Figure 3: The Export Screening Process 11

Improving labeling efficiency in automatic quality control of MRSI data.

PubMed

Pedrosa de Barros, Nuno; McKinley, Richard; Wiest, Roland; Slotboom, Johannes

2017-12-01

To improve the efficiency of the labeling task in automatic quality control of MR spectroscopy imaging data. 28'432 short and long echo time (TE) spectra (1.5 tesla; point resolved spectroscopy (PRESS); repetition time (TR)= 1,500 ms) from 18 different brain tumor patients were labeled by two experts as either accept or reject, depending on their quality. For each spectrum, 47 signal features were extracted. The data was then used to run several simulations and test an active learning approach using uncertainty sampling. The performance of the classifiers was evaluated as a function of the number of patients in the training set, number of spectra in the training set, and a parameter α used to control the level of classification uncertainty required for a new spectrum to be selected for labeling. The results showed that the proposed strategy allows reductions of up to 72.97% for short TE and 62.09% for long TE in the amount of data that needs to be labeled, without significant impact in classification accuracy. Further reductions are possible with significant but minimal impact in performance. Active learning using uncertainty sampling is an effective way to increase the labeling efficiency for training automatic quality control classifiers. Magn Reson Med 78:2399-2405, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Zagreb and Tenerife: Airline Accidents Involving Linguistic Factors

ERIC Educational Resources Information Center

Cookson, Simon

2009-01-01

The International Civil Aviation Organization (ICAO) is currently implementing a program to improve the language proficiency of pilots and air traffic controllers worldwide. In justifying the program, ICAO has cited a number of airline accidents that were at least partly caused by language factors. Two accidents cited by ICAO are analysed in this…

Marketing therapeutic recreation services.

PubMed

Thorn, B E

1984-01-01

The use of marketing strategies can enhance the delivery of therapeutic recreation services. This article discusses how agencies can adapt marketing techniques and use them to identify potential markets, improve image, evaluate external pressures, and maximize internal strengths. Four variables that can be controlled and manipulated in a proposed marketing plan are product, price, place and promotion.

Teacher Control over Interagency Collaboration: A Roadblock for Effective Transitioning of Youth with Disabilities

ERIC Educational Resources Information Center

Meadows, Denis; Davies, Michael; Beamish, Wendi

2014-01-01

Poor post-school outcomes for youth with disabilities have consistently been reported internationally. Interagency collaboration between school systems and post-school services is critical and key to improving post-school life for these youth. An initial Queensland study that benchmarked the teacher practice of 104 transition teachers and…

Redesigning the Role of Deputy Heads in Norwegian Schools--Tensions between Control and Autonomy?

ERIC Educational Resources Information Center

Abrahamsen, Hedvig

2018-01-01

A substantial body of research emphasises school leadership as a major influence on quality improvement in schools. Although numerous studies have identified the importance of the principal, fewer studies have examined the middle management level within schools, the deputy heads and assistant principals. Influenced by international trends, local…

An improved method to quantitate mature plant microRNA in biological matrices using periodate treatment and internal control

USDA-ARS?s Scientific Manuscript database

MicroRNAs (miRNAs) ubiquitously exist in microorganisms, plants and animals, and appear to modulate a wide range of critical biological processes. However, no definitive conclusion has been reached regarding the uptake of exogenous dietary small RNAs into mammalian circulation and organs and cross-k...

Eukaryotic cell flattening

NASA Astrophysics Data System (ADS)

Bae, Albert; Westendorf, Christian; Erlenkamper, Christoph; Galland, Edouard; Franck, Carl; Bodenschatz, Eberhard; Beta, Carsten

2010-03-01

Eukaryotic cell flattening is valuable for improving microscopic observations, ranging from bright field to total internal reflection fluorescence microscopy. In this talk, we will discuss traditional overlay techniques, and more modern, microfluidic based flattening, which provides a greater level of control. We demonstrate these techniques on the social amoebae Dictyostelium discoideum, comparing the advantages and disadvantages of each method.

Integrated risk management for improving internal traffic control, work-zone safety, and mobility during major construction : tech transfer summary.

DOT National Transportation Integrated Search

2012-10-01

Construction work zones are among the most dangerous places to work in any industry in the world. This is because many factors in construction, such as constant change in working environments and driver errors, contribute to a workplace with a higher...

Overcoming the obstacles of implementing infection prevention and control guidelines.

PubMed

Birgand, G; Johansson, A; Szilagyi, E; Lucet, J-C

2015-12-01

Reasons for a successful or unsuccessful implementation of infection prevention and control (IPC) guidelines are often multiple and interconnected. This article reviews key elements from the national to the individual level that contribute to the success of the implementation of IPC measures and gives perspectives for improvement. Governance approaches, modes of communication and formats of guidelines are discussed with a view to improve collaboration and transparency among actors. The culture of IPC influences practices and varies according to countries, specialties and healthcare providers. We describe important contextual aspects, such as relationships between actors and resources and behavioural features including professional background or experience. Behaviour change techniques providing goal-setting, feedback and action planning have proved effective in mobilizing participants and may be key to trigger social movements of implementation. The leadership of international societies in coordinating actions at international, national and institutional levels using multidisciplinary approaches and fostering collaboration among clinical microbiology, infectious diseases and IPC will be essential for success. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Leadership and Cultural Challenges in Operating the International Space Station

NASA Technical Reports Server (NTRS)

Clement, J. L.; Ritsher, J. B.; Saylor, S. A.; Kanas, N.

2006-01-01

Operating the International Space Station (ISS) involves an indefinite, continuous series of long-duration international missions, and this requires an unprecedented degree of cooperation across multiple sites, organizations, and nations. ISS flight controllers have had to find ways to maintain effective team performance in this challenging new context. The goal of this study was to systematically identify and evaluate the major leadership and cultural challenges faces by ISS flight controllers, and to highlight the approaches that they have found most effective to surmount these challenges. We conducted a qualitative survey using a semi-structured interview. Subjects included 14 senior NASA flight controllers who were chosen on the basis of having had substantial experience working with international partners. Data were content analyzed using an iterative process with multiple coders and consensus meetings to resolve discrepancies. To further explore the meaning of the interview findings, we also conducted some new analyses of data from a previous questionnaire study of Russian and American ISS mission control personnel. The interview data showed that respondents had substantial consensus on several leadership and cultural challenges and on key strategies for dealing with them, and they offered a wide range of specific tactics for implementing these strategies. Surprisingly few respondents offered strategies for addressing the challenge of working with team members whose native language is not American English. The questionnaire data showed that Americans think it is more important than Russians that mission control personnel speak the same dialect of one shared common language. Although specific to the ISS program, our results are consistent with recent management, cultural, and aerospace research. We aim to use our results to improve training for current and future ISS flight controllers.

Combining neural and behavioral indicators in the assessment of internalizing psychopathology in children and adolescents.

PubMed

Moser, Jason S; Durbin, C Emily; Patrick, Christopher J; Schmidt, Norman B

2015-01-01

Anxiety and mood disorders are among the most prevalent mental health problems affecting our youth. We propose that assessment and treatment efforts in this area can benefit from a focus on developmentally sensitive neurobehavioral trait constructs, that is, individual difference constructs with direct referents in both neurobiology and behavior across the lifespan. This approach dovetails with the National Institute of Mental Health's Research Domain Criteria initiative, which aims to improve classification and treatment of psychopathology by delineating dimensions of functioning that transcend measurement domains and traditional diagnostic categories. We highlight two neurobehavioral dimensions with clear relevance for understanding internalizing problems at differing ages: (a) defensive reactivity and (b) cognitive control. Individual differences in defensive reactivity are posited to reflect variations in sensitivity of the brain's negative valence systems, whereas differences in cognitive control are theorized to reflect variations in neural systems dedicated to regulating behavior and affect. Focusing on these target constructs, we illustrate a psychoneurometric approach to assessment of internalizing psychopathology entailing use of neural, self-report, and behavioral indicators. We address the feasibility of the psychoneurometric approach for clinical application and present results from a pilot study demonstrating expected associations for neural, parent-report, and behavioral measures of defensive reactivity and cognitive control with internalizing symptoms in preschoolers. Together, our conceptual and empirical analyses highlight the promise of multimethod, dimensional assessment of internalizing psychopathology in the lab and in the clinic.

[On the improvement of the legal support of the food safety in the conditions of trade and economic integration of states-members of the Customs union and the Russian Federation's accession to the WTO].

PubMed

Bragina, I V; Aksenova, O I; Bokit'ko, B G; Gorsky, A A

2013-01-01

In the article priority activities of The Federal Service for the Oversight of Consumer Protection and Welfare on improvement of standard legal support of safety of foodstuff and control of compliance of foodstuff to legislation requirements are reported. The main documents directed on harmonization of the international requirements with national ones and requirements of the Customs union on safety of foodstuff are submitted. Work within a framework of Russian Federation's accession to the WTO is described. And data on control of quality and safety of foodstuff are provided also.

Effects of glucosamine-chondroitin combination on synovial fluid IL-1β, IL-6, TNF-α and PGE2 levels in internal derangements of temporomandibular joint

PubMed Central

Esen, Emin; Tatli, Ufuk

2015-01-01

Background The aim of the present study was to evaluate the effects of glucosamine-chondroitin sulphate combination on internal derangements of temporomandibular joint in clinical and biochemical manners. Material and Methods This randomized clinical study included 31 cases reporting joint tenderness, in which disc displacement was detected on MR imaging. In all patients, synovial fluid sampling was performed under local anesthesia. In the study group, the patients were prescribed a combination of 1500 mg glucosamine and 1200 mg chondroitin sulphate, while patients in the control group were only prescribed 50 mg tramadol HCl (twice daily) for pain control. After 8 weeks, synovial fluid sampling was repeated in the same manner. The levels of pain, maximum mouth opening (MMO), synovial fluid IL-1ß, IL-6, TNF-α and PGE2 measured before and after pharmacological intervention were compared. Results The reduction in pain levels was significant in both groups. There was no significant difference between two groups in terms of pain reduction. The improvement in MMO was significant in the study group but it was not in the control group. The MMO improvement was significantly higher in the study group compared to the control group. In the study group, significant decrease was observed in PGE2 level, while the decreases in IL-1β, IL-6 and TNF-α levels were not significant. In the control group, no significant decrease was observed in any of the inflammatory cytokines after 8 weeks, moreover IL-1ß and IL-6 levels were increased. Alterations of IL-1ß and IL-6 levels were significant in study group while TNF-α and PGE2 levels were not, compared to control group. Conclusions In conclusion, these results might suggest that glucosamine-chondroitin combination significantly increases the MMO and decreases the synovial fluid IL1β and IL6 levels in internal derangements of TMJ compared to tramadol. The modifications of synovial fluid TNF-α and PGE2 levels do not reach statistical significance. This combination also provides efficient pain relief in similar level with tramadol, a narcotic analgesic. Key words: Chondroitin sulphate, glucosamine, internal derangement, TMJ, tramadol. PMID:25662545

[Acceptance and commitment therapy (ACT) and improving chess performance in promising young chess-players].

PubMed

Ruiz, Francisco J; Luciano, Carmen

2009-08-01

Acceptance and Commitment Therapy (ACT) is shown to be effective in relatively distant fields from the so-called psychological disorders. One of these areas is sport performance improvement. The aim of the current study is to expand the application of brief ACT protocols to improve chess-players' performance. In a previous study, a brief protocol was applied to international-level adult chess-players that was effective. The current study aims to apply an equivalent brief ACT protocol, but in this case, applied in a group format to promising young chess-players. In addition, this brief protocol is compared to a non-intervention control condition. Results show that the ACT brief protocol improved the performance in 5 out of 7 participants, and that none of the chess-players in the control condition reached the established change criterion. The differences between the conditions in chess performance were statistically significant. The results are discussed, emphasizing the replicated impact of a brief ACT protocol on the improvement of chess-players' performance.

The effectiveness of dried cranberries ( Vaccinium macrocarpon) in men with lower urinary tract symptoms.

PubMed

Vidlar, Ales; Vostalova, Jitka; Ulrichova, Jitka; Student, Vladimir; Stejskal, David; Reichenbach, Richard; Vrbkova, Jana; Ruzicka, Filip; Simanek, Vilim

2010-10-01

Lower urinary tract symptoms (LUTS) are a common condition in older men. The objective of the present study was to evaluate the efficacy and tolerability of cranberry (Vaccinium macrocarpon) powder in men at risk of prostate disease with LUTS, elevated prostate-specific antigen (PSA), negative prostate biopsy and clinically confirmed chronic non-bacterial prostatitis. Forty-two participants received either 1500 mg of the dried powdered cranberries per d for 6 months (cranberry group; n 21) or no cranberry treatment (control group; n 21). Physical examination, International Prostate Symptom Score, quality of life (QoL), five-item version of the International Index of Erectile Function (IIEF-5), basic clinical chemistry parameters, haematology, Se, testosterone, PSA (free and total), C-reactive protein (CRP), antioxidant status, transrectal ultrasound prostate volume, urinary flow rate, ultrasound-estimated post-void residual urine volume at baseline, and at 3 and 6 months, and urine ex vivo anti-adherence activity were determined in all subjects. In contrast to the control group, patients in the cranberry group had statistically significant improvement in International Prostate Symptom Score, QoL, urination parameters including voiding parameters (rate of urine flow, average flow, total volume and post-void residual urine volume), and lower total PSA level on day 180 of the study. There was no influence on blood testosterone or serum CRP levels. There was no statistically significant improvement in the control group. The results of the present trial are the first firm evidence that cranberries may ameliorate LUTS, independent of benign prostatic hyperplasia or C-reactive protein level.

Bridging the gap between financial reporting and the revenue cycle.

PubMed

Clark, Kari; Bang, Derek A

2012-09-01

Implementing a standardized financial reporting and revenue cycle monitoring platform can help healthcare organizations improve their net revenue reporting and budgeting processes. Consistent, standardized data help the finance office estimate accounts receivable reserves more accurately, streamline the month-end closing process, and strengthen internal controls. The benefits of standardizing the finance and revenue cycle functions are particularly significant in large organizations with multiple facilities, but even single-facility providers can benefit from improved communication between the business office and finance.

National Aeronautics and Space Administration: Leadership and Systems Needed to Effect Financial Management Improvements

DTIC Science & Technology

2002-03-20

financial reporting requirements-an unqualified opinion on its financial statements, no material internal control weaknesses, and financial management systems that are in substantial compliance the requirements of the Federal Financial Management Improvement Act (FFMIA). This implied that NASA not only could generate reliable information once a year for external financial reporting purposes but also could provide accurate, reliable information for day-today decision-making. In contrast with the unqualified or clean audit opinions of its previous

Structured patient handoff on an internal medicine ward: A cluster randomized control trial.

PubMed

Tam, Penny; Nijjar, Aman P; Fok, Mark; Little, Chris; Shingina, Alexandra; Bittman, Jesse; Raghavan, Rashmi; Khan, Nadia A

2018-01-01

The effect of a multi-faceted handoff strategy in a high volume internal medicine inpatient setting on process and patient outcomes has not been clearly established. We set out to determine if a multi-faceted handoff intervention consisting of education, standardized handoff procedures, including fixed time and location for face-to-face handoff would result in improved rates of handoff compared with usual practice. We also evaluated resident satisfaction, health resource utilization and clinical outcomes. This was a cluster randomized controlled trial in a large academic tertiary care center with 18 inpatient internal medicine ward teams from January-April 2013. We randomized nine inpatient teams to an intervention where they received an education session standardizing who and how to handoff patients, with practice and feedback from facilitators. The control group of 9 teams continued usual non-standardized handoffs. The primary process outcome was the rate of patients handed over per 1000 patient nights. Other process outcomes included perceptions of inadequate handoff by overnight physicians, resource utilization overnight and hospital length of stay. Clinical outcomes included medical errors, frequency of patients requiring higher level of care overnight, and in-hospital mortality. The intervention group demonstrated a significant increase in the rate of patients handed over to the overnight physician (62.90/1000 person-nights vs. 46.86/1000 person-nights, p = 0.002). There was no significant difference in other process outcomes except resource utilization was increased in the intervention group (26.35/1000 person-days vs. 17.57/1000 person-days, p-value = 0.01). There was no significant difference between groups in medical errors (4.8% vs. 4.1%), need for higher level of care or in hospital mortality. Limitations include a dependence of accurate record keeping by the overnight physician, the possibility of cross-contamination in the handoff process, analysis at the cluster level and an overall low number of clinical events. Implementation of a multi-faceted resident handoff intervention did not result in a significant improvement in patient safety although did improve number of patients handed off. Novel methods to improve handoff need to be explored. Registered at ClinicalTrials.gov: NCT01796756.

Diabetes prevention and control in the workplace: a pilot project for county employees.

PubMed

Barham, Kalleen; West, Susan; Trief, Paula; Morrow, Cynthia; Wade, Michael; Weinstock, Ruth S

2011-01-01

To improve nutrition and physical activity of county employees and promote weight loss. Random assignment to begin the program when first offered or after 3 months ("wait control" group). Worksite. Onondaga County employees (n = 45) at risk for diabetes (n = 35) or with diabetes (n = 10). Mean (±SD) age = 51.2 (± 8.0) years and body mass index (BMI) = 37.3 ± (6.8 kg/m). Twelve weekly healthy lifestyle sessions based on the Diabetes Prevention Program curriculum, followed by monthly sessions for up to 12 months. Medical: Weight, BMI, waist circumference, blood pressure, fasting glucose, lipid, and hemoglobin A1c levels. Psychosocial/behavioral: Health-related quality of life Short Form-12, Impact of Weight on Quality of Life Scale), physical activity (International Physical Activity Questionnaire), eating behavior (3-Factor Eating Questionnaire, National Cancer Institute Fat Screener), job satisfaction. The intervention group lost significant weight compared to the wait control group over the first 3 months (mean [95% CI], -2.23 kg [-3.5 to 0.97]) vs [+ 0.73 kg (+0.17 to +1.28)], with a decrease in BMI (P < .001) and waist circumference (P = .004), an increase in physical activity (International Physical Activity Questionnaire, P = .011) and lower dietary fat intake (P = .018). Over 12 months, 22.5% (9/40) lost more than 5% body weight and 12.5% (5/40) lost more than 7% body weight. After the first 3 months, there was gradual partial weight regain but reduction in waist circumference was maintained. The intervention group demonstrated significant improvement in Impact of Weight on Quality of Life Scale (P < .001), 3-Factor Eating (cognitive restraint P < .001, uncontrolled eating P = .003, and emotional eating P = .001), International Physical Activity Questionnaire (P = .011), and Short Form-12 Physical Component Summary (P = .048). No improvements were observed in blood pressure, lipid, hemoglobin A1c, or glucose levels. Job satisfaction was inversely related to BMI at baseline (P = .001) with a trend for improvement with the modest weight loss. A worksite intervention program can help government employees adopt healthier lifestyles and achieve modest weight loss.

A 12-week rehabilitation program improves body composition, pain sensation, and internal/external torques of baseball pitchers with shoulder impingement symptom.

PubMed

Cha, Jun-Youl; Kim, Jae-Hak; Hong, Ju; Choi, Young-Tae; Kim, Min-Ho; Cho, Ji-Hyun; Ko, Il-Gyu; Jee, Yong-Seok

2014-02-01

The aim of this study was to investigate the effects of a 12-week rehabilitation program on body composition, shoulder pain, and isokinetic internal/external torques of pitchers with impingement syndrome. A total of 30 pitchers were divided into 2 groups: experimental group (EG, n = 16) and control group (CG, n= 14). The rehabilitation program consisted of physical therapy, warm-up, work-out, and cool-down. As results, body weight and fat mass of EG were decreased whereas muscle mass of EG was significantly increased after the experiment. The pain degrees in resting, normal daily activity, and strenuous activity on the numeric pain rating scale were significantly decreased in the EG. The internal and external peak torques (PTs) of uninvolved and involved sides of EG were increased in EG after 12 weeks. Such results provide a deficit ratio of both sides in EG close to normal values. The ratios of internal/external PTs in EG were also close to the reference values. The internal and external total works of both sides in EG were similar to the values of PT. The fatigue indices of internal and external rotators of both sides in EG were decreased. As a conclusion, a 12-week rehabilitation program reduced the shoulder pain, improved the body composition and enhanced the isokinetic shoulder internal/external rotators in EG with impingement symptoms. Also the study suggested that the rehabilitation program evened out the ratio between internal and external rotators and lowered the fatigue level after the experiment.

A 12-week rehabilitation program improves body composition, pain sensation, and internal/external torques of baseball pitchers with shoulder impingement symptom

PubMed Central

Cha, Jun-Youl; Kim, Jae-Hak; Hong, Ju; Choi, Young-Tae; Kim, Min-Ho; Cho, Ji-Hyun; Ko, Il-Gyu; Jee, Yong-Seok

2014-01-01

The aim of this study was to investigate the effects of a 12-week rehabilitation program on body composition, shoulder pain, and isokinetic internal/external torques of pitchers with impingement syndrome. A total of 30 pitchers were divided into 2 groups: experimental group (EG, n = 16) and control group (CG, n= 14). The rehabilitation program consisted of physical therapy, warm-up, work-out, and cool-down. As results, body weight and fat mass of EG were decreased whereas muscle mass of EG was significantly increased after the experiment. The pain degrees in resting, normal daily activity, and strenuous activity on the numeric pain rating scale were significantly decreased in the EG. The internal and external peak torques (PTs) of uninvolved and involved sides of EG were increased in EG after 12 weeks. Such results provide a deficit ratio of both sides in EG close to normal values. The ratios of internal/external PTs in EG were also close to the reference values. The internal and external total works of both sides in EG were similar to the values of PT. The fatigue indices of internal and external rotators of both sides in EG were decreased. As a conclusion, a 12-week rehabilitation program reduced the shoulder pain, improved the body composition and enhanced the isokinetic shoulder internal/external rotators in EG with impingement symptoms. Also the study suggested that the rehabilitation program evened out the ratio between internal and external rotators and lowered the fatigue level after the experiment. PMID:24678503

Secondary Prevention of Cardiovascular Disease in Patients With Type 2 Diabetes Mellitus: International Insights From the TECOS Trial (Trial Evaluating Cardiovascular Outcomes With Sitagliptin).

PubMed

Pagidipati, Neha J; Navar, Ann Marie; Pieper, Karen S; Green, Jennifer B; Bethel, M Angelyn; Armstrong, Paul W; Josse, Robert G; McGuire, Darren K; Lokhnygina, Yuliya; Cornel, Jan H; Halvorsen, Sigrun; Strandberg, Timo E; Delibasi, Tuncay; Holman, Rury R; Peterson, Eric D

2017-09-26

Intensive risk factor modification significantly improves outcomes for patients with diabetes mellitus and cardiovascular disease. However, the degree to which secondary prevention treatment goals are achieved in international clinical practice is unknown. Attainment of 5 secondary prevention parameters-aspirin use, lipid control (low-density lipoprotein cholesterol <70 mg/dL or statin therapy), blood pressure control (<140 mm Hg systolic, <90 mm Hg diastolic), angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, and nonsmoking status-was evaluated among 13 616 patients from 38 countries with diabetes mellitus and known cardiovascular disease at entry into TECOS (Trial Evaluating Cardiovascular Outcomes With Sitagliptin). Logistic regression was used to evaluate the association between individual and regional factors and secondary prevention achievement at baseline. Cox proportional hazards regression analysis was used to determine the association between baseline secondary prevention achievement and cardiovascular death, myocardial infarction, or stroke. Overall, 29.9% of patients with diabetes mellitus and cardiovascular disease achieved all 5 secondary prevention parameters at baseline, although 71.8% achieved at least 4 parameters. North America had the highest proportion (41.2%), whereas Western Europe, Eastern Europe, and Latin America had proportions of ≈25%. Individually, blood pressure control (57.9%) had the lowest overall attainment, whereas nonsmoking status had the highest (89%). Over a median 3.0 years of follow-up, a higher baseline secondary prevention score was associated with improved outcomes in a step-wise graded relationship (adjusted hazard ratio, 0.60; 95% confidence interval, 0.47-0.77 for those patients achieving all 5 measures versus those achieving ≤2). In an international trial population, significant opportunities exist to improve the quality of cardiovascular secondary prevention care among patients with diabetes mellitus and cardiovascular disease, which in turn could lead to reduced risk of downstream cardiovascular events. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00790205. © 2017 American Heart Association, Inc.

Situation analysis of the National Comprehensive Cancer Control Program (2013) in the I. R. of Iran; assessment and recommendations based on the IAEA imPACT mission.

PubMed

Rouhollahi, Mohammad Reza; Mohagheghi, Mohammad Ali; Mohammadrezai, Narges; Ghiasvand, Reza; Ghanbari Motlagh, Ali; Harirchi, Iraj; Zendehdel, Kazem

2014-04-01

Iran was engaged in the Program of Action for Cancer Therapy (PACT) in 2012, and delegates from the International Atomic Energy Agency (IAEA), and the World Health Organization (WHO) evaluated the National Cancer Control Program (NCCP) status (the imPACT mission), based on which they provided recommendations for improvements of NCCP in the I.R. of Iran. We reported the results of this situational analysis and discussed the recommendations and their implication in the promotion of NCCP in the I.R. of Iran.  International delegates visited the I.R. of Iran and evaluated different aspects and capacities of NCCP in Iran. In addition, a Farsi version of the WHO/IAEA self-assessment tool was completed by local experts and stakeholders, including experts from different departments of the Ministry of Health and Medical Education (MOHME) and representatives from the National Cancer Research Network (NCRN). Following these evaluations, the PACT office provided recommendations for improving the NCCP in Iran. Almost all the recommendations were endorsed by MOHME. The PACT program provided 31 recommendations for improvement of NCCP in Iran in six categories, including planning, cancer registration and information, prevention, early detection, diagnosis and treatment, and palliative care. The most important recommendation was to establish a strong, multi-sectoral NCCP committee and develop an updated national cancer control program. The imPACT mission report provided a comprehensive view about the NCCP status in Iran. An appropriate response to these recommendations and filing the observed gaps will improve the NCCP status in the I.R. of Iran.

National surveys on internal quality control for blood gas analysis and related electrolytes in clinical laboratories of China.

PubMed

Duan, Min; Wang, Wei; Zhao, Haijian; Zhang, Chuanbao; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

2018-05-01

Internal quality control (IQC) is essential for precision evaluation and continuous quality improvement. This study aims to investigate the IQC status of blood gas analysis (BGA) in clinical laboratories of China from 2014 to 2017. IQC information on BGA (including pH, pCO2, pO2, Na+, K+, Ca2+, Cl-) was submitted by external quality assessment (EQA) participant laboratories and collected through Clinet-EQA reporting system in March from 2014 to 2017. First, current CVs were compared among different years and measurement systems. Then, percentages of laboratories meeting five allowable imprecision specifications for each analyte were calculated, respectively. Finally, laboratories were divided into different groups based on control rules and frequency to compare their variation trend. The current CVs of BGA were significantly decreasing from 2014 to 2017. pH and pCO2 got the highest pass rates when compared with the minimum imprecision specification, whereas pO2, Na+, K+, Ca2+, Cl- got the highest pass rates when 1/3 TEa imprecision specification applied. The pass rates of pH, pO2, Na+, K+, Ca2+, Cl- were significantly increasing during the 4 years. The comparisons of current CVs among different measurement systems showed that the precision performance of different analytes among different measurement systems had no regular distribution from 2014 to 2017. The analysis of IQC practice indicated great progress and improvement among different years. The imprecision performance of BGA has improved from 2014 to 2017, but the status of imprecision performance in China remains unsatisfying. Therefore, further investigation and continuous improvement measures should be taken.

Control Laws for a Dual-Spin Stabilized Platform

NASA Technical Reports Server (NTRS)

Lim, K. B.; Moerder, D. D.

