Regenerative Medicine Will Make Orthopaedic Implants Obsolete In Our Time Orthopaedic Research Society First Annual Meeting Debate, San Diego, March 21st , 2017.

PubMed

Johnstone, Brian; Jacobs, Joshua J; Sandell, Linda J; Wilkinson, J Mark

2018-05-10

The mission of the Orthopaedic Research Society is to promote and advance musculoskeletal research worldwide. With this in mind, the Annual Meeting Program Committee sought to establish a debate as a key component of the meeting. Our purpose was to provoke discussion on topics that are core to our mission and to engage all constituencies within the society by examining questions of broad relevance. To this end, the topic "Regenerative medicine will make orthopaedic implants obsolete in our time" was selected as the title of the inaugural debate. The arguments for and against the motion are presented in this perspectives article. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Exploring Factors Influencing Self-Efficacy in Information Security an Empirical Analysis by Integrating Multiple Theoretical Perspectives in the Context of Using Protective Information Technologies

ERIC Educational Resources Information Center

Reddy, Dinesh Sampangirama

2017-01-01

Cybersecurity threats confront the United States on a daily basis, making them one of the major national security challenges. One approach to meeting these challenges is to improve user cybersecurity behavior. End user security behavior hinges on end user acceptance and use of the protective information technologies such as anti-virus and…

Perceived risks around choice and decision making at end-of-life: a literature review.

PubMed

Wilson, F; Gott, M; Ingleton, C

2013-01-01

the World Health Organization identifies meeting patient choice for care as central to effective palliative care delivery. Little is known about how choice, which implies an objective balancing of options and risks, is understood and enacted through decision making at end-of-life. to explore how perceptions of 'risk' may inform decision-making processes at end-of-life. an integrative literature review was conducted between January and February 2010. Papers were reviewed using Hawker et al.'s criteria and evaluated according to clarity of methods, analysis and evidence of ethical consideration. All literature was retained as background data, but given the significant international heterogeneity the final analysis specifically focused on the UK context. the databases Medline, PsycINFO, Assia, British Nursing Index, High Wire Press and CINAHL were explored using the search terms decision*, risk, anxiety, hospice and palliative care, end-of-life care and publication date of 1998-2010. thematic analysis of 25 papers suggests that decision making at end-of-life is multifactorial, involving a balancing of risks related to caregiver support; service provider resources; health inequalities and access; challenges to information giving; and perceptions of self-identity. Overall there is a dissonance in understandings of choice and decision making between service providers and service users. the concept of risk acknowledges the factors that shape and constrain end-of-life choices. Recognition of perceived risks as a central factor in decision making would be of value in acknowledging and supporting meaningful decision making processes for patients with palliative care needs and their families.

Cancer multidisciplinary team meetings in practice: Results from a multi-institutional quantitative survey and implications for policy change.

PubMed

Rankin, Nicole M; Lai, Michelle; Miller, Danielle; Beale, Philip; Spigelman, Allan; Prest, Gabrielle; Turley, Kim; Simes, John

2018-02-01

Multidisciplinary care is advocated as best practice in cancer care. Relatively little is documented about multidisciplinary team (MDT) meeting functioning, decision making and the use of evidence to support decision making in Australia. This descriptive study aimed to examine team functioning, the role of team meetings and evidence use in MDTs whose institutions are members of Sydney Catalyst Translational Cancer Research Centre. We designed a structured 40-item survey instrument about topics that included meeting purpose, organization, resources and documentation; caseload estimates; use of evidence and quality assurance; patient involvement and supportive care needs; and open-ended items about the MDTs strengths and weaknesses. Participants were invited to participate via email and the survey was administered online. Data were analyzed using descriptive and comparative statistics. Thirty-seven MDTs from seven hospitals participated (100% response) and represented common (70%) and rare tumor groups (30%). MDT meeting purpose was reported as treatment (100%) or diagnostic decision making (88%), or for education purposes (70%). Most MDTs based treatment decisions on group consensus (92%), adherence to clinical practice guidelines (57%) or other evidence-based medicine sources (33%). The majority of MDTs discussed only a proportion of new patients at each meeting emphasizing the importance of educational aspects for other cases. Barriers exist in the availability of data to enable audit and reflection on evidence-based practice. MDT strengths included collaboration and quality discussion about patients. MDT meetings focus on treatment decision making, with group consensus playing a significant role in translating research evidence from guidelines into clinical decision making. With a varying proportion of patients discussed in each MDT meeting, a wider audit of multidisciplinary care would enable more accurate assessments of whether treatment recommendations are in accordance with best-practice evidence. © 2017 John Wiley & Sons Australia, Ltd.

Business---Education: Parallels in Management.

ERIC Educational Resources Information Center

Speer, Edgar B.

1976-01-01

Administrators of higher education are facing a challenge and opportunity that parallels those faced by managers in American business. The economic situation presents a struggle to make ends meet as well as an opportunity to sharpen its role in society, to redefine its goals. Administrators in both fields are using management-by-objective theories…

Impact and evaluation of International Cancer Control Congresses.

PubMed

Sarwal, Kavita; Trapido, Edward J; Sutcliffe, Simon; Qiao, You-Lin

2013-01-01

International meetings on various aspects of cancer- its etiology, its diagnosis, its treatment, its palliation, and its prevention and control are held frequently. Many have similar themes, and many seek and receive the same speakers and audiences. A fundamental question arises: what difference does any individual meeting/congress/ conference make or add to our understanding of the relevant issues? While many meetings conduct evaluations at the end of the Congress, few use evaluation as a tool to guide design, implementation, and evaluation of both short and long term impacts, and address the question of "what difference did the Congress make". The International Cancer Control Congresses, which are held biennially in different regions of the world, took the opportunity to use evaluation in this way, and ask the relevant questions. This paper describes that evaluation session of the ICCC4, held in Seoul, Korea in November 2011, which was part of the larger evaluation issue.

Double lead spiral platen parallel jaw end effector

NASA Technical Reports Server (NTRS)

Beals, David C.

1989-01-01

The double lead spiral platen parallel jaw end effector is an extremely powerful, compact, and highly controllable end effector that represents a significant improvement in gripping force and efficiency over the LaRC Puma (LP) end effector. The spiral end effector is very simple in its design and has relatively few parts. The jaw openings are highly predictable and linear, making it an ideal candidate for remote control. The finger speed is within acceptable working limits and can be modified to meet the user needs; for instance, greater finger speed could be obtained by increasing the pitch of the spiral. The force relaxation is comparable to the other tested units. Optimization of the end effector design would involve a compromise of force and speed for a given application.

Cleared Hot: A Forward Air Control (Airborne) Concepts Trainer

DTIC Science & Technology

2006-09-01

list of high-level objectives imitating a detailed requirements document. In those cases, software developers are forced to make best guesses about...software developers are forced to make best guesses about how to meet those objectives. Is there a better method? We embarked on a project to create a...with participants at the end of an 18-month development cycle, we did the next best thing: Cleared Hot was taken to the mission subject matter

Sex Work and Students: An Exploratory Study

ERIC Educational Resources Information Center

Roberts, Ron; Bergstrom, Sandra; La Rooy, David

2007-01-01

Available evidence suggests that changes in the funding of higher education have led to some students entering the sex industry in order to make ends meet. The current study comprises a sample of undergraduates (N=130) in the south of England, who completed a cross-sectional survey of their financial circumstances, health, psychological…

Making IT ends meet. Susquehanna Health System outsources Siemens' prized product to nearby hospitals looking for an affordable alternative.

PubMed

Becker, Cinda

2004-08-16

Susquehanna Health System has been offering small, rural hospitals a more affordable information technology system through a unique outsourcing agreement. The system's CIO, Pamela Wirth, left, has advocated the provider-to-provider arrangement, which could draw the ire of some vendors.

The Hidden Poor: Over Three-Quarters of a Million Older Californians Overlooked by Official Poverty Line.

PubMed

Padilla-Frausto, Imelda D; Wallace, Steven P

2015-08-01

More than three-quarters of a million (772,000) older Californians are among the "hidden poor"--older adults with incomes above the federal poverty line (FPL) but below a minimally decent standard of living as determined by the Elder Economic Security Standard™ Index (Elder Index) in 2011. This policy brief uses the most recent Elder Index calculations to document the wide discrepancy that exists between the FPL and the Elder Index. This study finds that the FPL significantly underestimates the number of economically insecure older adults who are unable to make ends meet. Yet, because many public assistance programs are aligned with the FPL, potentially hundreds of thousands of economically insecure older Californians are denied aid. The highest rates of the hidden poor among older adults are found among renters, Latinos, women, those who are raising grandchildren, and people in the oldest age groups. Raising the income and asset eligibility requirement thresholds for social support programs such as Supplemental Security Income (SSI), housing, health care, and food assistance would help California's older hidden poor make ends meet.

Report 59 of the AMA Board of Trustees (A-96). Physician-assisted suicide. Reference Committee on Amendments to Constitution and Bylaws.

PubMed

1996-08-01

This Board of Trustees report calls for reaffirmation of the position of the American Medical Association (AMA) in opposition to physicians assisting their patients in committing suicide. The AMA maintains that the appropriate step for physicians is not to assist a patient in death but to provide compassion and palliative care. In providing end-of-life care, the option of allowing physicians to intentionally cause the death of patients is a line that should not be crossed. This position is based on the historical role of physicians as advocates for healing. The report discusses AMA activity to design and implement a comprehensive physician education plan on end-of-life care in response to the House of Delegates' action in adopting Board of Trustees Report 48-I-95, "Quality Care at the End of Life." This plan will further the AMA's commitment that patients should receive high quality care during every stage of life, including the end of life. The goal of this educational campaign is to advance the medical culture by making palliative treatment and care directions based on values-based advance care planning the standard of care for meeting the needs of patients at the end of life. The basis for this activity will be the acknowledgment that physicians, while unable to always provide a cure, should always be able to relieve suffering, address the psychological needs of patients at the end of life, add value to remaining life, and help patients die with dignity. The report presents information on state legislative activities and judicial actions relating to physician-assisted suicide. The report also presents a discussion on the ethical under-pinnings against physician participation in patients' suicides. This report recommends that: the AMA reaffirm current policies 140.952 and 140.966 (AMA Policy Compendium), in accordance with Council on Ethical and Judicial Affairs Opinion 2.211 (opposition to physician-assisted suicide); the AMA initiate an educational campaign to make palliative treatment and care directions based on values-based advance care planning the standard of care for meeting the needs of patients at the end of life; the AMA continue to seek out opportunities to present the views of medicine on physician-assisted suicide and improving the quality of care for patients at the end of life; the AMA disseminate this report throughout the Federation with a request that it be distributed to local physicians; and the Board of Trustees present the House of Delegates with an update on these and related activities at the 1996 Interim Meeting and the 1997 Annual Meeting.

A method for studying decision-making by guideline development groups.

PubMed

Gardner, Benjamin; Davidson, Rosemary; McAteer, John; Michie, Susan

2009-08-05

Multidisciplinary guideline development groups (GDGs) have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR) study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making. A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis. Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE) acute physical health GDG. This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making groups.

What Happens to Teacher Salaries during a Recession? Schools in Crisis: Making Ends Meet

ERIC Educational Resources Information Center

Simpkins, Jim; Roza, Marguerite; Simburg, Suzanne

2012-01-01

In many districts where budgets are tight and forcing cuts in services, are teacher incomes also falling behind? Is teaching becoming a less remunerative occupation relative to other local opportunities such that over time it may become less attractive? Or, do the automatic salary triggers shift wages up despite revenue constraints? This study…

Students and Sex Work in the UK: Providers and Purchasers

ERIC Educational Resources Information Center

Roberts, Ron; Jones, Amy; Sanders, Teela

2013-01-01

Available evidence suggests that changes in the funding of UK higher education in recent years have been accompanied by an increased student presence in the sex industry, ostensibly for financial reasons and to make ends meet. The current study comprises a sample of students ("N" = 200) drawn from several universities in the UK. Data…

Making Bosnia-Herzegovina Safe for Democracy: (With Some Help from the Kindergartens)

ERIC Educational Resources Information Center

Krogh, Suzanne L.

2008-01-01

More than a dozen years ago, meetings held in Dayton, Ohio sponsored by the Clinton administration brought to an end three years of intense conflict in Bosnia-Herzegovina. Of all the many organizational attempts at community building and democratization since then, one of the most successful has been the adoption of elementary and secondary…

The Dark Side of College (Un)affordability: Food and Housing Insecurity in Higher Education

ERIC Educational Resources Information Center

Broton, Katharine; Goldrick-Rab, Sara

2016-01-01

Some students from low-income families are unable to pay their college costs without experiencing material hardship. What they do to make ends meet (e.g., go hungry and homeless) inhibits learning and discourages persistence. Strategic college leaders are investigating the needs of their students and drawing on the strengths of their institutions…

Partners for Learning, Not Funding

ERIC Educational Resources Information Center

Alba, Guy D.

2012-01-01

During the author's first years as a teacher, he took a part-time job to make ends meet. As an exercise instructor in a large insurance company's corporate fitness center, he worked with a wide range of employees, including the top executives. Some of those executives asked how their company could help the school. Instead of asking for a monetary…

Developing a Course on the Law of Peace Operations: Method and Practice--Making Ends Meet

ERIC Educational Resources Information Center

Oswald, Bruce M.

2007-01-01

This paper reflects on my personal experience conceptualising and teaching the law of peace operations course at The Melbourne Law School. More specifically, the paper examines some of the key challenges I have faced in developing the most appropriate conceptual framework and teaching methodologies to assist graduate students to better understand…

Better care for the dying. Hawaii healthcare system develops a manual for end-of-life care.

PubMed

Kalua, P M; Tan, S Y; Bacon, J G

1999-01-01

In early 1996, as it became clear that Americans were becoming increasingly concerned about end-of-life care, the leaders of St. Francis Healthcare System (SFHS), Honolulu, convened a meeting at which local people--community and parish representatives as well as healthcare professionals--discussed the matter. The meeting's participants identified 10 issues as essential in end-of-life care: decision making, pain management and comfort care, pastoral and spiritual care, psychosocial care, hospice and home care, cardiopulmonary resuscitation, futility, withholding and withdrawing treatment, artificial nutrition and hydration, physician-assisted suicide and euthanasia. The participants then divided themselves into 10 teams, each of which spent six months studying one of the identified essential issues. In each case, the team reviewed the relevant SFHS policies and procedures and compared them with national standards. The team also interviewed staff members about the policies and procedures, comparing the written versions with actual practices. Each team then wrote a chapter on its assigned issue, after which a core committee wove the chapters into an end-of-life care manual for SFHS. The manual was published in June 1997. The system's leaders currently use the manual to educate staff members in good end-of-life care.

Doing and Teaching Disciplinary Literacy with Adolescent Learners: A Social and Cultural Enterprise

ERIC Educational Resources Information Center

Moje, Elizabeth Birr

2015-01-01

In this essay, Elizabeth Birr Moje argues that educators can make radical change in student learning and well-being if they reframe teachers' work with youth as less about meeting standards and more about teaching youth to navigate the multiple literacy contexts in which they live, learn, and work. To that end, Moje offers a take on disciplinary…

Making Ends (and Bytes) Meet: The Challenges of Teaching Multimedia at an Urban, Underfunded University (3-U)

ERIC Educational Resources Information Center

Shumow, Moses; Sheerin, Michael Scott

2013-01-01

In a time of dynamic changes in mass communication and the restructuring of communication programs, and in the face of shrinking education budgets, educators are being pushed to update their programs to include a new emphasis on multimedia production while sustaining traditional modes of mass communication. Through surveys (N = 121) and focus…

Are Residents Losing Their Edge in Public University Admissions? The Case at the University of Washington. Schools in Crisis: Making Ends Meet

ERIC Educational Resources Information Center

Blume, Grant; Roza, Marguerite

2012-01-01

This case study examines admissions data at the University of Washington (UW) in order to quantify the effect on admissions standards for residents versus nonresidents. Like many other state flagship universities, the UW has suffered from constrained state revenues during the recent recessionary years. The findings suggest that Washington…

Building a Grad Nation: Progress and Challenge in Ending the High School Dropout Epidemic. Annual Update, 2010-2011

ERIC Educational Resources Information Center

Balfanz, Robert; Bridgeland, John M.; Fox, Joanna Hornig; Moore, Laura A.

2011-01-01

America continues to make progress in meeting its high school dropout challenge. Leaders in education, government, nonprofits and business have awakened to the individual, social and economic costs of the dropout crisis and are working together to solve it. This year, all states, districts, and schools are required by law to calculate high school…

49 CFR 23.57 - What happens if a recipient falls short of meeting its overall goals?

Code of Federal Regulations, 2012 CFR

2012-10-01

... shown on your Uniform Report of ACDBE Participation (found in Appendix A to this Part) at the end of any... section to the FAA for approval. If the FAA approves the report, you will be regarded as complying with... demonstrates that current trends make it unlikely that you, as an airport, will achieve ACDBE awards and...

49 CFR 23.57 - What happens if a recipient falls short of meeting its overall goals?

Code of Federal Regulations, 2014 CFR

2014-10-01

... shown on your Uniform Report of ACDBE Participation (found in Appendix A to this Part) at the end of any... section to the FAA for approval. If the FAA approves the report, you will be regarded as complying with... demonstrates that current trends make it unlikely that you, as an airport, will achieve ACDBE awards and...

49 CFR 23.57 - What happens if a recipient falls short of meeting its overall goals?

Code of Federal Regulations, 2013 CFR

2013-10-01

... shown on your Uniform Report of ACDBE Participation (found in Appendix A to this Part) at the end of any... section to the FAA for approval. If the FAA approves the report, you will be regarded as complying with... demonstrates that current trends make it unlikely that you, as an airport, will achieve ACDBE awards and...

How To Help Your Kids Choose To Be Tobacco-Free: A Guide for Parents of Children Ages 3 through 19.

ERIC Educational Resources Information Center

Schwebel, Robert

Focusing entirely on tobacco use, this book offers parents a powerful program for preventing or ending their children's tobacco addiction. The book provides practical strategies and suggestions to show parents how to help their children to make wise health choices and prepare them to meet their physical, social, and emotional needs without…

Being Researchers for the First Time: Reflections on the Development of an Inclusive Research Group

ERIC Educational Resources Information Center

Tilly, Liz

2015-01-01

Money, Friends and Making Ends Meet was an inclusive research project; it enabled a group of people with a learning disability who do not receive specialist support services to explore their own lives. This group are often labelled as having a mild learning disability. The research project focused on the strategies they used to cope with day to…

Making Ends Meet: Six Programs That Help Working Families and Employers. A Guide for Business Leaders and Policymakers.

ERIC Educational Resources Information Center

Patel, Nisha; Greenberg, Mark; Savner, Steve; Turetsky, Vicki

This document is intended to provide business leaders, policymakers, and others with information about the operation and value of six work support programs designed to help low-income parents obtain the assistance needed to enter a job, retain employment, and better provide for their families' needs. The six programs profiled are as follows: the…

Innovating toward Sustainability: How Computer Labs Can Enable New Staffing Structures, and New Savings. Schools in Crisis: Making Ends Meet

ERIC Educational Resources Information Center

Simburg, Suzanne; Roza, Marguerite

2012-01-01

Even as new educational technologies have emerged, staffing innovations have seemed all but impossible in American schools. Charter and district schools alike long ago surrendered to the notion that education requires at least as many core teachers as is determined from dividing enrollment by class size. A few new school designs suggest that we…

Prognostic categories and timing of negative prognostic communication from critical care physicians to family members at end-of-life in an intensive care unit.

PubMed

Gutierrez, Karen M

2013-09-01

Negative prognostic communication is often delayed in intensive care units, which limits time for families to prepare for end-of-life. This descriptive study, informed by ethnographic methods, was focused on exploring critical care physician communication of negative prognoses to families and identifying timing influences. Prognostic communication of critical care physicians to nurses and family members was observed and physicians and family members were interviewed. Physician perception of prognostic certainty, based on an accumulation of empirical data, and the perceived need for decision-making, drove the timing of prognostic communication, rather than family needs. Although prognoses were initially identified using intuitive knowledge for patients in one of the six identified prognostic categories, utilizing decision-making to drive prognostic communication resulted in delayed prognostic communication to families until end-of-life (EOL) decisions could be justified with empirical data. Providers will better meet the needs of families who desire earlier prognostic information by separating prognostic communication from decision-making and communicating the possibility of a poor prognosis based on intuitive knowledge, while acknowledging the uncertainty inherent in prognostication. This sets the stage for later prognostic discussions focused on EOL decisions, including limiting or withdrawing treatment, which can be timed when empirical data substantiate intuitive prognoses. This allows additional time for families to anticipate and prepare for end-of-life decision-making. © 2012 John Wiley & Sons Ltd.

The Opportunity Cost of Smaller Classes: A State-By-State Spending Analysis. Schools in Crisis: Making Ends Meet

ERIC Educational Resources Information Center

Roza, Marguerite; Ouijdani, Monica

2012-01-01

Two seemingly different threads are in play on the issue of class size. The first is manifested in media reports that tell readers that class sizes are rising to concerning levels. The second thread appears in the work of some researchers and education leaders and suggests that repurposing class-size reduction funds to pay for other reforms may…

What Does Washington State Get for Its Investment in Bonuses for Board Certified Teachers? Schools in Crisis: Making Ends Meet. Rapid Response

ERIC Educational Resources Information Center

Simpkins, Jim

2011-01-01

Washington State is set to spend nearly $100 million in the next two years on pay bonuses for teachers who receive national board certification. This investment is supposed to improve the state's teaching force and encourage the most capable teachers to work in high-poverty schools. Does it accomplish those goals? Governor Christine Gregoire's…

Not the Drones You’re Looking for: Civil Drones Invading Stability Operations

DTIC Science & Technology

2016-06-01

APPROVAL The undersigned certify that this thesis meets master’s-level standards of research , argumentation, and expression...Naval War College in 2015. His career as a developmental engineer and acquisition officer has included assignments at the Air Force Research ...culmination of not only an extensive research effort, but of an academic and intellectual journey two years in the making and I would be remiss to end

21 CFR 312.47 - Meetings.

Code of Federal Regulations, 2013 CFR

2013-04-01

... meetings held near completion of Phase 3 and before submission of a marketing application (“pre-NDA... uses under investigation. (ii) Eligibility for meeting. While the end-of-Phase 2 meeting is designed... Phase 3 tests are made. The scheduling of an end-of-Phase 2 meeting is not, however, intended to delay...

19th International Seapower Symposium

DTIC Science & Technology

2010-07-01

are the inter- national agreements, partnerships, and constructs that we are going to need to build to make sure that we’re dealing with all facets...expect to meet in the future. Way Forward Key Performance Areas (Ends) 1. Capabilities and capacity building (DEBEX 27 Nov 08) 2. Engage: The whole...Strengthen regulatory boundaries 7. Build up the African sea powers These are the key performance areas we have so far identified and we believe that

21 CFR 312.47 - Meetings.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Phase 3 plan and protocols and the adequacy of current studies and plans to assess pediatric safety and...) “End-of-Phase 2” meetings and meetings held before submission of a marketing application. At specific... and evaluation process. In particular, FDA has found that meetings at the end of Phase 2 of an...

Communication as care at end of life: an emerging issue from an exploratory action research study of renal end-of-life care for ethnic minorities in the UK.

PubMed

Wilkinson, Emma; Randhawa, Gurch; Brown, Edwina A; Da Silva Gane, Maria; Stoves, John; Warwick, Graham; Akhtar, Tahira; Magee, Regina; Sharman, Sue; Farrington, Ken

2014-09-01

South Asian people have a higher risk of developing kidney disease, are disproportionately represented in the patient population requiring renal replacement therapy and wait longer to receive a kidney transplant, compared with white Europeans. As a result, there is a demand for end-of-life care, which meets the needs of this group of patients. Providing end-of-life care to patients from different cultures is a challenge for renal services as there can be barriers to communication in the form of language, delegated decision-making within families and reluctance to discuss death. To explore end-of-life care for South Asians with kidney disease, 16 interviews with patients and 14 focus groups with care providers were conducted at four research sites in the UK with large South Asian populations. Using an action research design the data were analysed thematically and fed back to inform the research in a cyclical manner. If patients are not fully aware of their condition or of what end-of-life care is, it is less likely that they will be able to be involved in decision-making about their care and this is compounded where there are communication barriers. Variations in care provider awareness and experience of providing end-of-life care to South Asian patients, in turn, contributes to lack of patient awareness of end-of-life care. Communication as care at the end of life should be explored further. Researching the South Asian patient experience of end of life highlights many relevant and generalisable issues. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

East meets West: cross-cultural perspective in end-of-life decision making from Indian and German viewpoints.

PubMed

Chattopadhyay, Subrata; Simon, Alfred

2008-06-01

Culture creates the context within which individuals experience life and comprehend moral meaning of illness, suffering and death. The ways the patient, family and the physician communicate and make decisions in the end-of-life care are profoundly influenced by culture. What is considered as right or wrong in the healthcare setting may depend on the socio-cultural context. The present article is intended to delve into the cross-cultural perspectives in ethical decision making in the end-of-life scenario. We attempt to address the dynamics of the roles of patient, family and physician therein across two countries from East and West, namely, India and Germany. In India, where illness is more a shared family affair than an individual incident, a physician is likely to respect the family's wishes and may withhold the [Symbol: see text]naked truth' about the diagnosis of a fatal disease to the patient. In Germany, a physician is legally required to inform the patient about the disease. In India, advance directive being virtually non-existent, the family acts as the locus of the decision-making process, taking into account the economic cost of available medical care. In Germany, advance directive is regarded as mandatory and healthcare is covered by insurance. Family and the physician appear to play larger roles in ethical decision making for patients in India than for those in Germany, who place greater emphasis on autonomy of the individual patient. Our study explicates how culture matters in ethical decision-making and why the bioethical discourse is necessary in the concrete realities of the socio-cultural context. To explore the possibility of finding a common ground of morality across different cultures while acknowledging and respecting cultural diversity, thus remains a formidable challenge for the bioethicists.

Capacity Building for the Access and Application of NASA Earth Science Data

NASA Astrophysics Data System (ADS)

Blevins, B.; Prados, A. I.; Hook, E.

2016-12-01

Since 2008, NASA's Applied Remote Sensing Training (ARSET) program has built capacity in applied remote sensing by building awareness, and enabling access and use of NASA Earth science data. To reach decision and policy makers from all sectors, ARSET hosts hands-on workshops and online webinars. With over 70 trainings, reaching more than 6,000 people from 130 countries and 1,600 organizations, ARSET has ample experience with assessing and meeting end-user needs. To meet the spectrum of needs and levels of attendee expertise, ARSET holds trainings for both the novice and experienced end-user. Trainings employ exercises, assignments, and live demonstrations of data access tools to reinforce remote sensing concepts and to facilitate data use and analysis techniques. This program is in a unique position to collect important feedback from thousands of participants each year through formal surveys and informal methods on NASA tools, portals, data formats, and the applications of Earth science data for end-user decision making activities. This information is shared with NASA data centers and program managers to help inform data portal development and to help prioritize the production of new satellite derived data products. This presentation will discuss the challenges that arise in capacity building trainings, the integration of community feedback into the training development cycle, and lessons learned throughout the process.

Factors associated with family satisfaction with end-of-life care in the ICU: a systematic review.

PubMed

Hinkle, Laura J; Bosslet, Gabriel T; Torke, Alexia M

2015-01-01

Family satisfaction with end-of-life care in the ICU has not previously been systematically reviewed. Our objective was to perform a review, synthesizing published data identifying factors associated with family satisfaction with end-of-life care in critically ill adult populations. The following electronic databases were searched: MEDLINE (Medical Literature Analysis and Retrieval System Online), MEDLINE Updated, EMBASE (Excerpta Medical Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycInfo, and PubMed. Two authors reviewed retrieved titles and abstracts. Studies describing nonadult and non-ICU populations or not addressing end-of-life care, family satisfaction, or factors affecting satisfaction were excluded. The remaining articles underwent full review and data extraction by two authors. Quality was assessed using a checklist based on the recommendations of the Consolidated Standards for Reporting Trials group. The search yielded 1,072 articles, with 23 articles describing 14 studies meeting inclusion criteria. All studies obtained satisfaction data from family members via surveys and structured interviews. Specific communication strategies increasing satisfaction included: expressions of empathy, nonabandonment, and assurances of comfort and provision of written information. Additionally, support for shared decision-making, family presence at time of death, and specific patient-care measures such as extubation before death were associated with increased satisfaction. Good-quality communication, support for shared decision-making, and specific patient-care measures were associated with increased satisfaction with end-of-life care. Assessing the family's desire to participate in shared decision-making may also be an important factor. Few interventions increased satisfaction. Future research is needed to further define optimal communication strategies, understand effective integration of palliative care into the ICU, and define significant score changes in survey instruments.

Planning and conducting meetings effectively, part I: planning a meeting.

PubMed

Harolds, Jay

2011-12-01

Meetings are held by leaders for many purposes, including conveying information, raising morale, asking for opinions, brain storming, making people part of the problem-solving process, building trust, getting to a consensus, and making decisions. However, many meetings waste time, some undermine the leader's power, and some decrease morale. Part I of this series of articles gives some tips on basic planning for decision-making meetings. Part II of this series of articles analyzes selected components of decision-making meetings. Part III of this series will be on how the chairperson keeps decision-making meetings on track to make them efficient and productive.

Challenges and Approach for Making the Top End Optical Assembly for the 4-meter Advanced Technology Solar Telescope

NASA Astrophysics Data System (ADS)

Canzian, Blaise; Barentine, J.; Hull, T.

2012-01-01

L-3 Integrated Optical Systems (IOS) Division has been selected by the National Solar Observatory (NSO) to make the Top End Optical Assembly (TEOA) for the 4-meter Advanced Technology Solar Telescope (ATST) to operate at Haleakala, Maui. ATST will perform to a very high optical performance level in a difficult thermal environment. The TEOA, containing the 0.65-meter silicon carbide secondary mirror and support, mirror thermal management system, mirror positioning and fast tip-tilt system, field stop with thermally managed heat dump, thermally managed Lyot stop, safety interlock and control system, and support frame, operates in the "hot spot” at the prime focus of the ATST and so presents special challenges. In this paper, we will describe the L-3 IOS technical approach to meet these challenges, including subsystems for opto-mechanical positioning, rejected and stray light control, wavefront tip-tilt compensation, and thermal management. Key words: ATST, TEOA, L-3 IOS, thermal management, silicon carbide (SiC) mirrors, hexapods, solar astronomy

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

PubMed

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

2017-12-01

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

Physician-Researchers' Experiences of the Consent Process in the Sociocultural Context of a Developing Country

PubMed Central

Malik, Aisha Y.

2011-01-01

Background: International guidelines for medical research involving human subjects maintain the primacy of informed consent while recognizing cultural diversity. Methods: This article draws on empirical data obtained from interviews with physician-researchers in teaching hospitals of Lahore, Pakistan, to identify social and cultural factors that affect the consent process for participants in research. Results: This article presents variable findings with regards to communication, comprehension, and decision making. While some physicians consider that social factors such as lack of education, a patriarchal family system, and skepticism about research can make patients dependent on either the physician-researcher or the family, others believe that patients do make independent decisions. Conclusions: In light of the findings, the article ends with a recommendation for communication and decision making that is sensitive to the local sociocultural environment while at the same time meeting the ethical imperative of respect for persons. PMID:22816063

Physician-Researchers' Experiences of the Consent Process in the Sociocultural Context of a Developing Country.

PubMed

Malik, Aisha Y

2011-07-01

Background: International guidelines for medical research involving human subjects maintain the primacy of informed consent while recognizing cultural diversity. Methods: This article draws on empirical data obtained from interviews with physician-researchers in teaching hospitals of Lahore, Pakistan, to identify social and cultural factors that affect the consent process for participants in research. Results: This article presents variable findings with regards to communication, comprehension, and decision making. While some physicians consider that social factors such as lack of education, a patriarchal family system, and skepticism about research can make patients dependent on either the physician-researcher or the family, others believe that patients do make independent decisions. Conclusions: In light of the findings, the article ends with a recommendation for communication and decision making that is sensitive to the local sociocultural environment while at the same time meeting the ethical imperative of respect for persons.

[Limiting life sustaining therapies].

PubMed

Azoulay, E

2006-09-01

Intensivists are increasingly implementing end-of-life decisions in patients who remain dependent on life sustaining therapies without hope for recovery. Descriptive studies have provided epidemiological data on ICU end-of-life care, identifying areas for improvement. Qualitative studies have highlighted the complexity of the decision making process. In addition to considering the legal and ethical issues involved, this review describes cultural, religious and individual variations observed in ICU end-of-life care. It is important for intensivists to respect patients' preferences and values, but also, in some family members, to avoid increasing the burden and the guilt of sharing the decision. Intensivists should improve their ability to meet the needs of dying patients and their family members. Each situation, patient, family and caregiver is unique, and therefore needs a specific approach. Introducing palliative care and multidisciplinary teams into the ICU might provide an additional opportunity for patients and families to be informed and listened to.

Head and Neck Cancer in the Elderly: Frailty, Shared Decisions, and Avoidance of Low Value Care.

PubMed

Mady, Leila J; Nilsen, Marci L; Johnson, Jonas T

2018-05-01

Head and neck cancer (HNC) is a disease of older adults. Recurrent and metastatic head and neck squamous cell carcinoma portends a poor prognosis, with median overall survival of less than 12 months. Within this vulnerable population, significant treatment-related toxicities and physical and psychosocial sequelae can be devastating to quality of life at the end of life. Shared decision making and early comprehensive palliative and support services are at the crux of the approach to older adults with HNC. In doing so, low-value care that fails to meet the goals of patients and their caregivers at the end-of-life may be avoided. Copyright © 2018 Elsevier Inc. All rights reserved.

45. MAIN MEETING ROOM COLUMNS. Ends of gallery columns identified ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

45. MAIN MEETING ROOM COLUMNS. Ends of gallery columns identified at the time of removal for transfer to the George School for re-erection. The stamp reads, 'REMOVED FROM 12th ST. MTG HSE PHILA 1972'. - Twelfth Street Meeting House, 20 South Twelfth Street, Philadelphia, Philadelphia County, PA

21st Century Science for Sustainable Development in the Developing World

NASA Astrophysics Data System (ADS)

Sachs, J. D.

2004-12-01

Meeting the Millennium Development Goals and, ultimately, eradicating extreme poverty, engages experts from many academic disciplines and different parts of society- climatologists, earth engineers, ecologists, economists, public health specialists, social activists, and politicians. We are in the midst of exciting technological and scientific breakthroughs that make it realistic to end extreme poverty by 2025. Indeed, the experiences of China and India in recent years have illustrated that technology can accelerate economic development to impressively high rates. India, which boasts growth rates of nearly 8% over the past decade, may end hunger among its population as early as 2007, thanks in large part to the Green Revolution underway there. The work of agronomists and economists are not unrelated - the science behind soil nutrients, water, and germplasm all fuel sustainable development. Science and technology are important ingredients for growth, and they are improving at an ever-increasing rate. When applied for the sake of human benefit, we have a tool of unprecedented strength. But the developing world has also reached a point of unprecedented environmental stress. Biodiversity faces serious threats, as do water supplies, forests, and the atmosphere. Developing and developed nations continue to grapple with the consequences of greenhouse gas emissions. We must maintain our scientific investigations and analysis while ensuring that development policy addresses long-term environmental needs. The energy sector is one obvious example. Several developing countries, China and India included, harbor vast coal deposits. Fueling development with coal will drastically exacerbate the ongoing spiral of man-made climate change. My presentation will focus on the contributions that 21st century science can make-indeed, must make-to ensure that sustainable development occurs and we meet the Millennium Challenge of cutting extreme poverty in half by 2015.

My Most Memorial Meeting - The June, 1997, San Diego Meeting

NASA Astrophysics Data System (ADS)

Philip, A. G. Davis

1999-05-01

At the June, 1997 AAS meeting in San Diego I arranged a topical session on the Shapley Visiting Lectureships Program. There were poster papers and speakers from the early days of the program, going back to the Visiting Lectureships Program of the AAS. Then the three past directors and the present director described their activities in running the program from 1979 to 1997. We had other speakers who described their many visits to institutions over the years and representatives from two institutions which had received many visits. This session provided much interesting information about the Shapley Program and its history. At the end of the program several people pledged, and then gave, a substantial sum to the Shapley Endowment Fund. Because of all these events and happenings, the San Diego Meeting was a highlight meeting for me. A second meeting with significance to the Shapley Program was the June, 1996 meeting in Madison, Wisconsin. At this meeting certificates were awarded to 31 lecturers who had made 15 or more Shapley visits and 18 lecturers who had made 25 or more visits. A dinner was held at which those lecturers in these two groups who were present at the meeting were personally awarded their certificates. The remaining certificates were mailed after the meeting. The success of the Shapley Program is directly related to the devotion of its group of lecturers who spend considerable time and effort in making the two day visits to host institutions.

77 FR 9731 - Voluntary Service National Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-17

...) National Advisory Committee (NAC) will be held March 14-16, 2012, at the Charleston Marriott, 170 Lockwood Boulevard, Charleston, South Carolina. On March 14, the meeting will begin at 8 a.m. and end at 11:30 a.m. On March 15-16, the meeting will begin at 8:30 a.m. and end at 4:30 p.m. The meeting is open to the...

Fosmid Cre-LoxP Inverse PCR Paired-End (Fosmid CLIP-PE), a Novel Method for Constructing Fosmid Pair-End Library (Seventh Annual Sequencing, Finishing, Analysis in the Future (SFAF) Meeting 2012)

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

Peng, Ze

2012-06-01

Ze Peng from DOE JGI presents "Fosmid Cre-LoxP Inverse PCR Paired-End (Fosmid CLIP-PE), a Novel Method for Constructing Fosmid Pair-End Library" at the 7th Annual Sequencing, Finishing, Analysis in the Future (SFAF) Meeting held in June, 2012 in Santa Fe, NM.

Fosmid Cre-LoxP Inverse PCR Paired-End (Fosmid CLIP-PE), a Novel Method for Constructing Fosmid Pair-End Library (Seventh Annual Sequencing, Finishing, Analysis in the Future (SFAF) Meeting 2012)

ScienceCinema

Peng, Ze

2018-01-24

Ze Peng from DOE JGI presents "Fosmid Cre-LoxP Inverse PCR Paired-End (Fosmid CLIP-PE), a Novel Method for Constructing Fosmid Pair-End Library" at the 7th Annual Sequencing, Finishing, Analysis in the Future (SFAF) Meeting held in June, 2012 in Santa Fe, NM.

QoS support for end users of I/O-intensive applications using shared storage systems

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

Davis, Marion Kei; Zhang, Xuechen; Jiang, Song

2011-01-19

I/O-intensive applications are becoming increasingly common on today's high-performance computing systems. While performance of compute-bound applications can be effectively guaranteed with techniques such as space sharing or QoS-aware process scheduling, it remains a challenge to meet QoS requirements for end users of I/O-intensive applications using shared storage systems because it is difficult to differentiate I/O services for different applications with individual quality requirements. Furthermore, it is difficult for end users to accurately specify performance goals to the storage system using I/O-related metrics such as request latency or throughput. As access patterns, request rates, and the system workload change in time,more » a fixed I/O performance goal, such as bounds on throughput or latency, can be expensive to achieve and may not lead to a meaningful performance guarantees such as bounded program execution time. We propose a scheme supporting end-users QoS goals, specified in terms of program execution time, in shared storage environments. We automatically translate the users performance goals into instantaneous I/O throughput bounds using a machine learning technique, and use dynamically determined service time windows to efficiently meet the throughput bounds. We have implemented this scheme in the PVFS2 parallel file system and have conducted an extensive evaluation. Our results show that this scheme can satisfy realistic end-user QoS requirements by making highly efficient use of the I/O resources. The scheme seeks to balance programs attainment of QoS requirements, and saves as much of the remaining I/O capacity as possible for best-effort programs.« less

Simulation Control Graphical User Interface Logging Report

NASA Technical Reports Server (NTRS)

Hewling, Karl B., Jr.

2012-01-01

One of the many tasks of my project was to revise the code of the Simulation Control Graphical User Interface (SIM GUI) to enable logging functionality to a file. I was also tasked with developing a script that directed the startup and initialization flow of the various LCS software components. This makes sure that a software component will not spin up until all the appropriate dependencies have been configured properly. Also I was able to assist hardware modelers in verifying the configuration of models after they have been upgraded to a new software version. I developed some code that analyzes the MDL files to determine if any error were generated due to the upgrade process. Another one of the projects assigned to me was supporting the End-to-End Hardware/Software Daily Tag-up meeting.

Intelligent data management for real-time spacecraft monitoring

NASA Technical Reports Server (NTRS)

Schwuttke, Ursula M.; Gasser, Les; Abramson, Bruce

1992-01-01

Real-time AI systems have begun to address the challenge of restructuring problem solving to meet real-time constraints by making key trade-offs that pursue less than optimal strategies with minimal impact on system goals. Several approaches for adapting to dynamic changes in system operating conditions are known. However, simultaneously adapting system decision criteria in a principled way has been difficult. Towards this end, a general technique for dynamically making such trade-offs using a combination of decision theory and domain knowledge has been developed. Multi-attribute utility theory (MAUT), a decision theoretic approach for making one-time decisions is discussed and dynamic trade-off evaluation is described as a knowledge-based extension of MAUT that is suitable for highly dynamic real-time environments, and provides an example of dynamic trade-off evaluation applied to a specific data management trade-off in a real-world spacecraft monitoring application.

13. CELLAR, UNDER MAIN MEETING ROOM, LOOKING NORTH. The 1909 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. CELLAR, UNDER MAIN MEETING ROOM, LOOKING NORTH. The 1909 hot air furnace with brick wall enclosure of possibly earlier origin. A hot air system of two furnaces was installed with ventilating ducts in the east end in 1852. There was a hot air system in the west end without ventilating ducts. - Twelfth Street Meeting House, 20 South Twelfth Street, Philadelphia, Philadelphia County, PA

A fast fully constrained geometric unmixing of hyperspectral images

NASA Astrophysics Data System (ADS)

Zhou, Xin; Li, Xiao-run; Cui, Jian-tao; Zhao, Liao-ying; Zheng, Jun-peng

2014-11-01

A great challenge in hyperspectral image analysis is decomposing a mixed pixel into a collection of endmembers and their corresponding abundance fractions. This paper presents an improved implementation of Barycentric Coordinate approach to unmix hyperspectral images, integrating with the Most-Negative Remove Projection method to meet the abundance sum-to-one constraint (ASC) and abundance non-negativity constraint (ANC). The original barycentric coordinate approach interprets the endmember unmixing problem as a simplex volume ratio problem, which is solved by calculate the determinants of two augmented matrix. One consists of all the members and the other consist of the to-be-unmixed pixel and all the endmembers except for the one corresponding to the specific abundance that is to be estimated. In this paper, we first modified the algorithm of Barycentric Coordinate approach by bringing in the Matrix Determinant Lemma to simplify the unmixing process, which makes the calculation only contains linear matrix and vector operations. So, the matrix determinant calculation of every pixel, as the original algorithm did, is avoided. By the end of this step, the estimated abundance meet the ASC constraint. Then, the Most-Negative Remove Projection method is used to make the abundance fractions meet the full constraints. This algorithm is demonstrated both on synthetic and real images. The resulting algorithm yields the abundance maps that are similar to those obtained by FCLS, while the runtime is outperformed as its computational simplicity.

Industrial Wireless Sensors: A User's Perspective on the Impact of Standards on Wide-spread Deployment

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

Taft, Cyrus W.; Manges, Wayne W; Sorge, John N

2012-01-01

The role of wireless sensing technologies in industrial instrumentation will undoubtedly become more important in the years ahead. . Deployment of such instrumentation in an industrial setting with its heightened security and robustness criteria hinges on user acceptance of verified performance as well as meeting cost requirements. Today, industrial users face many choices when specifying a wireless sensor network, including radio performance, battery life, interoperability, security, and standards compliance. The potential market for industrial wireless sensors is literally millions of wireless instruments and it is imperative that accurate information for applying the technology to real-world applications be available to themore » end-user so that they can make informed deployment decisions. The majority of industrial wireless automation designs now being deployed or being considered for deployment are based on three different standards . The HART Communications Foundation s WirelessHART (IEC 62591), the International Society of Automation s ISA100.11a, and the offering from the Industrial Wireless Alliance of China known as WIA-PA (IEC 62601). Aside from these industrial automation standards, users must also be cognizant of the underlying wireless network standards IEEE 802.11, IEEE 802.15.4, and IEEE 802.15.3a and their interactions with the three principal industrial automation protocols mentioned previously. The crucial questions being asked by end users revolve around sensor network performance, interoperability, reliability, and security. This paper will discuss potential wireless sensor applications in power plants, barriers to the acceptance of wireless technology, concerns related to standards, and provide an end user prospective on the issues affecting wide-spread deployment of wireless sensors. Finally, the authors conclude with a discussion of a recommended path forward including how standards organizations can better facilitate end user decision making and how end users can locate and use objective information for decision making.« less

Traditional expectations versus US realities: first- and second-generation Asian Indian perspectives on end-of-life care.

PubMed

Sharma, Rashmi K; Khosla, Nidhi; Tulsky, James A; Carrese, Joseph A

2012-03-01

Although end-of-life care preferences vary across racial/ethnic groups, little is known about how cultural values affect end-of-life care preferences among South Asian immigrants and their offspring in the US. To examine the perspectives of first- and second-generation South Asians living in the US regarding end-of-life care. Focus group study. Discussions explored participant preferences and experiences with family members facing the end of life. Twelve first-generation and 11 second-generation self-identified Asian Indians living in the mid-Atlantic region. Content analysis of focus group transcripts. First-generation participants ranged in age from 41 to 76 years and were evenly split by gender. Second-generation participants ranged in age from 23 to 36 years and included seven women and four men. All participants were highly educated, and two thirds were either studying or working in a health care field. All but two subjects were Hindu. Several themes emerged that highlighted cultural differences and challenges for this population in the context of end-of-life care: attitudes toward death and suffering; family duty; and preferences for information disclosure and decision making. Participants described cultural challenges due to the evolution of traditional roles, lack of explicit discussion between patients and family members about preferences and care expectations, and a tension between wanting to meet traditional expectations and the challenges in doing so given US social realities. Traditional cultural values, such as duty to family, greatly influenced end-of-life care preferences and retained importance across generations. Clinicians caring for Asian Indian patients at the end of life may be better able to assess care preferences after exploring the complex interplay between traditional expectations and specific social realities for each patient. Particular attention should be given to attitudes toward death and suffering, family duty, and preferences for information disclosure and decision making.

Mental disorder ethics: theory and empirical investigation

PubMed Central

Eastman, N; Starling, B

2006-01-01

Mental disorders and their care present unusual problems within biomedical ethics. The disorders themselves invite an ethical critique, as does society's attitude to them; researching the diagnosis and treatment of mental disorders also presents special ethical issues. The current high profile of mental disorder ethics, emphasised by recent political and legal developments, makes this a field of research that is not only important but also highly topical. For these reasons, the Wellcome Trust's biomedical ethics programme convened a meeting, “Investigating Ethics and Mental Disorders”, in order to review some current research, and to stimulate topics and methods of future research in the field. The meeting was attended by policy makers, regulators, research funders, and researchers, including social scientists, psychiatrists, psychologists, lawyers, philosophers, criminologists, and others. As well as aiming to inspire a stronger research endeavour, the meeting also sought to stimulate an improved understanding of the methods and interactions that can contribute to “empirical ethics” generally. This paper reports on the meeting by describing contributions from individual speakers and discussion sections of the meeting. At the end we describe and discuss the conclusions of the meeting. As a result, the text is referenced less than would normally be expected in a review. Also, in summarising contributions from named presenters at the meeting it is possible that we have created inaccuracies; however, the definitive version of each paper, as provided directly by the presenter, is available at http://www.wellcome.ac.uk/doc.WTX025116.html. PMID:16446414

[The 10th Annual Meeting of the Japanese Society for Pharmaceutical Palliative Care and Sciences].

PubMed

Shiokawa, Mitsuru; Kawamura, Kazumi

2018-01-01

　The 10th Annual Meeting of the Japanese Society for Pharmaceutical Palliative Care and Sciences was held at Act City Hamamatsu, Japan, with a total of 2634 participants in attendance. The theme of the meeting was realized through a number of new concepts, such as a debate symposium, information sessions, nurses' workshops, and so on. The results obtained from the participation questionnaire (n=438), which were aggregated up to 1 month following the end of this year's meeting, revealed that 89% of the participants at considered it to have been appealing. In particular, 63% of the participants favored the adoption of a debate symposium whereby it was possible to ask and respond to questions in real time. In the free comments section of the questionnaire, the participants expressed how they felt the debate symposium made it easy to give their opinions, and that this element might be further developed in the future. They also stated that they found the introduction of the Clica system effective in terms of making the annual meeting an active learning place. One issue that was highlighted concerned the observation that the hall used to host the symposium was designed as a concert venue, which meant it was highly shielded from the outside environment, in addition to access to the internet being blocked. I hope that many of the projects from this Annual Meeting will serve to guide the future style of the Society's Annual Meetings.

Informed Decision-Making in the Context of Prenatal Chromosomal Microarray.