2008-01-01

This paper describes two attitude control laws suitable for atmospheric flight vehicles with a steady angular momentum bias in the vehicle yaw axis. This bias is assumed to be provided by an internal flywheel, and is introduced to enhance roll and pitch stiffness. The first control law is based on Lyapunov stability theory, and stability proofs are given. The second control law, which assumes that the angular momentum bias is large, is based on a classical PID control. It is shown that the large yaw-axis bias requires that the PI feedback component on the roll and pitch angle errors be cross-fed. Both control laws are applied to a vehicle simulation in the presence of disturbances for several values of yaw-axis angular momentum bias. It is seen that both control laws provide a significant improvement in attitude performance when the bias is sufficiently large, but the nonlinear control law is also able to provide improved performance for a small value of bias. This is important because the smaller bias corresponds to a smaller requirement for mass to be dedicated to the flywheel.

Strengthening core public health capacity based on the implementation of the International Health Regulations (IHR) (2005): Chinese lessons

PubMed Central

Liu, Bin; Sun, Yan; Dong, Qian; Zhang, Zongjiu; Zhang, Liang

2015-01-01

As an international legal instrument, the International Health Regulations (IHR) is internationally binding in 196 countries, especially in all the member states of the World Health Organization (WHO). The IHR aims to prevent, protect against, control, and respond to the international spread of disease and aims to cut out unnecessary interruptions to traffic and trade. To meet IHR requirements, countries need to improve capacity construction by developing, strengthening, and maintaining core response capacities for public health risk and Public Health Emergency of International Concern (PHEIC). In addition, all the related core capacity requirements should be met before June 15, 2012. If not, then the deadline can be extended until 2016 upon request by countries. China has promoted the implementation of the IHR comprehensively, continuingly strengthening the core public health capacity and advancing in core public health emergency capacity building, points of entry capacity building, as well as risk prevention and control of biological events (infectious diseases, zoonotic diseases, and food safety), radiological, nuclear, and chemical events, and other catastrophic events. With significant progress in core capacity building, China has dealt with many public health emergencies successfully, ensuring that its core public health capacity has met the IHR requirements, which was reported to WHO in June 2014. This article describes the steps, measures, and related experiences in the implementation of IHR in China. PMID:26029897

Overview, Control Strategies, and Lessons Learned in the CDC Response to the 2014-2016 Ebola Epidemic.

PubMed

Bell, Beth P; Damon, Inger K; Jernigan, Daniel B; Kenyon, Thomas A; Nichol, Stuart T; O'Connor, John P; Tappero, Jordan W

2016-07-08

During 2014-2016, CDC, working with U.S. and international partners, mounted a concerted response to end the unprecedented epidemic of Ebola virus disease (Ebola) in West Africa. CDC's response, which was the largest in the agency's history, was directed simultaneously at controlling the epidemic in West Africa and strengthening preparedness for Ebola in the United States. Although experience in responding to approximately 20 Ebola outbreaks since 1976 had provided CDC and other international responders an understanding of the disease and how to stop its spread, the epidemic in West Africa presented new and formidable challenges. The initial response was slow and complicated for several reasons, including wide geographic spread of cases, poor public health and societal infrastructure, sociodemographic factors, local unfamiliarity with Ebola, and distrust of government and health care workers. In the United States, widespread public alarm erupted after Ebola cases were diagnosed in Dallas, Texas, and New York City, New York. CDC, in collaboration with its U.S. and international counterparts, applied proven public health strategies as well as innovative new approaches to help control the Ebola epidemic in West Africa and strengthen public health readiness in the United States. Lessons learned include the recognition that West African and other countries need effective systems to detect and stop infectious disease threats, the need for stronger international surge capacity for times when countries are overwhelmed by an outbreak, and the importance of improving infection prevention and control in health care settings. The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

Pelvic floor muscle training to improve urinary incontinence in young, nulliparous sport students: a pilot study.

PubMed

Da Roza, Thuane; de Araujo, Maíta Poli; Viana, Rui; Viana, Sara; Jorge, Renato Natal; Bø, Kari; Mascarenhas, Teresa

2012-08-01

Urinary incontinence (UI) is prevalent in sport students. We hypothesized that pelvic floor muscle training (PFMT) can improve pelvic floor muscle (PFM) strength and symptoms of UI in this group of physically active women. Sixteen sport students with UI participated in this pre-post test pilot study. However, only seven of them, mean age 20.0 ± 0.8 years, completed the 8-week program. Activity level was measured by the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The outcome measure was the International Consultation on Incontinence Questionnaire-Short Form (ICIQ UI SF). PFM strength was measured by manometry as maximum voluntary contraction (MVC). Vaginal resting pressure improved by 17.4 cmH(2)O (SD 6.7), p = 0.04 and MVC by 16.4 cmH(2)O (SD 5.8), p = 0.04. ICIQ UI SF score, frequency, and amount of leakage showed statistically significant improvement. PFMT increased PFM strength and reduced frequency and amount of UI episodes in sport students that completed an 8-week PFMT program. Randomized controlled trials are warranted to confirm these results.

Evaluation of a Shoulder Injury Prevention Program in Wheelchair Basketball.

PubMed

Wilroy, Jereme; Hibberd, Elizabeth

2017-11-15

Previous literature has theorized that alterations in shoulder physical characteristics are present in wheelchair athletes and contribute to shoulder pain and injury. Limited empirical evidence is present that evaluates the effectiveness of a shoulder injury prevention program focusing on improving these altered characteristics. To evaluate the effectiveness of a 6-week intervention program at improving characteristics that increases the risk of developing pain or shoulder injury. Pre and post-test. Home-based and controlled laboratory. Seven collegiate wheelchair athletes. Shoulder range of motion (ROM) and scapular muscle strength were assessed, and a 5-minute injury prevention program was taught to participants. Participants completed the intervention 3 times per week for 6 weeks. Following completion of the program, a post-intervention screening was performed. Internal/external rotation ROM, retraction strength, and internal/external rotation strength. Participants experienced a significant improvement in dominant limb shoulder internal rotation ROM (t6=3.56,p=0.012) with an average increase of 11.4° of IR ROM, and a significant improvement in dominant limb shoulder external rotation (ER) ROM (t6=2.79,p=0.032) with an average increase of 8.0° of ER ROM. There were no significant increases in shoulder IR or ER strength and scapular retraction strength (p>0.05). Improvements in ROM have previously been linked to decreases in shoulder pain and injury in other upper-extremity dominant sports by improving scapular kinematics. These results provide evidence that a 6-week strengthening and stretching intervention program may decrease risk factors for shoulder injury in wheelchair athletics.

Improved Control of Charging Voltage for Li-Ion Battery

NASA Technical Reports Server (NTRS)

Timmerman, Paul; Bugga, Ratnakumar

2006-01-01

The protocol for charging a lithium-ion battery would be modified, according to a proposal, to compensate for the internal voltage drop (charging current internal resistance of the battery). The essence of the modification is to provide for measurement of the internal voltage drop and to increase the terminal-voltage setting by the amount of the internal voltage drop. Ordinarily, a lithium-ion battery is charged at constant current until its terminal voltage attains a set value equal to the nominal full-charge potential. The set value is chosen carefully so as not to exceed the lithium-plating potential, because plated lithium in metallic form constitutes a hazard. When the battery is charged at low temperature, the internal voltage drop is considerable because the electrical conductivity of the battery electrolyte is low at low temperature. Charging the battery at high current at any temperature also gives rise to a high internal voltage drop. In some cases, the internal voltage drop can be as high as 1 volt per cell. Because the voltage available for charging is less than the terminal voltage by the amount of the internal voltage drop, the battery is not fully charged (see figure), even when the terminal voltage reaches the set value. In the modified protocol, the charging current would be periodically interrupted so that the zero-current battery-terminal voltage indicative of the state of charge could be measured. The terminal voltage would also be measured at full charging current. The difference between the full-current and zero-current voltages would equal the internal voltage drop. The set value of terminal voltage would then be increased beyond the nominal full-charge potential by the amount of the internal voltage drop. This adjustment would be performed repeatedly, in real time, so that the voltage setting would track variations in the internal voltage drop to afford full charge without risk of lithium plating. If the charging current and voltage settings were controlled by a computer, then this method of charge control could readily be implemented in software.

Comparison of infection between internal-external and external percutaneous transhepatic biliary drainage in treating patients with malignant obstructive jaundice.

PubMed

Xu, Chuan; Huang, Xin-En; Wang, Shu-Xiang; Lv, Peng-Hua; Sun, Ling; Wang, Fu-An

2015-01-01

Percutaneous transhepatic biliary drainage (PTBD) is a form of palliative care for patients with malignant obstructive jaundice. We here compared the infection incidence between internal-external and external drainage for patients with malignant obstructive jaundice. Patients with malignant obstructive jaundice without infection before surgery receiving internal-external or external drainage from January 2008 to July 2014 were recruited. According to percutaneous transhepatic cholangiography (PTC), if the guide wire could pass through the occlusion and enter the duodenum, we recommended internal-external drainage, and external drainage biliary drainage was set up if the occlusion was not crossed. All patients with infection after procedure received a cultivation of blood and a bile bacteriological test. Among 110 patients with malignant obstructive jaundice, 22 (52.4%) were diagnosed with infection after the procedure in the internal-external drainage group, whereas 19 (27.9%) patients were so affected in the external drainage group, the difference being significant (p<0.05). In 8 patients (36.3%) in the internal-external group infection was controlled, as compared to 12 (63.1%) in the external group (p<0.05). The mortality rate for patients with infection not controlled in internal-external group in one month was 42.8%, while this rate in external group was 28.6% (p<0.05). External drainage is a good choice, which could significantly reduce the chance of biliary infection caused by bacteria, and decrease the mortality rate at one month and improve the long-term prognosis.

Factors Associated with the Adoption of Food Safety Controls by the Mexican Meat Industry

NASA Astrophysics Data System (ADS)

Maldonado-Simán, Ema; Martínez-Hernández, Pedro Arturo; García-Muñiz, José G.; Cadena-Meneses, José

Food marketing at international and domestic markets has focused on processing systems that improve food safety. The objective of this research is to determine the factors influencing the implementation of the HACCP system in the Mexican meat industry, and to identify the main marketing destination of their products. Only 18.5% of enterprises reports fully operational HACCP in their plants. The main destination of their production in the domestic market is supermarkets, suppliers and distributors and specific niches of the domestic market. Exports are to USA, Japan, Korea and Central America and some niches of the domestic market with requirements of higher quality. The four principal factors that motivate enterprises to adopt HACCP are associated with improvement of plant efficiency and profitability, adoption of good practices, improvement of product quality and waste reduction. It is concluded that Mexican enterprises adopt HACCP to successfully remain and face competition by foreign enterprises in the domestic market and to a lesser extent to compete in the international market.

Civil propulsion technology for the next twenty-five years

NASA Technical Reports Server (NTRS)

Rosen, Robert; Facey, John R.

1987-01-01

The next twenty-five years will see major advances in civil propulsion technology that will result in completely new aircraft systems for domestic, international, commuter and high-speed transports. These aircraft will include advanced aerodynamic, structural, and avionic technologies resulting in major new system capabilities and economic improvements. Propulsion technologies will include high-speed turboprops in the near term, very high bypass ratio turbofans, high efficiency small engines and advanced cycles utilizing high temperature materials for high-speed propulsion. Key fundamental enabling technologies include increased temperature capability and advanced design methods. Increased temperature capability will be based on improved composite materials such as metal matrix, intermetallics, ceramics, and carbon/carbon as well as advanced heat transfer techniques. Advanced design methods will make use of advances in internal computational fluid mechanics, reacting flow computation, computational structural mechanics and computational chemistry. The combination of advanced enabling technologies, new propulsion concepts and advanced control approaches will provide major improvements in civil aircraft.

Needs and availability of snake antivenoms: relevance and application of international guidelines.

PubMed

Scheske, Laura; Ruitenberg, Joost; Bissumbhar, Balram

2015-04-04

Snakebite has recently been declared a global public health emergency. Empirical data showing the true burden of snakebite is lacking. Treatment with specific antivenoms is considered the only cure. However, several factors have led to an ongoing antivenom crisis. This study offers recommendations concerning the improvement of antivenom access and control, by providing an overview of the factors limiting the successful implementation of international guidelines within the international industry and state institutions. It further investigates the reasons for the epidemiological knowledge gap regarding snakebites. Data for this study was collected using surveys with closed- and open-ended questions, which allowed for descriptive and thematic analysis, respectively. Participants for this study were selected as follows: 46 manufacturers were contacted from the open-access World Health Organization (WHO) Database for antivenom producers; 23 National Health Authorities (NHAs) of high-burden countries were contacted; and 11 poison centers or experts were randomly contacted. In total, responses from 6/46 (13%) manufacturers, 10/23 (43%) NHAs, and 3/11 (27%) poison centers were received. The low response rates had a limiting effect on the coverage of this study, allowing only exploratory conclusions to be drawn. Based on the gathered information, a probable reason for the epidemiological knowledge gap is the low priority given to snakebites on public health agendas, driving interest and funding away from research in this field. As a consequence, the ensuing lack in funding is preventing state institutions and manufacturers from implementing international guidelines to the highest standards. Furthermore, manufacturers indicated that international guidelines were often not applicable in the field, lacking technical information and protocols. Snakebite ranks low on international public health agendas, and partially due to this low priority, NHAs have shown limited efforts in conducting epidemiological studies, training health workers on snakebite management and creating national snakebite management strategies. The lack of NHA involvement is reflected in poor access to appropriate antivenoms as well as a lack of antivenom regulation. Manufacturers are taking positive steps toward full implementation of international guidelines and are improving quality control procedures. However, in order for international guidelines to become truly useful in the field, more technical guidance is required. This study reflects that there is a general lack of knowledge transfer amongst various actors: most producers, health authorities, and experts expect increased and improved communication and guidance from leading international bodies. Due to the low response rates observed in this study, conclusions drawn herein are not representative of the global situation; yet provide an exploratory insight on the difficulties facing antivenom management. © 2015 by Kerman University of Medical Sciences.

Heat acclimation improves heat exercise tolerance and heat dissipation in individuals with extensive skin grafts.

PubMed

Schlader, Zachary J; Ganio, Matthew S; Pearson, James; Lucas, Rebekah A I; Gagnon, Daniel; Rivas, Eric; Kowalske, Karen J; Crandall, Craig G

2015-07-01

Burn survivors with extensive skin grafts have impaired heat dissipation and thus heat tolerance. This study tested the hypothesis that heat acclimation (HA) improves these factors in this population. Thirty-four burn survivors were stratified into highly [>40% body surface area (BSA) grafted, n = 15] and moderately (17-40% BSA grafted, n = 19) grafted groups. Nine healthy nonburned subjects served as controls. Subjects underwent 7 days of HA involving 90 min of exercise at ∼ 50% peak oxygen uptake in 40°C, 30% relative humidity. On days 1 and 7, subjects exercised in the heat at a fixed rate of metabolic heat production. Pre-HA, all controls and 18/19 subjects in the 17-40% group completed 90 min of exercise. Conversely, heat exercise tolerance was lower (P < 0.01) in the > 40% group, with 7/15 subjects not completing 90 min of exercise. Post-HA, heat exercise tolerance was similar between groups (P = 0.39) as all subjects, except one, completed 90 min of exercise. Pre-HA, the magnitude of the increase in internal temperature during exercise occurred sequentially (P ≤ 0.03) according to BSA grafted (>40%: 1.6 ± 0.5°C; 17-40%: 1.2 ± 0.3°C; control: 0.9 ± 0.2°C). HA attenuated (P < 0.01) increases in internal temperature in the control (by 0.2 ± 0.3°C), 17-40% (by 0.3 ± 0.3°C), and > 40% (by 0.3 ± 0.4°C) groups, the magnitude of which was similar between groups (P = 0.42). These data indicate that HA improves heat tolerance and dissipation in burn survivors with grafted skin, and the magnitude of these improvements are not influenced by the extent of skin grafting. Copyright © 2015 the American Physiological Society.

Heat acclimation improves heat exercise tolerance and heat dissipation in individuals with extensive skin grafts

PubMed Central

Schlader, Zachary J.; Ganio, Matthew S.; Pearson, James; Lucas, Rebekah A. I.; Gagnon, Daniel; Rivas, Eric; Kowalske, Karen J.

2015-01-01

Burn survivors with extensive skin grafts have impaired heat dissipation and thus heat tolerance. This study tested the hypothesis that heat acclimation (HA) improves these factors in this population. Thirty-four burn survivors were stratified into highly [>40% body surface area (BSA) grafted, n = 15] and moderately (17-40% BSA grafted, n = 19) grafted groups. Nine healthy nonburned subjects served as controls. Subjects underwent 7 days of HA involving 90 min of exercise at ∼50% peak oxygen uptake in 40°C, 30% relative humidity. On days 1 and 7, subjects exercised in the heat at a fixed rate of metabolic heat production. Pre-HA, all controls and 18/19 subjects in the 17–40% group completed 90 min of exercise. Conversely, heat exercise tolerance was lower (P < 0.01) in the >40% group, with 7/15 subjects not completing 90 min of exercise. Post-HA, heat exercise tolerance was similar between groups (P = 0.39) as all subjects, except one, completed 90 min of exercise. Pre-HA, the magnitude of the increase in internal temperature during exercise occurred sequentially (P ≤ 0.03) according to BSA grafted (>40%: 1.6 ± 0.5°C; 17–40%: 1.2 ± 0.3°C; control: 0.9 ± 0.2°C). HA attenuated (P < 0.01) increases in internal temperature in the control (by 0.2 ± 0.3°C), 17–40% (by 0.3 ± 0.3°C), and >40% (by 0.3 ± 0.4°C) groups, the magnitude of which was similar between groups (P = 0.42). These data indicate that HA improves heat tolerance and dissipation in burn survivors with grafted skin, and the magnitude of these improvements are not influenced by the extent of skin grafting. PMID:25930025

Food, mood, and attitude: reducing risk for eating disorders in college women.

PubMed

Franko, Debra L; Mintz, Laurie B; Villapiano, Mona; Green, Traci Craig; Mainelli, Dana; Folensbee, Lesley; Butler, Stephen F; Davidson, M Meghan; Hamilton, Emily; Little, Debbie; Kearns, Maureen; Budman, Simon H

2005-11-01

Food, Mood, and Attitude (FMA) is a CD-ROM prevention program developed to decrease risk for eating disorders in college women. Female 1st-year students (N = 240) were randomly assigned to the intervention (FMA) or control group. Equal numbers of students at risk and of low risk for developing an eating disorder were assigned to each condition. Participants in the FMA condition improved on all measures relative to controls. Significant 3-way interactions (Time x Condition x Risk Status) were found on measures of internalization of sociocultural attitudes about thinness, shape concerns, and weight concerns, indicating that at-risk participants in the intervention group improved to a greater extent than did low-risk participants. At follow-up, significantly fewer women in the FMA group reported overeating and excessive exercise relative to controls.

Reduced-impact sliding pressure control valve for pneumatic hammer drill

DOEpatents

Polsky, Yarom [Oak Ridge, TN; Grubelich, Mark C [Albuquerque, NM; Vaughn, Mark R [Albuquerque, NM

2012-05-15

A method and means of minimizing the effect of elastic valve recoil in impact applications, such as percussive drilling, where sliding spool valves used inside the percussive device are subject to poor positioning control due to elastic recoil effects experienced when the valve impacts a stroke limiting surface. The improved valve design reduces the reflected velocity of the valve by using either an energy damping material, or a valve assembly with internal damping built-in, to dissipate the compression stress wave produced during impact.

Material Science

NASA Image and Video Library

2003-01-12

The Center for Advanced Microgravity Materials Processing (CAMMP), a NASA-sponsored Research Partnership Center, is working to improve zeolite materials for storing hydrogen fuel. CAMMP is also applying zeolites to detergents, optical cables, gas and vapor detection for environmental monitoring and control, and chemical production techniques that significantly reduce by-products that are hazardous to the environment. Shown here are zeolite crystals (top) grown in a ground control experiment and grown in microgravity on the USML-2 mission (bottom). Zeolite experiments have also been conducted aboard the International Space Station.

Clinical and Educational Outcomes of an Integrated Inpatient Quality Improvement Curriculum for Internal Medicine Residents.

PubMed

Ogrinc, Greg; Cohen, Emily S; van Aalst, Robertus; Harwood, Beth; Ercolano, Ellyn; Baum, Karyn D; Pattison, Adam J; Jones, Anne C; Davies, Louise; West, Al

2016-10-01

Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. We sought to determine the clinical and educational impact of an integrated QI curriculum. This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum. QI project effectiveness was assessed using statistical process control. Learning outcomes were assessed with the Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) and through self-efficacy, interprofessional care attitudes, and satisfaction of learners. Free text responses by residents and a focus group of nurses who worked with the residents provided information about the acceptability of the intervention. The QI projects improved many clinical processes and outcomes, but not all led to improvements. Educational outcome response rates were 65% (68 of 105) at baseline, 50% (18 of 36) for the early intervention group at midpoint, 67% (24 of 36) for the control group at midpoint, and 53% (42 of 80) for the late intervention group. Composite QIKAT-R scores (range, 0-27) increased from 13.3 at baseline to 15.3 at end point ( P  < .01), as did the self-efficacy composite score ( P  < .05). Satisfaction with the curriculum was rated highly by all participants. Learning and participating in hands-on QI can be integrated into the usual inpatient work of resident physicians.

Power-Quality Improvement in PFC Bridgeless SEPIC-Fed BLDC Motor Drive

NASA Astrophysics Data System (ADS)

Singh, Bhim; Bist, Vashist

2013-06-01

This article presents a design of a power factor correction (PFC)-based brushless DC (BLDC) motor drive. The speed control of BLDC motor is achieved by controlling the DC link voltage of the voltage source inverter (VSI) feeding BLDC motor using a single voltage sensor. A front-end bridgeless single-ended primary inductance converter (SEPIC) is used for DC link voltage control and PFC operation. A bridgeless SEPIC is designed to operate in discontinuous inductor current mode (DICM) thus utilizing a simple control scheme of voltage follower. An electronic commutation of BLDC motor is used for VSI to operate in a low-frequency operation for reduced switching losses in the VSI. Moreover, a bridgeless topology offers less conduction losses due to absence of diode bridge rectifier for further increasing the efficiency. The proposed BLDC motor drive is designed to operate over a wide range of speed control with an improved power-quality at the AC mains under the recommended international power-quality standards such as IEC 61000-3-2.

A Method for Generating Reduced Order Linear Models of Supersonic Inlets

NASA Technical Reports Server (NTRS)

Chicatelli, Amy; Hartley, Tom T.

1997-01-01

For the modeling of high speed propulsion systems, there are at least two major categories of models. One is based on computational fluid dynamics (CFD), and the other is based on design and analysis of control systems. CFD is accurate and gives a complete view of the internal flow field, but it typically has many states and runs much slower dm real-time. Models based on control design typically run near real-time but do not always capture the fundamental dynamics. To provide improved control models, methods are needed that are based on CFD techniques but yield models that are small enough for control analysis and design.

Non-Static error tracking control for near space airship loading platform

NASA Astrophysics Data System (ADS)

Ni, Ming; Tao, Fei; Yang, Jiandong

2018-01-01

A control scheme based on internal model with non-static error is presented against the uncertainty of the near space airship loading platform system. The uncertainty in the tracking table is represented as interval variations in stability and control derivatives. By formulating the tracking problem of the uncertainty system as a robust state feedback stabilization problem of an augmented system, sufficient condition for the existence of robust tracking controller is derived in the form of linear matrix inequality (LMI). Finally, simulation results show that the new method not only has better anti-jamming performance, but also improves the dynamic performance of the high-order systems.

Enhancements to the GRIDGEN structured grid generation system for internal and external flow applications

NASA Technical Reports Server (NTRS)

Steinbrenner, John P.; Chawner, John R.

1992-01-01

GRIDGEN is a government domain software package for interactive generation of multiple block grids around general configurations. Though it has been freely available since 1989, it has not been widely embraced by the internal flow community due to a misconception that it was designed for external flow use only. In reality GRIDGEN has always worked for internal flow applications, and GRIDGEN ongoing enhancements are increasing the quality of and efficiency with which grids for external and internal flow problems may be constructed. The software consists of four codes used to perform the four steps of the grid generation process. GRIDBLOCK is first used to decompose the flow domain into a collection of component blocks and then to establish interblock connections and flow solver boundary conditions. GRIDGEN2D is then used to generate surface grids on the outer shell of each component block. GRIDGEN3D generates grid points on the interior of each block, and finally GRIDVUE3D is used to inspect the resulting multiple block grid. Three of these codes (GRIDBLOCK, GRIDGEN2D, and GRIDVUE3D) are highly interactive and graphical in nature, and currently run on Silicon Graphics, Inc., and IBM RS/6000 workstations. The lone batch code (GRIDGEN3D) may be run on any of several Unix based platforms. Surface grid generation in GRIDGEN2D is being improved with the addition of higher order surface definitions (NURBS and parametric surfaces input in IGES format and bicubic surfaces input in PATRAN Neutral File format) and double precision mathematics. In addition, two types of automation have been added to GRIDGEN2D that reduce the learning curve slope for new users and eliminate work for experienced users. Volume grid generation using GRIDGEN3D has been improved via the addition of an advanced hybrid control function formulation that provides both orthogonality and clustering control at the block faces and clustering control on the block interior.

A Baltic Sea estuary as a phosphorus source and sink after drastic load reduction: seasonal and long-term mass balances for the Stockholm inner archipelago for 1968-2015

NASA Astrophysics Data System (ADS)

Walve, Jakob; Sandberg, Maria; Larsson, Ulf; Lännergren, Christer

2018-05-01

Internal phosphorus (P) loading from sediments, controlled by hypoxia, is often assumed to hamper the recovery of lakes and coastal areas from eutrophication. In the early 1970s, the external P load to the inner archipelago of Stockholm, Sweden (Baltic Sea), was drastically reduced by improved sewage treatment, but the internal P loading and its controlling factors have been poorly quantified. We use two slightly different four-layer box models to calculate the area's seasonal and annual P balance (input-export) and the internal P exchange with sediments in 1968-2015. For 10-20 years after the main P load reduction, there was a negative P balance, small in comparison to the external load, and probably due to release from legacy sediment P storage. Later, the stabilized, near-neutral P balance indicates no remaining internal loading from legacy P, but P retention is low, despite improved oxygen conditions. Seasonally, sediments are a P sink in spring and a P source in summer and autumn. Most of the deep-water P release from sediments in summer-autumn appears to be derived from the settled spring bloom and is exported to outer areas during winter. Oxygen consumption and P release in the deep water are generally tightly coupled, indicating limited iron control of P release. However, enhanced P release in years of deep-water hypoxia suggests some contribution from redox-sensitive P pools. Increasing deep-water temperatures that stimulate oxygen consumption rates in early summer have counteracted the effect of lowered organic matter sedimentation on oxygen concentrations. Since the P turnover time is short and legacy P small, measures to bind P in Stockholm inner archipelago sediments would primarily accumulate recent P inputs, imported from the Baltic Sea and from Lake Mälaren.

Birth control, population control, and family planning: an overview.

PubMed

Critchlow, D T

1995-01-01

This overview of the US birth control movement reflects on the emergence of family planning policy due to the efforts of Margaret Sanger, feminists, and the civil rights movement, the eugenics motive to limit "deviant" populations, and the population control movement, which aims to solve social and economic problems through fertility control. Population control moved through three stages: from the cause of "voluntary motherhood" to advance suffrage and women's political and social status, to the concept of "birth control" promoted by socialist feminists to help empower women and the working class, to, from 1920 on, a liberal movement for civil rights and population control. Physicians such as Dr. Robert Latou Dickinson legitimized the movement in the formation of the Committee on Maternal Health in 1925, but the movement remained divided until 1939, when Sanger's group merged with the American Birth Control League, the predecessor of the present Planned Parenthood Federation of America. A key legal decision in 1939 in the United States v. One Package amended the Comstock Act and allowed for the distribution of birth control devices by mail to physicians. Sanger, after a brief retirement, formed the International Planned Parenthood Federation and supported research into the pill. Eugenicists through the Committee on Maternal Health supported Christopher Tietze and others developing the pill. Final constitutional access to contraception based on the right to privacy was granted in Griswold v. Connecticut. The ruling in Eisenstadt v. Baird in 1972 extended this right to unmarried persons. The right to privacy was further extended in the Roe v. Wade decision in 1973 on legal abortion. The argument for improving the quality of the population remained from the formation of the Population Reference Bureau in 1929 through the 1960s. Under the leadership of Rockefeller, population control was defined as justified on a scientific and humanitarian basis. US government support for national and international family planning proceeded slowly through the 1950s, 1960s, and 1970s. Congress during 1967-70 enacted strong legislation in support of national and international family planning. The Bucharest conference in 1974 highlighted the inadequacies of international population control that deemphasized economic development. Polarization and divisiveness on population policy persists.