PubMed

Baker, Jessica; Shuman, Cheryl; Chitayat, David; Wasim, Syed; Okun, Nan; Keunen, Johannes; Hofstedter, Renee; Silver, Rachel

2018-03-07

The introduction of chromosomal microarray (CMA) into the prenatal setting has involved considerable deliberation due to the wide range of possible outcomes (e.g., copy number variants of uncertain clinical significance). Such issues are typically discussed in pre-test counseling for pregnant women to support informed decision-making regarding prenatal testing options. This research study aimed to assess the level of informed decision-making with respect to prenatal CMA and the factor(s) influencing decision-making to accept CMA for the selected prenatal testing procedure (i.e., chorionic villus sampling or amniocentesis). We employed a questionnaire that was adapted from a three-dimensional measure previously used to assess informed decision-making with respect to prenatal screening for Down syndrome and neural tube defects. This measure classifies an informed decision as one that is knowledgeable, value-consistent, and deliberated. Our questionnaire also included an optional open-ended question, soliciting factors that may have influenced the participants' decision to accept prenatal CMA; these responses were analyzed qualitatively. Data analysis on 106 participants indicated that 49% made an informed decision (i.e., meeting all three criteria of knowledgeable, deliberated, and value-consistent). Analysis of 59 responses to the open-ended question showed that "the more information the better" emerged as the dominant factor influencing both informed and uninformed participants' decisions to accept prenatal CMA. Despite learning about the key issues in pre-test genetic counseling, our study classified a significant portion of women as making uninformed decisions due to insufficient knowledge, lack of deliberation, value-inconsistency, or a combination of these three measures. Future efforts should focus on developing educational approaches and counseling strategies to effectively increase the rate of informed decision-making among women offered prenatal CMA.

Financial coping strategies of mental health consumers: managing social benefits.

PubMed

Caplan, Mary Ager

2014-05-01

Mental health consumers depend on social benefits in the forms of supplemental security income and social security disability insurance for their livelihood. Although these programs pay meager benefits, little research has been undertaken into how this population makes ends meet. Using a qualitative approach, this study asks what are the financial coping strategies of mental health consumers? Seven approaches were identified: subsidies, cost-effective shopping, budgeting, prioritizing, technology, debt management, and saving money. Results illustrate the resourcefulness of mental health consumers in managing meager social benefits and highlight the need to strengthen community mental health efforts with financial capabilities education.

Investigating preferences for mosquito-control technologies in Mozambique with latent class analysis.

PubMed

Smith, Rachel A; Barclay, Victoria C; Findeis, Jill L

2011-07-21

It is common practice to seek the opinions of future end-users during the development of innovations. Thus, the aim of this study is to investigate latent classes of users in Mozambique based on their preferences for mosquito-control technology attributes and covariates of these classes, as well as to explore which current technologies meet these preferences. Surveys were administered in five rural villages in Mozambique. The data were analysed with latent class analysis. This study showed that users' preferences for malaria technologies varied, and people could be categorized into four latent classes based on shared preferences. The largest class, constituting almost half of the respondents, would not avoid a mosquito-control technology because of its cost, heat, odour, potential to make other health issues worse, ease of keeping clean, or inadequate mosquito control. The other three groups are characterized by the attributes which would make them avoid a technology; these groups are labelled as the bites class, by-products class, and multiple-concerns class. Statistically significant covariates included literacy, self-efficacy, willingness to try new technologies, and perceived seriousness of malaria for the household. To become widely diffused, best practices suggest that end-users should be included in product development to ensure that preferred attributes or traits are considered. This study demonstrates that end-user preferences can be very different and that one malaria control technology will not satisfy everyone.

A qualitative exploration of patient and family views and experiences of treatment decision-making in bipolar II disorder.

PubMed

Fisher, Alana; Manicavasagar, Vijaya; Sharpe, Louise; Laidsaar-Powell, Rebekah; Juraskova, Ilona

2018-02-01

Treatment decision-making in bipolar II disorder (BPII) is challenging, yet the decision support needs of patients and family remain unknown. To explore patient and family perspectives of treatment decision-making in BPII. Semistructured, qualitative interviews were conducted with 28 patients with BPII-diagnosis and 13 family members with experience in treatment decision-making in the outpatient setting. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics and preferences for patient decision-making involvement were assessed. Four inter-related themes emerged: (1) Attitudes and response to diagnosis and treatment; (2) Influences on decision-making; (3) The nature and flow of decision-making; (4) Decision support and challenges. Views differed according to patient involvement preferences, time since diagnosis and patients' current mood symptoms. This is the first known study to provide in-depth patient and family insights into the key factors influencing BPII treatment decision-making, and potential improvements and challenges to this process. Findings will inform the development of BPII treatment decision-making resources that better meet the informational and decision-support priorities of end users. This research was partly funded by a Postgraduate Research Grant awarded to the first author by the University of Sydney. No conflicts of interest declared.

NEWS: Hands-on telescopes!

NASA Astrophysics Data System (ADS)

2000-05-01

As part of the International Astronomical Union Meeting taking place in Manchester in August, the Education Committee of the Royal Astronomical Society is organizing a day conference on using robotic telescopes in schools. `Astronomy research projects for schools and university students' will commence at 10.30 on Friday 18 August 2000. This discussion meeting will explore ways in which students at school and university can participate in research projects, and at the same time increase their understanding of astronomy and develop useful skills. The increase in access to robotic telescopes and to astronomy databases is making research by school and undergraduate students ever more feasible. In addition, useful research can be done with very modest telescope systems, of the sort a school could afford. A range of international speakers will describe and demonstrate the possibilities, as well as leading the discussion. This meeting is being organized by the Education Committee of the Royal Astronomical Society and by Commission 46 of the International Astronomical Union. It is being held at the end of the IAU General Assembly. Those who pay the registration fee for the General Assembly need pay no further fee for attending the discussion meeting; otherwise there is a fee of £10. Refreshments will be provided at no charge. To obtain a registration form for this discussion meeting please contact Alan Pickwick (Alan_C_Pickwick@compuserve.com).

21 CFR 312.47 - Meetings.

Code of Federal Regulations, 2010 CFR

2010-04-01

... resources permit. The general principle underlying the conduct of such meetings is that there should be free...) “End-of-Phase 2” meetings and meetings held before submission of a marketing application. At specific... meetings held near completion of Phase 3 and before submission of a marketing application (“pre-NDA...

WEAMR — A Weighted Energy Aware Multipath Reliable Routing Mechanism for Hotline-Based WSNs

PubMed Central

Tufail, Ali; Qamar, Arslan; Khan, Adil Mehmood; Baig, Waleed Akram; Kim, Ki-Hyung

2013-01-01

Reliable source to sink communication is the most important factor for an efficient routing protocol especially in domains of military, healthcare and disaster recovery applications. We present weighted energy aware multipath reliable routing (WEAMR), a novel energy aware multipath routing protocol which utilizes hotline-assisted routing to meet such requirements for mission critical applications. The protocol reduces the number of average hops from source to destination and provides unmatched reliability as compared to well known reactive ad hoc protocols i.e., AODV and AOMDV. Our protocol makes efficient use of network paths based on weighted cost calculation and intelligently selects the best possible paths for data transmissions. The path cost calculation considers end to end number of hops, latency and minimum energy node value in the path. In case of path failure path recalculation is done efficiently with minimum latency and control packets overhead. Our evaluation shows that our proposal provides better end-to-end delivery with less routing overhead and higher packet delivery success ratio compared to AODV and AOMDV. The use of multipath also increases overall life time of WSN network using optimum energy available paths between sender and receiver in WDNs. PMID:23669714

WEAMR-a weighted energy aware multipath reliable routing mechanism for hotline-based WSNs.

PubMed

Tufail, Ali; Qamar, Arslan; Khan, Adil Mehmood; Baig, Waleed Akram; Kim, Ki-Hyung

2013-05-13

Reliable source to sink communication is the most important factor for an efficient routing protocol especially in domains of military, healthcare and disaster recovery applications. We present weighted energy aware multipath reliable routing (WEAMR), a novel energy aware multipath routing protocol which utilizes hotline-assisted routing to meet such requirements for mission critical applications. The protocol reduces the number of average hops from source to destination and provides unmatched reliability as compared to well known reactive ad hoc protocols i.e., AODV and AOMDV. Our protocol makes efficient use of network paths based on weighted cost calculation and intelligently selects the best possible paths for data transmissions. The path cost calculation considers end to end number of hops, latency and minimum energy node value in the path. In case of path failure path recalculation is done efficiently with minimum latency and control packets overhead. Our evaluation shows that our proposal provides better end-to-end delivery with less routing overhead and higher packet delivery success ratio compared to AODV and AOMDV. The use of multipath also increases overall life time of WSN network using optimum energy available paths between sender and receiver in WDNs.

Standardized End Point Definitions for Coronary Intervention Trials: The Academic Research Consortium-2 Consensus Document.

PubMed

Garcia-Garcia, Hector M; McFadden, Eugène P; Farb, Andrew; Mehran, Roxana; Stone, Gregg W; Spertus, John; Onuma, Yoshinobu; Morel, Marie-Angèle; van Es, Gerrit-Anne; Zuckerman, Bram; Fearon, William F; Taggart, David; Kappetein, Arie-Pieter; Krucoff, Mitchell W; Vranckx, Pascal; Windecker, Stephan; Cutlip, Donald; Serruys, Patrick W

2018-06-14

The Academic Research Consortium (ARC)-2 initiative revisited the clinical and angiographic end point definitions in coronary device trials, proposed in 2007, to make them more suitable for use in clinical trials that include increasingly complex lesion and patient populations and incorporate novel devices such as bioresorbable vascular scaffolds. In addition, recommendations for the incorporation of patient-related outcomes in clinical trials are proposed. Academic Research Consortium-2 is a collaborative effort between academic research organizations in the United States and Europe, device manufacturers, and European, US, and Asian regulatory bodies. Several in-person meetings were held to discuss the changes that have occurred in the device landscape and in clinical trials and regulatory pathways in the last decade. The consensus-based end point definitions in this document are endorsed by the stakeholders of this document and strongly advocated for clinical trial purposes. This Academic Research Consortium-2 document provides further standardization of end point definitions for coronary device trials, incorporating advances in technology and knowledge. Their use will aid interpretation of trial outcomes and comparison among studies, thus facilitating the evaluation of the safety and effectiveness of these devices.

78 FR 5243 - Motor Carrier Safety Advisory Committee (MCSAC): Public Meeting of Subcommittees

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... subcommittee on Compliance, Safety, Accountability (CSA) will meet on Tuesday and Wednesday, February 5 and 6... end of each day. Times and Dates: The meeting will be held Tuesday-Wednesday, February 5-6, 2013, from... February 5-6, 2013, meeting is the third subcommittee meeting. II. Meeting Participation Oral comments from...

Community Based Flood Modeling in Southern and Baja California to Meet End User Needs for Decision-Making

NASA Astrophysics Data System (ADS)

Sanders, B. F.

2017-12-01

Flooding of coastal and fluvial systems are the most significant natural hazards facing society, and damages have been escalating for decades globally and in the U.S. Almost all metropolitan areas are exposed to flood risk. The threat from river flooding is especially high in India and China, and coastal cities around the world are threatened by storm surge and rising sea levels. Several trends including rising sea levels, urbanization, deforestation, and rural-to-urban population shifts will increase flood exposure in the future. Flood impacts are escalating despite advances in hazards science and extensive effort to manage risks. The fundamental issue is not that flooding is becoming more severe, even though it is in some places, but rather that societies are become more vulnerable to flood impacts. A critical factor contributing to the escalation of flood impacts is that the most vulnerable sectors of communities are left out of processes to prepare for and respond to flooding. Furthermore, the translation of knowledge about flood hazards and vulnerabilities into actionable information for communities has not been effective. In Southern and Baja California, an interdisciplinary team of researchers has partnered with stakeholders in flood vulnerable communities to co-develop flood hazard information systems designed to meet end-user needs for decision-making. The initiative leveraged the power of advanced, fine-scale hydraulic models of flooding to craft intuitive visualizations of context-sensitive scenarios. This presentation will cover the ways by which the process of flood inundation modeling served as a focal point for knowledge development, as well as the unique visualizations that populate on-line information systems accessible here: http://floodrise.uci.edu/online-flood-hazard-viewers/

Business Meetings That Make Business.

ERIC Educational Resources Information Center

Lobingier, John, Jr.

This book defines initial objectives, gives post-meeting critiques, and points out steps and decisions necessary to make a success of every type of meeting ranging from small committees to large extravaganzas. It instructs on how to plan programs, incorporate audiovisual aids, deal with hotels, and make schedules work. Include d are the five basic…

The DEVELOP National Program: Building Dual Capacity in Decision Makers and Young Professionals Through NASA Earth Observations

NASA Astrophysics Data System (ADS)

Childs, L. M.; Rogers, L.; Favors, J.; Ruiz, M.

2012-12-01

Through the years, NASA has played a distinct/important/vital role in advancing Earth System Science to meet the challenges of environmental management and policy decision making. Within NASA's Earth Science Division's Applied Sciences' Program, the DEVELOP National Program seeks to extend NASA Earth Science for societal benefit. DEVELOP is a capacity building program providing young professionals and students the opportunity to utilize NASA Earth observations and model output to demonstrate practical applications of those resources to society. Under the guidance of science advisors, DEVELOP teams work in alignment with local, regional, national and international partner organizations to identify the widest array of practical uses for NASA data to enhance related management decisions. The program's structure facilitates a two-fold approach to capacity building by fostering an environment of scientific and professional development opportunities for young professionals and students, while also providing end-user organizations enhanced management and decision making tools for issues impacting their communities. With the competitive nature and growing societal role of science and technology in today's global workplace, DEVELOP is building capacity in the next generation of scientists and leaders by fostering a learning and growing environment where young professionals possess an increased understanding of teamwork, personal development, and scientific/professional development and NASA's Earth Observation System. DEVELOP young professionals are partnered with end user organizations to conduct 10 week feasibility studies that demonstrate the use of NASA Earth science data for enhanced decision making. As a result of the partnership, end user organizations are introduced to NASA Earth Science technologies and capabilities, new methods to augment current practices, hands-on training with practical applications of remote sensing and NASA Earth science, improved remote sensing and geographic information science (GIS) capabilities, and opportunities for networking with the NASA and Earth Science community. By engaging young professionals and end user organizations, DEVELOP strives to uniquely build capacity through the extension of NASA Earth Science outcomes to the public through projects that innovatively use NASA Earth observations to address environmental concerns and impact policy and decision making.

Transitioning from AOP to IATA - Exploiting mechanistic ...

EPA Pesticide Factsheets

Slide presentation at satellite meeting of the QSAR2016 Meeting on How to Transition from AOP to IATA-Exploiting mechanistic insight for practical decision making. . Slide presentation at satellite meeting of the QSAR2016 Meeting on How to Transition from AOP to IATA-Exploiting mechanistic insight for practical decision making. .

76 FR 2083 - Pacific Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

... Fishery Management Council; Public Meeting AGENCY: National Marine Fisheries Service (NMFS), National..., February 7, 2011 and end at 5:30 p.m. or as necessary to complete business for the day. The Panel will... ending at 5:30 p.m. each day, or as necessary to complete business. The Panel will adjourn by noon on...

Examining family meetings at end of life: The model of practice in a hospice inpatient unit.

PubMed

Meeker, Mary Ann; Waldrop, Deborah P; Seo, Jin Young

2015-10-01

Our purpose was to rigorously examine the nature of family meetings as conducted in an inpatient hospice care unit in order to generate an inductive theoretical model. In this two-phase project, we first interviewed eight members of the interdisciplinary care team who participated in multiple family meetings each week. Interview questions explored why and how they conducted family meetings. Using an observation template created from these interview data, we subsequently conducted ethnographic observations during family meetings. Using the methods of grounded theory, our findings were synthesized into a theoretical model depicting the structure and process of formal family meetings within this setting. The core of the family meeting was characterized by cognitive and affective elements aimed at supporting the family and facilitating quality care by clarifying the past, easing the present, and protecting the future. This inductive model was subsequently found to be highly aligned with a sense of coherence, an important influence on coping, and adaptation to the stress of a life-limiting illness. Provider communication with family members is particularly critical during advanced illness and end-of-life care. The National Consensus Project clinical practice guidelines for quality palliative care list regular family meetings among the recommended practices for excellent communication during end-of-life care, but do not provide specific guidance on how and when to provide such meetings. Our findings provide a theoretical model that can inform the design of a family meeting to address family members' needs for meaningful and contextualized information, validation of their important contributions to care, and preparation for the patient's death.

Development, modelling, and pilot testing of a complex intervention to support end-of-life care provided by Danish general practitioners.

PubMed

Winthereik, Anna Kirstine; Neergaard, Mette Asbjoern; Jensen, Anders Bonde; Vedsted, Peter

2018-06-20

Most patients in end-of-life with life-threatening diseases prefer to be cared for and die at home. Nevertheless, the majority die in hospitals. GPs have a pivotal role in providing end-of-life care at patients' home, and their involvement in the palliative trajectory enhances the patient's possibility to stay at home. The aim of this study was to develop and pilot-test an intervention consisting of continuing medical education (CME) and electronic decision support (EDS) to support end-of-life care in general practice. We developed an intervention in line with the first phases of the guidelines for complex interventions drawn up by the Medical Research Council. Phase 1 involved the development of the intervention including identification of key barriers to provision of end-of-life care for GPs and of facilitators of change. Furthermore the actual modelling of two components: CME meeting and EDS. Phase 2 focused on pilot-testing and intervention assessment by process evaluation. In phase 1 lack of identification of patients at the end of life and limited palliative knowledge among GPs were identified as barriers. The CME meeting and the EDS were developed. The CME meeting was a four-hour educational meeting performed by GPs and specialists in palliative care. The EDS consisted of two parts: a pop-up window for each patient with palliative needs and a list of all patients with palliative needs in the practice. The pilot testing in phase 2 showed that the CME meeting was performed as intended and 120 (14%) of the GPs in the region attended. The EDS was integrated in existing electronic records but was shut down early for external reasons; 50 (5%) GPs signed up. The pilot-testing demonstrated a need to strengthen the implementation as attending rate was low in the current set-up. We developed a complex intervention to support GPs in providing end-of-life care. The pilot-test showed general acceptance of the CME meetings. The EDS was shut down early and needs further evaluation before examining the whole intervention in a larger study, where evaluation could be based on patient-related outcomes and impact on end-of-life care. Clinicaltrials.gov ( NCT02050256 ) January 30, 2014.

Cancer care decision making in multidisciplinary meetings.

PubMed

Dew, Kevin; Stubbe, Maria; Signal, Louise; Stairmand, Jeannine; Dennett, Elizabeth; Koea, Jonathan; Simpson, Andrew; Sarfati, Diana; Cunningham, Chris; Batten, Lesley; Ellison-Loschmann, Lis; Barton, Josh; Holdaway, Maureen

2015-03-01

Little research has been undertaken on the actual decision-making processes in cancer care multidisciplinary meetings (MDMs). This article was based on a qualitative observational study of two regional cancer treatment centers in New Zealand. We audiorecorded 10 meetings in which 106 patient cases were discussed. Members of the meetings categorized cases in varying ways, drew on a range of sources of authority, expressed different value positions, and utilized a variety of strategies to justify their actions. An important dimension of authority was encountered authority-the authority a clinician has because of meeting the patient. The MDM chairperson can play an important role in making explicit the sources of authority being drawn on and the value positions of members to provide more clarity to the decision-making process. Attending to issues of process, authority, and values in MDMs has the potential to improve cancer care decision making and ultimately, health outcomes. © The Author(s) 2014.

Religiosity and Well-Being among Older Jewish Israelis: Findings from SHARE.

PubMed

Litwin, Howard; Schwartz, Ella; Avital, Dana

2017-01-01

This study examined the correlates of religiosity among Jewish Israelis aged 50 and older. Based on the second wave of Survey of Health, Ageing and Retirement in Europe, the findings show that almost half the Jewish respondents never pray and that, on average, prayer frequency is lower among Jewish Israelis than it is among most of their European counterparts. Multivariate logistic analyses revealed that those who pray more often have more health conditions, are less able to make ends meet financially and have fewer years of education. However, when facing ill health those who pray more often display a relatively lesser decline in their sense of well being.

News update.

PubMed

2012-11-28

The RCN has raised concerns that many healthcare assistants are paid less than the ethical minimum. While the current UK-wide minimum wage is £6.19 per hour, the Living Wage Foundation - which campaigns for minimum wages that refl ect the cost of living - claims the minimum wage should be £8.30 per hour in London and £7.20 per hour in other parts of UK. Commenting during the recent Living Wage Week, RCN general secretary Peter Carter said: 'This affects college members, particularly healthcare assistants in the private sector, who are often paid less than the living wage. Some struggle to make ends meet, forcing them to claim benefi ts.'

Factors affecting long-term-care residents' decision-making processes as they formulate advance directives.

PubMed

Lambert, Heather C; McColl, Mary Ann; Gilbert, Julie; Wong, Jiahui; Murray, Gale; Shortt, Samuel E D

2005-10-01

The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a long-term-care facility were interviewed by use of a semistructured format. Open and axial coding of interview transcripts were carried out and the factors contributing to the decision process were defined. Elders based their decisions primarily on information gathered from personal experiences with death and illness. They obtained very little information from professionals or the media. Major factors considered by elders as they weighed information included spiritual, emotional, and social considerations. The factors considered during the decision-making process were oriented more toward the individual's experiences and less on contributions from objective sources than anticipated. Decision making for advance directives is a highly personalized process. The approach of health professionals when assisting with end-of-life decision making should be planned with these contributing factors in mind, so that the services offered to the individuals in this population best meet their needs.

Making Debris Avoidance Decisions for ESMO's EOS Mission Set

NASA Technical Reports Server (NTRS)

Mantziaras, Dimitrios

2016-01-01

The presentation will cover the aspects of making debris risk decisions from the NASA Mission Director's perspective, specifically for NASA Earth Science Mission Operations (ESMO) Earth Observing System (EOS) mission set. ESMO has been involved in analyzing potential debris risk conjunctions with secondary objects since the inception of this discipline. Through the cumulated years of experience and continued exposure to various debris scenarios, ESMO's understanding of the problem and process to deal with this issue has evolved. The presentation will describe the evolution of the ESMO process, specifically as it relates to the maneuver execution and spacecraft risk management decision process. It will briefly cover the original Drag Make-Up Maneuver, several day, methodical manually intensive, ramp up waive off approach, to the present day more automated, pre-canned onboard command, tools based approach. The presentation will also cover the key information needed to make debris decisions and challenges in doing so while still trying to meet science goals, constellation constraints and manage resources. A slide or two at the end of the presentation, will be devoted to discussing what further improvements could be helpful to improve decision making and future process improvement plans challenges.

77 FR 23277 - Wekiva River System Advisory Management Committee Meetings (FY2012)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

...: Notice of upcoming scheduled meetings. SUMMARY: This notice announces a schedule of upcoming meetings for... 5, 2012 (Recreation Hall). Time: All scheduled meetings will begin at 3 p.m. and will end by 5 p.m... public. Each scheduled meeting will result in decisions and steps that advance the Wekiva River System...

75 FR 40850 - Notice of Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-14

... meeting may end early if all business is completed. If the meeting date and location are changed due to... Membership 10. Old Business a. Denali Subsistence Management Plan b. Subsistence Uses of Horns, Antlers... Subsistence Resource Commission (SRC) program. SUMMARY: The Denali National Park SRC plans to meet to develop...

Meeting End User Needs in Collaborative Medical Device Technology Development Research Projects: A Qualitative Case Study.

PubMed

Strisland, Frode; Svagård, Ingrid Storruste; Austad, Hanne Opsahl; Reitan, Jarl

2017-01-01

The aim of this case study has been to investigate to what extent user centered design (UCD) methodologies have been applied, how the process and outcomes were perceived by project team members, and what were potential barriers towards meeting end user needs. The case studied was the European Union Framework 7 integrated project d-LIVER (2011-2015), which aimed at developing an integrated care system for chronic liver disease patient management. d-LIVER is an example of a public funded, international, multidisciplinary, collaborative research project where development starts from a low technology readiness level, but where research is motivated by societal needs for better health care solutions. Awareness of central end user needs are therefore crucial. 14 project participants were interviewed. To meet societal and end user needs represent a prominent motivation factor for participants. The project organization with only clinical partners interacting with end users was accepted as a fact of life and not as a project pain point. A summary of observations and recommendations for good practice is given.

How safe is safe enough. The relation of environmental characteristics and economic competitiveness in fusion-reactor design

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

Holdren, J.P.

The need for fusion energy depends strongly on fusion's potential to achieve ambitious safety goals more completely or more economically than fission can. The history and present complexion of public opinion about environment and safety gives little basis for expecting either that these concerns will prove to be a passing fad or that the public will make demands for zero risk that no energy source can meet. Hazard indices based on ''worst case'' accidents and exposures should be used as design tools to promote combinations of fusion-reactor materials and configurations that bring the worst cases down to levels small comparedmore » to the hazards people tolerate from electricity at the point of end use. It may well be possible, by building such safety into fusion from the ground up, to accomplish this goal at costs competitive with other inexhaustible electricity sources. Indeed, the still rising and ultimately indeterminate costs of meeting safety and environmental requirements in nonbreeder fission reactors and coal-burning power plants mean that fusion reactors meeting ambitious safety goals may be able to compete economically with these ''interim'' electricity sources as well.« less

Data management by using R: big data clinical research series.

PubMed

Zhang, Zhongheng

2015-11-01

Electronic medical record (EMR) system has been widely used in clinical practice. Instead of traditional record system by hand writing and recording, the EMR makes big data clinical research feasible. The most important feature of big data research is its real-world setting. Furthermore, big data research can provide all aspects of information related to healthcare. However, big data research requires some skills on data management, which however, is always lacking in the curriculum of medical education. This greatly hinders doctors from testing their clinical hypothesis by using EMR. To make ends meet, a series of articles introducing data management techniques are put forward to guide clinicians to big data clinical research. The present educational article firstly introduces some basic knowledge on R language, followed by some data management skills on creating new variables, recoding variables and renaming variables. These are very basic skills and may be used in every project of big data research.

Effectiveness Trial of an Intensive Communication Structure for Families of Long-Stay ICU Patients

PubMed Central

Douglas, Sara L.; O’Toole, Elizabeth; Gordon, Nahida H.; Hejal, Rana; Peerless, Joel; Rowbottom, James; Garland, Allan; Lilly, Craig; Wiencek, Clareen; Hickman, Ronald

2010-01-01

Background: Formal family meetings have been recommended as a useful approach to assist in goal setting, facilitate decision making, and reduce use of ineffective resources in the ICU. We examined patient outcomes before and after implementation of an intensive communication system (ICS) to test the effect of regular, structured formal family meetings on patient outcomes among long-stay ICU patients. Methods: One hundred thirty-five patients receiving usual care and communication were enrolled as the control group, followed by enrollment of intervention patients (n = 346), from five ICUs. The ICS included a family meeting within 5 days of ICU admission and weekly thereafter. Each meeting discussed medical update, values and preferences, and goals of care; treatment plan; and milestones for judging effectiveness of treatment. Results: Using multivariate analysis, there were no significant differences between control and intervention patients in length of stay (LOS), the primary end point. Similarly, there were no significant differences in indicators of aggressiveness of care or treatment limitation decisions (ICU mortality, LOS, duration of ventilation, treatment limitation orders, or use of tracheostomy or percutaneous gastrostomy). Exploratory analysis suggested that in the medical ICUs, the intervention was associated with a lower prevalence of tracheostomy among patients who died or had do-not-attempt-resuscitation orders in place. Conclusions: The negative findings of the main analysis, in combination with preliminary evidence of differences among types of unit, suggest that further examination of the influence of patient, family, and unit characteristics on the effects of a system of regular family meetings may be warranted. Despite the lack of influence on patient outcomes, structured family meetings may be an effective approach to meeting information and support needs. Trial registry: ClinicalTrials.gov; No.: NCT01057238 ; URL: www.clinicaltrials.gov PMID:20576734

Advanced End-to-end Simulation for On-board Processing (AESOP)

NASA Technical Reports Server (NTRS)

Mazer, Alan S.

1994-01-01

Developers of data compression algorithms typically use their own software together with commercial packages to implement, evaluate and demonstrate their work. While convenient for an individual developer, this approach makes it difficult to build on or use another's work without intimate knowledge of each component. When several people or groups work on different parts of the same problem, the larger view can be lost. What's needed is a simple piece of software to stand in the gap and link together the efforts of different people, enabling them to build on each other's work, and providing a base for engineers and scientists to evaluate the parts as a cohesive whole and make design decisions. AESOP (Advanced End-to-end Simulation for On-board Processing) attempts to meet this need by providing a graphical interface to a developer-selected set of algorithms, interfacing with compiled code and standalone programs, as well as procedures written in the IDL and PV-Wave command languages. As a proof of concept, AESOP is outfitted with several data compression algorithms integrating previous work on different processors (AT&T DSP32C, TI TMS320C30, SPARC). The user can specify at run-time the processor on which individual parts of the compression should run. Compressed data is then fed through simulated transmission and uncompression to evaluate the effects of compression parameters, noise and error correction algorithms. The following sections describe AESOP in detail. Section 2 describes fundamental goals for usability. Section 3 describes the implementation. Sections 4 through 5 describe how to add new functionality to the system and present the existing data compression algorithms. Sections 6 and 7 discuss portability and future work.

Quality of communication in interpreted versus noninterpreted PICU family meetings.

PubMed

Van Cleave, Alisa C; Roosen-Runge, Megan U; Miller, Alison B; Milner, Lauren C; Karkazis, Katrina A; Magnus, David C

2014-06-01

To describe the quality of physician-family communication during interpreted and noninterpreted family meetings in the PICU. Prospective, exploratory, descriptive observational study of noninterpreted English family meetings and interpreted Spanish family meetings in the pediatric intensive care setting. A single, university-based, tertiary children's hospital. Participants in PICU family meetings, including medical staff, family members, ancillary staff, and interpreters. Thirty family meetings (21 English and nine Spanish) were audio-recorded, transcribed, de-identified, and analyzed using the qualitative method of directed content analysis. Quality of communication was analyzed in three ways: 1) presence of elements of shared decision-making, 2) balance between physician and family speech, and 3) complexity of physician speech. Of the 11 elements of shared decision-making, only four occurred in more than half of English meetings, and only three occurred in more than half of Spanish meetings. Physicians spoke for a mean of 20.7 minutes, while families spoke for 9.3 minutes during English meetings. During Spanish meetings, physicians spoke for a mean of 14.9 minutes versus just 3.7 minutes of family speech. Physician speech complexity received a mean grade level score of 8.2 in English meetings compared to 7.2 in Spanish meetings. The quality of physician-family communication during PICU family meetings is poor overall. Interpreted meetings had poorer communication quality as evidenced by fewer elements of shared decision-making and greater imbalance between physician and family speech. However, physician speech may be less complex during interpreted meetings. Our data suggest that physicians can improve communication in both interpreted and noninterpreted family meetings by increasing the use of elements of shared decision-making, improving the balance between physician and family speech, and decreasing the complexity of physician speech.

Physical Therapists' Perceptions of School-Based Practices.

PubMed

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

2015-01-01

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

[Fourth evaluation of the law on the review of termination of life on request and assisted suicide (Euthanasia Act)].

PubMed

van der Heide, A; Onwuteaka-Philipsen, B D; van Delden, J J M; Gevers, J K M; van der Maas, P J; van der Wal, G

2005-09-24

This fall, an extensive study will start to evaluate the Dutch Euthanasia Act. This law was enacted in 2002. According to this law, physicians must report cases of euthanasia and physician-assisted suicide. The cases are then judged by regional euthanasia review committees consisting of a lawyer, a physician and an ethicist. Only if they conclude that the case does not meet the requirements for prudent practice, it will be sent to the public prosecutor. The study will be focused on the practice of medical end-of-life decision-making, the functioning and effects of the Euthanasia Act, and opinions of physicians about the scope of the law and the demarcation between different end-of-life decisions. The study will comprise 4 sub-studies: a judicial evaluation, a death certificate study, a survey among physicians and a panel study among physicians, nurses, members of euthanasia review committees, lawyers and ethicists. This study is the fourth in a row of nationwide studies into end-of-life practices that have been performed since 1990. The previous studies contributed to the public debate about medical care at the end of life and to the development of policy in this field. It is expected that this study, by providing up-to-date information on and insight into end-of-life care in the Netherlands, will do the same.

End-to-End Fault Tolerance Using Transport Layer Multihoming

DTIC Science & Technology

2005-01-01

it meets the academic and professional standard required by the University as a dissertation for the degree of Doctor of Philosophy...dissertation and that in my opinion it meets the academic and professional standard required by the University as a dissertation for the degree of Doctor...grow tired of revising the same text over and over, he always showed enthusiasm for helping me improve its

49 CFR 393.45 - Brake tubing and hoses; hose assemblies and end fittings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 5 2013-10-01 2013-10-01 false Brake tubing and hoses; hose assemblies and end... assemblies and end fittings. (a) General construction requirements for tubing and hoses, assemblies, and end fittings. All brake tubing and hoses, brake hose assemblies, and brake hose end fittings must meet the...

49 CFR 393.45 - Brake tubing and hoses; hose assemblies and end fittings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 5 2011-10-01 2011-10-01 false Brake tubing and hoses; hose assemblies and end... assemblies and end fittings. (a) General construction requirements for tubing and hoses, assemblies, and end fittings. All brake tubing and hoses, brake hose assemblies, and brake hose end fittings must meet the...

49 CFR 393.45 - Brake tubing and hoses; hose assemblies and end fittings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 5 2014-10-01 2014-10-01 false Brake tubing and hoses; hose assemblies and end... assemblies and end fittings. (a) General construction requirements for tubing and hoses, assemblies, and end fittings. All brake tubing and hoses, brake hose assemblies, and brake hose end fittings must meet the...

Provision of integrated psychosocial services for cancer survivors post-treatment

PubMed Central

Recklitis, Christopher J; Syrjala, Karen L

2018-01-01

Meeting the psychosocial needs of patients with cancer has been recognised as a priority within oncology care for several decades. Many approaches that address these needs have been developed and described; however, until recently much of this work had focused on patients during treatment and end-of-life care. With continued improvement in therapies, the population of cancer survivors who can expect to live for 5 or more years after cancer diagnosis has increased dramatically, as have associated concerns about how to meet their medical, psychosocial, and health behaviour needs after treatment. Guidelines and models for general survivorship care routinely address psychosocial needs, and similar guidelines for psychosocial care of patients with cancer are being extended to address the needs of survivors. In this Series paper, we summarise the existing recommendations for the provision of routine psychosocial care to survivors, as well as the challenges present in providing this care. We make specific recommendations for the integration of psychosocial services into survivorship care. PMID:28049576

DIAGNOSIS DIALOG: RECAP AND RELEVANCE TO RECENT APTA ACTIONS

PubMed Central

2017-01-01

For at least 40 years, physical therapists have been contemplating the issue of diagnosis. After the profession chose to require completion of doctoral-level training for entry into the profession, making some decisions about diagnosis became essential. In the 2004 Maley Lecture, Cynthia Coffin-Zadai called the profession to action on the question of diagnosis. One response to her call was the formation of a group of physical therapists from across the country to engage in an extended conversation about diagnosis. The Diagnosis Dialog group first met in St. Louis in 2006 and at the end of the meeting they decided to continue the discussion at another meeting. In fact, they met a total of 13 times over 10 years. The purposes of this article are to a) summarize briefly some of the topics that were discussed and b) demonstrate the relevance of those discussions to recent APTA actions regarding the adoption of the movement system as the core of physical therapist practice, education, and research. PMID:29158949

Idaho National Laboratory 2015-2023 Ten-Year Site Plan

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

Sheryl Morton; Elizabeth Connell; Bill Buyers

2013-09-01

This Idaho National Laboratory (INL) Ten-Year Site Plan (TYSP) describes the strategy for accomplishing the long-term objective of sustaining the INL infrastructure to meet the Department of Energy Office of Nuclear Energy (DOE-NE) mission: to promote nuclear power as a resource capable of making major contributions in meeting the nation’s energy supply, environmental and energy security needs. This TYSP provides the strategy for INL to accomplish its mission by: (1) linking R&D mission goals to core capabilities and infrastructure requirements; (2) establishing a ten-year end-state vision for INL facility complexes; (3) identifying and prioritizing infrastructure needs and capability gaps; (4)more » establishing maintenance and repair strategies that allow for sustainment of mission-critical (MC) facilities; and (5) applying sustainability principles to each decision and action. The TYSP serves as the infrastructure-planning baseline for INL; and, though budget formulation documents are informed by the TYSP, it is not itself a budget document.« less

Standardized End Point Definitions for Coronary Intervention Trials: The Academic Research Consortium-2 Consensus Document.

PubMed

Garcia-Garcia, Hector M; McFadden, Eugène P; Farb, Andrew; Mehran, Roxana; Stone, Gregg W; Spertus, John; Onuma, Yoshinobu; Morel, Marie-Angèle; van Es, Gerrit-Anne; Zuckerman, Bram; Fearon, William F; Taggart, David; Kappetein, Arie-Pieter; Krucoff, Mitchell W; Vranckx, Pascal; Windecker, Stephan; Cutlip, Donald; Serruys, Patrick W

2018-06-12

The Academic Research Consortium (ARC)-2 initiative revisited the clinical and angiographic end point definitions in coronary device trials, proposed in 2007, to make them more suitable for use in clinical trials that include increasingly complex lesion and patient populations and incorporate novel devices such as bioresorbable vascular scaffolds. In addition, recommendations for the incorporation of patient-related outcomes in clinical trials are proposed. Academic Research Consortium-2 is a collaborative effort between academic research organizations in the United States and Europe, device manufacturers, and European, US, and Asian regulatory bodies. Several in-person meetings were held to discuss the changes that have occurred in the device landscape and in clinical trials and regulatory pathways in the last decade. The consensus-based end point definitions in this document are endorsed by the stakeholders of this document and strongly advocated for clinical trial purposes. This Academic Research Consortium-2 document provides further standardization of end point definitions for coronary device trials, incorporating advances in technology and knowledge. Their use will aid interpretation of trial outcomes and comparison among studies, thus facilitating the evaluation of the safety and effectiveness of these devices. © 2018 American Heart Association, Inc., and European Society of Cardiology.

The intensive care unit family meeting: Making it happen☆

PubMed Central

Gay, Elizabeth B.; Pronovost, Peter J.; Bassett, Rick D.; Nelson, Judith E.

2012-01-01

The intensive care unit (ICU) family meeting is an important forum for discussion about the patient’s condition, prognosis, and care preferences; for listening to the family’s concerns; and for decision making about appropriate goals of treatment. For patients, families, clinicians, and health care systems, the benefits of early and effective communication through these meetings have been clearly established. Yet, evidence suggests that family meetings still fail to occur in a timely way for most patients in ICUs. In this article, we address the “quality gap” between knowledge and practice with respect to regular implementation of family meetings. We first examine factors that may serve as barriers to family meetings. We then share practical strategies that may be helpful in overcoming some of these barriers. Finally, we describe performance improvement initiatives by ICUs in different parts of the country that have achieved striking successes in making family meetings happen. PMID:19327312

Collaborative care: Using six thinking hats for decision making.

PubMed

Cioffi, Jane Marie

2017-12-01

To apply six thinking hats technique for decision making in collaborative care. In collaborative partnerships, effective communications need to occur in patient, family, and health care professional meetings. The effectiveness of these meetings depends on the engagement of participants and the quality of the meeting process. The use of six thinking hats technique to engage all participants in effective dialogue is proposed. Discussion paper. Electronic databases, CINAHL, Pub Med, and Science Direct, were searched for years 1990 to 2017. Using six thinking hats technique in patient family meetings nurses can guide a process of dialogue that focuses decision making to build equal care partnerships inclusive of all participants. Nurses will need to develop the skills for using six thinking hats technique and provide support to all participants during the meeting process. Collaborative decision making can be augmented by six thinking hat technique to provide patients, families, and health professionals with opportunities to make informed decisions about care that considers key issues for all involved. Nurses who are most often advocates for patients and their families are in a unique position to lead this initiative in meetings as they network with all health professionals. © 2017 John Wiley & Sons Australia, Ltd.

Conformance Testing: Measurement Decision Rules

NASA Technical Reports Server (NTRS)

Mimbs, Scott M.

2010-01-01

The goal of a Quality Management System (QMS) as specified in ISO 9001 and AS9100 is to provide assurance to the customer that end products meet specifications. Measuring devices, often called measuring and test equipment (MTE), are used to provide the evidence of product conformity to specified requirements. Unfortunately, processes that employ MTE can become a weak link to the overall QMS if proper attention is not given to the measurement process design, capability, and implementation. Documented "decision rules" establish the requirements to ensure measurement processes provide the measurement data that supports the needs of the QMS. Measurement data are used to make the decisions that impact all areas of technology. Whether measurements support research, design, production, or maintenance, ensuring the data supports the decision is crucial. Measurement data quality can be critical to the resulting consequences of measurement-based decisions. Historically, most industries required simplistic, one-size-fits-all decision rules for measurements. One-size-fits-all rules in some cases are not rigorous enough to provide adequate measurement results, while in other cases are overly conservative and too costly to implement. Ideally, decision rules should be rigorous enough to match the criticality of the parameter being measured, while being flexible enough to be cost effective. The goal of a decision rule is to ensure that measurement processes provide data with a sufficient level of quality to support the decisions being made - no more, no less. This paper discusses the basic concepts of providing measurement-based evidence that end products meet specifications. Although relevant to all measurement-based conformance tests, the target audience is the MTE end-user, which is anyone using MTE other than calibration service providers. Topics include measurement fundamentals, the associated decision risks, verifying conformance to specifications, and basic measurement decisions rules.

76 FR 7230 - Notice of Public Meeting, Coeur d'Alene District Resource Advisory Council Meeting; Idaho

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-09

... Advisory Council (RAC) will meet as indicated below. DATES: March 22, 2011. The meeting will start at 8 a.m. and end at about 3:30 p.m. with the public comment period from 1 p.m. to 1:30 p.m. The meeting will be... FURTHER INFORMATION CONTACT: Lisa Wagner, RAC Coordinator, BLM Coeur d'Alene District, 3815 Schreiber Way...

76 FR 24048 - Notice of Public Meeting, Coeur d'Alene District Resource Advisory Council Meeting; Idaho

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

... Advisory Council (RAC) will meet as indicated below. DATES: June 1, 2011. The meeting will start at 8 a.m. and end no later than 3 p.m. with the public comment period from 1 p.m. to 1:30 p.m. The meeting will... CONTACT: Lisa Wagner, RAC Coordinator, BLM Coeur d'Alene District, 3815 Schreiber Way, Coeur d'Alene...

A Multimethod Analysis of Shared Decision-Making in Hospice Interdisciplinary Team Meetings Including Family Caregivers

PubMed Central

Washington, Karla T.; Oliver, Debra Parker; Gage, L. Ashley; Albright, David L.; Demiris, George

2015-01-01

Background Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. Aim We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. Design We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes. Setting/participants Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. Results Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in health care delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. Conclusions The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers. PMID:26281854

A multimethod analysis of shared decision-making in hospice interdisciplinary team meetings including family caregivers.

PubMed

Washington, Karla T; Oliver, Debra Parker; Gage, L Ashley; Albright, David L; Demiris, George

2016-03-01

Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes. Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in healthcare delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers. © The Author(s) 2015.

Completion of the Design of the Top End Optical Assembly for ATST

NASA Astrophysics Data System (ADS)

Canzian, Blaise; Barentine, J.

2013-01-01

L-3 Integrated Optical Systems (IOS) Division has been selected by the National Solar Observatory (NSO) to make the Top End Optical Assembly (TEOA) for the 4-meter Advanced Technology Solar Telescope (ATST) to operate at Haleakala, Maui. ATST will perform to a very high optical performance level in a difficult operational environment. The TEOA (including a 0.65-meter silicon carbide secondary mirror and support, mirror thermal management system, mirror positioning and fast tip-tilt system, field stop with thermally managed heat dump, Lyot stop, safety interlock and control system, and support frame) operates in the “hot spot” at the prime focus of the ATST, presenting unusual challenges. L-3 IOS has passed Critical Design Review of the TEOA. In this paper, we describe L-3 IOS success meeting technical challenges, including our solutions for optic fabrication, opto-mechanical positioning, rejected and stray light control, wavefront tip-tilt compensation, and thermal management and control.

Identifying and Managing Undue Influence From Family Members in End-of-Life Decisions for Patients With Advanced Cancer.

PubMed

Baker, Francis X; Gallagher, Colleen M

2017-10-01

Undue influence from family members of patients with advanced cancer remains a serious ethical problem in end-of-life decision making. Despite the wealth of articles discussing the problem of undue influence, little has been written by way of practical guidance to help clinicians identify and effectively manage situations of undue influence. This article briefly lays out how to identify and manage situations of undue influence sensitively and effectively. We explain how undue influence may present itself in the clinic and distinguish it from ethically permissible expressions of relational autonomy. In addition, we lay out a process by which any clinician suspecting undue influence may gather additional information and, if necessary, conduct a family meeting to address the undue influence. It is our hope that by providing clinicians at all levels of patient care with such guidance, they will feel empowered to respond to cases of undue influence when they arise.

76 FR 55646 - Pacific Fishery Management Council; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-08

... Fishery Management Council; Public Meetings AGENCY: National Marine Fisheries Service (NMFS), National... public meeting of the Pacific Fishery Management Council's (Council) Scientific and Statistical Committee.... and will end at 5:30 p.m. or as necessary to complete business each day during the week. ADDRESSES...

Decision Making and Communications Process Assessment of NASA Using Three Change Requests from the Space Launch System Program

NASA Technical Reports Server (NTRS)

Hicks, Karen Campbell

2015-01-01

This thesis investigated the communication and decision making process as part of the Systems Engineering practices at the NASA/Marshall Center to determine its level of effectiveness. Data was collected across three change requests to assess how decisions were made, how the decisions were communicated, and whether a process mattered in the formulation and dissemination of those decisions. Data results revealed the comprehensive decision making process for the technical change requests to be effective. Evidence revealed that the process was sufficiently tailored to accommodate the need of each individual technical change which promoted effective communication amongst the stakeholders in the formulation of the strategic decision recommendations elevated to upper management. However, data results also revealed the dissemination of the final decision and approval of the change requests from the higher organizational level down to all stakeholders was less effective. An establishment of a culmination meeting at the end of the change request decision process in which to close the communication loop with all entities would be beneficial.

Readout, first- and second-level triggers of the new Belle silicon vertex detector

NASA Astrophysics Data System (ADS)

Friedl, M.; Abe, R.; Abe, T.; Aihara, H.; Asano, Y.; Aso, T.; Bakich, A.; Browder, T.; Chang, M. C.; Chao, Y.; Chen, K. F.; Chidzik, S.; Dalseno, J.; Dowd, R.; Dragic, J.; Everton, C. W.; Fernholz, R.; Fujii, H.; Gao, Z. W.; Gordon, A.; Guo, Y. N.; Haba, J.; Hara, K.; Hara, T.; Harada, Y.; Haruyama, T.; Hasuko, K.; Hayashi, K.; Hazumi, M.; Heenan, E. M.; Higuchi, T.; Hirai, H.; Hitomi, N.; Igarashi, A.; Igarashi, Y.; Ikeda, H.; Ishino, H.; Itoh, K.; Iwaida, S.; Kaneko, J.; Kapusta, P.; Karawatzki, R.; Kasami, K.; Kawai, H.; Kawasaki, T.; Kibayashi, A.; Koike, S.; Korpar, S.; Križan, P.; Kurashiro, H.; Kusaka, A.; Lesiak, T.; Limosani, A.; Lin, W. C.; Marlow, D.; Matsumoto, H.; Mikami, Y.; Miyake, H.; Moloney, G. R.; Mori, T.; Nakadaira, T.; Nakano, Y.; Natkaniec, Z.; Nozaki, S.; Ohkubo, R.; Ohno, F.; Okuno, S.; Onuki, Y.; Ostrowicz, W.; Ozaki, H.; Peak, L.; Pernicka, M.; Rosen, M.; Rozanska, M.; Sato, N.; Schmid, S.; Shibata, T.; Stamen, R.; Stanič, S.; Steininger, H.; Sumisawa, K.; Suzuki, J.; Tajima, H.; Tajima, O.; Takahashi, K.; Takasaki, F.; Tamura, N.; Tanaka, M.; Taylor, G. N.; Terazaki, H.; Tomura, T.; Trabelsi, K.; Trischuk, W.; Tsuboyama, T.; Uchida, K.; Ueno, K.; Ueno, K.; Uozaki, N.; Ushiroda, Y.; Vahsen, S.; Varner, G.; Varvell, K.; Velikzhanin, Y. S.; Wang, C. C.; Wang, M. Z.; Watanabe, M.; Watanabe, Y.; Yamada, Y.; Yamamoto, H.; Yamashita, Y.; Yamashita, Y.; Yamauchi, M.; Yanai, H.; Yang, R.; Yasu, Y.; Yokoyama, M.; Ziegler, T.; Žontar, D.

2004-12-01

A major upgrade of the Silicon Vertex Detector (SVD 2.0) of the Belle experiment at the KEKB factory was installed along with new front-end and back-end electronics systems during the summer shutdown period in 2003 to cope with higher particle rates, improve the track resolution and meet the increasing requirements of radiation tolerance. The SVD 2.0 detector modules are read out by VA1TA chips which provide "fast or" (hit) signals that are combined by the back-end FADCTF modules to coarse, but immediate level 0 track trigger signals at rates of several tens of a kHz. Moreover, the digitized detector signals are compared to threshold lookup tables in the FADCTFs to pass on hit information on a single strip basis to the subsequent level 1.5 trigger system, which reduces the rate below the kHz range. Both FADCTF and level 1.5 electronics make use of parallel real-time processing in Field Programmable Gate Arrays (FPGAs), while further data acquisition and event building is done by PC farms running Linux. The new readout system hardware is described and the first results obtained with cosmics are shown.