An Evaluation of Internal Control for a Nonappropriated Fund Instrumentality (NAFI)

DTIC Science & Technology

1992-03-01

to which an internal control system meets these guidelines , a plan of investigation must be iormulated. Planning an internal control review is...INTERNAL CONTROL . ........ 7 C. INTERNAL CONTROL STANDARDS ... ... .......... 8 D. PLANNING INTERNAL CONTROL REVIEW . ....... . 13 E. EVALUATING...Dining Facility. The critical areas of research are those which present the greatest risk of material loss to the financial operation of the NAFI

Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse? A randomized controlled trial.

PubMed

Braekken, Ingeborg H; Majida, Memona; Ellström Engh, Marie; Bø, Kari

2015-02-01

Pelvic floor muscle training (PFMT) has level 1 evidence of reducing the size and symptoms associated with pelvic organ prolapse (POP). There is scant knowledge, however, regarding whether PFMT has an effect on sexual function. The aim of the trial was to evaluate the effect of PFMT on sexual function in women with POP. In this randomized controlled trial, 50 women were randomized to an intervention group (6 months of PFMT and lifestyle advice) and 59 women were randomized to a control group (lifestyle advice only). Participants completed a validated POP-specific questionnaire to describe frequency and bother of prolapse, bladder, bowel, and sexual symptoms and answered a semi-structured interview. No significant change in number of women being sexually active was reported. There were no significant differences between groups regarding change in satisfaction with frequency of intercourse. Interview data revealed that 19 (39%) of women in the PFMT group experienced improved sexual function vs. two (5%) in the control group (P<0.01). Specific improvements reported by some of the women were increased control, strength and awareness of the pelvic floor, improved self-confidence, sensation of a "tighter" vagina, improved libido and orgasms, resolution of pain with intercourse, and heightened sexual gratification for partners. Women who described improved sexual function demonstrated the greatest increases in pelvic floor muscle (PFM) strength (mean 16 ± 10 cmH2 0) and endurance (mean 150 ± 140 cmH2 0s) (P<0.01). PFMT can improve sexual function in some women. Women reporting improvement in sexual function demonstrated the greatest increase in PFM strength and endurance. © 2014 International Society for Sexual Medicine.

A multiple choice testing program coupled with a year-long elective experience is associated with improved performance on the internal medicine in-training examination.

PubMed

Mathis, Bradley R; Warm, Eric J; Schauer, Daniel P; Holmboe, Eric; Rouan, Gregory W

2011-11-01

The Internal Medicine In-Training Exam (IM-ITE) assesses the content knowledge of internal medicine trainees. Many programs use the IM-ITE to counsel residents, to create individual remediation plans, and to make fundamental programmatic and curricular modifications. To assess the association between a multiple-choice testing program administered during 12 consecutive months of ambulatory and inpatient elective experience and IM-ITE percentile scores in third post-graduate year (PGY-3) categorical residents. Retrospective cohort study. One hundred and four categorical internal medicine residents. Forty-five residents in the 2008 and 2009 classes participated in the study group, and the 59 residents in the three classes that preceded the use of the testing program, 2005-2007, served as controls. A comprehensive, elective rotation specific, multiple-choice testing program and a separate board review program, both administered during a continuous long-block elective experience during the twelve months between the second post-graduate year (PGY-2) and PGY-3 in-training examinations. We analyzed the change in median individual percent correct and percentile scores between the PGY-1 and PGY-2 IM-ITE and between the PGY-2 and PGY-3 IM-ITE in both control and study cohorts. For our main outcome measure, we compared the change in median individual percentile rank between the control and study cohorts between the PGY-2 and the PGY-3 IM-ITE testing opportunities. After experiencing the educational intervention, the study group demonstrated a significant increase in median individual IM-ITE percentile score between PGY-2 and PGY-3 examinations of 8.5 percentile points (p < 0.01). This is significantly better than the increase of 1.0 percentile point seen in the control group between its PGY-2 and PGY-3 examination (p < 0.01). A comprehensive multiple-choice testing program aimed at PGY-2 residents during a 12-month continuous long-block elective experience is associated with improved PGY-3 IM-ITE performance.

A randomized trial of a three-hour protected nap period in a medicine training program: sleep, alertness, and patient outcomes.

PubMed

Shea, Judy A; Dinges, David F; Small, Dylan S; Basner, Mathias; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian J; Novak, Cristina; Bellini, Lisa M; Dine, C Jessica; Mollicone, Daniel J; Volpp, Kevin G

2014-03-01

Protected sleep periods for internal medicine interns have previously resulted in increased amount slept and improved cognitive alertness but required supplemental personnel. The authors evaluated intern and patient outcomes associated with protected nocturnal nap periods of three hours that are personnel neutral. Randomized trial at Philadelphia Veterans Affairs Medical Center (PVAMC) Medical Service and Hospital of the University of Pennsylvania (HUP) Oncology Unit. During 2010-2011, four-week blocks were randomly assigned to a standard intern schedule (extended duty overnight shifts of up to 30 hours), or sequential protected sleep periods (phone sign-out midnight to 3:00 AM [early shift] intern 1; 3:00 to 6:00 AM [late shift] intern 2). Participants wore wrist Actiwatches, completed sleep diaries, and performed daily assessments of behavioral alertness. Between-group comparisons of means and proportions controlled for within-person correlations. HUP interns had significantly longer sleep durations during both early (2.40 hours) and late (2.44 hours) protected periods compared with controls (1.55 hours, P < .0001). At PVAMC sleep duration was longer only for the late shift group (2.40 versus 1.90 hours, P < .036). Interns assigned to either protected period were significantly less likely to have call nights with no sleep and had fewer attentional lapses on the Psychomotor Vigilance Test. Differences in patient outcomes between standard schedule months versus intervention months were not observed. Protected sleep periods of three hours resulted in more sleep during call and reductions in periods of prolonged wakefulness, providing a plausible alternative to 16-hour shifts.

VANDENBERG AIR FORCE BASE, CALIF. - Outside the clean room at Vandenberg Air Force Base, Calif., the SciSat-1 spacecraft (background) has been removed from the shipping container mounting base (lower left) and placed on the handling fixture. Sci-Sat, which will undergo instrument checkout and spacecraft functional testing, weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

NASA Image and Video Library

2003-06-26

VANDENBERG AIR FORCE BASE, CALIF. - Outside the clean room at Vandenberg Air Force Base, Calif., the SciSat-1 spacecraft (background) has been removed from the shipping container mounting base (lower left) and placed on the handling fixture. Sci-Sat, which will undergo instrument checkout and spacecraft functional testing, weighs approximately 330 pounds and after launch will be placed in a 400-mile-high polar orbit to investigate processes that control the distribution of ozone in the upper atmosphere. The data from the satellite will provide Canadian and international scientists with improved measurements relating to global ozone processes and help policymakers assess existing environmental policy and develop protective measures for improving the health of our atmosphere, preventing further ozone depletion. The mission is designed to last two years.

Precursor to the TRICARE Next Generation Program

DTIC Science & Technology

2004-06-01

Precursor to T-NEX 6 Appendix A - Maps of Interest 84 Appendix B - International Classification of Diseases Codes 86...utilization management, and disease management (Lupo, 2003). Health management will be demonstrated by measurable quality improvements, population...National Association of County and City Health Officials and the Center for Disease Control and Prevention that helps key officials review community

State University of New York, College at Old Westbury. Report 96-F-46.

ERIC Educational Resources Information Center

Barber, Jerry

In March 1996, the New York State Comptroller's Office completed a review of the financial management practices of the State University of New York College at Old Westbury between April 1993 and February 1995. The Office's final report included 17 recommendations for improving the internal control structure over cash receipts and disbursements,…

Expediting the Quest for Quality: The Role of IQAC in Academic Audit

ERIC Educational Resources Information Center

Nitonde, Rohidas

2016-01-01

Academic Audit is an important tool to control and maintain standards in academic sector. It has been found highly relevant by the experts across the world. Academic audit helps institutions to introspect and improve their quality. The present paper intends to probe into the possible role of Internal Quality Assurance Cell (IQAC) in Academic Audit…

Non-biological synthetic spike-in controls and the AMPtk software pipeline improve mycobiome data

Treesearch

Jonathan M. Palmer; Michelle A. Jusino; Mark T. Banik; Daniel L. Lindner

2018-01-01

High-throughput amplicon sequencing (HTAS) of conserved DNA regions is a powerful technique to characterize microbial communities. Recently, spike-in mock communities have been used to measure accuracy of sequencing platforms and data analysis pipelines. To assess the ability of sequencing platforms and data processing pipelines using fungal internal transcribed spacer...

Efficacy of an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder: Evaluation in a Randomized Controlled Trial

ERIC Educational Resources Information Center

Roemer, Lizabeth; Orsillo, Susan M.; Salters-Pedneault, Kristalyn

2008-01-01

Generalized anxiety disorder (GAD) is a chronic anxiety disorder, associated with comorbidity and impairment in quality of life, for which improved psychosocial treatments are needed. GAD is also associated with reactivity to and avoidance of internal experiences. The current study examined the efficacy of an acceptance-based behavioral therapy…

Ion plated gold films: Properties, tribological behavior and performance

NASA Technical Reports Server (NTRS)

Spalvins, Talivaldis

1987-01-01

The glow discharge energizing favorably modifies and controls the coating/substrate adherence and the nucleation and growth sequence of ion plated gold films. As a result the adherence, coherence, internal stresses, and morphology of the films are significantly improved. Gold ion plated films because of their graded coating/substrate interface and fine uniform densely packed microstructure not only improve the tribological properties but also induce a surface strengthening effect which improves the mechanical properties such as yield, tensile, and fatigue strength. Consequently significant improvements in the tribological performance of ion plated gold films as compared to vapor deposited gold films are shown in terms of decreased friction/wear and prolonged endurance life.

Reducing Bolt Preload Variation with Angle-of-Twist Bolt Loading

NASA Technical Reports Server (NTRS)

Thompson, Bryce; Nayate, Pramod; Smith, Doug; McCool, Alex (Technical Monitor)

2001-01-01

Critical high-pressure sealing joints on the Space Shuttle reusable solid rocket motor require precise control of bolt preload to ensure proper joint function. As the reusable solid rocket motor experiences rapid internal pressurization, correct bolt preloads maintain the sealing capability and structural integrity of the hardware. The angle-of-twist process provides the right combination of preload accuracy, reliability, process control, and assembly-friendly design. It improves significantly over previous methods. The sophisticated angle-of-twist process controls have yielded answers to all discrepancies encountered while the simplicity of the root process has assured joint preload reliability.

The attention schema theory: a mechanistic account of subjective awareness

PubMed Central

Graziano, Michael S. A.; Webb, Taylor W.

2015-01-01

We recently proposed the attention schema theory, a novel way to explain the brain basis of subjective awareness in a mechanistic and scientifically testable manner. The theory begins with attention, the process by which signals compete for the brain’s limited computing resources. This internal signal competition is partly under a bottom–up influence and partly under top–down control. We propose that the top–down control of attention is improved when the brain has access to a simplified model of attention itself. The brain therefore constructs a schematic model of the process of attention, the ‘attention schema,’ in much the same way that it constructs a schematic model of the body, the ‘body schema.’ The content of this internal model leads a brain to conclude that it has a subjective experience. One advantage of this theory is that it explains how awareness and attention can sometimes become dissociated; the brain’s internal models are never perfect, and sometimes a model becomes dissociated from the object being modeled. A second advantage of this theory is that it explains how we can be aware of both internal and external events. The brain can apply attention to many types of information including external sensory information and internal information about emotions and cognitive states. If awareness is a model of attention, then this model should pertain to the same domains of information to which attention pertains. A third advantage of this theory is that it provides testable predictions. If awareness is the internal model of attention, used to help control attention, then without awareness, attention should still be possible but should suffer deficits in control. In this article, we review the existing literature on the relationship between attention and awareness, and suggest that at least some of the predictions of the theory are borne out by the evidence. PMID:25954242

Evaluation of Pushback Decision-Support Tool Concept for Charlotte Douglas International Airport Ramp Operations

NASA Technical Reports Server (NTRS)

Hayashi, Miwa; Hoang, Ty; Jung, Yoon C.; Malik, Waqar; Lee, Hanbong; Dulchinos, Victoria L.

2015-01-01

This paper proposes a new departure pushback decision-support tool (DST) for airport ramp-tower controllers. It is based on NASA's Spot and Runway Departure Advisor (SARDA) collaborative decision-making concept, except with the modification that the gate releases now are controlled by tactical pushback (or gate-hold) advisories instead of strategic pre-assignments of target pushback times to individual departure flights. The proposed ramp DST relies on data exchange with the airport traffic control tower (ATCT) to coordinate pushbacks with the ATCT's flow-management intentions under current operational constraints, such as Traffic Management Initiative constraints. Airlines would benefit in reduced taxi delay and fuel burn. The concept was evaluated in a human-in-the-loop simulation experiment with current ramp-tower controllers at the Charlotte Douglas International Airport as participants. The results showed that the tool helped reduce taxi time by one minute per flight and overall departure flight fuel consumption by 10-12% without reducing runway throughput. Expect Departure Clearance Time (EDCT) conformance also was improved when advisories were provided. These benefits were attained without increasing the ramp-tower controllers' workload. Additionally, the advisories reduced the ATCT controllers' workload.

Application of Sigma Metrics Analysis for the Assessment and Modification of Quality Control Program in the Clinical Chemistry Laboratory of a Tertiary Care Hospital.

PubMed

Iqbal, Sahar; Mustansar, Tazeen

2017-03-01

Sigma is a metric that quantifies the performance of a process as a rate of Defects-Per-Million opportunities. In clinical laboratories, sigma metric analysis is used to assess the performance of laboratory process system. Sigma metric is also used as a quality management strategy for a laboratory process to improve the quality by addressing the errors after identification. The aim of this study is to evaluate the errors in quality control of analytical phase of laboratory system by sigma metric. For this purpose sigma metric analysis was done for analytes using the internal and external quality control as quality indicators. Results of sigma metric analysis were used to identify the gaps and need for modification in the strategy of laboratory quality control procedure. Sigma metric was calculated for quality control program of ten clinical chemistry analytes including glucose, chloride, cholesterol, triglyceride, HDL, albumin, direct bilirubin, total bilirubin, protein and creatinine, at two control levels. To calculate the sigma metric imprecision and bias was calculated with internal and external quality control data, respectively. The minimum acceptable performance was considered as 3 sigma. Westgard sigma rules were applied to customize the quality control procedure. Sigma level was found acceptable (≥3) for glucose (L2), cholesterol, triglyceride, HDL, direct bilirubin and creatinine at both levels of control. For rest of the analytes sigma metric was found <3. The lowest value for sigma was found for chloride (1.1) at L2. The highest value of sigma was found for creatinine (10.1) at L3. HDL was found with the highest sigma values at both control levels (8.8 and 8.0 at L2 and L3, respectively). We conclude that analytes with the sigma value <3 are required strict monitoring and modification in quality control procedure. In this study application of sigma rules provided us the practical solution for improved and focused design of QC procedure.

Hereditary internal anal sphincter myopathy causing proctalgia fugax and constipation. A newly identified condition.

PubMed

Kamm, M A; Hoyle, C H; Burleigh, D E; Law, P J; Swash, M; Martin, J E; Nicholls, R J; Northover, J M

1991-03-01

A newly identified myopathy of the internal anal sphincter is described. In the affected family, at least one member from each of five generations had severe proctalgia fugax; onset was usually in the third to fifth decades of life. Three members of the family have been studied in detail. Each had severe pain intermittently during the day and hourly during the night. Constipation was an associated symptom, in particular difficulty with rectal evacuation. Clinically the internal anal sphincter was thickened and of decreased compliance. The maximum anal canal pressure was usually increased with marked ultraslow wave activity. Anal endosonography confirmed a grossly thickened internal anal sphincter. Two patients were treated by internal anal sphincter strip myectomy; one showed marked improvement and one was relieved of the constipation but had only slight improvement of the pain. The hypertrophied muscle in two of the patients showed unique myopathic changes, consisting of vacuolar changes with periodic acid-Schiff-positive polyglycosan bodies in the smooth muscle fibers and increased endomysial fibrosis. In vitro organ-bath studies showed insensitivity of the muscle to noradrenaline, isoprenaline, carbachol, dimethylpiperazinium, and electrical-field stimulation. Immunohistochemical studies for substance P, calcitonin gene-related peptide, galanin, neuropeptide Y, and vasoactive intestinal peptide showed staining in a similar distribution to that in control tissue. A specific autosomal-dominant inherited myopathy of the internal anal sphincter that causes anal pain and constipation has been identified and characterized.

Changes in insurance physicians' attitudes, self-efficacy, intention, and knowledge and skills regarding the guidelines for depression, following an implementation strategy.

PubMed

Zwerver, Feico; Schellart, Antonius J M; Anema, Johannes R; van der Beek, Allard J

2013-03-01

To improve guideline adherence by insurance physicians (IPs), an implementation strategy was developed and investigated in a randomized controlled trial. This implementation strategy involved a multifaceted training programme for a group of IPs in applying the guidelines for depression. In this study we report the impact of the implementation strategy on the physicians' attitude, intention, self-efficacy, and knowledge and skills as behavioural determinants of guideline adherence. Any links between these self-reported behavioural determinants and levels of guideline adherence were also determined. Just before and 3 months after the implementation of the multifaceted training, a questionnaire designed to measure behavioural determinants on the basis of the ASE (attitude, social norm, self-efficacy) model was completed by the intervention (n = 21) and the control group (n = 19). Items of the questionnaire were grouped to form scales of ASE determinants. Internal consistency of the scales was calculated using Cronbach's alphas. Differences between groups concerning changes in ASE determinants, and the association of these changes with improvements in guideline adherence, were analyzed using analysis of covariance. The internal consistency of the scales of ASE determinants proved to be sufficiently reliable, with Cronbach's alphas of at least 0.70. At follow-up after 3 months, the IPs given the implementation strategy showed significant improvement over the IPs in the control group for all ASE determinants investigated. Changes in knowledge and skills were only weakly associated with improvements in guideline adherence. The implementation strategy developed for insurance physicians can increase their attitude, intention, self-efficacy, and knowledge and skills when applying the guidelines for depression. These changes in behavioural determinants might indicate positive changes in IPs' behaviour towards the use of the guidelines for depression. However, only changes in knowledge and skills related to the use of the guidelines were associated with improvements in IPs' actual performance when applying the guidelines.

Plasma deposition and surface modification techniques for wear resistance

NASA Technical Reports Server (NTRS)

Spalvins, T.

1982-01-01

The ion-assisted or plasma coating technology is discussed as it applies to the deposition of hard, wear resistant refractory compound films. Of the many sputtering and ion plating modes and configurations the reactive magnetron sputtering and the reactive triode ion plating techniques are the preferred ones to deposit wear resistant coatings for tribological applications. Both of these techniques incorporate additional means to enhance the ionization efficiency and chemical reaction to precision tailor desirable tribological characteristics. Interrelationships between film formation, structure, and ribological properties are strictly controlled by the deposition parameters and the substrate condition. The enhanced ionization contributes to the excellent adherence and coherence, reduced internal stresses and improved structural growth to form dense, cohesive, equiaxed grain structure for improved wear resistance and control.

Decreasing internal focus of attention improves postural control during quiet standing in young healthy adults.

PubMed

Nafati, Gilel; Vuillerme, Nicolas

2011-12-01

This experiment was designed to investigate whether and how decreasing the amount of attentional focus invested in postural control could affect bipedal postural control. Twelve participants were asked to stand upright as immobile as possible on a force platform in one control condition and one cognitive condition. In the latter condition, they performed a short-term digit-span memory task. Decreased center-of-gravity displacements and decreased center-of-foot-pressure displacements minus center-of-gravity displacements were observed in the cognitive condition relative to the control condition. These results suggest that shifting the attentional focus away from postural control by executing a concurrent attention-demanding task could increase postural performance and postural efficiency.

Examining the relationship between health locus of control and God Locus of Health Control: Is God an internal or external source?

PubMed

Boyd, Joni M; Wilcox, Sara

2017-11-01

For many people, the influence of believing in a higher power can elicit powerful effects. This study examined the relationship between God control, health locus of control, and frequency of religious attendance within 838 college students through online surveys. Regression analysis showed that chance and external locus of control and frequency of religious attendance were significant and positive predictors of God Locus of Health Control. The association of powerful others external locus of control and God Locus of Health Control differed by race (stronger in non-Whites than Whites) and somewhat by gender (stronger in women than men). For some people, the role of a supreme being, or God, should be considered when designing programs for improving health behaviors.

Critical Need for Plutonium and Uranium Isotopic Standards with Lower Uncertainties

DOE PAGES

Mathew, Kattathu Joseph; Stanley, Floyd E.; Thomas, Mariam R.; ...

2016-09-23

Certified reference materials (CRMs) traceable to national and international safeguards database are a critical prerequisite for ensuring that nuclear measurement systems are free of systematic biases. CRMs are used to validate measurement processes associated with nuclear analytical laboratories. Diverse areas related to nuclear safeguards are impacted by the quality of the CRM standards available to analytical laboratories. These include: nuclear forensics, radio-chronometry, national and international safeguards, stockpile stewardship, nuclear weapons infrastructure and nonproliferation, fuel fabrication, waste processing, radiation protection, and environmental monitoring. For the past three decades the nuclear community is confronted with the strange situation that improvements in measurementmore » data quality resulting from the improved accuracy and precision achievable with modern multi-collector mass spectrometers could not be fully exploited due to large uncertainties associated with CRMs available from New Brunswick Laboratory (NBL) that are used for instrument calibration and measurement control. Similar conditions prevail for both plutonium and uranium isotopic standards and for impurity element standards in uranium matrices. Herein, the current status of U and Pu isotopic standards available from NBL is reviewed. Critical areas requiring improvement in the quality of the nuclear standards to enable the U. S. and international safeguards community to utilize the full potential of modern multi-collector mass spectrometer instruments are highlighted.« less

Critical Need for Plutonium and Uranium Isotopic Standards with Lower Uncertainties

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

Mathew, Kattathu Joseph; Stanley, Floyd E.; Thomas, Mariam R.

Certified reference materials (CRMs) traceable to national and international safeguards database are a critical prerequisite for ensuring that nuclear measurement systems are free of systematic biases. CRMs are used to validate measurement processes associated with nuclear analytical laboratories. Diverse areas related to nuclear safeguards are impacted by the quality of the CRM standards available to analytical laboratories. These include: nuclear forensics, radio-chronometry, national and international safeguards, stockpile stewardship, nuclear weapons infrastructure and nonproliferation, fuel fabrication, waste processing, radiation protection, and environmental monitoring. For the past three decades the nuclear community is confronted with the strange situation that improvements in measurementmore » data quality resulting from the improved accuracy and precision achievable with modern multi-collector mass spectrometers could not be fully exploited due to large uncertainties associated with CRMs available from New Brunswick Laboratory (NBL) that are used for instrument calibration and measurement control. Similar conditions prevail for both plutonium and uranium isotopic standards and for impurity element standards in uranium matrices. Herein, the current status of U and Pu isotopic standards available from NBL is reviewed. Critical areas requiring improvement in the quality of the nuclear standards to enable the U. S. and international safeguards community to utilize the full potential of modern multi-collector mass spectrometer instruments are highlighted.« less

Applying the Chronic Care Model to Homeless Veterans: Effect of a Population Approach to Primary Care on Utilization and Clinical Outcomes

PubMed Central

Buckel, Lauren; Bourgault, Claire; Blumen, Jonathan; Redihan, Stephen G.; Jiang, Lan; Friedmann, Peter

2010-01-01

Objectives. We compared a population-tailored approach to primary care for homeless veterans with a usual care approach. Methods. We conducted a retrospective prolective cohort study of homeless veterans enrolled in a population-tailored primary care clinic matched to a historical sample in general internal medicine clinics. Overall, 177 patients were enrolled: 79 in the Homeless-Oriented Primary Care Clinic and 98 in general internal medicine primary care. Results. Homeless-oriented primary care–enrolled patients had greater improvements in hypertension, diabetes, and lipid control, and primary care use was higher during the first 6 months (5.96 visits per person vs 1.63 for general internal medicine) but stabilized to comparable rates during the second 6 months (2.01 vs 1.31, respectively). Emergency department (ED) use was also higher (2.59 vs 1.89 visits), although with 40% lower odds for nonacute ED visits than for the general internal medicine group (95% confidence interval = 0.2, 0.8). Excluding substance abuse and mental health admissions, hospitalizations were reduced among the homeless veterans between the 2 periods (28.6% vs 10.8%; P < .01) compared with the general internal medicine group (48.2% vs 44.4%; P = .6; difference of differences, P < .01). Conclusions. Tailoring primary care to homeless veterans can decrease unnecessary ED use and medical admissions and improve chronic disease management. PMID:20966377

Improved reliability of pH measurements.

PubMed

Spitzer, Petra; Werner, Barbara

2002-11-01

Measurements of pH are performed on a large scale at laboratory level, and in industry. To meet the quality-control requirements and other technical specifications there is a need for traceability in measurement results. The prerequisite for the international acceptance of analytical data is reliability. To measure means to compare. Comparability entails use of recognised references to which the standard buffer solutions used for calibration of pH meter-electrode assemblies can be traced. The new recommendation on the measurement of pH recently published as a provisional document by the International Union on Pure and Applied Chemistry (IUPAC) enables traceability for measured pH values to a conventional reference frame which is recognised world-wide. The primary method for pH will be described. If analytical data are to be accepted internationally it is necessary to demonstrate the equivalence of the national traceability structures, including national measurement standards. For the first time key comparisons for pH have been performed by the Consultative Committee for Amount of Substance (CCQM, set up by the International Bureau of Weights and Measures, BIPM) to assess the equivalence of the national measurement procedures used to determine the pH of primary standard buffer solutions. The results of the first key comparison on pH CCQM-K9, and other international initiatives to improve the consistency of the results of measurement for pH, are reported.

Selective embolization of the internal iliac arteries for the treatment of intractable hemorrhage in children with malignancies.

PubMed

Bae, Sul Hee; Han, Dong Kyun; Baek, Hee Jo; Park, Sun Ju; Chang, Nam Kyu; Kook, Hoon; Hwang, Tai Ju

2011-04-01

Acute internal hemorrhage is an occasionally life-threatening complication in pediatric cancer patients. Many therapeutic approaches have been used to control bleeding with various degrees of success. In this study, we evaluated the efficacy of selective internal iliac artery embolization for controlling acute intractable bleeding in children with malignancies. We retrospectively evaluated the cases of 6 children with various malignancies (acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, T-cell prolymphocytic leukemia, Langerhans cell histiocytosis, and rhabdomyosarcoma), who had undergone selective arterial embolization (SAE) of the internal iliac artery at the Chonnam National University Hwasun Hospital between January 2004 and December 2009. SAE was performed by an interventional radiologist using Gelfoam® and/or Tornado® coils. The patients were 5 boys and 1 girl with median age of 6.9 years (range, 0.7-14.8 years) at the time of SAE. SAE was performed once in 4 patients and twice in 2, and the procedure was unilateral in 2 and bilateral in 4. The causes of hemorrhage were as follows: hemorrhagic cystitis (HC) in 3 patients, procedure-related internal iliac artery injuries in 2 patients, and tumor rupture in 1 patient. Initial attempt at conservative management was unsuccessful. Of the 6 patients, 5 (83.3%) showed improvement after SAE without complications. SAE may be a safe and effective procedure for controlling acute intractable hemorrhage in pediatric malignancy patients. This procedure may obviate the need for surgery, which carries an attendant risk of morbidity and mortality in cancer patients with critical conditions.