Improving Palliative Care Team Meetings: Structure, Inclusion, and "Team Care".

PubMed

Brennan, Caitlin W; Kelly, Brittany; Skarf, Lara Michal; Tellem, Rotem; Dunn, Kathleen M; Poswolsky, Sheila

2016-07-01

Increasing demands on palliative care teams point to the need for continuous improvement to ensure teams are working collaboratively and efficiently. This quality improvement initiative focused on improving interprofessional team meeting efficiency and subsequently patient care. Meeting start and end times improved from a mean of approximately 9 and 6 minutes late in the baseline period, respectively, to a mean of 4.4 minutes late (start time) and ending early in our sustainability phase. Mean team satisfaction improved from 2.4 to 4.5 on a 5-point Likert-type scale. The improvement initiative clarified communication about patients' plans of care, thus positively impacting team members' ability to articulate goals to other professionals, patients, and families. We propose several recommendations in the form of a team meeting "toolkit." © The Author(s) 2015.

How senior entomologists can be involved in the annual meeting: organization and the coming together of a large event

USDA-ARS?s Scientific Manuscript database

The Annual Meeting for the Entomological Society of America is a large event where planning is started at the end of the previous years’ meeting. The President of the Society named the Program Committee Co-Chairs for Entomology 2017 at the 2015 Annual Meeting, so that they could handle the duties o...

75 FR 65377 - Notice of Public Meeting for the National Park Service (NPS) Alaska Region's Subsistence Resource...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-22

... Resource Commission (SRC) program. SUMMARY: The Gates of the Arctic National Park SRC will meet to develop.... Gates of the Arctic National Park SRC Meeting Date and Location: The Gates of the Arctic National Park... meeting may end early if all business is completed. For Further Information On the Gates of the Arctic...

Automated Performance Characterization of DSN System Frequency Stability Using Spacecraft Tracking Data

NASA Technical Reports Server (NTRS)

Pham, Timothy T.; Machuzak, Richard J.; Bedrossian, Alina; Kelly, Richard M.; Liao, Jason C.

2012-01-01

This software provides an automated capability to measure and qualify the frequency stability performance of the Deep Space Network (DSN) ground system, using daily spacecraft tracking data. The results help to verify if the DSN performance is meeting its specification, therefore ensuring commitments to flight missions; in particular, the radio science investigations. The rich set of data also helps the DSN Operations and Maintenance team to identify the trends and patterns, allowing them to identify the antennas of lower performance and implement corrective action in a timely manner. Unlike the traditional approach where the performance can only be obtained from special calibration sessions that are both time-consuming and require manual setup, the new method taps into the daily spacecraft tracking data. This new approach significantly increases the amount of data available for analysis, roughly by two orders of magnitude, making it possible to conduct trend analysis with good confidence. The software is built with automation in mind for end-to-end processing. From the inputs gathering to computation analysis and later data visualization of the results, all steps are done automatically, making the data production at near zero cost. This allows the limited engineering resource to focus on high-level assessment and to follow up with the exceptions/deviations. To make it possible to process the continual stream of daily incoming data without much effort, and to understand the results quickly, the processing needs to be automated and the data summarized at a high level. Special attention needs to be given to data gathering, input validation, handling anomalous conditions, computation, and presenting the results in a visual form that makes it easy to spot items of exception/ deviation so that further analysis can be directed and corrective actions followed.

Automated Performance Characterization of DSN System Frequency Stability Using Spacecraft Tracking Data

NASA Technical Reports Server (NTRS)

Pham, Timothy T.; Machuzak, Richard J.; Bedrossian, Alina; Kelly, Richard M.; Liao, Jason C.

2012-01-01

This software provides an automated capability to measure and qualify the frequency stability performance of the Deep Space Network (DSN) ground system, using daily spacecraft tracking data. The results help to verify if the DSN performance is meeting its specification, therefore ensuring commitments to flight missions; in particular, the radio science investigations. The rich set of data also helps the DSN Operations and Maintenance team to identify the trends and patterns, allowing them to identify the antennas of lower performance and implement corrective action in a timely manner. Unlike the traditional approach where the performance can only be obtained from special calibration sessions that are both time-consuming and require manual setup, the new method taps into the daily spacecraft tracking data. This new approach significantly increases the amount of data available for analysis, roughly by two orders of magnitude, making it possible to conduct trend analysis with good confidence. The software is built with automation in mind for end-to-end processing. From the inputs gathering to computation analysis and later data visualization of the results, all steps are done automatically, making the data production at near zero cost. This allows the limited engineering resource to focus on high-level assessment and to follow up with the exceptions/deviations. To make it possible to process the continual stream of daily incoming data without much effort, and to understand the results quickly, the processing needs to be automated and the data summarized at a high level. Special attention needs to be given to data gathering, input validation, handling anomalous conditions, computation, and presenting the results in a visual form that makes it easy to spot items of exception/deviation so that further analysis can be directed and corrective actions followed.

Lessons Learned for Collaborative Clinical Content Development

PubMed Central

Collins, S.A.; Bavuso, K.; Zuccotti, G.; Rocha, R.A.

2013-01-01

Background Site-specific content configuration of vendor-based Electronic Health Records (EHRs) is a vital step in the development of standardized and interoperable content that can be used for clinical decision-support, reporting, care coordination, and information exchange. The multi-site, multi-stakeholder Acute Care Documentation (ACD) project at Partners Healthcare Systems (PHS) aimed to develop highly structured clinical content with adequate breadth and depth to meet the needs of all types of acute care clinicians at two academic medical centers. The Knowledge Management (KM) team at PHS led the informatics and knowledge management effort for the project. Objectives We aimed to evaluate the role, governance, and project management processes and resources for the KM team’s effort as part of the standardized clinical content creation. Methods We employed the Center for Disease Control’s six step Program Evaluation Framework to guide our evaluation steps. We administered a forty-four question, open-ended, semi-structured voluntary survey to gather focused, credible evidence from members of the KM team. Qualitative open-coding was performed to identify themes for lessons learned and concluding recommendations. Results Six surveys were completed. Qualitative data analysis informed five lessons learned and thirty specific recommendations associated with the lessons learned. The five lessons learned are: 1) Assess and meet knowledge needs and set expectations at the start of the project; 2) Define an accountable decision-making process; 3) Increase team meeting moderation skills; 4) Ensure adequate resources and competency training with online asynchronous collaboration tools; 5) Develop focused, goal-oriented teams and supportive, consultative service based teams. Conclusions Knowledge management requirements for the development of standardized clinical content within a vendor-based EHR among multi-stakeholder teams and sites include: 1) assessing and meeting informatics knowledge needs, 2) setting expectations and standardizing the process for decision-making, and 3) ensuring the availability of adequate resources and competency training. PMID:23874366

Bedside nurse involvement in end-of-life decision making: a brief review of the literature.

PubMed

Erickson, Jodi

2013-01-01

Bedside nurses in the critical care setting deal with death on a regular basis. Historically, end-of-life decision making has been addressed by physicians with the family and patient, yet nurses may be a better resource for families during the decision-making process. The purpose of this article was to provide a brief review of literature surrounding end-of-life decision making. As patient advocates, nurses should be more actively involved with facilitating the end-of-life decision-making process for critically ill patients and their families.

HEPEX - achievements and challenges!

NASA Astrophysics Data System (ADS)

Pappenberger, Florian; Ramos, Maria-Helena; Thielen, Jutta; Wood, Andy; Wang, Qj; Duan, Qingyun; Collischonn, Walter; Verkade, Jan; Voisin, Nathalie; Wetterhall, Fredrik; Vuillaume, Jean-Francois Emmanuel; Lucatero Villasenor, Diana; Cloke, Hannah L.; Schaake, John; van Andel, Schalk-Jan

2014-05-01

HEPEX is an international initiative bringing together hydrologists, meteorologists, researchers and end-users to develop advanced probabilistic hydrological forecast techniques for improved flood, drought and water management. HEPEX was launched in 2004 as an independent, cooperative international scientific activity. During the first meeting, the overarching goal was defined as: "to develop and test procedures to produce reliable hydrological ensemble forecasts, and to demonstrate their utility in decision making related to the water, environmental and emergency management sectors." The applications of hydrological ensemble predictions span across large spatio-temporal scales, ranging from short-term and localized predictions to global climate change and regional modeling. Within the HEPEX community, information is shared through its blog (www.hepex.org), meetings, testbeds and intercompaison experiments, as well as project reportings. Key questions of HEPEX are: * What adaptations are required for meteorological ensemble systems to be coupled with hydrological ensemble systems? * How should the existing hydrological ensemble prediction systems be modified to account for all sources of uncertainty within a forecast? * What is the best way for the user community to take advantage of ensemble forecasts and to make better decisions based on them? This year HEPEX celebrates its 10th year anniversary and this poster will present a review of the main operational and research achievements and challenges prepared by Hepex contributors on data assimilation, post-processing of hydrologic predictions, forecast verification, communication and use of probabilistic forecasts in decision-making. Additionally, we will present the most recent activities implemented by Hepex and illustrate how everyone can join the community and participate to the development of new approaches in hydrologic ensemble prediction.

77 FR 38065 - The President's Management Advisory Board (PMAB); Notification of Upcoming Public Advisory Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-26

... President's Management Advisory Board (PMAB); Notification of Upcoming Public Advisory Meeting AGENCY...: The President's Management Advisory Board (PMAB), a Federal Advisory Committee established in...: The meeting will be held on Wednesday, July 11, 2012, beginning at 9 a.m. eastern time, ending no...

Helping Resource Managers Understand Hydroclimatic Variability and Forecasts: A Case Study in Research Equity

NASA Astrophysics Data System (ADS)

Hartmann, H. C.; Pagano, T. C.; Sorooshian, S.; Bales, R.

2002-12-01

Expectations for hydroclimatic research are evolving as changes in the contract between science and society require researchers to provide "usable science" that can improve resource management policies and practices. However, decision makers have a broad range of abilities to access, interpret, and apply scientific research. "High-end users" have technical capabilities and operational flexibility capable of readily exploiting new information and products. "Low-end users" have fewer resources and are less likely to change their decision making processes without clear demonstration of benefits by influential early adopters (i.e., high-end users). Should research programs aim for efficiency, targeting high-end users? Should they aim for impact, targeting decisions with high economic value or great influence (e.g., state or national agencies)? Or should they focus on equity, whereby outcomes benefit groups across a range of capabilities? In this case study, we focus on hydroclimatic variability and forecasts. Agencies and individuals responsible for resource management decisions have varying perspectives about hydroclimatic variability and opportunities for using forecasts to improve decision outcomes. Improper interpretation of forecasts is widespread and many individuals find it difficult to place forecasts in an appropriate regional historical context. In addressing these issues, we attempted to mitigate traditional inequities in the scope, communication, and accessibility of hydroclimatic research results. High-end users were important in prioritizing information needs, while low-end users were important in determining how information should be communicated. For example, high-end users expressed hesitancy to use seasonal forecasts in the absence of quantitative performance evaluations. Our subsequently developed forecast evaluation framework and research products, however, were guided by the need for a continuum of evaluation measures and interpretive materials to enable low-end users to increase their understanding of probabilistic forecasts, credibility concepts, and implications for decision making. We also developed an interactive forecast assessment tool accessible over the Internet, to support resource decisions by individuals as well as agencies. The tool provides tutorials for guiding forecast interpretation, including quizzes that allow users to test their forecast interpretation skills. Users can monitor recent and historical observations for selected regions, communicated using terminology consistent with available forecast products. The tool also allows users to evaluate forecast performance for the regions, seasons, forecast lead times, and performance criteria relevant to their specific decision making situations. Using consistent product formats, the evaluation component allows individuals to use results at the level they are capable of understanding, while offering opportunity to shift to more sophisticated criteria. Recognizing that many individuals lack Internet access, the forecast assessment webtool design also includes capabilities for customized report generation so extension agents or other trusted information intermediaries can provide material to decision makers at meetings or site visits.

Evaluation and development of potentially better practices for improving family-centered care in neonatal intensive care units.

PubMed

Saunders, Roger P; Abraham, Marie R; Crosby, Mary Jo; Thomas, Karen; Edwards, William H

2003-04-01

Technological and scientific advances have progressively decreased neonatal morbidity and mortality. Less attention has been given to meeting the psychosocial needs of the infant and family than on meeting the infant's physical needs. Parents' participation in making decisions and caring for their child has often been limited. Environments designed for efficient technological care may not be optimal for nurturing the growth and development of sick neonates or their families. Eleven centers collaborating on quality improvement tried to make the care of families better by focusing on understanding and improving family-centered care. Through internal process analysis, review of the evidence, collaborative learning, and benchmarking site visits to centers of excellence in family-centered care, a list of potentially better practices was developed. Choice of which practices to implement and methods of implementation were center specific. Improvement goals were in 3 areas: parent-reported outcomes, staff beliefs and practices, and clinical outcomes in length of stay and feeding practices. Measurement tools for the first 2 areas were developed and pilots were conducted. Length of stay and feeding outcomes were not different before the collaboration (1998) and at the formal end of the collaboration (2000). Prospective parent-reported outcomes are being collected, and the staff beliefs and practices questionnaire will be repeated in all centers to determine the impact of the project in those areas.

[Operational qualification of the computer-based information system and electronic data interchanges in a hospital blood bank].

PubMed

Vaquier, C; Legrand, D; Caldani, C

2009-05-01

Since 1985, a Council Resolution defines a new approach to technical harmonization and standards. The directives resulting from this new approach establish the essential safety requirements with which products put on the market must conform, and which should therefore enjoy free movement throughout the European Union, owing to a presumption of conformity. However, if the manufacturer is responsible for the conformity of its product in terms of safety, it is the end-user who must make sure that its requirements for a specific use or a considered application are satisfied and that the product meets its needs. It is the objective of the procedure of validation, which calls upon protocols of qualification intended to show the aptitude of a material, a system, a device, of an installation, to meet the requirements of specified quality and safety. This concept of qualification applies to the data-processing software of the hospital blood banks. Only the stage of operational qualification will be developed here. It involves scenarios made up of test files which make it possible to check the electronic data interchanges between the hospital blood bank and the blood establishment (transmission of the results of analysis, transmission of the data of traceability), as well as the functions of assistance to the issuing of the labile blood products.

The enactment stage of end-of-life decision-making for children.

PubMed

Sullivan, Jane Elizabeth; Gillam, Lynn Heather; Monagle, Paul Terence

2018-01-11

Typically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors' and parents' roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents' experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process. A qualitative methodology was used. Semi-structured interviews were conducted with bereaved parents, who had discussed end-of-life decisions for their child who had a life-limiting condition and who had died. Data were thematically analysed. Twenty-five bereaved parents participated. Findings indicate that, despite differences in context, including the child's condition and age, end-of-life decision-making did not end when an end-of-life decision was made. Enacting the decision was the next stage in a process. Time intervals between stages and enactment pathways varied, but the enactment was always distinguishable as a separate stage. Decision enactment involved making further decisions - parents needed to discern the appropriate time to implement their decision to withdraw or withhold life-sustaining medical treatment. Unexpected events, including other people's actions, impacted on parents enacting their decision in the way they had planned. Several parents had to re-implement decisions when their child recovered from serious health issues without medical intervention. Significance of results A novel, critical finding was that parents experienced end-of-life decision-making as a sequence of interconnected stages, the final stage being enactment. The enactment stage involved further decision-making. End-of-life decision-making is better understood as a process rather than a discrete once-off event. The enactment stage has particular emotional and practical implications for parents. Greater understanding of this stage can improve clinician's support for parents as they care for their child.

75 FR 9429 - Notice of Public Meeting, Eastern Washington Resource Advisory Council Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

... (EWRAC) will meet as indicated below. DATES: Meeting will take place on March 25, 2010, from 10 a.m. to 2..., Washington 98837-2950. FOR FURTHER INFORMATION CONTACT: BLM Spokane District, 1103 N. Fancher Rd., Spokane... public. It will begin at 10 a.m. and end at 2 p.m. on March 25. Members of the public will have an...

Translational research in addiction: toward a framework for the development of novel therapeutics.

PubMed

Paterson, Neil E

2011-06-15

The development of novel substance use disorder (SUD) therapeutics is insufficient to meet the medical needs of a growing SUD patient population. The identification of translatable SUD models and tests is a crucial step in establishing a framework for SUD therapeutic development programs. The present review begins by identifying the clinical features of SUDs and highlights the narrow regulatory end-point required for approval of a novel SUD therapeutic. A conceptual overview of dependence is provided, followed by identification of potential intervention targets in the addiction cycle. The main components of the addiction cycle provide the framework for a discussion of preclinical models and their clinical analogs, all of which are focused on isolated behavioral end-points thought to be relevant to the persistence of compulsive drug use. Thus, the greatest obstacle to successful development is the gap between the multiplicity of preclinical and early clinical end-points and the regulatory end-point of sustained abstinence. This review proposes two pathways to bridging this gap: further development and validation of the preclinical extended access self-administration model; inclusion of secondary end-points comprising all of the measures highlighted in the present discussion in Phase 3 trials. Further, completion of the postdictive validation of analogous preclinical and clinical assays is of high priority. Ultimately, demonstration of the relevance and validity of a variety of end-points to the ultimate goal of abstinence will allow researchers to identify truly relevant therapeutic mechanisms and intervention targets, and establish a framework for SUD therapeutic development that allows optimal decision-making and resource allocation. 2011 Elsevier Inc. All rights reserved.

Meaningful lives: Supporting young people with psychosis in education, training and employment: an international consensus statement.

PubMed

2010-11-01

Unemployment is the major disability faced by people with psychotic illness. Unemployment rates of 75–95% are found among those with schizophrenia. Unemployment is associated with poorer social and economic inclusion, greater symptomatology, decreased autonomy and generally poorer life functioning. Unemployment also makes up over half of the total costs associated with psychotic illness. A meeting was convened in London in June 2008. Invitees to this meeting included people from the USA, Canada and the UK interested in vocational intervention in early psychosis from either a research, clinical, economic or policy point of view. From this meeting a larger group–the International First Episode Vocational Recovery (iFEVR) group–has developed an international consensus statement about vocational recovery in first episode psychosis. The document is a basic statement of the rights of young people with psychosis to pursue employment, education and training; the evidence which exists to help them do this; and ways in which individuals, organizations and governments can assist the attainment of these ends. It is hoped that the Meaningful Lives consensus statement will increase the focus on the area of functional recovery and lift it to be seen in parallel with symptomatic recovery in the approach to treating early psychosis.

78 FR 69665 - SFIREG Full Committee; Notice of Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-20

...The Association of American Pesticide Control Officials (AAPCO)/State FIFRA Issues Research and Evaluation Group (SFIREG), Full Committee will hold a 2-day meeting, beginning on December 9, 2013 and ending December 10, 2013. This notice announces the location and times for the meeting and sets forth the tentative agenda topics.

75 FR 44841 - Hazardous Materials: Special Permits and Approvals-Minimum Level of Fitness Determinations...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-29

... Materials: Special Permits and Approvals--Minimum Level of Fitness Determinations; Public Meeting AGENCY... Special Permit and Approval applicant fitness determinations. PHMSA will hold a public meeting on August... minimum level of fitness. DATES: Public Meeting: August 19, 2010; starting at 9:30 a.m. and ending by 3:30...

77 FR 51533 - SFIREG POM Working Committee; Notice of Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-24

... (SFIREG), Pesticides Operations and Management (POM) Working Committee will hold a 2-day meeting, beginning on September 17, 2012, and ending September 18, 2012. This notice announces the location and times... CONTACT, preferably at least 10 days prior to the meeting, to give EPA as much time as possible to process...

76 FR 62813 - Pilot Program To Evaluate Proposed Proprietary Name Submissions; Public Meeting on Pilot Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-11

...] Pilot Program To Evaluate Proposed Proprietary Name Submissions; Public Meeting on Pilot Program Results... voluntary pilot program that enabled participating pharmaceutical firms to evaluate proposed proprietary... public meeting at the end of fiscal year 2011 to discuss the results of the pilot program, but the Agency...

SPOKES: An end-to-end simulation facility for spectroscopic cosmological surveys

DOE PAGES

Nord, B.; Amara, A.; Refregier, A.; ...

2016-03-03

The nature of dark matter, dark energy and large-scale gravity pose some of the most pressing questions in cosmology today. These fundamental questions require highly precise measurements, and a number of wide-field spectroscopic survey instruments are being designed to meet this requirement. A key component in these experiments is the development of a simulation tool to forecast science performance, define requirement flow-downs, optimize implementation, demonstrate feasibility, and prepare for exploitation. We present SPOKES (SPectrOscopic KEn Simulation), an end-to-end simulation facility for spectroscopic cosmological surveys designed to address this challenge. SPOKES is based on an integrated infrastructure, modular function organization, coherentmore » data handling and fast data access. These key features allow reproducibility of pipeline runs, enable ease of use and provide flexibility to update functions within the pipeline. The cyclic nature of the pipeline offers the possibility to make the science output an efficient measure for design optimization and feasibility testing. We present the architecture, first science, and computational performance results of the simulation pipeline. The framework is general, but for the benchmark tests, we use the Dark Energy Spectrometer (DESpec), one of the early concepts for the upcoming project, the Dark Energy Spectroscopic Instrument (DESI). As a result, we discuss how the SPOKES framework enables a rigorous process to optimize and exploit spectroscopic survey experiments in order to derive high-precision cosmological measurements optimally.« less

End-of-life choices for African-American and white infants in a neonatal intensive-care unit: a pilot study.

PubMed Central

Moseley, Kathryn L.; Church, Annamaria; Hempel, Bridget; Yuan, Harry; Goold, Susan Door; Freed, Gary L.

2004-01-01

BACKGROUND: African-American adults are more likely than white adults to desire the continuation of life-sustaining medical treatment (LSMT) at the end of life. No studies have examined racial differences in parental end-of-life decisions for neonates. OBJECTIVE: To collect preliminary data to determine whether differences exist in the choices made by parents of African-American and white infants when a physician has recommended withholding or withdrawing LSMT from their infant to develop hypotheses for future work. DESIGN/METHODS: A retrospective chart review of African-American and white infants who died in an urban neonatal intensive care unit (NICU) over a two-year period. Charts were abstracted for demographics, cause of death, and documentation of meetings where the physician recommended withholding or withdrawing LSMT. RESULTS: Thirty-eight infant charts met study criteria (58% African-American, 42% white). Documentation of physician recommendations to limit LSMT was present in 61% of charts. Approached families of white infants agreed to limit LSMT 80% of the time compared to 62% of the families of African-American infants. CONCLUSIONS: In this pilot study, parents of African-American and white infants appeared to make different end-of-life choices for their children. A larger study is needed to confirm these findings and further explore contributing factors such as mistrust, religiosity, and perceived discrimination. PMID:15253324

Ultra-Low Carbon Emissions from Coal-Fired Power Plants through Bio-Oil Co-Firing and Biochar Sequestration.

PubMed

Dang, Qi; Mba Wright, Mark; Brown, Robert C

2015-12-15

This study investigates a novel strategy of reducing carbon emissions from coal-fired power plants through co-firing bio-oil and sequestering biochar in agricultural lands. The heavy end fraction of bio-oil recovered from corn stover fast pyrolysis is blended and co-fired with bituminous coal to form a bio-oil co-firing fuel (BCF). Life-cycle greenhouse gas (GHG) emissions per kWh electricity produced vary from 1.02 to 0.26 kg CO2-eq among different cases, with BCF heavy end fractions ranging from 10% to 60%, which corresponds to a GHG emissions reduction of 2.9% to 74.9% compared with that from traditional bituminous coal power plants. We found a heavy end fraction between 34.8% and 37.3% is required to meet the Clean Power Plan's emission regulation for new coal-fired power plants. The minimum electricity selling prices are predicted to increase from 8.8 to 14.9 cents/kWh, with heavy end fractions ranging from 30% to 60%. A minimum carbon price of $67.4 ± 13 per metric ton of CO2-eq was estimated to make BCF power commercially viable for the base case. These results suggest that BCF co-firing is an attractive pathway for clean power generation in existing power plants with a potential for significant reductions in carbon emissions.

Palliative care nursing involvement in end-of-life decision-making: Qualitative secondary analysis.

PubMed

Hernández-Marrero, Pablo; Fradique, Emília; Pereira, Sandra Martins

2018-01-01

Nurses are the largest professional group in healthcare and those who make more decisions. In 2014, the Committee on Bioethics of the Council of Europe launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations" (hereinafter, Guide), aiming at improving decision-making processes and empowering professionals in making end-of-life decisions. The Guide does not mention nurses explicitly. To analyze the ethical principles most valued by nurses working in palliative care when making end-of-life decisions and investigate if they are consistent with the framework and recommendations of the Guide; to identify what disputed/controversial issues are more frequent in these nurses' current end-of-life care practices. Qualitative secondary analysis. Participants/context: Three qualitative datasets including 32 interviews from previous studies with nurses working in palliative care in Portugal. Ethical consideration: Ethical approval was obtained from the Ethics Research Lab of the Instituto de Bioética (Ethics Research Lab of the Institute of Bioethics) (Ref.04.2015). Ethical procedures are thoroughly described. All participant nurses referred to autonomy as an ethical principle paramount in end-of-life decision-making. They were commonly involved in end-of-life decision-making. Palliative sedation and communication were the most mentioned disputed/controversial issues. Autonomy was highly valued in end-of-life care and decision-making. Nurses expressed major concerns in assessing patients' preferences, wishes, and promoting advance care planning. Nurses working in palliative care in Portugal were highly involved in end-of-life decision-making. These processes embraced a collective, inclusive approach. Palliative sedation was the most mentioned disputed issue, which is aligned with previous findings. Communication also emerged as a sensitive ethical issue; it is surprising, however, that only three nurses referred to it. While the Guide does not explicitly mention nurses in its content, this study shows that nurses working in palliative care in Portugal are involved in these processes. Further research is needed on nurses' involvement and practices in end-of-life decision-making.

Ethical Challenges and Solutions Regarding Delirium Studies in Palliative Care

PubMed Central

Sweet, Lisa; Adamis, Dimitrios; Meagher, David; Davis, Daniel; Currow, David; Bush, Shirley H.; Barnes, Christopher; Hartwick, Michael; Agar, Meera; Simon, Jessica; Breitbart, William; MacDonald, Neil; Lawlor, Peter G.

2014-01-01

Context Delirium occurs commonly in settings of palliative care (PC), in which patient vulnerability in the unique context of end-of-life care and delirium-associated impairment of decision-making capacity may together present many ethical challenges. Objectives Based on deliberations at the Studies to Understand Delirium in Palliative Care Settings (SUNDIPS) meeting and an associated literature review, this article discusses ethical issues central to the conduct of research on delirious PC patients. Methods Together with an analysis of the ethical deliberations at the SUNDIPS meeting, we conducted a narrative literature review by key words searching of relevant databases and a subsequent hand search of initially identified articles. We also reviewed statements of relevance to delirium research in major national and international ethics guidelines. Results Key issues identified include the inclusion of PC patients in delirium research, capacity determination, and the mandate to respect patient autonomy and ensure maintenance of patient dignity. Proposed solutions include designing informed consent statements that are clear, concise, and free of complex phraseology; use of concise, yet accurate, capacity assessment instruments with a minimally burdensome schedule; and use of PC friendly consent models, such as facilitated, deferred, experienced, advance, and proxy models. Conclusion Delirium research in PC patients must meet the common standards for such research in any setting. Certain features unique to PC establish a need for extra diligence in meeting these standards and the employment of assessments, consent procedures, and patient-family interactions that are clearly grounded on the tenets of PC. PMID:24388124

Critical thinking by nurses on ethical issues like the termination of pregnancies.

PubMed

Botes, A

2000-09-01

This research forms part of a larger interdisciplinary research project on the termination of pregnancies. The focus of this part of the project is on the ethical issues related to termination of pregnancies. The practice of the professional nurse is confronted with ethical dilemmas and disputes. Whether the nurse chooses to participate in the termination of pregnancies or not, the core function of the nurse is that of counseling and ethical decision-making. Effective counseling requires empathy, respect for human rights and unconditional acceptance of a person. Making ethical decisions implies making critical decisions. It is self-evident, therefore, that such decisions should be based on sound arguments and logical reasoning. It is of vital importance that ethical decisions can be justified on rational ground. Decision-making is a critical thinking approach process for choosing the best action to meet a desired goal. The research question that is relevant for this paper is: Are nurses thinking critically about ethical issues like the termination of pregnancies? To answer the research question a qualitative, exploratory, descriptive design was used (Mouton, 1996:103-169). Registered nurses were selected purposively (Creswell, 1994:15). 1200 registered nurses completed the open-ended questionnaires. Focus group interviews were conducted with 22 registered nurses from a public hospital for women and child health services. Data analysis, using secondary data from open-ended questionnaires and transcribed focus group interviews, were based on the approach of Morse and Field (1994:25-34) and Strauss and Corbin (1990). The themes and categories from open coding were compared, conceptualized and linked with theories on critical thinking (Paul, 1994; Watson & Glaser, 1991 and the American Philosophical Association, 1990). The measures of Lincoln and Guba (1985) and Morse (1994) related to secondary data analysis were employed to ensure trustworthiness. Based on these findings the researcher concluded that nurses are not thinking critically when making ethical decisions concerning the termination of pregnancies. Recommendations are made as a possible solution for this problem.

Policies for Enabling Corporate Sourcing of Renewable Energy Internationally: A 21st Century Power Partnership Report

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

Bird, Lori; Heeter, Jenny; O'Shaughnessy, Eric

This paper explores the policy and regulatory enabling environment for corporate sourcing of renewables. The paper has been developed in support of the Corporate Sourcing of Renewables Campaign, which was launched at the Clean Energy Ministerial (CEM) meeting in June 2016. Through the campaign, a subset of CEM member governments is collaborating with corporate and nongovernmental organization partners to facilitate increased corporate procurement of renewables and pursue supportive policies for corporate procurement. This paper finds that policy certainty is essential to creating vibrant markets for renewable energy. While policymakers may need to adjust policy mechanisms over time as markets gomore » through different stages of maturity, they must also consider the economic decisions that end-users make in evaluating projects. Policy interaction is also important to consider because buyers seek assurances that their investments in renewables have impact and wish to make clear claims about their renewable energy purchases.« less

Expert system and process optimization techniques for real-time monitoring and control of plasma processes

NASA Astrophysics Data System (ADS)

Cheng, Jie; Qian, Zhaogang; Irani, Keki B.; Etemad, Hossein; Elta, Michael E.

1991-03-01

To meet the ever-increasing demand of the rapidly-growing semiconductor manufacturing industry it is critical to have a comprehensive methodology integrating techniques for process optimization real-time monitoring and adaptive process control. To this end we have accomplished an integrated knowledge-based approach combining latest expert system technology machine learning method and traditional statistical process control (SPC) techniques. This knowledge-based approach is advantageous in that it makes it possible for the task of process optimization and adaptive control to be performed consistently and predictably. Furthermore this approach can be used to construct high-level and qualitative description of processes and thus make the process behavior easy to monitor predict and control. Two software packages RIST (Rule Induction and Statistical Testing) and KARSM (Knowledge Acquisition from Response Surface Methodology) have been developed and incorporated with two commercially available packages G2 (real-time expert system) and ULTRAMAX (a tool for sequential process optimization).

41 CFR 101-26.100-1 - Procurement of lowest cost items.

Code of Federal Regulations, 2010 CFR

2010-07-01

... similar items to meet particular end-use requirements under the GSA stock program, special order program... functional end-use procurement needs of the various ordering agencies. Therefore, in submitting requisitions... source from which the lowest cost item can be obtained which will adequately serve the functional end-use...

Highlight report: Launch of a large integrated European in vitro toxicology project: EU-ToxRisk.

PubMed

Daneshian, Mardas; Kamp, Hennicke; Hengstler, Jan; Leist, Marcel; van de Water, Bob

2016-05-01

The integrated European project, EU-ToxRisk, proudly sees itself as "flagship" exploring new alternative-to-animal approaches to chemical safety evaluation. It promotes mechanism-based toxicity testing and risk assessment according to the principles laid down for toxicology for the twenty-first century. The project was officially launched in January 2016 with a kickoff meeting in Egmond aan Zee, the Netherlands. Over 100 scientists representing academia and industry as well as regulatory authorities attended the inaugural meeting. The project will integrate advances in in vitro and in silico toxicology, read-across methods, and adverse outcome pathways. EU-ToxRisk will continue to make use of the case study strategy deployed in SEURAT-1, a FP7 initiative ended in December 2015. Even though the development of new non-animal methods is one target of EU-ToxRisk, the project puts special emphasis on their acceptance and implementation in regulatory contexts. This €30 million Horizon 2020 project involves 38 European partners and one from the USA. EU-ToxRisk aims at the "development of a new way of risk assessment."

High-End Scientific Computing

EPA Pesticide Factsheets

EPA uses high-end scientific computing, geospatial services and remote sensing/imagery analysis to support EPA's mission. The Center for Environmental Computing (CEC) assists the Agency's program offices and regions to meet staff needs in these areas.

78 FR 64967 - Center for Scientific Review; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

....m., Crystal City Marriott, 1999 Jefferson Davis Highway, Arlington, VA 22202 which was published in... and end on November 15, 2013. The time and location remain the same. The meeting is closed to the...

78 FR 77664 - Defense Policy Board (DPB); Notice of Federal Advisory Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-24

... through the end of the meeting on January 15, the DPB will have secret through top secret (SCI) level... without disclosing secret or classified material. Committee's Designated Federal Officer or Point of...

75 FR 33576 - Tehama County Resource Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

... (RAC) will meet in Red Bluff, California. Agenda items to be covered include: (1) Introductions; (2... agenda. DATES: The meeting will be held on June 24, 2010 from 9 a.m. and end at approximately 12 p.m.... Individuals wishing to speak or propose agenda items must send their names and proposals to Randy Jero...

78 FR 78362 - National Institute for Occupational Safety and Health Personal; Notice of public meeting in...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... public commenter has spoken, whichever occurs first. ADDRESSES: First United Methodist Church, 53..., first served basis. The meeting will end at 8:30PM EST or after the last public commenter has spoken... Institute for Occupational Safety and Health Personal; Notice of public meeting in Endicott, New York AGENCY...

End-of-Life Decision Making in Palliative Care and Recommendations of the Council of Europe: Qualitative Secondary Analysis of Interviews and Observation Field Notes.

PubMed

Martins Pereira, Sandra; Fradique, Emília; Hernández-Marrero, Pablo

2018-05-01

End-of-life decisions (ELDs) are embedded in clinical, sociocultural, political, economic, and ethical concerns. In 2014, the Council of Europe (CoE) through its Committee on Bioethics launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations," aiming at improving decision-making processes and empowering professionals in making ELDs. To analyze if end-of-life decision making in palliative care (PC) is consistent with this Guide and to identify if disputed/controversial issues are part of current ELDs. Qualitative secondary analysis. Four qualitative datasets, including 44 interviews and 9 team observation field notes from previous studies with PC teams/professionals in Portugal. An analysis grid based on the abovementioned guide was created considering three dimensions: ethical and legal frameworks, decision-making process, and disputed/controversial issues. The majority of the professionals considered the ethical principle of autonomy paramount in end-of-life decision making. Justice and beneficence/nonmaleficence were also valued. Although not mentioned in the Guide, the professionals also considered other ethical principles when making ELDs, namely, responsibility, integrity, and dignity. Most of the interviewees and field notes referred to the collective interprofessional dimension of the decision-making process. Palliative sedation and the wish to hasten death were the most mentioned disputed/controversial issues. The nature, limitations, and benefits of qualitative secondary analysis are discussed. End-of-life decision-making processes made by Portuguese PC teams seem to be consistent with the guidelines of the CoE. Further research is needed about disputed/controversial issues and the actual use, effectiveness, and impact of ethical guidelines for end-of-life decision making on professionals' empowerment and for all parties involved.

Educational Reform and Educational Research: New Challenges in Linking Research, Information and Decision Making. Final Report of the International Meeting (Tokyo, Japan, September 4-14, 1995).

ERIC Educational Resources Information Center

National Inst. for Educational Research, Tokyo (Japan).

This document summarizes proceedings of a meeting held in September 1995. The purpose of the meeting was to gather educators and policymakers in order to establish criteria concerning links between educational research and decision making. Twenty participants from the following countries attended: Argentina, Australia, Bahrain, Botswana, Brazil,…

75 FR 7290 - Notice of Public Meeting, Coeur d'Alene District Resource Advisory Council Meeting and Recreation...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-18

.... The meeting will start at 8 a.m. on April 6 and end around 12 p.m. on April 7. The public comment period will be from 1 p.m. to 1:30 p.m. on April 6. The meeting will be held at the Bureau of Land Management Office, 3815 Schreiber Way, Coeur d'Alene, Idaho. FOR FURTHER INFORMATION CONTACT: Lisa Wagner...

Developing an ESIP-wide Process "Pipeline" to Extract Data-driven Stories from Compelling Agriculture and Energy Research on Climate Resilience

NASA Astrophysics Data System (ADS)

Hoebelheinrich, N. J.; Eckman, R.; Teng, W. L.; Beltz, C.

2016-12-01

The classic approach to scientific storytelling, especially for publication, is to establish the research problem, describe the potential solution and the efforts to solve the problem, and end with the results - whether "successful" or not - as the "Ta Da!" of the story. This classic approach, however, does not necessarily adapt well to the kind of storytelling that policy-making and general public end-users find more compelling, i.e., with the "Ta Da!" element of the story immediately evident. Working with the U.S. Climate Resilience Toolkit (CRT) staff, two collaborative groups of the Earth Science Information Partners (ESIP), Agriculture and Climate and Energy and Climate, have begun to assist agriculture and energy researchers in making the switch in story telling approach and, thus, get more easily understood and actionable information out to potential end-users about how the research data produced can help them. The CRT is a platform for telling stories based on both end-user needs and the data that are used to meet those needs. The ESIP groups are establishing an ESIP-wide process "pipeline," through which research results and data, with the help of group discussions and the use of CRT templates, are transformed into potential stories. When appropriate, the stories are handed off to the CRT staff to be fully developed. Two case studies that are in the process of being added to the CRT involve (1) the use of the RETScreen tool by Natural Resources Canada and (2) a fallow lands mapping project with the California Department of Water Resources to monitor ongoing drought conditions in California. These two case studies will be used to illustrate the process pipeline being developed, discuss lessons learned to date, and suggest future plans for further refining and expanding the process "pipeline."

Spatial Knowledge Infrastructures - Creating Value for Policy Makers and Benefits the Community

NASA Astrophysics Data System (ADS)

Arnold, L. M.

2016-12-01

The spatial data infrastructure is arguably one of the most significant advancements in the spatial sector. It's been a game changer for governments, providing for the coordination and sharing of spatial data across organisations and the provision of accessible information to the broader community of users. Today however, end-users such as policy-makers require far more from these spatial data infrastructures. They want more than just data; they want the knowledge that can be extracted from data and they don't want to have to download, manipulate and process data in order to get the knowledge they seek. It's time for the spatial sector to reduce its focus on data in spatial data infrastructures and take a more proactive step in emphasising and delivering the knowledge value. Nowadays, decision-makers want to be able to query at will the data to meet their immediate need for knowledge. This is a new value proposal for the decision-making consumer and will require a shift in thinking. This paper presents a model for a Spatial Knowledge Infrastructure and underpinning methods that will realise a new real-time approach to delivering knowledge. The methods embrace the new capabilities afforded through the sematic web, domain and process ontologies and natural query language processing. Semantic Web technologies today have the potential to transform the spatial industry into more than just a distribution channel for data. The Semantic Web RDF (Resource Description Framework) enables meaning to be drawn from data automatically. While pushing data out to end-users will remain a central role for data producers, the power of the semantic web is that end-users have the ability to marshal a broad range of spatial resources via a query to extract knowledge from available data. This can be done without actually having to configure systems specifically for the end-user. All data producers need do is make data accessible in RDF and the spatial analytics does the rest.

Let's Talk Critical. Development and Evaluation of a Communication Skills Training Program for Critical Care Fellows.

PubMed

Hope, Aluko A; Hsieh, S Jean; Howes, Jennifer M; Keene, Adam B; Fausto, James A; Pinto, Priya A; Gong, Michelle Ng

2015-04-01

Although expert communication between intensive care unit clinicians with patients or surrogates improves patient- and family-centered outcomes, fellows in critical care medicine do not feel adequately trained to conduct family meetings. We aimed to develop, implement, and evaluate a communication skills program that could be easily integrated into a U.S. critical care fellowship. We developed four simulation cases that provided communication challenges that critical care fellows commonly face. For each case, we developed a list of directly observable tasks that could be used by faculty to evaluate fellows during each simulation. We developed a didactic curriculum of lectures/case discussions on topics related to palliative care, end-of-life care, communication skills, and bioethics; this month-long curriculum began and ended with the fellows leading family meetings in up to two simulated cases with direct observation by faculty who were not blinded to the timing of the simulation. Our primary measures of effectiveness were the fellows' self-reported change in comfort with leading family meetings after the program was completed and the quality of the communication as measured by the faculty evaluators during the family meeting simulations at the end of the month. Over 3 years, 31 critical care fellows participated in the program, 28 of whom participated in 101 family meeting simulations with direct feedback by faculty facilitators. Our trainees showed high rates of information disclosure during the simulated family meetings. During the simulations done at the end of the month compared with those done at the beginning, our fellows showed significantly improved rates in: (1) verbalizing an agenda for the meeting (64 vs. 41%; Chi-square, 5.27; P = 0.02), (2) summarizing what will be done for the patient (64 vs. 39%; Chi-square, 6.21; P = 0.01), and (3) providing a follow-up plan (60 vs. 37%; Chi-square, 5.2; P = 0.02). More than 95% of our participants (n = 27) reported feeling "slightly" or "much" more comfortable with discussing foregoing life-sustaining treatment and leading family discussions after the month-long curriculum. A communication skills program can be feasibly integrated into a critical care training program and is associated with improvements in fellows' skills and comfort with leading family meetings.

Let’s Talk Critical. Development and Evaluation of a Communication Skills Training Program for Critical Care Fellows

PubMed Central

Hsieh, S. Jean; Howes, Jennifer M.; Keene, Adam B.; Fausto, James A.; Pinto, Priya A.; Gong, Michelle Ng

2015-01-01

Rationale: Although expert communication between intensive care unit clinicians with patients or surrogates improves patient- and family-centered outcomes, fellows in critical care medicine do not feel adequately trained to conduct family meetings. Objectives: We aimed to develop, implement, and evaluate a communication skills program that could be easily integrated into a U.S. critical care fellowship. Methods: We developed four simulation cases that provided communication challenges that critical care fellows commonly face. For each case, we developed a list of directly observable tasks that could be used by faculty to evaluate fellows during each simulation. We developed a didactic curriculum of lectures/case discussions on topics related to palliative care, end-of-life care, communication skills, and bioethics; this month-long curriculum began and ended with the fellows leading family meetings in up to two simulated cases with direct observation by faculty who were not blinded to the timing of the simulation. Our primary measures of effectiveness were the fellows’ self-reported change in comfort with leading family meetings after the program was completed and the quality of the communication as measured by the faculty evaluators during the family meeting simulations at the end of the month. Measurements and Main Results: Over 3 years, 31 critical care fellows participated in the program, 28 of whom participated in 101 family meeting simulations with direct feedback by faculty facilitators. Our trainees showed high rates of information disclosure during the simulated family meetings. During the simulations done at the end of the month compared with those done at the beginning, our fellows showed significantly improved rates in: (1) verbalizing an agenda for the meeting (64 vs. 41%; Chi-square, 5.27; P = 0.02), (2) summarizing what will be done for the patient (64 vs. 39%; Chi-square, 6.21; P = 0.01), and (3) providing a follow-up plan (60 vs. 37%; Chi-square, 5.2; P = 0.02). More than 95% of our participants (n = 27) reported feeling “slightly” or “much” more comfortable with discussing foregoing life-sustaining treatment and leading family discussions after the month-long curriculum. Conclusions: A communication skills program can be feasibly integrated into a critical care training program and is associated with improvements in fellows’ skills and comfort with leading family meetings. PMID:25741996

26 CFR 1.503(e)-3 - Effective dates.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) for taxable years ending after March 15, 1956. Thus, if during a taxable year ending before March 16, 1956, an employees' trust made a loan which meets the requirements of section 503(e), such loan will... exemption for taxable years ending after March 15, 1956, although such loan was not considered adequately...

78 FR 13695 - Notice of Public Meeting, Eastern Washington Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... Land Policy and Management Act of 1976 and the Federal Advisory Committee Act of 1972, the U.S... (EWRAC) will meet as indicated below. DATES: March 21, 2013. SUPPLEMENTARY INFORMATION: The meeting will be open to the public. It will begin at 10 a.m. and end at 2 p.m. on March 21. Members of the public...

Sensemaking of patient safety risks and hazards.

PubMed

Battles, James B; Dixon, Nancy M; Borotkanics, Robert J; Rabin-Fastmen, Barbara; Kaplan, Harold S

2006-08-01

In order for organizations to become learning organizations, they must make sense of their environment and learn from safety events. Sensemaking, as described by Weick (1995), literally means making sense of events. The ultimate goal of sensemaking is to build the understanding that can inform and direct actions to eliminate risk and hazards that are a threat to patient safety. True sensemaking in patient safety must use both retrospective and prospective approach to learning. Sensemaking is as an essential part of the design process leading to risk informed design. Sensemaking serves as a conceptual framework to bring together well established approaches to assessment of risk and hazards: (1) at the single event level using root cause analysis (RCA), (2) at the processes level using failure modes effects analysis (FMEA) and (3) at the system level using probabilistic risk assessment (PRA). The results of these separate or combined approaches are most effective when end users in conversation-based meetings add their expertise and knowledge to the data produced by the RCA, FMEA, and/or PRA in order to make sense of the risks and hazards. Without ownership engendered by such conversations, the possibility of effective action to eliminate or minimize them is greatly reduced.

Sensemaking of Patient Safety Risks and Hazards

PubMed Central

Battles, James B; Dixon, Nancy M; Borotkanics, Robert J; Rabin-Fastmen, Barbara; Kaplan, Harold S

2006-01-01

In order for organizations to become learning organizations, they must make sense of their environment and learn from safety events. Sensemaking, as described by Weick (1995), literally means making sense of events. The ultimate goal of sensemaking is to build the understanding that can inform and direct actions to eliminate risk and hazards that are a threat to patient safety. True sensemaking in patient safety must use both retrospective and prospective approach to learning. Sensemaking is as an essential part of the design process leading to risk informed design. Sensemaking serves as a conceptual framework to bring together well established approaches to assessment of risk and hazards: (1) at the single event level using root cause analysis (RCA), (2) at the processes level using failure modes effects analysis (FMEA) and (3) at the system level using probabilistic risk assessment (PRA). The results of these separate or combined approaches are most effective when end users in conversation-based meetings add their expertise and knowledge to the data produced by the RCA, FMEA, and/or PRA in order to make sense of the risks and hazards. Without ownership engendered by such conversations, the possibility of effective action to eliminate or minimize them is greatly reduced. PMID:16898979

Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria

PubMed Central

Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

2017-01-01

End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees’ roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery. PMID:28344984

Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria.

PubMed

Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

2016-11-01

End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees' roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery.

Preparations for Meeting New York and Connecticut MTBE Bans

EIA Publications

2003-01-01

In response to a Congressional request, the Energy Information Administration examined the progress being made to meet the bans on the use of methyl tertiary butyl ether (MTBE) being implemented in New York and Connecticut at the end of 2003.

Defense.gov Special Report: Travels with Carter - January 2013

Science.gov Websites

in a bilateral meeting with Indian defense officials during a six-day international trip that ended last night. Story Carter Meets with Jordanian Leaders, Praises U.S. Troops On the final leg of his six

XII Recontres De Blois

NASA Technical Reports Server (NTRS)

Kaluzienski, Louis (Technical Monitor); Forman, William

2004-01-01

In the initial awarding of the grant, we had difficulty phasing our proposed support of graduate students, postdoctoral fellows and young US scientists with the meeting schedule and the grant cycle. Initially, the grant arrived too late to support the meeting. The following year, a combination of the renewal process and the meeting announcement prevented us from announcing the support opportunity sufficiently in advance to allow us to make awards and provide support. As described in the initial proposal, the Moriond and Blois meetings are a unique opportunity for younger researchers to make oral presentations of their work at an international venue. As noted above, the phasing of meetings combined with the difficulty of arranging foreign travel for scientists at other institutions precluded the possibility of supporting the proposed meetings and providing young US scientists and post-doctoral fellows support to attend these meetings.

Using Deep Learning Model for Meteorological Satellite Cloud Image Prediction

NASA Astrophysics Data System (ADS)

Su, X.

2017-12-01

A satellite cloud image contains much weather information such as precipitation information. Short-time cloud movement forecast is important for precipitation forecast and is the primary means for typhoon monitoring. The traditional methods are mostly using the cloud feature matching and linear extrapolation to predict the cloud movement, which makes that the nonstationary process such as inversion and deformation during the movement of the cloud is basically not considered. It is still a hard task to predict cloud movement timely and correctly. As deep learning model could perform well in learning spatiotemporal features, to meet this challenge, we could regard cloud image prediction as a spatiotemporal sequence forecasting problem and introduce deep learning model to solve this problem. In this research, we use a variant of Gated-Recurrent-Unit(GRU) that has convolutional structures to deal with spatiotemporal features and build an end-to-end model to solve this forecast problem. In this model, both the input and output are spatiotemporal sequences. Compared to Convolutional LSTM(ConvLSTM) model, this model has lower amount of parameters. We imply this model on GOES satellite data and the model perform well.