Effects of Assertiveness Training and Expressive Writing on Acculturative Stress in International Students: A Randomized Trial

PubMed Central

Tavakoli, Shedeh; Lumley, Mark A.; Hijazi, Alaa M.; Slavin-Spenny, Olga M.; Parris, George P.

2010-01-01

International university students often experience acculturative stress, and culturally appropriate techniques to manage stress are needed. This randomized trial tested the effects of group assertiveness training, private expressive writing, their combination, and a wait-list control on the acculturative stress, affect, and health of 118 international students at an urban, American university. Interventions were conducted at the start of a semester, and assessments were conducted at baseline and the end of the semester. Group assertiveness training was rated positively by students and led to lower negative affect, whereas expressive writing was less well received and led to higher homesickness and fear, but also higher positive affect. The combined intervention had no effects, perhaps because the two components negated each other. It is concluded that group assertiveness training improves emotional adjustment of international students, but expressive writing has mixed effects and needs further development and study. PMID:20357910

CDC Support for Global Public Health Emergency Management.

PubMed

Brencic, Daniel J; Pinto, Meredith; Gill, Adrienne; Kinzer, Michael H; Hernandez, Luis; Pasi, Omer G

2017-12-01

Recent pandemics and rapidly spreading outbreaks of infectious diseases have illustrated the interconnectedness of the world and the importance of improving the international community's ability to effectively respond. The Centers for Disease Control and Prevention (CDC), building on a strong foundation of lessons learned through previous emergencies, international recognition, and human and technical expertise, has aspired to support nations around the world to strengthen their public health emergency management (PHEM) capacity. PHEM principles streamline coordination and collaboration in responding to infectious disease outbreaks, which align with the core capacities outlined in the International Health Regulations 2005. CDC supports PHEM by providing in-country technical assistance, aiding the development of plans and procedures, and providing fellowship opportunities for public health emergency managers. To this end, CDC partners with US agencies, international partners, and multilateral organizations to support nations around the world to reduce illness and death from outbreaks of infectious diseases.

Deep Brain Stimulation of the Internal Globus Pallidus Improves Response Initiation and Proactive Inhibition in Patients With Parkinson’s Disease

PubMed Central

Pan, Yixin; Wang, Linbin; Zhang, Yingying; Zhang, Chencheng; Qiu, Xian; Tan, Yuyan; Zhou, Haiyan; Sun, Bomin; Li, Dianyou

2018-01-01

Background: Impulse control disorder is not uncommon in patients with Parkinson’s disease (PD) who are treated with dopamine replacement therapy and subthalamic deep brain stimulation (DBS). Internal globus pallidus (GPi)-DBS is increasingly used, but its role in inhibitory control has rarely been explored. In this study, we evaluated the effect of GPi-DBS on inhibitory control in PD patients. Methods: A stop-signal paradigm was used to test response initiation, proactive inhibition, and reactive inhibition. The subjects enrolled in the experiment were 27 patients with PD, of whom 13 had received only drug treatment and 14 had received bilateral GPi-DBS in addition to conventional medical treatment and 15 healthy individuals. Results: Our results revealed that with GPi-DBS on, patients with PD showed significantly faster responses than the other groups in trials where it was certain that no stop signal would be presented. Proactive inhibition was significantly different in the surgical patients with GPi-DBS on versus when GPi-DBS was off, in surgical patients with GPi-DBS on versus drug-treated patients, and in healthy controls versus drug-treated patients. Correlation analyses revealed that when GPi-DBS was on, there was a statistically significant moderate positive relationship between proactive inhibition and dopaminergic medication. Conclusion: GPi-DBS may lead to an increase in response initiation speed and improve the dysfunctional proactive inhibitory control observed in PD patients. Our results may help us to understand the role of the GPi in cortical-basal ganglia circuits. PMID:29681869

Brain-computer interface technology: a review of the Second International Meeting.

PubMed

Vaughan, Theresa M; Heetderks, William J; Trejo, Leonard J; Rymer, William Z; Weinrich, Michael; Moore, Melody M; Kübler, Andrea; Dobkin, Bruce H; Birbaumer, Niels; Donchin, Emanuel; Wolpaw, Elizabeth Winter; Wolpaw, Jonathan R

2003-06-01

This paper summarizes the Brain-Computer Interfaces for Communication and Control, The Second International Meeting, held in Rensselaerville, NY, in June 2002. Sponsored by the National Institutes of Health and organized by the Wadsworth Center of the New York State Department of Health, the meeting addressed current work and future plans in brain-computer interface (BCI) research. Ninety-two researchers representing 38 different research groups from the United States, Canada, Europe, and China participated. The BCIs discussed at the meeting use electroencephalographic activity recorded from the scalp or single-neuron activity recorded within cortex to control cursor movement, select letters or icons, or operate neuroprostheses. The central element in each BCI is a translation algorithm that converts electrophysiological input from the user into output that controls external devices. BCI operation depends on effective interaction between two adaptive controllers, the user who encodes his or her commands in the electrophysiological input provided to the BCI, and the BCI that recognizes the commands contained in the input and expresses them in device control. Current BCIs have maximum information transfer rates of up to 25 b/min. Achievement of greater speed and accuracy requires improvements in signal acquisition and processing, in translation algorithms, and in user training. These improvements depend on interdisciplinary cooperation among neuroscientists, engineers, computer programmers, psychologists, and rehabilitation specialists, and on adoption and widespread application of objective criteria for evaluating alternative methods. The practical use of BCI technology will be determined by the development of appropriate applications and identification of appropriate user groups, and will require careful attention to the needs and desires of individual users.

Lean Six Sigma in Health Care: Improving Utilization and Reducing Waste.

PubMed

Almorsy, Lamia; Khalifa, Mohamed

2016-01-01

Healthcare costs have been increasing worldwide mainly due to over utilization of resources. The savings potentially achievable from systematic, comprehensive, and cooperative reduction in waste are far higher than from more direct and blunter cuts in care and coverage. At King Faisal Specialist Hospital and Research Center inappropriate and over utilization of the glucose test strips used for whole blood glucose determination using glucometers was observed. The hospital implemented a project to improve its utilization. Using the Six Sigma DMAIC approach (Define, Measure, Analyze, Improve and Control), an efficient practice was put in place including updating the related internal policies and procedures and the proper implementation of an effective users' training and competency check off program. That resulted in decreasing the unnecessary Quality Control (QC) runs from 13% to 4%, decreasing the failed QC runs from 14% to 7%, lowering the QC to patient testing ratio from 24/76 to 19/81.

Dynamic inverse models in human-cyber-physical systems

NASA Astrophysics Data System (ADS)

Robinson, Ryan M.; Scobee, Dexter R. R.; Burden, Samuel A.; Sastry, S. Shankar

2016-05-01

Human interaction with the physical world is increasingly mediated by automation. This interaction is characterized by dynamic coupling between robotic (i.e. cyber) and neuromechanical (i.e. human) decision-making agents. Guaranteeing performance of such human-cyber-physical systems will require predictive mathematical models of this dynamic coupling. Toward this end, we propose a rapprochement between robotics and neuromechanics premised on the existence of internal forward and inverse models in the human agent. We hypothesize that, in tele-robotic applications of interest, a human operator learns to invert automation dynamics, directly translating from desired task to required control input. By formulating the model inversion problem in the context of a tracking task for a nonlinear control system in control-a_ne form, we derive criteria for exponential tracking and show that the resulting dynamic inverse model generally renders a portion of the physical system state (i.e., the internal dynamics) unobservable from the human operator's perspective. Under stability conditions, we show that the human can achieve exponential tracking without formulating an estimate of the system's state so long as they possess an accurate model of the system's dynamics. These theoretical results are illustrated using a planar quadrotor example. We then demonstrate that the automation can intervene to improve performance of the tracking task by solving an optimal control problem. Performance is guaranteed to improve under the assumption that the human learns and inverts the dynamic model of the altered system. We conclude with a discussion of practical limitations that may hinder exact dynamic model inversion.

Seed defective reduction in automotive Electro-Deposition Coating Process of truck cabin

NASA Astrophysics Data System (ADS)

Sonthilug, Aekkalag; Chutima, Parames

2018-02-01

The case study company is one of players in Thailand’s Automotive Industry who manufacturing truck and bus for both domestic and international market. This research focuses on a product quality problem about seed defects occurred in the Electro-Deposition Coating Process of truck cabin. The 5-phase of Six Sigma methodology including D-Define, M-Measure, A-Analyze, I-Improve, and C-Control is applied to this research to identify root causes of problem for setting new parameters of each significant factor. After the improvement, seed defects in this process is reduced from 9,178 defects per unit to 876 defects per unit (90% improvement)

Predictors of yoga use among internal medicine patients.

PubMed

Cramer, Holger; Lauche, Romy; Langhorst, Jost; Paul, Anna; Michalsen, Andreas; Dobos, Gustav

2013-07-13

Yoga seems to be an effective means to cope with a variety of internal medicine conditions. While characteristics of yoga users have been investigated in the general population, little is known about predictors of yoga use and barriers to yoga use in internal medicine patients. The aim of this cross-sectional analysis was to identify sociodemographic, clinical, and psychological predictors of yoga use among internal medicine patients. A cross-sectional analysis was conducted among all patients being referred to a Department of Internal and Integrative Medicine during a 3-year period. It was assessed whether patients had ever used yoga for their primary medical complaint, the perceived benefit, and the perceived harm of yoga practice. Potential predictors of yoga use including sociodemographic characteristics, health behavior, internal medicine diagnosis, general health status, mental health, satisfaction with health, and health locus of control were assessed; and associations with yoga use were tested using multiple logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for significant predictors. Of 2486 participants, 303 (12.19%) reported having used yoga for their primary medical complaint. Of those, 184 (60.73%) reported benefits and 12 (3.96%) reported harms due to yoga practice. Compared to yoga non-users, yoga users were more likely to be 50-64 years old (OR = 1.45; 95%CI = 1.05-2.01; P = 0.025); female (OR = 2.45; 95%CI = 1.45-4.02; P < 0.001); and college graduates (OR = 1.61; 95%CI = 1.14-2.27; P = 0.007); and less likely to currently smoke (OR = 0.61; 95%CI = 0.39-0.96; P = 0.031). Manifest anxiety (OR = 1.47; 95%CI = 1.06-2.04; P = 0.020); and high internal health locus of control (OR = 1.92; 95%CI = 1.38-2.67; P < 0.001) were positively associated with yoga use, while high external-fatalistic health locus of control (OR = 0.66; 95%CI = 0.47-0.92; P = 0.014) was negatively associated with yoga use. Yoga was used for their primary medical complaint by 12.19% of an internal integrative medicine patient population and was commonly perceived as beneficial. Yoga use was not associated with the patients' specific diagnosis but with sociodemographic factors, mental health, and health locus of control. To improve adherence to yoga practice, it should be considered that male, younger, and anxious patients and those with low internal health locus of control might be less intrinsically motivated to start yoga.

Daily peer review of abnormal cervical smears in the assessment of individual practice as an additional method of internal quality control.

PubMed

Confortini, M; Di Stefano, C; Biggeri, A; Bulgaresi, P; Di Claudio, G; Grisotto, L; Maddau, C; Matucci, M; Petreschi, C; Troni, G M; Turco, P; Foxi, P

2016-02-01

An important internal quality control system used in the Cancer Prevention and Research Institute cytopathology laboratory in Florence is the peer review procedure, based on the review of all abnormal cytological smears which routinely emerge. Peer review is an important training opportunity for all cytologists, especially for those with less experience. This article shows the results of the peer review procedure. Of the 63 754 Papanicolaou (Pap) smears screened in 2011, 1086 were considered to be abnormal [at least atypical squamous cells of undetermined significance (ASC-US+)] on primary screening (selected by a single cytologist) and were subjected to the peer review procedure. The overall performance of the laboratory's cytologists was evaluated using a multiple rater analysis and the comparison of each cytologist with the final diagnosis. Further, the agreement was assessed by means of Cohen's kappa and weighted kappa statistics. In general, a moderate/substantial level of agreement between the ten cytologists and the final diagnoses was evident. Kappa values for each reader compared with the final diagnosis ranged from 0.54 to 0.69. The overall kappa value was 0.62 [95% confidence interval (CI), 0.58-0.66] and overall weighted kappa value was 0.76 (95% CI, 0.74-0.79). The category-specific agreement showed the lowest values for atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H). In summary, peer review represents an important internal quality control in the evaluation and improvement of inter-observer agreement and of the functioning of the laboratory as a whole. Multi-head microscope sessions may improve particularly the reproducibility of borderline diagnoses and, above all, can be an important training contribution for cytologists. © 2014 John Wiley & Sons Ltd.

Traceability from a US perspective.

PubMed

Smith, G C; Tatum, J D; Belk, K E; Scanga, J A; Grandin, T; Sofos, J N

2005-09-01

Traceability of a food consists of development of "an information trail that follows the food product's physical trail". Internationally, the US is lagging behind many countries in developing traceability systems for food in general and especially for livestock, poultry and their products. The US food industry is developing, implementing and maintaining traceability systems designed to improve food supply management, facilitate traceback for food safety and quality, and differentiate and market foods with subtle or undetectable quality attributes. Traceability, for livestock, poultry and meat, in its broadest context, can, could, or will eventually be used: (1) to ascertain origin and ownership, and to deter theft and misrepresentation, of animals and meat; (2) for surveillance, control and eradication of foreign animal diseases; (3) for biosecurity protection of the national livestock population; (4) for compliance with requirements of international customers; (5) for compliance with country-of-origin labeling requirements; (6) for improvement of supply-side management, distribution/delivery systems and inventory controls; (7) to facilitate value-based marketing; (8) to facilitate value-added marketing; (9) to isolate the source and extent of quality-control and food-safety problems; and (10) to minimize product recalls and make crisis management protocols more effective. Domestically and internationally, it has now become essential that producers, packers, processors, wholesalers, exporters and retailers assure that livestock, poultry and meat are identified, that record-keeping assures traceability through all or parts of the complete life-cycle, and that, in some cases, the source, the production-practices and/or the process of generating final products, can be verified. At issue, as the US develops traceback capabilities, will be the breadth, depth and precision of its specific traceability systems.

Patients' education, and its impact on care outcomes, resource consumption and working conditions: data from the International Diabetes Management Practices Study (IDMPS).

PubMed

Gagliardino, J J; Aschner, P; Baik, S H; Chan, J; Chantelot, J M; Ilkova, H; Ramachandran, A

2012-04-01

To evaluate the impact of diabetes education provided to patients with type 2 diabetes mellitus (T2DM) in non-controlled studies ("real-world conditions") on quality of care, resource consumption and conditions of employment. This cross-sectional study and longitudinal follow-up describe the data (demographic and socioeconomic profiles, clinical characteristics, treatment of hyperglycaemia and associated cardiovascular risk factors, resource consumption) collected during the second phase (2006) of the International Diabetes Management Practices Study (IDMPS). Patients received diabetes education directly from the practice nurse, dietitian or educator, or were referred to ad hoc group-education programmes; all programmes emphasized healthy lifestyle changes, self-care and active participation in disease control and treatment. Educated vs non-educated T2DM patients (n=5692 in each group), paired by age, gender and diabetes duration, were randomly recruited for the IDMPS by participating primary-care physicians from 27 countries in Eastern Europe, Asia, Latin America and Africa. Outcome measures included clinical (body weight, height, waist circumference, blood pressure, foot evaluation), metabolic (HbA(1c) levels, blood lipid profile) and biochemical control measures. Treatment goals were defined according to American Diabetes Association guidelines. T2DM patients' education significantly improved the percentage of patients achieving target values set by international guidelines. Educated patients increased their insulin use and self-care performance, had a lower rate of chronic complications and a modest increase in cost of care, and probably higher salaries and slightly better productivity. Diabetes education is an efficient tool for improving care outcomes without having a major impact on healthcare costs. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Assessing Occupational Exposure to Chemicals in an International Epidemiological Study of Brain Tumours

PubMed Central

van Tongeren, Martie

2013-01-01

The INTEROCC project is a multi-centre case–control study investigating the risk of developing brain cancer due to occupational chemical and electromagnetic field exposures. To estimate chemical exposures, the Finnish Job Exposure Matrix (FINJEM) was modified to improve its performance in the INTEROCC study and to address some of its limitations, resulting in the development of the INTEROCC JEM. An international team of occupational hygienists developed a crosswalk between the Finnish occupational codes used in FINJEM and the International Standard Classification of Occupations 1968 (ISCO68). For ISCO68 codes linked to multiple Finnish codes, weighted means of the exposure estimates were calculated. Similarly, multiple ISCO68 codes linked to a single Finnish code with evidence of heterogeneous exposure were refined. One of the key time periods in FINJEM (1960–1984) was split into two periods (1960–1974 and 1975–1984). Benzene exposure estimates in early periods were modified upwards. The internal consistency of hydrocarbon exposures and exposures to engine exhaust fumes was improved. Finally, exposure to polycyclic aromatic hydrocarbon and benzo(a)pyrene was modified to include the contribution from second-hand smoke. The crosswalk ensured that the FINJEM exposure estimates could be applied to the INTEROCC study subjects. The modifications generally resulted in an increased prevalence of exposure to chemical agents. This increased prevalence of exposure was not restricted to the lowest categories of cumulative exposure, but was seen across all levels for some agents. Although this work has produced a JEM with important improvements compared to FINJEM, further improvements are possible with the expansion of agents and additional external data. PMID:23467593

ICT-based system to predict and prevent falls (iStoppFalls): study protocol for an international multicenter randomized controlled trial.

PubMed

Gschwind, Yves J; Eichberg, Sabine; Marston, Hannah R; Ejupi, Andreas; Rosario, Helios de; Kroll, Michael; Drobics, Mario; Annegarn, Janneke; Wieching, Rainer; Lord, Stephen R; Aal, Konstantin; Delbaere, Kim

2014-08-20

Falls are very common, especially in adults aged 65 years and older. Within the current international European Commission's Seventh Framework Program (FP7) project 'iStoppFalls' an Information and Communication Technology (ICT) based system has been developed to regularly assess a person's risk of falling in their own home and to deliver an individual and tailored home-based exercise and education program for fall prevention. The primary aims of iStoppFalls are to assess the feasibility and acceptability of the intervention program, and its effectiveness to improve balance, muscle strength and quality of life in older people. This international, multicenter study is designed as a single-blinded, two-group randomized controlled trial. A total of 160 community-dwelling older people aged 65 years and older will be recruited in Germany (n = 60), Spain (n = 40), and Australia (n = 60) between November 2013 and May 2014. Participants in the intervention group will conduct a 16-week exercise program using the iStoppFalls system through their television set at home. Participants are encouraged to exercise for a total duration of 180 minutes per week. The training program consists of a variety of balance and strength exercises in the form of video games using exergame technology. Educational material about a healthy lifestyle will be provided to each participant. Final reassessments will be conducted after 16 weeks. The assessments include physical and cognitive tests as well as questionnaires assessing health, fear of falling, quality of life and psychosocial determinants. Falls will be followed up for six months by monthly falls calendars. We hypothesize that the regular use of this newly developed ICT-based system for fall prevention at home is feasible for older people. By using the iStoppFalls sensor-based exercise program, older people are expected to improve in balance and strength outcomes. In addition, the exercise training may have a positive impact on quality of life by reducing the risk of falls. Taken together with expected cognitive improvements, the individual approach of the iStoppFalls program may provide an effective model for fall prevention in older people who prefer to exercise at home. Australian New Zealand Clinical Trials Registry Trial ID: ACTRN12614000096651.International Standard Randomised Controlled Trial Number: ISRCTN15932647.

ICT-based system to predict and prevent falls (iStoppFalls): study protocol for an international multicenter randomized controlled trial

PubMed Central

2014-01-01

Background Falls are very common, especially in adults aged 65 years and older. Within the current international European Commission’s Seventh Framework Program (FP7) project ‘iStoppFalls’ an Information and Communication Technology (ICT) based system has been developed to regularly assess a person’s risk of falling in their own home and to deliver an individual and tailored home-based exercise and education program for fall prevention. The primary aims of iStoppFalls are to assess the feasibility and acceptability of the intervention program, and its effectiveness to improve balance, muscle strength and quality of life in older people. Methods/Design This international, multicenter study is designed as a single-blinded, two-group randomized controlled trial. A total of 160 community-dwelling older people aged 65 years and older will be recruited in Germany (n = 60), Spain (n = 40), and Australia (n = 60) between November 2013 and May 2014. Participants in the intervention group will conduct a 16-week exercise program using the iStoppFalls system through their television set at home. Participants are encouraged to exercise for a total duration of 180 minutes per week. The training program consists of a variety of balance and strength exercises in the form of video games using exergame technology. Educational material about a healthy lifestyle will be provided to each participant. Final reassessments will be conducted after 16 weeks. The assessments include physical and cognitive tests as well as questionnaires assessing health, fear of falling, quality of life and psychosocial determinants. Falls will be followed up for six months by monthly falls calendars. Discussion We hypothesize that the regular use of this newly developed ICT-based system for fall prevention at home is feasible for older people. By using the iStoppFalls sensor-based exercise program, older people are expected to improve in balance and strength outcomes. In addition, the exercise training may have a positive impact on quality of life by reducing the risk of falls. Taken together with expected cognitive improvements, the individual approach of the iStoppFalls program may provide an effective model for fall prevention in older people who prefer to exercise at home. Trial registration Australian New Zealand Clinical Trials Registry Trial ID: ACTRN12614000096651. International Standard Randomised Controlled Trial Number: ISRCTN15932647. PMID:25141850

12 CFR 618.8430 - Internal controls.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Internal controls. 618.8430 Section 618.8430 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Internal Controls § 618.8430 Internal controls. Each Farm Credit institution's board of directors must adopt an internal control policy, providing adequate direction to...

Interventions to prevent and control food-borne diseases associated with a reduction in traveler's diarrhea in tourists to Jamaica.

PubMed

Ashley, David V M; Walters, Christine; Dockery-Brown, Cheryl; McNab, André; Ashley, Deanna E C

2004-01-01

In 1996 a study found that approximately one in four tourists to Jamaica were affected with traveler's diarrhea (TD) during their stay. That year the Ministry of Health initiated a program for the prevention and control of TD. The aim of this ongoing program was to reduce attack rates of TD from 25% to 12% over a 5-year period by improving the environmental health and food safety standards of hotels. Hotel-based surveillance procedures for TD were implemented in sentinel hotels in Negril and Montego Bay in 1996, Ocho Rios in 1997, and Kingston in 1999. A structured program provided training and technical assistance to nurses, food and beverage staff, and environmental sanitation personnel in the implementation of Hazard Analysis Critical Control Point principles for monitoring food safety standards. The impact of interventions on TD was assessed in a survey of tourists departing from the international airport in Montego Bay in 1997-1998 and from the international airport in Kingston in 1999-2000. The impact of the training and technical assistance program on food safety standards and practices was assessed in hotels in Ocho Rios as of 1998 and in Kingston from 1999. At the end of May 2002, TD incidence rates were 72% lower than in 1996, when the Ministry of Health initiated its program for the prevention and control of TD. Both hotel surveillance data and airport surveillance data suggest that the vast majority of travelers to Kingston and southern regions are not afflicted with TD during their stay. The training and technical assistance program improved compliance to food safety standards over time. Interventions to prevent and control TD in visitors to Jamaica are positively associated with a reduction in TD in the visitor population and improvements in food safety standards and practices in hotels.

Evaluation of warfarin management with international normalized ratio self-testing and online remote monitoring and management plus low-dose vitamin k with genomic considerations: a pilot study.

PubMed

Bussey, Henry I; Bussey, Marie; Bussey-Smith, Kristin L; Frei, Christopher R

2013-11-01

As better international normalized ratio (INR) control and self-testing reduce events in warfarin-treated patients, and vitamin K supplementation may improve INR control, our primary objective was to evaluate the effect of a system combining frequent INR self-testing with online remote monitoring and management (STORM₂) and low-dose vitamin K supplementation on INR control; our secondary objectives were to assess the impact of STORM₂ on clinician time and to evaluate the influence of pharmacogenomics on INR stability and warfarin dose after vitamin K supplementation. Prospective pre- and postintervention study. Freestanding clinical research center. Fifty-five patients treated with long-term warfarin therapy who were referred from four anticoagulation clinics and seven medical practices. All patients performed weekly INR self-testing and received vitamin K 100 µg/day and online anticoagulation management for 1 year. INR control and time required for anticoagulation management were assessed, and an analysis of warfarin dosing and INR stability by genetic polymorphism subgroup (vitamin K epoxide reductase complex 1 [VKORC1] and cytochrome P450 2C9 isoenzyme) was performed; vitamin K product content was also analyzed. The percentage of time that the INR is within the time in therapeutic range (TTR) improved from 56% before the intervention to 81% after the intervention (p<0.0001), and time spent at extreme INR values of lower than 1.5 or higher than 5 was reduced from 3.1% to 0.4% (p=0.01). Clinician time was less than 10 minutes per four patient visits per month. Genetic polymorphisms did not correlate with INR stability or the increase in warfarin dose after vitamin K supplementation. The content of the vitamin K product, however, was only 34-76% of the labeled amount. Patients with the GG VKORC1 genotype required a higher warfarin dose than predicted by the genomic-based dosing chart in the warfarin package insert. The 25% point improvement in TTR with STORM₂ is a greater improvement than reported previously with other efforts to improve TTR. STORM₂ required a minimum amount of clinician time. Pharmacogenomics were not predictive of improved INR control or the magnitude of the warfarin dose after vitamin K supplementation, although the content of the product was unreliable. Patients with the GG VKORC1 genotype required a higher warfarin dose than predicted by the product information. The potential clinical impact of improved INR control with this method warrants comparisons with conventionally managed warfarin and with the new oral anticoagulants. © 2013 Pharmacotherapy Publications, Inc.

Internal quality control: planning and implementation strategies.

PubMed

Westgard, James O

2003-11-01

The first essential in setting up internal quality control (IQC) of a test procedure in the clinical laboratory is to select the proper IQC procedure to implement, i.e. choosing the statistical criteria or control rules, and the number of control measurements, according to the quality required for the test and the observed performance of the method. Then the right IQC procedure must be properly implemented. This review focuses on strategies for planning and implementing IQC procedures in order to improve the quality of the IQC. A quantitative planning process is described that can be implemented with graphical tools such as power function or critical-error graphs and charts of operating specifications. Finally, a total QC strategy is formulated to minimize cost and maximize quality. A general strategy for IQC implementation is recommended that employs a three-stage design in which the first stage provides high error detection, the second stage low false rejection and the third stage prescribes the length of the analytical run, making use of an algorithm involving the average of normal patients' data.

Using a pocket card to improve end-of-life care on internal medicine clinical teaching units: a cluster-randomized controlled trial.