SU-F-T-225: Is It Time to Have Pre-Configured Therapeutic Beams Available in Commercial Treatment Planning Systems?

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

Ding, G

Purpose: Commissioning radiation beams requires considerable effort to obtain the beam data for beam configuration in a commercial treatment planning system. With the advances in technology, the manufacturer of accelerators now has the ability to adjust radiation beam parameters to meet pre-determined specifications with high precision. This study aims to illustrate the feasibility of making pre-configured radiation beams available in commercial treatment planning systems. Methods: In recent years, Varian has made a set of measured beam data from the TrueBeam accelerator available to users. Although the beam data are provided as “suggestive data” without warranty, the commissioned data measured bymore » users have been shown to be in excellent agreement with the data set provided when the beams from the installed Linacs were adjusted to meet the beam specifications. An unofficial survey among Varian Linac TrueBeam users shows that the suggestive data set has been used with validation by users in some clinics. This indicates that radiation beams from a specified Linac can be standardized and pre-configured in a treatment planning system. Results: Two newly installed Varian TrueBeam accelerators at two different centers were examined in which one set of commissioned beam data was obtained from measurements performed by an independent physics consulting company and the other was measured by local physicists in the department. All beams from both accelerators were tuned to meet the manufacturer’s specifications. Discrepancies of less than 1% were found between the commissioned beam data from both accelerators and the suggestive data set provided by Varian. Conclusion: It may be feasible that radiation beams can be pre-configured in commercial treatment planning systems. The radiation beam users will perform the beam validation and end-to-end tests instead of configuring beams. This framework can increase both the efficiency and the accuracy in commercial radiation treatment planning systems.« less

78 FR 79456 - Government-Wide Travel Advisory Committee (GTAC); Public Advisory Committee Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-30

... purpose of the GTAC is to conduct public meetings, submit reports and to make recommendations to existing... vehicles) and sustainability of federal travel. Meeting Access: The meeting is open to the public via...

Stop wasting valuable time.

PubMed

Mankins, Michael C

2004-09-01

Companies routinely squander their most precious resource--the time of their top executives. In the typical company, senior executives meet to discuss strategy for only three hours a month. And that time is poorly spent in diffuse discussions never even meant to result in any decision. The price of misused executive time is high. Delayed strategic decisions lead to overlooked waste and high costs, harmful cost reductions, missed new product and business development opportunities, and poor long-term investments. But a few deceptively simple changes in the way top management teams set agendas and structure team meetings can make an enormous difference in their effectiveness. Efficient companies use seven techniques to make the most of the time their top executives spend together. They keep strategy meetings separate from meetings focused on operations. They explore issues through written communications before they meet, so that meeting time is used solely for reaching decisions. In setting agendas, they rank the importance of each item according to its potential to create value for the company. They seek to get issues not only on, but also off, the agenda quickly, keeping to a clear implementation timetable. They make sure they have considered all viable alternatives before deciding a course of action. They use a common language and methodology for reaching decisions. And they insist that, once a decision is made, they stick to it--that there be no more debate or mere grudging compliance. Once leadership teams get the basics right, they can make more fundamental changes in the way they work together. Strategy making can be transformed from a series of fragmented and unproductive events into a streamlined, effective, and continuing management dialogue. In companies that have done this, management meetings aren't a necessary evil; they're a source of real competitive advantage.

Implementation of a Nurse-Led Family Meeting in a Neuroscience Intensive Care Unit.

PubMed

Wu, Huixin; Ren, Dianxu; Zinsmeister, Glenn R; Zewe, Gretchen E; Tuite, Patricia K

2016-01-01

The aims of this study were to develop, implement, and evaluate the impact of early intensive care unit (ICU) nurse-led family meetings on nurse-family communication, family decision making, and satisfaction of family members. Intensive care unit nurses are in an ideal position to meet family needs, and family members may cope better with the crisis of an ICU admission if consistent honest information is provided by nurses; however, there are no early ICU family meetings led by bedside nurses. This quality improvement project was implemented in a 10-bed neuroscience ICU over a 3-month period. A convenience sample of 23 nurses participated in the project. Following development of a communication protocol to facilitate nurse-led meetings, the nurses received education and then implemented the protocol. Thirty-one family members participated in the project. Family members were surveyed before and after the meetings. Mean meeting time was 26 (SD, 14) minutes. Following implementation of the meetings, findings demonstrated that families felt that communication improved (P = .02 and P = .008), they had appropriate information for decision making allowing them to feel in control (P = .002), and there was an increase in family satisfaction (P = .001). Early ICU nurse-led family meetings were feasible, improved communication between ICU nurses and family members, facilitated decision making in ICU families, and increased satisfaction of family members.

45 CFR 503.25 - Announcement of meetings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Announcement of meetings. 503.25 Section 503.25... REGULATIONS Government in the Sunshine Regulations § 503.25 Announcement of meetings. (a) The Commission meets... than eight days before the beginning of a meeting of the Commission, the Commission will make available...

Making Information Useful: Engagement in the Sustained National Climate Assessment Process

NASA Astrophysics Data System (ADS)

Lough, G. C.; Cloyd, E.

2015-12-01

Creation of actionable information requires that the producers of that information understand the needs of the intended users and decision makers. To that end, the U.S. Global Change Research Program's sustained National Climate Assessment process includes a focus on engaging users through an inclusive, broad-based, and ongoing process. Such a process provides opportunities for scientific experts and decision makers to share knowledge about the climate-related issues, impacts, and potential response actions that are most important in a particular region or sector. Such a process is also highly transparent in order to produce results that are credible, salient, and legitimate for both scientists and decision makers, ultimately making the results extremely useful. To implement these principles, USGCRP implements a broad-based engagement strategy that invites participation from users and stakeholder communities and considers methods for communicating with potential users at every step. The strategy elicits contributions to help shape the framing of the assessment process and products, improve the transparency of the process, and increase the utility of the final information. Specific user inputs are gathered through workshops, public comment opportunities, town hall meetings, presentations, requests for information, submitted documents, and open meetings. Further, a network of contributors self-organizes around topics of interest to extend assessment activities to a wider range of user groups. Here, we describe the outcomes of these innovations in assessment engagement and identify clear successes, notable surprises, future evaluation needs, and areas for new ideas.

Uncharted terrain: preference construction at the end of life.

PubMed

White, Mary T

2014-01-01

Respect for patients' self-determination has long been considered central to efforts to improve end-of-life care, yet efforts to promote advance directives or engage patients in end-of-life discussions are often unsuccessful. In this article, I contend that this is because the shared decision-making approach typically used in healthcare assumes patients' capacity to make rational choices, which is not always possible in end-of-life decisions. Drawing on decision theory, behavioral psychology, and related studies of end-of-life care, I present a growing body of evidence that suggests the novelty, complexity, and uncertainty of end-of-life circumstances make rational and stable preferences difficult to establish. I argue that an effective decision-making approach for the terminally ill must recognize and respond to the unique characteristics of end-of-life choices, including their nonrational dimensions. I conclude with a description of an initiative that appears to do so, resulting in increased patients' satisfaction. Copyright 2014 The Journal of Clinical Ethics. All rights reserved.

1. DEDICATION PLAQUE ENTITLED FIVE MILE VIADUCT ON NORTH END ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. DEDICATION PLAQUE ENTITLED FIVE MILE VIADUCT ON NORTH END OF BRIDGE. - U.S. Route 78 Bridge (Five Mile Viaduct), U.S. Route 78 spanning CSX Railroad & Meeting Street (S-39), North Charleston, Charleston County, SC

48 CFR 52.225-2 - Buy American Act Certificate.

Code of Federal Regulations, 2010 CFR

2010-10-01

... listed in paragraph (b) of this provision, is a domestic end product and that for other than COTS items... COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.” The terms “commercially available off-the-shelf (COTS) item, ” “component,” “domestic end...

A peer mentoring group for junior clinician educators: four years' experience.

PubMed

Lord, Julie A; Mourtzanos, Emmanuel; McLaren, Kimberly; Murray, Suzanne B; Kimmel, Ryan J; Cowley, Deborah S

2012-03-01

To study the effect of a peer mentoring group (PMG). Six junior clinician educator faculty and one senior faculty at the University of Washington Medical Center's Department of Psychiatry formed a PMG in 2006. The PMG had 30 meetings during 2006-2010. Group format, goals, and meeting agendas were determined solely by participants. Feedback about positive and negative outcomes of participation in the PMG was determined by open-ended response to three sets of questions; qualitative analysis was performed by an outside research consultant. Program evaluation revealed benefits and undesirable or unintended outcomes. Reported benefits were increased workplace satisfaction; improved social connection; increased professional productivity and personal growth/development through accountability, collaboration, mutual learning, support, and information sharing; synergy, collaboration, and diversity of thought; increased involvement in professional activities; opportunity for peer discussions in a safe environment; and increased accountability and motivation. Undesirable or unintentional outcomes were exclusivity, lack of hierarchy, scheduling of meetings, absence of an intentional curriculum, diverse and competing interests, personal-professional enmeshment, and occasional loss of focus due to overemphasis on personal matters. Every member of the PMG was retained, and scholarly productivity increased, as did collaboration with other group members. Participants in this PMG experienced qualitative benefits and perceived advantages in career advancement and scholarly productivity. Negative consequences did not deter participation in the PMG or outweigh benefits. The self-sufficient and low-cost structure makes it particularly portable.

78 FR 64961 - Center for Scientific Review; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

... Charles Street, Baltimore, MD 21201 which was published in the Federal Register on September 9, 2013, 78 FR 174 pgs. 55086-55087. The meeting will start on November 20, 2013 at 8:00 a.m. and will end on...

The anatomy of clinical decision-making in multidisciplinary cancer meetings

PubMed Central

Soukup, Tayana; Petrides, Konstantinos V.; Lamb, Benjamin W.; Sarkar, Somita; Arora, Sonal; Shah, Sujay; Darzi, Ara; Green, James S. A.; Sevdalis, Nick

2016-01-01

Abstract In the UK, treatment recommendations for patients with cancer are routinely made by multidisciplinary teams in weekly meetings. However, their performance is variable. The aim of this study was to explore the underlying structure of multidisciplinary decision-making process, and examine how it relates to team ability to reach a decision. This is a cross-sectional observational study consisting of 1045 patient reviews across 4 multidisciplinary cancer teams from teaching and community hospitals in London, UK, from 2010 to 2014. Meetings were chaired by surgeons. We used a validated observational instrument (Metric for the Observation of Decision-making in Cancer Multidisciplinary Meetings) consisting of 13 items to assess the decision-making process of each patient discussion. Rated on a 5-point scale, the items measured quality of presented patient information, and contributions to review by individual disciplines. A dichotomous outcome (yes/no) measured team ability to reach a decision. Ratings were submitted to Exploratory Factor Analysis and regression analysis. The exploratory factor analysis produced 4 factors, labeled “Holistic and Clinical inputs” (patient views, psychosocial aspects, patient history, comorbidities, oncologists’, nurses’, and surgeons’ inputs), “Radiology” (radiology results, radiologists’ inputs), “Pathology” (pathology results, pathologists’ inputs), and “Meeting Management” (meeting chairs’ and coordinators’ inputs). A negative cross-loading was observed from surgeons’ input on the fourth factor with a follow-up analysis showing negative correlation (r = −0.19, P < 0.001). In logistic regression, all 4 factors predicted team ability to reach a decision (P < 0.001). Hawthorne effect is the main limitation of the study. The decision-making process in cancer meetings is driven by 4 underlying factors representing the complete patient profile and contributions to case review by all core disciplines. Evidence of dual-task interference was observed in relation to the meeting chairs’ input and their corresponding surgical input into case reviews. PMID:27310981

Usability test of a hand exoskeleton for activities of daily living: an example of user-centered design.

PubMed

Almenara, Maria; Cempini, Marco; Gómez, Cristina; Cortese, Mario; Martín, Cristina; Medina, Josep; Vitiello, Nicola; Opisso, Eloy

2017-01-01

(1) To assess a robotic device (Handexos) during the design process with regard to usability, end user satisfaction and safety, (2) to determine whether Handexos can improve the activities of daily living (ADLs) of spinal cord injury (SCI) patients and stroke patients with upper-limb dysfunction. During a 2-year development stage of the device, a total of 37 participants (aged 22-68), 28 clinicians (experts) and nine patients with SCI or stroke (end users) were included in a user-centered design process featuring usability tests. They performed five grasps wearing the device. The assessments were obtained at the end of the session by filling out a questionnaire and making suggestions. The experts' opinion was that the modified device was an improvement over the preliminary version, although this was not reflected in the scores. Whereas end user scores for comfort, grasp, performance and safety were above the sufficiency threshold, the scores for year 2 were lower than those for year 1. The findings demonstrate that although Handexos meets the initial functional requirements and underlines the potential for assisting SCI and post-stroke subjects in ADLs, several aspects such as mechanical complexity and low adaptability to different hand sizes need to be further addressed. Implications for Rehabilitation Wearable robotics devices could improve the activities of daily living in patients with spinal cord injury or stroke. They could be a tool for rehabilitation of the upper limb. Further usability tests to improve this type of tools are recommended.

A Review of Palliative and Hospice Care in the Context of Islam: Dying with Faith and Family.

PubMed

Mendieta, Maximiliano; Buckingham, Robert W

2017-11-01

By starting to understand Muslim culture, we can seek common ground with Islamic culture within the American experience and bridge opportunities for better palliative and hospice care here and in Middle Eastern countries. The United States, Canada, and Europe are education hubs for Middle Eastern students, creating an opportunity for the palliative and hospice care philosophy to gain access by proxy to populations of terminally ill patients who can benefit from end-of-life care. The aim was to assess the state of research and knowledge about palliative and hospice care within the context of Muslim culture and religion. Within the guide of the key search terms, we learned that at a glance, over 100 articles meet the search criteria, but after a closer inspection, only a portion actually contributed knowledge to the literature. This confirmed the need for research in this vein. More importantly, we posit that once the layers of culture, religion, norms, and nationality are removed, human beings share a kinship based on family, spirituality, death and dying, and fear of pain. This is evident when we compare the Middle Eastern end-of-life experience with the western end-of-life care. A true opportunity to make a lasting impact at the patient level exists for palliative and hospice care researchers if we seek to understand, gain knowledge, and respect Muslim culture and Islamic issues at the end of life.

Ethical challenges and solutions regarding delirium studies in palliative care.

PubMed

Sweet, Lisa; Adamis, Dimitrios; Meagher, David J; Davis, Daniel; Currow, David C; Bush, Shirley H; Barnes, Christopher; Hartwick, Michael; Agar, Meera; Simon, Jessica; Breitbart, William; MacDonald, Neil; Lawlor, Peter G

2014-08-01

Delirium occurs commonly in settings of palliative care (PC), in which patient vulnerability in the unique context of end-of-life care and delirium-associated impairment of decision-making capacity may together present many ethical challenges. Based on deliberations at the Studies to Understand Delirium in Palliative Care Settings (SUNDIPS) meeting and an associated literature review, this article discusses ethical issues central to the conduct of research on delirious PC patients. Together with an analysis of the ethical deliberations at the SUNDIPS meeting, we conducted a narrative literature review by key words searching of relevant databases and a subsequent hand search of initially identified articles. We also reviewed statements of relevance to delirium research in major national and international ethics guidelines. Key issues identified include the inclusion of PC patients in delirium research, capacity determination, and the mandate to respect patient autonomy and ensure maintenance of patient dignity. Proposed solutions include designing informed consent statements that are clear, concise, and free of complex phraseology; use of concise, yet accurate, capacity assessment instruments with a minimally burdensome schedule; and use of PC friendly consent models, such as facilitated, deferred, experienced, advance, and proxy models. Delirium research in PC patients must meet the common standards for such research in any setting. Certain features unique to PC establish a need for extra diligence in meeting these standards and the employment of assessments, consent procedures, and patient-family interactions that are clearly grounded on the tenets of PC. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Ethics of End of Life Decisions in Pediatrics: A Narrative Review of the Roles of Caregivers, Shared Decision-Making, and Patient Centered Values.

PubMed

Santoro, Jonathan D; Bennett, Mariko

2018-04-26

Background: This manuscript reviews unique aspects of end of life decision-making in pediatrics. Methods: A narrative literature review of pediatric end of life issues was performed in the English language. Results: While a paternalistic approach is typically applied to children with life-limiting medical prognoses, the cognitive, language, and physical variability in this patient population is wide and worthy of review. In end of life discussions in pediatrics, the consideration of a child’s input is often not reviewed in depth, although a shared decision-making model is ideal for use, even for children with presumed limitations due to age. This narrative review of end of life decision-making in pediatric care explores nomenclature, the introduction of the concept of death, relevant historical studies, limitations to the shared decision-making model, the current state of end of life autonomy in pediatrics, and future directions and needs. Although progress is being made toward a more uniform and standardized approach to care, few non-institutional protocols exist. Complicating factors in the lack of guidelines include the unique facets of pediatric end of life care, including physical age, paternalism, the cognitive and language capacity of patients, subconscious influencers of parents, and normative values of death in pediatrics. Conclusions: Although there have been strides in end of life decision-making in pediatrics, further investigation and research is needed in this field.

Enabling Technologies for Characterizing Exoplanet Systems with Exo-C

NASA Astrophysics Data System (ADS)

Cahoy, Kerri Lynn; Belikov, Ruslan; Stapelfeldt, Karl R.; Chakrabarti, Supriya; Trauger, John T.; Serabyn, Eugene; McElwain, Michael W.; Pong, Christopher M.; Brugarolas, Paul

2015-01-01

The Exoplanet Science and Technology Definition Team's Internal Coronagraph mission design, called 'Exo-C', utilizes several technologies that have advanced over the past decade with support from the Exoplanet Exploration Program. Following the flow of photons through the telescope, the science measurement is enabled by (i) a precision pointing system to keep the target exoplanet system precisely positioned on the detector during the integration time, (ii) high-performance coronagraphs to block the parent star's light so that the planet's reflected light can be detected, (iii) a wavefront control system to compensate for any wavefront errors such as those due to thermal or mechanical deformations in the optical path, especially errors with high spatial frequencies that could cause contrast-reducing speckles, and (iv) an integral field spectrograph (IFS) that provides moderate resolution spectra of the target exoplanets, permitting their characterization and comparison with models and other data sets. Technologies such as the wavefront control system and coronagraphs will also benefit from other funded efforts in progress, such as the Wide Field Infrared Survey Telescope Astrophysics Focused Telescope Assets (WFIRST-AFTA) program. Similarly, the Exo-C IFS will benefit from the Prototype Imaging Spectrograph for Coronagraphic Exoplanet Studies (PISCES) demonstration. We present specific examples for each of these technologies showing that the state of the art has advanced to levels that will meet the overall scientific, cost, and schedule requirements of the Exo-C mission. These capabilities have matured with testbed and/or ground-telescope demonstrations and have reached a technological readiness level (TRL) that supports their inclusion in the baseline design for potential flight at the end of this decade. While additional work remains to build and test flight-like components (that concurrently meet science as well as size, weight, power, and environmental requirements) and to integrate these subsystems together for a hardware-in-the-loop end-to-end demonstration, the overall readiness of the suite of enabling technologies makes a compelling case for Exo-C among the exoplanet direct imaging mission candidates.

Prevalence and factors of intensive care unit conflicts: the conflicus study.

PubMed

Azoulay, Elie; Timsit, Jean-François; Sprung, Charles L; Soares, Marcio; Rusinová, Katerina; Lafabrie, Ariane; Abizanda, Ricardo; Svantesson, Mia; Rubulotta, Francesca; Ricou, Bara; Benoit, Dominique; Heyland, Daren; Joynt, Gavin; Français, Adrien; Azeivedo-Maia, Paulo; Owczuk, Radoslaw; Benbenishty, Julie; de Vita, Michael; Valentin, Andreas; Ksomos, Akos; Cohen, Simon; Kompan, Lidija; Ho, Kwok; Abroug, Fekri; Kaarlola, Anne; Gerlach, Herwig; Kyprianou, Theodoros; Michalsen, Andrej; Chevret, Sylvie; Schlemmer, Benoît

2009-11-01

Many sources of conflict exist in intensive care units (ICUs). Few studies recorded the prevalence, characteristics, and risk factors for conflicts in ICUs. To record the prevalence, characteristics, and risk factors for conflicts in ICUs. One-day cross-sectional survey of ICU clinicians. Data on perceived conflicts in the week before the survey day were obtained from 7,498 ICU staff members (323 ICUs in 24 countries). Conflicts were perceived by 5,268 (71.6%) respondents. Nurse-physician conflicts were the most common (32.6%), followed by conflicts among nurses (27.3%) and staff-relative conflicts (26.6%). The most common conflict-causing behaviors were personal animosity, mistrust, and communication gaps. During end-of-life care, the main sources of perceived conflict were lack of psychological support, absence of staff meetings, and problems with the decision-making process. Conflicts perceived as severe were reported by 3,974 (53%) respondents. Job strain was significantly associated with perceiving conflicts and with greater severity of perceived conflicts. Multivariate analysis identified 15 factors associated with perceived conflicts, of which 6 were potential targets for future intervention: staff working more than 40 h/wk, more than 15 ICU beds, caring for dying patients or providing pre- and postmortem care within the last week, symptom control not ensured jointly by physicians and nurses, and no routine unit-level meetings. Over 70% of ICU workers reported perceived conflicts, which were often considered severe and were significantly associated with job strain. Workload, inadequate communication, and end-of-life care emerged as important potential targets for improvement.

Theories of Health Care Decision Making at the End of Life: A Meta-Ethnography.

PubMed

Kim, Kyounghae; Heinze, Katherine; Xu, Jiayun; Kurtz, Melissa; Park, Hyunjeong; Foradori, Megan; Nolan, Marie T

2017-08-01

The aim of this meta-ethnography is to appraise the types and uses of theories relative to end-of-life decision making and to develop a conceptual framework to describe end-of-life decision making among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS) and their caregivers or providers. We used PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases to extract English-language articles published between January 2002 and April 2015. Forty-three articles were included. The most common theories included decision-making models ( n = 14) followed by family-centered ( n = 11) and behavioral change models ( n = 7). A conceptual framework was developed using themes including context of decision making, communication and negotiation of decision making, characteristics of decision makers, goals of decision making, options and alternatives, and outcomes. Future research should enhance and apply these theories to guide research to develop patient-centered decision-making programs that facilitate informed and shared decision making at the end of life among patients with advanced illness and their caregivers.

Supporting end of life decision making: Case studies of relational closeness in supported decision making for people with severe or profound intellectual disability.

PubMed

Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

2017-11-01

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions. Five people with severe or profound intellectual disability's experiences of supported decision making were examined. This article is particularly focused on one participant's experiences at the end of his life. All five case studies identified that supporters were most effective in providing decision-making support for participants when they were relationally close to the person and had knowledge of the person's life story, particularly in relation to events that demonstrated preference. Findings from this study provide new understandings of supported decision making for people with severe or profound intellectual disability and have particular relevance for supporting decision making at the end of life. © 2017 John Wiley & Sons Ltd.

MEMS-based platforms for mechanical manipulation and characterization of cells

NASA Astrophysics Data System (ADS)

Pan, Peng; Wang, Wenhui; Ru, Changhai; Sun, Yu; Liu, Xinyu

2017-12-01

Mechanical manipulation and characterization of single cells are important experimental techniques in biological and medical research. Because of the microscale sizes and highly fragile structures of cells, conventional cell manipulation and characterization techniques are not accurate and/or efficient enough or even cannot meet the more and more demanding needs in different types of cell-based studies. To this end, novel microelectromechanical systems (MEMS)-based technologies have been developed to improve the accuracy, efficiency, and consistency of various cell manipulation and characterization tasks, and enable new types of cell research. This article summarizes existing MEMS-based platforms developed for cell mechanical manipulation and characterization, highlights their specific design considerations making them suitable for their designated tasks, and discuss their advantages and limitations. In closing, an outlook into future trends is also provided.

Eating For Two: How Metabolism Establishes Interspecies Interactions in the Gut

PubMed Central

Fischbach, Michael A.; Sonnenburg, Justin L.

2011-01-01

In bacterial communities, ‘tight economic times’ are the norm. Of the many challenges bacteria face in making a living, perhaps none are more important than generating energy, maintaining redox balance, and acquiring carbon and nitrogen to synthesize primary metabolites. The ability of bacteria to meet these challenges depends heavily on the rest of their community. Indeed, the most fundamental way in which bacteria communicate is by importing the substrates for metabolism and exporting metabolic end products. As an illustration of this principle, we will travel down a carbohydrate catabolic pathway common to many species of Bacteroides, highlighting the interspecies interactions established (often inevitably) at its key steps. We also discuss the metabolic considerations in maintaining the stability of host-associated microbial communities. PMID:22018234

Concentrating Solar Power Fact Sheet

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

None

2015-12-01

This fact sheet is an overview of the Concentrating Solar Power (CSP) subprogram at the U.S. Department of Energy SunShot Initiative. CSP is a dispatchable, renewable energy option that uses mirrors to focus and concentrate sunlight onto a receiver, from which a heat transfer fluid carries the intense thermal energy to a power block to generate electricity. CSP systems can store solar energy to be used when the sun is not shining. It will help meet the nation’s goal of making solar energy fully cost-competitive with other energy sources by the end of the decade. Worldwide, CSP activity is rapidlymore » scaling, with approximately 10 gigawatts (GW) in various stages of operation or development. In the United States alone, nearly 2 GW of CSP are in operation.« less

78 FR 66372 - Center for Scientific Review; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

... September 05, 2013, 78 FR 54664-54665. The meeting will be held at the Hotel Monaco Baltimore, 2 North Charles Street, Baltimore, MD 21201 on November 22, 2013, starting at 08:00 a.m. and ending at 07:00 p.m...

Health Care Professionals' Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study.

PubMed

Milberg, Anna; Torres, Sandra; Ågård, Pernilla

2016-01-01

The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals' understandings of cross-cultural interaction during end-of-life care. Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis. The health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, 'unusual' emotional and pain expressions, the expectation that these patients' families would be 'different' and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting "the unknown". In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients. The study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as "the unknown" since they anticipate a variety of challenges and do not seem confident enough that they can provide good quality care when cross-cultural interaction is at stake.

Communication practices in physician decision-making for an unstable critically ill patient with end-stage cancer.

PubMed

Mohan, Deepika; Alexander, Stewart C; Garrigues, Sarah K; Arnold, Robert M; Barnato, Amber E

2010-08-01

Shared decision-making has become the standard of care for most medical treatments. However, little is known about physician communication practices in the decision making for unstable critically ill patients with known end-stage disease. To describe communication practices of physicians making treatment decisions for unstable critically ill patients with end-stage cancer, using the framework of shared decision-making. Analysis of audiotaped encounters between physicians and a standardized patient, in a high-fidelity simulation scenario, to identify best practice communication behaviors. The simulation depicted a 78-year-old man with metastatic gastric cancer, life-threatening hypoxia, and stable preferences to avoid intensive care unit (ICU) admission and intubation. Blinded coders assessed the encounters for verbal communication behaviors associated with handling emotions and discussion of end-of-life goals. We calculated a score for skill at handling emotions (0-6) and at discussing end of life goals (0-16). Twenty-seven hospital-based physicians. Independent variables included physician demographics and communication behaviors. We used treatment decisions (ICU admission and initiation of palliation) as a proxy for accurate identification of patient preferences. Eight physicians admitted the patient to the ICU, and 16 initiated palliation. Physicians varied, but on average demonstrated low skill at handling emotions (mean, 0.7) and moderate skill at discussing end-of-life goals (mean, 7.4). We found that skill at discussing end-of-life goals was associated with initiation of palliation (p = 0.04). It is possible to analyze the decision making of physicians managing unstable critically ill patients with end-stage cancer using the framework of shared decision-making.

From users involvement to users' needs understanding: a case study.

PubMed

Niès, Julie; Pelayo, Sylvia

2010-04-01

Companies developing and commercializing Healthcare IT applications may decide to involve the users in the software development lifecycle in order to better understand the users' needs and to optimize their products. Unfortunately direct developers-users dialogues are not sufficient to ensure a proper understanding of the users' needs. It is also necessary to involve human factors specialists to analyze the users' expression of their needs and to properly formalize the requirements for design purposes. The objective of this paper is to present a case study reporting the collaborative work between HF experts and a company developing and commercializing a CPOE. This study shows how this collaboration helps resolve the limits of direct users involvement and usual problems pertaining to users' needs description and understanding. The company participating in the study has implemented a procedure to convene regular meetings allowing direct exchanges between the development team and users' representatives. Those meetings aim at getting users' feedbacks on the existing products and at validating further developments. In parallel with usual HF methods supporting the analysis of the work system (onsite observations followed by debriefing interviews) and the usability evaluation of the application (usability inspection and usability tests), HF experts took the opportunity of the meetings organized by the company to collect, re-interpret and re-formulate the needs expressed by the users. The developers perceive the physicians' requirements concerning the display of the patient's list of medication as contradictory. In a previous meeting round the users had required a detailed view of the medication list against the synthesized existing one. Once this requirement satisfied, the users participating in the current meeting round require a synthesized view against the existing detailed one. The development team is unable to understand what they perceive as a reverse claim. Relying on a cognitive analysis of the physicians' decision making concerning the patient's treatment, the HF experts help re-formulate the physicians' cognitive needs in terms of synthesized/detailed display of the medication list depending on the stage of the decision making process. This led to an astute re-engineering of the application allowing the physicians to easily navigate back and forth between the synthesized and detailed views depending on the progress of their decision making. This study demonstrates that the integration of users' representatives in the software lifecycle is a good point for the end users. But it remains insufficient to resolve the complex usability problems of the system. Such solutions require the integration of HF expertise. Moreover, such an involvement of HF experts may generate benefits in terms of reduction of (i) the number of iterative developments and (ii) the users' training costs. (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Quantifying Japanese Residents' Preferences for Public Meetings in Watershed Decision-Making Process

ERIC Educational Resources Information Center

Sakagami, Masaji; Ohno, Tomohiko; Tanaka, Takuya

2010-01-01

In this article, we quantified Japanese residents' potential preferences for public participation, specifically public meetings, concerning regional environmental issues in Yodo River watershed decision-making process. We conducted a choice experiments (CE) survey in the Yodo River watershed in Japan. Our findings confirmed that residents assign a…

The Family Meeting in Palliative Care: Role of the Oncology Nurse.

PubMed

Glajchen, Myra; Goehring, Anna

2017-12-01

To describe the family meeting in palliative and end-of-life care, highlighting the role of the oncology nurse. Specific strategies will be provided for pre-meeting preparation, communication, and follow-up activities. A conceptual framework drawn from family and communication theory, and best practices from the clinical, research, nursing, and palliative care literature. Working with patients and families is complex, but the family meeting is a promising tool and a potential quality indicator in palliative care. The nurse is well positioned to participate fully in every aspect of the family meeting. Copyright © 2017 Elsevier Inc. All rights reserved.

Quality assessment of decision-making in colorectal cancer multidisciplinary meetings.

PubMed

Seretis, Charalampos; Mankotia, Rajnish; Goonetilleke, Kolitha; Rawstorne, Edward

2014-01-01

The quality of decision-making in the colorectal multidisciplinary team (MDT) meetings can significantly affect the quality of care delivered to patients with colorectal cancer. We performed a prospective study to assess the quality of the MDT meetings in a specialized colorectal unit using an externally observational validated tool. An externally validated observational tool, the Colorectal Multidisciplinary Team Metric for Observation of Decision-Making (cMDT-MODe), was used to assess the quality of clinical decision-making in 64 cases. Although case history information presented by the responsible surgeon was rated high (4.4/5), the quality of radiological and histopathological information regarding each patient's case which was available at the time was less adequate, scoring 3.9/5 and 3.8/5, respectively. Moreover, the precise knowledge of patients' personal views and circumstances was a field requiring further improvement. In a general overview however, the quality and extent of the available information enabled the MDT to provide a clear recommendation regarding the patients' treatment plans in 87.5% of the cases. The cMDT-MODe tool can be used to prospectively audit the quality of clinical decision-making in the colorectal MDT meetings and highlight the fields of potential improvement.

Making Meetings Work Better.

ERIC Educational Resources Information Center

Standke, Linda

1978-01-01

Focusing on the increased use by trainers of off-site facilities for employee training meetings, this article looks at some improvements and the expanding market in the meeting site industry. It also highlights emerging trends in the industry and covers the growth of meeting planning into a profession. (EM)

43 CFR 418.21 - Diversion of Truckee River water to Lahontan Reservoir, July through December.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Adjustments to Lahontan Reservoir Storage Targets table and § 418.22. Diversions shall be started to achieve the end-of-month storage targets listed in the table in § 418.22 and will be discontinued when storage is forecast to meet or exceed the end-of-month storage targets at the end of the month. Diversions...

43 CFR 418.21 - Diversion of Truckee River water to Lahontan Reservoir, July through December.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Adjustments to Lahontan Reservoir Storage Targets table and § 418.22. Diversions shall be started to achieve the end-of-month storage targets listed in the table in § 418.22 and will be discontinued when storage is forecast to meet or exceed the end-of-month storage targets at the end of the month. Diversions...

43 CFR 418.21 - Diversion of Truckee River water to Lahontan Reservoir, July through December.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Adjustments to Lahontan Reservoir Storage Targets table and § 418.22. Diversions shall be started to achieve the end-of-month storage targets listed in the table in § 418.22 and will be discontinued when storage is forecast to meet or exceed the end-of-month storage targets at the end of the month. Diversions...

78 FR 3041 - Notice of Sunshine Act Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-15

..., 2013--Tentative Thursday, January 31, 2013 9:00 a.m. Briefing on Public Participation in NRC Regulatory Decision-Making (Public Meeting) (Contact: Lance Rakovan, 301-415-2589). This meeting will be webcast live...

Residential End Uses: Historical Efficiency Data and Incremental Installed Costs for Efficiency Upgrades

EIA Publications

2017-01-01

The residential sector comprises equipment consuming various fuels and providing different end-use services. When replacing equipment, consumers may choose to purchase equipment that meets minimum federal equipment efficiency standards, or they may opt for higher-efficiency equipment, such as equipment that meets or exceeds ENERGY STAR® specifications. Consumers may also choose to purchase or retrofit different types of equipment, which may require additional costs (e.g., for ducts, exhaust vents, natural gas lines, or electrical connections) to install. The stock mix of equipment types, efficiency levels, and fuels consumed directly affects total residential sector energy consumption.

75 FR 51103 - Notice of Public Meeting, Eastern Washington Resource Advisory Council Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-18

... will be open to the public. It will begin at 10 a.m. and end at 2 p.m. on September 16. Members of the public will have an opportunity to address the EWRAC at 10 a.m. The meeting will be held at The Potato..., 1103 N. Fancher Rd., Spokane Valley, WA 99212, or call (509) 536-1200. Robert B. Towne, Spokane...

Demonstration of digital fronthaul over self-seeded WDM-PON in commercial LTE environment.

PubMed

Ma, Yiran; Xu, Zhiguang; Zhang, Chengliang; Lin, Huafeng; Wang, Qing; Zhou, Min; Wang, Heng; Yu, Jingwen; Wang, Xiaomu

2015-05-04

CPRI between BBU and RRU equipment is carried by self-seeded WDM-PON prototype system within commercial LTE end-to-end environment. Delay and jitter meets CPRI requirements while services demonstrated show the same performance as bare fiber.

Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

PubMed

Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

2018-01-01

Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.

78 FR 2660 - First Responder Network Authority Board Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... Network Authority Board Meeting AGENCY: National Telecommunications and Information Administration, U.S... meeting of the Board of the First Responder Network Authority (FirstNet). DATES: The meeting will be held... network. The FirstNet Board is responsible for making strategic decisions regarding FirstNet's operations...

49 CFR 556.6 - Meetings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 6 2010-10-01 2010-10-01 false Meetings. 556.6 Section 556.6 Transportation Other... OF TRANSPORTATION EXEMPTION FOR INCONSEQUENTIAL DEFECT OR NONCOMPLIANCE § 556.6 Meetings. (a) At a meeting held under this part, any interested person may make oral (as well as written) presentations of...

40 CFR 1603.9 - Procedures for public announcement of meetings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... meetings. (a) For each meeting, the CSB shall make public announcement, at least one week before the... meeting; (4) Whether the meeting is to be open or closed; and (5) The name and business telephone number...) The one week advance notice required by paragraph (a) of this section may be reduced only if: (1) A...

49 CFR 804.7 - Procedures for public announcement of meetings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... announcement of meetings. (a) For each meeting, the NTSB shall make public announcement, at least one week... meeting; (4) Whether the meeting is to be open or closed; and (5) The name and business telephone number...) The one week advance notice required by paragraph (a) of this section may be reduced only if: (1) A...

49 CFR 804.7 - Procedures for public announcement of meetings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... announcement of meetings. (a) For each meeting, the NTSB shall make public announcement, at least one week... meeting; (4) Whether the meeting is to be open or closed; and (5) The name and business telephone number...) The one week advance notice required by paragraph (a) of this section may be reduced only if: (1) A...

40 CFR 1603.9 - Procedures for public announcement of meetings.

Code of Federal Regulations, 2011 CFR

2011-07-01

... meetings. (a) For each meeting, the CSB shall make public announcement, at least one week before the... meeting; (4) Whether the meeting is to be open or closed; and (5) The name and business telephone number...) The one week advance notice required by paragraph (a) of this section may be reduced only if: (1) A...

12 CFR 516.170 - When will OTS conduct a meeting on an application?

Code of Federal Regulations, 2010 CFR

2010-01-01

... application, or otherwise determines that a meeting will benefit the decision-making process. OTS may limit... inform the applicant and all commenters requesting a meeting of its decision to grant or deny a meeting request, or of its decision to conduct a meeting on its own initiative. (c) If OTS decides to conduct a...

Parents and end-of-life decision-making for their child: roles and responsibilities.

PubMed

Sullivan, Jane; Gillam, Lynn; Monagle, Paul

2015-09-01

Whether parents want to be and should be the decision-maker for their child in end-of-life matters are contested clinical and ethical questions. Previous research outcomes are equivocal. A qualitative interview method was used to examine the views and experiences of 25 bereaved parents in end-of-life decision-making for their child. Data were analysed thematically. Three types of decision-making roles were identified: self-determined, guided (both involving active decision-making) and acquiescent (passive).The majority of parents had been active in the decision-making process for their child. They perceived themselves as the ultimate end-of-life decision-maker. This was perceived as part of their parental responsibility. A minority of parents did not consider that they had been an active, ultimate decision-maker. Generally, parents in the self-determined and guided groups reported no negative consequences from their decision-making involvement. Importantly, parents in the acquiescent group described their experience as difficult at the time and subsequently, although not all difficulties related directly to decision-making. Parents considered that in principle parents should be the end-of-life decision-maker for their child, but understood personal characteristics and preference could prevent some parents from taking this role. This study unequivocally supports parents' desire to fulfil the end-of-life decision-making role. It provides a nuanced understanding of parents' roles and contributes evidence for the ethical position that parents should be the end-of-life decision-makers for their child, unless not in the child's best interests. On the whole, parents want this role and can manage its consequences. Indeed, not being the end-of-life decision-maker could be detrimental to parents' well-being. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Mars Sample Handling and Requirements Panel (MSHARP)

NASA Technical Reports Server (NTRS)

Carr, Michael H.; McCleese, Daniel J.; Bada, Jeffrey L.; Bogard, Donald D.; Clark, Benton C.; DeVincenzi, Donald; Drake, Michael J.; Nealson, Kenneth H.; Papike, James J.; Race, Margaret S.;

Educating Students for a Lifetime of Physical Activity: Enhancing Mindfulness, Motivation, and Meaning.

PubMed

Ennis, Catherine D

2017-09-01

For many years, pedagogical scholars and physical education (PE) teachers have worked to enhance effective teaching and learning environments. Yet for some children, youth, and young adults, many of the benefits associated with a physically active lifestyle remain elusive. Enhancing programming and performance to meet physical activity goals may require moving programs beyond "effective." It will require teachers and program leaders to focus programmatic attention on strategies to actually increase students' out-of-class physical activity behavior. Transformative PE provides physical activity content within a nurturing and motivating environment that can change students' lives. It focuses on PE students' role in cognitive decision making, self-motivation, and their search for personal meaning that can add connection and relevance to physical activities. In this SHAPE America - Society of Health and Physical Educators Research Quarterly for Exercise and Sport Lecture, I have synthesized the research on these topics to emphasize useful findings applicable to teachers' everyday planning and teaching. Using sport, physical activity, dance, and adventure activities as the means to an end for personal and social growth, we can meet our commitment to effective standards-based education while preparing students for a lifetime of physical activity.

Remediation of an oily leachate pond in Estonia.

PubMed

Kriipsalu, Mait; Marques, Marcia; Hogland, William

2005-12-01

Until recent years, waste oil and oil-contaminated waters commonly ended up in landfills. At some dump sites, ponds of oily liquids and leachate were formed. To remediate such ponds, an interdisciplinary approach is now required, keeping costs at an affordable level, particularly in countries with changing economies. From 1974 to 1993, liquid oily wastes taken to the Laguja landfill, in Estonia, were disposed of in a pond with a surface area of 9800 m2. It was estimated that the pond contained 4500-6000 m3 of oily water and 3500 m3 of oil-containing bottom sediments. This study aimed at developing an environmentally sound and cost-effective method for remediation of the oily liquids, leachate and contaminated underlying sediment material, to meet the existing legal demands. It was concluded that treatment of contaminated water is well established and the procedures carried out to meet the regulatory demands achieved satisfactory results. However, regarding treatment of sediments it was concluded that legal and technological aspects, as well as monitoring procedures are not fully established and are usually underestimated. Laboratory investigations can provide valuable information in decision-making, and contribute to effective full-scale remediation planning.

Isotopic Ratios in Nitriles from Submillimeter Spectroscopy Using SMA and ALMA

NASA Astrophysics Data System (ADS)

Gurwell, Mark A.; Moreno, Raphael; Vinatier, Sandrine; Lellouch, Emmanuel; Butler, Bryan J.; Moullet, Arielle; Lara, Luisa; Hidayat, Taufiq

2016-10-01

We present submillimeter spectroscopic observations of Titan obtained using the Submillimeter Array (SMA) in 2011, and the Atacama Large Millimeter/Submillimeter Array (ALMA) in 2012, some of which have previously been presented but not fully analyzed (1, 2, 3). The SMA observations were obtained at low spatial resolution, providing disk average spectra, but the ALMA observations provide low resolution mapping of Titan (~0.4"-0.6" when Titan was 0.77" surface diameter). We will present detailed radiative transfer analysis of detected spectral lines to derive isotopic ratios in two nitriles: HCN (D/H, 13C/12C, 15N/14N) and HC3N (15N/14N). The analysis makes use of nearly concurrent CIRS temperature profiles as important constraints for the vertical profiles of these species, allowing high precision measurements of the ratios. Finally, we will highlight current and future ALMA observations that will allow monitoring of non-symmetric molecular species in Titan's upper atmosphere from Earth, beyond the end of the Cassini mission.(1) Gurwell et al (2011) EPSC-DPS Joint Meeting 2011, p270. (2) Moreno et al (2014) EPSC 2014 Abstracts, Vol. 9, id. EPSC2014-438. (3) Moreno etal (2014), DPS meeting #46, id.211.19

75 FR 81971 - Gulf of Mexico Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

..., Special Spiny Lobster and Special Reef Fish Scientific and Statistical Committees. DATES: The meeting will.... During the first day of the meeting, the Standing and Special Spiny Lobster Scientific and Statistical Committees will meet jointly to review a spiny lobster update assessment and make recommendations to the...

National Water Program End of the Year Performance Reports and Best Practices

EPA Pesticide Factsheets

Each year, EPA's Office of Water conducts an assessment of the end of the year results for all performance measures of the National Water Program to determine progress in meeting the goals outlined in the Agency's Strategic Plan and NWPG.

a Simulation-As Framework Facilitating Webgis Based Installation Planning

NASA Astrophysics Data System (ADS)

Zheng, Z.; Chang, Z. Y.; Fei, Y. F.

2017-09-01

Installation Planning is constrained by both natural and social conditions, especially for spatially sparse but functionally connected facilities. Simulation is important for proper deploy in space and configuration in function of facilities to make them a cohesive and supportive system to meet users' operation needs. Based on requirement analysis, we propose a framework to combine GIS and Agent simulation to overcome the shortness in temporal analysis and task simulation of traditional GIS. In this framework, Agent based simulation runs as a service on the server, exposes basic simulation functions, such as scenario configuration, simulation control, and simulation data retrieval to installation planners. At the same time, the simulation service is able to utilize various kinds of geoprocessing services in Agents' process logic to make sophisticated spatial inferences and analysis. This simulation-as-a-service framework has many potential benefits, such as easy-to-use, on-demand, shared understanding, and boosted performances. At the end, we present a preliminary implement of this concept using ArcGIS javascript api 4.0 and ArcGIS for server, showing how trip planning and driving can be carried out by agents.

76 FR 27664 - Office on Violence Against Women; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-12

... children and teens who witness and/or are victimized by domestic violence, dating violence, and sexual... presentations from the National Network to End Domestic Violence and the Stalking Resource Center) and a... DEPARTMENT OF JUSTICE Office on Violence Against Women; Notice of Meeting AGENCY: Office on...

Ranking by Medians

ERIC Educational Resources Information Center

Martin, Brian

2016-01-01

Brian Martin describes a difficult committee meeting he once attended which consisted of one representative from each department. When the meeting ended it left a bitter taste for many who participated. Having learned from this experience, Martin became a chair of the committee and tried a new system that overcame many of the previous problems.…

Comparisons of guardianship laws and surrogate decision-making practices in China, Japan, Thailand and Australia: a review by the Asia Consortium, International Psychogeriatric Association (IPA) capacity taskforce.

PubMed

Tsoh, Joshua; Peisah, Carmelle; Narumoto, Jin; Wongpakaran, Nahathai; Wongpakaran, Tinakon; O'Neill, Nick; Jiang, Tao; Ogano, Shoichi; Mimura, Masaru; Kato, Yuka; Chiu, Helen

2015-06-01

The International Psychogeriatric Association (IPA) capacity taskforce was established to promote the autonomy, proper access to care, and dignity of persons with decision-making disabilities (DMDs) across nations. The Asia Consortium of the taskforce was established to pursue these goals in the Asia-Pacific region. This paper is part of the Asia Consortium's initiative to promote understanding and advocacy in regard to surrogate decision-making across the region. The current guardianship laws are compared, and jurisdictional variations in the processes for proxy decision-making to support persons with DMDs and other health and social needs in China, Japan, Thailand, and Australia are explored. The different Asia-Pacific countries have various proxy decision-making mechanisms in place for persons with DMDs, which are both formalized according to common law, civil law, and other legislation, and shaped by cultural practices. Various processes for guardianship and mechanisms for medical decision-making and asset management exist across the region. Processes that are still evolving across the region include those that facilitate advanced planning as a result of the paucity of legal structures for enduring powers of attorney (EPA) and guardianship in some regions, and the struggle to achieve consensual positions in regard to end-of-life decision-making. Formal processes for supporting decision-making are yet to be developed. The diverse legal approaches to guardianship and administration must be understood to meet the challenges of the rapidly ageing population in the Asia-Pacific region. Commonalities in the solutions and difficulties faced in encountering these challenges have global significance.

Process for making diamonds

NASA Technical Reports Server (NTRS)

Rasquin, J. R.; Estes, M. F. (Inventor)

1973-01-01

A description is given of a device and process for making industrial diamonds. The device is composed of an exponential horn tapering from a large end to a small end, with a copper plate against the large end. A magnetic hammer abuts the copper plate. The copper plate and magnetic hammer function together to create a shock wave at the large end of the horn. As the wave propagates to the small end, the extreme pressure and temperature caused by the wave transforms the graphite, present in an anvil pocket at the small end, into diamonds.

Ethical frameworks for surrogates’ end-of-life planning experiences: A qualitative systematic review

PubMed Central

Kim, Hyejin; Deatrick, Janet A; Ulrich, Connie M

2016-01-01

Despite the growing body of knowledge about surrogate decision making, we know very little about the use of ethical frameworks including ethical theories, principles, and concepts to understand surrogates’ day-to-day experiences in end-of-life care planning for incapacitated adults. This systematic review of 30 qualitative research papers was conducted to identify the types of ethical frameworks used to address surrogates’ experiences in end-of-life care planning for incapacitated adults as well as the most common themes or patterns found in surrogate decision making research.. Seven papers explicitly identified ethical theories, principles, or concepts for their studies, such as autonomy, substituted judgment, and best interests. Themes identified about surrogate decision making included: responsibilities and goals, factors affecting surrogates’ decision making, and outcomes for surrogates. In fact, an overarching theme of “wanting to do the right thing” for incapacitated adults and/or themselves was prominent. Understanding the complexity of surrogates’ experiences of end-of-life care planning is beyond the scope of conventional ethical frameworks. Ethical frameworks that address individuality and contextual variations related to decision making may more appropriately guide surrogate decision making research that explores surrogates’ end-of-life care planning experiences. PMID:27005954

Two pathways to self-forgiveness: A hedonic path via self-compassion and a eudaimonic path via the reaffirmation of violated values.

PubMed

Woodyatt, Lydia; Wenzel, Michael; Ferber, Matthew

2017-09-01

Self-forgiveness is often measured as a hedonic end-state, as the presence of positive affect and the absence of negative affect towards the self following a wrongdoing. However, self-forgiveness is also referred to as a difficult process. Self-forgiveness as a process of accepting responsibility and working through one's wrongdoing is a substantially un-hedonic - it is likely to be uncomfortable and at times painful. In this study, we examine two pathways to self-forgiveness: a hedonic focused pathway (via self-compassion) and a eudaimonic pathway (via reaffirmation of transgressed values). Across two studies, the data suggest that following interpersonal transgressions, self-compassion reduces self-punitiveness and increases end-state self-forgiveness (Study 1) via a reduction in perceived stigma (Study 2). In contrast, value reaffirmation increases the process of genuine self-forgiveness and reduces defensiveness (Study 1) via increased concern for shared group values (Study 2), in turn increasing desire to reconcile (Study 1), and amend-making and end-state self-forgiveness 1 week following the intervention (Study 2). The results suggest that both pathways can lead to self-forgiveness; however, following a transgression, self-forgiveness via a eudaimonic pathway offers greater promise for meeting the needs of both offenders and victims. © 2017 The British Psychological Society.

Supporting End of Life Decision Making: Case Studies of Relational Closeness in Supported Decision Making for People with Severe or Profound Intellectual Disability

ERIC Educational Resources Information Center

Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

2017-01-01

Background: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions.…

Capitated risk-bearing managed care systems could improve end-of-life care.

PubMed

Lynn, J; Wilkinson, A; Cohn, F; Jones, S B

1998-03-01

Capitated or salaried managed care systems offer an important opportunity to provide high quality, cost-effective end-of-life care. However, capitated healthcare delivery systems have strong incentives to avoid patient populations in need of such care. Care currently provided at the end of life in fee-for-service practice is commonly deficient, with high rates of avoidable pain and other burdens. Only hospice offers a better track record, yet access to hospice is limited, and length of stay is short. Traditional staff- or group-model managed care plans, with their emphasis on prevention, patient education, cost efficiency, service coordination, and integrated provider networks, present a dynamic set of conditions and organizational structures that would support real change. Advantages derived from managed care systems providing quality end-of-life care include coordinated care across delivery sites, interdisciplinary teams, integrated services, and opportunities to develop innovative care programs, service arrays, utilization controls, and accountability for care standards. We propose a special comprehensive system of managed care, which we call MediCaring, for seriously ill persons nearing the end of life. MediCaring would encompass the best elements of palliative care within a managed care structure: comprehensive, supportive, community-based services that meet personal and medical needs, a focus on patient preferences, symptom management, family counseling, and support. Other programs, such as hospice, have shown that continuity and coordinated care, financed through a capitated payment and directed at a special population, are both feasible and effective. There are obstacles to improving care at the end of life. Managed care systems, like most of medical care, have largely ignored the terminally ill patient. Current financing arrangements make it financially undesirable for insurers to recruit or retain the very sick; very ill patients can be costly over a prolonged time. In addition, inertia and habit inhibit change, and there are few criteria by which to judge whether care at the end-of-life is "good." Nevertheless, capitated or salaried managed care systems committed to enhanced end-of-life care seem well positioned to achieve it if payment reimbursements were revised to encourage this end.

77 FR 9214 - National Security Education Board Members Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-16

... DEPARTMENT OF DEFENSE Office of the Secretary National Security Education Board Members Meeting... meeting of the National Security Education Board. The purpose of the meeting is to review and make... Security Education Act, Title VII of Public Law 102- 183, as amended. DATES: March 15, 2012, from 9 a.m.-2...

22 CFR 507.8 - Recording keeping of closed meetings.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of a meeting, closed to the public. (b) The Board, after review by the Chairman, shall make promptly... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Recording keeping of closed meetings. 507.8 Section 507.8 Foreign Relations BROADCASTING BOARD OF GOVERNORS RULES FOR IMPLEMENTING OPEN MEETINGS UNDER...

The Development of Solution Focused Multi-Agency Meetings in a Psychological Service

ERIC Educational Resources Information Center

Alexander, Shiona; Sked, Heather

2010-01-01

This article outlines the successful development of multi-agency meetings as part of a staged approach aimed at supporting families and children within the Scottish Highland Council Area. Drawing on the research evidence for the factors which help to make meetings effective, a distinctive meeting structure was developed. This structure is…

Design Your Future: College & Career Preparation Guide, 2014-2015

ERIC Educational Resources Information Center

North Dakota University System, 2014

2014-01-01

This publication was created to help eighth-grade students make a successful transition to high school and begin looking at college and career options. Topics covered in the booklet include: (1) Making the transition to high school; (2) Meeting state academic standards; (3) Taking the courses needed to complete high school and to meet college…

Meeting Wise: Making the Most of Collaborative Time for Educators

ERIC Educational Resources Information Center

Boudett, Kathryn Parker; City, Elizabeth A.

2014-01-01

This book, by two editors of "Data Wise: A Step-by-Step Guide to Using Assessment Results to Improve Teaching and Learning," attempts to bring about a fundamental shift in how educators think about the meetings we attend. They make the case that these gatherings are potentially the most important venue where adult and organizational…

Resource Analysis of Cognitive Process Flow Used to Achieve Autonomy

DTIC Science & Technology

2016-03-01

to be used as a decision - making aid to guide system designers and program managers not necessarily familiar with cognitive pro- cessing, or resource...implementing end-to-end cognitive processing flows multiplies and the impact of these design decisions on efficiency and effectiveness increases [1]. The...end-to-end cognitive systems and alternative computing technologies, then system design and acquisition personnel could make systematic analyses and

Explore Mediterranean in classroom

NASA Astrophysics Data System (ADS)

Balesevic, Ivana

2017-04-01

I am a science teacher at a primary school and my students are very interested in science. Through this year I will work with my students, organizing several workshops and or results will be presented on poster. I will work with several groups (4-6) students 8th grade. In this poster all activities will be presented, showing how science is easy to learn even in a classroom. 1. Workshop > Chemical characteristic of sea water Using school laboratory each group of students will analyze the physical and chemical characteristic of sea water and they have to explain the results to younger student's 5th and 6th grade. The final result will be presented on poster. 2. Workshop> Meet the Mediterranean life During this workshop students will work in different groups. The aim of the workshop is to meet lots of species that we can find in Mediterranean using movies, phone applications, internet explorer, science books and school collections of invertebrates … 3. Workshop>Stop the pollution Several groups of students have to debate about causes of pollution and possibilities for prevention. At the end of workshop we will organize a quiz. Student's answers and suggestions will be shown on the poster. 4. Workshop> How we see the Mediterranean During this workshop students will make models of Mediterranean in 2d and 3d perspective, using different materials. They can show on models parts of Mediterranean area, country, sea... After making models students need to visit 5th and 6th grade classes, to show them and explain the final results. Few models will be presented on poster

Making Information Useful: Engagement in the National Climate Assessment Process

NASA Astrophysics Data System (ADS)

Lough, G. C.; Cloyd, E.

2014-12-01

Creation of actionable information requires that the producers of that information understand the needs of the intended users and decision makers. To that end, development of the Third National Climate Assessment included a focus on engaging users through an inclusive, broad-based, and sustained process. Such a process provides opportunities for scientific experts and decision makers to share knowledge about the climate-related issues, impacts, and potential response actions that are most important in a particular region or sector. Such a process is also highly transparent in order to produce results that are credible, salient, and legitimate for both scientists and decision makers, ultimately making the results extremely useful. To implement these principles for the recent NCA, a broad-based engagement strategy was implemented from the start of the process. The strategy invited participation from users and stakeholder communities at each stage of the process, and considered methods for communicating with potential users at every step. The strategy was designed to elicit contributions to help shape the framing of the assessment, improve the transparency of the process, and increase the utility of the final information. Specific user inputs were gathered through a series of workshops, public comment opportunities, town hall meetings, presentations, requests for information, submitted documents, and open meetings. Further, a network of contributors self-organized around topics of interest to extend the NCA to a wider range of user groups. Here, we describe the outcomes of these innovations in assessment engagement and identify clear successes, notable surprises, future evaluation needs, and areas for new ideas.

The advantages and limitations of seeking sex online: a comparison of reasons given for online and offline sexual liaisons by men who have sex with men.

PubMed

Ross, Michael W; Rosser, B R Simon; McCurdy, Sheryl; Feldman, Jamie

2007-02-01

The Internet has developed as a major site for sexual activity, both cybersex and for making contacts for sex in real life (IRL). As part of a major study of HIV-risk behavior on the Internet and IRL , we obtained on-line responses from 1,017 Latino men who have sex with men (MSM) in the U.S. Open-ended questions solicited responses regarding whether respondents preferred to meet sexual partners first IRL (48.4%), on the Internet (31.6%), or "it depends" (20%), and "why?". Data were analyzed by theme, with themes grouped into overarching domains. Data indicate that for those preferring the Internet, themes represented were ease of Internet use, its advantages for people who were shy, and its anonymity, safety, the excitement and opportunity for experimentation of Internet contact, ability to avoid interpersonal contact, and control of visuals and the environment. Reasons for preferring meeting IRL included some of the same themes, but emphasizing the importance of a "real presence" and the possibility to build a relationship. Where "it depends", key themes were contextual: mood, time, setting, alcohol and drug use, sexual needs and urgency, and relationship intentions. Antagonistic advantages were often noted for cybersex and IRL. These data suggest that motivations for making Internet sexual contact in MSM are complex, depend on the context and nature of the relationship sought, and that the Internet has allowed the development of a class of sexual contacts located between IRL and fantasy.

Death Anxiety in Hospitalized End-of-Life Patients as Captured from a Structured Electronic Health Record

PubMed Central

Lodhi, Muhammad Kamran; Cheema, Umer Iftikhar; Stifter, Janet; Wilkie, Diana J.; Keenan, Gail M.; Yao, Yingwei; Ansari, Rashid; Khokhar, Ashfaq A.

2015-01-01

The nursing outcomes of hospitalized patients whose plans of care include death anxiety, which is a diagnosis among patients at the end-of-life, are obscure. The authors of the current article applied data mining techniques to nursing plan-of-care data for patients diagnosed with death anxiety, as defined by North American Nursing Diagnosis Association International, from four different hospitals to examine nursing care outcomes and associated factors. Results indicate that <50% of patients met the expected outcome of comfortable death. Gerontology unit patients were more likely to meet the expected outcome than patients from other unit types, although results were not statistically significant. Younger patients (i.e., age <65) had a lower chance of meeting the outcome compared with older patients (i.e., age ≥65) (χ2(1) = 9.266, p < 0.004). Longer stays improved the chances of meeting the outcome (χ2(2) = 6.47, p < 0.04). Results indicate that death anxiety outcomes are suboptimal and suggest the need to better educate clinicians about diagnosing and treating death anxiety among patients who face the end-of-life transition. PMID:25157534

Development and Validation of a Family Meeting Assessment Tool (FMAT).

PubMed

Hagiwara, Yuya; Healy, Jennifer; Lee, Shuko; Ross, Jeanette; Fischer, Dixie; Sanchez-Reilly, Sandra

2018-01-01

A cornerstone procedure in Palliative Medicine is to perform family meetings. Learning how to lead a family meeting is an important skill for physicians and others who care for patients with serious illnesses and their families. There is limited evidence on how to assess best practice behaviors during end-of-life family meetings. Our aim was to develop and validate an observational tool to assess trainees' ability to lead a simulated end-of-life family meeting. Building on evidence from published studies and accrediting agency guidelines, an expert panel at our institution developed the Family Meeting Assessment Tool. All fourth-year medical students (MS4) and eight geriatric and palliative medicine fellows (GPFs) were invited to participate in a Family Meeting Objective Structured Clinical Examination, where each trainee assumed the physician role leading a complex family meeting. Two evaluators observed and rated randomly chosen students' performances using the Family Meeting Assessment Tool during the examination. Inter-rater reliability was measured using percent agreement. Internal consistency was measured using Cronbach α. A total of 141 trainees (MS4 = 133 and GPF = 8) and 26 interdisciplinary evaluators participated in the study. Internal reliability (Cronbach α) of the tool was 0.85. Number of trainees rated by two evaluators was 210 (MS4 = 202 and GPF = 8). Rater agreement was 84%. Composite scores, on average, were significantly higher for fellows than for medical students (P < 0.001). Expert-based content, high inter-rater reliability, good internal consistency, and ability to predict educational level provided initial evidence for construct validity for this novel assessment tool. Copyright © 2017 American Academy of Hospice and Palliative Medicine. All rights reserved.

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

Bird, L.; Kaiser, M.

In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 750 utilities--or about 25% of all utilities nationally--provide their customers a "green power" option. Through these programs, more than 70 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs--or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2006 data on utility green pricing programs, and examines trendsmore » in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.« less

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

Bird, Lori; Kaiser, Marshall

In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 750 utilities—or about 25% of all utilities nationally—provide their customers a “green power” option. Through these programs, more than 70 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs—or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2006 data on utility green pricing programs, and examines trendsmore » in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.« less

Commercial motorcycle drivers' perceptions of risk and road safety in urban Nigeria: an explorative study.

PubMed

Sanusi, Adebayo Adesola; Emmelin, Maria

2015-01-01

Road traffic injury is a great public health challenge with an emerging trend of increasing rates and high mortality involving commercial motorcycles in Nigeria. A qualitative approach was used with 10 in-depth interviews conducted to explore the risk perceptions of commercial motorcyclists in Ibadan, Nigeria. The data analysis using manifest and latent content analysis resulted in an overarching theme: inadequate structures and internalised norms prevent change. The three themes leading to the overarching theme are: risk-taking as generally acceptable; risk-taking as an intrinsic part of occupation; and risk-taking as a way to make ends meet. The study suggests that there is a great need for adequate regulation as regards training and licensing of riders. Also the need to tighten enforcement of traffic rules is paramount to road safety in Nigeria.

NASA Applied Sciences Program. Overview Presentation; Discovering and Demonstrating Innovative and Practical Applications of Earth Science

NASA Technical Reports Server (NTRS)

Irwin, Daniel

2010-01-01

Goal 1: Enhance Applications Research Advance the use of NASA Earth science in policy making, resource management and planning, and disaster response. Key Actions: Identify priority needs, conduct applied research to generate innovative applications, and support projects that demonstrate uses of NASA Earth science. Goal 2: Increase Collaboration Establish a flexible program structure to meet diverse partner needs and applications objectives. Key Actions: Pursue partnerships to leverage resources and risks and extend the program s reach and impact. Goal 3:Accelerate Applications Ensure that NASA s flight missions plan for and support applications goals in conjunction with their science goals, starting with mission planning and extending through the mission life cycle. Key Actions: Enable identification of applications early in satellite mission lifecycle and facilitate effective ways to integrate end-user needs into satellite mission planning

Finding and accessing diagrams in biomedical publications.

PubMed

Kuhn, Tobias; Luong, ThaiBinh; Krauthammer, Michael

2012-01-01

Complex relationships in biomedical publications are often communicated by diagrams such as bar and line charts, which are a very effective way of summarizing and communicating multi-faceted data sets. Given the ever-increasing amount of published data, we argue that the precise retrieval of such diagrams is of great value for answering specific and otherwise hard-to-meet information needs. To this end, we demonstrate the use of advanced image processing and classification for identifying bar and line charts by the shape and relative location of the different image elements that make up the charts. With recall and precisions of close to 90% for the detection of relevant figures, we discuss the use of this technology in an existing biomedical image search engine, and outline how it enables new forms of literature queries over biomedical relationships that are represented in these charts.

76 FR 26720 - 2011 Annual Meeting of the Ozone Transport Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-09

... efficiency, architectural industrial and maintenance coatings, consumer products, institution commercial and..., aftermarket catalysts, lightering, and non- road idling. DATES: The meeting will be held on June 15, 2011 starting at 9 a.m. and ending at 3:30 p.m. Location: Washington Marriott Wardman Park, 2660 Woodley Road NW...

18. Interior view of large unoccupied meeting/gathering room looking towards ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

18. Interior view of large unoccupied meeting/gathering room looking towards small stage and opened doorway to exterior vestibule; showing through wall air conditioning unit; north end of east wing on main floor; view to southwest. - Ellsworth Air Force Base, Group Administration & Secure Storage Building, 2372 Westover Avenue, Blackhawk, Meade County, SD

75 FR 12745 - SFIREG Environmental Quality Issues Working Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-17

..., beginning on April 26, 2010, and ending April 27, 2010. This notice announces the location and times for... CONTACT, preferably at least 10 days prior to the meeting, to give EPA as much time as possible to process... Crystal Dr., Arlington, VA., First Floor, South Conference Room. FOR FURTHER INFORMATION CONTACT: Ron...

Thanksgiving Address of the North American Indian Ohenton Kariwatehkwen.

ERIC Educational Resources Information Center

Mitchell, Watenriio (Michael), Comp.; And Others

Translated by the North American Indian Travelling College, this traditional Thanksgiving Address is delivered before and after all meetings and ceremonies of the Iroquois people. Through this address, the Creator is introduced into a ceremony, social dance, or council, and, at the end of the meeting, the address brings the minds of the people…

77 FR 56193 - Defense Policy Board; Federal Advisory Committee Meeting Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-12

...: Beginning at 8:00 a.m. on October 2 through the end of the meeting on October 3, the DPB will have secret through top secret (SCI) level discussions on national security issues regarding Iran, including Internal... secret or classified material. Committee's Designated Federal Officer or Point of Contact: Ann Hansen...

The End of the Brezhnev Era: Stasis and Succession.

DTIC Science & Technology

1984-06-01

appeareances and speeches. On June 22, Andropov attended ceremonies associated with the Dimitrov centenery at the Kremlin, and on June 24 he gave a V..’ short... Kirile nko *Not present at the Kremlin meeting, but possibly consulted by telephone. Of course, awaiting the publication of the minutes to the meeting

Standard Setting: A Systematic Approach to Interpreting Student Learning.

ERIC Educational Resources Information Center

DeMars, Christine E.; Sundre, Donna L.; Wise, Steven L.

2002-01-01

Describes workshops designed to set standards for freshman technological literacy at James Madison University (Virginia). Results indicated that about 30% of incoming freshmen could meet the standards set initially; by the end of the year, an additional 50-60% could meet them. Provides recommendations for standard setting in a general education…

A Comparative Analysis of Computer End-User Support in the Air Force and Civilian Organizations

DTIC Science & Technology

1991-12-01

This explanation implies a further stratification of end users based on the specific tasks they perform, a new model of application combinations, and a...its support efforts to meet the needs of its end-uiser clientele iore closely. 79 INTEGRATED .9 VERBAL ANALYTIC Figure 14. Test Model of Applications ...The IC Model : IEM, Canada. ...............19 Proliferation of ICs ... ............... 20 Services ... ..................... 21 IC States

View looking to end of Federal Trade Commission Building where ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

View looking to end of Federal Trade Commission Building where Constitution and Pennsylvania avenues meet; view includes the fountain built in 1950 to commemorate Andrew Mellon - Federal Trade Commission Building, Bounded by Sixth and Seventh streets, Pennsylvania and Constitution avenues, NW, Washington, District of Columbia, DC

Comparison of wintertime asphalt and concrete pavement surface temperatures on U.S. Route 40 near Heber, Utah.

DOT National Transportation Integrated Search

2014-06-01

Asphalt and concrete pavement surface temperatures were compared at a location on U.S. Route 40 in : northern Utah where asphalt and concrete meet end to end at the base of the mountain pass. An environmental : sensor station was installed to facilit...

Making decisions at the end of life when caring for a person with dementia: a literature review to explore the potential use of heuristics in difficult decision-making.

PubMed

Mathew, R; Davies, N; Manthorpe, J; Iliffe, S

2016-07-19

Decision-making, when providing care and treatment for a person with dementia at the end of life, can be complex and challenging. There is a lack of guidance available to support practitioners and family carers, and even those experienced in end of life dementia care report a lack of confidence in decision-making. It is thought that the use of heuristics (rules of thumb) may aid decision-making. The aim of this study is to identify whether heuristics are used in end of life dementia care, and if so, to identify the context in which they are being used. A narrative literature review was conducted taking a systematic approach to the search strategy, using the Centre for Reviews and Dissemination guidelines. Rapid appraisal methodology was used in order to source specific and relevant literature regarding the use of heuristics in end of life dementia care. A search using terms related to dementia, palliative care and decision-making was conducted across 4 English language electronic databases (MEDLINE, EMBASE, PsycINFO and CINAHL) in 2015. The search identified 12 papers that contained an algorithm, guideline, decision tool or set of principles that we considered compatible with heuristic decision-making. The papers addressed swallowing and feeding difficulties, the treatment of pneumonia, management of pain and agitation, rationalising medication, ending life-sustaining treatment, and ensuring a good death. The use of heuristics in palliative or end of life dementia care is not described in the research literature. However, this review identified important decision-making principles, which are largely a reflection of expert opinion. These principles may have the potential to be developed into simple heuristics that could be used in practice. 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/

Making decisions at the end of life when caring for a person with dementia: a literature review to explore the potential use of heuristics in difficult decision-making

PubMed Central

Mathew, R; Davies, N; Manthorpe, J; Iliffe, S

2016-01-01

Objective Decision-making, when providing care and treatment for a person with dementia at the end of life, can be complex and challenging. There is a lack of guidance available to support practitioners and family carers, and even those experienced in end of life dementia care report a lack of confidence in decision-making. It is thought that the use of heuristics (rules of thumb) may aid decision-making. The aim of this study is to identify whether heuristics are used in end of life dementia care, and if so, to identify the context in which they are being used. Design A narrative literature review was conducted taking a systematic approach to the search strategy, using the Centre for Reviews and Dissemination guidelines. Rapid appraisal methodology was used in order to source specific and relevant literature regarding the use of heuristics in end of life dementia care. Data sources A search using terms related to dementia, palliative care and decision-making was conducted across 4 English language electronic databases (MEDLINE, EMBASE, PsycINFO and CINAHL) in 2015. Results The search identified 12 papers that contained an algorithm, guideline, decision tool or set of principles that we considered compatible with heuristic decision-making. The papers addressed swallowing and feeding difficulties, the treatment of pneumonia, management of pain and agitation, rationalising medication, ending life-sustaining treatment, and ensuring a good death. Conclusions The use of heuristics in palliative or end of life dementia care is not described in the research literature. However, this review identified important decision-making principles, which are largely a reflection of expert opinion. These principles may have the potential to be developed into simple heuristics that could be used in practice. PMID:27436665

The Application of Surface Potential Test on Hand-making Insulation for Generator Stator End-winding

NASA Astrophysics Data System (ADS)

Lu, Zhu-mao; Liu, Qing; Wang, Tian-zheng; Bai, Lu; Li, Yan-peng

2017-05-01

This paper presents the advantage of surface potential test on hand-making insulation for generator stator end-winding insulation detection, compared with DC or AC withstand voltage test, also details the test principle, connection method and test notes. And through the case, surface potential test on hand-making insulation proved effective for insulation quality detection after generator stator end-winding maintenance, and the experimental data is useful and reliable for the electrical equipment operation and maintenance in the power plant.

Progress making the top end optical assembly (TEOA) for the 4-meter Advanced Technology Solar Telescope

NASA Astrophysics Data System (ADS)

Canzian, Blaise; Barentine, J.; Arendt, J.; Bader, S.; Danyo, G.; Heller, C.

2012-09-01

L-3 Integrated Optical Systems (IOS) Division has been selected by the National Solar Observatory (NSO) to design and produce the Top End Optical Assembly (TEOA) for the 4-meter Advanced Technology Solar Telescope (ATST) to operate at Haleakal', Maui. ATST will perform to a very high optical performance level in a difficult thermal environment. The TEOA, containing the 0.65-meter silicon carbide secondary mirror and support, mirror thermal management system, mirror positioning and fast tip-tilt system, field stop with thermally managed heat dump, thermally managed Lyot stop, safety interlock and control system, and support frame, operates in the "hot spot" at the prime focus of the ATST and so presents special challenges. In this paper, we describe progress in the L-3 technical approach to meeting these challenges, including silicon carbide off-axis mirror design, fabrication, and high accuracy figuring and polishing all within L-3; mirror support design; the design for stray light control; subsystems for opto-mechanical positioning and high accuracy absolute mirror orientation sensing; Lyot stop design; and thermal management of all design elements to remain close to ambient temperature despite the imposed solar irradiance load.

Design of the VLT data flow model

NASA Astrophysics Data System (ADS)

Peron, Michele; Grosbol, Preben

1997-03-01

The basic objective of modern observatories is to globally maximize their efficiency and ensure a high, constant and predictable data quality. These challenges can only be met if the scientific operation of such facilities, from the submission of observing programs to the archiving of all information, is carried out in a consistent and well controlled manner. The size, complexity and long operational lifetime of such systems make it difficult to predict and control their behavior with the necessary accuracy. Moreover they are subject to changes and are cumbersome to maintain. We present in this paper an object-oriented end-to-end operations model which describes the flow of science data associated with the operation of the VLT. The analysis model helped us to get a clear understanding of the problem domain. We were able in the design phase to partition the system into subsystems, each of them being allocated to a team for detailed design and implementation. Each of these subsystems is addressed in this paper. Prototypes will be implemented in the near future and tested on the new technology telescope (NTT). They will allow us to clarify the astronomical requirements and check the new operational concepts introduced to meet the ambitious goals of the VLT.

Utilization of bagasse and coconut fibers waste as fillers of sandwich composite for bridge railway sleepers

NASA Astrophysics Data System (ADS)

Soehardjo, K. A.; Basuki, A.

2017-07-01

The bridge railway sleepers is an essential component in the construction of railways, as the foundation of the rail support in order to withstand the load a train that runs above it. Sleepers used in bridge construction are expected to have a longer service life, lighter weight and durable so that can be used more efficient. This research was carried out to create a model of bridges railway sleepers made of sandwich structured composite from fiber glass, epoxy resin with fillers waste of bagasse (sugar cane pulp mill) or coconut fiberboard (copra industry) that using polyurethane as an adhesive. The process of making was conditioned for small and medium industrial applications. Railway sleepers’ specifications adapted to meet the requirements of end user. The process steps in this research include; lay-up fiberglass combined with bagasse/coconut fiberboard (as fillers), gluing with epoxy resin, molded it with pressure to be solid, curing after solidification process. The specimens of composite, bagasse and coconut fiber board were tested for tensile and compressive strength. The prototype were tested of mechanical test: flexural moment test to the stand rail, flexural moment test to the middle of the sleepers and tensile strength test on one side of the sleepers, in accordance to SNI 11-3388-1994 Method testing of single block concrete sleepers and bearing single rail fastening systems. The results of mechanical testing all variations meet the technical specifications of end user such as test results for flexural moment on all prototypes, after load test, there is no visible crack. While in the tensile strength test, it seem the prototype with coconut fiberboard filler, shows better performance than bagasse fiberboard filler, the decisions is just depended on techno economic and lifetime.

Health Care Professionals’ Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study

PubMed Central

Torres, Sandra; Ågård, Pernilla

2016-01-01

Objective The academic debate on cross-cultural interaction within the context of end-of-life care takes for granted that this interaction is challenging. However, few empirical studies have actually focused on what health care professionals think about this interaction. This study aimed to explore health care professionals’ understandings of cross-cultural interaction during end-of-life care. Methods Sixty end-of-life care professionals were recruited from eleven care units in Sweden to take part in focus group interviews. These interviews were analyzed using qualitative content analysis. Results The health care professionals interviewed talked about cross-cultural interaction in end-of-life care as interaction that brings about uncertainty, stress and frustration even though they had limited experience of this type of interaction. The focus group discussions brought attention to four specific challenges that they expected to meet when they care for patients with migrant backgrounds since they took for granted that they would have an ethno-cultural background that is different to their own. These challenges had to do with communication barriers, ‘unusual’ emotional and pain expressions, the expectation that these patients’ families would be ‘different’ and the anticipation that these patients and their families lack knowledge. At the core of the challenges in question is the idea that cross-cultural interaction means meeting “the unknown”. In addition, the end-of-life care professionals interviewed talked about patients whose backgrounds they did not share in homogenizing terms. It is against this backdrop that they worried about their ability to provide end-of-life care that is individualized enough to meet the needs of these patients. Conclusions The study suggests that end-of-life care professionals who regard cross-cultural interaction in this manner could face actual challenges when caring for patients whose backgrounds they regard as “the unknown” since they anticipate a variety of challenges and do not seem confident enough that they can provide good quality care when cross-cultural interaction is at stake. PMID:27880814

18 CFR 1301.44 - Notice of meetings.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Notice of meetings... Government in the Sunshine Act § 1301.44 Notice of meetings. (a) TVA shall make a public announcement of the time, place, and subject matter of each meeting, whether it is to be open or closed to the public, and...

Continuing Education: Making a Difference. Proceedings of the Annual Meeting of the Association for Continuing Higher Education (68th, Los Angeles, California, October 27-30, 2006)

ERIC Educational Resources Information Center

Barrineau, Irene T., Ed.

2006-01-01

The 68th Annual Meeting of the Association for Continuing Higher Education was themed "Continuing Education: Making a Difference." The conference sessions explored continuing education's ability to transform lives, communities, and institutions while producing a strong return on investment. Speakers reflected on continuing education's…

Communication and Decision-Making About End-of-Life Care in the Intensive Care Unit.

PubMed

Brooks, Laura Anne; Manias, Elizabeth; Nicholson, Patricia

2017-07-01

Clinicians in the intensive care unit commonly face decisions involving withholding or withdrawing life-sustaining therapy, which present many clinical and ethical challenges. Communication and shared decision-making are key aspects relating to the transition from active treatment to end-of-life care. To explore the experiences and perspectives of nurses and physicians when initiating end-of-life care in the intensive care unit. The study was conducted in a 24-bed intensive care unit in Melbourne, Australia. An interpretative, qualitative inquiry was used, with focus groups as the data collection method. Intensive care nurses and physicians were recruited to participate in a discipline-specific focus group. Focus group discussions were audio-recorded, transcribed, and subjected to thematic data analysis. Five focus groups were conducted; 17 nurses and 11 physicians participated. The key aspects discussed included communication and shared decision-making. Themes related to communication included the timing of end-of-life care discussions and conducting difficult conversations. Implementation and multidisciplinary acceptance of end-of-life care plans and collaborative decisions involving patients and families were themes related to shared decision-making. Effective communication and decision-making practices regarding initiating end-of-life care in the intensive care unit are important. Multidisciplinary implementation and acceptance of end-of-life care plans in the intensive care unit need improvement. Clear organizational processes that support the introduction of nurse and physician end-of-life care leaders are essential to optimize outcomes for patients, family members, and clinicians. ©2017 American Association of Critical-Care Nurses.

Scientific meeting abstracts: significance, access, and trends.

PubMed Central

Kelly, J A

1998-01-01

Abstracts of scientific papers and posters that are presented at annual scientific meetings of professional societies are part of the broader category of conference literature. They are an important avenue for the dissemination of current data. While timely and succinct, these abstracts present problems such as an abbreviated peer review and incomplete bibliographic access. METHODS: Seventy societies of health sciences professionals were surveyed about the publication of abstracts from their annual meetings. Nineteen frequently cited journals also were contacted about their policies on the citation of meeting abstracts. Ten databases were searched for the presence of meetings abstracts. RESULTS: Ninety percent of the seventy societies publish their abstracts, with nearly half appearing in the society's journal. Seventy-seven percent of the societies supply meeting attendees with a copy of each abstract, and 43% make their abstracts available in an electronic format. Most of the journals surveyed allow meeting abstracts to be cited. Bibliographic access to these abstracts does not appear to be widespread. CONCLUSIONS: Meeting abstracts play an important role in the dissemination of scientific knowledge. Bibliographic access to meeting abstracts is very limited. The trend toward making meeting abstracts available via the Internet has the potential to give a broader audience access to the information they contain. PMID:9549015

Student Projects that Make a Meaningful and Lasting Contribution to Course Content

ERIC Educational Resources Information Center

Schmidt, Shelly J.

2013-01-01

The objective of this teaching tip is to share with others an idea of how to transform student projects from a dead-end process to a value-added end product, value-added end products that make a meaningful and lasting contribution to course content for use by future students. (Contains 2 tables.)

Preferences for autonomy in end-of-life decision making in modern Korean society.

PubMed

Kim, Su Hyun

2015-03-01

The demand for autonomy in medical decision making is increasing among Korean people, but it is not well known why some people prefer autonomy in decision making but others do not. The aim of this study was to determine the extent to which Korean adults wished to exercise autonomy in the process of decision making regarding end-of-life treatment and to determine whether economic issues and family functioning, in particular, were associated with preferences for participation in decision making in Korean people. This study was a cross-sectional correlational study using a survey. Data were collected using structured questionnaires from 354 patients or their families who visited ambulatory departments at two general hospitals in South Korea, recruited by the proportionate quota sampling method. Data analysis was performed using multinomial logistic regression analyses. The study was approved by the hospitals' directors and the ethics committee of Kyungpook National University Hospital. Written informed consent was given by all participants. A majority of Korean people wanted to make autonomous decisions regarding treatment at the end of life. Preferences for autonomous decision making regarding end-of-life treatment, rather than relying on family, showed a significant increase in association with poor family functioning and low income. Results of this study suggested the necessity for development of alternatives to a dominant traditional "family-centered" approach in Korean people, in order to enhance end-of-life decision making for people who wish to take an active role in the decision-making process. Healthcare providers need to examine not only patients' preferred decision-making style but also any reasons for their choice, in particular, family conflict and financial burden. © The Author(s) 2014.

Zusammenfassung

NASA Astrophysics Data System (ADS)

Fullerton, A. W.

2012-12-01

The “Tony Fest” was a fabulous meeting! Lac Taureau provided a beautiful setting resplendent with summer sunshine and fresh air; scenic vistas and a warm lake; delicious food and abundant refreshments to stimulate astrophysical advancement. With copious collegiality and a fine balance between the pursuit of scientific rigor and physical recreation, the meeting was both an adventure and an education: a fest worthy of its namesake! All of which makes the task of summarizing the meeting next to impossible! Instead, I can only attempt a “drawing together” — a Zusammenfassung, as Herr Professor Doktor Doktor Moffat might say — of the things that make this meeting especially memorable for me. I know that each of the participants will carry their own personal highlights with them for a long time to come.

Teams and teamwork at NASA Langley Research Center

NASA Technical Reports Server (NTRS)

Dickinson, Terry L.

1994-01-01

The recent reorganization and shift to managing total quality at the NASA Langley Research Center (LaRC) has placed an increasing emphasis on teams and teamwork in accomplishing day-to-day work activities and long-term projects. The purpose of this research was to review the nature of teams and teamwork at LaRC. Models of team performance and teamwork guided the gathering of information. Current and former team members served as participants; their collective experience reflected membership in over 200 teams at LaRC. The participants responded to a survey of open-ended questions which assessed various aspects of teams and teamwork. The participants also met in a workshop to clarify and elaborate on their responses. The work accomplished by the teams ranged from high-level managerial decision making (e.g., developing plans for LaRC reorganization) to creating scientific proposals (e.g., describing spaceflight projects to be designed, sold, and built). Teams typically had nine members who remained together for six months. Member turnover was around 20 percent; this turnover was attributed to heavy loads of other work assignments and little formal recognition and reward for team membership. Team members usually shared a common and valued goal, but there was not a clear standard (except delivery of a document) for knowing when the goal was achieved. However, members viewed their teams as successful. A major factor in team success was the setting of explicit a priori rules for communication. Task interdependencies between members were not complex (e.g., sharing of meeting notes and ideas about issues), except between members of scientific teams (i.e., reliance on the expertise of others). Thus, coordination of activities usually involved scheduling and attendance of team meetings. The team leader was designated by the team's sponsor. This leader usually shared power and responsibilities with other members, such that team members established their own operating procedures for decision making. Sponsors followed a hands-off policy during team operations, but they approved and reviewed team products. Most teams, particularly high-level decision-making teams, had little or no authority to carry out their decisions. Team members had few interpersonal conflicts. They monitored each other respectfully about meeting deadlines. Feedback and backup behaviors were seen as desirable aspects of teamwork, wanted by the members, and done appropriately.

77 FR 67342 - First Responder Network Authority Board Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-09

... Network Authority Board Meeting AGENCY: National Telecommunications and Information Administration, U.S... Responder Network Authority (FirstNet). DATES: The meetings will be held on December 11, 2012; April 23... safety broadband network. The FirstNet Board is responsible for making strategic decisions regarding...

76 FR 28960 - National Security Education Board Members Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-19

... DEPARTMENT OF DEFENSE Office of the Secretary National Security Education Board Members Meeting... Education Board. The purpose of the meeting is to review and make recommendations to the Secretary of Defense concerning requirements established by the David L. Boren National Security Education Act, Title...

77 FR 27739 - National Security Education Board Members Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... DEPARTMENT OF DEFENSE Office of the Secretary National Security Education Board Members Meeting... Education Board. The purpose of the meeting is to review and make recommendations to the Secretary of Defense concerning requirements established by the David L. Boren National Security Education Act, Title...

Integrated vector management for malaria control

PubMed Central

Beier, John C; Keating, Joseph; Githure, John I; Macdonald, Michael B; Impoinvil, Daniel E; Novak, Robert J

2008-01-01

Integrated vector management (IVM) is defined as "a rational decision-making process for the optimal use of resources for vector control" and includes five key elements: 1) evidence-based decision-making, 2) integrated approaches 3), collaboration within the health sector and with other sectors, 4) advocacy, social mobilization, and legislation, and 5) capacity-building. In 2004, the WHO adopted IVM globally for the control of all vector-borne diseases. Important recent progress has been made in developing and promoting IVM for national malaria control programmes in Africa at a time when successful malaria control programmes are scaling-up with insecticide-treated nets (ITN) and/or indoor residual spraying (IRS) coverage. While interventions using only ITNs and/or IRS successfully reduce transmission intensity and the burden of malaria in many situations, it is not clear if these interventions alone will achieve those critical low levels that result in malaria elimination. Despite the successful employment of comprehensive integrated malaria control programmes, further strengthening of vector control components through IVM is relevant, especially during the "end-game" where control is successful and further efforts are required to go from low transmission situations to sustained local and country-wide malaria elimination. To meet this need and to ensure sustainability of control efforts, malaria control programmes should strengthen their capacity to use data for decision-making with respect to evaluation of current vector control programmes, employment of additional vector control tools in conjunction with ITN/IRS tactics, case-detection and treatment strategies, and determine how much and what types of vector control and interdisciplinary input are required to achieve malaria elimination. Similarly, on a global scale, there is a need for continued research to identify and evaluate new tools for vector control that can be integrated with existing biomedical strategies within national malaria control programmes. This review provides an overview of how IVM programmes are being implemented, and provides recommendations for further development of IVM to meet the goals of national malaria control programmes in Africa. PMID:19091038

Pre-Launch End-to-End Testing Plans for the SPAce Readiness Coherent Lidar Experiment (SPARCLE)

NASA Technical Reports Server (NTRS)

Kavaya, Michael J.

1999-01-01

The SPAce Readiness Coherent Lidar Experiment (SPARCLE) mission was proposed as a low cost technology demonstration mission, using a 2-micron, 100-mJ, 6-Hz, 25-cm, coherent lidar system based on demonstrated technology. SPARCLE was selected in late October 1997 to be NASA's New Millennium Program (NMP) second earth-observing (EO-2) mission. To maximize the success probability of SPARCLE, NASA/MSFC desired expert guidance in the areas of coherent laser radar (CLR) theory, CLR wind measurement, fielding of CLR systems, CLR alignment validation, and space lidar experience. This led to the formation of the NASA/MSFC Coherent Lidar Technology Advisory Team (CLTAT) in December 1997. A threefold purpose for the advisory team was identified as: 1) guidance to the SPARCLE mission, 2) advice regarding the roadmap of post-SPARCLE coherent Doppler wind lidar (CDWL) space missions and the desired matching technology development plan 3, and 3) general coherent lidar theory, simulation, hardware, and experiment information exchange. The current membership of the CLTAT is shown. Membership does not result in any NASA or other funding at this time. We envision the business of the CLTAT to be conducted mostly by email, teleconference, and occasional meetings. The three meetings of the CLTAT to date, in Jan. 1998, July 1998, and Jan. 1999, have all been collocated with previously scheduled meetings of the Working Group on Space-Based Lidar Winds. The meetings have been very productive. Topics discussed include the SPARCLE technology validation plan including pre-launch end-to-end testing, the space-based wind mission roadmap beyond SPARCLE and its implications on the resultant technology development, the current values and proposed future advancement in lidar system efficiency, and the difference between using single-mode fiber optical mixing vs. the traditional free space optical mixing. attitude information from lidar and non-lidar sensors, and pointing knowledge algorithms will meet this second requirement. The topic of this paper is the pre-launch demonstration of the first requirement, adequate sensitivity of the SPARCLE lidar.

Multidisciplinary Meeting (MDM) Can Provide Education and Reinforcement of Inter-Professional Development

ERIC Educational Resources Information Center

Zafiropoulos, George; Byfield, David

2016-01-01

The introduction of a multidisciplinary meeting (MDM) was analysed through a retrospective empirical study. The question of using it as a valuable tool to reinforce inter-professional development was made. The data was collected from 60 forth year Chiropractic students, who were at the end of their education and who were practicing their…

30 CFR 203.52 - What criteria must I meet to get relief?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What criteria must I meet to get relief? 203.52 Section 203.52 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT RELIEF OR REDUCTION IN ROYALTY RATES OCS Oil, Gas, and Sulfur General Royalty Relief for End-Of...

Impact Evaluation of the Minnesota Reading Corps K-3 Program

ERIC Educational Resources Information Center

Markovitz, Carrie E.; Hernandez, Marc W.; Hedberg, Eric C.; Silberglitt, Benjamin

2014-01-01

Minnesota Reading Corps (MRC) is the largest AmeriCorps State program in the country. The goal of MRC is to ensure that students become successful readers and meet reading proficiency targets by the end of the third grade. To meet this goal, the MRC program, and its host organization, ServeMinnesota Action Network, recruit, train, place and…

Meeting the Educational Challenges of Income Inequality

ERIC Educational Resources Information Center

Duncan, Greg J.; Murnane, Richard J.

2014-01-01

Can the nation's schools meet today's challenge of providing all students with the skills they will need to thrive in the rapidly changing economy and society of the 21st century? The authors point out in this article that a large percentage of children, overwhelmingly from low-income families, end their formal schooling without the…

75 FR 57496 - Notice of Public Meeting, Santa Rosa and San Jacinto Mountains National Monument Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-21

.... DATES: September 20, 2010. The meeting will start at 3 p.m. and end at 6 p.m. with the public comment..., Second Floor Conference Room, 38686 El Cerrito Road, Palm Desert, California. FOR FURTHER INFORMATION... Center Drive, Palm Springs, CA 92262, or telephone (760) 833-7136. SUPPLEMENTARY INFORMATION: The MAC...

75 FR 2488 - Pacific Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... to the public. DATES: The Joint Canada-U.S. Review Panel will be held beginning at 9 a.m., Monday, February 8, 2010 and will continue through Wednesday, February 10, 2010. The meetings will begin at 9 a.m. and end at 5:30 p.m. each day or until business for each day is completed. [[Page 2489

Storage system software solutions for high-end user needs

NASA Technical Reports Server (NTRS)

Hogan, Carole B.

1992-01-01

Today's high-end storage user is one that requires rapid access to a reliable terabyte-capacity storage system running in a distributed environment. This paper discusses conventional storage system software and concludes that this software, designed for other purposes, cannot meet high-end storage requirements. The paper also reviews the philosophy and design of evolving storage system software. It concludes that this new software, designed with high-end requirements in mind, provides the potential for solving not only the storage needs of today but those of the foreseeable future as well.

"Helping Smart Kids Get Smarter"

ERIC Educational Resources Information Center

Harney, John O.

2007-01-01

The top end of the education achievement gap is a chasm. Few Black and Hispanic students score over 1200 on the SAT, fewer enroll in selective colleges, and fewer still earn advanced degrees. Yet education reforms and media attention focus overwhelmingly on the lower end of the divide, preoccupied with students meeting minimum standards. In this…

Ending Social Promotion Without Leaving Children Behind: The Case of New York City

ERIC Educational Resources Information Center

McCombs, Jennifer Sloan, Ed.; Kirby, Sheila Nataraj, Ed.; Mariano, Louis T., Ed.

2009-01-01

Many states and school districts are implementing test-based requirements for promotion at key transitional points in students' schooling careers, thus ending the practice of "social promotion"--promoting students who have failed to meet academic standards and requirements for that grade. In 2003-2004, the New York City Department of…

49 CFR 393.86 - Rear impact guards and rear end protection.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false Rear impact guards and rear end protection. 393.86... AND ACCESSORIES NECESSARY FOR SAFE OPERATION Miscellaneous Parts and Accessories § 393.86 Rear impact... rear impact guard that meets the requirements of Federal Motor Vehicle Safety Standard No. 223 (49 CFR...

20 CFR 404.332 - When wife's and husband's benefits begin and end.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., father, mother, parent or disabled child. Your benefits will end if you remarry the insured who is not... first month covered by your application in which you meet all the other requirements for entitlement... person becomes entitled, your benefits cannot begin before January 1985 based on an application filed no...

20 CFR 404.371 - When parent's benefits begin and end.

Code of Federal Regulations, 2013 CFR

2013-04-01

... benefits beginning with the first month covered by your application in which you meet all the other requirements for entitlement. (b) Your entitlement to benefits ends with the month before the month in which... larger than the parent's benefit. (2) You marry, unless your marriage is to someone entitled to wife's...

20 CFR 404.371 - When parent's benefits begin and end.

Code of Federal Regulations, 2012 CFR

2012-04-01

... benefits beginning with the first month covered by your application in which you meet all the other requirements for entitlement. (b) Your entitlement to benefits ends with the month before the month in which... larger than the parent's benefit. (2) You marry, unless your marriage is to someone entitled to wife's...

20 CFR 404.371 - When parent's benefits begin and end.

Code of Federal Regulations, 2011 CFR

2011-04-01

... benefits beginning with the first month covered by your application in which you meet all the other requirements for entitlement. (b) Your entitlement to benefits ends with the month before the month in which... larger than the parent's benefit. (2) You marry, unless your marriage is to someone entitled to wife's...

20 CFR 404.332 - When wife's and husband's benefits begin and end.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., father, mother, parent or disabled child. Your benefits will end if you remarry the insured who is not... first month covered by your application in which you meet all the other requirements for entitlement... person becomes entitled, your benefits cannot begin before January 1985 based on an application filed no...

20 CFR 404.332 - When wife's and husband's benefits begin and end.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., father, mother, parent or disabled child. Your benefits will end if you remarry the insured who is not... first month covered by your application in which you meet all the other requirements for entitlement... person becomes entitled, your benefits cannot begin before January 1985 based on an application filed no...

20 CFR 404.332 - When wife's and husband's benefits begin and end.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., father, mother, parent or disabled child. Your benefits will end if you remarry the insured who is not... first month covered by your application in which you meet all the other requirements for entitlement... person becomes entitled, your benefits cannot begin before January 1985 based on an application filed no...

20 CFR 404.371 - When parent's benefits begin and end.

Code of Federal Regulations, 2014 CFR

2014-04-01

... benefits beginning with the first month covered by your application in which you meet all the other requirements for entitlement. (b) Your entitlement to benefits ends with the month before the month in which... larger than the parent's benefit. (2) You marry, unless your marriage is to someone entitled to wife's...

Complex Decision-Making Applications for the NASA Space Launch System

NASA Technical Reports Server (NTRS)

Lyles, Garry; Flores, Tim; Hundley, Jason; Feldman, Stuart; Monk, Timothy

2012-01-01

The Space Shuttle program is ending and elements of the Constellation Program are either being cancelled or transitioned to new NASA exploration endeavors. The National Aeronautics and Space Administration (NASA) has worked diligently to select an optimum configuration for the Space Launch System (SLS), a heavy lift vehicle that will provide the foundation for future beyond low earth orbit (LEO) large-scale missions for the next several decades. Thus, multiple questions must be addressed: Which heavy lift vehicle will best allow the agency to achieve mission objectives in the most affordable and reliable manner? Which heavy lift vehicle will allow for a sufficiently flexible exploration campaign of the solar system? Which heavy lift vehicle configuration will allow for minimizing risk in design, test, build and operations? Which heavy lift vehicle configuration will be sustainable in changing political environments? Seeking to address these questions drove the development of an SLS decision-making framework. From Fall 2010 until Spring 2011, this framework was formulated, tested, fully documented, and applied to multiple SLS vehicle concepts at NASA from previous exploration architecture studies. This was a multistep process that involved performing figure of merit (FOM)-based assessments, creating Pass/Fail gates based on draft threshold requirements, performing a margin-based assessment with supporting statistical analyses, and performing sensitivity analysis on each. This paper discusses the various methods of this process that allowed for competing concepts to be compared across a variety of launch vehicle metrics. The end result was the identification of SLS launch vehicle candidates that could successfully meet the threshold requirements in support of the SLS Mission Concept Review (MCR) milestone.

"People don't understand what goes on in here": A consensual qualitative research analysis of inmate-caregiver perspectives on prison-based end-of-life care.