PubMed

Mikhael, Joseph; Baker, Lindsay; Downar, James

2008-08-01

End-of-life care is suboptimally taught in undergraduate and postgraduate education in Canada. Previous interventions to improve residents' knowledge and comfort have involved lengthy comprehensive educational modules or dedicated palliative care rotations. To determine the effectiveness of a cheap, portable, and easily implemented pocket reference for improving residents' knowledge and comfort level in dealing with pain and symptom management on the medical ward. Cluster-randomized controlled trial conducted from August 2005 to June 2006. Medical clinical teaching units (CTUs) in 3 academic hospitals in Toronto, Canada. All residents rotating through the medical CTUs who consented to participate in the study. Residents at 1 hospital received a pocket reference including information about pain and symptom control, as well as 1-2 didactic end-of-life teaching sessions per month normally given as part of the rotation. Residents at the other 2 hospitals received only the didactic sessions. A 10-question survey assessing knowledge and comfort level providing end-of-life care to medical inpatients, as well as focus group interviews. One hundred thirty-six residents participated on 3 CTUs for a participation rate of approximately 75%. Comfort levels improved in both control (p < .01) and intervention groups (p < .01), but the increase in comfort level was significantly higher in the intervention group (z = 2.57, p < .01). Knowledge was not significantly improved in the control group (p = .06), but was significantly improved in the intervention group (p = .01). Greater than 90% of residents in the intervention group used the card at least once per week, and feedback from the focus groups was very positive. Our pocket card is a feasible, economical, and educational intervention that improves resident comfort level and knowledge in delivering end-of-life care on CTUs.

Measuring effectiveness of drugs in observational databanks: promises and perils

PubMed Central

Krishnan, Eswar; Fries, James F

2004-01-01

Observational databanks have inherent strengths and shortcomings. As in randomized controlled trials, poor design of these databanks can either exaggerate or reduce estimates of drug effectiveness and can limit generalizability. This commentary highlights selected aspects of study design, data collection and statistical analysis that can help overcome many of these inadequacies. An international metaRegister and a formal mechanism for standardizing and sharing drug data could help improve the utility of databanks. Medical journals have a vital role in enforcing a quality checklist that improves reporting. PMID:15059263

Aerodynamic investigations into various low speed L/D improvement devices on the 140A/B space shuttle orbiter configuration in the Rockwell International low speed wind tunnel (OA86)

NASA Technical Reports Server (NTRS)

Mennell, R. C.

1974-01-01

Tests were conducted to investigate various base drag reduction techniques in an attempt to improve Orbiter lift-to-drag ratios and to calculate sting interference effects on the Orbiter aerodynamic characteristics. Test conditions and facilites, and model dimensional data are presented along with the data reduction guidelines and data set/run number collation used for the studies. Aerodynamic force and moment data and the results of stability and control tests are also given.

Randomized, double-blind, placebo-controlled trial of saw palmetto in men with lower urinary tract symptoms.

PubMed

Gerber, G S; Kuznetsov, D; Johnson, B C; Burstein, J D

2001-12-01

To assess the effects of saw palmetto on urinary symptoms, sexual function, and urinary flow rate in men with lower urinary tract symptoms using a double-blind, randomized, placebo-controlled trial. The eligible patients were 45 years of age or older and had an International Prostate Symptom Score of 8 or greater. After a 1-month placebo run-in period, 85 men were randomized to receive saw palmetto or placebo for 6 months. Patients were evaluated using the International Prostate Symptom Score, a sexual function questionnaire, and by measurement of the urinary flow rate. The mean symptom score decreased from 16.7 to 12.3 in the saw palmetto group compared with 15.8 to 13.6 in the placebo group (P = 0.038). The quality-of-life score improved to a greater degree in the saw palmetto group, but this difference was not statistically significant. No change occurred in the sexual function questionnaire results in either group. The peak flow rate increased by 1.0 mL/s and 1.4 mL/s in the saw palmetto and placebo groups, respectively (P = 0.73). Saw palmetto led to a statistically significant improvement in urinary symptoms in men with lower urinary tract symptoms compared with placebo. Saw palmetto had no measurable effect on the urinary flow rates. The mechanism by which saw palmetto improves urinary symptoms remains unknown.

Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial.

PubMed

Desai, Sanjay V; Feldman, Leonard; Brown, Lorrel; Dezube, Rebecca; Yeh, Hsin-Chieh; Punjabi, Naresh; Afshar, Kia; Grunwald, Michael R; Harrington, Colleen; Naik, Rakhi; Cofrancesco, Joseph

2013-04-22

On July 1, 2011, the Accreditation Council for Graduate Medical Education implemented further restrictions of its 2003 regulations on duty hours and supervision. It remains unclear if the 2003 regulations improved trainee well-being or patient safety. To determine the effects of the 2011 Accreditation Council for Graduate Medical Education duty hour regulations compared with the 2003 regulations concerning sleep duration, trainee education, continuity of patient care, and perceived quality of care among internal medicine trainees. Crossover study design in an academic research setting. Medical house staff. General medical teams were randomly assigned using a sealed-envelope draw to an experimental model or a control model. We randomly assigned 4 medical house staff teams (43 interns) using a 3-month crossover design to a 2003-compliant model of every fourth night overnight call (control) with 30-hour duty limits or to one of two 2011-compliant models of every fifth night overnight call (Q5) or a night float schedule (NF), both with 16-hour duty limits. We measured sleep duration using actigraphy and used admission volumes, educational opportunities, the number of handoffs, and satisfaction surveys to assess trainee education, continuity of patient care, and perceived quality of care. RESULTS The study included 560 control, 420 Q5, and 140 NF days that interns worked and 834 hospital admissions. Compared with controls, interns on NF slept longer during the on call period (mean, 5.1 vs 8.3 hours; P = .003), and interns on Q5 slept longer during the postcall period (mean, 7.5 vs 10.2 hours; P = .05). However, both the Q5 and NF models increased handoffs, decreased availability for teaching conferences, and reduced intern presence during daytime work hours. Residents and nurses in both experimental models perceived reduced quality of care, so much so with NF that it was terminated early. Compared with a 2003-compliant model, two 2011 duty hour regulation-compliant models were associated with increased sleep duration during the on-call period and with deteriorations in educational opportunities, continuity of patient care, and perceived quality of care.

Sense of coherence, self-esteem, and health locus of control in subjects with type 1 diabetes mellitus with/without satisfactory metabolic control.

PubMed

Nuccitelli, C; Valentini, A; Caletti, M T; Caselli, C; Mazzella, N; Forlani, G; Marchesini, G

2018-03-01

Despite intensive training, a few individuals with Type 1 diabetes mellitus (T1DM) fail to reach the desired metabolic targets. To evaluate the association between disease-related emotional and cognitive aspects and metabolic control in subjects with T1DM. Health locus of control (HLOC), sense of coherence (SOC), and self-esteem were assessed in T1DM subjects using validated questionnaires. Sixty-seven consecutive subjects who did not attain the desired HbA1c target (mean HbA1c, 8.3% [67 mmol/mol]) were compared with 30 cases in satisfactory metabolic control (HbA1c levels <7%-53 mmol/mol). In the overall population, SOC was negatively associated with BMI and average HbA1c, as was the association of self-esteem with HbA1c. Subjects attaining the desired metabolic target were characterized by higher SOC scores, higher Internal HLOC and prevalent Internal vs. Powerful-others HLOC. Compared to subjects in good metabolic control, subjects with unsatisfactory control had lower scores of SOC, Internal HLOC and Self-esteem, with no difference in Powerful others, or Chance HLOC. In the same group, SOC in the upper tertile was significantly associated with self-esteem (OR 1.35; 95% CI 1.08-1.69) and PHLOC (OR 1.24; 95% CI 1.03-1.49), after adjustment for age, sex, educational level, and comorbidities. Patients who fail to reach a satisfactory metabolic control tend to rely on significant others, trusting in the physicians' skills or on the efficiency of the health-care system. Strategies aimed at increasing self-efficacy and SOC, based on personal ability, are eagerly awaited to help patients improve diabetes care.

Development of internal amplification controls for DNA profiling with the AmpFℓSTR(®) SGM Plus(®) kit.

PubMed

Zahra, Nathalie; Hadi, Sibte; Smith, Judith A; Iyengar, Arati; Goodwin, William

2011-06-01

DNA extracted from forensic samples can be degraded and also contain co-extracted contaminants that inhibit PCR. The effects of DNA degradation and PCR inhibition are often indistinguishable when examining a DNA profile. Two internal amplification controls (IACs) were developed to improve quality control of PCR using the AmpFℓSTR® SGM Plus® kit. The co-amplification of these controls with DNA samples was used to monitor amplification efficiency and detect PCR inhibitors. IAC fragments of 90 and 410 bp (IAC₉₀ and IAC₄₁₀) were generated from the plasmid pBR322 using tailed primers and then amplified with ROX-labelled primers. Co-amplification of IAC₉₀ and IAC₄₁₀ was performed with varying amounts of template DNA, degraded DNA and DNA contaminated with humic acid, heme and indigo dye. Both IAC₉₀ and IAC₄₁₀ were successfully amplified with human DNA without significantly affecting the quality of the DNA profile, even with DNA amounts lower than 0.5 ng. In the presence of inhibitors, the IAC₉₀ signal was still present after all human DNA loci fail to amplify; in contrast, the IAC₄₁₀ signal was reduced or absent at low levels of inhibition. Amplification of the two IACs provided an internal PCR control and allowed partial profiles caused by inhibition to be distinguished from degraded DNA profiles. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Improved Controls for Fusion RF Systems. Final technical report

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

Casey, Jeffrey A.

2011-11-08

We have addressed the specific requirements for the integrated systems controlling an array of klystrons used for Lower Hybrid Current Drive (LHCD). The immediate goal for our design was to modernize the transmitter protection system (TPS) for LHCD on the Alcator C-Mod tokamak at the MIT Plasma Science and Fusion Center (MIT-PSFC). Working with the Alcator C-Mod team, we have upgraded the design of these controls to retrofit for improvements in performance and safety, as well as to facilitate the upcoming expansion from 12 to 16 klystrons. The longer range goals to generalize the designs in such a way thatmore » they will be of benefit to other programs within the international fusion effort was met by designing a system which was flexible enough to address all the MIT system requirements, and modular enough to adapt to a large variety of other requirements with minimal reconfiguration.« less

A comparison between electromechanical and pneumatic-controlled knee simulators for the investigation of wear of total knee replacements.

PubMed

Abdelgaied, Abdellatif; Fisher, John; Jennings, Louise M

2017-07-01

More robust preclinical experimental wear simulation methods are required in order to simulate a wider range of activities, observed in different patient populations such as younger more active patients, as well as to fully meet and be capable of going well beyond the existing requirements of the relevant international standards. A new six-station electromechanically driven simulator (Simulation Solutions, UK) with five fully independently controlled axes of articulation for each station, capable of replicating deep knee bending as well as other adverse conditions, which can be operated in either force or displacement control with improved input kinematic following, has been developed to meet these requirements. This study investigated the wear of a fixed-bearing total knee replacement using this electromechanically driven fully independent knee simulator and compared it to previous data from a predominantly pneumatically controlled simulator in which each station was not fully independently controlled. In addition, the kinematic performance and the repeatability of the simulators have been investigated and compared to the international standard requirements. The wear rates from the electromechanical and pneumatic knee simulators were not significantly different, with wear rates of 2.6 ± 0.9 and 2.7 ± 0.9 mm 3 /million cycles (MC; mean ± 95% confidence interval, p = 0.99) and 5.4 ± 1.4 and 6.7 ± 1.5 mm 3 /MC (mean ± 95 confidence interval, p = 0.54) from the electromechanical and pneumatic simulators under intermediate levels (maximum 5 mm) and high levels (maximum 10 mm) of anterior-posterior displacements, respectively. However, the output kinematic profiles of the control system, which drive the motion of the simulator, followed the input kinematic profiles more closely on the electromechanical simulator than the pneumatic simulator. In addition, the electromechanical simulator was capable of following kinematic and loading input cycles within the tolerances of the international standard requirements (ISO 14243-3). The new-generation electromechanical knee simulator with fully independent control has the potential to be used for a much wider range of kinematic conditions, including high-flexion and other severe conditions, due to its improved capability and performance in comparison to the previously used pneumatic-controlled simulators.

A comparison between electromechanical and pneumatic-controlled knee simulators for the investigation of wear of total knee replacements

PubMed Central

Abdelgaied, Abdellatif; Fisher, John; Jennings, Louise M

2017-01-01

More robust preclinical experimental wear simulation methods are required in order to simulate a wider range of activities, observed in different patient populations such as younger more active patients, as well as to fully meet and be capable of going well beyond the existing requirements of the relevant international standards. A new six-station electromechanically driven simulator (Simulation Solutions, UK) with five fully independently controlled axes of articulation for each station, capable of replicating deep knee bending as well as other adverse conditions, which can be operated in either force or displacement control with improved input kinematic following, has been developed to meet these requirements. This study investigated the wear of a fixed-bearing total knee replacement using this electromechanically driven fully independent knee simulator and compared it to previous data from a predominantly pneumatically controlled simulator in which each station was not fully independently controlled. In addition, the kinematic performance and the repeatability of the simulators have been investigated and compared to the international standard requirements. The wear rates from the electromechanical and pneumatic knee simulators were not significantly different, with wear rates of 2.6 ± 0.9 and 2.7 ± 0.9 mm3/million cycles (MC; mean ± 95% confidence interval, p = 0.99) and 5.4 ± 1.4 and 6.7 ± 1.5 mm3/MC (mean ± 95 confidence interval, p = 0.54) from the electromechanical and pneumatic simulators under intermediate levels (maximum 5 mm) and high levels (maximum 10 mm) of anterior–posterior displacements, respectively. However, the output kinematic profiles of the control system, which drive the motion of the simulator, followed the input kinematic profiles more closely on the electromechanical simulator than the pneumatic simulator. In addition, the electromechanical simulator was capable of following kinematic and loading input cycles within the tolerances of the international standard requirements (ISO 14243-3). The new-generation electromechanical knee simulator with fully independent control has the potential to be used for a much wider range of kinematic conditions, including high-flexion and other severe conditions, due to its improved capability and performance in comparison to the previously used pneumatic-controlled simulators. PMID:28661228

Testing specificity among parents' depressive symptoms, parenting, and child internalizing and externalizing symptoms.

PubMed

Gruhn, Meredith A; Dunbar, Jennifer P; Watson, Kelly H; Reising, Michelle M; McKee, Laura; Forehand, Rex; Cole, David A; Compas, Bruce E

2016-04-01

The present study examined the specificity in relations between observed withdrawn and intrusive parenting behaviors and children's internalizing and externalizing symptoms in an at-risk sample of children (ages 9 to 15 years old) of parents with a history of depression (N = 180). Given past findings that parental depression and parenting behaviors may differentially impact boys and girls, gender was examined as a moderator of the relations between these factors and child adjustment. Correlation and linear regression analyses showed that parental depressive symptoms were significantly related to withdrawn parenting for parents of boys and girls and to intrusive parenting for parents of boys only. When controlling for intrusive parenting, preliminary analyses demonstrated that parental depressive symptoms were significantly related to withdrawn parenting for parents of boys, and this association approached significance for parents of girls. Specificity analyses yielded that, when controlling for the other type of problem (i.e., internalizing or externalizing), withdrawn parenting specifically predicted externalizing problems but not internalizing problems in girls. No evidence of specificity was found for boys in this sample, suggesting that impaired parenting behaviors are diffusely related to both internalizing and externalizing symptoms for boys. Overall, results highlight the importance of accounting for child gender and suggest that targeting improvement in parenting behaviors and the reduction of depressive symptoms in interventions with parents with a history of depression may have potential to reduce internalizing and externalizing problems in this high-risk population. (c) 2016 APA, all rights reserved).

Assuring fish safety and quality in international fish trade.

PubMed

Ababouch, Lahsen

2006-01-01

International trade in fishery commodities reached US 58.2 billion dollars in 2002, a 5% improvement relative to 2000 and a 45% increase over 1992 levels. Within this global trade, developing countries registered a net trade surplus of US 17.4 billion dollars in 2002 and accounted for almost 50% by value and 55% of fish exports by volume. This globalization of fish trade, coupled with technological developments in food production, handling, processing and distribution, and the increasing awareness and demand of consumers for safe and high quality food have put food safety and quality assurance high in public awareness and a priority for many governments. Consequently, many countries have tightened food safety controls, imposing additional costs and requirements on imports. As early as 1980, there was an international drive towards adopting preventative HACCP-based safety and quality systems. More recently, there has been a growing awareness of the importance of an integrated, multidisciplinary approach to food safety and quality throughout the entire food chain. Implementation of this approach requires an enabling policy and regulatory environment at national and international levels with clearly defined rules and standards, establishment of appropriate food control systems and programmes at national and local levels, and provision of appropriate training and capacity building. This paper discusses the international framework for fish safety and quality, with particular emphasis on the United Nation's Food and Agricultural Organization's (FAO) strategy to promote international harmonization and capacity building.

Testing Specificity Among Parents’ Depressive Symptoms, Parenting, and Child Internalizing and Externalizing Symptoms

PubMed Central

Gruhn, Meredith A.; Dunbar, Jennifer P.; Watson, Kelly H.; Reising, Michelle M.; McKee, Laura; Forehand, Rex; Cole, David A.; Compas, Bruce E.

2016-01-01

The present study examined the specificity in relations between observed withdrawn and intrusive parenting behaviors and children's internalizing and externalizing symptoms in an at risk sample of children (ages 9 to 15-years-old) of parents with a history of depression (N = 180). Given past findings that parental depression and parenting behaviors may differentially impact boys and girls, gender was examined as a moderator of the relations between these factors and child adjustment. Correlation and linear regression analyses showed that parental depressive symptoms were significantly related to withdrawn parenting for parents of boys and girls and to intrusive parenting for parents of boys only. When controlling for intrusive parenting, preliminary analyses demonstrated that parental depressive symptoms were significantly related to withdrawn parenting for parents of boys, and this association approached significance for parents of girls. Specificity analyses yielded that, when controlling for the other type of problem (i.e., internalizing or externalizing), withdrawn parenting specifically predicted externalizing problems but not internalizing problems in girls. No evidence of specificity was found for boys in this sample, suggesting that impaired parenting behaviors are diffusely related to both internalizing and externalizing symptoms for boys. Overall, results highlight the importance of accounting for child gender and suggest that targeting improvement in parenting behaviors and the reduction of depressive symptoms in interventions with parents with a history of depression may have potential to reduce internalizing and externalizing problems in this high-risk population. PMID:26882467

Strengthening core public health capacity based on the implementation of the International Health Regulations (IHR) (2005): Chinese lessons.

PubMed

Liu, Bin; Sun, Yan; Dong, Qian; Zhang, Zongjiu; Zhang, Liang

2015-04-17

As an international legal instrument, the International Health Regulations (IHR) is internationally binding in 196 countries, especially in all the member states of the World Health Organization (WHO). The IHR aims to prevent, protect against, control, and respond to the international spread of disease and aims to cut out unnecessary interruptions to traffic and trade. To meet IHR requirements, countries need to improve capacity construction by developing, strengthening, and maintaining core response capacities for public health risk and Public Health Emergency of International Concern (PHEIC). In addition, all the related core capacity requirements should be met before June 15, 2012. If not, then the deadline can be extended until 2016 upon request by countries. China has promoted the implementation of the IHR comprehensively, continuingly strengthening the core public health capacity and advancing in core public health emergency capacity building, points of entry capacity building, as well as risk prevention and control of biological events (infectious diseases, zoonotic diseases, and food safety), radiological, nuclear, and chemical events, and other catastrophic events. With significant progress in core capacity building, China has dealt with many public health emergencies successfully, ensuring that its core public health capacity has met the IHR requirements, which was reported to WHO in June 2014. This article describes the steps, measures, and related experiences in the implementation of IHR in China. © 2015 by Kerman University of Medical Sciences.

Appearance Self-Attitudes of African American and European American Women: Media Comparisons and Internalization of Beauty Ideals

ERIC Educational Resources Information Center

Jefferson, Deana L.; Stake, Jayne E.

2009-01-01

African American (AA) women have reported less body image disturbance than European American (EA) women, but questions remain about the nature and extent of this difference. This study examined differences in the body image of 80 AA women and 89 EA women with an improved methodology that controlled for body size, distinguished between satisfaction…

Internal Aspects of the Skill Transfer of Manual Assembly Work

ERIC Educational Resources Information Center

Doyo, Daisuke

2009-01-01

In manual assembly work, parts are often assembled by applying force with a simple tool or by hand. A worker thus needs control the force he or she applies in working, as an appropriate level of force is requisite for minimizing work failures and improving efficiency. The object of this study is to clarify the relationship between the level of…

Canada's Approach to School Funding: The Adoption of Provincial Control of Education Funding in Three Provinces

ERIC Educational Resources Information Center

Herman, Juliana

2013-01-01

The academic success of Finland, South Korea, and others on recent international tests has sparked a renewed interest among educators and those concerned with education policy in the United States in looking to other countries for examples of how we might improve our education system. Teacher training and quality in leading countries has received…

The quest for equity in Latin America: a comparative analysis of the health care reforms in Brazil and Colombia

PubMed Central

2012-01-01

Introduction Brazil and Colombia have pursued extensive reforms of their health care systems in the last couple of decades. The purported goals of such reforms were to improve access, increase efficiency and reduce health inequities. Notwithstanding their common goals, each country sought a very different pathway to achieve them. While Brazil attempted to reestablish a greater level of State control through a public national health system, Colombia embraced market competition under an employer-based social insurance scheme. This work thus aims to shed some light onto why they pursued divergent strategies and what that has meant in terms of health outcomes. Methods A critical review of the literature concerning equity frameworks, as well as the health care reforms in Brazil and Colombia was conducted. Then, the shortfall inequality values of crude mortality rate, infant mortality rate, under-five mortality rate, and life expectancy for the period 1960-2005 were calculated for both countries. Subsequently, bivariate and multivariate linear regression analyses were performed and controlled for possibly confounding factors. Results When controlling for the underlying historical time trend, both countries appear to have experienced a deceleration of the pace of improvements in the years following the reforms, for all the variables analyzed. In the case of Colombia, some of the previous gains in under-five mortality rate and crude mortality rate were, in fact, reversed. Conclusions Neither reform seems to have had a decisive positive impact on the health outcomes analyzed for the defined time period of this research. This, in turn, may be a consequence of both internal characteristics of the respective reforms and external factors beyond the direct control of health reformers. Among the internal characteristics: underfunding, unbridled decentralization and inequitable access to care seem to have been the main constraints. Conversely, international economic adversities, high levels of rural and urban violence, along with entrenched income inequalities seem to have accounted for the highest burden among external factors. PMID:22296659

International Space Station (ISS) Carbon Dioxide Removal Assembly (CDRA) Desiccant/Adsorbent Bed (DAB) Orbital Replacement Unit (ORU) Redesign

NASA Technical Reports Server (NTRS)

Reysa, Richard P.; Lumpkin, John P.; Sherif, Dian El; Kay, Robert; Williams, David E.

2007-01-01

The Carbon Dioxide Removal Assembly (CDRA) is a part of the International Space Station (ISS) Environmental Control and Life Support (ECLS) system. The CDRA provides carbon dioxide (CO2) removal from the ISS on-orbit modules. Currently, the CDRA is the secondary removal system on the ISS, with the primary system being the Russian Vozdukh. Within the CDRA are two desiccant/adsorbent beds (DAB), which perform the carbon dioxide removal function. The DAB adsorbent containment approach required improvements with respect to adsorbent containment. These improvements were implemented through a redesign program and have been implemented on units returning from orbit. This paper presents a DAB design modification implementation description, a hardware performance comparison between the unmodified and modified DAB configurations, and a description of the modified DAB hardware implementation into the on-orbit CDRA.

Engineering the internal surfaces of three-dimensional nanoporous catalysts by surfactant-modified dealloying.

PubMed

Wang, Zhili; Liu, Pan; Han, Jiuhui; Cheng, Chun; Ning, Shoucong; Hirata, Akihiko; Fujita, Takeshi; Chen, Mingwei

2017-10-20

Tuning surface structures by bottom-up synthesis has been demonstrated as an effective strategy to improve the catalytic performances of nanoparticle catalysts. Nevertheless, the surface modification of three-dimensional nanoporous metals, fabricated by a top-down dealloying approach, has not been achieved despite great efforts devoted to improving the catalytic performance of three-dimensional nanoporous catalysts. Here we report a surfactant-modified dealloying method to tailor the surface structure of nanoporous gold for amplified electrocatalysis toward methanol oxidation and oxygen reduction reactions. With the assistance of surfactants, {111} or {100} faceted internal surfaces of nanoporous gold can be realized in a controllable manner by optimizing dealloying conditions. The surface modified nanoporous gold exhibits significantly enhanced electrocatalytic activities in comparison with conventional nanoporous gold. This study paves the way to develop high-performance three-dimensional nanoporous catalysts with a tunable surface structure by top-down dealloying for efficient chemical and electrochemical reactions.

[Educational and social outcome after childhood cancer].

PubMed

Bonneau, Jacinthe; Dugas, Karyn; Louis, Aurélien; Morel, Laëtitia; Toughza, Jihane; Frappaz, Didier

2015-01-01

The survival rate improvement of childhood cancer survivors lead to question about their educational and social outcome. Authors suggest an international review in order to find risk factors of school or social failure after cancer experience. Principal cohort is studied in USA (the Children Cancer Survivor Study). Nevertheless, European studies are also published. The results vary, depending on subpopulation studied and on control choice (siblings or general population). Treatment improvement and supportive care make difficult to compare studies with current situations. Moreover, there are not international standard of education or social outcome. School and social behaviour are influenced by: types of tumor (cerebral tumor but also sometimes hemopathy and osteosarcoma), age at diagnosis (very young children and adolescent), treatments (neurotoxical treatments, hematopoietic stem cell transplant), and social or educational status of the parents. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

12 CFR 618.8430 - Internal controls.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Internal controls. 618.8430 Section 618.8430 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Internal Controls § 618.8430 Internal controls. Each Farm Credit institution's board of directors must adopt an internal...

12 CFR 618.8430 - Internal controls.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Internal controls. 618.8430 Section 618.8430 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Internal Controls § 618.8430 Internal controls. Each Farm Credit institution's board of directors must adopt an internal...

12 CFR 618.8430 - Internal controls.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Internal controls. 618.8430 Section 618.8430 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Internal Controls § 618.8430 Internal controls. Each Farm Credit institution's board of directors must adopt an internal...

12 CFR 618.8430 - Internal controls.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 7 2014-01-01 2014-01-01 false Internal controls. 618.8430 Section 618.8430 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM GENERAL PROVISIONS Internal Controls § 618.8430 Internal controls. Each Farm Credit institution's board of directors must adopt an internal...

Space Station Control Moment Gyroscope Lessons Learned

NASA Technical Reports Server (NTRS)

Gurrisi, Charles; Seidel, Raymond; Dickerson, Scott; Didziulis, Stephen; Frantz, Peter; Ferguson, Kevin

2010-01-01

Four 4760 Nms (3510 ft-lbf-s) Double Gimbal Control Moment Gyroscopes (DGCMG) with unlimited gimbal freedom about each axis were adopted by the International Space Station (ISS) Program as the non-propulsive solution for continuous attitude control. These CMGs with a life expectancy of approximately 10 years contain a flywheel spinning at 691 rad/s (6600 rpm) and can produce an output torque of 258 Nm (190 ft-lbf)1. One CMG unexpectedly failed after approximately 1.3 years and one developed anomalous behavior after approximately six years. Both units were returned to earth for failure investigation. This paper describes the Space Station Double Gimbal Control Moment Gyroscope design, on-orbit telemetry signatures and a summary of the results of both failure investigations. The lessons learned from these combined sources have lead to improvements in the design that will provide CMGs with greater reliability to assure the success of the Space Station. These lessons learned and design improvements are not only applicable to CMGs but can be applied to spacecraft mechanisms in general.

Pharmacist-led, primary care-based disease management improves hemoglobin A1c in high-risk patients with diabetes.

PubMed

Rothman, Russell; Malone, Robb; Bryant, Betsy; Horlen, Cheryl; Pignone, Michael

2003-01-01

We developed and evaluated a comprehensive pharmacist-led, primary care-based diabetes disease management program for patients with Type 2 diabetes and poor glucose control at our academic general internal medicine practice. The primary goal of this program was to improve glucose control, as measured by hemoglobin A1c (HbA1c). Clinic-based pharmacists offered support to patients with diabetes through direct teaching about diabetes, frequent phone follow-up, medication algorithms, and use of a database that tracked patient outcomes and actively identified opportunities to improve care. From September 1999, to May 2000, 159 subjects were enrolled, and complete follow-up data were available for 138 (87%) patients. Baseline HbA1c averaged 10.8%, and after an average of 6 months of intervention, the mean reduction in HbA1c was 1.9 percentage points (95% confidence interval, 1.5-2.3). In predictive regression modeling, baseline HbA1c and new onset diabetes were associated with significant improvements in HbA1c. Age, race, gender, educational level, and provider status were not significant predictors of improvement. In conclusion, a pharmacist-based diabetes care program integrated into primary care practice significantly reduced HbA1c among patients with diabetes and poor glucose control.

Investigation on sense of control parameters for joystick interface in remote operated container crane application

NASA Astrophysics Data System (ADS)

Abdullah, U. N. N.; Handroos, H.

2017-09-01

Introduction: This paper presents the study of sense of control parameters to improve the lack of direct motion feeling through remote operated container crane station (ROCCS) joystick interface. The investigations of the parameters in this study are important to develop the engineering parameters related to the sense of control goal in the next design process. Methodology: Structured interviews and observations were conducted to obtain the user experience data from thirteen remote container crane operators from two international terminals. Then, interview analysis, task analysis, activity analysis and time line analysis were conducted to compare and contrast the results from interviews and observations. Results: Four experience parameters were identified to support the sense of control goal in the later design improvement of the ROCC joystick interface. The significance of difficulties to control, unsynchronized movements, facilitate in control and decision making in unexpected situation as parameters to the sense of control goal were validated by' feedbacks from operators as well as analysis. Contribution: This study provides feedback directly from end users towards developing a sustainable control interface for ROCCS in specific and remote operated off-road vehicles in general.

A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners.

PubMed

Ireland, Michael J; Clough, Bonnie; Gill, Kim; Langan, Fleur; O'Connor, Angela; Spencer, Lyndall

2017-04-01

Stress and burnout are highly prevalent among medical doctors, and are associated with negative consequences for doctors, patients, and organizations. The purpose of the current study was to examine the effectiveness of a mindfulness training intervention in reducing stress and burnout among medical practitioners, by means of a Randomised Controlled Trial design. Participants were 44 intern doctors completing an emergency department rotation in a major Australian hospital. Participants were randomly assigned to either an active control (one hour extra break per week) or the 10-week mindfulness training intervention. Measures of stress and burnout were taken pre-, mid- and post intervention. Participants undergoing the 10-week mindfulness training program reported greater improvements in stress and burnout relative to participants in the control condition. Significant reduction in stress and burnout was observed for participants in the mindfulness condition. No such reductions were observed for participants in the control condition. Mindfulness interventions may provide medical practitioners with skills to effectively manage stress and burnout, thereby reducing their experience of these symptoms. It is likely that doctors would benefit from the inclusion of such a training program as a part of their general medical education.

A low temperature furnace for solution crystal growth on the International Space Station

NASA Astrophysics Data System (ADS)

Baç, Nurcan; Harpster, Joseph; Maston, Robert A.; Sacco, Albert

2000-01-01

The Zeolite Crystal Growth Furnace Unit (ZCG-FU) is the first module in an integrated payload designed for low temperature crystal growth in solutions on the International Space Station (ISS). This payload is scheduled to fly on the ISS flight 7A.1 in an EXPRESS rack. Its name originated from early shuttle flight experiments limited to the growth of zeolite crystals but has since grown to include other materials of significant commercial interest using the solution method of crystal growth. Zeolites, ferroelectrics, piezeoelectrics and silver halides are some of the materials considered. The ZCG-FU experiment consists of a furnace unit and its electronic control system, and mechanically complex, crystal growth autoclaves suitable for use with a particular furnace and solution. The ZCG facility is being designed to grow into four independent furnaces controlled by IZECS (Improved Zeolite Electronic Control System). IZECS provides monitoring of critical parameters, data logging, safety monitoring, air-to-ground control and operator interfacing. It is suitable for controlling the four furnaces either individually or all at one time. It also contains the power management solid-state drivers and switches for the ZCG-FU furnace. The furnace contains 19 tubes operating at three different temperature zones. .

International Space Station (ISS)

NASA Image and Video Library

2001-02-01

The Marshall Space Flight Center (MSFC) is responsible for designing and building the life support systems that will provide the crew of the International Space Station (ISS) a comfortable environment in which to live and work. Scientists and engineers at the MSFC are working together to provide the ISS with systems that are safe, efficient, and cost-effective. These compact and powerful systems are collectively called the Environmental Control and Life Support Systems, or simply, ECLSS. In this photograph, the life test area on the left of the MSFC ECLSS test facility is where various subsystems and components are tested to determine how long they can operate without failing and to identify components needing improvement. Equipment tested here includes the Carbon Dioxide Removal Assembly (CDRA), the Urine Processing Assembly (UPA), the mass spectrometer filament assemblies and sample pumps for the Major Constituent Analyzer (MCA). The Internal Thermal Control System (ITCS) simulator facility (in the module in the right) duplicates the function and operation of the ITCS in the ISS U.S. Laboratory Module, Destiny. This facility provides support for Destiny, including troubleshooting problems related to the ITCS.

Percutaneous Cervical Sympathetic Block for Pain Control after Internal Carotid Artery Dissection. A Report of Two Cases.

PubMed

Saeed, Omar; Khan, Asif A; Herial, Nabeel A; Aytac, Emrah; Qureshi, Adnan I

2017-01-01

Medical treatment of cranio-cervical pain can be suboptimal in patients with internal carotid artery (ICA) dissection. We report the use of cervical sympathetic block for treatment of pain in two patients with ICA dissection. A 58-year-old man and a 43-year-old woman presented with severe cranio-cervical pain associated with left and right ICA dissection confirmed by magnetic resonance imaging and cerebral angiography. Due to suboptimal control of pain with medical treatment, cervical sympathetic block was performed under fluoroscopic guidance using 20 ml of bupivacaine injected lateral to the posterior aspect of sixth vertebral body in both patients. On self-reported pain scale, the 58-year-old man reported improvement in pain intensity from 8/10 pain to 0/10 within 1 h of blockade. The patient remained relatively pain free for the 24-h post blockade. Mild recurrence of pain was noted on Day 2. The 43-year-old woman reported improvement in pain intensity from 6/10 pain to 0/10 within 1 h of blockade. The patient remained pain free for five days with recurrence to previous intensity. Cervical sympathetic blockade in patients with ICA dissection may be an effective option in the event of suboptimal pain control with medical treatment; however, the technique may be limited due to relatively short duration of action.

Improved design of anaerobic digesters for household biogas production in indonesia: one cow, one digester, and one hour of cooking per day.

PubMed

Usack, Joseph G; Wiratni, Wiratni; Angenent, Largus T

2014-01-01

A government-sponsored initiative in Indonesia to design and implement low-cost anaerobic digestion systems resulted in 21 full-scale systems with the aim to satisfy the cooking fuel demands of rural households owning at least one cow. The full-scale design consisted of a 0.3 m diameter PVC pipe, which was operated as a conventional plug-flow system. The system generated enough methane to power a cooking stove for ∼ 1 h. However, eventual clogging from solids accumulation inside the bioreactor proved to be a major drawback. Here, we improved the digester configuration to remedy clogging while maintaining system performance. Controlled experiments were performed using four 9-L laboratory-scale digesters operated at a temperature of 27 ± 1 °C, a volatile solids loading rate of 2.0 g VS · L(-1) · day(-1), and a 21-day hydraulic retention time. Two of the digesters were replicates of the original design (control digesters), while the other two digesters included internal mixing or effluent recycle (experimental digesters). The performance of each digester was compared based on methane yields, VS removal efficiencies, and steady-state solids concentrations during an operating period of 311 days. Statistical analyses revealed that internal mixing and effluent recycling resulted in reduced solids accumulation compared to the controls without diminishing methane yields or solids removal efficiencies.

Tighten water-chemistry control after boiler layup

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

Brestel, L.

1994-01-01

The potential for internal deposition and corrosion can affect boiler reliability by reducing thermal efficiency, tube integrity, and the time between chemical cleanings. While chemical control specifications for normal operation have been developed by consensus of manufacturers and industry, their impact on shutdowns, layups, and startups is not always appreciated. The discussion of chemical-control options applies to boiler systems operating in the medium- and high-pressure ranges. Identification and correction of root causes underlying the chemistry problems encountered and application of the principles involved should result in shorter startup times, improved control over phosphate hideout, and reduced need for chemical cleaning.more » Each of these has a significant cost impact; together, they are the true measure of a successful chemistry-control program.« less

78 FR 78899 - Comparability Determination for Switzerland: Certain Entity-Level Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

.../24 of November 20, 2008, Supervision and Internal Control of Banks,\\33\\ requires banks to take the... internal control function in conformity with the bank's risk profile; Must have internal documentation of... effectiveness of internal controls; Must maintain and regularly test internal control functions; and Must define...

Comparison of shoulder internal rotation test with the elbow flexion test in the diagnosis of cubital tunnel syndrome.

PubMed

Ochi, Kensuke; Horiuchi, Yukio; Tanabe, Aya; Morita, Kozo; Takeda, Kentaro; Ninomiya, Ken

2011-05-01

To compare the shoulder internal rotation test-a new, provocative test-with the elbow flexion test in the diagnosis of cubital tunnel syndrome (CubTS). Twenty-five patients with CubTS were examined before and after surgery with 10 seconds each of the elbow flexion and shoulder internal rotation tests. Fifty-four asymptomatic individuals and 14 neuropathy patients with a diagnosis other than CubTS were also examined as control cases. For the shoulder internal rotation test, the patient's upper extremity was kept at 90° abduction, maximum internal rotation, and 10° flexion at the shoulder, with 90° elbow flexion and neutral position of the forearm and wrist, with finger extension. Test results were considered positive if any slight symptom attributable to CubTS occurred within 10 seconds. Extraneural pressure inside the cubital tunnel was intraoperatively measured with the positions of both the elbow flexion and shoulder internal rotation tests, in 15 of the CubTS cases. Statistical analyses were performed using Student's t-test with a confidence level of 95%. The preoperative sensitivity in CubTS cases was 80% in the 10-second shoulder internal rotation test and 36% in the 10-second elbow flexion test, and these differences were significant. None of the control cases had positive results in either test. All the CubTS cases improved with surgery; after surgery, neither test provoked symptoms in any surgical patient. The extraneural pressure increased in both provocative positions with no significant difference. Positive results for the 10-second shoulder internal rotation test were more sensitive than that for the elbow flexion test of the same duration and seemed specific to CubTS. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Trial-by-Trial Motor Cortical Correlates of a Rapidly Adapting Visuomotor Internal Model

PubMed Central

Ryu, Stephen I.

2017-01-01

Accurate motor control is mediated by internal models of how neural activity generates movement. We examined neural correlates of an adapting internal model of visuomotor gain in motor cortex while two macaques performed a reaching task in which the gain scaling between the hand and a presented cursor was varied. Previous studies of cortical changes during visuomotor adaptation focused on preparatory and perimovement epochs and analyzed trial-averaged neural data. Here, we recorded simultaneous neural population activity using multielectrode arrays and focused our analysis on neural differences in the period before the target appeared. We found that we could estimate the monkey's internal model of the gain using the neural population state during this pretarget epoch. This neural correlate depended on the gain experienced during recent trials and it predicted the speed of the subsequent reach. To explore the utility of this internal model estimate for brain–machine interfaces, we performed an offline analysis showing that it can be used to compensate for upcoming reach extent errors. Together, these results demonstrate that pretarget neural activity in motor cortex reflects the monkey's internal model of visuomotor gain on single trials and can potentially be used to improve neural prostheses. SIGNIFICANCE STATEMENT When generating movement commands, the brain is believed to use internal models of the relationship between neural activity and the body's movement. Visuomotor adaptation tasks have revealed neural correlates of these computations in multiple brain areas during movement preparation and execution. Here, we describe motor cortical changes in a visuomotor gain change task even before a specific movement is cued. We were able to estimate the gain internal model from these pretarget neural correlates and relate it to single-trial behavior. This is an important step toward understanding the sensorimotor system's algorithms for updating its internal models after specific movements and errors. Furthermore, the ability to estimate the internal model before movement could improve motor neural prostheses being developed for people with paralysis. PMID:28087767

Internal Spin Control, Squeezing and Decoherence in Ensembles of Alkali Atomic Spins

NASA Astrophysics Data System (ADS)

Norris, Leigh Morgan

Large atomic ensembles interacting with light are one of the most promising platforms for quantum information processing. In the past decade, novel applications for these systems have emerged in quantum communication, quantum computing, and metrology. Essential to all of these applications is the controllability of the atomic ensemble, which is facilitated by a strong coupling between the atoms and light. Non-classical spin squeezed states are a crucial step in attaining greater ensemble control. The degree of entanglement present in these states, furthermore, serves as a benchmark for the strength of the atom-light interaction. Outside the broader context of quantum information processing with atomic ensembles, spin squeezed states have applications in metrology, where their quantum correlations can be harnessed to improve the precision of magnetometers and atomic clocks. This dissertation focuses upon the production of spin squeezed states in large ensembles of cold trapped alkali atoms interacting with optical fields. While most treatments of spin squeezing consider only the case in which the ensemble is composed of two level systems or qubits, we utilize the entire ground manifold of an alkali atom with hyperfine spin f greater than or equal to 1/2, a qudit. Spin squeezing requires non-classical correlations between the constituent atomic spins, which are generated through the atoms' collective coupling to the light. Either through measurement or multiple interactions with the atoms, the light mediates an entangling interaction that produces quantum correlations. Because the spin squeezing treated in this dissertation ultimately originates from the coupling between the light and atoms, conventional approaches of improving this squeezing have focused on increasing the optical density of the ensemble. The greater number of internal degrees of freedom and the controllability of the spin-f ground hyperfine manifold enable novel methods of enhancing squeezing. In particular, we find that state preparation using control of the internal hyperfine spin increases the entangling power of squeezing protocols when f>1/2. Post-processing of the ensemble using additional internal spin control converts this entanglement into metrologically useful spin squeezing. By employing a variation of the Holstein-Primakoff approximation, in which the collective spin observables of the atomic ensemble are treated as quadratures of a bosonic mode, we model entanglement generation, spin squeezing and the effects of internal spin control. The Holstein-Primakoff formalism also enables us to take into account the decoherence of the ensemble due to optical pumping. While most works ignore or treat optical pumping phenomenologically, we employ a master equation derived from first principles. Our analysis shows that state preparation and the hyperfine spin size have a substantial impact upon both the generation of spin squeezing and the decoherence of the ensemble. Through a numerical search, we determine state preparations that enhance squeezing protocols while remaining robust to optical pumping. Finally, most work on spin squeezing in atomic ensembles has treated the light as a plane wave that couples identically to all atoms. In the final part of this dissertation, we go beyond the customary plane wave approximation on the light and employ focused paraxial beams, which are more efficiently mode matched to the radiation pattern of the atomic ensemble. The mathematical formalism and the internal spin control techniques that we applied in the plane wave case are generalized to accommodate the non-homogeneous paraxial probe. We find the optimal geometries of the atomic ensemble and the probe for mode matching and generation of spin squeezing.

Internal Spin Control, Squeezing and Decoherence in Ensembles of Alkali Atomic Spins

NASA Astrophysics Data System (ADS)

Norris, Leigh Morgan

Large atomic ensembles interacting with light are one of the most promising platforms for quantum information processing. In the past decade, novel applications for these systems have emerged in quantum communication, quantum computing, and metrology. Essential to all of these applications is the controllability of the atomic ensemble, which is facilitated by a strong coupling between the atoms and light. Non-classical spin squeezed states are a crucial step in attaining greater ensemble control. The degree of entanglement present in these states, furthermore, serves as a benchmark for the strength of the atom-light interaction. Outside the broader context of quantum information processing with atomic ensembles, spin squeezed states have applications in metrology, where their quantum correlations can be harnessed to improve the precision of magnetometers and atomic clocks. This dissertation focuses upon the production of spin squeezed states in large ensembles of cold trapped alkali atoms interacting with optical fields. While most treatments of spin squeezing consider only the case in which the ensemble is composed of two level systems or qubits, we utilize the entire ground manifold of an alkali atom with hyperfine spin f greater or equal to 1/2, a qudit. Spin squeezing requires non-classical correlations between the constituent atomic spins, which are generated through the atoms' collective coupling to the light. Either through measurement or multiple interactions with the atoms, the light mediates an entangling interaction that produces quantum correlations. Because the spin squeezing treated in this dissertation ultimately originates from the coupling between the light and atoms, conventional approaches of improving this squeezing have focused on increasing the optical density of the ensemble. The greater number of internal degrees of freedom and the controllability of the spin-f ground hyperfine manifold enable novel methods of enhancing squeezing. In particular, we find that state preparation using control of the internal hyperfine spin increases the entangling power of squeezing protocols when f >1/2. Post-processing of the ensemble using additional internal spin control converts this entanglement into metrologically useful spin squeezing. By employing a variation of the Holstein-Primakoff approximation, in which the collective spin observables of the atomic ensemble are treated as quadratures of a bosonic mode, we model entanglement generation, spin squeezing and the effects of internal spin control. The Holstein-Primakoff formalism also enables us to take into account the decoherence of the ensemble due to optical pumping. While most works ignore or treat optical pumping phenomenologically, we employ a master equation derived from first principles. Our analysis shows that state preparation and the hyperfine spin size have a substantial impact upon both the generation of spin squeezing and the decoherence of the ensemble. Through a numerical search, we determine state preparations that enhance squeezing protocols while remaining robust to optical pumping. Finally, most work on spin squeezing in atomic ensembles has treated the light as a plane wave that couples identically to all atoms. In the final part of this dissertation, we go beyond the customary plane wave approximation on the light and employ focused paraxial beams, which are more efficiently mode matched to the radiation pattern of the atomic ensemble. The mathematical formalism and the internal spin control techniques that we applied in the plane wave case are generalized to accommodate the non-homogeneous paraxial probe. We find the optimal geometries of the atomic ensemble and the probe for mode matching and generation of spin squeezing.

Improved spectrophotometric cell for hydrothermal solutions

USGS Publications Warehouse

Susak, N.J.; Crerar, D.A.; Forseman, T.C.; Haas, J.L.

1981-01-01

A simple, inexpensive spectrophotometric cell was designed for use with aqueous solutions for which temperature is a maximum of 325??C and pressure, 28 MPa. The cell has an internal volume of 5 ml and a path length of 1.31 cm. Each furnace assembly is 120 mm in diameter ?? 150 mm high and will fit into most commercial spectrophotometers. Temperature is controlled by a standard set-point controller and a balancing circuit that is used to maintain the temperature of the sample and reference cell within 1??C of each other at any temperature.

Zeolite Crystal Growth in Microgravity and on Earth

NASA Technical Reports Server (NTRS)

2003-01-01

The Center for Advanced Microgravity Materials Processing (CAMMP), a NASA-sponsored Research Partnership Center, is working to improve zeolite materials for storing hydrogen fuel. CAMMP is also applying zeolites to detergents, optical cables, gas and vapor detection for environmental monitoring and control, and chemical production techniques that significantly reduce by-products that are hazardous to the environment. Shown here are zeolite crystals (top) grown in a ground control experiment and grown in microgravity on the USML-2 mission (bottom). Zeolite experiments have also been conducted aboard the International Space Station.

Evidence of improved knowledge and skills after an elective rotation in a hospice and palliative care program for internal medicine residents.

PubMed

von Gunten, Charles F; Twaddle, Martha; Preodor, Michael; Neely, Kathy Johnson; Martinez, Jeanne; Lyons, John

2005-01-01

There is compelling evidence that residents training in primary care need education in palliative care. Evidence for effective curricula is needed. The objective of this study was to test whether a clinical elective improves measures of knowledge and skill. Residents from three categorical training programs in internal medicine were recruited to an elective including clinical experiences in an acute hospital palliative care consultation service, on an acute hospice and palliative care unit, and in-home hospice care. A 25-question pre- and post-test and a videotaped interview with a standardized patient were used to assess communication skills and measure outcomes. Residents demonstrated a 10 percent improvement in knowledge after the four-week elective (p < 0.05). All residents demonstrated basic competency in communication skills at the end of the rotation. These results indicate that clinical rotation shows promise as an educational intervention to improve palliative care knowledge and skills in primary care residents. An important limitation of the study is that it is an elective; further studies with a required rotation and/or a control group are needed to confirm the findings.

Considerations on BVD eradication for the Irish livestock industry

PubMed Central

2011-01-01

Animal Health Ireland has produced clear guidelines for the control of Bovine Viral Diarrhoea (BVD) infection in Irish cattle herds. In the course of developing these guidelines it was clear that a framework for regional and/or national BVD control would be required to increase the uptake of BVD control at farm level and reduce the overall prevalence of the disease. This paper assessed the economic impact of BVD, epidemiological aspects of the disease to its control, models of BVD control, international experiences of BVD control programmes. The technical knowledge and test technology exists to eradicate BVD. Indeed, many countries have successfully and others are embarking on control of the disease. The identification and prompt elimination of PI cattle will form the basis of any control programme. The trade of such animals must be curtailed. Pregnant and potentially pregnant carrying PI foetuses pose a significant threat. International experience indicates systematic, well coordinated programmes have the most success, while voluntary programmes can make good initial progress but ultimately fail. The farming community must buy into any proposed programme, and without their support, failure is likely. To buy into the programme and create such a demand for BVD control, farmers must first be well informed. It is likely that stemming economic loss and improving productivity will be the primary motivator at individual farm level. PMID:21967764

25 CFR 542.32 - What are the minimum internal control standards for internal audit for Tier B gaming operations?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 2 2013-04-01 2013-04-01 false What are the minimum internal control standards for internal audit for Tier B gaming operations? 542.32 Section 542.32 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.32 What are the minimum internal control standards for...

25 CFR 542.22 - What are the minimum internal control standards for internal audit for Tier A gaming operations?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 2 2012-04-01 2012-04-01 false What are the minimum internal control standards for internal audit for Tier A gaming operations? 542.22 Section 542.22 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.22 What are the minimum internal control standards for...

25 CFR 542.22 - What are the minimum internal control standards for internal audit for Tier A gaming operations?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 2 2013-04-01 2013-04-01 false What are the minimum internal control standards for internal audit for Tier A gaming operations? 542.22 Section 542.22 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.22 What are the minimum internal control standards for...

25 CFR 542.22 - What are the minimum internal control standards for internal audit for Tier A gaming operations?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 2 2014-04-01 2014-04-01 false What are the minimum internal control standards for internal audit for Tier A gaming operations? 542.22 Section 542.22 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.22 What are the minimum internal control standards for...

25 CFR 542.22 - What are the minimum internal control standards for internal audit for Tier A gaming operations?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 2 2011-04-01 2011-04-01 false What are the minimum internal control standards for internal audit for Tier A gaming operations? 542.22 Section 542.22 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.22 What are the minimum internal control standards for...

25 CFR 542.32 - What are the minimum internal control standards for internal audit for Tier B gaming operations?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 2 2011-04-01 2011-04-01 false What are the minimum internal control standards for internal audit for Tier B gaming operations? 542.32 Section 542.32 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.32 What are the minimum internal control standards for...

25 CFR 542.32 - What are the minimum internal control standards for internal audit for Tier B gaming operations?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 2 2012-04-01 2012-04-01 false What are the minimum internal control standards for internal audit for Tier B gaming operations? 542.32 Section 542.32 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.32 What are the minimum internal control standards for...

25 CFR 542.32 - What are the minimum internal control standards for internal audit for Tier B gaming operations?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 2 2014-04-01 2014-04-01 false What are the minimum internal control standards for internal audit for Tier B gaming operations? 542.32 Section 542.32 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.32 What are the minimum internal control standards for...

EMPRESS: A European Project to Enhance Process Control Through Improved Temperature Measurement

NASA Astrophysics Data System (ADS)

Pearce, J. V.; Edler, F.; Elliott, C. J.; Rosso, L.; Sutton, G.; Andreu, A.; Machin, G.

2017-08-01

A new European project called EMPRESS, funded by the EURAMET program `European Metrology Program for Innovation and Research,' is described. The 3 year project, which started in the summer of 2015, is intended to substantially augment the efficiency of high-value manufacturing processes by improving temperature measurement techniques at the point of use. The project consortium has 18 partners and 5 external collaborators, from the metrology sector, high-value manufacturing, sensor manufacturing, and academia. Accurate control of temperature is key to ensuring process efficiency and product consistency and is often not achieved to the level required for modern processes. Enhanced efficiency of processes may take several forms including reduced product rejection/waste; improved energy efficiency; increased intervals between sensor recalibration/maintenance; and increased sensor reliability, i.e., reduced amount of operator intervention. Traceability of temperature measurements to the International Temperature Scale of 1990 (ITS-90) is a critical factor in establishing low measurement uncertainty and reproducible, consistent process control. Introducing such traceability in situ (i.e., within the industrial process) is a theme running through this project.

Blocking the benefit of group-based HIV-prevention efforts during adolescence: the problem of HIV-related stigma.

PubMed

Barker, David H; Swenson, Rebecca R; Brown, Larry K; Stanton, Bonita F; Vanable, Peter A; Carey, Michael P; Valois, Robert F; Diclemente, Ralph J; Salazar, Laura F; Romer, Daniel

2012-04-01

HIV-related stigma has been shown to impede HIV-antibody testing and safer sexual practices in adults. Less is known about its effects on prevention programs among at-risk youth. This study examined the longitudinal relationships between HIV-stigma and HIV-knowledge following completion of a validated group-based intervention. Data were provided by 1,654 African-American adolescents who participated in a large multi-city prevention trial (Project iMPACCS). Participants were randomly assigned to an empirically-validated skill-based intervention or a general health promotion control group. Both stigma and knowledge were assessed at baseline and post-intervention. Results suggested that adolescents participating in the intervention showed improvements in knowledge and decreases in stigma when compared to controls. Improvements in stigma appeared to be partly driven by improvements in knowledge. Higher baseline stigma was shown to reduce gains in knowledge in both the treatment and control groups. Results suggest that HIV-stigma can interfere with how youth identify with and internalize messages from group-based prevention trials.

[Update on microbiological quality assurance meat and meat products in Morocco].

PubMed

Rachidi, H; Latrache, H

2018-03-01

Food safety has become an absolute necessity in all countries. As a result, Morocco has taken several measures and actions to develop food safety and food-borne disease control. This study aimed to highlight the level of improvement in the quality assurance of meat and meat products in Morocco. It is based on a non-exhaustive review of the regulatory texts governing food safety in the country, as well as a statistical study on establishments of meat and meat products adopting a self-checking system and approved by the National Office of Sanitary Safety of Food. Morocco has introduced several laws and regulations requiring sanitary control of food products. Also, the number of establishments of meat and meat products adopting a system of self-control and approved by the National Office of Sanitary Safety of Food has improved significantly. It has increased from 58 in 2007 to 273 in 2016. The adoption of self-monitoring systems allows better access to international markets, improved quality of food products and a considerable reduction in microbial contamination. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Motivational "spill-over" during weight control: increased self-determination and exercise intrinsic motivation predict eating self-regulation.

PubMed

Mata, Jutta; Silva, Marlene N; Vieira, Paulo N; Carraça, Eliana V; Andrade, Ana M; Coutinho, Sílvia R; Sardinha, Luis B; Teixeira, Pedro J

2009-11-01

Successful weight management relies on at least two health behaviors, eating and exercise. However, little is known about their interaction on a motivational and behavioral level. Based on the Hierarchical Model of Motivation the authors examined whether exercise-specific motivation can transfer to eating regulation during a lifestyle weight control program. The authors further investigated whether general, treatment-related, and exercise motivation underlie the relation between increased exercise and improved eating regulation. Overweight/obese women participated in a 1-year randomized controlled trial (N = 239). The intervention focused on promoting physical activity and internal motivation for exercise and weight loss, following Self-Determination Theory. The control group received general health education. General and exercise specific self-determination, eating self-regulation variables, and physical activity behavior. General self-determination and more autonomous exercise motivation predicted eating self-regulation over 12 months. Additionally, general and exercise self-determination fully mediated the relation between physical activity and eating self-regulation. Increased general self-determination and exercise motivation seem to facilitate improvements in eating self-regulation during weight control in women. These motivational mechanisms also underlie the relationship between improvements in exercise behavior and eating regulation. PsycINFO Database Record (c) 2009 APA, all rights reserved.