PubMed

Depner, Rachel M; Grant, Pei C; Byrwa, David J; Breier, Jennifer M; Lodi-Smith, Jennifer; Luczkiewicz, Debra L; Kerr, Christopher W

2018-05-01

The age demographic of the incarcerated is quickly shifting from young to old. Correctional facilities are responsible for navigating inmate access to healthcare; currently, there is no standardization for access to end-of-life care. There is growing research support for prison-based end-of-life care programs that incorporate inmate peer caregivers as a way to meet the needs of the elderly and dying who are incarcerated. This project aims to (a) describe a prison-based end-of-life program utilizing inmate peer caregivers, (b) identify inmate-caregiver motivations for participation, and (c) analyze the role of building trust and meaningful relationships within the correctional end-of-life care setting. A total of 22 semi-structured interviews were conducted with inmate-caregivers. Data were analyzed using Consensual Qualitative Research methodology. All inmate-caregivers currently participating in the end-of-life peer care program at Briarcliff Correctional Facility were given the opportunity to participate. All participants were male, over the age of 18, and also incarcerated at Briarcliff Correctional Facility, a maximum security, state-level correctional facility. In total, five over-arching and distinct domains emerged; this manuscript focuses on the following three: (a) program description, (b) motivation, and (c) connections with others. Findings suggest that inmate-caregivers believe they provide a unique and necessary adaptation to prison-based end-of-life care resulting in multilevel benefits. These additional perceived benefits go beyond a marginalized group gaining access to patient-centered end-of-life care and include potential inmate-caregiver rehabilitation, correctional medical staff feeling supported, and correctional facilities meeting end-of-life care mandates. Additional research is imperative to work toward greater standardization of and access to end-of-life care for the incarcerated.

Learning From A Negative Example

NASA Astrophysics Data System (ADS)

Schwartz, Brian B.

1998-03-01

Listed below, in no particular order, are the most important rules for giving a good talk at a professional meeting. 1. Carefully check each viewgraph for spelly misteaks. II. KEEP all Type ON each viewgraph the Same Size and Fonts. 3. DO NOT OVERUSE BOLD IN ORDER TO MAKE A POINT. 4. Be sure to keep within the confines and boundaries of the template provided to you by the 8. Make sure the viewgraphs are ordered correctly. 5. Absolutely no alcohol during the talk. (This applies to the speaker only.) 6. Answer all questions, even if you have to make up the answer. 7. Do not raise or lower your voice suddenly. This could disturb those resting in the audience. 9. Make use of the accuracy - clarity duality. It is very easy to be both inaccurate and unclear at the same time. 10. No salacious physics jokes about two physicists and a religious person. 11. Your talk should be extemporaneously given and remember: No singing or dancing most of the time. 12. Be sure to include the phrase on each overhead: " This talk could not possibly be supported by the US Government, Industry or any Educational Institution." 13. Prior to the talk, practice the art of ducking any flying vegetables. 14. Don't let boo's or hisses cause you to stray from your prepared talk. 15. Under no circumstances should you delete any overheads from your talk. If you need to, speak more rapidly and quickly flash all of the viewgraphs. The Guinness Book of World Records for an APS meeting is 56 viewgraphs, 12 with substantial equations, given in only 10 minutes at a spoken rate of 430 words per minute. (This is the equivalent to compressing a 2-hour talk, saving the audience from 1 hour and 50 minutes of boredom). 16. Hand gestures to emphasize particular points can be used extensively, provided they do not insult any particular ethnic group. 17 There is no need for a concluding overhead if you have said or think you have said everything. 18. In the end, there are no rules.

Governing in the Sunshine: Open Meetings, Open Records, and Effective Governance in Public Higher Education. Public Policy Paper Series No. 04-01

ERIC Educational Resources Information Center

Hearn, James C.; McLendon, Michael K.; Gilchrist, Leigh Z.

2004-01-01

Sunshine laws are designed to make meetings and records of public entities visible so that a state can help ensure accountability of decision making affecting public resources. The laws often pit the news media's desire for greater public disclosure of information on public college and university governance against institutional leaders' desire to…

Social Work and End-of-Life Decisions: Self-Determination and the Common Good.

ERIC Educational Resources Information Center

Wesley, Carol A.

1996-01-01

Self-determination and the common good must be respected in social work practice and policy regarding end-of-life decisions. This article discusses self-determination in end-of-life decision making, ethical decision making and the NASW Code of Ethics, and professional ethics based on a balanced view of both self-determination and the common good.…

Role of High-End Computing in Meeting NASA's Science and Engineering Challenges

NASA Technical Reports Server (NTRS)

Biswas, Rupak

2006-01-01

High-End Computing (HEC) has always played a major role in meeting the modeling and simulation needs of various NASA missions. With NASA's newest 62 teraflops Columbia supercomputer, HEC is having an even greater impact within the Agency and beyond. Significant cutting-edge science and engineering simulations in the areas of space exploration, Shuttle operations, Earth sciences, and aeronautics research, are already occurring on Columbia, demonstrating its ability to accelerate NASA s exploration vision. The talk will describe how the integrated supercomputing production environment is being used to reduce design cycle time, accelerate scientific discovery, conduct parametric analysis of multiple scenarios, and enhance safety during the life cycle of NASA missions.

75 FR 4348 - Pacific Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

... Pacific Fishery Management Council (Pacific Council) will convene a joint meeting of the Ecosystem Plan Development Team (EPDT) and Ecosystem Advisory Subpanel (EAS) which is open to the public. DATES: The meeting... review Pacific Council guidance and make recommendations on implementing an ecosystem-based management...

77 FR 70450 - Risk Communication Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-26

... barriers such as prevention or warning fatigue or inaccurate risk perception. FDA intends to make...] Risk Communication Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS... and Drug Administration (FDA). The meeting will be open to the public. Name of Committee: Risk...

A Structured Approach to End-of-Life Decision Making Improves Quality of Care for Patients With Terminal Illness in a Teaching Hospital in Ghana.

PubMed

Edwin, Ama Kyerewaa; Johnson McGee, Summer; Opare-Lokko, Edwina Addo; Gyakobo, Mawuli Kotope

2016-03-01

To determine whether a structured approach to end-of-life decision-making directed by a compassionate interdisciplinary team would improve the quality of care for patients with terminal illness in a teaching hospital in Ghana. A retrospective analysis was done for 20 patients who consented to participate in the structured approach to end-of-life decision-making. Twenty patients whose care did not follow the structured approach were selected as controls. Outcome measures were nociceptive pain control, completing relationships, and emotional response towards dying. These measures were statistically superior in the study group compared to the control group. A structured approach to end-of-life decision-making significantly improves the quality of care for patients with terminal illness in the domains of pain control, completing relationships and emotional responses towards dying. © The Author(s) 2014.

“The problem often is that we do not have a family spokesperson but a spokesgroup”: Family Member Informal Roles in End-of-Life Decision-Making in Adult ICUs

PubMed Central

Quinn, Jill R.; Schmitt, Madeline; Baggs, Judith Gedney; Norton, Sally A.; Dombeck, Mary T.; Sellers, Craig R.

2013-01-01

Background To support the process of effective family decision-making, it is important to recognize and understand informal roles various family members may play in the end-of-life decision-making process. Objective The purpose of this study was to describe some informal roles consistently enacted by family members involved in the process of end-of-life decision-making in intensive care units (ICUs). Methods Ethnographic study. Data were collected via participant observation with field notes and semi-structured interviews on four ICUs in an academic health center in the mid-Atlantic United States from 2001 to 2004. The units studied were a medical ICU, a surgical ICU, a burn and trauma ICU, and a cardiovascular ICU. Participants Participants included health care clinicians, patients, and family members. Results Informal roles for family members consistently observed were:, Primary Caregiver, Primary Decision Maker, Family Spokesperson, Out-of-Towner, Patient Wishes Expert, Protector, Vulnerable Member, and Health Care Expert. The identified informal roles were part of family decision making processes, and each role was part of a potentially complicated family dynamic for end-of-life decision-making within the family system, and between the family and health care domains. Conclusions These informal roles reflect the diverse responses to demands for family decision making in what is usually a novel and stressful situation. Identification and description of these family member informal roles can assist clinicians to recognize and understand the functions of these roles in family decision making at the end-of-life, and guide development of strategies to support and facilitate increased effectiveness of family discussions and decision-making processes. PMID:22210699

Patients' perceptions of sharing in decisions: a systematic review of interventions to enhance shared decision making in routine clinical practice.

PubMed

Légaré, France; Turcotte, Stéphane; Stacey, Dawn; Ratté, Stéphane; Kryworuchko, Jennifer; Graham, Ian D

2012-01-01

Shared decision making is the process in which a healthcare choice is made jointly by the health professional and the patient. Little is known about what patients view as effective or ineffective strategies to implement shared decision making in routine clinical practice. This systematic review evaluates the effectiveness of interventions to improve health professionals' adoption of shared decision making in routine clinical practice, as seen by patients. We searched electronic databases (PubMed, the Cochrane Library, EMBASE, CINAHL, and PsycINFO) from their inception to mid-March 2009. We found additional material by reviewing the reference lists of the studies found in the databases; systematic reviews of studies on shared decision making; the proceedings of various editions of the International Shared Decision Making Conference; and the transcripts of the Society for Medical Decision Making's meetings. In our study selection, we included randomized controlled trials, controlled clinical trials, controlled before-and-after studies, and interrupted time series analyses in which patients evaluated interventions to improve health professionals' adoption of shared decision making. The interventions in question consisted of the distribution of printed educational material; educational meetings; audit and feedback; reminders; and patient-mediated initiatives (e.g. patient decision aids). Two reviewers independently screened the studies and extracted data. Statistical analyses considered categorical and continuous process measures. We computed the standardized effect size for each outcome at the 95% confidence interval. The primary outcome of interest was health professionals' adoption of shared decision making as reported by patients in a self-administered questionnaire. Of the 6764 search results, 21 studies reported 35 relevant comparisons. Overall, the quality of the studies ranged from 0% to 83%. Only three of the 21 studies reported a clinically significant effect for the primary outcome that favored the intervention. The first study compared an educational meeting and a patient-mediated intervention with another patient-mediated intervention (median improvement of 74%). The second compared an educational meeting, a patient-mediated intervention, and audit and feedback with an educational meeting on an alternative topic (improvement of 227%). The third compared an educational meeting and a patient-mediated intervention with usual care (p = 0.003). All three studies were limited to the patient-physician dyad. To reduce bias, future studies should improve methods and reporting, and should analyze costs and benefits, including those associated with training of health professionals. Multifaceted interventions that include educating health professionals about sharing decisions with patients and patient-mediated interventions, such as patient decision aids, appear promising for improving health professionals' adoption of shared decision making in routine clinical practice as seen by patients.

The individual, the government and the global community: sharing responsibility for health post-2015 in Vanuatu, a small island developing state.

PubMed

Ibell, Claire; Sheridan, Simon A; Hill, Peter S; Tasserei, John; Maleb, Marie-France; Rory, Jean-Jacques

2015-10-24

The end of 2015 will see the creation of the sustainable development goals - the new global framework for development. The process of creating universally relevant goals has involved community consultation throughout the world. Within this process it is vital that Pacific Island countries are included as they face particular development challenges due to their size and geographical location. As small island developing states, many Pacific Island countries struggle to overcome high rates of poverty and poor health outcomes. In order to include Pacific voices in the new health related sustainable development goals, Vanuatu was selected as a representative of the Pacific for this qualitative study. This paper presents the perspectives of communities throughout Vanuatu on their essential health needs and how best to meet them. This paper examines the perspectives of 102 individuals from throughout Vanuatu. Ten focus group discussions and 2 individual interviews were conducted within communities in September 2013. Discussions focused on community perceptions of health, essential health needs, and responsibility in achieving health needs. Discussions were audio recorded and transcribed. The transcripts were then analysed using a theoretical thematic approach in order to identify central themes and subthemes. Individuals in this study demonstrated a comprehensive understanding of health, defining health in a holistic manner. Participants identified clear environmental and societal factors that impact upon health, and emphasized failures within the current health system as important barriers to attaining good health. Participants described the challenges faced in taking responsibility for one's health, and pointed to both the government and the international community as key players in meeting the essential health needs of communities. As a small island developing state, Vanuatu faces accentuated development challenges - particularly as globalisation and climate change progress. The individuals and communities in this study demonstrate a clear understanding of their needs, and show a strong desire for change. They point to both the government and the international community to assist in meeting health needs, and stress that respect for traditional governance and community involvement in decision-making are vital in this process. In order to ensure that the new health goals effectively meet local needs in Vanuatu such factors must be incorporated into policy and implementation decision-making.

Wind blade spar cap and method of making

DOEpatents

Mohamed, Mansour H [Raleigh, NC

2008-05-27

A wind blade spar cap for strengthening a wind blade including an integral, unitary three-dimensional woven material having a first end and a second end, corresponding to a root end of the blade and a tip end of the blade, wherein the material tapers in width from the first to the second end while maintaining a constant thickness and decreasing weight therebetween, the cap being capable of being affixed to the blade for providing increased strength with controlled variation in weight from the root end to the tip end based upon the tapered width of the material thereof. The present inventions also include the method of making the wind blade spar cap and a wind blade including the wind blade spar cap.

Eating and drinking interventions for people at risk of lacking decision-making capacity: who decides and how?

PubMed

Clarke, Gemma; Galbraith, Sarah; Woodward, Jeremy; Holland, Anthony; Barclay, Stephen

2015-06-11

Some people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions are disrupted. Increasingly multi-professional groups are being utilised to make difficult ethical decisions within healthcare. This paper reports upon a service evaluation which examined decision-making within a UK hospital Feeding Issues Multi-Professional Team. A three month observation of a hospital-based multi-professional team concerning feeding issues, and a one year examination of their records. The key research questions are: a) How are decisions made concerning artificial nutrition for individuals at risk of lacking decision-making capacity? b) What are the key decision-making factors that are balanced? c) Who is involved in the decision-making process? Decision-making was not a singular decision, but rather involved many different steps. Discussions involving relatives and other clinicians, often took place outside of meetings. Topics of discussion varied but the outcome relied upon balancing the information along four interdependent axes: (1) Risks, burdens and benefits; (2) Treatment goals; (3) Normative ethical values; (4) Interested parties. Decision-making was a dynamic ongoing process with many people involved. The multiple points of decision-making, and the number of people involved with the decision-making process, mean the question of 'who decides' cannot be fully answered. There is a potential for anonymity of multiple decision-makers to arise. Decisions in real world clinical practice may not fit precisely into a model of decision-making. The findings from this service evaluation illustrate that within multi-professional team decision-making; decisions may contain elements of both substituted and supported decision-making, and may be better represented as existing upon a continuum.

75 FR 82039 - National Maritime Security Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... meeting may close early if all business is finished. Written material and requests to make oral..., Arlington, VA 22209. Additionally, this meeting will be broadcast via a web enabled interactive online[email protected] . This notice may be viewed in our online docket, USCG-2010-1005, at http://www.regulations...

76 FR 62418 - Antiviral Drugs Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-07

... regarding special accommodations due to a disability, visitor parking and transportation may be accessed at.../phone line to learn about possible modifications before coming to the meeting. Agenda: On December 14... advisory committee meetings and will make every effort to accommodate persons with physical disabilities or...

12 CFR 272.4 - Committee actions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Committee actions. 272.4 Section 272.4 Banks....4 Committee actions. (a) Actions at meetings. Actions are taken at meetings of the Committee except as described below. (b) Actions between meetings. Special circumstances may make it desirable in the...

76 FR 8350 - Notice of Federal Advisory Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-14

... federal advisory committee meeting of the DoD Board of Actuaries will take place: DATES: July 14-15, 2011... Office of the Actuary, 4040 N. Fairfax Drive, Suite 308, Arlington, VA 22203. SUPPLEMENTARY INFORMATION... Board of Actuaries meeting or make an oral presentation or submit a written statement for consideration...

A Near-Optimal Distributed QoS Constrained Routing Algorithm for Multichannel Wireless Sensor Networks

PubMed Central

Lin, Frank Yeong-Sung; Hsiao, Chiu-Han; Yen, Hong-Hsu; Hsieh, Yu-Jen

2013-01-01

One of the important applications in Wireless Sensor Networks (WSNs) is video surveillance that includes the tasks of video data processing and transmission. Processing and transmission of image and video data in WSNs has attracted a lot of attention in recent years. This is known as Wireless Visual Sensor Networks (WVSNs). WVSNs are distributed intelligent systems for collecting image or video data with unique performance, complexity, and quality of service challenges. WVSNs consist of a large number of battery-powered and resource constrained camera nodes. End-to-end delay is a very important Quality of Service (QoS) metric for video surveillance application in WVSNs. How to meet the stringent delay QoS in resource constrained WVSNs is a challenging issue that requires novel distributed and collaborative routing strategies. This paper proposes a Near-Optimal Distributed QoS Constrained (NODQC) routing algorithm to achieve an end-to-end route with lower delay and higher throughput. A Lagrangian Relaxation (LR)-based routing metric that considers the “system perspective” and “user perspective” is proposed to determine the near-optimal routing paths that satisfy end-to-end delay constraints with high system throughput. The empirical results show that the NODQC routing algorithm outperforms others in terms of higher system throughput with lower average end-to-end delay and delay jitter. In this paper, for the first time, the algorithm shows how to meet the delay QoS and at the same time how to achieve higher system throughput in stringently resource constrained WVSNs.

Getting with the times: a narrative review of the literature on group decision making in virtual environments and implications for promotions committees.

PubMed

Acai, Anita; Sonnadara, Ranil R; O'Neill, Thomas A

2018-06-01

Concerns around the time and administrative burden of trainee promotion processes have been reported, making virtual meetings an attractive option for promotions committees in undergraduate and postgraduate medicine. However, whether such meetings can uphold the integrity of decision-making processes has yet to be explored. This narrative review aimed to summarize the literature on decision making in virtual teams, discuss ways to improve the effectiveness of virtual teams, and explore their implications for practice. In August 2017, the Web of Science platform was searched with the terms 'decision making' AND 'virtual teams' for articles published within the last 20 years. The search yielded 336 articles, which was narrowed down to a final set of 188 articles. A subset of these, subjectively deemed to be of high-quality and relevant to the work of promotions committees, was included in this review. Virtual team functioning was explored with respect to team composition and development, idea generation and selection, group memory, and communication. While virtual teams were found to potentially offer a number of key benefits over face-to-face meetings including convenience and scheduling flexibility, inclusion of members at remote sites, and enhanced idea generation and external storage, these benefits must be carefully weighed against potential challenges involving planning and coordination, integration of perspectives, and relational conflict among members, all of which can potentially reduce decision-making quality. Avenues to address these issues and maximize the outcomes of virtual promotions meetings are offered in light of the evidence.

End-of-life decisions for people with intellectual disabilities, an interview study with patient representatives.

PubMed

Wagemans, Annemieke M A; Van Schrojenstein Lantman-de Valk, Henny M J; Proot, Ireen M; Metsemakers, Job; Tuffrey-Wijne, Irene; Curfs, Leopold M G

2013-09-01

Not much is known about the process of end-of-life decision-making for people with intellectual disabilities. To clarify the process of end-of-life decision-making for people with intellectual disabilities from the perspective of patient representatives. A qualitative study based on semi-structured interviews, recorded digitally and transcribed verbatim. Data were analysed using Grounded Theory procedures. We interviewed 16 patient representatives after the deaths of 10 people with intellectual disabilities in the Netherlands. The core category 'Deciding for someone else' describes the context in which patient representatives took end-of-life decisions. The patient representatives felt highly responsible for the outcomes. They had not involved the patients in the end-of-life decision-making process, nor any professionals other than the doctor. The categories of 'Motives' and 'Support' were connected to the core category of 'Deciding for someone else'. 'Motives' refers to the patient representatives' ideas about quality of life, prevention from suffering, patients who cannot understand the burden of interventions and emotional reasons reported by patient representatives. 'Support' refers to the support that patient representatives wanted the doctors to give to them in the decision-making process. From the perspective of the patient representatives, the process of end-of-life decision-making can be improved by ensuring clear roles and an explicit description of the tasks and responsibilities of all participants. Regular discussion between everyone involved including people with intellectual disabilities themselves can improve knowledge about each other's motives for end-of-decisions and can clarify expectations towards each other.

Ethics curriculum for emergency medicine graduate medical education.

PubMed

Marco, Catherine A; Lu, Dave W; Stettner, Edward; Sokolove, Peter E; Ufberg, Jacob W; Noeller, Thomas P

2011-05-01

Ethics education is an essential component of graduate medical education in emergency medicine. A sound understanding of principles of bioethics and a rational approach to ethical decision-making are imperative. This article addresses ethics curriculum content, educational approaches, educational resources, and resident feedback and evaluation. Ethics curriculum content should include elements suggested by the Liaison Committee on Medical Education, Accreditation Council for Graduate Medical Education, and the Model of the Clinical Practice of Emergency Medicine. Essential ethics content includes ethical principles, the physician-patient relationship, patient autonomy, clinical issues, end-of-life decisions, justice, education in emergency medicine, research ethics, and professionalism. The appropriate curriculum in ethics education in emergency medicine should include some of the content and educational approaches outlined in this article, although the optimal methods for meeting these educational goals may vary by institution. Copyright © 2011 Elsevier Inc. All rights reserved.

Beyond formalism

NASA Technical Reports Server (NTRS)

Denning, Peter J.

1991-01-01

The ongoing debate over the role of formalism and formal specifications in software features many speakers with diverse positions. Yet, in the end, they share the conviction that the requirements of a software system can be unambiguously specified, that acceptable software is a product demonstrably meeting the specifications, and that the design process can be carried out with little interaction between designers and users once the specification has been agreed to. This conviction is part of a larger paradigm prevalent in American management thinking, which holds that organizations are systems that can be precisely specified and optimized. This paradigm, which traces historically to the works of Frederick Taylor in the early 1900s, is no longer sufficient for organizations and software systems today. In the domain of software, a new paradigm, called user-centered design, overcomes the limitations of pure formalism. Pioneered in Scandinavia, user-centered design is spreading through Europe and is beginning to make its way into the U.S.

Forming Mandrels for X-Ray Mirror Substrates

NASA Technical Reports Server (NTRS)

Blake, Peter N.; Saha, Timo; Zhang, Will; O'Dell, Stephen; Kester, Thomas; Jones, William

2011-01-01

Future x-ray astronomical missions, like the International X-ray Observatory (IXO), will likely require replicated mirrors to reduce both mass and production costs. Accurately figured and measured mandrels - upon which the mirror substrates are thermally formed - are essential to enable these missions. The challenge of making these mandrels within reasonable costs and schedule has led the Goddard and Marshall Space Flight Centers to develop in-house processes and to encourage small businesses to attack parts of the problem. Both Goddard and Marshall have developed full-aperture polishing processes and metrologies that yield high-precision axial traces of the finished mandrels. Outside technologists have been addressing challenges presented by subaperture CNC machining processes: particularly difficult is the challenge of reducing mid-spatial frequency errors below 2 nm rms. The end-product of this approach is a realistic plan for the economically feasible production of mandrels that meet program requirements in both figure and quantity.

Finding and Accessing Diagrams in Biomedical Publications

PubMed Central

Kuhn, Tobias; Luong, ThaiBinh; Krauthammer, Michael

2012-01-01

Complex relationships in biomedical publications are often communicated by diagrams such as bar and line charts, which are a very effective way of summarizing and communicating multi-faceted data sets. Given the ever-increasing amount of published data, we argue that the precise retrieval of such diagrams is of great value for answering specific and otherwise hard-to-meet information needs. To this end, we demonstrate the use of advanced image processing and classification for identifying bar and line charts by the shape and relative location of the different image elements that make up the charts. With recall and precisions of close to 90% for the detection of relevant figures, we discuss the use of this technology in an existing biomedical image search engine, and outline how it enables new forms of literature queries over biomedical relationships that are represented in these charts. PMID:23304318

A Formal Framework for the Analysis of Algorithms That Recover From Loss of Separation

NASA Technical Reports Server (NTRS)

Butler, RIcky W.; Munoz, Cesar A.

2008-01-01

We present a mathematical framework for the specification and verification of state-based conflict resolution algorithms that recover from loss of separation. In particular, we propose rigorous definitions of horizontal and vertical maneuver correctness that yield horizontal and vertical separation, respectively, in a bounded amount of time. We also provide sufficient conditions for independent correctness, i.e., separation under the assumption that only one aircraft maneuvers, and for implicitly coordinated correctness, i.e., separation under the assumption that both aircraft maneuver. An important benefit of this approach is that different aircraft can execute different algorithms and implicit coordination will still be achieved, as long as they all meet the explicit criteria of the framework. Towards this end we have sought to make the criteria as general as possible. The framework presented in this paper has been formalized and mechanically verified in the Prototype Verification System (PVS).

Risk factors for common mental disorders in women. Population-based longitudinal study.

PubMed

Patel, Vikram; Kirkwood, Betty R; Pednekar, Sulochana; Weiss, Helen; Mabey, David

2006-12-01

The determinants of common mental disorders in women have not been described in longitudinal studies from a low-income country. Population-based cohort study of 2494 women aged 18 to 50 years, in India. The Revised Clinical Interview Schedule was used for the detection of common mental disorders. There were 39 incident cases of common mental disorder in 2166 participants eligible for analysis (12-month rate 1.8%, 95% CI 1.3-2.4%). The following baseline factors were independently associated with the risk for common mental disorder: poverty (low income and having difficulty making ends meet); being married as compared with being single; use of tobacco; experiencing abnormal vaginal discharge; reporting a chronic physical illness; and having higher psychological symptom scores at baseline. Programmes to reduce the burden of common mental disorder in women should target poorer women, women with chronic physical illness and who have gynaecological symptoms, and women who use tobacco.

Emplotting Hikikomori: Japanese Parents' Narratives of Social Withdrawal.

PubMed

Rubinstein, Ellen

2016-12-01

Hikikomori, often glossed as "social withdrawal," emerged as a sociomedical condition among Japanese youth at the end of the twentieth century, and it continues to fascinate and concern the public. Explanatory frameworks for hikikomori abound, with different stakeholders attributing it to individual psychopathology, poor parenting, and/or a lack of social support structures. This article takes an interpretive approach to hikikomori by exploring parents' narrative constructions of hikikomori children in support group meetings and in-depth interviews. I argue that some parents were able to find hope in hikikomori by 'emplotting' their children's experiences into a larger narrative about onset, withdrawal, and recovery, which helped them remain invested in the present by maintaining a sense of possibility about the future. Contrary to literature that examines hikikomori as an epidemic of isolated individuals, I demonstrate how parents play a key role in hikikomori through meaning-making activities that have the potential to shape their children's experiences of withdrawal.

Prepare for Landing

ERIC Educational Resources Information Center

DiLisi, Gregory A.; Rarick, Richard A.

2007-01-01

"The 2006 Winter Meeting of the AAPT Was Over..."and the flight home from Anchorage to Cleveland was just about to end--eight hours in the air, only two complimentary beverages, no meals, a jump across four time zones, a one-year-old baby daughter, and a wife whose motto for the week was, "Why did they choose to have a winter meeting in Alaska?"…

Perceptions of Civility for Mobile Phone Use in Formal and Informal Meetings

ERIC Educational Resources Information Center

Washington, Melvin C.; Okoro, Ephraim A.; Cardon, Peter W.

2014-01-01

We report our survey research about what American business professionals consider appropriate or civil mobile phone behavior during formal and informal meetings. The findings come from two of our recent research studies: an open-ended survey of 204 employees at a beverage distributor on the East Coast and a nationwide, random-sample survey of 350…

It is not known the impact or implications of a study skills class and its effect on high school students in relation to performance on math and science Georgia High School Graduation Test

NASA Astrophysics Data System (ADS)

Smith, Mary E.

The Georgia State Board of Education has put in place requirements that high school students must meet in order to advance to a higher grade level and to achieve credits for graduation. Georgia requires all ninth, tenth, eleventh, and twelfth graders to take an end-of-course test after completing class time for academic core subjects. The student's final grade in the end-of-course test course will be calculated using the course grade as 85% and the end-of-course test score as 15%. The student must have a final course grade of 70 or above to pass the course and to earn credit toward graduation. Students in Georgia are required to take the Georgia High School Graduation Test. The tests consist of five parts, writing, math, science, social studies and language arts. Students must make a minimum score of 500 which indicates the student was proficient in mastering the objectives for that particular section of the test. Not all students finish high school in four years due to obstacles that occur. Tutorial sessions are provided for those that wish to participate. High schools may offer study skills classes for students that need extra help in focusing their attention on academic courses. Study skill courses provide the student with techniques that he or she may find useful in organizing thoughts and procedures that direct the student towards success.

Impact of advance care planning on the care of patients with heart failure: study protocol for a randomized controlled trial.

PubMed

Malhotra, Chetna; Sim, David Kheng Leng; Jaufeerally, Fazlur; Vikas, Nivedita Nadkarni; Sim, Genevieve Wong Cheng; Tan, Boon Cheng; Ng, Clarice Shu Hwa; Tho, Pei Leng; Lim, Jingfen; Chuang, Claire Ya-Ting; Fong, Florence Hui Mei; Liu, Joy; Finkelstein, Eric A

2016-06-10

Despite the promise and popularity of advance care planning, there is insufficient evidence that advance care planning helps patients to meet their end-of-life care preferences, especially in Asian settings. Thus, the proposed study aims to assess whether patients with advanced heart failure who are receiving advance care planning have a greater likelihood of receiving end-of-life care consistent with their preferences compared to patients receiving usual care. Secondary objectives are to compare differences in health care expenditures, quality of life, anxiety and depression, understanding of own illness, participation in decision-making and concordance with their caregiver's preferences for end-of-life care, between patients with advanced heart failure receiving advance care planning and usual care. This is a two-arm randomized controlled trial of advance care planning versus usual care (control) conducted at two institutions in Singapore. Two hundred and eighty-two patients with advanced heart failure (n = 94 in the advance care planning arm; n = 188 in the control arm receiving usual care) will be recruited from these centers and followed for 1 year or until they die, whichever is earlier. Additionally, the study will include up to one caregiver per patient enrolled. If advance care planning is proven to be effective, the results will help to promote its uptake among health care providers and patients both within Singapore and in other countries. NCT02299180 . Registered on 18 November 2014.

Making Interoperability Easier with the NASA Metadata Management Tool

NASA Astrophysics Data System (ADS)

Shum, D.; Reese, M.; Pilone, D.; Mitchell, A. E.

2016-12-01

ISO 19115 has enabled interoperability amongst tools, yet many users find it hard to build ISO metadata for their collections because it can be large and overly flexible for their needs. The Metadata Management Tool (MMT), part of NASA's Earth Observing System Data and Information System (EOSDIS), offers users a modern, easy to use browser based tool to develop ISO compliant metadata. Through a simplified UI experience, metadata curators can create and edit collections without any understanding of the complex ISO-19115 format, while still generating compliant metadata. The MMT is also able to assess the completeness of collection level metadata by evaluating it against a variety of metadata standards. The tool provides users with clear guidance as to how to change their metadata in order to improve their quality and compliance. It is based on NASA's Unified Metadata Model for Collections (UMM-C) which is a simpler metadata model which can be cleanly mapped to ISO 19115. This allows metadata authors and curators to meet ISO compliance requirements faster and more accurately. The MMT and UMM-C have been developed in an agile fashion, with recurring end user tests and reviews to continually refine the tool, the model and the ISO mappings. This process is allowing for continual improvement and evolution to meet the community's needs.

Proceedings of the Symposium on the Protection Against Radiation Hazards in Space Book 1: Radiation Environment in Space. Effects of Space Radiation on Radio Sensitive Objects. Biological Effects of Space Radiation

NASA Technical Reports Server (NTRS)

1962-01-01

The realization in recent years that outer space is traversed by high-energy radiations has caused man to reevaluate the feasibility of manned or even instrumented exploration outside our atmosphere. Fortunately, it is possible to determine the nature and intensities of these radiations and to produce similar radiations on earth by means of accelerators. Thus we can learn how to attenuate them and to design capsules which afford protection against them. Of course this protection carries a weight penalty so that there is a premium on optimizing the shield design. Many groups in the United states are engaged in research to this end,and it was the purpose of this symposium to bring these groups together so that they could exchange information. To make the meeting more comprehensive, sessions on the nature of the radiations and their effects on people and things were included. However, the major part of the meeting was devoted to discussions on shielding research, comprising theoretical calculations and experiments carried out mainly with high-energy accelerators. The symposium committee feels that the aims of the symposium were met and that progress in space research program was greatly accelerated thereby.

Fleeing from Frankenstein's Monster and Meeting Kafka on the Way: Algorithmic Decision-Making in Higher Education

ERIC Educational Resources Information Center

Prinsloo, Paul

2017-01-01

In the socio-technical imaginary of higher education, algorithmic decision-making offers huge potential, but we also cannot deny the risks and ethical concerns. In fleeing from Frankenstein's monster, there is a real possibility that we will meet Kafka on our path, and not find our way out of the maze of ethical considerations in the nexus between…

78 FR 27369 - Sunshine Act Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-10

..., May 15, 2013, 9:00-10:30 a.m. PLACE: Corporation for National and Community Service, 1201 New York... generally available one hour after a call ends. The toll-free phone number for the replay is 866-507-3580, replay passcode 3603. The end replay date is May 29, 2013, 10:59 p.m. (CT). STATUS: Open. MATTERS TO BE...

78 FR 76108 - Sunshine Act Meeting Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

... TIME: Tuesday, December 17, 2013, 9:00-10:00 a.m. (ET). PLACE: Corporation for National and Community... number. Replays are generally available one hour after a call ends. The toll-free phone number for the replay is 888-566-0076, replay passcode 6617. The end replay date is December 24, 2013, 10:59 p.m. (CT...

78 FR 59339 - Sunshine Act Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-26

..., October 9, 2013, 9:00-10:30 a.m. (ET). PLACE: Corporation for National and Community Service, 1201 New... number. Replays are generally available one hour after a call ends. The toll-free phone number for the replay is 866-396-6277, replay passcode 5955. The end replay date is October 16, 2013, 10:59 p.m. (CT...

COVERING A CORE BY EXTRUSION

DOEpatents

Karnie, A.J.

1963-07-16

A method of covering a cylindrical fuel core with a cladding metal ms described. The metal is forced between dies around the core from both ends in two opposing skirts, and as these meet the ends turn outward into an annular recess in the dics. By cutting off the raised portion formed by the recess, oxide impurities are eliminated. (AEC)

End User Computing at a South African Technikon: Enabling Disadvantaged Students To Meet Employers' Requirements.

ERIC Educational Resources Information Center

Marsh, Cecille

A two-phase study examined the skills required of competent end-users of computers in the workplace and assessed the computing awareness and technological environment of first-year students entering historically disadvantaged technikons in South Africa. First, a DACUM (Developing a Curriculum) panel of nine representatives of local business and…

12 CFR 713.6 - What is the permissible deductible?

Code of Federal Regulations, 2010 CFR

2010-01-01

... based on it having assets in excess of $1 million as reflected in its most recent year-end 5300 call... of this title as determined by its most recent examination report. A credit union that previously... recent year-end 5300 call report because either its assets have decreased or it no longer meets the net...

New Teacher Perceptions of Induction Programs: A Study of Open-Ended Commentary

ERIC Educational Resources Information Center

Williams, Nicole V.; Gillham, John C.

2016-01-01

The purpose of this study was to learn if teachers believe their experiences with the Ohio Resident Educator Program (OREP) improved their ability to meet the Ohio Standards for the Teaching Profession (OSTP). Two hundred forty-five teachers voluntarily participated in a thirty-three question Likert-based survey with seven open-ended comment…

Health Care Decisions at the End of Life: Theological and Ethical Foundations for Decision Making.

ERIC Educational Resources Information Center

Allegretti, Joseph G.

This paper provides a framework for making sense of perplexing problems surrounding issues of death and dying by exploring the theological and ethical background to health care decision making at the end of life. The paper first examines several of the basic principles that theologians and secular ethicists employ when analyzing such questions.…

Systemic Data-Based Decision Making: A Systems Approach for Using Data in Schools

ERIC Educational Resources Information Center

Walser, Tamara M.

2009-01-01

No Child Left Behind has increased data collection and reporting, the development of data systems, and interest in using data for decision-making in schools and classrooms. Ends-driven decision making has become common educational practice, where the ends justify the means at all costs, and short-term results trump longer-term outcomes and the…

75 FR 42375 - Missoula County Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... RAC legislation and RAC mission, establish a process for project proposal evaluation and decision making, set future meeting dates and receive public comment on the meeting subjects and proceedings...

Do patient race and sex change surgeon recommendations for TKA?

PubMed

Dy, Christopher J; Lyman, Stephen; Boutin-Foster, Carla; Felix, Karla; Kang, Yoon; Parks, Michael L

2015-02-01

Prior investigations have suggested that physician-related factors may contribute to differential use of TKA among women and ethnic minorities. We sought to evaluate the effect of surgeon bias on recommendations for TKA. Using an experimental approach with standardized patient scenarios, we sought to evaluate surgeon recommendations regarding TKA, specifically to determine whether recommendations for TKA are influenced by (1) patient race, and (2) patient sex. We developed four computerized scenarios for all combinations of race (white or black) and sex (male or female) for otherwise similar patients with end-stage knee osteoarthritis. Patients gave an orthopaedic history of 2 years worsening pain with decreased functional status and failure of oral antiinflammatory medications and corticosteroid intraarticular injections. Orthopaedic surgeons attending the 2012 annual meetings of the New York State Society of Orthopaedic Surgeons and American Association of Hip and Knee Surgeons were recruited for the study. Surgeons passing an open recruitment table at each meeting were asked to participate. Of the 1111 surgeons in attendance at either meeting, 113 (10.2%) participated in the study. All participants viewed the "control" patient's story (white male) and were randomized to view one of the three "experimental" scenarios (white female, black male, black female). After viewing each scenario, the participants were anonymously asked whether they would recommend TKA. An a priori power analysis showed that 112 participants were needed to detect a 15% difference in the likelihood of recommending surgery for white versus nonwhite patients in the test scenarios evaluated with 90% power at a level of significance of 0.05. Of the 39 surgeons who viewed the white male plus black female scenario, there were 33 (85%) concordant responses (TKA offered to both patients) and six discordant responses (TKA offered to only one of the patients), with no effect of patient race and sex (p = 0.99). Of the 37 surgeons who viewed the white male plus black male scenario, there were 33 (89%) concordant responses and four discordant responses, with no effect of patient race (p = 0.32). Of the 37 surgeons who viewed the white male plus white female scenario, there were 30 (77%) concordant responses and seven discordant responses, with no effect of patient sex (p = 0.71). After orthopaedic surgeons viewed video scenarios of patients with end-stage knee osteoarthritis, patient race and sex were not associated with a different likelihood of a surgical recommendation. Our findings support the notion that patient race and sex may be less influential on decision making when there are strong clinical data to support a decision. Physician bias may have a greater effect on decision making in situations where the indications for surgery are less clear.

California Earthquake Clearinghouse Crisis Information-Sharing Strategy in Support of Situational Awareness, Understanding Interdependencies of Critical Infrastructure, Regional Resilience, Preparedness, Risk Assessment/mitigation, Decision-Making and Everyday Operational Needs

NASA Astrophysics Data System (ADS)

Rosinski, A.; Morentz, J.; Beilin, P.

2017-12-01

The principal function of the California Earthquake Clearinghouse is to provide State and Federal disaster response managers, and the scientific and engineering communities, with prompt information on ground failure, structural damage, and other consequences from significant seismic events such as earthquakes and tsunamis. The overarching problem highlighted in discussions with Clearinghouse partners is the confusion and frustration of many of the Operational Area representatives, and some regional utilities throughout the state on what software applications they should be using and maintaining to meet State, Federal, and Local, requirements, and for what purposes, and how to deal with the limitations of these applications. This problem is getting in the way of making meaningful progress on developing multi-application interoperability and the necessary supporting cross-sector information-sharing procedures and dialogue on essential common operational information that entities need to share for different all hazards missions and related operational activities associated with continuity, security, and resilience. The XchangeCore based system the Clearinghouse is evolving helps deal with this problem, and does not compound it by introducing yet another end-user application; there is no end-user interface with which one views XchangeCore, all viewing of data provided through XchangeCore occurs in and on existing, third-party operational applications. The Clearinghouse efforts with XchangeCore are compatible with FEMA, which is currently using XchangeCore-provided data for regional and National Business Emergency Operations Center (source of business information sharing during emergencies) response. Also important, and should be emphasized, is that information-sharing is not just for response, but for preparedness, risk assessment/mitigation decision-making, and everyday operational needs for situational awareness. In other words, the benefits of the Clearinghouse information sharing efforts transcend emergency response. The Clearinghouse is in the process of developing an Information-Sharing System Guide and CONOPS/ templates, that should be aimed a multi-stakeholder, non-technical audience.

Developing Tools to Counteract and Prevent Suicide Bomber Incidents: A Case Study in Value Sensitive Design.

PubMed

Royakkers, Lambèr; Steen, Marc

2017-08-01

Developers and designers make all sorts of moral decisions throughout an innovation project. In this article, we describe how teams of developers and designers engaged with ethics in the early phases of innovation based on case studies in the SUBCOP project (SUBCOP stands for 'SUicide Bomber COunteraction and Prevention'). For that purpose, Value Sensitive Design (VSD) will be used as a reference. Specifically, we focus on the following two research questions: How can researchers/developers learn about users' perspectives and values during the innovation process? and How can researchers/developers take into account these values, and related design criteria, in their decision-making during the innovation process? Based on a case study of several innovation processes in this project, we conclude the researchers/developers involved are able to do something similar to VSD (without them knowing about VSD or calling it 'VSD'), supported by relatively simple exercises in the project, e.g., meetings with potential end-users and discussions with members of the Ethical Advisory Board of the project. Furthermore, we also found-possibly somewhat counterintuitively-that a commercial, with its focus on understanding and satisfying customers' needs, can promote VSD.

Back-to-the-future: a fresh policy initiative for fisheries and a restoration ecology for ocean ecosystems

PubMed Central

Pitcher, Tony J.

2005-01-01

‘Back-to-the-future’ (BTF) is an integrative approach to a restoration ecology of the oceans that attempts to solve the fisheries crisis. To this end, it harnesses the latest understanding of ecosystem processes, developments in whole ecosystem simulation modelling, and insight into the human dimension of fisheries management. BTF includes new methods for describing past ecosystems, designing fisheries that meet criteria for sustainability and responsibility, and evaluating the costs and benefits of fisheries in restored ecosystems. Evaluation of alternative policy choices, involving trade-offs between conservation and economic values, employs a range of economic, social and ecological measures. Automated searches maximize values of objective functions, and the methodology includes analyses of model parameter uncertainty. Participatory workshops attempt to maximize compliance by fostering a sense of ownership among all stakeholders. Some challenges that have still to be met include improving methods for quantitatively describing the past, reducing uncertainty in ecosystem simulation techniques and in making policy choices robust against climate change. Critical issues include whether past ecosystems make viable policy goals, and whether desirable goals may be reached from today’s ecosystem. Examples from case studies in British Columbia, Newfoundland and elsewhere are presented. PMID:15713591

Ethical Analysis of Withdrawing Total Artificial Heart Support.

PubMed

DeMartino, Erin S; Wordingham, Sara E; Stulak, John M; Boilson, Barry A; Fuechtmann, Kayla R; Singh, Nausheen; Sulmasy, Daniel P; Pajaro, Octavio E; Mueller, Paul S

2017-05-01

To describe the characteristics of patients who undergo withdrawal of total artificial heart support and to explore the ethical aspects of withdrawing this life-sustaining treatment. We retrospectively reviewed the medical records of all adult recipients of a total artificial heart at Mayo Clinic from the program's inception in 2007 through June 30, 2015. Management of other life-sustaining therapies, approach to end-of-life decision making, engagement of ethics and palliative care consultation, and causes of death were analyzed. Of 47 total artificial heart recipients, 14 patients or their surrogates (30%) requested withdrawal of total artificial heart support. No request was denied by treatment teams. All 14 patients were supported with at least 1 other life-sustaining therapy. Only 1 patient was able to participate in decision making. It is widely held to be ethically permissible to withdraw a life-sustaining treatment when the treatment no longer meets the patient's health care-related goals (ie, the burdens outweigh the benefits). These data suggest that some patients, surrogates, physicians, and other care providers believe that this principle extends to the withdrawal of total artificial heart support. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Application Level Processing for Long-Lived and Information Rich Wireless Sensor Networks

NASA Astrophysics Data System (ADS)

Wilkins, R.; Gaura, E.; Brusey, J.

2013-12-01

A primary design goal in Wireless Sensor Networks (WSNs) is to ensure the longest possible node lifetime with the available power budget while still meeting application requirements. Since radio transmissions often consume the most power in WSN devices, it follows that a node should aim to maximise its lifetime by transmitting only the data or information required to enable the motivating application. Full raw data streams are often not required since summaries of data are sufficient to meet application needs summaries are often performed at a central point after collection). When raw data is not a requirement, it makes sense to perform as much application-specific processing on-node as possible to minimise the amount of transmissions a node must make. For example, in home environment monitoring, the amount of time a room spends within an acceptable temperature range is more important than the raw stream of temperature measurements. The work presents Bare Necessities (BN) which implements the calculation of application-specific summaries on-node. In the case of knowing the amount time a room spends within an acceptable temperature range, BN encodes the raw signal as a distribution over bins (e.g. a bin might comprise temperatures between 18 °C and 22 °C). BN conserves power by only transmitting when changes to the distribution occur only sending the bare necessities of information the end user is interested in (thus the algorithm name). In the case of home monitoring it has been shown that BN can lead to a packet transmission reduction of 99.98%, increasing a nodes lifetime by a factor of 14 when compared to sense-and-send nodes. A summary of the Bare Necessities process at the node.

Office of Inspector General audit report on Project Hanford management contract costs and performance

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

NONE

1998-11-01

On August 6, 1996, the Richland Operations Office (Richland) awarded the Project Hanford Management Contract (Management Contract) to Fluor Daniel Hanford, Inc. (Fluor Daniel). This performance-based, 5-year contract to support cleanup of the Department of Energy`s (DOE) Hanford Site (Hanford) contained performance goals or expectations related to the stabilization, transition, and diversification of the Tri-Cities` economy near Hanford in southeastern Washington. One of these economic goals was that Fluor Daniel and its major subcontractors would help generate 3,000 new, non-Hanford, private sector jobs that would help stabilize and diversify the Tri-Cities` economy. The contract specifically called for Fluor Daniel tomore » help generate 200 jobs, establish an investment fund, and bring 6 new growth-oriented enterprise companies to the Tri-Cities by the end of Fiscal Year (FY) 1997. The objective of the audit was to determine whether Richland was making adequate progress in stabilizing and diversifying the economy of the Tri-Cities by creating 3,000 new, non-Hanford jobs within 5 years. Accordingly, the author examined the progress made in FY 1997, which was the first year of the Management Contract. Richland and Fluor Daniel are at risk of not meeting the Management Contract`s goals of stabilizing and diversifying the economy of the Tri-Cities because most of the new jobs created during FY 1997 were not comparable to Hanford jobs and, thus, may not sustain long-term economic goals. Therefore, Fluor Daniel has not met its expectations in the first year and is not making adequate progress toward meeting the Management Contract`s overall economic goals.« less

Knowledge About and Perceptions of Advance Care Planning and Communication of Chinese-American Older Adults.

PubMed

Yonashiro-Cho, Jeanine; Cote, Sarah; Enguidanos, Susan

2016-09-01

Although advance care planning (ACP) is associated with better care at the end of life, better quality of death, and less psychological distress in survivors, ethnic disparities in ACP completion rates have been documented and may be attributable to lack of knowledge about ACP or differences in cultural values and preferences. Despite rapid increases in the size of the Asian-American population, little is known about ACP preferences of Chinese Americans. The purpose of this study is to explore the knowledge, attitudes, and preferences of older Chinese Americans toward ACP. Focus groups with Chinese older adults (n = 34) were conducted in Mandarin, Cantonese, and English, and transcripts were analyzed using a grounded theory approach. Identified themes included knowledge and experience with ACP and end-of-life care options, health as a factor in timing of ACP and communication, and communication of end-of-life care preferences. Knowledge of and experience with ACP and end-of-life decision-making varied according to focus group, although few participants had an advance directive. Findings suggest that Chinese older adults prefer to use indirect communication strategies, such as commenting on the circumstances of others rather than directly stating their wishes, and informal contexts, such as during a family dinner rather than formal meeting, to convey their care preferences to loved ones and may employ similar tactics when communicating with clinicians. This is particularly important given the recent decision by the Centers for Medicare and Medicaid Services to provide reimbursement to physicians for engaging in advance care planning conversations. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Impact of provider level, training and gender on the utilization of palliative care and hospice in neuro-oncology: a North-American survey.

PubMed

Walbert, Tobias; Glantz, Michael; Schultz, Lonni; Puduvalli, Vinay K

2016-01-01

Specialized palliative care (PC) services have emerged to address symptoms and provide end-of-life management for patients with brain tumors. The utilization patterns of PC in neuro-oncology are unknown. A 22-question survey was distributed to participants of the society for neuro-oncology annual meeting 2012 (n = 4487). Nonparametric methods including Wilcoxon two-sample and Kruskal-Wallis tests were used to assess differences in responses. 239 (5.3 %) evaluable responses were received; 79 % of respondents were physicians, and 17 % were nurses or midlevel providers. Forty-seven percent were medical or neuro-oncologists, 31 % neurosurgeons and 11 % radiation oncologists. Forty percent had no formal training in PC, 57 % had some formal training and 3 % completed a PC fellowship. Seventy-nine percent practiced in an academic setting. Of the respondents, 57 % referred patients to PC when symptoms required treatment and 18 % at end of life. Only 51 % of all providers felt comfortable dealing with end-of-life issues and symptoms, while 33 % did not. Fifty-one percent preferred a service named "Supportive Care" rather than "Palliative Care" (MDs > midlevel providers, p < 0.001), and 32 % felt that patient expectations for ongoing therapy hindered their ability to make PC referrals. Female gender, formal training in neuro-oncology and PC, and medical versus surgical neuro-oncology training were significantly associated with hospice referral, comfort in dealing with end-of-life issues, and ease of access to PC services. Provider level, specialty, gender, training in PC and neuro-oncology have significant impact on the utilization of PC and hospice in neuro-oncology.

45 CFR 1703.104 - Open meeting policy.

Code of Federal Regulations, 2014 CFR

2014-10-01

... INFORMATION SCIENCE GOVERNMENT IN THE SUNSHINE ACT General Provisions § 1703.104 Open meeting policy. The public is entitled to the fullest practicable information regarding the decision-making processes of the...

78 FR 66865 - Negotiated Rulemaking Committee, Notice of Change to Schedule of Committee Meetings-Title IV...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

...On June 12, 2013, we announced our intention to establish a negotiated rulemaking committee to prepare proposed regulations to establish standards for programs that prepare students for gainful employment in a recognized occupation. We also announced the schedule for committee meetings. Because of the Federal Government shutdown due to a lapse in appropriations, we are rescheduling the second session of committee meetings to November 18-20, 2013. In addition, the last day of the second session will end at 5:00 p.m. instead of at noon.

Less Expensive Internal Management Options May be Viable Alternatives for Countering Critical Military Skill Shortages.

DTIC Science & Technology

1982-04-19

funded authorized spaces for an occupation at .a specified skill level and the number of personnel in the inventory who, for assignment pur- poses, meet t...ose requirements. Because the Air Force’s end of fiscal year personnel inventory usually is at or very close to its congressionally authorized end...used projected end of fiscal year 1982 authoriza- tions and the actual personnel inventory as of September 30, 1981. Using these criteria the study

Radiological Protection Studies for NGLS XTOD

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

Xiao, Shanjie; Santana-Leitner, Mario; Rokni, Sayed

The X-ray transport, optics and diagnostic system (XTOD) starts from the end of bending magnets sending electrons to the main dump and ends at the end wall separating the accelerator tunnel from the user experimental hall (hereafter referred as EH wall), as shown in Figure 1. Figure 1.a shows the general schematic and Figure 1.b shows the initial layout with possible shielding components. This document summarizes the extensive studies on the shielding and collimator system design necessary to meet the radiation protection requirements.

Opportunities for making ends meet and upward mobility: differences in organizational deprivation across urban and suburban poor neighborhoods.

PubMed

Murphy, Alexandra K; Wallace, Danielle

2010-01-01

Objectives. Given the recent rise of poverty in U.S. suburbs, this study asks: What poor neighborhoods are most disadvantageous, those in the city or those in the suburbs? Building on recent urban sociological work demonstrating the importance of neighborhood organizations for the poor, we are concerned with one aspect of disadvantage—the lack of availability of organizational resources oriented toward the poor. By breaking down organizations into those that promote mobility versus those that help individuals meet their daily subsistence needs, we seek to explore potential variations in the type of disadvantage that may exist.Methods. We test whether poor urban or suburban neighborhoods are more likely to be organizationally deprived by breaking down organizations into three types: hardship organizations, educational organizations, and employment organizations. We use data from the 2000 U.S. County Business Patterns and the 2000 U.S. Census and test neighborhood deprivation using logistic regression models.Results. We find that suburban poor neighborhoods are more likely to be organizationally deprived than are urban poor neighborhoods, especially with respect to organizations that promote upward mobility. Interesting racial and ethnic composition factors shape this more general finding.Conclusion. Our findings suggest that if a poor individual is to live in a poor neighborhood, with respect to access to organizational resources, he or she would be better off living in the central city. Suburban residence engenders isolation from organizations that will help meet one's daily needs and even more so from those offering opportunities for mobility.

Coaching Older Adults and Carers to have their preferences Heard (COACH): A randomised controlled trial in an intermediate care setting (study protocol).

PubMed

Masters, Stacey; Gordon, Jason; Whitehead, Craig; Davies, Owen; Giles, Lynne C; Ratcliffe, Julie

2012-01-01

Frail older people who are considering movement into residential aged care or returning home following a hospital admission often face complex and difficult decisions.Despite research interest in this area, a recent Cochrane review was unable to identify any studies of interventions to support decision-making in this group that met the experimental or quasi-experimental study design criteria. This study tests the impact of a multi-component coaching intervention on the quality of preparation for care transitions, targeted to older adults and informal carers. In addition, the study assesses the impact of investing specialist geriatric resources into consultations with families in an intermediate care setting where decisions about future care needs are being made. This study was a randomised controlled trial of 230 older adults admitted to intermediate care in Australia. Masked assessment at 3 and 12 months examined physical functioning, health-related quality of life and utilisation of health and aged care resources. A geriatrician and specialist nurse delivered a coaching intervention to both the older person and their carer/family. Components of the intervention included provision of a Question Prompt List prior to meeting with a geriatrician (to clarify medical conditions and treatments, medications, 'red flags', end of life decisions and options for future health care) and a follow-up meeting with a nurse who remained in telephone contact. Participants received a printed summary and an audio recording of the meeting with the geriatrician. The costs and outcomes of the intervention are compared with usual care. Australian New Zealand Clinical Trials Registry (ACTRN12607000638437).

Social work and end-of-life decisions: self-determination and the common good.

PubMed

Wesley, C A

1996-05-01

Client self-determination is the key element of NASW's policy statement about social work intervention in end-of-life decisions. However, both self-determination and the common good must be respected in social work practice and policy regarding end-of-life decisions. This article discusses self-determination in end-of-life decision making, ethical decision making and the NASW Code of Ethics, and professional ethics based on a balanced view of both self-determination and the common good. Recommendations for professional practice and social policy are offered.

End-of-life decision-making for children with severe developmental disabilities: The parental perspective.

PubMed

Zaal-Schuller, I H; de Vos, M A; Ewals, F V P M; van Goudoever, J B; Willems, D L

2016-01-01

The objectives of this integrative review were to understand how parents of children with severe developmental disorders experience their involvement in end-of-life decision-making, how they prefer to be involved and what factors influence their decisions. We searched MEDLINE, EMBASE, CINAHL and PsycINFO. The search was limited to articles in English or Dutch published between January 2004 and August 2014. We included qualitative and quantitative original studies that directly investigated the experiences of parents of children aged 0-18 years with severe developmental disorders for whom an end-of-life decision had been considered or made. We identified nine studies that met all inclusion criteria. Reportedly, parental involvement in end-of-life decision-making varied widely, ranging from having no involvement to being the sole decision-maker. Most parents preferred to actively share in the decision-making process regardless of their child's specific diagnosis or comorbidity. The main factors that influenced parents in their decision-making were: their strong urge to advocate for their child's best interests and to make the best (possible) decision. In addition, parents felt influenced by their child's visible suffering, remaining quality of life and the will they perceived in their child to survive. Most parents of children with severe developmental disorders wish to actively share in the end-of-life decision-making process. An important emerging factor in this process is the parents' feeling that they have to stand up for their child's interests in conversations with the medical team. Copyright © 2015 Elsevier Ltd. All rights reserved.

75 FR 15776 - Advisory Committee on Former Prisoners of War; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-30

... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Former Prisoners of War; Notice of Meeting... Act) that the Advisory Committee on Former Prisoners of War has scheduled a meeting for April 12-14... prisoners of war, and to make recommendations on the needs of such veterans for compensation, health care...

77 FR 52135 - Advisory Committee on Former Prisoners of War, Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-28

... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Former Prisoners of War, Notice of Meeting... Committee Act) that the Advisory Committee on Former Prisoners of War (FPOW) has scheduled a meeting on... former prisoners of war, and to make recommendations on the needs of such Veterans for compensation...

75 FR 9895 - Science Advisory Board Staff Office; Notification of a Public Meeting of the Science Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-04

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9122-2] Science Advisory Board Staff Office; Notification of a Public Meeting of the Science Advisory Board; Committee on Science Integration for Decision Making... Agency (EPA or Agency) Science Advisory Board (SAB) Staff Office announces a public meeting of the SAB...

76 FR 63929 - Joint Meeting of the Drug Safety and Risk Management Advisory Committee and the Dermatologic and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

...- 0002. Information regarding special accommodations due to a disability, visitor parking, and... line/phone line to learn about possible modifications before coming to the meeting. Agenda: The Food... advisory committee meetings and will make every effort to accommodate persons with physical disabilities or...

75 FR 40816 - Northern Illinois Hydropower, LLC; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-14

... Agency, Old State Capitol Building, Springfield, IL 62701. c. FERC Contact: Janet Hutzel, (202) 502-8675 or janet[email protected] . d. Purpose of Meeting: Commission staff will be meeting with Illinois... upon a request made by interested parties. Please make that request to Janet Hutzel via e-mail at janet...

77 FR 12577 - Department of Defense (DoD) Board of Actuaries; Federal Advisory Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense (DoD) Board of Actuaries... that the following Federal advisory committee meeting of the DoD Board of Actuaries will take place... Actuaries meeting or make an oral presentation or submit a written statement for consideration at the...

U.S. DOE Southeast Clean Energy Application Center

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

Panzarella, Isaac; Mago, Pedro; Kalland, Stephen

2013-12-31

Between 2010 and 2013, the U.S. Department of Energy (DOE) funded the Southeast Clean Energy Application Center (SE-CEAC), co-located at the North Carolina Solar Center at NC State University (NCSU) and at Mississippi State University. The SE-CEAC was one of eight regional CEACs established to promote and assist in transforming the market for combined heat and power (CHP), district energy (DE) and waste heat to power (WHP) throughout the U.S. CHP locates power generation at the point of demand and makes productive use of the residual thermal energy for process and space heating in factories and businesses, thus lowering themore » cost of meeting electricity and heat requirements and increasing energy efficiency. The overall goal of the SE-CEAC was to support end-user implementation and overall market transformation for CHP and related clean energy technologies. Five objectives were targeted to achieve the goal: 1. Market Analysis and Information Dissemination 2. Outreach and Education for Potential CHP End-users 3. Policy Support for State and Regional Stakeholders 4. Technical Assistance to Support CHP Deployment 5. Collaboration with DOE and other CEACs Throughout the project, the CEACs provided key services of education and outreach, technical assistance and market analysis in support of project objectives. These services were very effective at achieving key objectives of assisting prospective CHP end-users and informing policy makers, utilities and others about the benefits of CHP. There is a marked increase in the awareness of CHP technologies and applications as an energy resource among end-users, policymakers, utility regulators, electric utilities and natural gas utilities in the Southeast region as a result. At the end of 2013, a number of best-practice policies for CHP were applied or under consideration in various Southeast states. The SE-CEAC met its targets for providing technical assistance with over 50 analyses delivered for 412 MW of potential end-users CHP applications. Of these 50 MW of projects were under consideration at the end of 2013 based on SE-CEAC technical assistance findings.« less

Radiologist participation in multi-disciplinary teams in breast cancer improves reflective practice, decision making and isolation.

PubMed

Alcantara, S B; Reed, W; Willis, K; Lee, W; Brennan, P; Lewis, S

2014-09-01

This study aims to explore Australian radiologists' experiences of participating in breast cancer multi-disciplinary team (MDT) meetings to identify enablers and barriers to participation as well their perception of confidence and patient care. Qualitative methods incorporating observation and interviews were used. Twenty-one breast cancer MDT meetings were observed across Sydney to study the dynamics of the meetings, the level of participation by radiologists and their most important interactions. Qualitative semi-structured interviews were conducted with 10 radiologists participating in these meetings regarding participation, educational opportunities and improvements to work practices. Radiologists' participation in breast cancer MDT meetings is influenced by the type of meeting they attend with higher levels of participation and a more dominant 'valued' role being evident in pre-interventional meetings. The key themes to emerge from the data include the importance of 'sharing experiences', the 'radiologist-pathologist relationship' and the value of 'continuing participation'. Radiologists believed their confidence in their clinical decision making increased when there was immediate feedback from pathologists. This study highlights the benefits of radiologists regularly participating in breast cancer MDT meetings in terms of continuing professional education resulting from collegial experiential learning. Radiologists' perceived patient care and workplace isolation were improved by sharing experiences with other cancer care colleagues. © 2013 John Wiley & Sons Ltd.

2017-04-28_W88 ALT 370 Program Overview(OUO).

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

Daniels, Vonceil

2017-04-01

All major program milestones have been met and the program is executing within budget. The ALT 370 program achieved Phase 6.4 authorization in February of this year. Five component Final Design Reviews (FDRs) have been completed, indicating progress in finalizing the design and development phase of the program. A series of ground-based qualification activities have demonstrated that designs are meeting functional requirements. The first fully functional flight test, FCET-53, demonstrated end-to-end performance in normal flight environments in February. Similarly, groundbased nuclear safety and hostile environments testing indicates that the design meets requirements in these stringent environments. The first in amore » series of hostile blast tests was successfully conducted in April.« less

75 FR 82001 - Environmental Management Site-Specific Advisory Board, Oak Ridge Reservation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... environmental restoration, waste management, and related activities. Tentative Agenda: The main meeting... meeting in a fashion that will facilitate the orderly conduct of business. Individuals wishing to make...

76 FR 36101 - Environmental Management Site-Specific Advisory Board, Oak Ridge Reservation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-21

... environmental restoration, waste management, and related activities. Tentative Agenda: The main meeting... meeting in a fashion that will facilitate the orderly conduct of business. Individuals wishing to make...

75 FR 24685 - Environmental Management Site-Specific Advisory Board, Oak Ridge Reservation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... environmental restoration, waste management, and related activities. Tentative Agenda: The main meeting... meeting in a fashion that will facilitate the orderly conduct of business. Individuals wishing to make...

7 CFR 25.100 - Eligibility requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... poverty, unemployment, and general distress, as described in § 25.102; (c) Meets the area size and... government making the nomination; and (e) Meets the poverty rate criteria contained in § 25.104. (f...

7 CFR 25.100 - Eligibility requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... poverty, unemployment, and general distress, as described in § 25.102; (c) Meets the area size and... government making the nomination; and (e) Meets the poverty rate criteria contained in § 25.104. (f...

7 CFR 25.100 - Eligibility requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... poverty, unemployment, and general distress, as described in § 25.102; (c) Meets the area size and... government making the nomination; and (e) Meets the poverty rate criteria contained in § 25.104. (f...

7 CFR 25.100 - Eligibility requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... poverty, unemployment, and general distress, as described in § 25.102; (c) Meets the area size and... government making the nomination; and (e) Meets the poverty rate criteria contained in § 25.104. (f...

7 CFR 25.100 - Eligibility requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... poverty, unemployment, and general distress, as described in § 25.102; (c) Meets the area size and... government making the nomination; and (e) Meets the poverty rate criteria contained in § 25.104. (f...

National Online Meeting Proceedings (19th, New York, New York, May 12-14, 1998).

ERIC Educational Resources Information Center

Williams, Martha E., Ed.

This volume contains 52 of the 70 papers that were reviewed and selected for presentation at the 1998 National Online Meeting. While the balance of the papers are not included in this Proceedings, their titles, together with author names and author affiliations, are listed at the end of the volume and they are included in the index. The volume…

33 CFR 165.T10-0693 - Regulated Navigation Area; Greenville Bridge Demolition, Lower Mississippi River, Mile 531.3.

Code of Federal Regulations, 2011 CFR

2011-07-01

... vessel shall adjust its speed so as to avoid a meeting situation in the RNA. (ii) If the RNA is... its speed so as to avoid a meeting situation in the RNA. (ii) If the RNA is temporarily closed to... regulated navigation area (RNA): All waters of the Lower Mississippi River beginning at mile 528 and ending...

33 CFR 165.T10-0693 - Regulated Navigation Area; Greenville Bridge Demolition, Lower Mississippi River, Mile 531.3.

Code of Federal Regulations, 2012 CFR

2012-07-01

... vessel shall adjust its speed so as to avoid a meeting situation in the RNA. (ii) If the RNA is... its speed so as to avoid a meeting situation in the RNA. (ii) If the RNA is temporarily closed to... regulated navigation area (RNA): All waters of the Lower Mississippi River beginning at mile 528 and ending...

Paramedics' experiences of end-of-life care decision making with regard to nursing home residents: an exploration of influential issues and factors.

PubMed

Murphy-Jones, Georgina; Timmons, Stephen

2016-10-01

For a patient nearing the end of his or her life, transfer from a nursing home to the ED can be inappropriate, with potentially negative consequences, but transfer in these circumstances is, regrettably, all too common. There is a lack of published literature exploring how paramedics make decisions in end-of-life care situations. This study aims to explore how paramedics make decisions when asked to transport nursing home residents nearing the end of their lives. Phenomenological influenced design with a pragmatic approach. Semi-structured face-to-face interviews were conducted with six paramedics in an English NHS Ambulance Trust and subsequent data collected by text message. Audio-recorded interviews were transcribed verbatim and analysed using a thematic approach. Three themes emerged in relation to the decision to transport patients from nursing homes to EDs in end-of-life care situations. Paramedics identified difficulties in understanding nursing home residents' wishes. When a patient no longer had the capacity for decision making, paramedics' reasoning processes were aligned to best interest decision making, weighing the risks and benefits of hospitalisation. Paramedics found it challenging to balance patients' best interests with pressure from others: nursing staff, patients' relatives and colleagues. A range of factors influence paramedics' decisions to transport nursing home residents to EDs in end-of-life care situations. Decision making became a process of negotiation when the patient's perceived best interests conflicted with that of others, resulting in contrasting approaches by paramedics. This paper considers how paramedics might be better trained and supported in dealing with these situations, with the aim of providing dignified and appropriate care to patients as they reach the end of their lives. 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/

Cost or Quality?

ERIC Educational Resources Information Center

Purzer, Senay; Duncan-Wiles, Daphne; Strobel, Johannes

2013-01-01

Hopscotch, basketball, or hide-and-seek? Children have many choices at recess, and while making these choices they must consider and make trade-offs. The way they make these decisions is not that different from the thought processes engineers use when making design trade-offs. Engineers have to make trade-offs because a design that meets all…

78 FR 56231 - Government-Wide Travel Advisory Committee (GTAC); Public Advisory Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-12

... Thursday, November 7, 2013, beginning at 9:00 a.m. Eastern Standard Time, and ending no later than 4:00 p.m. Eastern Standard Time and Tuesday, December 10, 2013, beginning at 9:00 a.m. Eastern Standard Time, and ending no later than 4:00 p.m. Eastern Standard Time. FOR FURTHER INFORMATION CONTACT: Ms. Marcerto Barr...

Accounts for the year ended 2000 June 30

NASA Astrophysics Data System (ADS)

Tucker, D.; Hewitt, N. D.

2001-06-01

The Council of the British Astronomical Association presents its audited Accounts for the session ended 2000 June 30. We regret that due to a change of Auditor it was not possible to present these accounts at the Annual General Meeting held on 2000 October 25. They will now be presented for approval at the AGM of the 2000(2001 session, 2001 October 31.

The Interplay of Gender in the Careers of White Female and Male Senior Professors. ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Beaman-Smith, Kandis; Placier, Margaret

A grounded theory study was conducted using open-ended interviews with white male and female senior, tenured faculty members. The setting was a major Midwestern research one university. Four male and five female participants, all white agreed to participate. An open-ended interview protocol was used. Following grounded theory strategies, open…

A geospatial framework for dynamic route planning using congestion prediction in transportation systems.

DOT National Transportation Integrated Search

2011-01-01

The goal this research is to develop an end-to-end data-driven system, dubbed TransDec : (short for Transportation Decision-Making), to enable decision-making queries in : transportation systems with dynamic, real-time and historical data. With Trans...

The incompatibility of healthcare services and end-of-life needs in advanced liver disease: A qualitative interview study of patients and bereaved carers.

PubMed

Hudson, Benjamin; Hunt, Victoria; Waylen, Andrea; McCune, Catherine Anne; Verne, Julia; Forbes, Karen

2018-05-01

Liver disease represents the third commonest cause of death in adults of working age and is associated with an extensive illness burden towards the end of life. Despite this, patients rarely receive palliative care and are unlikely to be involved in advance care planning discussions. Evidence addressing how existing services meet end-of-life needs, and exploring attitudes of patients and carers towards palliative care, is lacking. To explore the needs of patients and carers with liver disease towards the end of life, evaluate how existing services meet need, and examine patient and carer attitudes towards palliative care. Qualitative study - semi-structured interviews analysed using thematic analysis. Settings/participants: A total of 17 participants (12 patients, 5 bereaved carers) recruited from University Hospitals Bristol. Participants described escalating physical, psychological and social needs as liver disease progressed, including disabling symptoms, emotional distress and uncertainty, addiction, financial hardship and social isolation. End-of-life needs were incompatible with the healthcare services available to address them; these were heavily centred in secondary care, focussed on disease modification at the expense of symptom control and provided limited support after curative options were exhausted. Attitudes towards palliative care were mixed, however, participants valued opportunities to express future care preferences (particularly relating to avoidance of hospital admission towards the end of life) and an increased focus on symptomatic and logistical aspects of care. The needs of patients with liver disease and their carers are frequently incompatible with the healthcare services available to them towards the end of life. Novel strategies, which recognise the life-limiting nature of liver disease explicitly and improve coordination with community services, are required if end-of-life care is to improve.

The Drug Safety and Risk Management Advisory Committee: a case study of meeting frequency, content, and outcomes before and after FDAAA.

PubMed

Morrato, Elaine H; Ling, Sarah B

2012-11-01

The Food and Drug Administration Amendments Act (FDAAA) of 2007 granted FDA-expanded drug safety authority. We hypothesized that meetings involving the FDA Drug Safety and Risk Management (DSaRM) Advisory Committee might serve as a barometer for the impact of FDAAA on drug safety regulatory decision making. We conducted a case study analysis of 42 DSaRM advisory committee meetings held between 2002 and 2011. Publicly available sources (FDA meeting minutes and materials, safety alerts, and drug manufacturer Web sites) were reviewed to describe and compare DSaRM meeting frequency, content and outcomes between the pre-FDAAA (2002-2007) and post-FDAAA (2008-2011) periods. DSaRM meeting frequency increased after FDAAA (from 2.7 to 6.5 meetings per year). DSaRM meetings were more likely to be held jointly with other drug advisory committees after FDAAA (from 68% to 92% of meetings). DSaRM members were invited participants in 35 additional meetings of other drug advisory committees (2007-2011). DSaRM meetings were more likely to review issues of approvability (eg, new drugs, new indications, and new product formulations) after FDAAA. FDA questions to the committee were more likely to request an explicit drug safety assessment after FDAAA (from 31% to 76% of meetings). Content analysis of meeting outcomes and subsequent FDA regulatory decisions did not suggest a more or less risk aversive climate after FDAAA. Increased DSaRM advisory committee activity indicates its advice was being sought more broadly for drug regulatory decision making and at earlier stages of drug development after FDAAA was enacted.

Multiresource allocation and scheduling for periodic soft real-time applications

NASA Astrophysics Data System (ADS)

Gopalan, Kartik; Chiueh, Tzi-cker

2001-12-01

Real-time applications that utilize multiple system resources, such as CPU, disks, and network links, require coordinated scheduling of these resources in order to meet their end-to-end performance requirements. Most state-of-the-art operating systems support independent resource allocation and deadline-driven scheduling but lack coordination among multiple heterogeneous resources. This paper describes the design and implementation of an Integrated Real-time Resource Scheduler (IRS) that performs coordinated allocation and scheduling of multiple heterogeneous resources on the same machine for periodic soft real-time application. The principal feature of IRS is a heuristic multi-resource allocation algorithm that reserves multiple resources for real-time applications in a manner that can maximize the number of applications admitted into the system in the long run. At run-time, a global scheduler dispatches the tasks of the soft real-time application to individual resource schedulers according to the precedence constraints between tasks. The individual resource schedulers, which could be any deadline based schedulers, can make scheduling decisions locally and yet collectively satisfy a real-time application's performance requirements. The tightness of overall timing guarantees is ultimately determined by the properties of individual resource schedulers. However, IRS maximizes overall system resource utilization efficiency by coordinating deadline assignment across multiple tasks in a soft real-time application.

Advance care planning within survivorship care plans for older cancer survivors: A systematic review.

PubMed

O'Caoimh, Rónán; Cornally, Nicola; O'Sullivan, Ronan; Hally, Ruth; Weathers, Elizabeth; Lavan, Amanda H; Kearns, Tara; Coffey, Alice; McGlade, Ciara; Molloy, D William

2017-11-01

Advances in the medical treatment of cancer have increased the number of survivors, particularly among older adults, who now represent the majority of these. Survivorship care plans (SCPs) are documents that cancer patients receive summarising their care, usually at the end of treatment but preferably from initial diagnosis. These may increase patient satisfaction and represent an opportunity to initiate preventative strategies and address future care needs. Advance care planning (ACP), incorporating advance healthcare decision-making, including formal written directives, increases satisfaction and end-of-life care. This paper systematically reviews evaluations of ACP within SCPs among older (≥65 years) cancer survivors. No studies meeting the inclusion criteria were identified by search strategies conducted in PubMed/MEDLINE and the Cochrane databases. One paper examined cancer survivors' mainly positive views of ACP. Another discussed the use of a SCP supported by a 'distress inventory' that included an advance care directive (living will) as an issue, though no formal evaluation was reported. Although ACP is important for older adults, no study was found that evaluated its role within survivorship care planning. Despite the risk of recurrence and the potential for morbidity and mortality, especially among older cancer survivors, ACP is not yet a feature of SCPs. Copyright © 2017 Elsevier B.V. All rights reserved.

76 FR 60848 - National Mammography Quality Assurance Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-30

.../phone line to learn about possible modifications before coming to the meeting. Agenda: On November 4... status of the Full Field Digital Mammography universal quality control manual. FDA intends to make...

78 FR 18601 - Respirator Certification Fees; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-27

... rely on NIOSH approved respiratory equipment. DATES: April 30, 2013, 10 a.m. to 4 p.m. EDT, or after... approved respiratory equipment. Requests to make presentations at the public meeting should be mailed to...

76 FR 24573 - Advisory Committee on Former Prisoners of War; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-02

... DEPARTMENT OF VETERANS AFFAIRS Advisory Committee on Former Prisoners of War; Notice of Meeting... Committee Act) that the Advisory Committee on Former Prisoners of War has scheduled a meeting on May 16-18... benefits under title 38, United States Code, for veterans who are former prisoners of war, and to make...

ACHP | News

Science.gov Websites

Search skip specific nav links Home arrow News arrow June 27, 2012 ACHP Rightsizing Task Force to Meet in Cleveland The ACHP's Rightsizing Task Force will be making a visit to Cleveland, Ohio, June 25-26 for a tour and a listening session and open meeting. The task force will host a public meeting on June 26 at

75 FR 66184 - The Future of Aviation Advisory Committee (FAAC) Subcommittee on Financing; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-27

..., and sufficient level of funding for our aviation system and make recommendations to the Secretary for... recommendations to the Secretary of Transportation to ensure the competitiveness of the U.S. aviation industry and... recommendations for presentation at the final meeting of the FAAC on December 15, 2010. Registration The meeting...

75 FR 60491 - The Future of Aviation Advisory Committee (FAAC) Subcommittee on Financing; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-30

... FAAC is to provide advice and recommendations to the Secretary of Transportation to ensure the... the need for a stable, secure, and sufficient level of funding for our aviation system and make recommendations to the Secretary for action. This is the fourth meeting of this subcommittee. DATES: The meeting...

75 FR 8425 - Advisory Committee on International Postal and Delivery Services

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-24

... of the public interested in providing public input to the meeting should contact Mr. Chris Wood... meeting must reach Mr. Wood by letter, e-mail, or fax by this same date. A member of the public requesting reasonable accommodation should make the request to Mr. Wood by that same date. Meeting agenda: The agenda of...

Let's Get Parents Ready for Their Initial IEP Meeting

ERIC Educational Resources Information Center

Hammond, Helen; Ingalls, Lawrence

2017-01-01

Parental participation in the initial Individual Education Program (IEP) meeting is a critical component of the process. Even though parents have rights to be equally involved in making decisions at the IEP meetings, frequently parents aren't prepared to be equal members on the team with school personnel. This study focused on a preparation…

[Designing the Annual Meeting and Active Learning System].

PubMed

Kawamura, Kazumi

2018-01-01

　At the 10th Annual Meeting of the Japanese Society for Pharmaceutical Palliative Care and Sciences our theme centered on active learning systems where adult learners engage on their own initiative. Many of the participants were pharmacists active in clinical practices. Regardless of their specialized skill-sets, pharmacists are constantly faced with difficult challenges in their daily work. Passive, one-way lectures are one resource for them, but unfortunately such lectures provide limited insights for resolving concrete problems. The present meeting aimed to show participants how to obtain information they need to solve specific real-world problems. This paper summarizes how we planned this year's meeting, including details about the debate symposium, social lunch, and online questionnaires. All these elements had the end goal of enabling learners proactivity to become their own best resource for learning. It is sincerely hoped that the design and execution of this meeting will prove resourceful for future annual meetings.

Medical end-of-life decisions in Switzerland 2001 and 2013: Who is involved and how does the decision-making capacity of the patient impact?

PubMed

Schmid, Margareta; Zellweger, Ueli; Bosshard, Georg; Bopp, Matthias

2016-01-01

In Switzerland, the prevalence of medical end-of-life practices had been assessed on a population level only once - in 2001 - until in 2013/14 an identical study was conducted. We aimed to compare the results of the 2001 and 2013 studies with a special focus on shared decision-making and patients' decision-making capacity. Our study encompassed a 21.3% sample of deaths among residents of the German-speaking part of Switzerland aged 1 year or older. From 4998 mailed questionnaires, 3173 (63.5%) were returned. All data were weighted to adjust for age- and sex-specific differences in response rates. Cases with at least one reported end-of-life practice significantly increased from 74.5% (2001) to 82.3% (2013) of all deaths eligible for an end-of-life decision (p <0.001). In 51.2% there was a combination of at least two different end-of-life decisions in one case. In relation to discussion with patients or relatives and otherwise expressed preferences of the patient, 76.5% (74.5-78.4%) of all cases with reported medical end-of-life practice in 2013 (2001: 74.4%) relied on shared decision-making, varying from 79.8% (76.5-82.7%) among not at all capable patients to 87.8% (85.0-90.2%) among fully capable patients. In contrast to a generally increasing trend, the prevalence of end-of-life practices discussed with fully capable patients decreased from 79.0% (75.3-82.3%) in 2001 to 73.2% (69.6-76.0%) in 2013 (p = 0.037). Despite a generally high incidence of end-of-life practices in Switzerland, there remains potential for further improvement in shared decision-making. Efforts to motivate physicians to involve patients and relatives may be a win-win situation.

Recommendations for Making Decisions about the Participation of Students with Disabilities in Statewide Assessment Programs: A Report on a Working Conference To Develop Guidelines for Statewide Assessments and Students with Disabilities. Synthesis Report 15.

ERIC Educational Resources Information Center

Ysseldyke, James E.; And Others

This report is a summary of a May 1994 meeting on the participation of students with disabilities in statewide assessment programs. The report reviews the background of the meeting, states the issues addressed, and summarizes the major points of agreement reached. A set of recommendations is offered for making participation and accommodation…

Being Right Isn't Always Enough: NFL Culture and Team Physicians' Conflict of Interest.

PubMed

McKinney, Ross

2016-11-01

The job of being a sports team physician is difficult, regardless of the level, from high school to the National Football League. When a sports league receives the intensity of attention leveled at the NFL, though, a difficult occupation becomes even more challenging. Even for the NFL players themselves, players' best interests regarding health issues are often unclear. Football players are, as a lot, highly competitive individuals. They want to win, and they want to help the team win. It's a warrior culture, and respect is earned by playing hurt. Should the team physician respect a player's autonomy when this means allowing him to make choices that might lead to further personal harm, especially if the player's choices align with the preference of the coach and management? Or should the doctor set limits and balance the player's choices with a paternalistic set of constraints, perhaps in opposition to both the player's and the team's desires? Simplification of this web of conflicts of interest is the goal of the model proposed by Glenn Cohen, Holly Lynch, and Christopher Deubert. In my view, their proposal is very clever. As an idea, it meets the expectations its authors set, namely, to minimize the problem of conflict of interest in the delivery of health care services to NFL football players. The ethics of the proposal align well with certain moral goals, like treating the player's interests more fairly and treating the player's health as an end instead of as the means to an end. But will such a proposal ever make headway in the pressurized environment of the NFL? © 2016 The Hastings Center.

Palliative care consultation in the process of organ donation after cardiac death.

PubMed

Kelso, Catherine McVearry; Lyckholm, Laurie J; Coyne, Patrick J; Smith, Thomas J

2007-02-01

Palliative care consultation has been demonstrated to be useful in many situations in which expert symptom management, communication around sensitive issues, and family support may serve to enhance or improve care. The process of organ donation is an example of this concept, specifically the process of donation after cardiac death (DCD). DCD allows patients with severe, irreversible brain injuries that do not meet standard criteria for brain death to donate organs when death is declared by cardiopulmonary criteria. The DCD method of donation has been deemed an ethically appropriate means of organ donation and is supported by the organ procurement and medical communities, as well as the public. The palliative care (PC) team can make a significant contribution to the care of the patient and family in the organ donation process. In this paper we describe the controlled DCD process at one institution that utilizes the PC team to provide expert end-of-life care, including comprehensive medical management and family support. PC skills and principles applicable to the DCD process include communication, coordination of care, and skillful ventilator withdrawal. If death occurs within 90 minutes of withdrawal of life support, organs may be successfully recovered for transplantation. If the patient survives longer than 90 minutes, his or her care continues to be provided by the PC team. Palliative care can contribute to standardizing quality end-of-life care practices in the DCD process and provide education for involved personnel. Further experience, research and national discussions will be helpful in refining these practices, to make this difficult and challenging experience as gentle and supportive as possible for the courageous families who participate in this process.

Patient satisfaction with extended-interval warfarin monitoring.

PubMed

Carris, Nicholas W; Hwang, Andrew Y; Smith, Steven M; Taylor, James R; Sando, Karen; Powell, Jason; Rosenberg, Eric I; Zumberg, Marc S; Gums, John G; Dietrich, Eric A; Anderson, Katherine Vogel

2016-11-01

Extended-interval monitoring of warfarin has been proposed to reduce follow-up burden and improve patient satisfaction. We aimed to make an initial assessment of anticoagulation satisfaction before and after an extended-interval warfarin monitoring intervention. We conducted a translational prospective single-arm pilot study of extended-interval warfarin monitoring in five pharmacist-managed anticoagulation clinics. Patients meeting CHEST guideline criteria for extended-interval warfarin monitoring began progressive extended-interval follow-up (6, 8, and 12 weeks thereafter). The Duke Anticoagulation Satisfaction Scale (DASS) was administered at baseline and at end-of-study or study removal (in patients no longer appropriate for extended interval follow-up). Forty-six patients had evaluable pre- and post-intervention DASS survey data. Mean age of patients was 66.5 years, 74 % were non-Hispanic whites, and 48 % were men. Patients completed a mean ± SD of 34 ± 22 weeks of follow-up. Mean ± SD total DASS score at baseline was 45.2 ± 14.2 versus 49.1 ± 14.9 at end-of-study (mean change, +3.9 [95 % CI -0.6-8.4; p = 0.09]), indicating no benefit-and trending toward decrement-to anticoagulation satisfaction. Change in anticoagulation satisfaction varied substantially following extended-interval monitoring, with no evidence of improved satisfaction. Plausible reasons for patients not preferring extended-interval monitoring include increased anxiety and disengagement from self-management activities, both potentially related to less frequent feedback and reassurance during extended interval-monitoring. Additional research is needed to identify who is likely to benefit most from extended-interval monitoring. Anticoagulation satisfaction should be considered with clinical factors and shared-decision making when implementing extended-interval warfarin monitoring.

Pilot study completed: Paving the way for stereoscopic DEMs, orthophotos and vector maps over the ice-free parts of Greenland

NASA Astrophysics Data System (ADS)

Levinsen, Joanna F.; Borgstrøm, Rasmus E.

2017-04-01

We present the work towards developing new Digital Elevation Models (DEMs), orthophotos, and vector maps over the ice-free parts of Greenland. The products will be based on high-resolution stereoscopic images co-registered to Ground Control Points (GCPs) to reduce horizontal and vertical errors. Here, we provide a status overview of our achievements wrt. DEMs and orthophotos. We have conducted a pilot study in which four areas have been mapped using SPOT-6 and -7 images: The Disko Bay, Narsaq, Tasiilaq, and Zackenberg. The images have been acquired in 2016, with a few additions from 2014, and the areas cover approximately 82.000 km2, i.e. ˜20% of the total ice-free area. The technical requirements for the products have been defined in close collaboration with end-users from governmental institutions, emergency management offices, the tourist industry, etc., to ensure a direct applicability following product completion. This has resulted in 8 m DEMs and 1.5 m orthophotos. Validation against GCPs shows horizontal and vertical offsets of approximately 0.5 ± 2 m, i.e. values that meet our expectations and satisfy end-user needs. The GCPs make out an extensive network of huts, helipads, ports, large boulders, etc., measured using GPS by collaborators during field campaigns. The experiences gained in the product development as well as the broad range of collaborations provides confidence that the set-up for a production of the total ice-free area has been established, which can deliver products with a high accuracy in time and space. That will make them useful for a wide range of purposes. The next step therefore is to secure the given upgrade. More on that to come!

Fourteenth-Sixteenth Microbial Genomics Conference-2006-2008

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

Miller, Jeffrey H

2011-04-18

The concept of an annual meeting on the E. coli genome was formulated at the Banbury Center Conference on the Genome of E. coli in October, 1991. The first meeting was held on September 10-14, 1992 at the University of Wisconsin, and this was followed by a yearly series of meetings, and by an expansion to include The fourteenth meeting took place September 24-28, 2006 at Lake Arrowhead, CA, the fifteenth September 16-20, 2007 at the University of Maryland, College Park, MD, and the sixteenth September 14-18, 2008 at Lake Arrowhead. The full program for the 16th meeting is attached.more » There have been rapid and exciting advances in microbial genomics that now make possible comparing large data sets of sequences from a wide variety of microbial genomes, and from whole microbial communities. Examining the “microbiomes”, the living microbial communities in different host organisms opens up many possibilities for understanding the landscape presented to pathogenic microorganisms. For quite some time there has been a shifting emphasis from pure sequence data to trying to understand how to use that information to solve biological problems. Towards this end new technologies are being developed and improved. Using genetics, functional genomics, and proteomics has been the recent focus of many different laboratories. A key element is the integration of different aspects of microbiology, sequencing technology, analysis techniques, and bioinformatics. The goal of these conference is to provide a regular forum for these interactions to occur. While there have been a number of genome conferences, what distinguishes the Microbial Genomics Conference is its emphasis on bringing together biology and genetics with sequencing and bioinformatics. Also, this conference is the longest continuing meeting, now established as a major regular annual meeting. In addition to its coverage of microbial genomes and biodiversity, the meetings also highlight microbial communities and the use of genomic information to aid in the understanding of pathogens and biothreats. An additional focus cover s“bioenergetics. The meetings have a mix of invited and participant-initiated presentations and poster sessions during which investigators from different disciplines become familiar with available data bases and new tools facilitating coordination of information. The fields are moving very fast both in the acquisition of new knowledge of genome contents and also in the management and analysis of the information. The key is connecting bodies of knowledge on sequences, genetic organization and regulation to be able to relate the significance of this information to understanding cellular processes. To our knowledge, no other meeting synthesizes the biology of organisms, sequence information and database analysis, as well as the comparison with other completed genome sequences.« less

Living kidney donation: considerations and decision-making.

PubMed

Agerskov, Hanne; Bistrup, Claus; Ludvigsen, Mette Spliid; Pedersen, Birthe D

2014-06-01

When possible, renal transplantation is the treatment of choice for patients with end-stage kidney disease. Technological developments in immunology have made it possible to perform kidney transplants between donors and recipients despite antibodies against the donor organ. This allows for a wider range of relationships between recipient and donor. We investigated experiences of, and reflections on, kidney donation among genetic and non-genetic living donors before first consultation at the transplant centre. The aim was to investigate early experiences in the process of becoming a living kidney donor (LKD). The study was conducted within a phenomenological-hermeneutic theoretical framework. Data were generated through semi-structured interviews with 18 potential donors. Data were interpreted and discussed in accordance with the Ricoeur's text interpretation theory on the three levels of naïve reading, structural analysis and critical interpretation and discussion. Two themes emerged: the decision-making process and dilemmas in decision-making. The study identifies that the decision about donation was made in relation to one's own life, family situation and in relation to the recipient-considerations that demonstrate that a range of dilemmas can occur during the decision-making process. The desire to help was prominent and was of significance in decision-making. The study provides insight and knowledge for the health care professionals to meet and involve donors' narratives in reflections about and modifications to clinical nursing practice. It is essential that health care professionals have an understanding and appreciation of the experiences and concerns among LKDs, and this can help in planning and providing individual nursing care and support to donors. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Active Donor Management During the Hospital Phase of Care Is Associated with More Organs Transplanted per Donor.

PubMed

Patel, Madhukar S; De La Cruz, Salvador; Sally, Mitchell B; Groat, Tahnee; Malinoski, Darren J

2017-10-01

Meeting donor management goals when caring for potential organ donors has been associated with more organs transplanted per donor (OTPD). Concern persists, however, as to whether this indicates that younger/healthier donors are more likely to meet donor management goals or whether active management affects outcomes. A prospective observational study of all standard criteria donors was conducted by 10 organ procurement organizations across United Network for Organ Sharing Regions 4, 5, and 6. Donor management goals representing normal critical care end points were measured at 2 time points: when a catastrophic brain injury was recognized and a referral was made to the organ procurement organization by the DH; and after brain death was declared and authorization for organ donation was obtained. Donor management goals Bundle "met" was defined as achieving any 7 of 9 end points. A positive Bundle status change was defined as not meeting the Bundle at referral and subsequently achieving it at authorization. The primary outcomes measure was having ≥4 OTPD. Data were collected for 1,398 standard criteria donors. Of the 1,166 (83%) who did not meet the Bundle at referral, only 254 (22%) had a positive Bundle status change. On adjusted analysis, positive Bundle status change increased the odds of achieving ≥4 OTPD significantly (odds ratio 2.04; 95% CI 1.49 to 2.81; p < 0.001). A positive donor management goal Bundle status change during donor hospital management is associated with a 2-fold increase in achieving ≥4 OTPD. Active critical care management of the potential organ donor, as evidenced by improvement in routinely measured critical care end points can be a means by which to substantially increase the number of organs available for transplantation. Published by Elsevier Inc.

Comparing end-of-life practices in different policy contexts: a scoping review.

PubMed

Boivin, Antoine; Marcoux, Isabelle; Garnon, Geneviève; Lehoux, Pascale; Mays, Nicholas; Prémont, Marie-Claude; Chao, Yi-Sheng; van Leeuwen, Evert; Pineault, Raynald

2015-04-01

End-of-life policy reforms are being debated in many countries. Research evidence is used to support different assumptions about the effects of public policies on end-of-life practices. It is however unclear whether reliable international practice comparisons can be conducted between different policy contexts. Our aim was to assess the feasibility of comparing similar end-of-life practices in different policy contexts. This is a scoping review of empirical studies on medical end-of-life practices. We developed a descriptive classification of end-of-life practices that distinguishes practices according to their legal status. We focused on the intentional use of lethal drugs by physicians because of international variations in the legal status of this practice. Bibliographic database searches were supplemented by expert consultation and hand searching of reference lists. The sensitivity of the search strategy was tested using a set of 77 articles meeting our inclusion criteria. Two researchers extracted end-of-life practice definitions, study methods and available comparisons across policy contexts. Canadian decision-makers were involved to increase the policy relevance of the review. In sum, 329 empirical studies on the intentional use of lethal drugs by doctors were identified, including studies from 19 countries. The bibliographic search captured 98.7% of studies initially identified as meeting the inclusion criteria. Studies on the intentional use of lethal drugs were conducted in jurisdictions with permissive (62%) and restrictive policies (43%). The most common study objectives related to the frequency of end-of-life practices, determinants of practices, and doctors' adherence to regulatory standards. Large variations in definitions and research methods were noted across studies. The use of a descriptive classification was useful to translate end-of-life practice definitions across countries. A few studies compared end-of-life practice in countries with different policies, using consistent research methods. We identified no comprehensive review of end-of-life practices across different policy contexts. It is feasible to compare end-of-life practices in different policy contexts. A systematic review of international evidence is needed to inform public deliberations on end-of-life policies and practice. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

20 CFR 416.932 - When presumptive payments begin and end.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FOR THE AGED, BLIND, AND DISABLED Determining Disability and Blindness Presumptive Disability and Blindness § 416.932 When presumptive payments begin and end. We may make payments to you on the basis of presumptive disability or presumptive blindness before we make a formal determination about your disability or...

Planning the Transition to End-of-Life Care in Advanced Cancer (PDQ®)—Health Professional Version

Cancer.gov

Planning the transition to end-of-life care in advanced cancer involves making decisions that can be challenging and emotionally distressing. Get information about likely topics and strategies to improve patient-oncologist communication and decision making in this clinician summary.

78 FR 15726 - Cellular, Tissue and Gene Therapies Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-12

.... In open session, the committee will hear updates of research programs in the Laboratory of Chemistry... advisory committee meetings and will make every effort to accommodate persons with physical disabilities or...

76 FR 66041 - Caribbean Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-25

... public, and will be conducted in English. ADDRESSES: The meeting will be held at the Embassy Suites Hotel... discussion and make a recommendation to the CFMC regarding funding a pilot ERAEF study in St. Thomas, USVI...

75 FR 65466 - Environmental Management Site-Specific Advisory Board, Oak Ridge Reservation

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... Agenda: The main meeting presentation will be on the Oak Ridge National Laboratory Central Campus Stack... meeting in a fashion that will facilitate the orderly conduct of business. Individuals wishing to make...

76 FR 25699 - Eunice Kennedy Shriver National Institute of Child Health & Human Development; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-05

... to make your reservation. Additional seating will be available in the meeting overflow rooms... Federal Domestic Assistance Program Nos. 93.864, Population Research; 93.865, Research for Mothers and...

Proceedings of the Annual Meeting of the Association of Higher Education Facilities Officers (86th, Cincinnati, OH, June 20-22, 1999).

ERIC Educational Resources Information Center

APPA: Association of Higher Education Facilities Officers, Alexandria, VA.

This proceedings document presents the texts of 11 papers presented at the 1999 annual meeting of the Association of Higher Education Facilities Officers. The papers are: (1) "Is There a Pot of Gold at the End of the Rainbow?" (James J. Sebesta, Charles Strutz, and Frank Brewer); (2) "Preparing for Y2K" (Joe Spoonemore, Michael Montgomery, and…

Induced Insecurity: Understanding the Potential Pitfalls in Developing Theater Campaign Plans

DTIC Science & Technology

2015-06-11

effective partnerships that meet outlined in higher- level strategic guidance . 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. UMITATION OF... effective partnerships that meet the desired end states outlined in higher-level strategic guidance. DEDICATION To the millions of men and women who...and draw conclusions, it does not always prove to be an effective means of predicting the outcome of current or future events. In addition, the

Developing evidence that is fit for purpose: a framework for payer and research dialogue.

PubMed

Sabharwal, Rajeev K; Graff, Jennifer S; Holve, Erin; Dubois, Robert W

2015-09-01

Matching the supply and demand of evidence requires an understanding of when more evidence is needed, as well as the type of evidence that will meet this need. This article describes efforts to develop and refine a decision-making framework that considers payers' perspectives on the utility of evidence generated by different types of research methods, including real-world evidence. Conceptual framework development with subsequent testing during a roundtable dialogue. The framework development process included a literature scan to identify existing frameworks and relevant articles on payer decision making. The framework was refined during a stand-alone roundtable in December 2013 hosted by the research team, which included representatives from public and private payers, pharmacy benefit management, the life sciences industry, and researchers. The roundtable discussion also included an application of the framework to 3 case studies. Application of the framework to the clinical scenarios and the resulting discussion provided key insights into when new evidence is needed to inform payer decision making and what questions should be addressed. Payers are not necessarily seeking more evidence about treatment efficacy; rather, they are seeking more evidence for relevant end points that illustrate the differences between treatment alternatives that can justify the resources required to change practice. In addition, payers are interested in obtaining new evidence that goes beyond efficacy, with an emphasis on effectiveness, longer-term safety, and delivery system impact. We believe that our decision-making framework is a useful tool to increase dialogue between evidence generators and payers, while also allowing for greater efficiency in the research process.

Energy conservation with automatic flow control valves

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

Phillips, D.

Automatic flow control valves are offered in a wide range of sizes starting at 1/2 in. with flow rates of 0.5 gpm and up. They are also provided with materials and end connections to meet virtually any fan-coil system requirement. Among these are copper sweat type valves; ductile iron threaded valves; male/female threaded brass valves; and combination flow control/ball valves with union ends.

From Campus Tug-of-War to Pulling Together: Using the Lean Approach

ERIC Educational Resources Information Center

MacIntyre, Stephen; Meade, Kelly; McEwen, Melissa

2009-01-01

Some days seem like bouts in an endless game of tug-of-war. At one end of the rope, facilities professionals must do more--tackle deferred maintenance, develop a climate strategy, and meet the energy and operational needs for a complex mix of building types and stakeholders. Tugging on the other end are the obstacles of less money, staff, and…

Texas High School Seniors: The Path of Students Who Fail the First Administration of End of Course Exams and Eventually Meet Standard and Graduate

ERIC Educational Resources Information Center

Nanez, Lilia G.