[Basic considerations during outsourcing of clinical data management services].

PubMed

Shen, Tong; Liu, Yan

2015-11-01

With worldwide improvements in the regulations of international and domestic clinical trial conductions, the quality of clinical trials and trial data management are receiving a great deal of attention. To ensure the quality of clinical trials, maintain business flexibilities and effectively utilize internal and external resources, the outsourcing model is used in the management of clinical data in operation of pharmaceutical companies. The essential criteria of a successful outsourcing mode in clinical trial are selection of qualified contract research organizations (CRO); establishment of appropriate outsourcing model, and generation of effective quality control systems to ensure the authenticity, integrity and accuracy of the clinical trial data.

[Nursing service certification. Norm UNE-EN-ISO 9001-2008].

PubMed

Salazar de la Guerra, R; Ferrer Arnedo, C; Labrador Domínguez, M J; Sangregorio Matesanz, A

2014-01-01

To certify the nursing services using a quality management system, taking an international standard as a reference, and based on a continuous improvement process. The standard was revised, and the Quality Management System documentation was updated, consisting of a Quality Manual and 7 control procedures. All the existing procedures were coded in accordance with the documentation control process. Each operational procedure was associated with a set of indicators which permitted to know the results obtained, analyze the deviations and to implement further improvements. The system was implemented successfully. Twenty-eight care procedures and eleven procedures concerning techniques were incorporated into the management system. Thirty indicators were established that allowed the whole process to be monitored. All patients were assigned to a nurse in their clinical notes and all of them had a personalized Care Plan according to planning methodology using North American Nursing Diagnosis Association (NANDA), Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) international rankings. The incidence of falls, as well as the incidence of chronic skin wounds, was low, taking into account the characteristics of the patient and the duration of the stay (mean=35.87 days). The safety indicators had a high level of compliance, with 90% of patients clearly identified and 100% with hygiene protocol. The confidence rating given to the nurses was 91%. The certification enabled the quality of the service to be improved using a structured process, analyzing the results, dealing with non-conformities and introducing improvements. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Lessons from malaria control to help meet the rising challenge of dengue.

PubMed

Anders, Katherine L; Hay, Simon I

2012-12-01

Achievements in malaria control could inform efforts to control the increasing global burden of dengue. Better methods for quantifying dengue endemicity-equivalent to parasite prevalence surveys and endemicity mapping used for malaria-would help target resources, monitor progress, and advocate for investment in dengue prevention. Success in controlling malaria has been attributed to widespread implementation of interventions with proven efficacy. An improved evidence base is needed for large-scale delivery of existing and novel interventions for vector control, alongside continued investment in dengue drug and vaccine development. Control of dengue is unlikely to be achieved without coordinated international financial and technical support for national programmes, which has proven effective in reducing the global burden of malaria. Copyright © 2012 Elsevier Ltd. All rights reserved.

The DIII-D Plasma Control System as a Scientific Research Tool

NASA Astrophysics Data System (ADS)

Hyatt, A. W.; Ferron, J. R.; Humphreys, D. A.; Leuer, J. A.; Walker, M. L.; Welander, A. S.

2006-10-01

The digital plasma control system (PCS) is an essential element of the DIII-D tokamak as a scientific research instrument, providing experimenters with real-time measurement and control of the plasma equilibrium, heating, current drive, transport, stability, and plasma-wall interactions. A wide range of sensors and actuators allow feedback control not only of global quantities such as discharge shape, plasma energy, and toroidal rotation, but also of non-axisymmetric magnetic fields and features of the internal profiles of temperature and current density. These diverse capabilities of the PCS improve the effectiveness of tokamak operation and enable unique physics experiments. We will present an overview of the PCS and the systems it controls and interacts with, and show examples of various plasma parameters controlled by the PCS and its actuators.

An international nanoscience advisory board to improve and harmonize nanotechnology oversight

NASA Astrophysics Data System (ADS)

Marchant, Gary E.; White, Andrew

2011-04-01

As governments around the world begin to implement regulations aimed at controlling nanotechnology, those regulations should be based upon the best available science, applied as consistently as possible within jurisdictions and, to the extent feasible, across jurisdictions. These goals would be easier to achieve with the creation of an international nanoscience advisory board. Such a body could be modeled on similar international scientific advisory bodies for other issues, such as the Intergovernmental Panel on Climate Change (IPCC) and the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services. Such a body should also take into account lessons learned from these similar organizations. An international nanoscience advisory board could assist regulatory bodies by providing a central source of accurate scientific information about the risks and benefits of nanotechnology, including relevant uncertainties, rather than having each regulatory body make these determinations independently. An international nanoscience advisory board could facilitate harmonization within and between jurisdictions by involving the top experts in the field to produce a centralized knowledge base for regulatory decisions. While an international nanoscience advisory board presents many potential benefits, it also faces significant difficulties, which are best illustrated by examining the history and challenges of existing international science advisory bodies.

Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement.

PubMed

Dorrington, Melanie S; Herceg, Ana; Douglas, Kirsty; Tongs, Julie; Bookallil, Marianne

2015-01-01

This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.

An Improved Power Quality Based Sheppard-Taylor Converter Fed BLDC Motor Drive

NASA Astrophysics Data System (ADS)

Singh, Bhim; Bist, Vashist

2015-12-01

This paper deals with the design and analysis of a power factor correction based Sheppard-Taylor converter fed brushless dc motor (BLDCM) drive. The speed of the BLDCM is controlled by adjusting the dc link voltage of the voltage source inverter (VSI) feeding BLDCM. Moreover, a low frequency switching of the VSI is used for electronically commutating the BLDCM for reduced switching losses. The Sheppard-Taylor converter is designed to operate in continuous conduction mode to achieve an improved power quality at the ac mains for a wide range of speed control and supply voltage variation. The BLDCM drive is designed and its performance is simulated in a MATLAB/Simulink environment to achieve the power quality indices within the limits of the international power quality standard IEC-61000-3-2.

Emerging Trends in International Law Concerning Global Infectious Disease Control1

PubMed Central

2003-01-01

International cooperation has become critical in controlling infectious diseases. In this article, I examine emerging trends in international law concerning global infectious disease control. The role of international law in horizontal and vertical governance responses to infectious disease control is conceptualized; the historical development of international law regarding infectious diseases is described; and important shifts in how states, international institutions, and nonstate organizations use international law in the context of infectious disease control today are analyzed. The growing importance of international trade law and the development of global governance mechanisms, most prominently in connection with increasing access to drugs and other medicines in unindustrialized countries, are emphasized. Traditional international legal approaches to infectious disease control—embodied in the International Health Regulations—may be moribund. PMID:12643821

Traumatic aneurysms of the internal carotid artery at the base of the skull. Two cases treated surgically.

PubMed

Magnan, P E; Branchereau, A; Cannoni, M

1992-01-01

Internal carotid aneurysms at the base of the skull after blunt trauma are infrequent but their management is difficult, leading many surgeons to only attempt ligation. We report 2 cases presenting with high traumatic aneurysms, following motorcycle accidents. The 2 aneurysms underwent repair by a venous graft. The petrous portion of the carotid artery was approached and controlled by an ENT surgeon. This "infratemporal" approach was used exposing the facial nerve, combined with temporary anterior sub-luxation of the temporomaxillary joint to expose the lower part of the carotid canal which was opened up with a drill in order to control the carotid artery in the petrous canal. Both patients developed facial nerve palsies which improved within 3 months. Postoperative angiography showed patent vein grafts and the patients were doing well, without any symptoms 18 and 24 months later.

Drug Policy and the Public Good: a summary of the book.

PubMed

2010-07-01

Drug Policy and the Public Good was written by an international group of scientists from the fields of addiction, public health, criminology and policy studies to improve the linkages between drug research and drug policy. The book provides a conceptual basis for evidence-informed drug policy and describes epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; health and social services for drug users; attempts to control the supply of drugs, including the international treaty system; law enforcement and ventures into decriminalization; and control of the psychotropic substance market through prescription drug regimes. The final chapters discuss the current state of drug policies in different parts of the world and describe the need for future approaches to drug policy that are coordinated and informed by evidence.

Quality management for the international transport of laboratory animals.

PubMed

Leary, Steven L

2008-01-01

Increased collaboration between investigators at different institutions has increased the number of laboratory animals being transported. The current system of laws and regulations governing animal shipments is inconsistent and government agencies often have areas of overlapping regulatory management. Furthermore, the lack of industry-wide shipping standards and good practices contributes to confusion among those responsible for shipment. One answer to these quality control issues would be the establishment of independent, industry-regulated 'good practices' for animal transport, similar to those used in laboratories for experimental design. These good practices could be based on the existing International Air Transport Association Live Animals Regulations, with contributions from representatives of the specialties involved. Additionally, quality control under the current system of patchwork regulations could be improved if each institution, both academic and commercial, would designate a single point of contact to follow each shipment from start to finish.

Improving household air, drinking water and hygiene in rural Peru: a community-randomized-controlled trial of an integrated environmental home-based intervention package to improve child health.

PubMed

Hartinger, S M; Lanata, C F; Hattendorf, J; Verastegui, H; Gil, A I; Wolf, J; Mäusezahl, D

2016-12-01

Diarrhoea and acute lower respiratory infections are leading causes of childhood morbidity and mortality, which can be prevented by simple low-cost interventions. Integrated strategies can provide additional benefits by addressing multiple health burdens simultaneously. We conducted a community-randomized-controlled trial in 51 rural communities in Peru to evaluate whether an environmental home-based intervention package, consisting of improved solid-fuel stoves, kitchen sinks, solar disinfection of drinking water and hygiene promotion, reduces lower respiratory infections, diarrhoeal disease and improves growth in children younger than 36 months. The attention control group received an early child stimulation programme. We recorded 24 647 child-days of observation from 250 households in the intervention and 253 in the attention control group during 12-month follow-up. Mean diarrhoea incidence was 2.8 episodes per child-year in the intervention compared with 3.1 episodes in the control arm. This corresponds to a relative rate of 0.78 [95% confidence interval (CI): 0.58-1.05] for diarrhoea incidence and an odds ratio of 0.71 (95% CI: 0.47-1.06) for diarrhoea prevalence. No effects on acute lower respiratory infections or children's growth rates were observed. Combined home-based environmental interventions slightly reduced childhood diarrhoea, but the confidence interval included unity. Effects on growth and respiratory outcomes were not observed, despite high user compliance of the interventions. The absent effect on respiratory health might be due to insufficient household air quality improvements of the improved stoves and additional time needed to achieve attitudinal and behaviour change when providing composite interventions. © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association

Text message-based diabetes self-management support (SMS4BG): study protocol for a randomised controlled trial.

PubMed

Dobson, Rosie; Whittaker, Robyn; Jiang, Yannan; Shepherd, Matthew; Maddison, Ralph; Carter, Karen; Cutfield, Richard; McNamara, Catherine; Khanolkar, Manish; Murphy, Rinki

2016-04-02

Addressing the increasing prevalence, and associated disease burden, of diabetes is a priority of health services internationally. Interventions to support patients to effectively self-manage their condition have the potential to reduce the risk of costly and debilitating complications. The utilisation of mobile phones to deliver self-management support allows for patient-centred care at the frequency and intensity that patients desire from outside the clinic environment. Self-Management Support for Blood Glucose (SMS4BG) is a novel text message-based intervention for supporting people with diabetes to improve self-management behaviours and achieve better glycaemic control and is tailored to individual patient preferences, demographics, clinical characteristics, and culture. This study aims to assess whether SMS4BG can improve glycaemic control in adults with poorly controlled diabetes. This paper outlines the rationale and methods of the trial. A two-arm, parallel, randomised controlled trial will be conducted across New Zealand health districts. One thousand participants will be randomised at a 1:1 ratio to receive SMS4BG, a theoretically based and individually tailored automated text message-based diabetes self-management support programme (intervention) in addition to usual care, or usual care alone (control). The primary outcome is change in glycaemic control (HbA1c) at 9 months. Secondary outcomes include glycaemic control at 3 and 6 months, self-efficacy, self-care behaviours, diabetes distress, health-related quality of life, perceived social support, and illness perceptions. Cost information and healthcare utilisation will also be collected as well as intervention satisfaction and interaction. This study will provide information on the effectiveness of a text message-based self-management support tool for people with diabetes. If found to be effective it has the potential to provide individualised support to people with diabetes across New Zealand (and internationally), thus extending care outside the clinic environment. Australian New Zealand Clinical Trials Registry: ACTRN12614001232628 .

Sensitive single-stage PCR using custom-synthesized internal controls.

PubMed

Zimmermann, K; Rieger, M; Gross, P; Turecek, P L; Schwarz, H P

2000-04-01

A new approach for an internally controlled PCR was developed using a custom-synthesized oligonucleotide as the internal control. Three different PCR setups demonstrated the usefulness of this approach: (i) the addition of the respective internal control to samples containing ssDNA virus Parvo B19; (ii) the co-extraction of plasma samples and the respective internal control for the detection of the ssDNA virus TTV; and (iii) the addition of the respective internal control to a crude lysate of tail pieces for the genotyping of FVIII knockout mice, demonstrating that this approach is also applicable for dsDNA.

Promoting women's human rights: A qualitative analysis of midwives' perceptions about virginity control and hymen 'reconstruction'.

PubMed

Christianson, Monica; Eriksson, Carola

2015-06-01

To explore midwives' perceptions regarding virginity control and hymen 'reconstructions', and how these practices can be debated from a gender perspective. An international group of 266 midwives answered an open-ended question in a Web survey. The great majority came from the Western world, among them, the majority were from Europe. Data were analysed using qualitative content analysis. Three themes emerged: misogynistic practices that cement the gender order, which revealed how the respondents viewed virginity control and hymen 'reconstructions'; raising public awareness and combatting practices that demean women, which were suggested as strategies by which to combat these practices; and promoting agency in women and providing culturally sensitive care, which were considered to improve health care encounters. Virginity control and hymen 'reconstructions' are elements of patriarchy, whereby violence and control are employed to subordinate women. To counter these practices, macro and micro-level activities are needed to expand women's human rights in the private and the public spheres. Political activism, international debates, collaboration between sectors such as health care and law-makers may lead to increased gender equality. A women-centred approach whereby women are empowered with agency will make women more capable of combatting virginity control and hymen 'reconstruction'.

Assessing the potential for improved scramjet performance through application of electromagnetic flow control

NASA Astrophysics Data System (ADS)

Lindsey, Martin Forrester

Sustained hypersonic flight using scramjet propulsion is the key technology bridging the gap between turbojets and the exoatmospheric environment where a rocket is required. Recent efforts have focused on electromagnetic (EM) flow control to mitigate the problems of high thermomechanical loads and low propulsion efficiencies associated with scramjet propulsion. This research effort is the first flight-scale, three-dimensional computational analysis of a realistic scramjet to determine how EM flow control can improve scramjet performance. Development of a quasi-one dimensional design tool culminated in the first open source geometry of an entire scramjet flowpath. This geometry was then tested extensively with the Air Force Research Laboratory's three-dimensional Navier-Stokes and EM coupled computational code. As part of improving the model fidelity, a loosely coupled algorithm was developed to incorporate thermochemistry. This resulted in the only open-source model of fuel injection, mixing and combustion in a magnetogasdynamic (MGD) flow controlled engine. In addition, a control volume analysis tool with an electron beam ionization model was presented for the first time in the context of the established computational method used. Local EM flow control within the internal inlet greatly impacted drag forces and wall heat transfer but was only marginally successful in raising the average pressure entering the combustor. The use of an MGD accelerator to locally increase flow momentum was an effective approach to improve flow into the scramjet's isolator. Combustor-based MGD generators proved superior to the inlet generator with respect to power density and overall engine efficiency. MGD acceleration was shown to be ineffective in improving overall performance, with all of the bypass engines having approximately 33% more drag than baseline and none of them achieving a self-powered state.

Physical activity and nutrition behaviour outcomes of a cluster-randomized controlled trial for adults with metabolic syndrome in Vietnam.

PubMed

Tran, Van Dinh; Lee, Andy H; Jancey, Jonine; James, Anthony P; Howat, Peter; Mai, Le Thi Phuong

2017-01-13

Metabolic syndrome is prevalent among Vietnamese adults, especially those aged 50-65 years. This study evaluated the effectiveness of a 6 month community-based lifestyle intervention to increase physical activity levels and improve dietary behaviours for adults with metabolic syndrome in Vietnam. Ten communes, involving participants aged 50-65 years with metabolic syndrome, were recruited from Hanam province in northern Vietnam. The communes were randomly allocated to either the intervention (five communes, n = 214) or the control group (five communes, n = 203). Intervention group participants received a health promotion package, consisting of an information booklet, education sessions, a walking group, and a resistance band. Control group participants received one session of standard advice during the 6 month period. Data were collected at baseline and after the intervention to evaluate programme effectiveness. The International Physical Activity Questionnaire - Short Form and a modified STEPS questionnaire were used to assess physical activity and dietary behaviours, respectively, in both groups. Pedometers were worn by the intervention participants only for 7 consecutive days at baseline and post-intervention testing. To accommodate the repeated measures and the clustering of individuals within communes, multilevel mixed regression models with random effects were fitted to determine the impacts of intervention on changes in outcome variables over time and between groups. With a retention rate of 80.8%, the final sample comprised 175 intervention and 162 control participants. After controlling for demographic and other confounding factors, the intervention participants showed significant increases in moderate intensity activity (P = 0.018), walking (P < 0.001) and total physical activity (P = 0.001), as well as a decrease in mean sitting time (P < 0.001), relative to their control counterparts. Significant improvements in dietary behaviours were also observed, particularly reductions in intake of animal internal organs (P = 0.001) and in using cooking oil for daily meal preparation (P = 0.001). The prescribed community-based physical activity and nutrition intervention programme successfully improved physical activity and dietary behaviours for adults with metabolic syndrome in Vietnam. Australian New Zealand Clinical Trials Registry, ACTRN12614000811606 . Registered on 31 July 2014.

DOD Financial Management: Improvement Needed in DOD Components’ Implementation of Audit Readiness Effort

DTIC Science & Technology

2011-09-01

DOD Financial Management Abbreviations AFB Air Force Base COSO Committee of Sponsoring Organizations of the Treadway... Management and mismanagement.11 All of DOD’s programs on GAO’s High- Risk List relate to its business operations, including systems and processes... Management maintains audit readiness through risk -based periodic testing of internal controls utilizing the OMB Circular No. A-123, Appendix A

Seven Experiment Designs Addressing Problems of Safety and Capacity on Two-Lane Rural Highways : Volume 5. Experimental Design for Vehicle Equivalency and Capacity Including Effects of Commercial and Recreational Vehicles on Rural Non-Controlled Access

DOT National Transportation Integrated Search

1994-04-01

The Advantage I-75 project was established as an international public/private partnership to provide a testbed for deploying advanced IVHS technologies designed to increase transport efficiency, improve safety, and enhance mobility along the 2,200-mi...

Financial Management: Overall Plan Needed To Guide System Improvements at Education. United States General Accounting Office Report to the Secretary of Education.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

The U.S. Department of Education's financial management environment and effectiveness are described, together with the reliability of its accounting and internal control systems for the management of the money it gives or lends to schools, individual students, states, and local education agencies. The study found that key accounting and related…

Can Professional Development Improve School Leadership? Results from a Randomized Control Trial Assessing the Impact of McREL's Balanced Leadership Program on Principals in Rural Michigan Schools

ERIC Educational Resources Information Center

Miller, Robert James; Goddard, Roger D.; Kim, Minjung; Jacob, Robin; Goddard, Yvonne; Schroeder, Patricia

2016-01-01

Purpose: This multiyear experimental study was designed to examine (1) the causal impact of McREL International's Balanced Leadership® Professional Development (BLPD) program on school principals' learning, beliefs, and behaviors and (2) whether there were differences in the types of outcomes the professional development influenced. Outcomes…

Learning from Ebola Virus: How to Prevent Future Epidemics

PubMed Central

Kekulé, Alexander S.

2015-01-01

The recent Ebola virus disease (EVD) epidemic in Guinea, Liberia and Sierra Leone demonstrated that the World Health Organization (WHO) is incapable to control outbreaks of infectious diseases in less developed regions of the world. This essay analyses the causes for the failure of the international response and proposes four measures to improve resilience, early detection and response to future outbreaks of infectious diseases. PMID:26184283

78 FR 63873 - Minimum Internal Control Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

... Internal Control Standards AGENCY: National Indian Gaming Commission, Interior. ACTION: Final rule. SUMMARY: The National Indian Gaming Commission (NIGC) amends its minimum internal control standards for Class... Internal Control Standards. 64 FR 590. The rule added a new part to the Commission's regulations...

78 FR 11793 - Minimum Internal Control Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-20

... Internal Control Standards AGENCY: National Indian Gaming Commission. ACTION: Proposed rule. SUMMARY: The National Indian Gaming Commission (NIGC) proposes to amend its minimum internal control standards for Class... NIGC published a final rule in the Federal Register called Minimum Internal Control Standards. 64 FR...

Effects of health empowerment intervention on resilience of adolescents in a tribal area: A study using the Solomon four-groups design.

PubMed

Sarkar, Kaushik; Dasgupta, Aparajita; Sinha, Multipada; Shahbabu, Bhaskar

2017-10-01

Resilience prevents the emergence of stress-related mental health problems among adolescents. Adolescents in tribal areas of India are more prone to develop such problems. The primary objective was to determine the effect of combined life skills-based health empowerment intervention on the resilience of school-going adolescents in a tribal area. The secondary objectives were to determine the effect of the intervention on internal health locus of control and self-determination and to compare the effect of intervention on resilience between non-tribal and tribal adolescents. We conducted this quasi-experimental study using a Solomon four-group design among 742 adolescents in two schools of Purulia, West Bengal, India. Students of the pretested group were examined for resilience using the Child Youth Resilience Measurement scale. A life skills education-based health empowerment intervention was administered among students of the experimental group. Post-test data on resilience, self-determination, internal health locus of control and pathological behaviour was obtained 3 months after the completion of intervention. A multi-level general linear mixed model was constructed to determine the effect of intervention on resilience. Resilience was less among tribal adolescents at baseline. The intervention significantly improved resilience [β Adjusted  = 11.19 (95% CI = 10.55, 11.83], with a greater increase for tribal adolescents [β tribal-nontribal  = 1.53 (95% CI = 0.03, 3.03)]. The intervention also significantly improved internal health locus of control (marginal mean increment 1.38 ± 0.05), self-determination (marginal mean increment 3.71 ± 0.09) and reduced pathological behaviour of the adolescents. Our study informed the current health policy that the existing life skills education-based programme should be reviewed and modified to include generic life skills, and the life skills education-based programme should be coupled with developmental interventions aimed at improving adult education and family climate for optimum effect on mental health and health behaviour of adolescents. Copyright © 2017 Elsevier Ltd. All rights reserved.

Unique effects of The transporters animated series and of parental support on emotion recognition skills of children with ASD: Results of a randomized controlled trial.

PubMed

Gev, Tali; Rosenan, Ruthie; Golan, Ofer

2017-05-01

Emotion recognition (ER) and understanding deficits are characteristic of autism spectrum disorder (ASD). The Transporters (TT) animated series has shown promising results in teaching children with ASD to recognize emotions, with mixed findings about generalization and maintenance of effects. This study aimed to evaluate the unique role of TT and of parental support in the acquisition, generalization, and maintenance of acquired ER skills in children with ASD. 77 Israeli children with high functioning ASD, aged 4-7 were randomly assigned into four groups according to a 2 × 2 design of the factors Series (TT, control series) and Parental Support (with/without). Thirty typically developing children, matched to the ASD groups on mental age, were tested with no intervention. Participants' ER (on three generalization levels) and emotional vocabulary (EV) were tested pre and post 8 weeks of intervention, and at 3 months' follow-up. Compared to the control series, watching TT significantly improved children's ER skills at all generalization levels, with good skill maintenance. All groups improved equally on EV. The amount of parental support given, in the groups that had received it, contributed to the generalization and maintenance of ER skills. Autism severity negatively correlated with ER improvement. The current study provides evidence to the unique role of TT in ER skill acquisition, generalization, and maintenance in children with high functioning ASD. In addition, this study provides evidence for a successful cultural adaptation of TT to a non-English speaking culture. Autism Res 2017, 10: 993-1003. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

42 CFR 460.136 - Internal quality assessment and performance improvement activities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Internal quality assessment and performance improvement activities. 460.136 Section 460.136 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES....136 Internal quality assessment and performance improvement activities. (a) Quality assessment and...

A randomized, controlled trial of team-based competition to increase learner participation in quality-improvement education.

PubMed

Scales, Charles D; Moin, Tannaz; Fink, Arlene; Berry, Sandra H; Afsar-Manesh, Nasim; Mangione, Carol M; Kerfoot, B Price

2016-04-01

Several barriers challenge resident engagement in learning quality improvement (QI). We investigated whether the incorporation of team-based game mechanics into an evidence-based online learning platform could increase resident participation in a QI curriculum. Randomized, controlled trial. Tertiary-care medical center residency training programs. Resident physicians (n = 422) from nine training programs (anesthesia, emergency medicine, family medicine, internal medicine, ophthalmology, orthopedics, pediatrics, psychiatry and general surgery) randomly allocated to a team competition environment (n = 200) or the control group (n = 222). Specialty-based team assignment with leaderboards to foster competition, and alias assignment to de-identify individual participants. Participation in online learning, as measured by percentage of questions attempted (primary outcome) and additional secondary measures of engagement (i.e. response time). Changes in participation measures over time between groups were assessed with a repeated measures ANOVA framework. Residents in the intervention arm demonstrated greater participation than the control group. The percentage of questions attempted at least once was greater in the competition group (79% [SD ± 32] versus control, 68% [SD ± 37], P= 0.03). Median response time was faster in the competition group (P= 0.006). Differences in participation continued to increase over the duration of the intervention, as measured by average response time and cumulative percent of questions attempted (each P< 0.001). Team competition increases resident participation in an online course delivering QI content. Medical educators should consider game mechanics to optimize participation when designing learning experiences. Published by Oxford University Press in association with the International Society for Quality in Health Care 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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

PubMed Central

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

2009-01-01

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

Implementing self sustained quality control procedures in a clinical laboratory.

PubMed

Khatri, Roshan; K C, Sanjay; Shrestha, Prabodh; Sinha, J N

2013-01-01

Quality control is an essential component in every clinical laboratory which maintains the excellence of laboratory standards, supplementing to proper disease diagnosis, patient care and resulting in overall strengthening of health care system. Numerous quality control schemes are available, with combinations of procedures, most of which are tedious, time consuming and can be "too technical" whereas commercially available quality control materials can be expensive especially for laboratories in developing nations like Nepal. Here, we present a procedure performed at our centre with self prepared control serum and use of simple statistical tools for quality assurance. The pooled serum was prepared as per guidelines for preparation of stabilized liquid quality control serum from human sera. Internal Quality Assessment was performed on this sample, on a daily basis which included measurement of 12 routine biochemical parameters. The results were plotted on Levey-Jennings charts and analysed with quality control rules, for a period of one month. The mean levels of biochemical analytes in self prepared control serum were within normal physiological range. This serum was evaluated every day along with patients' samples. The results obtained were plotted on control charts and analysed using common quality control rules to identify possible systematic and random errors. Immediate mitigation measures were taken and the dispatch of erroneous reports was avoided. In this study we try to highlight on a simple internal quality control procedure which can be performed by laboratories, with minimum technology, expenditure, and expertise and improve reliability and validity of the test reports.