2015-01-01

This qualitative phenomenological research study investigated Texas high school seniors who failed the initial administration of the End of Course (EOC) exams required for graduation but succeeded upon subsequent test administration. The four questions that guided the research explored the experienced regarding the EOC exams by identifying which…

Family communication and decision making at the end of life: a literature review.

PubMed

Wallace, Cara L

2015-06-01

Patients and families coping with a terminal illness are faced with a number of decisions over the course of their disease. The role that family communication plays in the process of decision making is an important one. The objectives for this review are to examine the current state of empirical literature on the relationship between family communication and decision making about end-of-life care, to identify gaps, and to discuss implications for policy, practice, and future research. Articles were identified using systematic keyword searches within the following relevant databases: Academic Search Complete, CINAHL Plus, Communications and Mass Media Complete, ERIC, PsychINFO, MEDLINE, SocINDEX, and ProQuest. The three bodies of relevant literature that emerged during this review include: (1) the importance of family communication at the end of life (EoL); (2) family decision making at the EoL; and (3) the interrelationship of communication (both within the family and with healthcare professionals) and decision making at the EoL. While the literature highlights the role of communication between medical professionals and the patient or family members, there is very little focus on the process of how family communication among the family members themselves contributes to decision making at the end of life. Barriers to end-of-life care are important considerations for helping patients to access timely and appropriate services. Understanding the pertinent role of family communication as it relates to the decision for EoL care is the first step in working to provide another avenue for overcoming these barriers.

Emotional Impact of End-of-Life Decisions on Professional Relationships in the ICU: An Obstacle to Collegiality?

PubMed

Laurent, Alexandra; Bonnet, Magalie; Capellier, Gilles; Aslanian, Pierre; Hebert, Paul

2017-12-01

End-of-life decisions are not only common in the ICU but also frequently elicit strong feelings among health professionals. Even though we seek to develop more collegial interprofessional approaches to care and health decision-making, there are many barriers to successfully managing complex decisions. The aim of this study is to better understand how emotions influence the end-of-life decision-making process among professionals working in ICU. Qualitative study with clinical interviews. All interviews were transcribed verbatim and analyzed thematically using interpretative phenomenological analysis. Two independent ICUs at the "Centre Hospitalier de l'Université de Montréal." Ten physicians and 10 nurses. None. During the end-of-life decision-making process, families and patients restructure the decision-making frame by introducing a strong emotional dimension. This results in the emergence of new challenges quite different from the immediacy often associated with intensive care. In response to changes in decision frames, physicians rely on their relationship with the patient's family to assist with advanced care decisions. Nurses, however, draw on their relationship and proximity to the patient to denounce therapeutic obstinacy. Our study suggests that during the end-of-life decision-making process, nurses' feelings toward their patients and physicians' feelings toward their patients' families influence the decisions they make. Although these emotional dimensions allow nurses and physicians to act in a manner that is consistent with their professional ethics, the professionals themselves seem to have a poor understanding of these dimensions and often overlook them, thus hindering collegial decisions.

Detailed analysis of acidic compounds in Mayan gas oil and hydrotreated products

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

Sturm, G.P. Jr.; Green, J.B.; Grigsby, R.D.

1989-04-01

The present and future importance of heavy crude as a primary energy resource is widely recognized in spite of the current oversupply of crude oil. Along with coal and shale oil, heavy crudes and heavy ends of conventional crude produced by primary and enhanced oil recovery methods are considered important and dependable resources to meet their nation's long-term energy needs. Heavy crudes impose more severe requirements upon refining technology to produce end products meeting current specifications in terms of stability, compatibility, and corrosiveness. This study is based on the premise that knowledge of the problem components in the feedstocks, intermediatemore » process streams, and products can aid in the development of efficient and economical means of producing higher quality products.« less

Equality for followers of South Asian religions in end-of-life care.

PubMed

Samanta, Jo

2013-06-01

Significant minority populations confer richness and diversity to British society. Responsive end-of-life care is a universal need that has ascended the public agenda following myriad reports of inadequate provision. Nevertheless, the potential exists for unwitting discrimination when caring for terminally ill patients on the basis of their religion or faith. Recent implementation of the Equality Act 2010, together with the government and professional initiatives, promises to positively impact upon this area of contemporary relevance and concern, although the extent to which facilitative policies can truly enhance patient care will depend upon how these are translated into care at the bedside. The contributions of health professionals will be central in meeting the challenges and seizing the opportunities for meeting the religion and faith interests of patients of South Asian descent.

40 CFR 35.4045 - What requirements must my group meet as a TAG recipient?

Code of Federal Regulations, 2010 CFR

2010-07-01

... for the purpose of participating in decision making at the Superfund site for which we provide a TAG... 40 Protection of Environment 1 2010-07-01 2010-07-01 false What requirements must my group meet as... Responsibilities As A Tag Recipient § 35.4045 What requirements must my group meet as a TAG recipient? Your group...

Development and Operations of the Astrophysics Data System

NASA Technical Reports Server (NTRS)

Murray, Stephen S.

1998-01-01

Preparations for the AAS meeting in January are progressing. We will have a talk, a poster, and a demonstration. We organized a meeting during the AAS conference to discuss bibliographic codes in order to make sure the different information providers can inter-operate. Our new server should be on-line for the AAS meeting. This will improve the search speed considerably.

40 CFR 60.1130 - How do I make my siting analysis available to the public?

Code of Federal Regulations, 2010 CFR

2010-07-01

... separation plan. Include the normal business hours of each library. (5) An agenda of the topics that will be...) Distribute your siting analysis and revised materials separation plan to the main public libraries in the... public meeting. (2) The time of the public meeting. (3) The location of the public meeting. (4) The...

76 FR 56454 - Consumer Advisory Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-13

... FEDERAL COMMUNICATIONS COMMISSION [DA 11-1493] Consumer Advisory Committee Meeting AGENCY: Federal... its Consumer Advisory Committee (Committee). The purpose of the Committee is to make recommendations to the Commission regarding consumer issues within the jurisdiction of the Commission and to...

42 CFR 456.653 - Acceptable reasons for not meeting requirements for annual on-site review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for Failure To Make a Satisfactory Showing of an Effective Institutional Utilization Control Program... will find an agency's showing satisfactory, even if it failed to meet the annual review requirements of...

Adequate number of clinicians on usability tests lacking, says study.

PubMed

2015-12-01

A new study reveals that some of the largest EMR vendors failed to meet certification standards, specifying that they state their user-centered design processes, and that they include at least 15 representative end-user participants in their usability tests. It is not clear why these vendors were certified despite not meeting the standards established by Office of the National Coordinator for Health Information Technology (ONC), but investigators suggest that emergency clinicians and administrators should engage with vendors early on, querying them about their user-centered processes. An analysis of the usability tests performed by 41 of some the largest EMR vendors found that 34% of them did not meet certification standards, specifying that they state their user-centered design process. Also, 63% of the vendors failed to include at least 15 representative end-users in their usability tests. Only 15% of the vendors used at least 15 participants who had clinical backgrounds in their usability tests. Experts urge clinicians to engage with EMR user groups to share best practices for optimizing specific EMR products.

George Williams in Thailand: An Ethical Decision-Making Exercise

ERIC Educational Resources Information Center

James, Constance R.; Smith, J. Goosby

2007-01-01

This article presents a classroom ethical decision-making exercise designed to help students make reasoned ethical decisions while gaining insight into their own and others' ethical decision-making strategies. During the exercise, students individually analyze an original mini-case, then meet in small groups to reach consensus on the advice and…

77 FR 35450 - Self-Regulatory Organizations; EDGA Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-13

... segregated by market participant identifiers (MPID), the Market Making exemption applies to the parent firm... the criteria for an exemption under market making. In recognition of the value that the Exchange derives from such market making, any Member that meets the market making obligations pursuant to Rule 11...

A model for emergency department end-of-life communications after acute devastating events--part II: moving from resuscitative to end-of-life or palliative treatment.

PubMed

Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

2012-11-01

The model for emergency department (ED) end-of-life communications after acute devastating events addresses decision-making capacity, surrogates, and advance directives, including legal definitions and application of these steps. Part II concerns communications moving from resuscitative to palliative and end-of-life treatments. After completing the steps involved in determining decision-making, emergency physicians (EPs) should consider starting palliative measures versus continuing resuscitative treatment. As communications related to these end-of-life decisions increasingly fall within the scope of emergency medicine (EM) practice, we need to become educated about and comfortable with them. © 2012 by the Society for Academic Emergency Medicine.

Preparing Future Leaders: An Integrated Quality Improvement Residency Curriculum.

PubMed

Potts, Stacy; Shields, Sara; Upshur, Carole

2016-06-01

The Accreditation Council for Graduate Medical Education (ACGME) has recognized the importance of quality improvement (QI) training and requires that accredited residencies in all specialties demonstrate that residents are "integrated and actively participate in interdisciplinary clinical quality improvement and patient safety activities." However, competing demands in residency training may make this difficult to accomplish. The study's objective is to develop and evaluate a longitudinal curriculum that meets the ACGME requirement for QI and patient safety training and links to patient-centered medical home (PCMH) practices. Residents in the Worcester Family Medicine Residency (WFMR) participated in a faculty-developed quality improvement curriculum that included web-based tutorials, quality improvement projects, and small-group sessions across all 3 years of residency. They completed self-evaluations of knowledge and use of curricular activities annually and at graduation, and comparisons were made between two graduating classes, as well as comparison of end of PGY2 to end of PGY3 for one class. Graduating residents who completed the full 3 years of the curriculum rated themselves as significantly more skilled in nine of 15 areas assessed at end of residency compared to after PGY2 and reported confidence in providing future leadership in a focus group. Five areas were also rated significantly higher than prior-year residents. Involving family medicine residents in a longitudinal curriculum with hands-on practice in implementing QI, patient safety, and chronic illness management activities that are inclusive of PCMH goals increased their self-perceived skills and leadership ability to implement these new and emerging evidence-based practices in primary care.

Improving the Nutritional Impact of the Supplemental Nutrition Assistance Program

PubMed Central

Leung, Cindy W.; Musicus, Aviva; Willett, Walter C.; Rimm, Eric B.

2017-01-01

Introduction The Supplemental Nutrition Assistance Program (SNAP) is the largest federal food assistance program designed to alleviate food insecurity and improve dietary intake. This study assessed the opinions of SNAP participants and food-insufficient nonparticipants on their perceptions of the program and strategies to improve its nutritional impact. Methods This study surveyed 387 individuals via Amazon Mechanical Turk, of whom 118 were SNAP participants and 269 were food insufficient but not enrolled in SNAP (nonparticipants). Open-ended questions were coded and analyzed for thematic content. For closed-ended questions, response frequencies were compared using chi-square tests. Data were analyzed in 2016. Results SNAP participants reported that the program successfully served its primary purpose: to allow individuals to buy enough food to make ends meet and reduce food insecurity. Importance was placed on buying food for their children/families and the ability to allocate money for other expenses. To improve the nutritional impact, SNAP participants suggested more nutrition education, increasing the benefit allotment, incentivizing healthful foods, and excluding unhealthful foods for purchase with SNAP. When participants and nonparticipants were asked to choose between SNAP and a nutritionally enhanced program combining healthy incentives with exclusions for sugary beverages (i.e., SNAP+), 68% of participants and 83% of nonparticipants chose SNAP+. Of those who initially chose SNAP, 68% of participants and 64% of nonparticipants chose SNAP+ if paired with a 50% increase in total benefits. Conclusions SNAP participants and food-insufficient nonparticipants support policies that facilitate purchases of healthful foods and limit purchases of unhealthful foods, specifically sugary beverages. PMID:28109422

Cost of Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS): prospective cohort study protocol.

PubMed

Teo, Irene; Singh, Ratna; Malhotra, Chetna; Ozdemir, Semra; Dent, Rebecca A; Kumarakulasinghe, Nesaretnam Barr; Yeo, Wee Lee; Cheung, Yin Bun; Malhotra, Rahul; Kanesvaran, Ravindran; Yee, Alethea Chung Pheng; Chan, Noreen; Wu, Huei Yaw; Chin, Soh Mun; Allyn, Hum Yin Mei; Yang, Grace Meijuan; Neo, Patricia Soek Hui; Nadkarni, Nivedita V; Harding, Richard; Finkelstein, Eric A

2018-04-23

Advanced cancer significantly impacts quality of life of patients and families as they cope with symptom burden, treatment decision-making, uncertainty and costs of treatment. In Singapore, information about the experiences of advanced cancer patients and families and the financial cost they incur for end-of-life care is lacking. Understanding of this information is needed to inform practice and policy to ensure continuity and affordability of care at the end of life. The primary objectives of the Cost of Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS) cohort study are to describe changes in quality of life and to quantify healthcare utilization and costs of patients with advanced cancer at the end of life. Secondary objectives are to investigate patient and caregiver preferences for diagnostic and prognostic information, preferences for end-of-life care, caregiver burden and perceived quality of care and to explore how these change as illness progresses and finally to measure bereavement adjustment. The purpose of this paper is to present the COMPASS protocol in order to promote scientific transparency. This cohort study recruits advanced cancer patients (n = 600) from outpatient medical oncology clinics at two public tertiary healthcare institutions in Singapore. Patients and their primary informal caregiver are surveyed every 3 months until patients' death; caregivers are followed until 6 months post patient death. Patient medical and billing records are obtained and merged with patient survey data. The treating medical oncologists of participating patients are surveyed to obtain their beliefs regarding care delivery for the patient. The study will allow combination of self-report, medical, and cost data from various sources to present a comprehensive picture of the end-of-life experience of advanced cancer patients in a unique Asian setting. This study is responsive to Singapore's National Strategy for Palliative Care which aims to identify opportunities to meet the growing need for high quality care for Singapore's aging population. Results will also be of interest to policy makers and researchers beyond Singapore who are interested to understand and improve the end-of-life experience of cancer patients. NCT02850640 (Prospectively registered on June 9, 2016).

End-of-life communication in veterinary medicine: delivering bad news and euthanasia decision making.

PubMed

Shaw, Jane R; Lagoni, Laurel

2007-01-01

Given the expectations of clients and the resultant impact of end-of-life conversations on pet owners and the veterinary team, compassionate end-of-life communication is considered to be an ethical obligation, a core clinical skill, and integral to the success of a veterinary team. End-of-life communication is related to significant clinical outcomes, including enduring veterinarian-client-patient relationships and veterinarian and client satisfaction. Effective techniques for end-of-life communication can be taught and are a series of learned skills. The purpose of this article is to present best practices for delivering bad news and euthanasia decision-making discussions. In this article, the SPIKES six-step model (setting, perception, invitation, knowledge, empathize, and summarize) currently employed in medical curricula is utilized to structure end-of-life conversations in veterinary medicine.

75 FR 54657 - Sunshine Act Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... Semitrailer Rear-End Collision Into Passenger Vehicles on Interstate 44, Near Miami, Oklahoma, June 26, 2009. News Media Contact: Telephone: (202) 314-6100. The press and public may enter the NTSB Conference...

Back-illuminate fiber system research for multi-object fiber spectroscopic telescope

NASA Astrophysics Data System (ADS)

Zhou, Zengxiang; Liu, Zhigang; Hu, Hongzhuan; Wang, Jianping; Zhai, Chao; Chu, Jiaru

2016-07-01

In the telescope observation, the position of fiber will highly influence the spectra efficient input in the fiber to the spectrograph. When the fibers were back illuminated on the spectra end, they would export light on the positioner end, so the CCD cameras could capture the photo of fiber tip position covered the focal plane, calculates the precise position information by light centroid method and feeds back to control system. A set of fiber back illuminated system was developed which combined to the low revolution spectro instruments in LAMOST. It could provide uniform light output to the fibers, meet the requirements for the CCD camera measurement. The paper was introduced the back illuminated system design and different test for the light resource. After optimization, the effect illuminated system could compare with the integrating sphere, meet the conditions of fiber position measurement.Using parallel controlled fiber positioner as the spectroscopic receiver is an efficiency observation system for spectra survey, has been used in LAMOST recently, and will be proposed in CFHT and rebuilt telescope Mayall. In the telescope observation, the position of fiber will highly influence the spectra efficient input in the fiber to the spectrograph. When the fibers were back illuminated on the spectra end, they would export light on the positioner end, so the CCD cameras could capture the photo of fiber tip position covered the focal plane, calculates the precise position information by light centroid method and feeds back to control system. After many years on these research, the back illuminated fiber measurement was the best method to acquire the precision position of fibers. In LAMOST, a set of fiber back illuminated system was developed which combined to the low revolution spectro instruments in LAMOST. It could provide uniform light output to the fibers, meet the requirements for the CCD camera measurement and was controlled by high-level observation system which could shut down during the telescope observation. The paper was introduced the back illuminated system design and different test for the light resource. After optimization, the effect illuminated system could compare the integrating sphere, meet the conditions of fiber position measurement.

Medical futility in children's nursing: making end-of-life decisions.

PubMed

Brien, Irene O; Duffy, Anita; Shea, Ellen O

Caring for infants at end of life is challenging and distressing for parents and healthcare professionals, especially in relation to making decisions regarding withholding or withdrawal of treatment. The concept of medical futility must be considered under these circumstances. Parents and healthcare professionals should be involved together in making these difficult decisions. However, for some parents, emotions and guilt often are unbearable and, understandably, parents can be reluctant to make a decision. Despite the recognition of parental autonomy, if parents disagree with a decision made by medical staff, the case will be referred to and solved by the courts. The courts' decisions are often based on the best interest of the child. In this article, the authors discuss the concepts of 'parental autonomy' and 'the child's best interests' when determining medical futility for infants or neonates. The role of the nurse when caring for the dying child and their family is multifaceted. While nurses do not have a legitimate role in decision making at the end of life, it is often nurses who, through their advocacy role, inform doctors about parents' wishes and it is often nurses who support parents during this difficult time. Furthermore, nurses caring for dying children should be familiar to the family, experienced in end-of-life care and comfortable talking to parents about death and dying and treatment choices. Children's nurses therefore require advanced communication skills and an essential understanding of the ethical and legal knowledge relating to medical futility in end-of-life children's nursing.

Snow on Sea Ice Workshop - An Icy Meeting of the Minds: Modelers and Measurers

DTIC Science & Technology

2015-09-30

1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Snow on Sea Ice Workshop - An Icy Meeting of the Minds...workshop was to promote more seamless and better integration between measurements and modeling of snow on sea ice , thereby improving our predictive...capabilities for sea ice . OBJECTIVES The key objective was to improve the ability of modelers and measurers work together closely. To that end, we

Report of the panel on geopotential fields: Gravity field, section 8

NASA Technical Reports Server (NTRS)

Anderson, Allen Joel; Kaula, William M.; Lazarewics, Andrew R.; Lefebvre, Michel; Phillips, Roger J.; Rapp, Richard H.; Rummel, Reinhard F.; Smith, David E.; Tapley, Byron D.; Zlotnick, Victor

1991-01-01

The objective of the Geopotential Panel was to develop a program of data acquisition and model development for the Earth's gravity and magnetic fields that meet the basic science requirements of the solid Earth and ocean studies. Presented here are the requirements for gravity information and models through the end of the century, the present status of our knowledge, data acquisition techniques, and an outline of a program to meet the requirements.

77 FR 33004 - Advisory Committee on Reactor Safeguards (ACRS) Meeting of the ACRS Subcommittee on Reliability...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-04

.... ``Guidance on the Treatment of Uncertainties Associated with PRAs in Risk-Informed Decision Making.'' The... procedures for the conduct of and participation in ACRS meetings were published in the Federal Register on...

A model for emergency department end-of-life communications after acute devastating events--part I: decision-making capacity, surrogates, and advance directives.

PubMed

Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

2012-09-01

Making decisions for a patient affected by sudden devastating illness or injury traumatizes a patient's family and loved ones. Even in the absence of an emergency, surrogates making end-of-life treatment decisions may experience negative emotional effects. Helping surrogates with these end-of-life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end-of-life communications after acute devastating events comprises the following steps: 1) determine the patient's decision-making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life-limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed. Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long-term benefit of continued life-sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision-making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end-of-life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end-of-life discussions and to implement shared decisions. © 2012 by the Society for Academic Emergency Medicine.

Factors associated with fulfilling the preference for dying at home among cancer patients: the role of general practitioners.

PubMed

Ko, Winne; Miccinesi, Guido; Beccaro, Monica; Moreels, Sarah; Donker, Gé A; Onwuteaka-Philipsen, Bregje; Alonso, Tomás V; Deliens, Luc; Van den Block, Lieve

2014-01-01

This study aimed to explore clinical and care-related factors associated with fulfilling cancer patients' preference for home death across four countries: Belgium (BE), The Netherlands (NL), Italy (IT), and Spain (ES). A mortality follow-back study was undertaken from 2009 to 2011 via representative networks of general practitioners (GPs). The study included all patients aged 18 and over who had died of cancer and whose home death preference and place of death were known by the GP. Factors associated with meeting home death preference were tested using multivariable logistic regressions. Among 2,048 deceased patients, preferred and actual place of death was known in 42.6 percent of cases. Home death preference met ranged from 65.5 to 90.9 percent. Country-specific factors included older age in BE, and decision-making capacity and being female in the NL. GPs' provision of palliative care was positively associated with meeting home death preference. Odds ratios (ORs) were: BE: 9.9 (95 percent confidence interval [CI] 3.7-26.6); NL: 9.7 (2.4-39.9); and IT: 2.6 (1.2-5.5). ORs for Spain are not shown because a multivariate model was not performed. Those who develop policy to facilitate home death need to examine available resources for primary end-of-life care.

USGS approach to real-time estimation of earthquake-triggered ground failure - Results of 2015 workshop

USGS Publications Warehouse

Allstadt, Kate E.; Thompson, Eric M.; Wald, David J.; Hamburger, Michael W.; Godt, Jonathan W.; Knudsen, Keith L.; Jibson, Randall W.; Jessee, M. Anna; Zhu, Jing; Hearne, Michael; Baise, Laurie G.; Tanyas, Hakan; Marano, Kristin D.

2016-03-30

The U.S. Geological Survey (USGS) Earthquake Hazards and Landslide Hazards Programs are developing plans to add quantitative hazard assessments of earthquake-triggered landsliding and liquefaction to existing real-time earthquake products (ShakeMap, ShakeCast, PAGER) using open and readily available methodologies and products. To date, prototype global statistical models have been developed and are being refined, improved, and tested. These models are a good foundation, but much work remains to achieve robust and defensible models that meet the needs of end users. In order to establish an implementation plan and identify research priorities, the USGS convened a workshop in Golden, Colorado, in October 2015. This document summarizes current (as of early 2016) capabilities, research and operational priorities, and plans for further studies that were established at this workshop. Specific priorities established during the meeting include (1) developing a suite of alternative models; (2) making use of higher resolution and higher quality data where possible; (3) incorporating newer global and regional datasets and inventories; (4) reducing barriers to accessing inventory datasets; (5) developing methods for using inconsistent or incomplete datasets in aggregate; (6) developing standardized model testing and evaluation methods; (7) improving ShakeMap shaking estimates, particularly as relevant to ground failure, such as including topographic amplification and accounting for spatial variability; and (8) developing vulnerability functions for loss estimates.

Regional Consultation Meeting on the Asia and Pacific Programme of Educational Innovation for Development (13th, Jomtien, Thailand, June 22-26, 1992). Final Report.

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

This report summarizes the proceedings of the Thirteenth Regional Consultation Meeting on the Asia and Pacific Programme of Educational Innovation for Development (APEID). The meeting's objectives were to: (1) make an overall review of APEID's work during the 5-year period 1987-91; (2) to discuss major educational innovations that have…

Proceedings of National Sea Grant College Program Marine Education Leaders' Meeting (Rockville, Maryland, February 21-22, 1979).

ERIC Educational Resources Information Center

Spector, Barbara S., Comp.

This document is a summary account of the proceedings of the first in a series of informal meetings convened by the Office of Sea Grant (OSG) to further marine education in the United States. The document should assist educators participating in future meetings by making it possible to avoid the necessity to re-define basic concepts and…

Policy Towards Social Sciences in Asia and Oceania. Report on the Meeting of Experts. Manila, Philippines, 3-7 April 1978.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and Oceania.

The document reports on a meeting of Asian social science policy experts sponsored by UNESCO. The objectives of the meeting were to review the basic elements of the social science policies of countries in Asia and Oceania, to examine the feasibility of establishing a Regional Centre for Social Science Research, and to make recommendations for…

Statistics of Land-Grant Colleges and Universities, Year Ended June 30, 1944. Bulletin, 1946, No. 16

ERIC Educational Resources Information Center

US Office of Education, Federal Security Agency, 1946

1946-01-01

For a number of years previous to the development of war conditions, a preliminary report on land-grant college statistics was issued in time for the fall meeting of the Association of Land-Grant Colleges and Universities. It was impossible to do this for the school year ending in June 1944 since the last report for that year was not received…

Administrators’ Perspectives on Changing Practice in End-of-Life Care in a State Prison System

PubMed Central

Penrod, Janice; Loeb, Susan J.; Smith, Carol A.

2013-01-01

Objective Sentencing trends have created a demographic shift in prison populations. Greater numbers of inmates are aging and dying in prison, creating a demand for enhanced end-of-life care. Changing practice to meet escalating care demands in corrections settings is complicated by economic constraints, attitudinal barriers, and organizational features. This study explored perspectives of end-of-life care held by administrators in a state prison system to reveal challenges to changing practice to meet the needs of inmates suffering advanced illness and dying in prison. Design and Sample Qualitative interviews were conducted with 12 administrators from the central office of a state department of corrections. Results Key influences impacting end-of-life care services included: local prison culture; treatment versus security focus; case-by-case consideration; public sentiment; budget neutral approaches; and conflicting views of service targets. Conclusions These findings revealed the organizational structures, attitudes, and beliefs held by the administrative echelon of a state prison system and were used to guide the derivation of discrete approaches to changing practice in this complex system. Contextual evaluation permitted a much deeper understanding of the influences on changing practice in this hierarchical bureaucracy. This type of preliminary evaluation is crucial to infusing new practice initiatives in complex organizations caring for stigmatized, at-risk populations. PMID:24588128

Preferences for care towards the end of life when decision-making capacity may be impaired: A large scale cross-sectional survey of public attitudes in Great Britain and the United States.

PubMed

Clarke, Gemma; Fistein, Elizabeth; Holland, Anthony; Barclay, Matthew; Theimann, Pia; Barclay, Stephen

2017-01-01

There is continuing public debate about treatment preferences at the end of life, and the acceptability and legal status of treatments that sustain or end life. However, most surveys use binary yes/no measures, and little is known about preferences in neurological disease when decision-making capacity is lost, as most studies focus on cancer. This study investigates changes in public preferences for care towards the end of life, with a focus on measures to sustain or end life. Large-scale international public opinion surveys using a six-stage patient vignette, respondents chose a level of intervention for each stage as health and decision-making capacity deteriorated. Cross-sectional representative samples of the general public in Great Britain and the USA (N = 2016). Primary outcome measure: changes in respondents' preferences for care, measured on a four-point scale designed before data collection. The scale ranged from: maintaining life at all costs; to intervention with agreement; to no intervention; to measures for ending life. There were no significant differences between GB and USA. Preference for measures to sustain life at all costs peaked at short-term memory loss (30.2%, n = 610). Respondents selecting 'measures to help me die peacefully' increased from 3.9% to 37.0% as the condition deteriorated, with the largest increase occurring when decision-making capacity was lost (10.3% to 23.0%). Predictors of choosing 'measures to help me die peacefully' at any stage were: previous personal experience (OR = 1.34, p<0.010), and older age (OR = 1.09 per decade, p<0.010). Negative predictors: living with children (OR = 0.72, p<0.010) and being of "black" race/ethnicity (OR = 0.45, p<0.001). Public opinion was uniform between GB and USA, but markedly heterogeneous. Despite contemporaneous capacitous consent providing an essential legal safeguard in most jurisdictions, there was a high prevalence of preference for "measures to end my life peacefully" when decision-making capacity was compromised, which increased as dementia progressed. In contrast, a significant number chose preservation of life at all costs, even in end stage dementia. It is challenging to respect the longstanding values of people with dementia concerning either the inviolability of life or personal autonomy, whilst protecting those without decision-making capacity.

Video Eases End-of-Life Care Discussions

Cancer.gov

Patients with advanced cancer who watched a video that depicts options for end-of-life care were more certain of their end-of-life decision making than patients who only listened to a verbal narrative.

End-of-life care decisions in the pediatric intensive care unit: roles professionals play

PubMed Central

Michelson, Kelly Nicole; Patel, Rachna; Haber-Barker, Natalie; Emanuel, Linda; Frader, Joel

2014-01-01

Objective Describe the roles and respective responsibilities of pediatric intensive care unit (PICU) health care professionals (HCPs) in end-of-life care decisions faced by PICU parents. Design Retrospective qualitative study Setting University based tertiary care children’s hospital Participants Eighteen parents of children who died in the PICU and 48 PICU HCPs (physicians, nurses, social workers, child-life specialists, chaplains, and case managers). Interventions In depth, semi-structured focus groups and one-on-one interviews designed to explore experiences in end-of-life care decision making. Measurements and Main Results We identified end-of-life care decisions that parents face based on descriptions by parents and HCPs. Participants described medical and non-medical decisions addressed toward the end of a child’s life. From the descriptions, we identified seven roles HCPs play in end-of-life care decisions. The family supporter addresses emotional, spiritual, environmental, relational and informational family needs in a nondirective way. The family advocate helps families articulate their views and needs to HCPs. The information giver provides parents with medical information, identifies decisions or describes available options, and clarifies parents’ understanding. The general care coordinator helps facilitate interactions among HCPs in the PICU, among HCPs from different subspecialty teams, and between HCPs and parents. The decision maker makes or directly influences the defined plan of action. The end-of-life care coordinator organizes and executes functions occurring directly before, during and after dying/death. The point person develops a unique trusting relationship with parents. Conclusions Our results describe a framework for HCPs’ roles in parental end-of-life care decision making in the PICU that includes directive, value-neutral and organizational roles. More research is needed to validate these roles. Actively ensuring attention to these roles during the decision-making process could improve parents’ experiences at the end of a child’s life. PMID:23249788

78 FR 78368 - Allergenic Products Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... and make recommendations on the safety and efficacy of RAGWITEK, a short ragweed pollen allergen... ragweed pollen induced allergic rhinitis, with or without conjunctivitis. FDA intends to make background...

77 FR 35439 - Self-Regulatory Organizations; EDGX Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-13

... market participant identifiers (MPID), the Market Making exemption applies to the parent firm and all... criteria for an exemption under market making. In recognition of the value that the Exchange derives from such market making, any Member that meets the market making obligations pursuant to Rule 11.21(d) on at...

Decision-Making as a Struggle and a Play: On Alternative Rationalities in Schools as Organizations

ERIC Educational Resources Information Center

Salo, Petri

2008-01-01

In this article an alternative interpretation of the functions of decision-making and the inherent activities at teachers' meetings at schools are presented. The metaphor of "play" is introduced in order to make the teachers' actions during decision-making comprehensible, not only for outsiders, but more importantly for "involved insiders", such…

Genomics in the land of regulatory science.

PubMed

Tong, Weida; Ostroff, Stephen; Blais, Burton; Silva, Primal; Dubuc, Martine; Healy, Marion; Slikker, William

2015-06-01

Genomics science has played a major role in the generation of new knowledge in the basic research arena, and currently question arises as to its potential to support regulatory processes. However, the integration of genomics in the regulatory decision-making process requires rigorous assessment and would benefit from consensus amongst international partners and research communities. To that end, the Global Coalition for Regulatory Science Research (GCRSR) hosted the fourth Global Summit on Regulatory Science (GSRS2014) to discuss the role of genomics in regulatory decision making, with a specific emphasis on applications in food safety and medical product development. Challenges and issues were discussed in the context of developing an international consensus for objective criteria in the analysis, interpretation and reporting of genomics data with an emphasis on transparency, traceability and "fitness for purpose" for the intended application. It was recognized that there is a need for a global path in the establishment of a regulatory bioinformatics framework for the development of transparent, reliable, reproducible and auditable processes in the management of food and medical product safety risks. It was also recognized that training is an important mechanism in achieving internationally consistent outcomes. GSRS2014 provided an effective venue for regulators andresearchers to meet, discuss common issues, and develop collaborations to address the challenges posed by the application of genomics to regulatory science, with the ultimate goal of wisely integrating novel technical innovations into regulatory decision-making. Published by Elsevier Inc.

20 CFR 404.1527 - Evaluating opinion evidence.

Code of Federal Regulations, 2010 CFR

2010-04-01

... for making the determination or decision about whether you meet the statutory definition of disability.... (c) Making disability determinations. After we review all of the evidence relevant to your claim... decide whether you are disabled, we will make our determination or decision based on that evidence. (2...

International Micrographics Standards: Report of the 1979 Paris Meeting of ISO/TC171.

ERIC Educational Resources Information Center

Heynen, Jeffrey

1980-01-01

Describes a meeting of the technical committee on micrographics of the International Organization for Standardization, and fcuses on the committee's work relating to the reproduction of library materials within the general context of international standards-making activities. (FM)

78 FR 55064 - First Responder Network Authority Board Special Review Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-09

... Network Authority Board Special Review Committee Meeting AGENCY: National Telecommunications and... Responder Network Authority Special Review Committee. SUMMARY: The First Responder Network Authority (First... nationwide, interoperable public safety broadband network. The FirstNet Board is responsible for making...

Getting around the Cultural Hot Spots in Meetings.

ERIC Educational Resources Information Center

Gardenswartz, Lee

1993-01-01

Suggestions are made for making meetings in a college or university setting more productive, particularly with regard to avoiding cultural misunderstanding. The cultural sources of some behaviors that may inhibit participation and effectiveness are outlined, and strategies for overcoming them are offered. (MSE)

School to Work Transitions in Europe: Choice and Constraints

ERIC Educational Resources Information Center

Cuconato, Morena

2017-01-01

Starting from the assumption that school to work transitions constitute not only the end goal but also an integral part of educational trajectories, this article reconstructs the narratives of the decision-making processes of young people at the end of lower secondary education, namely the ways in which decision-making is referred to, the temporal…

The Allied Health Care Professional's Role in Assisting Medical Decision Making at the End of Life

ERIC Educational Resources Information Center

Lambert, Heather

2012-01-01

As a patient approaches the end of life, he or she faces a number of very difficult medical decisions. Allied health care professionals, including speech-language pathologists (SLPs) and occupational therapists (OTs), can be instrumental in assisting their patients to make advance care plans, although their traditional job descriptions do not…

Making Sense of Students' Actions in an Open-Ended Virtual Laboratory Environment

ERIC Educational Resources Information Center

Gal, Ya'akov; Uzan, Oriel; Belford, Robert; Karabinos, Michael; Yaron, David

2015-01-01

A process for analyzing log files collected from open-ended learning environments is developed and tested on a virtual lab problem involving reaction stoichiometry. The process utilizes a set of visualization tools that, by grouping student actions in a hierarchical manner, helps experts make sense of the linear list of student actions recorded in…

76 FR 71559 - Environmental Impacts Statements; Notice of Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

..., PROGRAMMATIC--Yakima River Basin Integrated Water Resource Management Plan, To Meet the Water Supply and... Mechanical Thinning, Uinta-Wasatch-Cache National Forest, Summit County, UT, Review Period Ends: 12/19/2011...

Brokers, consumers and the internet: how North American consumers navigate their infertility journeys.

PubMed

Speier, Amy R

2011-11-01

North Americans who suffer infertility often reach an end to treatment options at home, whether it is due to a lack of egg donors in Canada or the high cost of treatment in the USA. Patients navigate their way onto the internet, seeking support and other options. As women and couples 'do the research' online, they conduct endless Google searches, come across IVF brokers, join support groups, read blogs and meet others on the road of infertility. This paper considers the journeys that North American patients make to clinics in Moravia, Czech Republic. Along these travels, patients engage with support groups, other patients, IVF brokers and clinic co-ordinators. Since the distance travelled between North America and Europe is extensive, reproductive travels may be arranged by clinical staff, travel brokers and patients. Acting as consumers, North Americans make different 'choices' along their journeys – the use of a broker, if and when they should join online communities, which clinic to visit and where to stay. This study focuses on the question of how patient choices often determine the success of brokers and clinics, thus influencing the structure of cross-border reproductive care in the Czech Republic. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

End-user satisfaction analysis on library management system unnes using technology acceptance model towards national standard of integrated library

NASA Astrophysics Data System (ADS)

Hardyanto, W.; Purwinarko, A.; Adhi, M. A.

2018-03-01

The library which is the gate of the University should be supported by the existence of an adequate information system, to provide excellent service and optimal to every user. Library management system that has been in existence since 2009 needs to be re-evaluated so that the system can meet the needs of both operator and Unnes user in particular, and users from outside Unnes in general. This study aims to evaluate and improve the existing library management system to produce a system that is accountable and able to meet the needs of end users, as well as produce a library management system that is integrated Unnes. Research is directed to produce evaluation report with Technology Acceptance Model (TAM) approach and library management system integrated with the national standard.

Stakeholder Meeting: Integrated Knowledge Translation Approach to Address the Caregiver Support Gap.

PubMed

Holroyd-Leduc, Jayna M; McMillan, Jacqueline; Jette, Nathalie; Brémault-Phillips, Suzette C; Duggleby, Wendy; Hanson, Heather M; Parmar, Jasneet

2017-03-01

Family caregivers are an integral and increasingly overburdened part of the health care system. There is a gap between what research evidence shows is beneficial to caregivers and what is actually provided. Using an integrated knowledge translation approach, a stakeholder meeting was held among researchers, family caregivers, caregiver associations, clinicians, health care administrators, and policy makers. The objectives of the meeting were to review current research evidence and conduct multi-stakeholder dialogue on the potential gaps, facilitators, and barriers to the provision of caregiver supports. A two-day meeting was attended by 123 individuals. Three target populations of family caregivers were identified for discussion: caregivers of seniors with dementia, caregivers in end-of-life care, and caregivers of frail seniors with complex health needs. The results of this meeting can and are being used to inform the development of implementation research endeavours and policies targeted at providing evidence-informed caregiver supports.

Moving AGU Meetings sites [Comment to “Fall Meeting site”

NASA Astrophysics Data System (ADS)

Lanzerotti, L. J.; Maclennan, C. C.

1984-04-01

A recent letter to Eos by AGU member Dan Baker (March 13, 1984, p. 98) suggested that a method of reducing the attendance at the Fall AGU meeting would be to move it from San Francisco to his namesake, namely Bakersfield. He cited as a precedent the probably reduced attendance at the (at that time) upcoming Spring Meeting to be held in Cincinnati. While neither of us is promoting cities with names similar to ours, nevertheless we both believe that the recent meeting held in Cincinnati was a great success, even with the reduced number of registrants. The arrangements in the Convention Center, as well as the proximity of the hotels to the convention center and the amenities in the hotels were all excellent, and easily matched or surpassed the facilities in any of the cities in which the major meetings have been held to this time. Furthermore, we would like to make a qualitative judgment that the number of attendees at the individual sessions were perhaps as large as in a Baltimore or Washington meeting. In those meetings the number of registrants may have been larger, but the number of attendees at the given session may have been smaller; a significant proportion of the attendees at any given time would likely be visiting the offices of their contract monitors. Admittedly, the Spring Meeting has been an ideal opportunity to both attend scientific sessions and to lobby for additional research support. However, such lobbying does not necessarily make for increased attendance at the scientific sessions.

Communication of uncertainty in hydrological predictions: a user-driven example web service for Europe

NASA Astrophysics Data System (ADS)

Fry, Matt; Smith, Katie; Sheffield, Justin; Watts, Glenn; Wood, Eric; Cooper, Jon; Prudhomme, Christel; Rees, Gwyn

2017-04-01

Water is fundamental to society as it impacts on all facets of life, the economy and the environment. But whilst it creates opportunities for growth and life, it can also cause serious damages to society and infrastructure through extreme hydro-meteorological events such as floods or droughts. Anticipation of future water availability and extreme event risks would both help optimise growth and limit damage through better preparedness and planning, hence providing huge societal benefits. Recent scientific research advances make it now possible to provide hydrological outlooks at monthly to seasonal lead time, and future projections up to the end of the century accounting for climatic changes. However, high uncertainty remains in the predictions, which varies depending on location, time of the year, prediction range and hydrological variable. It is essential that this uncertainty is fully understood by decision makers so they can account for it in their planning. Hence, the challenge is to finds ways to communicate such uncertainty for a range of stakeholders with different technical background and environmental science knowledge. The project EDgE (End-to end Demonstrator for improved decision making in the water sector for Europe) funded by the Copernicus programme (C3S) is a proof-of-concept project that develops a unique service to support decision making for the water sector at monthly to seasonal and to multi-decadal lead times. It is a mutual effort of co-production between hydrologists and environmental modellers, computer scientists and stakeholders representative of key decision makers in Europe for the water sector. This talk will present the iterative co-production process of a web service that serves the need of the user community. Through a series of Focus Group meetings in Spain, Norway and the UK, options for visualising the hydrological predictions and associated uncertainties are presented and discussed first as mock-up dash boards, off-line tools and pre-operational services. Feedbacks received from the users are listed and prioritised for the next-generation of development to take place. In addition, sprint-review webinars are also organised to insure the developed services address the users' demands correctly. The tools are formally tested through a set of case studies representative of decision making in contrasting water sectors, including hydro-power in snow-dominated regions, public water supply in heavily regulated countries, and river basin management in an arid environments with multiple users. In addition to the visualisation, a key component of the project is the provision of user guidance. This helps the user understand the challenges of dealing with uncertainty and interpretation of the results, provides contextual background information, describes the service's functionality, and showcases examples of good practice.

Communication nonaccommodation in family conversations about end-of-life health decisions.

PubMed

Scott, Allison M; Caughlin, John P

2015-01-01

Furthering our understanding of how communication can improve end-of-life decision making requires a shift in focus from whether people talk to how people talk about end-of-life health decisions. This study used communication accommodation theory to examine the extent to which communication nonaccommodation distinguished more from less successful end-of-life conversations among family members. We analyzed elicited conversations about end-of-life health decisions from 121 older parent/adult child dyads using outside ratings of communication over- and underaccommodation and self-reported conversational outcomes. Results of multilevel linear modeling revealed that outside ratings of underaccommodation predicted self-reported and partner-reported uncertainty, and ratings of overaccommodation predicted self-reported decision-making efficacy and change in concordance accuracy. We discuss the methodological, theoretical, and practical implications of these findings.

The End: Astronomy Meets Eschatology

NASA Astrophysics Data System (ADS)

Impey, C.

2013-04-01

Personal endings carry the most emotional weight, but our growing awareness of the universe has acquainted us with a spectrum of endings on different cosmic scales. First, there is the occasional intrusion of large pieces of debris from the solar system, which can be triggered by the approach of a nearby star. Then, there is the disruption to life and the biosphere caused by stellar death and cataclysm. Finally, there are endings that play out on the largest backdrop of space and time, such as the gradual dimming of the Milky Way as the lowest mass stars expire and the removal of galaxies from view and the possible disruption of space-time caused by dark energy. The Copernican awareness of cosmic evolution helps to put our own modest endings in perspective.

Hanahau'oli School: Theory Meets Practice

ERIC Educational Resources Information Center

Peters, Robert

2015-01-01

Progressive schools, by their very nature, need to respond to changing societal conditions. Within that context, learning guided by the teachings of John Dewey will not only make the progressive tradition sustainable but also make it increasingly relevant in a future that will increasingly make demands on students to possess the knowledge to…

The involvement of cancer patients in the four stages of decision-making preceding continuous sedation until death: A qualitative study.

PubMed

Robijn, Lenzo; Seymour, Jane; Deliens, Luc; Korfage, Ida; Brown, Jayne; Pype, Peter; Van Der Heide, Agnes; Chambaere, Kenneth; Rietjens, Judith

2018-04-01

Involving patients in decision-making is considered to be particularly appropriate towards the end of life. Professional guidelines emphasize that the decision to initiate continuous sedation should be made in accordance with the wishes of the dying person and be preceded by their consent. To describe the decision-making process preceding continuous sedation until death with particular attention to the involvement of the person who is dying. Qualitative case studies using interviews. Interviews with 26 physicians, 30 nurses and 24 relatives caring for 24 patients with cancer who received continuous sedation until death in Belgium, the United Kingdom and the Netherlands. We distinguished four stages of decision-making: initiation, information exchange, deliberation and the decision to start continuous sedation until death. There was wide variation in the role the patient had in the decision-making process. At one end of the spectrum (mostly in the United Kingdom), the physician discussed the possible use of sedation with the patient, but took the decision themselves. At the other end (mostly in Belgium and the Netherlands), the patient initiated the conversation and the physician's role was largely limited to evaluating if and when the medical criteria were met. Decision-making about continuous sedation until death goes through four stages and the involvement of the patient in the decision-making varies. Acknowledging the potential sensitivity of raising the issue of end-of-life sedation, we recommend building into clinical practice regular opportunities to discuss the goals and preferences of the person who is dying for their future medical treatment and care.

Meeting review: 2002 O'Reilly Bioinformatics Technology Conference.

PubMed

Counsell, Damian

2002-01-01

At the end of January I travelled to the States to speak at and attend the first O'Reilly Bioinformatics Technology Conference. It was a large, well-organized and diverse meeting with an interesting history. Although the meeting was not a typical academic conference, its style will, I am sure, become more typical of meetings in both biological and computational sciences.Speakers at the event included prominent bioinformatics researchers such as Ewan Birney, Terry Gaasterland and Lincoln Stein; authors and leaders in the open source programming community like Damian Conway and Nat Torkington; and representatives from several publishing companies including the Nature Publishing Group, Current Science Group and the President of O'Reilly himself, Tim O'Reilly. There were presentations, tutorials, debates, quizzes and even a 'jam session' for musical bioinformaticists.

Meeting Review: 2002 O'Reilly Bioinformatics Technology Conference

PubMed Central

2002-01-01

At the end of January I travelled to the States to speak at and attend the first O’Reilly Bioinformatics Technology Conference [14]. It was a large, well-organized and diverse meeting with an interesting history. Although the meeting was not a typical academic conference, its style will, I am sure, become more typical of meetings in both biological and computational sciences. Speakers at the event included prominent bioinformatics researchers such as Ewan Birney, Terry Gaasterland and Lincoln Stein; authors and leaders in the open source programming community like Damian Conway and Nat Torkington; and representatives from several publishing companies including the Nature Publishing Group, Current Science Group and the President of O’Reilly himself, Tim O’Reilly. There were presentations, tutorials, debates, quizzes and even a ‘jam session’ for musical bioinformaticists. PMID:18628852

Localizing Visual Function in the Brain

DTIC Science & Technology

1992-08-13

fec, 93-16707 FIELO GROUP SUB. GR. 9. AUSTRACT lCadouhn as en wierg if wcooemar end idenatfy 67 bloeS squoIbofD A three day meeting, held in Rochester...were unaware of using radiolabelled agents or optical imaging in macaque monkeys. This meeting introduced many scientists to other researchers and...paramagnetic contrast agent injected into a vein. The relative blood volume in a slice of the brain can thus be deduced, and changes in blood volume

USSR Report. International Affairs.

DTIC Science & Technology

1987-05-13

ORGANIZATION OF INDUSTRIAL PRODUCTION (UEO) THE WORKING CLASS § THE CONTEMPORARY WORLD (UWC) PEOPLES OF ASIA & AFRICA (UAA) MILITARY HISTORY JOURNAL...and beyond. He said that the documents from the European Conference in Helsinki and the Madrid meeting have given an important stimulus to the work ...commission’s activity with the work of the Vienna meeting deserved all-round support, he said. "It is important that the Vienna followup meeting make

Machine vision method for online surface inspection of easy open can ends

NASA Astrophysics Data System (ADS)

Mariño, Perfecto; Pastoriza, Vicente; Santamaría, Miguel

2006-10-01

Easy open can end manufacturing process in the food canning sector currently makes use of a manual, non-destructive testing procedure to guarantee can end repair coating quality. This surface inspection is based on a visual inspection made by human inspectors. Due to the high production rate (100 to 500 ends per minute) only a small part of each lot is verified (statistical sampling), then an automatic, online, inspection system, based on machine vision, has been developed to improve this quality control. The inspection system uses a fuzzy model to make the acceptance/rejection decision for each can end from the information obtained by the vision sensor. In this work, the inspection method is presented. This surface inspection system checks the total production, classifies the ends in agreement with an expert human inspector, supplies interpretability to the operators in order to find out the failure causes and reduce mean time to repair during failures, and allows to modify the minimum can end repair coating quality.

78 FR 26635 - Environmental Management Site-Specific Advisory Board, Paducah

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

...On April 29, 2013, the Department of Energy (DOE) published a notice of open meeting announcing a meeting on May 16, 2013 of the Environmental Management Site-Specific Advisory Board, Paducah (78 FR 25064). This document makes a correction to that notice.

75 FR 6680 - Merchant Marine Personnel Advisory Committee; Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-10

.... (b) Briefings concerning on-going projects of interest to MERPAC. (c) Other items brought up for... makes recommendations to the Assistant Commandant for Operations on issues concerning merchant marine... following task statements may meet to deliberate-- (a) Task Statement 30, concerning Utilizing Military Sea...

Successful School Board Meetings.

ERIC Educational Resources Information Center

Anderson, Stuart A.

This handbook is intended to help school boards become more effective governing bodies by becoming more efficient in conducting routine business, improving their abilities to reach constructive decisions and to solve problems, making their meetings sources of good will among members, students, and the community, and developing and following…