77 FR 32444 - Minimum Internal Control Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... Internal Control Standards AGENCY: National Indian Gaming Commission. ACTION: Proposed rule. SUMMARY: The National Indian Gaming Commission (NIGC) proposes to amend its minimum internal control standards for Class... the Federal Register called Minimum Internal Control Standards. 64 FR 590. The rule added a new part...

Evolution of International Space Station Program Safety Review Processes and Tools

NASA Technical Reports Server (NTRS)

Ratterman, Christian D.; Green, Collin; Guibert, Matt R.; McCracken, Kristle I.; Sang, Anthony C.; Sharpe, Matthew D.; Tollinger, Irene V.

2013-01-01

The International Space Station Program at NASA is constantly seeking to improve the processes and systems that support safe space operations. To that end, the ISS Program decided to upgrade their Safety and Hazard data systems with 3 goals: make safety and hazard data more accessible; better support the interconnection of different types of safety data; and increase the efficiency (and compliance) of safety-related processes. These goals are accomplished by moving data into a web-based structured data system that includes strong process support and supports integration with other information systems. Along with the data systems, ISS is evolving its submission requirements and safety process requirements to support the improved model. In contrast to existing operations (where paper processes and electronic file repositories are used for safety data management) the web-based solution provides the program with dramatically faster access to records, the ability to search for and reference specific data within records, reduced workload for hazard updates and approval, and process support including digital signatures and controlled record workflow. In addition, integration with other key data systems provides assistance with assessments of flight readiness, more efficient review and approval of operational controls and better tracking of international safety certifications. This approach will also provide new opportunities to streamline the sharing of data with ISS international partners while maintaining compliance with applicable laws and respecting restrictions on proprietary data. One goal of this paper is to outline the approach taken by the ISS Progrm to determine requirements for the new system and to devise a practical and efficient implementation strategy. From conception through implementation, ISS and NASA partners utilized a user-centered software development approach focused on user research and iterative design methods. The user-centered approach used on the new ISS hazard system utilized focused user research and iterative design methods employed by the Human Computer Interaction Group at NASA Ames Research Center. Particularly, the approach emphasized the reduction of workload associated with document and data management activities so more resources can be allocated to the operational use of data in problem solving, safety analysis, and recurrence control. The methods and techniques used to understand existing processes and systems, to recognize opportunities for improvement, and to design and review improvements are described with the intent that similar techniques can be employed elsewhere in safety operations. A second goal of this paper is to provide and overview of the web-based data system implemented by ISS. The software selected for the ISS hazard systemMission Assurance System (MAS)is a NASA-customized vairant of the open source software project Bugzilla. The origin and history of MAS as a NASA software project and the rationale for (and advantages of) using open-source software are documented elsewhere (Green, et al., 2009).

Basal insulin initiation in primary vs. specialist care: similar glycaemic control in two different patient populations.

PubMed

Orozco-Beltran, D; Pan, C; Svendsen, A L; Faerch, L; Caputo, S

2016-03-01

To investigate the effect of healthcare provider (HCP) type (primary vs. specialist) on glycaemic control and other treatment parameters. Study of Once-Daily Levemir (SOLVE(™) ) is an international, 24-week, observational study of insulin initiation in people with type 2 diabetes. A total of 17,374 subjects were included, comprising 4144 (23.9%) primary care subjects. Glycaemic control improved in both HCP groups from baseline to final visit [glycated haemoglobin (HbA1c) -1.2 ± 1.4% (-13.1 ± 15.3 mmol/mol) and -1.3 ± 1.6% (-14.2 ± 17.5 mmol/mol), respectively]. After adjustment for known confounders, there was no statistically significant effect of HCP group on final HbA1c [-0.04%, 95% confidence interval (CI) -0.09 to -0.01 (-0.4 mmol/mol, 95% CI -1.0-0.1 mmol/mol), p = 0.1590]. However, insulin doses at the final visit were higher in primary care patients (+0.06, 95% CI 0.06-0.07 U/kg, p < 0.0001). Logistic regression demonstrated a significant effect of HCP type (primary vs. specialist care) on hypoglycaemia risk [odds ratio (OR) 0.75, 95% CI 0.64-0.87, p = 0.0002]. Primary care physicians took more time to train patients and had more frequent contact with patients than specialists (both p < 0.0001). Primary care physicians and specialists achieved comparable improvements in glycaemic control following insulin initiation. © 2016 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

Symptoms of internalizing and externalizing problems: modeling recovery curves after the death of a parent.

PubMed

Schmiege, Sarah J; Khoo, Siek Toon; Sandler, Irwin N; Ayers, Tim S; Wolchik, Sharlene A

2006-12-01

The death of a parent is a major family disruption that can place children at risk for later depression and other mental health problems. Theoretically based randomized controlled trial for parentally bereaved children. Two-hundred and forty-four children and adolescents and their caregivers from 156 families were randomly assigned to the Family Bereavement Program (FBP) intervention condition (90 families; 135 children) or to a control condition (66 families; 109 children). Data collection occurred from 1996 to 1998. Children and caregivers in the intervention condition met separately for 12 two-hour weekly sessions. Skills targeted by the program for children included positive coping, stress appraisals, control beliefs, and self-esteem. The caregiver program targeted caregiver mental health, life stressors, and improved discipline in the home. Both child and caregiver programs focused on improved quality of the caregiver-child relationship. Child and caregiver reports of internalizing and externalizing symptoms. Longitudinal growth curve modeling was performed to model symptoms over time from the point of parental death. The rate of recovery for girls in the program condition was significantly different from that of girls in the control condition across all outcomes. Boys in both conditions showed reduced symptoms over time. The methodology offers a conceptually unique way of assessing recovery in terms of reduced mental health problems over time after an event and has contributed to further understanding of FBP intervention effects. The intervention program facilitated recovery among girls, who did not show reduction in behavior problems without the program, while boys demonstrated decreased symptoms even without intervention.

Self-reported quality of life before and after aerobic exercise training in individuals with hypertension: a randomised-controlled trial.

PubMed

Maruf, Fatai A; Akinpelu, Aderonke O; Salako, Babatunde L

2013-07-01

The Effects of Aerobic Exercise Training (AET) on self-reported Quality of Life (QoL) in people with hypertension have been previously documented. However, data on black populations, especially from Africa, seem not to be available. This study investigated the effects of AET on QoL and exercise capacity in Nigerians on treatment for essential hypertension. This randomised-controlled trial involved newly diagnosed individuals, with mild-to-moderate essential hypertension randomly assigned to antihypertensive drugs (ADs) alone (control: n = 60) and AET+ADs (exercise: n = 60) groups. The study lasted for 12 weeks. QoL was measured using the World Health Organization QoL Short Form (WHOQoL-BREF) and exercise capacity was assessed using the Rockport Fitness Walk Test pre- and post-study. Physical health, psychological health, and social relationships domains of QoL improved significantly in the exercise and control groups post-intervention. The environment domain of QoL and exercise capacity improved significantly in only the exercise group. There were larger improvements in the physical health, psychological health, and environment domains of QoL, and exercise capacity in the exercise group. Aerobic exercise improves QoL and exercise capacity in individuals with essential hypertension. © 2013 The Authors. Applied Psychology: Health and Well-Being © 2013 The International Association of Applied Psychology.

Reducing neonatal infections in south and south central Vietnam: the views of healthcare providers

PubMed Central

2013-01-01

Background Infection causes neonatal mortality in both high and low income countries. While simple interventions to prevent neonatal infection are available, they are often poorly understood and implemented by clinicians. A basic understanding of healthcare providers' perceptions of infection control provides a platform for improving current practices. Our aim was to explore the views of healthcare providers in provincial hospitals in south and south central Vietnam to inform the design of programmes to improve neonatal infection prevention and control. Methods All fifty-four participants who attended a workshop on infection prevention and control were asked to complete an anonymous, written questionnaire identifying their priorities for improving neonatal infection prevention and control in provincial hospitals in south and south central Vietnam. Results Hand washing, exclusive breastfeeding and safe disposal of medical waste were nominated by most participants as priorities for preventing neonatal infections. Education through instructional posters and written guidelines, family contact, kangaroo-mother-care, limitation of invasive procedures and screening for maternal GBS infection were advocated by a smaller proportion of participants. Conclusions The opinions of neonatal healthcare providers at the workshop accurately reflect some of the current international recommendations for infection prevention. However, other important recommendations were not commonly identified by participants and need to be reinforced. Our results will be used to design interventions to improve infection prevention in Vietnam, and may be relevant to other low-resource countries. PMID:23570330

49 CFR 193.2631 - Internal corrosion control.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Internal corrosion control. 193.2631 Section 193... GAS FACILITIES: FEDERAL SAFETY STANDARDS Maintenance § 193.2631 Internal corrosion control. Each component that is subject to internal corrosive attack must be protected from internal corrosion by— (a...

Pathological Personality Traits and the Naturalistic Course of Internalizing Disorders among High-Risk Young Adults

PubMed Central

Conway, Christopher C.; Craske, Michelle G.; Zinbarg, Richard E.; Mineka, Susan

2015-01-01

Background A diagnosis of personality disorder (PD) signals a negative prognosis for depressive and anxiety disorders, but the precise abnormal personality traits that regulate the temporal course of internalizing psychopathology are unknown. In the present study, we examined prospective associations between abnormal personality traits and the onset and recurrence of internalizing disorders. Methods A sample of 371 young adults at high risk for internalizing problems completed the Schedule for Nonadaptive and Adaptive Personality-Second Edition—a measure of 12 abnormal personality traits and three temperament dimensions (i.e., Negative Temperament, Positive Temperament, Disinhibition versus Control)—and underwent annual diagnostic interviews over four years of follow-up. Results In multivariate survival analyses, Negative Temperament was a robust predictor of both new onsets and recurrences of internalizing disorder. Further, the Dependency and Self-Harm abnormal personality dimensions emerged as independent predictors of new onsets and recurrences, respectively, of internalizing disorders after statistically adjusting for variation in temperament. Conclusions Our findings suggest that abnormal personality traits and temperament dimensions have complementary effects on the trajectory of internalizing pathology during young adulthood. In assessment and treatment settings, targeting the abnormal personality and temperament dimensions with the greatest prognostic value stands to improve the early detection of enduring internalizing psychopathology. PMID:26344411

PATHOLOGICAL PERSONALITY TRAITS AND THE NATURALISTIC COURSE OF INTERNALIZING DISORDERS AMONG HIGH-RISK YOUNG ADULTS.

PubMed

Conway, Christopher C; Craske, Michelle G; Zinbarg, Richard E; Mineka, Susan

2016-01-01

A personality disorder diagnosis signals a negative prognosis for depressive and anxiety disorders, but the precise abnormal personality traits that determine the temporal course of internalizing psychopathology are unknown. In the present study, we examined prospective associations between abnormal personality traits and the onset and recurrence of internalizing disorders. A sample of 371 young adults at high risk for internalizing problems completed the Schedule for Nonadaptive and Adaptive Personality-Second Edition--a measure of 12 abnormal personality traits and three temperament dimensions (i.e., Negative Temperament, Positive Temperament, Disinhibition vs. Control)--and underwent annual diagnostic interviews over 4 years of follow-up. In multivariate survival analyses, Negative Temperament was a robust predictor of both new onsets and recurrences of internalizing disorder. Further, the Dependency and Self-Harm abnormal personality dimensions emerged as independent predictors of new onsets and recurrences, respectively, of internalizing disorders after statistically adjusting for variation in temperament. Our findings suggest that abnormal personality traits and temperament dimensions have complementary effects on the trajectory of internalizing pathology during young adulthood. In assessment and treatment settings, targeting the abnormal personality and temperament dimensions with the greatest prognostic value stands to improve the early detection of enduring internalizing psychopathology. © 2015 Wiley Periodicals, Inc.

International Cooperation at NASA

NASA Astrophysics Data System (ADS)

Tawney, Timothy; Feldstein, Karen

International cooperation is a cornerstone principle of NASA’s activities, especially within the activities of the Science Mission Directorate. Nearly two thirds of the flight missions in which NASA leads or participates involve international cooperation. Numerous ground based activities also rely on international cooperation, whether because of unique expertise, unique geography, or the need for a global response. Going forward, in an era of tighter budgets and a more integrated global perspective, NASA and the rest of the space agencies around the world will be forced to work more closely together, in a broader array of activities than ever before, in order to be able to afford to push the boundaries of space exploration. The goal of this presentation is to provide an overview of NASA’s current international science cooperative activities. It will include a discussion of why NASA conducts international cooperation and look at the mechanisms through which international cooperation can occur at NASA, including peer-to-peer development of relationships. It will also discuss some of the limiting factors of international cooperation, such as export control, and ways in which to manage those constraints. Finally, the presentation would look at some of the present examples where NASA is working to increase international cooperation and improve coordination. Case studies will be used to demonstrate these mechanisms and concepts. For example, NASA continues to participate in international coordination groups such as the International Mars Exploration Working Group (IMEWG) and International Space Exploration Coordination Group (ISECG), but is expanding into new areas as well. NASA is one of the leaders in expanding and improving international coordination in the area of Near-Earth Object detection, characterization, and mitigation. Having participated in the first meetings of such groups as the International Asteroid Warning Network (IAWN) and Space Missions Planning Advisory Group (SMPAG), NASA is placing an ever greater emphasis on sharing information among members and working to avoid duplication of effort for the betterment of all humanity. International cooperation at NASA takes many forms. In some cases NASA leads, while in other cases it follows the lead of our many international partners, all in the name of obtaining the best science. In many cases, truly stellar partnerships emerge. In a few cases, the partnership is ended before it can flourish. But in all cases, the partners are learning to work more closely together so that in the future, our partnerships will yield ever better results.

2 CFR 200.61 - Internal controls.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false Internal controls. 200.61 Section 200.61 Grants and Agreements Office of Management and Budget Guidance for Grants and Agreements OFFICE OF... REQUIREMENTS FOR FEDERAL AWARDS Acronyms and Definitions Acronyms § 200.61 Internal controls. Internal controls...

[Relaxation techniques for chronic pain].

PubMed

Diezemann, A

2011-08-01

Relaxation techniques are an integral part of the psychological therapy of chronic pain and follow very different objectives. These techniques lead to muscular and vegetative stabilization, serve as distraction from pain, to build up the internal focus of control and thus to improve self-efficacy. Additional targets are improvement of body awareness and stress management, shielding from sensory stimuli and recurrence prevention of migraine as well a sleeping aid. The most commonly used and best studied method is progressive muscle relaxation which has a good compliance because it is easy to learn and has a high plausibility for patients.

Protecting the world against meningitis: new recommendations from the CDC's advisory committee on immunization practices.

PubMed

Cyrus, Scott S

2011-10-01

Meningococcal meningitis is a rare but often fatal disease. Throughout adolescence, the incidence of meningococcal meningitis increases, reaching a peak among individuals between the ages of 16 and 21 years. Vaccines are available to combat this deadly disease. Recently, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices updated its recommendations on meningitis vaccination to improve outcomes and to prevent this disease in adolescents and other vulnerable populations, such as adults traveling internationally to epidemic areas. Improved meningitis vaccines and revised vaccination recommendations will help to create a healthier world.

Benefits of a Pharmacology Antimalarial Reference Standard and Proficiency Testing Program Provided by the Worldwide Antimalarial Resistance Network (WWARN)

PubMed Central

Lourens, Chris; Lindegardh, Niklas; Barnes, Karen I.; Guerin, Philippe J.; Sibley, Carol H.; White, Nicholas J.

2014-01-01

Comprehensive assessment of antimalarial drug resistance should include measurements of antimalarial blood or plasma concentrations in clinical trials and in individual assessments of treatment failure so that true resistance can be differentiated from inadequate drug exposure. Pharmacometric modeling is necessary to assess pharmacokinetic-pharmacodynamic relationships in different populations to optimize dosing. To accomplish both effectively and to allow comparison of data from different laboratories, it is essential that drug concentration measurement is accurate. Proficiency testing (PT) of laboratory procedures is necessary for verification of assay results. Within the Worldwide Antimalarial Resistance Network (WWARN), the goal of the quality assurance/quality control (QA/QC) program is to facilitate and sustain high-quality antimalarial assays. The QA/QC program consists of an international PT program for pharmacology laboratories and a reference material (RM) program for the provision of antimalarial drug standards, metabolites, and internal standards for laboratory use. The RM program currently distributes accurately weighed quantities of antimalarial drug standards, metabolites, and internal standards to 44 pharmacology, in vitro, and drug quality testing laboratories. The pharmacology PT program has sent samples to eight laboratories in four rounds of testing. WWARN technical experts have provided advice for correcting identified problems to improve performance of subsequent analysis and ultimately improved the quality of data. Many participants have demonstrated substantial improvements over subsequent rounds of PT. The WWARN QA/QC program has improved the quality and value of antimalarial drug measurement in laboratories globally. It is a model that has potential to be applied to strengthening laboratories more widely and improving the therapeutics of other infectious diseases. PMID:24777099

Prenatal Internal Locus of Control Is Positively Associated with Offspring IQ, Mediated through Parenting Behavior, Prenatal Lifestyle and Social Circumstances.

PubMed

Golding, Jean; Gregory, Steven; Ellis, Genette L; Iles-Caven, Yasmin; Nowicki, Stephen

2017-01-01

Locus of control (LOC) is a measure that identifies the likelihood as to whether an individual considers what happens to him is largely a matter of luck or fate (known as externally oriented) or whether it is something that the individual can influence (internality). Here we have used data collected as part of the Avon Longitudinal Study of Parents and Children (ALSPAC) to determine the associations between the mothers' LOC orientation before the birth of the child and her child's cognition measured at age 8. Using results from 6801 children we show that maternal internal LOC is associated with increased ability in offspring IQ, as measured using the WISC, with children of internally oriented mothers having an advantage of approximately 7 IQ points at age 8. As a sensitivity analysis we used the IQ test results of a sample of 986 preschool children tested using the WPSSI at age 4. A similar advantage was found among the offspring of the internally oriented mothers. We investigated mechanistic explanations for these results firstly by determining the extent to which three separate sets of factors known to be influenced by the LOC orientation might explain these findings. We showed that (a) perinatal life-style exposures, (b) parenting attitudes and strategies and (c) socio-economic circumstances, largely explain the mechanism through which the internality of the mother influences the cognition of the child. Similar effects were found using the smaller sample tested at age 4. The results indicate that efforts made to foster internality in adolescents and young adults prior to parenthood may result in improvements in the cognitive development of the next generation. Intervention studies are urgently needed.

Prenatal Internal Locus of Control Is Positively Associated with Offspring IQ, Mediated through Parenting Behavior, Prenatal Lifestyle and Social Circumstances

PubMed Central

Golding, Jean; Gregory, Steven; Ellis, Genette L.; Iles-Caven, Yasmin; Nowicki, Stephen

2017-01-01

Locus of control (LOC) is a measure that identifies the likelihood as to whether an individual considers what happens to him is largely a matter of luck or fate (known as externally oriented) or whether it is something that the individual can influence (internality). Here we have used data collected as part of the Avon Longitudinal Study of Parents and Children (ALSPAC) to determine the associations between the mothers’ LOC orientation before the birth of the child and her child’s cognition measured at age 8. Using results from 6801 children we show that maternal internal LOC is associated with increased ability in offspring IQ, as measured using the WISC, with children of internally oriented mothers having an advantage of approximately 7 IQ points at age 8. As a sensitivity analysis we used the IQ test results of a sample of 986 preschool children tested using the WPSSI at age 4. A similar advantage was found among the offspring of the internally oriented mothers. We investigated mechanistic explanations for these results firstly by determining the extent to which three separate sets of factors known to be influenced by the LOC orientation might explain these findings. We showed that (a) perinatal life-style exposures, (b) parenting attitudes and strategies and (c) socio-economic circumstances, largely explain the mechanism through which the internality of the mother influences the cognition of the child. Similar effects were found using the smaller sample tested at age 4. The results indicate that efforts made to foster internality in adolescents and young adults prior to parenthood may result in improvements in the cognitive development of the next generation. Intervention studies are urgently needed. PMID:28878722

The Effectiveness of Art Therapy in Reducing Internalizing and Externalizing Problems of Female Adolescents.

PubMed

Bazargan, Yasaman; Pakdaman, Shahla

2016-01-01

The internalizing and externalizing problems relating to childhood and adolescent have always been significant. Because there is special considerations in establishing communication with them and hence, the therapeutic methods for these problems must take into account these considerations. As establishing a therapeutic relationship is an important component of effective counseling, it seems that art therapy may help alleviate these problems. The purpose of this study is to determine the effectiveness of art therapy in reducing internalizing and externalizing problems of adolescent girls (14 - 18 years old). This is a semi-experimental study carried out in the form of a pre-test/post-test design with control group. The population of this study includes female students of Gole Laleh School of Art in district 3 of Tehran, Iran, out of which 30 students with internalizing problems and 30 individuals with externalizing problems were selected through targeted sampling. Students were randomly assigned to control and experimental groups. Experimental groups participated in 6 painting sessions designed based on Art therapy theories and previous studies. The material used for diagnosis of the problems in posttest and pretest was an Achenbach self-assessment form. Data were analyzed using a mixed analysis of variance (ANOVA). Our results showed that Art therapy significantly reduced internalizing problems (F = 17.61, P < 0.001); however, its effect in reducing externalizing problems was not significant (F = 3.93, P = 0.06). Art therapy as a practical therapeutic method can be used to improve internalizing problems. To reduce externalizing problems, more sessions may be needed. Thus, future studies are required to insure these findings.

Direct effects of tadalafil on lower urinary tract symptoms versus indirect effects mediated through erectile dysfunction symptom improvement: integrated data analyses from 4 placebo controlled clinical studies.

PubMed

Brock, Gerald B; McVary, Kevin T; Roehrborn, Claus G; Watts, Steven; Ni, Xiao; Viktrup, Lars; Wong, David G; Donatucci, Craig

2014-02-01

Tadalafil has regulatory approval for the treatment of men with signs/symptoms of benign prostatic hyperplasia with and without erectile dysfunction. We assessed whether the effects of treatment with tadalafil for lower urinary tract symptoms/benign prostatic hyperplasia are independent of improvements in erectile dysfunction. Four separate analyses used integrated data from 4 randomized, double-blind, placebo controlled studies in men with lower urinary tract symptoms/benign prostatic hyperplasia with and without erectile dysfunction to test whether total I-PSS (International Prostate Symptom Score) improvement was due to improvement in IIEF-EF (International Index of Erectile Function-Erectile Function domain score). Unidirectional and bidirectional path analysis models determined direct and indirect treatment effects mediated by improvements in lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction symptoms. A total of 1,496 men, of whom 77% had erectile dysfunction, received at least 1 dose of tadalafil 5 mg once daily or placebo. The placebo adjusted treatment effect for men with erectile dysfunction was represented by a mean decrease of -2.3 (p <0.0001) in total I-PSS vs -2.2 (p = 0.0007) for men without erectile dysfunction. The correlation between change from baseline in total I-PSS and IIEF-EF was weak (r(2) = 0.08, p <0.0001). The unidirectional path analysis model suggested that the total treatment effect on total I-PSS score improvement (2.25) was derived from a direct treatment effect of 1.57 (70%, p <0.001) and an indirect treatment effect of 0.67 (30% via IIEF-EF improvement, p <0.001). Bidirectional path analysis showed that total I-PSS improvement was largely attributed to direct (92.5%, p <0.001) vs indirect (7.5%, p = 0.32) treatment effects via IIEF-EF improvement. Regardless of the analytical approach, self-reported erectile dysfunction status did not appreciably influence tadalafil treatment response in men with lower urinary tract symptoms/benign prostatic hyperplasia, supporting the dual action of tadalafil on lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction. Copyright © 2014. Published by Elsevier Inc.

Teaching Cardiac Examination Skills

PubMed Central

Smith, Christopher A; Hart, Avery S; Sadowski, Laura S; Riddle, Janet; Evans, Arthur T; Clarke, Peter M; Ganschow, Pamela S; Mason, Ellen; Sequeira, Winston; Wang, Yue

2006-01-01

OBJECTIVE To determine if structured teaching of bedside cardiac examination skills improves medical residents' examination technique and their identification of key clinical findings. DESIGN Firm-based single-blinded controlled trial. SETTING Inpatient service at a university-affiliated public teaching hospital. PARTICIPANTS Eighty Internal Medicine residents. METHODS The study assessed 2 intervention groups that received 3-hour bedside teaching sessions during their 4-week rotation using either: (1) a traditional teaching method, “demonstration and practice” (DP) (n=26) or (2) an innovative method, “collaborative discovery” (CD) (n=24). The control group received their usual ward teaching sessions (n=25). The main outcome measures were scores on examination technique and correct identification of key clinical findings on an objective structured clinical examination (OSCE). RESULTS All 3 groups had similar scores for both their examination technique and identification of key findings in the preintervention OSCE. After teaching, both intervention groups significantly improved their technical examination skills compared with the control group. The increase was 10% (95% confidence interval [CI] 4% to 17%) for CD versus control and 12% (95% CI 6% to 19%) for DP versus control (both P<.005) equivalent to an additional 3 to 4 examination skills being correctly performed. Improvement in key findings was limited to a 5% (95% CI 2% to 9%) increase for the CD teaching method, CD versus control P=.046, equivalent to the identification of an additional 2 key clinical findings. CONCLUSIONS Both programs of bedside teaching increase the technical examination skills of residents but improvements in the identification of key clinical findings were modest and only demonstrated with a new method of teaching. PMID:16423116

Generalized internal model robust control for active front steering intervention

NASA Astrophysics Data System (ADS)

Wu, Jian; Zhao, Youqun; Ji, Xuewu; Liu, Yahui; Zhang, Lipeng

2015-03-01

Because of the tire nonlinearity and vehicle's parameters' uncertainties, robust control methods based on the worst cases, such as H ∞, µ synthesis, have been widely used in active front steering control, however, in order to guarantee the stability of active front steering system (AFS) controller, the robust control is at the cost of performance so that the robust controller is a little conservative and has low performance for AFS control. In this paper, a generalized internal model robust control (GIMC) that can overcome the contradiction between performance and stability is used in the AFS control. In GIMC, the Youla parameterization is used in an improved way. And GIMC controller includes two sections: a high performance controller designed for the nominal vehicle model and a robust controller compensating the vehicle parameters' uncertainties and some external disturbances. Simulations of double lane change (DLC) maneuver and that of braking on split- µ road are conducted to compare the performance and stability of the GIMC control, the nominal performance PID controller and the H ∞ controller. Simulation results show that the high nominal performance PID controller will be unstable under some extreme situations because of large vehicle's parameters variations, H ∞ controller is conservative so that the performance is a little low, and only the GIMC controller overcomes the contradiction between performance and robustness, which can both ensure the stability of the AFS controller and guarantee the high performance of the AFS controller. Therefore, the GIMC method proposed for AFS can overcome some disadvantages of control methods used by current AFS system, that is, can solve the instability of PID or LQP control methods and the low performance of the standard H ∞ controller.

Adaptive Neural Network Control for the Trajectory Tracking of the Furuta Pendulum.

PubMed

Moreno-Valenzuela, Javier; Aguilar-Avelar, Carlos; Puga-Guzman, Sergio A; Santibanez, Victor

2016-12-01

The purpose of this paper is to introduce a novel adaptive neural network-based control scheme for the Furuta pendulum, which is a two degree-of-freedom underactuated system. Adaptation laws for the input and output weights are also provided. The proposed controller is able to guarantee tracking of a reference signal for the arm while the pendulum remains in the upright position. The key aspect of the derivation of the controller is the definition of an output function that depends on the position and velocity errors. The internal and external dynamics are rigorously analyzed, thereby proving the uniform ultimate boundedness of the error trajectories. By using real-time experiments, the new scheme is compared with other control methodologies, therein demonstrating the improved performance of the proposed adaptive algorithm.